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PoD Test 3 > Trypanosomiasis and Leishmania > Flashcards

Trypanosomiasis and Leishmania Flashcards

1
Q

What organism causes Chagas diseae?

A

Trypanosoma cruzi

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2
Q

What is the vector for Trypanosoma?

A

Triatomine bugs

“kissing bugs”

Reduviid bugs

Endemic to Mexico, Central, South america

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3
Q

What is the timeframe of an acute Chagas infection?

A

Week-months after infection

When the patient has a high parasitic load

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4
Q

What are the symptoms of acute chagas?

A

Romana’s sign

Chagoma

Fever, myalgias, hepatomegaly, encephalitis, myocarditis

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5
Q

What organisms cause chronic chagas infection and where?

A

Amastigotes - live in gut and heart

Trypomastigotes - can infect new sites like the brain

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6
Q

What are the cardiac manifestations of chronic chagas infection?

A

Conduction - RBBB, LAFB

Arrhythmias

Dialted cardiomyopathy

CHF

Apical aneurysm

Stroke

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7
Q

What are the GI manifestations of a chronic chagas infection:?

A

Megaesophagus - dysphagia, odynophagia, weight loss, regurgitation, aspiration

Megacolon - prolonged constipation, abdominal pain, risk of volvulus and bowel ischemia

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8
Q

How is acute chagas diagnosed?

A

Parasites in blood or PCR

EKG/Echo

GI studies if symptomatic

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9
Q

How is Chronic chagas diagnosed?

A

Antibodies

Muscle biopsy

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10
Q

How is chagas transmitted congenitally?

A

1-10% transmissionr ate

Cord blood or peripheral blood

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11
Q

What is the danger of chagas in immunocompromised patients?

A

Can reactivate

Parasitemia

CSF

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12
Q

What is the treatment for chagas?

A

Benznidazole

Nifurtimox

Both effective in early acute phase

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13
Q

What patients get treated?

A

Acute/congenital infection

Chronic <50 w/o cardiomyopathy

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14
Q

What conditions is chagas treatment contraindicated for?

A

Hepatic/Renal insufficiency

Pregnancy

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15
Q

What condition does do trypanosoma brucei gambiense and Trypansoma b. rhodesiense cause?

A

African trypanosomiasis or

African sleeping sickness

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16
Q

What is the vector for african sleeping sickness?

A

Tsetse fly

17
Q

What occurs during the early infection with african trypanosomiasis?

A

Chancre at site of bite

Intermittent fever

Invasion of lymph nodes - Winterbottom sign

Myalgias/Arthralgias

18
Q

What occurs during the late infection with african trypanosomiasis?

A

Progression to CNS

Personality changes, psychosis, tremors, altered circadian rhythm

19
Q

How is african trypanosomiasis diagnosed?

A

Microscopy

Lymph node biopsy

Serology

CSF - stage determination

20
Q

What is the treatment for T.b. Rhodesiense?

A

Suramin - hemolyphatic

Melarsoprol - CNS involvement

21
Q

What is the treatment for T.b. Gambiense?

A

Pentamidine - hemolyphatic

Eflornithine - CNS involvement

22
Q

What is the vector of leishmaniasis?

A

Sand fly

Promastigote - transmitted through saliva

Amstigote - infects macrophages

23
Q

How does cutaneous leishmaniasis present?

A

Red papule at site of bite taht becomes pruritic and enlarges

Painless Ulcer formation - will heal without treatment

24
Q

How is cutaneous leishmaniasis diagnosed?

A

Amastigotes in smear or biopsy

25
Q

What are the treatments for cutaneous leishmaniasis?

A

Cryotherapy/heat/surgical excision

Paromycin

-azoles

Sodium Stibogluconate - from CDC

26
Q

What is mucocutaneous leishmaniasis?

A

Similar to cutaneous, but also involves mucous membranes

Nose/mouth/nasal spetum

27
Q

How does visceral leishmaniasis present?

A

Fevers/Chills/Vomiting

Anemia leading to greating of skin color

Low WBC

Can be rapidly fatal

28
Q

What is Post-kala-azar Eishmanial dermatitis?

A

Macular/maculopapular/nodular rash after visceral leishmaniasis

Reservoir for parasites

29
Q

How is visceral leishmaniasis diagnosed?

A

Travel history

Microscopay

Serologic testing

30
Q

How is visceral leishmaniasis treated?

A

Amphotericin B

Miltefosine

Sodium stibogluconate

PoD Test 3 (25 decks)

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