WEEK 9 - Protozoans: Coccidia, Plasmodium and Blood and Tissue Flagellates Flashcards
It is from an Italian term mal’aria
Malaria
Classical malarial attack or paroxysm (in order)
- Shaking chills (COLD STAGE)
- Fever (≥40°C) (HOT STAGE OR FLUSH PHASE)
- Generalized diaphoresis (SWEATING STAGE)
Paroxysyms occurs over _________ hours and initiated by synchronous to the rupture of ___________ with the release of ________________
6-10 hours
RBCs
Merozoites
Each year its clinical cases amounts _________________ which considered that has a worldwide prevalence
300-500 million
Drug of Choice for malaria (pregnancy)
Quinine
Vertebrate hosts includes _________, ___________, ____________, ___________
Reptiles, Birds, Rodents, and Primates
Drug of choice for severe malaria
Artemisinin and its derivatives artesunate and artemether (parenteral)
In the philippines _________ out of __________ provinces are endemic to malaria
65 out of 78
Incidence accounts for _________ per 1000 (2000)
0.48
Provinces in the Philippines which has high malarial endemicity are:
Palawan, Kalinga Apayao, Ifugao, Agusan del Sur
MDR falciparum malaria cases are prominent in:
Davao del Norte, Compostela Valley, Palawan
____________% of the cases of malaria are caused by P. falciparum and the remaining __________ % is caused by P. vivax
> 70%
<30%
True or False: There is a reported case of P. ovale in the Philippines? If true, where?
True, 1 reported case in Palawan
It is the principal malaria vector, abound in the foothill areas
Anopheles minimus var. Flavirostris
Its transmission is highly observed in coastal areas of Mindanao
Anopheles litoralis
True or False: Anopheles maculates and Anopheles flavirostris has transmission in lower altitudes
False, both have transmission in higher altitudes
It is a malaria vector thar abounds for forest fringes
Anopheles manyans
Give the (2) other types of Malaria
Transfusion Malaria
Congenital Malaria
This type of malaria is an accidental Plasmodium infection caused by the transfusion of whole blood or a blood component from a malaria infected donor to a recipient
Transfusion malaria
Type of malaria which malarial parasites demonstrated in the peripheral smear of the newborn from twenty-four hours to seven days of life
Congenital malaria
What are the two clinical manifestations of malaria?
[+] Recrudescence
[+] Relapse
It is when there is a reactivation of hypnozoite forms of the parasite in the liver
[+] Relapse
It is the renewal of parasitemia and/or clinical features arising from persistent undetectable asexual parasitemia in the absence of an EE cycle
[+] Recrudescence
What are the ways how to diagnose malaria
Thick blood films
Thin blood films
Quantitative buffy coat (QBC)
Malaria RDTs
Serologic Tests
PCR
These are the common serologic tests used in the diagnosis of malaria
IHA, IFAT, ELISA
True or False: blood specimens are collected just before the next anticipated fever spike or at the outset of a fever or every 6- 8 hours
True
It is one of the diagnostic tools of malaria where we check the presence of the parasites
Thick blood films
It is where we observe the appearance of infected RBCs, the appearance of parasites, and their stages
Thin blood films
Appearance of Erythrocyte Size of
P. falciparum and P. malariae
Normal size
Appearance of Erythrocyte Size of P. vivax and P. ovale
Enlarged size
Does P. falciparum have
Schuffner’s dots or Maurer’s dots?
Maurer’s dots
Does P. vivax have
Schuffner’s dots or Maurer’s dots?
Schuffner’s dots, with all stages EXCEPT early ring forms.
Does P. ovale have
Schuffner’s dots or Maurer’s dots?
Schuffner’s dots, with all stages EXCEPT early ring forms.
Does P. malariae have
Schuffner’s dots or Maurer’s dots?
Ziemann’s dots but rarely seen
What Plasmodium species have Young rings that are small, delicate, often with double chromatin dots. Gametocytes are crescent or elongate?
Plasmodium falciparum
What Plasmodium species have Irregular. Ameboid in trophozoites. Has “spread-out” appearance?
Plasmodium vivax
What Plasmodium species have Rounded, compact trophozoites. Occasionally slightly ameboid. Growing trophozoites have large chromatin mass?
Plasmodium ovale
What Plasmodium species have Rounded, compact trophozoites with dense cytoplasm. Band-form trophozoites occasionally seen?
Plasmodium malariae
What Plasmodium species have Black, coarse and conspicuous pigment in gametocytes?
Plasmodium falciparum
What Plasmodium species have Golden brown, inconspicuous pigment?
Plasmodium vivax
What Plasmodium species have Dark brown, conspicuous pigment?
Plasmodium ovale
What Plasmodium species have Dark brown, coarse, conspicuous pigment?
Plasmodium malariae
What Plasmodium species have a Number of
6-32; average is 20-24
Merozoites
Plasmodium falciparum
What Plasmodium species have a Number of
12-24; average is 16
Merozoites
Plasmodium vivax
What Plasmodium species have a Number of
6-14; average is 8
Merozoites
Plasmodium ovale
What Plasmodium species have a Number of
6-12; average is 8;
with ‘rosette’ schizonts occasionally seen in Merozoites
Plasmodium malariae
What Plasmodium species have Rings and/or gametocytes. Other stages develop in blood vessels of internal organs but are not seen in peripheral blood except in severe infections?
Plasmodium falciparum
What Plasmodium species can be found in ALL stages in circulating blood and may be seen on any given film?
P. vivax and P. ovale
What Plasmodium species can be found in All stages. Wide variety of stages usually not seen. Relatively few rings or gametocytes generally present?
Plasmodium malariae
Enumerate ALL Plasmodium species.
P. falciparum
P. vivax
P. ovale
P. malariae
Has Malaria-like infections
Transmitted by ticks and is found in a variety of animal species that serve as reservoirs
BABESIA SP.
BABESIA SP. is Transmitted by _____
ticks
Spectrum varies from latent, subclinical to fulmminant hemolytic disease
fatalities are reported in immunocompromised and splenectomized patients
BABESIA SP.
Which of the Plasmodium spp. is the most dangerous?
P. falciparum
Plasmodium species that can progress to cerebral malaria involving the central nervous system, acute renal failure, severe anemia, acute respiratory distress syndrome, and/or other severe manifestations
P. falciparum
Which of the Plasmodium spp. can produce relapse of infection?
P. vivax and P. ovale
Relapse of infection may occur during the dormant stage of hypnozoites, which is well-documented in _____ and clinical cases are also reported in ______
P. vivax and P. ovale
These species can persist in the liver, if left untreated, and re-invade the bloodstream weeks or years later
P. vivax and P. ovale
Are Red blood cells infected with P. falciparum are normal or enlarged?
normal
The P. ______ rings may have the classic headphone appearance constituted by a delicate cytoplasm and one or two small chromatin dots.
P. falciparum
the gametocytes have a unique crescent or sausage-shaped appearance, in which the chromatin may be a single mass (macrogamete) or diffuse (microgamete)
P. falciparum
The diagnostic stage of Isospora belli is the ________, which can be detected in stool samples using microscopy.
The infective stage is the _______, which can contaminate food or water and infect a new host upon ingestion.
oocyst, oocyst
The diagnostic stage of Cryptosporidium parvum is the _____.
The infective stage is the _____, which can survive in the environment and cause infection when ingested by a new host.
oocyst, oocyst
The diagnostic stage of Pneumocystis jirovecii is the ________, which can be detected in respiratory specimens using special staining techniques or PCR.
The infective stage is the ________, which can be transmitted from host to host through airborne transmission.
cyst, cyst
The diagnostic stage of Toxoplasma gondii is the ________, which can be detected in feces of infected cats or in tissue samples of infected animals using microscopy or PCR.
The infective stage for intermediate hosts (including humans) is the tissue ______ containing bradyzoites, which can be ingested through contaminated food or water.
oocyst, cyst
What characteristics help to differentiate one Plasmodium species from other species?
-Size of infected RBCs,
-Pigmentation,
-Inclusions, and
-Comparison of the different stages found in blood
________ smears are used primarily for the detection of Plasmodium parasites due to their higher sensitivity.
They involve concentrating blood onto a small area of the slide, increasing the chance of detecting low-level parasitemia. This smears are particularly useful for screening and initial diagnosis of malaria.
Thick smears, larger volume
_____ smears are used for species identification and morphological characterization of Plasmodium parasites.
They involve spreading blood across the slide, creating a monolayer of RBCs for examination under a microscope.
Thin smears
Which Plasmodium species is more malignant than others primarily because it can lead to severe complications, such as cerebral malaria, which is associated with high mortality rates?
Plasmodium falciparum
What are the methods used to estimate the parasitemic load of malaria parasites?
-Microscopic Examination
- Rapid Diagnostic Tests (RDTs)
-Quantitative Buffy Coat (QBC)
-Malaria Antigen Detection Assays
-Nucleic Acid Amplification Tests (NAATs)
-Automated Hematology Analyzers
Enumerate the vectors involved for the transmission of Leishmania donovani:
Sandfly (female Phlebotomus argentipes)
Enumerate the vectors involved for the transmission of Leishmania tropica minor and major
Minor: Sandfly (female Phlebotomus sergenti)
Major: Sandfly (female Phlebotomus papatasi)
Enumerate the vectors involved for the transmission of Trypanosoma gambiense
Tsetse fly (Glossina palpalis)
are small, non-flagellated forms found within the cells of the vertebrate host. They are typically found during the intracellular phase of the parasite’s life cycle.
Amastigote
are elongated, flagellated forms found primarily in the insect vector. They are adapted for survival and multiplication in the vector’s gut.
Promastigotes
are also flagellated forms found in the insect vector, particularly in the midgut and hindgut regions. They are an intermediate stage between promastigotes and infective forms.
Epimastigotes
are elongated, flagellated forms found in the vertebrate host’s blood and tissues. They are often the infective stage for the vertebrate host and can be transmitted between hosts by insect vectors.
Trypomastigotes
How can you differentiate between species of African sleeping sickness since both species have similar diagnostic morphology?
through molecular techniques such as polymerase chain reaction (PCR) targeting species-specific genetic markers
Outline the general prevention and control of vector-transmitted diseases.
-Vector control measures,
-community education
-vaccination.
Explain the laboratory diagnosis of Isospora belli and Cryptosporidium parvum?
-Stool Examination
-Microscopy
-Concentration Techniques
-PCR
-Immunofluorescence Assay (IFA)
Discuss the sexual and asexual reproduction of Toxoplasma gondii.
Toxoplasma gondii undergoes asexual reproduction (schizogony) in the intermediate host, where tachyzoites rapidly multiply and disseminate, while sexual reproduction (gametogony) occurs in the definitive host (cats), leading to the formation of oocysts shed in feces.
What factors give natural protection against Plasmodium infection?
Mosquito Avoidance and Control
Prior Exposure/Acquired Immunity
Use of Antimalarial drugs before traveling to an endemic location.
Socioeconomic factors such as better access to healthcare services and education.
Climate and environmental factors affect the breeding and distribution of vectors; it has both a negative and positive impact.
What is the effect of climate change on the spread of malaria?
As the climate warms it gives the mosquito a longer period to live and breed, as well as potentially expanding its habitat.
How do globalization and world trade contribute to the spread of mosquito-borne diseases such as malaria?
by facilitating the movement of people and goods across borders.
Increased travel and urbanization create environments conducive to mosquito breeding, while the transportation of goods can inadvertently introduce malaria vectors or parasites to new regions.
Climate change, exacerbated by globalization, further amplifies the risk by expanding the geographic range of mosquito vectors.
Limited access to healthcare and vector control measures in some regions exacerbates the challenge of controlling the spread of malaria in the context of globalization
Enumerate the three abnormal hemoglobin molecules
HbS, thalassemia, HBF
The human body has innate and resistance immunity, what are they?
Abnormal hemoglobin molecules
G6PD deficiency
Duffy negative genotype FyFy
Innate resistance and immunity which usually manifest in Black Africans
Duffy negative genotype FyFy
Receptor site on the RBC for P. vivax malaria is associate with what tyoe of antigen?
Duffy blood-group antigen
Immunity is both __________ and ________ specific which it requires repeated infections
Species and Strain specific
In terms of the pathogenesis of the Falciparum malaria, enumerate the steps involved
- Reduced deformability of erythrocytes
- Formation of knobs
- Soluble antigens of P. falciparum
It is due to the rigidity of the parasite, cytoskeletal changes and an increase in membrane stiffness and cytoplasmic viscosity
Reduce deformability of erythrocytes
Formation knobs contains ______, __________, riffins, __________ that are cytoadhesion
rosettins
PfEMP-1
It refers to the adherence of the infected erythrocytes containing late developmental stages of the parasite to the endothelium of capillaries and venules
T
These are the late developmental stages of the parasite
Trophozoites and schizonts
Soluble antigens of P. falciparum are potent inducers of ____________ which includes TNF, cachexin - fever
cytokines
sluggish flow of blood because ____________ blocks the flow
infected cells
Clinical syndromes associated with Falciparum malaria
- Prodromal period
- Malarial paroxysm
- Anemia
- Hepato-splenomegaly
- Complications of acute malaria (e.g. black water fever, cerebral malaria, renal impairment, pulmonary edema, hypoglycemias with lactic acidosis)
- Complications of chronic malaria
- Malaria in high risk groups
- Congenital malaria
- Transfusion malaria
What are the other complications of acute malaria
Gram-negative septicemia
Aspiration pneumonia
Gastrointestinal bleeding
Diarrhea
Secondary bacterial infections
All are complications of chronic malaria, except
Tropical splenomegaly syndrome (TSS)
High-grade fever
Falciparum recrudescence
Latent malaria
High-risk groups for malaria
Pregnant women and children
What are the symptoms of severe Falciparum malaria
- Prostration
- Unarousable coma
- Generalized convulsions
- Severe normocytic anemia
- Hypoglycemia
- Metabolic acidosis with respiratory distress
- Fluid and electrolyte disturbances
- Acute renal failure
- Acute pulmonary edema and adult respiratory distress syndrome (ARDS)
- Circulatory collapse, shock, septicemia
- Abnormal bleeding
- Jaundice
- Hemoglubinuria
- High fever
- Hyperparasitemia
It is also known as Algid malaria
Circulatory collapse, shock, septicemia
Unarousable coma is also known as_________________, if determined to be caused by the parasite
Cerebral malaria
A type of malaria that is known as Malignant Tertian
P. falciparum
It is the first probable symptom of severe Falciparum malaria which includes confusion or drowsiness with extreme weakness
Prostration
P. vivax and P. ovale are also known as _______________________
Quartan Malaria is scientifically known as _____________________
P. malariae
The prepatent period of P. falciparum is ________ to _______ days while its incubation period is ______ to _______.
11-14 days
8 - 15 days
The prepatent period of P. vivax is ________ to _______ days while its incubation period is ______ to _______.
11- 15 days
12 -20 days
The prepatent period of P. ovale is ________ to _______ days while its incubation period is ______ to _______.
14-26 days
11-16 days
The prepatent period of P. malariae is ________ to _______ days while its incubation period is ______ to _______.
3-4 weeks
18-40 days
How many hours is the erythrocytic cycle of P. falciparum, P. vivax, and P. ovale?
48 hours
TRUE or FALSE: For P. malariae, it has a 65 hours of erythrocytic cycle
False, 72 hours
These parasites infect young RBCs
P. ovale and P. vivax
TRUE or FALSE: All stages of RBCs are infected by the P. falciparum
True
The age of infected RBCs for P. malariae is_______________
Aging RBCs
Parasites that have a round to oval gametocyte shape
P. vivax, P. ovale, P. malaria
P. falciparum has a gametocyte shape of:
Crescent or banana shape
What is the treatment for uncomplicated P. falciparum
Chloroquine resistant/MDR
Treatment for falciparum malaria
Sulfadoxine-pyrimethamine combination and/or Quinine
This is the drug of choice for P. vivax and P. ovale, and P. malaria
Chloroquine
What is administered if P vivax and ovale manifest especially for relapsing cases of these two parasite0causing malaria
Primaquine
Give the control and preventive measures for the Plasmodium spp.
- Early diagnosis and prompt treatment are essential for control
- Personal protection (netting, screening, protective clothing, and repellents)
- Chemoprophylaxis
- Prophylactic treatment may be used
- Mosquito control or total eradication
- Avoidance of sharing intravenous needles
- Thorough screening of donor blood
Potential malaria vaccine
Among the 4 mentioned parasites (P. falciparum, P. ovale, P. vivax, and P. malaria) which has no persistent EE stages
P. falciparum
This is the duration of untreated infection per year of P. ovale, and P. vivax
1.5-4.0
0.5-2.0 is the untreated infection (year) of what parasite? And 1-30 is for
P. falciparum
P. malariae
Match the following: Parasitemia edition (average):
P. falciparum 20 000
P. vivax 50 000-500 000
P. ovale 9000
P. malariae 6000
P. falciparum 50 000-500 000
P. vivax 20 000
P. ovale 9000
P. malariae 6000
