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USMLE Step 2 > Infectious Disease: Protozoal Infections > Flashcards

Infectious Disease: Protozoal Infections Flashcards

(80 cards)

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1
Q

What are Protozoa

A

Parasitic, Unicellular, mobile organisms

Exist in different stages

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2
Q

What are the different stages of Protozoa

A

Trophozoites

Cysts

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3
Q

Describe Trophozoites

A

Motile, feeding, reproducing

Vulnerable to environment

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4
Q

Describe Cysts

A

More durable

Often in feces, water and lead to infection

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5
Q

Where is Giardia Lamblia (Giardiasis) commonly found

A

Cysts in moist environment
-water from mountain stream

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6
Q

What part of the GI tract does Giardiasis affect

A

Small intestine

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7
Q

How does Giardiasis present

A

Steatorrhea
bloating, foul smelling, fatty diarrhea

stools float

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8
Q

What immunodeficiency is associated with Giardiasis

A

IgA Deficiency
-selective
-Bruton’s agammaglobulinemia

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9
Q

How do you diagnose Giardiasis

A

Stool ova and parasites
-cysts and trophozoites in stool
-ELISA for Ag in stool

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10
Q

How do you treat Giardiasis

A

Metronidazole

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11
Q

What is a classic case of Giardiasis look like

A

Camper/hiker
diarrhea
flatulence

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12
Q

What is another name for Entamoeba Histolytica

A

Amebiasis/Amebic Dysentery

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13
Q

Where is Entamoeba Histolytica common

A

Regions with poor sanitation
-cysts in contaminated water

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14
Q

What form does Entamoeba Histolytica take in the small intestine

A

Trophozoites

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15
Q

How does Entamoeba Histolytica cause disease

A

Trophozoites invade tissue causing bloody diarrhea

ascends the portal system to cause liver abscesses

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16
Q

How does Entamoeba Histolytica classically present

A

Traveler

Bloody Diarrhea

RUQ pain

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17
Q

How do you diagnose Entamoeba Histolytica

A

Stool ova and parasites
-cysts
-trophozoites

Ag/Ab testing
-stool
-blood

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18
Q

What are the treatment options for Entamoeba Histolytica

A

Metronidazole

Luminal Agents

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19
Q

What is the role of metronidazole in Entamoeba Histolytica

A

Treat invasive diarrhea

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20
Q

What is an alternative for Metronidazole in Entamoeba Histolytica

A

Tinidazole

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21
Q

What is the role of luminal agents in Entamoeba Histolytica

A

Eliminate cysts to prevent transmission

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22
Q

What luminal agent is commonly used for Entamoeba Histolytica

A

Paromomycin

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23
Q

Where is Cryptosporidiosis found

A

Contaminated water

Swimming pools

May infect horses or cattle

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24
Q

How does Cryptosporidiois present in immunocompetent patients

A

Self-limited

mild, watery diarrhea

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25
How does Cryptosporidiosis present in immunocompromised patients
Chronic, severe watery diarrhea
26
How to diagnose Cryptosporidiosis
Stool Microscopy -acid fast oocysts stool Ag test
27
What are the treatment options for Cryptosporidiosis
Supportive measures Nitazoxanide ART for HIV patients Prevention is key
28
What patient population is Nitazxanide used for in Cryptosporidioisis
Severe symptoms in Immunocompetent patients
29
Where is Toxoplasmosis Commonly found
cats shed oocysts in stool infected meat from animals
30
What happens once Toxoplasmosis is ingested
Invades intestines and disseminates Latent phase in brain or muscle May reactivate later
31
What are the clinical features of Toxoplasmosis
Most are asymptomatic Mono-like illness Congenital Toxoplasmosis
32
How does the mono-like illness of Toxoplasmosis present
Fever Cervical Lymphadenopathy (-) Heterophile Ab
33
How does Congenital Toxoplasmosis present
Fetal Chorioretinitis -blindness Intracranial calcification
34
What patient populations has a severe reactivation disease from Toxoplasmosis
Immunocompromised
35
How does toxoplasmosis reactivation present
Fever,Headache Confusion Neurologic Defects Multiple ring-enhancing lesions with edema
36
What are the ring-enhancing lesions in HIV
Toxoplasmosis Primary CNS Lymphoma
37
What CD4 count is associated with Toxoplasmosis reactivation
<100
38
How to diagnose Toxoplasmosis in patients with HIV
Clinical findings Image with ring-enhancing lesions (+) IgG Ab
39
How to diagnose Toxoplasmosis in Immunocompetent patients
IgM and IgG Ab IgM indicates recent exposure
40
What is the method of definitive diagnosis for Toxoplasmosis
Brain Biopsy
41
How do you treat Toxoplasmosis in an immunocompetent patient
Usually no treatment
42
How do you treat Toxoplasmosis in and HIV patient
Sulfadiazine and Pyrimethamine -block folate synthesis pathway
43
Where is Naegleria Fowleri found
Freshwater lakes/ponds
44
What does Naegleria Fowleri Cause
Meningoencephalitis
45
How does Naegleria Fowleri cause infection
Contaminated water enters the nose to the cribiform plate
46
How does Naegleria Fowleri classically present
Recent swimming Fever, confusion, stiff neck CSF (-) for bacteria/virus Motile trophozoites in CSF often fatal
47
What causes Chagas Disease
Trypanosoma Cruzi
48
How is Chagas disease spread
Reduviid bug bite
49
Where is Chagas disease primarily found
Central and South America
50
How does the acute phase of Chagas Disease present
Fever, Lymphadenopathy Chagoma Romana Sign resolves over 2 months
51
What is the Romana sign
U/L Eyelid Edema seen in Chagas Disease
52
What does Chronic Chagas Disease involve
Heart Esophagus Colon
53
What organ is most commonly involved in Chronic Chagas Disease
The Heart
54
What effects does Chronic Chagas disease cause in the heart
RHF, LHF Ventricular Thrombi PE/Stroke
55
What effect does Chronic Chagas Disease have on the Esophagus and Colon
Nerve damage Dilation -achalasia -megaesopagus megacolon -severe constipation
56
How do you diagnose acute Chagas Disease
Blood smear -Trypomastigotes visible PCR testing
57
How do you diagnose Chronic Chagas Disease
Serology: IgG
58
Is acute or chronic Chagas more treatable
Acute
59
What are the treatment options for Chagas Disease
Nifurtimox or Benznidazole
60
What causes African Trypanosomiasis
Trypanosoma Brucei -T. Gambiense -T. Rhodesience
61
How is African Trypanosomiasis Spread
Tsetse Fly bite
62
What region is African Trypanosomiasis endemic to
Africa
63
What does African Trypanosomiasis cause
Sleeping sickness
64
What is the key feature of African Trypanosomiasis
Recurring fever
65
What are the common clinical features of African Trypanosomiasis
Indurated skin ulcer Cervical Lymphadenopathy Recurring fever
66
How does African Trypanosomiasis from T. Gambiense present
Low-grade chronic illness for years
67
How does African Trypanosomiasis from T. Rhodesience present
Acute, rapidly-progressive illness
68
How do you diagnose African Trypanosomiasis
Peripheral blood Trypomastigotes -also in chancre/nodes
69
What is the Early stage treatment for African Trypanosomiasis
Suramin -does not cross BBB
70
What complication can African Trypanosomiasis cause
Encephalitis
71
How do you treat Encephalitis caused by African Trypanosomiasis
Melarsoprol
72
What causes Visceral Leishmaniasis
Leishmania Donovani
73
How is Visceral Leishmaniasis spread
Sand fly
74
What area is Visceral Leishmaniasis endemic to
South Asia -India -Bangladesh -Nepal East Africa
75
What cell type does Visceral Leishmaniasis infect
Macrophages -spleen -liver -bone marrow
76
How does Visceral Leishmaniasis Present
Fever Painful Splenomegaly Pancytopenia Skin may darken -Kala-azar "Black fever"
77
How do you diagnose Visceral Leishmaniasis
Biopsy involved organs -amastigotes in macrophages -small, round or oval bodies
78
How do you treat Visceral Leishmaniasis
Amphotericin B Sodium Stibogluconate
79
How does Cutaneous Leishmaniasis Present
Large ulcer with indurated borders
80
How is cutaneous Leishmaniasis Treated
Topical Stibogluconate or Paromomycin

USMLE Step 2 (40 decks)

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