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Basic Pathology 2 > 14 Blood Flagellates > Flashcards

14 Blood Flagellates Flashcards

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1
Q

Causative agent of leishmaniasis

A

Leishmania donovani (most important)
L major
L brasiliensis

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2
Q

Small, dark teardrop-shaped

Motile due to presence of flagella

A

Leishmania amastigotes

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3
Q

Vector of leishmaniasis

A

Sandfly

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4
Q

Sandfly

Endemic in old-world countries (Europe, Asian and African countries)

A

Plebotomus

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5
Q

Sandfly

Endemic in new-world countries (America)

A

Lutzomiya

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6
Q

Primary reservoir hosts of Leishmania

A

Dogs (L. infantum)

Humans (L. donovani, L.tropica)

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7
Q

Modes of transmission of Leishmania

A 
Blood-borne:
Blood transfusion
Wound contamination
Exposure to contaminated samples
Vertical transmission
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8
Q

Infective stage of Leishmania

A

Promastigotes

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9
Q

What ingests the promastigotes as they enter the bloodstream

A

Macrophage

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10
Q

Promastigotes in the macrophages will become ____, which will reproduce via binary fission

A

Mastigotes

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11
Q

Also known as Baghdad ulcer, Delhi boil, Bouton d’ Orient
Least severe form of leishmaniasis
Symptoms include craters and erosions

A

Cutaneous leishmaniasis (CL)

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12
Q

Most common species that cause CL

A

L. major

Others include L. tropica, L. infantum

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13
Q

Mostly seen in South America

Caused by L. braziliensis

A

Mucocutaneous leishmaniasis (MCL)

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14
Q

Skin ulcers in MCL

A

Chiclero ulcers

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15
Q

AKA Parrot’s beak or Camel nose

Massive tissue destruction of the mucus membranes of the mouth and nose

A

Espundia

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16
Q

Morbidity is higher compared to MCL and CL
Affects big area of the body, but can also be found in localized areas of the skin
Resembles lepromatous leprosy

A

Diffuse cutaneous leishmaniasis (DCL)

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17
Q

What causes DCL

A

L. aethiopica

L. mexicana

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18
Q

Symptoms of DCL

A

Disseminated and chronic skin lesions

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19
Q

Most serious form of leishmaniasis
Has more than 95% mortality
Affects visceral organs

A

Visceral Leishmaniasis (VL)

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20
Q

Etiologic agents of VL

A

L. donovani

L. chagasi

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21
Q

Double quotidian fever
Weight loss
Prominent hepatomegaly, splenomegaly
Anemia, leukopenia, thrombocytopenia

A

VL

Kala azar

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22
Q

Diagnosing leishmaniasis

A 
Direct visualization
Freeze-dried direct agglutination test
rK39 Dipstick
Latex agglutination urine test
Leishmanin (Montenegro) skin test
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23
Q

Primary confirmatory diagnosis

Gold standard for confirming leishmaniasis

A

Direct visualization

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24
Q

Direct visualization uses tissue aspirate from:

A

Spleen
Bone marrow
Lymph nodes

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25
Direct visualization is unsuitable for filed use because:
Invasive | Low sensitivity
26
Detects antibodies | Rapid diagnostic test, hence, used in field
Freeze-dried direct agglutination test (DAT)
27
Based on recombinant antigen of Leishmania parasite | Being investigated for use in active case detection
rK39 Dipstick
28
Detects Leishmania antigens | Used among patients who have a compromised immune response
Latex agglutination urine test
29
Rapid diagnostic test used to detect exposure Used for CL and MCL Similar to an allergy test (PPD), wherein you inject an antigen and wait for delayed hypersensitvity region
Leismanin (Montenegro) skin test
30
Immunity against further infection can be attained
Leishmanization
31
Three methods of leishmanization
Intentional biting Pus inoculation Cultured promastigotes
32
Natural immunization
Intentional biting
33
Gets pus draining form lesion and inoculate into another person if person is healthy enough, he will develop antibodies
Pus inoculation
34
Live attenuated vaccination
Cultured promastigotes
35
Treatment for leishmaniasis
Antimonate-containing drugs (Pentavalent antimony drugs): Meglumine antimonite Sodium antimony gluconate
36
Prevention and control methods of leishmaniasis
``` Vector control (insect repellants, insecticides, kulambo) Reservoir control (poisoned baits) ```
37
Opportunistic AIDS infection
Leishmaniasis
38
New drug for treating leishmaniasis
Sitamaquine | Oral aminoquinolone
39
Also known as Human African Trypanosomiasis or African sleeping sickness
African trypanosoma
40
Majority of the cases of African trypanosoma come from ____
Sub-Saharan Africa
41
Causative agents of African trypanosoma
Trypanosoma brucei rhodesiense T. brucei gambiense T. brucei brucei
42
East and Southern Africa 2% of cases Faster killer but less prevalent (more fatal because there are less cases)
T. brucei rhodiense
43
West and Central Africa Has the most number of cases (98%) Slower killer than T. b. rhodesiense
T. b. gambiense
44
Cattle disease only
T. b. brucei
45
Vector of African trypanosoma
Tse-tse fly (Glossina spp)
46
Reservoir hosts of African trypanosoma
Dogs, pigs, cattle, wild animals
47
Infective stage of T. b. rhodiense
Metacyclic trypomastigotes
48
When tsetse flies are infected via blood ingestion, trypomastigotes become ____ in the gut
Procyclic trypomastigotes
49
Phases of African trypanosoma
Initial Early Late
50
Chancre formation (Dermolytic lesion) Pruritic lesion Lasts for 2-3 weeks
Initial Phase
51
A local, hard, painful lesion at the site of inoculation
Chancre
52
Heals by itself | A piece of dead tissue that is cast off from the surface of the skin
Eschar
53
Parasitic proliferation Systemic Lasts 1-6 months S/s include relapsing fever, headache, malaise, anemia, joint and muscle pains, Winterbottom sign
Early phase (hemolymphatic phase)
54
Enlarged posterior cervical lymph nodes
Winterbottom sign
55
Morbidity of the disease is seen Involvement of the CNS S/s include apathy, behavioral changes, headaches, sleep pattern changes, convulsions, speech defects, splenomegaly, Kerandel's sign, paralysis, progress to coma
Late phase (Meningoencephalitic phase)
56
Deep, delayed, bilateral hyperesthesia | Exaggerated response to any stimuli, particularly pain
Kerandel's sign
57
Mainly an immune-mediated hypersensitivity reaction due to parasite antigens acting on RBC, cardiac tissue and brain tissue
African trypanosoma
58
Diagnosis of African trypanosom
Direct visualization | Card agglutination test for trypanosome
59
Gold standard Visualizes highly motile trypomastigotes Mainly used in the early phase Invasive
Direct visualization
60
Useful for screening fo T.b. gambiense No comparable test for T. b. rhodesiense Rapid and specific Useful in the field setting
Card agglutination test for trypanosome (CATT)
61
For early stage of T. b. gambiense infection
Pentamide
62
For early stage of T. b. rhodiense infection
Suramin
63
First line drug for late-stage disease of both forms of sleeping sickness Removed due to toxicity and growing resistance
Melarsoprol
64
Current first line drug for T. b. gambiense sleeping sickness patients who do not respond to melarsoprol Ressurection drug
Eflornithine
65
Chagas disease | Majority of the cases come from Mexico, Central America and South America
South American Trypanosoma
66
Causative agent of Chagas disease | Has flagella
Trypanosoma cruzi
67
Zoonotic disease that can be transmitted to humans by blood-sucking triatomine bugs
Chagas disease
68
Infection of Chagas disease is most commonly acquried thorugh contact with ____ of an infected insect
Feces
69
Common triatomine vector species for Chagas disease belong to genera:
Triatoma Rhodnius Panstrongylus
70
Main vector for South American trypanosoma
Triatomine/Reduviid/Assassin bug
71
Triatomine bug releases infective ______ in its feces near the site of bite wound
Metacyclic trypomastigotes
72
Metacyclic trypomastigoes enter host's mucosal membranes and differentiate into ______
Intracellular amastigotes
73
Trypanosome amastigotes multiply by binary fission and differentiate into ____. which burst out and are released into bloodstream
Mature trypomastigotes
74
If the trypomastigotes are ingested by the triatomine bug, these transform into ____ in the vector's midgut
Epimastigotes
75
Diagnostic stage of T. cruzi
Amastigotes
76
Initial small furunculoid lesion at the bite site
Chagoma
77
``` Swollen palpebrae Due to conjunctival point of entry Painless but may be itchy on intial bite Persist up to 2 months Bugs bite at mucosal areas due to moisture present ```
Romana sign
78
Acute phase of Chagas disease include these s/s:
Chagoma Fever and lymphadenopathy Romana sign
79
Problematic phase, in which parasites are already proliferating inside the patients Could last from months to years Marked by fibrotic reactions
Indeterminate chronic phase
80
Diagnostic methods for Chagas disease
Direct visualization Indirect test Imaging test
81
Gold standard Involves observation of rapid movement of live trypomastigotes Only useful during first 2 months
Direct visualization
82
Immunologic tests Hemoculture in liver infusion tryptose medium Xenodiagnosis (use of live Triatomina bugs)
Indirect test
83
Treatment for Chagas disease | Inhibits unique enzyme trypanothione reductase
Nifurtimox | Benznidazole
84
Treatment for cardiopathy caused by Chagas disease
Allopurinol, itraconazole | Heart transplants
85
Preventive and control methods against Chagas disease
Vector control | Transfusional control

Basic Pathology 2 (8 decks)

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