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Clin Med > ID: Parasitic infections > Flashcards

ID: Parasitic infections Flashcards

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1
Q

list the 3 types of parasites

A
  1. single celled–protozoa
  2. multi celled–worms
  3. Ectoparasites–aka arthropods–scabies and lice
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2
Q

roundwords or?

A

nematodes

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3
Q

flatsworms or?

A

Platyhelminthes

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4
Q

list the subcategories of flatworms

A

tapeworms (cestodes)

flukes (trematodes)

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5
Q

diseases caused by Protozoa (5)

A 
Giardia 
Trich
malaria 
chagas dz 
african sleeping sickness
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6
Q

dz caused by arthropods (4)

A

lice
scabies
mites
fleas

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7
Q

trophozoite

A

protozoa life cycle

  • motile feeding reproducing form
  • surrounded by flexible cell membrane and a cyst–non-motile
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8
Q

cyst of a trophozoite

A

nonmotile, nonmetabolizing, nonreproducing form surrounded by a thick wall
*survives well in the environment and is often invovled in tramssion

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9
Q

list flaglated protoza

A

Leishmania

Trypanosoma

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10
Q

what is commonly associated with helminth infections

A

eosinophilia

aka elevated eosinophil counts

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11
Q

what caues malaria

transmision

A

unicelled parasite–>plasmodium

transmission=mosquitoe bite from the Anopheles genus

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12
Q

what is the MC and most lethal species of the Plasmodium genus

A

Plasmodium falciparum–malaria

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13
Q

Malaria

  • etiology
  • MC where
  • what organ is attacked first and then?
  • CM
  • what happens if untx
A

PLASMODIUM genus
***MC is the Falciparum and most dangerous:

**tropical dz
Liver is attacked first—then RBCs–>lysis

CM

  1. Cyclical fever– cold stage–>hot stage/high fever–>diaphoretic/drenching sweats stage fever is every third day*
    * HA
    * fatigue
    * mylagias
    * N/V/GI s/s
    * splenomealy MC
    * hepatomegaly in 1/3 of PT
    * anemia

untx:
* extensive brain and kidney damage
* *cerebral malaria-AMS, delirium, seicures, coma
* *blackwater fever=kidney

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14
Q

what disease can partialy protect against malaria

A

sickle cell

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15
Q

CM for blackwater fever malaria

A

KIDNEY DAMAGE

  • severe hemolysis
  • hemoglobinuria
  • renal failure
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16
Q

how does malaria relapse

A

the P. vivax and P. ovale species can cause the relapsing due to the hypnozoites latent in the liver
***can cause malaria years later

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17
Q

how to diagnose malaria

A
  1. clinical– fever + recent travel to tropics
  2. Giemsa-stained blood smear: thick and thin
    * THICK=detects precense of organisms
    * THIN=used for species ID
    * **species ID is imp bc of tx
  3. LABS: CBC will show
    * leukopenia
    * hemolytic anemia
    * thrombocytopenia
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18
Q

first line tx for uncomplicated P. falciparum malaria

  • alternative?
  • add on agent to kill latent species to prevent recurrence
A

Chloroquine

Hydroxychloroquine is alternative

Add on: Primaquine

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19
Q

TX for chloroquine-resistant P. Falciparum

1st and 2nd line

A

first line: Atovaquone/Proguanil or Artemisinin combination therapy

second: doxycycline, tetracycine, or clindamycin PLUS quinine sulfate

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20
Q

life threatening malaria infection tx

A

IV quinidine gluconate

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21
Q

prophylaxis for malaria if traveling

-sensitive and non resistant areas

A

Chloroquine for the chloroquine sensitive areas

chloroquine resistant areas: doxycycline, mefloquine or atovaquone-proguanil

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22
Q

what day of malaria infection does PT develop splenomegaly

A

4th day

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23
Q

what causes Chagas Dz

Study These Flashcards
A

Trypanosoma cruzi

24
Q

vector for chagas dz

Study These Flashcards
A

reduviid bug— kissing bug

bc it most commonly bites humans around the mouth or eyes

25
what cells are MC affected by Trypanosoma cruzi
myocardial glial reticuloendothelial cells
26
complications from Trypanosoma cruzi or chagas DZ
dilated cardiomyopathy | GI ddz
27
what is the leadig cause of CHF in latin america
Trypanosoma cruzi or chagas DZ
28
CM for Chagas DZ
Acute phase: *facial edema and a nodule near bite *bite around the eye-->unilateral palpebral swelling-->ROMANAS SIGN +fever +lymphadenopathy +hepatosplenomegaly Chronic: not everyone develops this form * CARDIAC-->dilated cardiomyopathy, CHF, arrythmias (MCC of death) * GI= 1. megacolon---constipation, colicky abd pain, bloating 2. megaesophagus--dysphagia and regurg of food * CNS=destruction of glial cells
29
Diagnosis for Chagas DZ-- each phase
Acute phase-->peripheral blood smear will show trypomastigotes-- flagellated chronic phase 1. ELISA 2. EKG 3. ECHO
30
TX for chagas dz
acute phase or PT without significant cardiac or GI disease: *****benznidazole or Nifurtimox for 90-120 days No treatment for chronic form with signiicant cardiac or GI dz
31
what causes african sleeping disese
Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense
32
vector for african sleeping dz
Tsetse fly
33
Trypanosoma brucei hambiense causes? | -severity of dz
african sleeping sickness along water courses in WEST africa -chronic course over several years
34
Trypanosoma brucei rhodesiense
causes afican sleeping sickness along arid regions of EAST africa -acute, rapidly progressive dz
35
CM for african sleeping sickness
EARLY STAGE--hemolytic stage * painless chancre at the bite site 2-3 days after bite * intermittent fever, malaise, HA, joint pain, itching * generalized or regional lymphadenopathy-- usually LARGE-- MC cervical LNs--> Winterbottom's sign LATE STAGE--CNS stage * encephalitis: HA, insomnia, mood changes * muscle tremors * slurred speech * day-time somnolence and coma
36
what causes the sleepiness in african sleeping sickness
tryptophol realsed by the dz
37
how to diagnose african sleeping sickenss- both stages
EARLY * blood smears or aspirate from enlarged LN * ELISA LATE *presence of trypanosomes
38
TX for african sleeping sicness | -both strains
Trypanosoma brucei gambiense * early=Pentamidine * late=Eflornithine and Nifurtimox Trypanosoma brucei rhodesiense * early= Suramin * late=Melarsoprol +/- Nifurtimox
39
toxoplasmosis is caused by
toxoplasma gondii
40
toxoplasmosis - cm - diagnosis - tx-pregnant and not pregnant
primary infection: usually asympto for immunocompetent adults -some can resemble mononucleosis Reactivation - **encephalitis--MC in AIDS pt with CD4<100 - **Chorioretinitis: posterior uveitis, eye pain and decreased visual acuity - pneumonitis: fever, dyspnea, nonproductive cough-- similar to PCP pneumonia diagnosis: 1. microscopic examination of Giemsa-stain--- crescent shaped trophozoites during acute infections 2. immunofluorescence assay/ELISA-->anti-toxoplasma IgG antibody 3. MRI-->multiple ring enhancing lesions tx: 1. Sulfadiazine or clindamycin PLUS Pyrimethamine * *add folic acid/leucovorin to prevent depletion 2. if pregnant: spiramycin Prophylaxis: for PT with CD4 <100 1. Trimethoprim-sulfamethoaxazole (Bactrim DS) 2. Alternative: Dapson + Pyrimethamine & Leucovorin
41
when can mother transmit toxoplasmosis to fetus?
if mother is newly infected DURING pregnancy
42
triad for CM in congential toxoplasmosis
1. chorioretinitis--inflammation of choroid in eye 2. encephalitis/hydrocephalus 3. intracranial calcifications
43
diagnosis for congenital toxoplasmosis
ELISA for anti-toxoplasma IgM antiboies
44
which antibodies do we test for: 1. non congential toxoplasmosis 2. congential toxoplasmosis
non congential--> anti-toxoplasma IgG congential--> anti-toxoplasma IgM
45
three main groups of helminths
nematodes cestodes trematodes
46
types of nematodes
roundworms pinworms hookworms whipworms
47
types of cestodes
beef, pork and fish tapeworms
48
types of trematodes
flukes--- each one is IDed whre in the body it is located
49
Roundworms | -name ?
Ascariasis--GIANT roundworm infection
50
Ascariasis - caused by? - transmission - CM - can lead to? - diagnosis - tx: preg and not preg
Ascaris Lumbricoides soil transmission CM: depends on worm load 1. small load: asympto 2. larger load: vague abd s/s: anorexia, nausea, vomiting, abdominal discomfort 3. HIGH load: intestinal obstruction--MC, hepatic or biliary manifestations * **can cause Ascaris pneumonia*** diagnosis: stool O/P +eosinophilia TX: 1. albendazole or Mebendazole 2. pregnant: pyrantel (only after 1st trimester)
51
which is the largest intestinal nematodes as adults?
ascariasis
52
two species of nematode worms associated with? - transmission and the cycle - can cause?
hookworm infection 1. Necator americanus--US and australia 2. Ancylostoma doudenale-- transmission= eggs deevlop into larvae in soil contaminated with dog or cat feces--penetrate skin--travel through venous circulation---lungs--coughed up---swallowed--enter intestines---dev into mature adults--attach to the blood vessels and can cause anemia
53
cm of hookworm infection diagnosis hookworkm -tx?
phase 1 (skin)--very pruritic erythematous maculopapular dermatitis (feet and ankles MC)--- resolves few days phase 2 (transpulmonary)-->MC asympto pahse 3 (GI): N/V/D ``` phase 4 (anemia): blood los at the site of attachment in the small intestine *****major impact of hookworm infection ``` Diagnosis: 1. CBC: hypochromatic microcytic anemia 2. Eosinophilia: increased IgE 3. stool guaiac: + 4. Stool O/P: eggs in stool TX: 1. ***Albendazole or Mebendazole or Pyranetel 2. iron supplements and vitamins
54
what is the major impact of hookworm infection
anemia
55
Enterobius vermiclaris - pathogen? - occurs in? - MC IN? - diganosis - tx - preg tx
*pinworms only occurs in humans-- no animal resvoir or vector**** transmission: fecal-oral with contaminated fomites MC in: school age kids 5-10YO CM: 1. perianal itching--esp at night (bc eggs are laid at night) 2. severe cases: abdominal pain, nausea, vom Diagnosis: 1. cellophane tape test or pinworm paddle test---early in Am to look for eggs under a micrscope 2. O/P---- will NOT show eggs but the adult worms TX: 1. Albendazole, Mebendazole or Pyrantel--only kill adult worms in COLON and not the eggs-- so re-treatment is needed x2 weeks 2. pregnant-- Pyrantel

Clin Med (52 decks)

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