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Clinical Parasitology > Chapter 6: Select Sporozoa: Plasmodium and Babesia > Flashcards

Chapter 6: Select Sporozoa: Plasmodium and Babesia Flashcards

1
Q

It refers to disease processes resulting from infections of parasites belonging to the phylum Apicomplexa.

A

Malaria and Babesiosis

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2
Q

Both genera of parasites belong to the class of parasites that have no obvious structures for the purpose of motility, known as?

A

Sporozoa

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3
Q

The space inside the ring is known as?

A

Vacuole

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4
Q

Quick Quiz 6-1

The infective stage of Plasmodium is (are)

A. Merozoites
B. Oocyst
C. Sporozoites
D. Gametocytes

A

C. Sporozoites

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5
Q

What are the specimens of choice for the laboratory diagnosis of malaria?

A

Giemsa-stained peripheral blood

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6
Q

The greatest number of parasites is present in the blood in between characteristic bouts of fever and chills resulting from the release of merozoites and toxic waste products from infected RBCs, known as

A

Paroxysms

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7
Q

The common associated disease and condition
names:

  • Benign tertian malaria
  • Vivax malaria

Relative age of infected RBCs:

  • Only young and immature cells

Appearance of infected RBCs:

  • Enlarged, distorted

Ring forms:

  • Delicate cytoplasmic ring measuring one-third of RBC diameter
  • Accolé forms possible

Developing trophozoite:

  • Irregular ameboid appearance
  • Ring remnants common
  • Brown pigment becomes

Immature schizont:

  • Multiple chromatin bodies
  • Often contains clumps of brown pigment

Mature schizont:

  • 12 to 24 merozoites
  • Brown pigment may be present

Microgametocyte:

  • Large pink to purple chromatin mass surrounded by colorless to pale halo
  • Brown pigment common

Macrogametocyte:

  • Round to oval cytoplasm
  • Eccentric chromatin mass
  • Light-brown pigment
A

Plasmodium vivax

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8
Q

The parasite may first be visible as a crescent-shaped mass at the outer edge of the red blood cell, a location known as

A

Accolé or Appliqué.

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9
Q

A remnant of the parasite feeding on RBC hemoglobin is visible as a brown pigment.

A

Hemozoin

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10
Q

In laboratory diagnosis, all morphologic forms of P. vivax may be seen on?

A

Thick and thin peripheral blood films

Note:

Although the best time to observe numerous infected RBCs is halfway between paroxysms

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10
Q

Treatment for P. vivax.

A
  • quinine
  • quinidine
  • chloroquine
  • amodiaquine
  • primaquine
  • pyrimethamine
  • sulfadoxine
  • dapsone
  • mefloquine
  • tetracycline
  • doxycycline
  • halofantrine
  • atovaquone
  • proguanil
  • ginghaosu
  • artemisinin
  • artemether
  • artesunate
  • pyronaridine
  • Fenozan B07
  • trioxanes
  • nonane
  • endoperoxides
  • azithromycin
  • WRZ38605
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10
Q

The morphologic forms of P. vivax, with the exception of early ring forms that are less than 8 to 10 hours post-infection, may contain tiny granules in the cytoplasm is known as?

A

Schüffner’s dots

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11
Q

Quick Quiz 6-4

Which morphologic characteristic may help in distinguishing P. vivax from P. falciparum?

A. Hemozoin
B. Schüffner’s dots
C. 72-hour paroxysm
D. None of the above

A

B. Schüffner’s dots

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12
Q

Quick Quiz 6-5

P. vivax characteristically invades:

A. Immature RBCs
B. Senescent RBCs
C. All RBCs
D. Lymphocytes

A

A. Immature RBCs

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13
Q

Quick Quiz 6-6

The incubation period for P. vivax is generally:

A. 6 to 8 days
B. 7 to 10 days
C. 12 to 24 days
D. 10 to 17 days

A

D. 10 to 17 days

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14
Q

The common associated disease and condition
names:

  • Benign tertian malaria
  • Ovale malaria

Relative age of infected RBCs:

  • Only young and immature cells

Appearance of infected RBCs:

  • Oval and enlarged, distorted with ragged cell walls

Ring form:

  • Resembles that of P. vivax
  • Ring larger in size than P. vivax

Developing trophozoite:

  • Ring appearance usually maintained until late in
    development

Immature schizont:

  • Progressive dividing chromatin surrounded by cytoplasmic material—often maintains circular shape early in development

Mature schizont:

  • Parasites occupy 75% of RBCs
  • Rosette arrangement of merozoites (average of eight merozoites typically present)

Microgametocyte & Macrogametocyte

  • Similar to P. vivax, only smaller in size
A

Plasmodium ovale

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15
Q

In laboratory diagnosis, all developmental stages of P. ovale may be seen on?

A

Blood film preparations

16
Q

These are usually difficult to distinguish because of their remarkable similarities for P. vivax and P. ovale.

A

Microgametocyte & Macrogametocyte

16
Q

Quick Quiz 6-7

Which morphologic form would be the best choice
for distinguishing between P. vivax and P. ovale?

A. Mature schizont
B. Ring form
C. Early trophozoite
D. Immature schizont

A

A. Mature schizont

17
Q

Quick Quiz 6-9

Which of the following is considered an antimalarial medication?

A. Amoxicillin
B. Erythromycin
C. Chloroquine
D. Dicyclomine

A

C. Chloroquine

18
Q

The common associated disease and condition
names:

  • Quartan malaria
  • Malarial malaria

Relative age of infected RBCs:

  • Only mature cells

Appearance of infected RBCs:

  • Normal size, no distortion

Ring form:

  • Smaller than P. vivax
  • Occupies one sixth of the RBC
  • Heavy chromatin dot
  • Vacuole may appear filled in
  • Pigment characteristically forms early

Developing trophozoite:

  • Roundish, oval, band, or bar shape
  • Cytoplasm contains coarse dark brown pigment
  • Vacuoles absent in mature stages

Immature schizont:

  • Similar to that of P. vivax, only smaller; may contain large and dark peripheral or central granules

Mature schizont:

  • Typically contains 6 to 12 merozoites arranged in rosettes or irregular clusters

Microgametocyte & Macrogametocyte:

  • Similar to P. vivax, only smaller in size; pigment usually darker and coarser
  • Older forms assume an oval shape
A

Plasmodium malariae

19
Q

The cytoplasm of heavily stained P. malariae may contain fine dustlike dots known as?

A

Ziemann’s dots

20
Q

In laboratory diagnosis, this stage is not commonly seen in P. malariae.

A

Ring form

21
Q

The most frequently encountered growth stages of
malariae seen are?

A
  • Developing trophozoite
  • Immature
  • Mature schizonts
22
Q

Patients suffering from quartan malaria (also known as malarial malaria) infections caused by the presence of P. malariae typically experience an incubation period of?

A

18-40 days

23
Q

The common associated disease and condition
names:

  • Black water fever
  • Malignant tertian
  • Malaria
  • Aestivoautumnal malaria
  • Subtertian
  • Malaria
  • Falciparum malaria

Relative age of infected RBCs:

  • May infect cells of all ages

Appearance of infected RBCs:

  • Normal size, no distortion

Ring form:

  • Circle configuration (one chromatin dot) or headphone configuration (two chromatin dots)
  • Multiple rings common
  • Accolé forms possible

Developing trophozoite:

  • Heavy rings common
  • Fine pigment granules
  • Mature forms are only seen in severe infections

Immature schizont:

  • Multiple chromatin bodies surrounded by cytoplasm
  • Only detected in severe infections

Mature schizont:

  • Typically consists of 8-36 merozoites

Microgametocyte:

  • Sausage or crescent-shaped
  • Dispersed central chromatin with nearby black
    pigment usually visible

Macrogametocyte:

  • Sausage or crescent-shaped
  • Compact chromatin
  • Black pigment surrounding chromatin may be
    visible
A

Plasmodium falciparum

24
Q

In P. falciparum, these growth stages may contain dark-staining, irregular to comma-shaped cytoplasmic dots called

A

Maurer’s dots

25
Q

Peripheral blood smears from patients suffering
with a mild to moderate P. falciparum infection
typically revealed in?

A
  • Ring forms
  • Gametocyte forms
26
Q

The infections with P. falciparum generally tend to occur in the warmer months of late summer and early autumn thus, the name.

A

Aestivoautumnal malaria

27
Q

A fulminating disease results and the intestinal symptoms (nausea, vomiting, and diarrhea) mimic those seen in malignant infections hence, the name

A

Malignant tertian malaria

28
Q

A collaborative effort of the following entities recently resulted in the development of a vaccine against malignant tertian malaria known as

A

RTS,S/AS0: GlaxoSmithKline Biologicals

29
Q

Quick Quiz 6-13

What age of red blood cell does P. falciparum typically invade?

A. Mature red blood cells
B. Immature red blood cells
C. All red blood cells, regardless of age
D. Does not invade red blood cells

A

C. All red blood cells, regardless of age

30
Q

Black water fever can be described by which of the
following:

A. Marked hemoglobinuria
B. Kidney involvement in P. falciparum infections
C. Caused by P. falciparum–induced red blood cell
destruction
D. All of the above

A

D. All of the above

31
Q

What examination of samples have been known to reveal the differences between the two Plasmodium species?

A

DNA extraction and nested-PCR examination

32
Q

Artemisinin has shown be quite effective when used as treatment for both mild and severe forms of malaria due to

A

P. knowlesi

33
Q

The specimen of choice for the recovery of Babesia
is:

A. Tissue
B. Cerebral spinal fluid (CSF)
C. Stool
D. Blood

A

D. Blood

34
Q

Which of the following are laboratory diagnostic procedures is recommended for specifically identifying T. microti?

A. Thick and thin blood films
B. Serologic testing
C. PCR techniques
D. Both B and C are correct.
E. None of the above

A

D. Both B and C are correct.

35
Q

Which of the following is not a location known for
infection by T. microti?

A. California
B. North Carolina
C. Mexico
D. Nantucket

A

A. California

36
Q

For which patient would babesiosis be more severe?

A. The splenectomized
B. The patient with Babesia divergens
C. Older adults
D. All of the above

A

D. All of the above

37
Q

Treatment for babesiosis

A
  • Clindamycin & Quinine
  • Atovaquone & Azithromycin
38
Q

What is the vector transmission of Babesia microti?

A

Ixodes dammini

39
Q

What is the vector transmission of Babesia divergens?

A

Ixodes ricinus

Clinical Parasitology (7 decks)

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