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Review / Wrong Answers > DIT review - Micro 10 > Flashcards

DIT review - Micro 10 Flashcards

1
Q

Transmission and presentation of Naegleria fowleri

A
  • Transmission:
    • Swimming in freshwater lakes – associated with water sports
    • Enters via cribriform plate
  • Presentation:
    • Rapidly fatal meningoencephalitiis
      • Nuchal rigidity and fever + AMS
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2
Q

Diagnosis and treatment of Naegleria

A
  • Diagnosis:
    • Lumbar puncture – Amoebas in spinal fluid
  • Treatment:
    • Amphotericin B
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3
Q

Transmission and presentation of Trypanosoma cruzii

A
  • Transmission:
    • Reduviid bug (“kissing big”) feces deposited in bite, then induced by scratching
    • Predominantly in South America
  • Presentation:
    • Chagas disease:
      • Dilated cardiomyopathy, megacolon, megaesophagus
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4
Q

Diagnosis and treatment of trypanosoma cruzii

A
  • Diagnosis:
    • Trypomastigote in blood smear
  • Treatment:
    • Nifurtimox (knee-high fur mocassins)
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5
Q

Transmission and presentation of babesia

A
  • Transmission:
    • Ixodes tick
    • Often coinfected with Lyme disease
    • Predominantly in Northeast US
  • Presentation:
    • Fever, hemolytic anemia, jaundice
    • Higher risk in sickle cell disease
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6
Q

Diagnosis and treatment of babesia

A
  • Diagnosis:
    • Blood smear containing ring form or maltese cross
  • Treatment:
    • Atovaquone + Azithromycin
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7
Q

Transmission and general presentation of malaria

A
  • Transmission:
    • Amopheles mosquito
  • Presentation:
    • Fever, headache, anemia, splenomegaly
    • Symptoms occur when RBCs rupture and release merozoites
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8
Q
  • What are the 4 plasmodium species
    • Describe fever cycles of each
    • Which one has dormant form in liver
A
  • Different species:
    • P. Vivax/Ovale
      • Fever cycle – 48 hours (tertian)
      • Dormant form (hypnozoite) in liver
    • P. malariae
      • Fever cycle – 72 hour (quartan)
    • P. falciparum
      • Fever cycle – irregular fever pattern
      • Parasitized RBCs occlude capillaries in brain (cerebral malaria), kidneys, lungs
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9
Q

Describe the life cycle of plasmodium

A
  • Malaria is transmitted by Anopholese mosquito, which carry sporozoites in saliva
  • Mosquitoes bite human host and mature to trophozoites in liver
  • Schizont divides into merozoites which burst from hepatocytes and infect RBCs
  • Once inside the RBC, lifecycle continues: trophozoite -> schizont -> merozoite -> infect RBC
    • Immature schizont has a ring form in the RBC
  • After merozoite infects the RBC, it can also form gametocytes, which are sexual form of plasmodium
  • Cycle continues when mosquitoes bite a human and take up RBCs containing gametocytes
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10
Q

Diagnosis of Plasmodium

A
  • Blood stain with Giemsa stain to see parasites in RBCs (trophozoite ring)
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11
Q

Histology specific to P. falciparum

A
  • P. Falciparum has banana-shaped gametocyte in blood smear
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12
Q

Malaria drug that has a lot of resistance

A
  • Chloroquine
    • For sensitive species
    • Blocks plasmodium heme polymerase
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13
Q

What is the reason behind adding Primaquine to Chloroquine

A
  • To kill dormant hynozoite in P. Vivax/Ovale
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14
Q

Which drugs treat chloroquine-resistant species

A
  • Mefloquine
    • For chloroquine-resistant species
    • Prophylaxis for travelers
  • Atovaquone +. Proguanil
    • For chloroquine-resistant species
    • Prophylaxis for travelers
    • For life-threatening disease caused by P. Falciparum
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15
Q

Which drugs are used for life-threatening disease caused by P. falciparum

A
  • Atovaquone +. Proguanil
    • For chloroquine-resistant species
    • Prophylaxis for travelers
    • For life-threatening disease caused by P. Falciparum
  • Quinidine
    • For life-threatening disease caused by P. Falciparum
    • Adverse effect = cinchonism
  • Artesunate
    • For life-threatening disease caused by P. Falciparum
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16
Q

Transmission and presentation of Leishmaniasis (both cutaneous and visceral)

A
  • Transmission:
    • Sandfly
    • Vertebrae are the hosts
  • Presentation:
    • Cutaneous leishmaniasis
      • Caused by Leishmania baziliensis
      • Skin ulcers
    • Visceral leishmaniasis (kala-azar)
      • Caused by Leishmania donovani
      • Spiking fevers, hepatosplenomegaly, pancytopenia, hyperpigmented lesions
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17
Q

Diagnosis and treatment of Leishmaniasis

A
  • Diagnosis:
    • Macrophages containing amastigotes
  • Treatment:
    • Sodium stibogluconate (T-bone steak) = cutaneous
    • Amphotericin = visceral
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18
Q

Transmission and presentation of Trichomonas

A
  • Transmission:
    • Sexual
  • Presentation:
    • Vaginitis – foul-smelling, greenish discharge; itching and burning; pH > 4.5
    • Cervicitis – strawberry cervix
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19
Q

Diagnosis and treatment of Trichomonas

A
  • Diagnosis:
    • Trophozoites (motile) on wet mount
  • Treatment:
    • Metronidazole (treat patient and partner)
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20
Q

Describe transmission and characteristics of Enterobius vermicularis

A
  • Sketchy = vermin lady crawling out of hole
  • Transmission:
    • Fecal-oral
  • Characteristics:
    • At night, females lay eggs in anus, people then scratch their butts
    • Anal pruritus
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21
Q

Diagnosis and treatment of enterobius

A
  • Diagnosis:
    • Tape test
  • Treatment:
    • Pyrantel pamoate
    • Bendazole
22
Q

Describe transmission and travel of bug in Ascaris lumbricoides

A
  • Sketchy = lumbering tree man
  • Transmission:
    • Fecal-oral
    • Transmitted by eating eggs in contaminated food or water; eggs hatch in small intestine and larvae migrate through gut wall and into the bloodstream and makes way to lungs; within the lungs they go through the capillaries into the alveoli and ascend into bronchus where they are swallowed and finally mature into adults in the small intestine
      • Similar to American dude, but entry is fecal oral, rather than cutaneous
23
Q

Characteristic presentation of Ascaris

A
  • Large worms can cause intestinal obstruction (most often ileocecal valve)
  • Respiratory symptoms
  • Eosinophilia
24
Q

Diagnosis and treatment of ascaris

A
  • Diagnosis:
    • Eggs in stool
  • Treatment:
    • Bendazole
25
Q

Which nematodes travel via the blood –> lungs –> intestine route?

A

Ascaris lumbricoides

Strongyloides stercoralis

Acylostoma duodenale / Necator americans

26
Q

Transmission and characteristics of Strongyloides

A
  • Sketchy = strong guy
  • Transmission:
    • Larvae penetrate skin of soles of feet
    • Once inside the bloodstream the larvae will go straight to the lungs and ascend to bronchiole tree and then get coughed up and swallowed; they then mature in the intestine
      • Similar to Ascaris, but entry is cutaneous rather than fecal-oral
  • Characteristics:
    • Autoinfection of host by laying eggs in intestinal wall, where larvae can hatch and re-penetrate the wall and enter bloodstream
    • Eosinophilia
27
Q

Diagnosis and treatment of Strongyloides

A
  • Diagnosis:
    • Larvae in stool
      • Eggs are laid into intestinal wall so don’t pass through stool
  • Treatment:
    • Bendazole
    • Ivermectin
28
Q

Transmission and characteristics of

  • Acylostoma duodenale / Necator americanus – Hookworm
A
  • Sketchy = American dude
  • Transmission:
    • Larvae penetrate skin of soles of feet
    • Once inside the bloodstream the larvae will go straight to the lungs and ascend to bronchiole tree and then get coughed up and swallowed; they then mature in the intestine
      • Similar to Ascaris, but entry is cutaneous rather than fecal-oral
  • Characteristics
    • Attach to the gut wall and feed from the capillaries of intestinal villi
      • Can develop severe iron deficiency anemia
    • Eosinophilia
29
Q

Diagnosis and treatment of americanus

A
  • Diagnosis:
    • Eggs in stool
  • Treatment:
    • Pyrantel pamoate
    • Bendazole
30
Q

Transmission of Trichinella spiralis

A
  • Sketchy = Porky trickster
  • Transmission:
    • Under-cooked meat (especially pork)
    • Fecal-oral
31
Q

Characteristics and treatment of Trichinella

A
  • Characteristics:
    • Trichinosis – fever, nausea, vomiting, periorbital edema myalgia
    • Larvae enter bloodstream and form cysts within striated muscle cells – inflammation of muscles
    • Esoinophilias
  • Treatment:
    • Bendazole
32
Q

Transmission, presentation, and treatment of Onchocerca volvulus

A
  • Onchocerca volvulus
    • Sketchy = black fly guy
    • Transmission:
      • Female blackfly
    • Presentation:
      • Hyper and hypo-pigmented spots
      • River blindness
      • Eosinophilia
    • Treatment:
      • Ivermectin
33
Q

Transmission, presentation, and treatment of Wuchereria bancrofti

A
  • Sketchy = witch
  • Transmission:
    • Female mosquito
  • Presentation:
    • Elephantiasis – worms invade lymph node and cause inflammation, blocking the lymphatic vessels
    • Eosinophilia
  • Treatment:
    • Diethylcarbamazine
34
Q

Transmission, presentation, and treatment of Toxocara canis

A
  • Sketchy = wolf man
  • Transmission:
    • Fecal-oral
    • Contamination of food with dog or cat feces
    • Larvae enter the body and never mature – that’s why this disease is called visceral larvae migrans
  • Presentation
    • Blindness
    • Eosinophilia
    • Organs usually affected = heart, liver, CNS
  • Treatment:
    • Bendazole
35
Q

Transmission, presentation, and treatment of Loa loa

A
  • Sketchy = swamp monster
  • Transmission:
    • Deer fly, horse fly, mango fly
  • Presentation:
    • Transient angioedema – local subcutaneous swelling
    • Worm crawling under conjunctiva
    • Eosinophilia
  • Treatment:
    • Diethylcarbamazine
    • Bendazole
36
Q

Describe the 2 different species of Taenia

Including transmission, intermediate host, and hooks/no hooks

A
  • Taenia = tents and carousel
    • Caused by eating cysts/larvae in undercooked meat
    • Species:
      • Taenia solium = pig under tent with sun and sold sign
        • Intermediate is pig
        • Has hooks on head when seen in hook O&P
      • Taenia saginata = cow under sagging tent
        • Intermediate is cow
        • No hooks
37
Q

What are the 2 different presentations of Taenia, their causes, and their treatment

A
  • Taeniasis = Intestinal tapeworm
    • From ingestion of larvae via undercooked pork
    • GI problems, malabsorption
    • Treat with Praziquantel
  • Neurocysticercosis
    • From ingesting eggs via water contaminated with animal feces (sketchy = poop water with eggs in fron of carousel)
    • Seizures, Swiss cheese head CT
    • Treat with Bendazole
38
Q

Transmission of Diphyllobothrium latum

A
  • Diphyllobothrium latum = port-a-potty
    • Transmission:
      • Ingestion of undercooked fish
      • This is the largest tapeworm
39
Q

Presentation and treatment of Diphyllobothrium

A
  • Presentation:
    • Diarrhea
    • B12/Cobalamin deficiency – megaloblastic anemia
  • Treatment:
    • Praziquantel
    • Noclosamide
40
Q

Transmission of Echinococcus granulosus

A
  • Sketchy = cocker spaniel
  • Transmission:
    • Dogs are definitive host
    • Humans are intermediate host
    • Transmitted via dog feces
41
Q
  • Presentation:
    • Hydatid cysts on liver with eggshell calcifications on cyst on liver CT
    • Rupture of cysts can cause anaphylaxis
      • Cyst must be injected with ethanol or hypertonic saline before removal
    • Eosinophilia
  • Treatment:
    • Surgical removal of cysts
      • Vs. liver cyst of Enteromoeba which is treated pharmaceutically
    • Bendazole

Presentation and treatment of Echinococcus

A
  • Presentation:
    • Hydatid cysts on liver with eggshell calcifications on cyst on liver CT
    • Rupture of cysts can cause anaphylaxis
      • Cyst must be injected with ethanol or hypertonic saline before removal
    • Eosinophilia
  • Treatment:
    • Surgical removal of cysts
      • Vs. liver cyst of Enteromoeba which is treated pharmaceutically
    • Bendazole
42
Q

Transmission of Schistosoma

A
  • Snails are host
  • Transmission via penetration of human skin
    • Swimmers are at risk
43
Q

Describe the path of Schistosoma once they enter the bloodstream

A
  • After gaining access to bloodstream, worms are carried to liver where they mature into the adults; adults lay eggs in humans who poop and pee in water; snails in the water become intermediate hosts
  • Once adults mature in liver, they like to migrate to other parts of the body depending on which type of Schistosoma they are (are 3 different types)
  • Worms will migrate against the portal flow to reach venous destination
44
Q

Describe the shape of the egg and presentation of S. Mansoni

A
  • S. Mansoni = merman
    • Egg with large lateral spine
    • Presentation:
      • Swimmers itch
      • Portal HTN – Gi hemorrhage, abd pain, liver cirrhosis, jaundice
45
Q

Describe shape of egg and presentation of S. Japonicum

A
  • S. Japonicum = Japanese tourist
    • Egg with have small/absent spine (almost perfectly round)
    • Presentation:
      • Swimmers itch
      • Portal HTN – Gi hemorrhage, abd pain, liver cirrhosis, jaundice
46
Q

Describe shape of egg and presentation of S. Haematobium

A
  • Egg will have a large terminal spine
  • Presentation:
    • Swimmers itch
    • Hematuria
    • Squamous cell carcinoma of bladder
47
Q

Describe transmission and egg shape of Chlonorchis sinensis

A
  • Transmission:
    • Snails are intermediate host
    • Worm transferred from snails to fish
    • Transmission via ingestion of undercooked fish
  • Eggs:
    • Operculated eggs on O&P (wearing a yamaca)
48
Q

Describe presentation of Clonorchis

A
  • Pigmented gallstones
  • Biliary fibrosis
  • Cholangiocarcinoma
49
Q

Describe transmission, presentation, and egg of Parogonimus westermani

A
  • Parogonimus westermani = penguin
    • Transmission
      • Snail is intermediate host
      • Transmitted via consumption of raw or undercooked crab meat
    • Presentation:
      • Chronic cough with bloody sputum
    • Egg:
      • Operculated eggs on O&P (wearing a yamaca)
50
Q

What is the treatment for all flukes (trematodes)

A

Praziquantel

Review / Wrong Answers (140 decks)

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