TA2 Flashcards
What are 3 possible treatment for candida?
fluconazole
or amphotericin or echinocandins
What are two possible treatment for aspergillus?
voriconazole or amphotericin
What are two treatments for zygomycetes?
surgical plus posaconazole or amphotericin
What are two possible treatment for cryptococcus?
amphotericin +/- 5FC
OR fluconazole
What are 3 possible treatments for histoplasma?
amphotericin or itraconazole or voriconazole
What are 3 possible treatment for blastomyces?
amphotericin or itraconazole or fluconazole
What is treatment for coccidioides?
amphotericin
plus fluconazole in immune compromised
What are 3 possible treatments for paracoccidioides?
itraconazole
amphotericin B
TMP-SMX
What is treatment for penicilium?
amphotericin + 5FC
What is side effect of fluconazole? what do you use it for?
hepatotoxicity
mainly cryptococcal meningitis, candida
What is side effect of itraconazole? What do you use it for?
hepatotoxicity, CHF, taste disturbances
mainly histoplasma, blastomyces, sporothrix
What is side effect of voriconazole? what do you use it for?
visual distrubances
invasive aspergillosis
What is side effect of posaconazole? what is it used for?
risk of prolonged QTc w/ quinidine, N/V, liver enzymes
zygomycetes
What is amphotericin mainly used for?
- cryptococcal meningitis
- zygomycetes
- disseminated histoplasmosis
- invasive aspergillosis
What 2 things can fluconazole not treat definitively?
aspergillus, mucor
What is target of echinocandins?
cell wall [vs other antifungals are cell membranes]
What do you use to diagnose/treat ascaris lumbricoides?
eggs with rough surface in stool
treat: mebendazole or albendazole
What do you use to diagnose/treat necatur americanus / ancyclostoma duodenale [hookworm]?
- visualized eggs in stool
- mebendazole or albendazole + iron
What do you use to diagnose/treat anyclostoma braziliense? What does it cause?
cutaneous larva migrans = creeping eruption, curly q rash on feet
albendazole or mebendazole
What do you use to diagnose/treat strongyloides?
- larvae in stool/sputum/biopsy
- albendazole or thiabendazole
- PLUS ivermectin
What are the parasites that are coughed up and swallowed?
- strongyloides
- hookworm
- ascaris
What do you use to diagnose/treat enterobius vermicularis?
- scotch tape test
- mebendazole or albendazole
What do you use to diagnose/treat trichuris trichiura?
- barrel shaped egg with polar plugs in stool
- mebendazole or albendazole
What do you use to diagnose/treat toxocara canis? What is another name for it
toxocara = dog helminth [sandbox]
visceral larva migrans, hepatosplenomegaly, blindness
- benzimidazoles
What do you use to diagnose/treat trichinella spiralis?
- elevated CPK, eosinophilia, spiral shaped larvae
- mebendazole and steroids
What do you use to diagnose/treat wurchereria bancrofti?
- detect microfilariae at night
- diethylcarbamazine
What do you use to diagnose/treat onchocerca volvulus?
- skin snips to find microfilariae in subcutaneous nodules
- ivermectin
How do you treat drancuncluiasis medinsi? what is it?
- slow mechanical extraction of worm over days
- clinical sign = foot pain, itchiness, from drinking water with crustaceans containing larvae
- find larvae in stool
How do you treat taenia solium?
for CNS –> albendazole + steroids
for GI –> praziquantel
Wht should you think: barrel shaped egg with polar plug in stool?
trichurius trichiura = whipworm
What diseases associated with culex mosquito?
- WNV
- japanese encephalitis
- wuchereria bancrofti
- st louis encephalitis
How do you get cysticercosis vs taepworm from taneia solium?
tapeworm = undercooked pork with larvae cysticercosis = contaminated food with eggs
What do you use to treat taenia saginata?
praziquantel
What do you use to diagnose/treat diphyllobothrium latum? how do you get it?
dx: oval/operculated eggs in feces
treat: praziquantel
get: consumption raw fish
What do you use to diagnose/treat echinococcus granulosus? how do you get it?
- dx: water lily appearance on imaging
- treat: PAIR [percutaneous, aspiration injection, respiration] or liver surgery + albendazole for lungs
- get: ingest eggs from dog feces
= dog tapeworm
What should you think: brazil, vomitting blood, pale, cold, clammy, abdomen distended, superficial veins prominent, fluid wave?
schistosoma mansoni
What are the four tretamodes?
schistosoma
fasciola hepatica
opistorchis
paragnoimus westermani
What do you use to diagnose/treat schistoma? how do you get it?
dx: eggs with operculum in feces/urine
treat: praziquantel
get: penetrate intact skin in water
What do you use to diagnose/treat fasciola hepatica? how do you get it?
dx: migratory RUQ pain, fever, gallstones, liver abcess
treat: veterinary triclabendazole
get: eat watercress infected
What do you use to diagnose/treat opistorchis sinensis? how do you get it?
= chinese river fluke
dx: operculated egg in gallbladder
treat: praziquantel
get: eat raw freshwater fish
What do you use to diagnose/treat paragonimus westermani ? how do you get it?
dx: cystic cavities in lungs [like TB]
treat: praziquantel
get: fecal oral ingestion raw shellfish in east asia
What is mech of action benzimidazoles [alb, medb, thia]?
inhibit assembly microtubules and glucose –> parasite immobilization and death, also larvacidal
Side effects of benzimidazoles?
- alopecia, ab pain, liver enzymes
What do you with treat thiabendazole?
strongyloides
What do you treat with albendazole?
round worms [ascaris, hookworm, strongyloides, enterobius, trichurius]
larval forms of fat worms [neurcysticercois]
What do you treat with mebendazole?
round worms
What is mech of action ivermectin? what does it treat?
- neurotoxic to worm nervous system, parasite paralysis
- use: intestinal and systemic nematodes [strongyloides], onchocerciasis [river blindness]
What is mech of action diethylcarbamizine? what does it treat?
- immobilized microfilariae
- use: filiarasis [wuchereria] and onchocerciasis
What is mech of action praziquantel? use?
- depolarized neuromuscular block, paralizes tapeworms and flukes
use: most flatworms and flukes – T solium/saginata, d latum, schistosoma
What is the only antimalarial that isnt a teratogen?
mefloquine
What malaria drug is safe in kids?
atavaquone/proguanil
What is daily dosing malaria prophylaxis?
doxycicline
What is dx/treatment for entamoeba?
dx: trophozoite with ingested RBC in diarrhea
metronidazole or tinidazole + iodoquinol to kill entamoeba cysts
What is dx/treatment for trichomonas vaginalis?
dx: wet mount of discharge see motility
treat: metronidazole or tinidazole + treat partner
What is treatment for naegleria, acanthamoeba, balamuthia?
– no treatment for meningoencephalitis that it causes == fatal
What is dx/treatment for cryptosporidium? isospora/cyclospora?
all dx: acid fast stain, immunostain of stool
treat: immune reconstitution +
nitazoxanid for crypto, TMP/SMX for Iso/Cyclo
What is treatment for giadria? dx?
dx: visualize with DFA
treat: metronidazole or tinidazole
What is mech of action of metronidazole/tinidazole? toxicity? use?
- disturbs e- balance in parasite
- use for anaerobic protozoa [entamoeba, giardia, trichomonas]
- tox: disulfiram life rxn if take with alcohol
What are main drugs for leishmeniasis?
- amphotericin
- antimonial compounds
What is mech of antimonial compounds? use? adverse?
mech: heavy metals
use: leishmania
adverse: cardiotox, nephrotox
What should you think when you se kinetoplast?
leishmania or
What is treatment for trypanosoma cruzi?
brenznidazole or nifurtimox
What is treatment for trypanosoma brucei rhodesiense?
early: suramin
late: melarsoprol
What is treatment for trypanosoma brucei gambiense?
early: pentamidine
late: melarsoprol
