Protozoa

Question 1

entamoeba histolytica

Answer 1

90% asx carriage
bloody diarrhea
liver abscess

Question 2

giardia lamblia

Answer 2

foul smelling greasy diarrhea
abdominal gassy distension
NO BLOOD b/c NO INVASION

Question 3

cyclospora cayetanesis

Answer 3

watery diarrhea
nausea and vomiting
often assoc w/ raspberries and strawberries
SEVERE in AIDS pts
acid-fast

Question 4

cryptosporidium

Answer 4

watery diarrhea vomiting and abdominal pain

SEVERE in AIDS pts

Question 5

isospora species

Answer 5

severe diarrhea and malabsorption in AIDS pts

acid-fast

Question 6

trichomonas vaginalis

Answer 6

painful vaginal itching
burning on urination
yellow-green malodorous frothy vaginal discharge

Question 7

naegleria fowleri

Answer 7

acute meningitis = HA fever vomit stiff neck
CSF = low glucose high neutrophil/protein
hx of swimming
fatal within a week

Question 8

acanthamoeba species

Answer 8

chronic granulomatous brain infxn = HA fever seizures focal neuro signs 
fatal w/in a yr
corneal infxn (usually d/t contact lenses)

Question 9

balamuthia mandrillaris

Answer 9

chronic granulomatous brain infxn (poor prognosis)
infects both immunocompetent and compromised
can cause chronic granulomatous skin lesions

Question 10

toxoplasma gondii

Answer 10

cats feces!
congenital acquired (TORCHES) = still birth, chorioretinitis, blindness, seizures, mental retardation, microcephaly; normal appearing infants may develop reactivation as adolescents or adults 

in immunocompromised pts: encephalitis (presenting as a brain mass), chorioretinitis, lymph node/liver/spleen enlargment, pneumonia
retina has white fluffy patches

Question 11

pneumocystis carinii (jiroveci)

Answer 11

really a fungus
interstitial pneumonia = fever, dry cough
MAJOR pathogen in AIDS pts (CD4 <200)

Question 12

malaria

Answer 12

high fever and shaking chills followed by period of profuse sweating 
tertian malaria = every 48 hrs
quartan = 72 hrs
P. falciparum = irregular episodes 
anemia
hepatomegaly 
splenomegaly 
brain lung kidney damage

Question 13

babesia microti

Answer 13

asx in normal pts
anemia in immunocompromised
maltese cross in RBCs

Question 14

leishmania

Answer 14

cutaneous leishmaniasis = single ulcer at sandfly bit (oriental sore). depigmented scar

diffuse leishmaniasis = nodules at bite site (does not ulcerate) and over body (esp nose)

mucocutaneous = ulcers on mucous membranes after first ulcer heals. erode nasal septum soft palate and lips

visceral leishmaniasis (kala-azar) = massive splenomegaly fever anorexia weight loss and abdom swelling. often fatal

Question 15

african trypanosome
trypanosoma brucei gambiense
trypanosoma brucei rhodesiense

Answer 15

african sleeping sickness:
somnolence, coma 
red hard painful skin ulcer 
fever HA and lymph node swelling
CNS sxs (behavioral changes, difficulty walking slurred speech, coma)

west african (gambiense) = slowly progressing fevers wasting and late neurologic sxs 
east african (rhodesiense) = more severe w/ rapid cycling fevers death in wks or mos

Question 16

american trypanosome

trypanosoma cruzi

Answer 16

chagas disease:
chagoma = hard red area at parasite entry
acute chagas disease = fever malaise and swollen lymph nodes (meningoencephalitis, acute myocarditis)
intermediate phase = NO sxs, positive abs
chronic chagas = cardiomyopathy (dilated heart), megadisease (megacolon, megaesophagus)