GI Persistent/Chronic Diarrhea

Question 1

describe characteristics of Giardia intestinalis

Answer 1

flagellated protozoan

Question 2

describe conditions that can lead to Giardia infection

Answer 2

• waterborne/foodborne disease:
  
  • poor sanitation
  • travel to endemic countries
  • recreational water; streams, lakes

Question 3

describe the pathogenesis of Giardia

Answer 3

Question 4

infection by Giardia is caused by ingestion of ____

Answer 4

infection by Giardia is caused by ingestion of cysts

Question 5

in a Giardia infection, ____ multiply and attach to (but do NOT invade) the _____

Answer 5

trophozoites multiply and attach to (but do NOT invade) the epithelial cells of the SI

Question 6

describe diagnosis of Giardiasis

Answer 6

• routine O&P examination
• 3 stools over several days
• microscopic stool examination for:
  
  • cysts and trophozoites
• ELISA

Question 7

the diagnostic form in Giardiasis are the ___ and ____

Answer 7

the diagnostic form in Giardiasis are the cysts and trophozoites

Question 8

describe the Sketchy

Answer 8

Question 9

Cyclospora cayetanensis is a ______

Answer 9

Cyclospora cayetanensis is a coccidian protozoan

Question 10

Cyclospora cayetanensis is commonly found in ____

Answer 10

Cyclospora cayetanensis is commonly found in developing countries; tropics & subtropics

Question 11

infection by Cyclospora cayetanensis is caused by ingestion of _____

Answer 11

infection by Cyclospora cayetanensis is caused by ingestion of oocysts (similar to Cryptosporidian, which is also a coccidian protozoan)

Question 12

in an infection with Cyclospora cayetanensis, ____ attaches to and invades the SI

Answer 12

in an infection with Cyclospora cayetanensis, sporozoites attaches to and invades the SI

Question 13

describe diagnosis of Cyclospora cayetanensis infection

Answer 13

• O&P:
  
  • oocysts
• differential staining with modified Ziehl-Neelsen

Question 14

Cyclospora cayetanensis & Cryptosporidium can be differentially stained with ____

Answer 14

Cyclospora cayetanensis & Cryptosporidium (both are coccidian protozoans) can be differentially stained with modified Ziehl-Neelsen

Question 15

Cystoisospora belli is a _____

Answer 15

Cystoisospora belli is a coccidian parasite

Question 16

Cystoisospora belli (aka Isospora belli) is commonly found in ____

Answer 16

Cystoisospora belli (aka Isospora belli ) is commonly found in tropical/subtropical (South America, Africa, SE Asia)

Question 17

Cystoisospora belli is commonly found in (4 locations) in the US

Answer 17

Cystoisospora belli is commonly found in the US in:

• immunosuppressed
• immigrants from Latin America
• daycare centers
• psychiatric institutions

Question 18

similar to Cryptosporidium and Cyclospora, infection with Cystoisospora is caused by ingestion of ____

Answer 18

similar to Cryptosporidium and Cyclospora, infection with Cystoisospora is caused by ingestion of oocysts

Question 19

Entamoeba histolytica is a _____

Answer 19

Entamoeba histolytica is a pseudopod forming protozoa

Question 20

Entamoeba histolytica is endemic to ____

Answer 20

Entamoeba histolytica is endemic to developing countries (temperate climates)

Question 21

describe the outcomes of Entamoeba infections

Answer 21

• outcomes:
  
  • asymptomatic (approx. 80%)
  • intestinal amoebiasis (amoebic diarrhea & dysentery)

Question 22

Entamoeba infection can also lead to extraintestinal amoebiasis, such as ____

Answer 22

Entamoeba infection can also lead to extraintestinal amoebiasis, such as liver abscess

Question 23

infection with Entamoeba is caused by ingestion of ____

Answer 23

infection with Entamoeba is caused by ingestion of cysts

Question 24

in an Entomeoba infection, after ingestion of cysts, they under excystation to release _____, which are nucleated, ___-shaped

Answer 24

after ingestion of cysts, they under excystation to release trophozoites, which are nucleated, flask-shaped

Question 25

in an infection with Entamoeba, the ____ attach to the \_\_\_\_\_

Answer 25

in an infection with Entamoeba, the **trophozoites** attach to the **large intestine mucosa**

Question 26

describe amoebic liver abscess

Answer 26

* right lobe predominant * 1-3 months post dysentery * predominantly adult males * defective cell-mediated immunity + T cells suppression, defective proliferative response

Question 27

describe diagnosis of an Entamoeba infection

Answer 27

* routine O&P * insensitive * **cysts and trophozoites**

Question 28

the diagnostic form in Entamoeba are the ___ and \_\_\_\_

Answer 28

the diagnostic form in Entamoeba are the **trophozoites** and **cysts**

Question 29

describe the Sketchy

Answer 29

Question 30

Balantidium coli is a \_\_\_\_

Answer 30

Balantidium coli is a **ciliated protozoan**

Question 31

\_\_\_\_ are the reservoir for B. coli

Answer 31

**pigs** are the reservoir for B. coli | (Ex: water contaminated with pig feces)

Question 32

list the clinical manifestations of B. coli

Answer 32

* asymptomatic * intermittent diarrhea, abdominal pain, weight loss * fulminant colitis (blood and mucus)

Question 33

infection with B. coli is caused by ingestion of \_\_\_\_

Answer 33

infection with B. coli is caused by ingestion of **cysts**

Question 34

infection with B. coli leads to excystation of cysts in the \_\_\_, followed by colonization of the ____ by \_\_\_\_

Answer 34

infection with B. coli leads to excystation of cysts in the **SI**, followed by colonization of the **LI** by **trophozoites**

Question 35

describe diagnosis of B. coli infection

Answer 35

* not routine O&P * cysts not frequent * invasive disease: endoscopy * necrosis & ulceration * **trophozoites** from scrapings

Question 36

the diagnostic form in B. coli are the \_\_\_

Answer 36

the diagnostic form in B. coli are the **trophozoites**

Question 37

describe the diagnosis of Cystoisproa belli what makes it unique?

Answer 37

diagnosis = **oocysts** unique because of **autofluorescence**