Blood and Tissue Parasites (part II)

Question 1

Babesia species: List four species which are known human pathogens

Answer 1

Theileria (Babesia) microti
Babesia divergens
B.ducani
Babesia spp. MO-1

Question 2

Most common Babesia specie which is found in the Northeast USA, Nantucket island.

Answer 2

Theileria (Babesia) microti

Question 3

Babesia species: Distribution

Answer 3

World wide
Babesia divergens (mainly Europe)
B.ducani (western USA)
Babesia spp. MO-1 (Midwerstern USA)

Question 4

Babesia species: Incidence of _____

Answer 4

babesiosis (US) (most cases in New England, Minnesota, and Wisconsin)

Question 5

Babesia species: Epidemiology

Answer 5

Ticks bites (deer tick and brown dog tick) transmit the parasite to human or mouse hots

Question 6

Babesia species: Host in natures

Answer 6

Use white footed mice and ticks as hosts

Question 7

Babesia species: Transmission

Answer 7

• Transmission has also occurred through blood transfusions!!!!! (2 cases in Indiana-both recipients died)
• Vertical transmission (going from mom to baby)has also occurred

Question 8

Babesia species: Infectious form

Answer 8

merozoite form; Maltese cross

Question 9

Babesia species: Symptoms

Answer 9

most asymptomatic; having no spleen makes a person more prone to severe or fatal disease

Question 10

Babesia species: Diagnosis thorugh microscope

Answer 10

• Examination of a Giemsa or Wright -giemsa stained blood smear
• Presence of ring form and characteristic merozoite in and outside of red cells; multiple rings and merozoites per cell

Question 11

Babesia species: Two other methods used in diagnosis

Answer 11

IFA-for detection of antibodies to Bebesia species

Molecular method-real time PCR for species which can speciate the organisms

Question 12

How can we distinguish Bebesia spp. from Plasmodium spp.?

Answer 12

Clinical and travel histories; Bebesia produces racket shaped merozoites; rings and merozoite are only seen in babesiosis; there are extracellular parasites seen in babesiosis

Question 13

Plasmodium species: causative agents of ____

Answer 13

malaria

Question 14

Plasmodium species: ____borne protoza

Answer 14

Mosquito

Question 15

List five different species of Plasmodium that are known to cause malaria in humans

Answer 15

-P.falciparum, P. malariae, P.ovale, P.vivax, P. knowlesi. (first four most common)

Question 16

Plasmodium species: distribution

Answer 16

Tropical and subtropical regions–mostly in Africa

Question 17

Plasmodium species: incidence of _____

Answer 17

Malaria

Question 18

Plasmodium species: complete life cycle requires two hots:_____ & _____

Answer 18

mosquitoes and humans

Question 19

Plasmodium species: What type of mosquitoes found?

Answer 19

Anopheles species mosquitoes

Question 20

P.falciparum: Epidemiology and incidence

Answer 20

Widespread, globally; predominant cause

Question 21

P. malariae: Epidemiology and incidence

Answer 21

Widespread, globally; less frequently seen causes

Question 22

P. ovale: Epidemiology and incidence

Answer 22

predominately in sub-Saharan Africa, other areas also

Question 23

P.vivax: Epidemiology and incidence

Answer 23

wide range than P.ovale, and their niches overlap; second most predominant cause

Question 24

P.knowlesi: Epidemiology and incidence

Answer 24

Southeast Asia; very rare cause

Question 25

Plasmodium species: two types of cycles

Answer 25

Exo-erythrocytic (occurs in liver | Erythrocytic

Question 26

Plasmodium species: Important notes about P.ovale and P.vivax in life cycle.

Answer 26

They both can stay dormant in liver---> diseae can relapse weeks or years later. RMR: with P.ovale and P.vivaz "IT's not OVer!!

Question 27

Plasmodium species: symptoms

Answer 27

- Blackwater fever: intravascular hemolysis, dark urine from Hgb; malaria caused by P.faciparum can be very dangerous!! - (fever, chills, fatigue, muscle aches, joint aches, diarrhea, vomiting, neurologic change)

Question 28

Plasmodium species: Types of blood smears used for examination

Answer 28

-Examination of a Giemsa or Wright-Giemsa stained blood smears

Question 29

Plasmodium species: Things to look for when examining the stained blood smears.

Answer 29

- Presence of ring forms, schizonts, gametocytes - Chuffner's dots in P.ovale & P.vivax - Thin and thick smears should be looked at

Question 30

Plasmodium species: two other methods for diagnosis

Answer 30

Molecular methods-PCR and Antigen detection-lateral flow test

Question 31

Plasmodium species: microscopic exam can be fixed with _____.

Answer 31

Methanol-RBCs will not lyse

Question 32

Plasmodium species: microscopic exam- why do we not fixed with methanol?

Answer 32

You need the RBCs to lyse

Question 33

No Schuffner's stippling

Answer 33

P.falciparum and P.malariae

Question 34

Infects normal sized or smaller than uninfected RBCs

Answer 34

P.falciparum

Question 35

Primarily ring forms seen in RBCs (applique form) and Multiple rings/RBCs, often hanging off the edges.

Answer 35

P.falciparum

Question 36

Gametocyte appearance of P.falciparum

Answer 36

Banana shaped

Question 37

infects normal to slightly larger RBCs

Answer 37

P.malariae

Question 38

May see band form trophozoites which looks like RBC is wearing a belt.

Answer 38

P.malariae

Question 39

No stippling and may have few Schizonts usually arranged in a rosette. And Gametocytes are round; may have dark brown pigment

Answer 39

P.malariae

Question 40

Infected RBCs larger than uninfected RBCs and RBCs are enlarged; many are fimbriated or round or oval

Answer 40

P.ovale

Question 41

Schuffner's stippling present with granules are much larger and darker

Answer 41

P.ovale

Question 42

Schizont (RBC in which parasites are undergoing asexual reproduction) contains 6-14 merozoites

Answer 42

P.ovale

Question 43

Often infects larger sized RBCs than uninfected RBCs and Schuffner's stippling present

Answer 43

P.vivax

Question 44

Schizont is larger and contains 12-24 merozoites

Answer 44

P.vivax

Question 45

Which organisms have growing trophs (rings), and gametocytes?

Answer 45

All plasmodium species

Question 46

Plasmodium species: Diagnosis through microscope

Answer 46

- Must distinguish plasmodium spp from babesia spp | - p.knowlesi, looks very similar to P.falciparum-PCR can discriminate the two

Question 47

Plasmodium knowelsi and P.falciparum look very smiliar how can we differentiate?

Answer 47

PCR can discriminate the two