Blood and Lymphatics II and III

Question 1

Filarial worms are thin, filamentous ____ that are acquired following a bite from _____ vectors, namely _____ and _____

Answer 1

Filarial worms are thin, filamentous nematodes that are acquired following a bite from arthropod vectors, namely black flies (Simulium) and mosquitoes

Question 2

name the 3 classifications of filariasis and the organisms that cause them

Answer 2

• lymphatic:
  
  • Wuchereria bancrofti, Brugia malayi, Brugia timori
• subcutaneous:
  
  • Loa loa, Onchocerca volvulus
• serous cavity:
  
  • Mansonella spp.

Question 3

the highest disease burdens of filariasis are in… (3 countries)

Answer 3

India, Nigeria, Indonesia

Question 4

describe the transmission of Wuchereria bancrofti

Answer 4

Question 5

describe the clinical disease of lymphatic filariasis

Answer 5

Question 6

describe how some cases of lymphedema can progress to elephantiasis

Answer 6

Question 7

lymphatic filariasis is acquired in ____

Answer 7

lymphatic filariasis is acquired in childhood

Question 8

describe how to recognize “sub-clinical” lymphatic drainage

Answer 8

lymphoscintigraphy and/or ultrasonography

Question 9

describe the direct methods to diagnose filariasis

Answer 9

Question 10

describe an indirect method of testing for filariasis

Answer 10

Question 11

Babesiosis is an ____-borne disease caused by a _____ that infects ______

Answer 11

Babesiosis is an arthropod-borne disease caused by a non-motile, protozoal parasite that infects RBCs

Question 12

Babesia microti is the causative parasite within the ___ and ____ region of the US

Answer 12

Babesia microti is the causative parasite within the Northeast and Midwest rregion of the US

Question 13

Babesiosis is transmitted by ____ (___ spp.)

Answer 13

Babesiosis is transmitted by deer tick (Ixodes spp.)

Question 14

describe the transmission of Babesiosis

Answer 14

Question 15

describe the clinical symptoms of Babesiosis

Answer 15

• most symptoms of B. microti infection are non-specific, mild-to-moderate viral-like and self-resolving
• the incubation period for acute illness is from 1-4 weeks or longer

Question 16

describe the populations in which Babesiosis can be life-threatening

Answer 16

• asplenic individuals
• immunocompromised
• organ damage or failure
• elderly

Question 17

describe the complications of babesiosis

Answer 17

• low and unstable blood pressure
• severe hemolytic anemia
• thrombocytopenia
• DIC/consumptive coagulopathy
• organ damage/failure
• death

Question 18

describe the diagnosis of Babesiosis

Answer 18

• blood smears are diagnositc
  
  • Babesiosis can be misdiagnosed as malaria since multiple forms similar to Plasmodia are visible within RBCs
• B. microti merozoites appear as elliptical “pear-shaped” forms sometimes seen as tetrads (Maltese cross) within RBCs
• confirmation includes IFA

Question 19

describe what is seen in the image

Answer 19

Question 20

describe methods to prevent and control Babesiosis

Answer 20

Question 21

describe the Sketchy

Answer 21

Question 22

summarize the differences between Babesiosis and malaria (P. falciparum)

Answer 22

Question 23

Plasmodium spp. are ____ parasites that invade ___

Answer 23

Plasmodium spp. are non-motile, protozoal parasites that invade RBCs

Question 24

in humans, P. ovale, P. vivax, P. malariae, and P. falciparum and transmitted by _____

Answer 24

in humans, P. ovale , P. vivax , P. malariae , and P. falciparum and transmitted by female Anopheles mosquito

Question 25

describe the Plasmodium life cycle

Answer 25

Question 26

in an exo-erythrocytic stagte following infxn, ___ infect ___ which go on to produce ____ by \_\_\_\_\_

Answer 26

in an exo-erythrocytic stagte following infxn , **sporozoites** infect **hepatocytes** which go on to produce **merozoites** by **schizogony**

Question 27

in the erythrocytic stage, ____ infect ____ and are propagated within them by \_\_\_\_

Answer 27

in the erythrocytic stage, **merozoites** infect **RBCs** and are propagated within them by **schizogony**

Question 28

\_\_\_\_\_\_ are products of the _____ stage; they are retrieved by a mosquito during a subsequent bite and fuse within the mosquito gut to produce a \_\_\_\_\_\_

Answer 28

**gametocytes (male and female)** are products of the **erythrocytic** stage; they are retrieved by a mosquito during a subsequent bite and fuse within the mosquito gut to produce a **zygote**

Question 29

describe the clinical symptoms of malaria

Answer 29

* malaria presents with flu-like symptoms: * **(fever, headache, muscle pain, nausea)** * **periodic cycles of chills, high fever** **and** **rigors (paroxysms)** * **RBC lysis results in anemia** and the spleen grows as it attempts to clear the parasite from the blood → **splenomegaly**

Question 30

describe benign tertian malaria and the species that cause it

Answer 30

* P. vivax and P. ovale (less frequently) = benign tertian malaria

Question 31

describe quartan malaria and the species that causes it

Answer 31

Question 32

describe malignant tertian malaria and the species that cause it

Answer 32

Question 33

summarize the *Plasmodium* species

Answer 33

Question 34

describe direct diagnostic tests for malaria

Answer 34

* direct diagnostic tests include: * molecular: PCR detects parasite nucleic acids * rapid tests: detect parasite antigen * parasites in blood smear (Gold standard)

Question 35

describe the complications of *P. falciparum*

Answer 35

Question 36

list genetic factors and acquired factors that may lead to malaria resistance

Answer 36

* genetic factors: * sickle cell disease * alpha and beta thalassemia * G6PD * hemolytic anemia * Duffy antigen mutation * acquired: * repeated malarial infections may induce partial protective immunity leading to absence of typical malarial symptoms