Wk 19 D2 Protozoa

Question 1

Toxoplasmosis gondii contracted by eating __ in ___ or __. __ can occur in pregnant women, causing __. Typically ___ but in immunocompromised leads to __ and ___. Often occurs with ___.

Answer 1

cysts, undercooked meat, cat feces
Trans-placental transmission, retardation/hydrocephalus
asymptomatic, retinitis, brain abcesses
AIDS

Question 2

Treatment of toxoplasmosis is with ___ and ___, or alternatively ___ (if ___ can’t be used). pyrimethamine can cause ___. Prophylaxis can be with ___ or non-pharmacologically by ___.

Answer 2

sulfadiazine + pyrimethamine
clindamycin if sulf not tolerated
megaloblastic anemia
tri-sulf, cook meat thoroughly away from cats

Question 3

If you’re suspecting Pneumocystis jiroveci, what would you do and how would you treat? What might you supplement treatment with for severe PCP? (ON TEST)

Answer 3

Methanamine silver stain to look for cysts
Treat with tri-sulf
Steroids to dampen inflammatory response in lung

Question 4

Where is Chagas endemic? When do you contract it and when does it typically manifest? What is the vector?
What tissues are most affected?
Classic sign of unilateral edema of eye?
Treatment?

Answer 4

Latin America
Contract as child, manifests as adult
Feces of kissing bug (reduviid bug)
Heart, nerve (megacolon, megaesophagus)
Romana's sign
nifurtimox  for acute phase, then only prevention

Question 5

What causes big “pizza ulcers” that travel along lymph nodes? How do you diagnose? What is vector? Why can’t the infection be resolved by macs?

Answer 5

Cutaneous leishmaniasis (could also be staph/strep/myco, sporotrix). Biopsy and microscopy. Sandfly. They live intracellularly and avoid Th1 by abnormal Treg function.

Question 6

What is an alternate presentation of leishmania?

Answer 6

F, malaise, hepatoSPLENOmegaly, wasting, anemia, thrombocytopenia, neutropenia, eosinopenia, hypergammaglobulin

Question 7

African trypanosomiasis spread by __. Leads to _. Can see Mott cells that look like ___ on ___.
West African parasite, east african parasite

Answer 7

Tsetse fly, Sleeping sickness,
Grape cluster, brain biopsy
Tbg, Tbr

Question 8

Giardia
Presents with
Diagnose with
Treat with

Answer 8

Drank water while hiking
Diarrhea watery, non-bloody, foul-smelling
Characteristic appearance on stool microscopy
Metronidazole (don’t drink!) or nitazoxanide

Question 9

Entamoeba histolytica (amebiasis)
Presents with
Diagnose with
Treat with

Answer 9

2 wk Bloody diarrhea, ab pain, tinismus
trophozoites in stool
Metronidazole

Question 10

Trichomoniasis (Trichomonas vaginalis)
Diagnosis
Treatment

Answer 10

watery, foul-smelling, greenish vaginal discharge accompanied by itching and burning
metro

Question 11

If diarrhea occurs longer than __, shift focus from __ to __.

Answer 11

2 wk
Bacteria
Protozoa

Question 12

Cryptosporidiosis (Cryptosporidium species)
Diagnose
Treat

Answer 12

Nonbloody diarrhea, Oocysts in fecal smears on acid fast stain
Nitazoxanide