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1
Q

Protozoa Categories

A

Intestinal
Blood and Tissue Apicomplexa
Flagellates
Free-Living

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2
Q

Helminths Categories

A

Nematodes (Roundworms)
Trematodes (Flukes)
Cestodes (Tapeworms)

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3
Q

Nematodes (roundworms) Categories

A

Intestinal
Tissue
Filarial

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4
Q

Cestodes (tapeworms) Catgories

A

Tissue

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5
Q

Intestinal Protozoa - species

A 
Giardia
Microsporidium
Cryptosporidium
Cyclospora
Cysytoisospora
D. fragilis
B. hominis
E. histolytica
E. dispar
B. coli
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6
Q

Blood and tissue Apicomplexa Protozoa - species

A

Palsmodium
Babesia
Toxoplasma

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7
Q

Flagellates (Protozoa) - Species

A

Leishmania
Trypanosoma
Trichomonas

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8
Q

Free-living (Protozoa) - species

A

Acanthamoeba
Balmuthia
Naeglaeria

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9
Q

Intestinal Nematodes (roundworms) - Species

A 
Ascaris lumbricoides (round)
Trichuris trichuria (whip)
Enterobius vermicularis (pin)
Ancylostoma duodenale (hook)
Necator americanus (hook)
Cappillaria philippinensis
Strongyloides stercoralis
Anisakis
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10
Q

Tissue Nematodes (roundworms) - Species

A 
Angiostrongylus (rat)
Gnathostoma
Dracunculus (guinea pig)
Trichinella (pig, bear)
Toxocara (cat, dog)
Bayliscaris (raccoon)
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11
Q

Filarial Nematodes (roundworms) - Species

A 
Wuchereria bancrofti
Brugia malayi
Loa loa
Onchocerca volulus
Mansonella
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12
Q

Trematodes (flukes) - Species

A

Schistosoma (skin)
Fasciola (sheep, watercress)
Clonorchis (fish, watercress)
Paragonimus (crabs, crayfish)

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13
Q

Tissue Cestodes (tapeworms) - Species

A 
Taenia solium (pig)
Taenia saginata (cow)
Diphyllobotherium latum (fish)
Hymenolopsis nana (arthropods)
Hymenolopsis diminuta (arthropods)
Echinococcus (dog, cat)
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14
Q

Suggested number of stools and time frame for O&P

A

3 stools over 10 days

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15
Q

Two stages of intestinal protozoa

A 
Trophozoite phase (active growing stage)
Cyst stage (dormant org)
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16
Q

E. histolytica/dispar troph characteristic morphologic features

A 
Size: 12-60um
Karyosome: Central, small, compact
Chromatin: Fine, granular, evenly distributed
Cytoplasm: Granular, with bacteria
Other: Look for RBCs=hitsolytica
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17
Q

E. hartmanni troph characteristic morphologic features

A

Looks like E. histolytica but smaller, 5-12um (E. hitso is 12-60um)

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18
Q

E. coli troph characteristic morphologic features

A

Size: 15-50um
Karyosome: Large, diffuse, eccentric
Chromatin: Clumpy, uneven
Cytoplasm: Vacuolated, with bacteria and yeast

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19
Q

Ioamoeba butschlii troph characteristic morphologic features

A

Size: 8-20um
Karyosome: klarge, “basket” shaped
Other: Nuclear halo

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20
Q

E. histolytica/dispar cyst characteristic morphologic features

A

Size: 10-20um
# Nuclei: 4
Chromatoid bodies: Rounded ends
Other: very refractile

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21
Q

E. coli cyst characteristic morphologic features

A

Size: 10-35um
# Nuclei: 8
Chromatoid bodies: Splintered ends
Other: distorted

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22
Q

Ioamoeba butschlii cyst characteristic morphologic features

A

Other: Glycogen vacuole

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23
Q

E. histolytica - Clinical presentation, incubation, Transmission

A

Clin: bloody diarrhea, asymptomatic, malaise
Incubation: 1 wk to months
trans: Ingestion of cysts from food/H2O, sexual transmission

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24
Q

B. coli - Clinical presentation, incubation, Transmission

A

Clin: Mild colitis, asympt, diarrhea, can be sim. to amoebic dysentery
Incubation: days to weeks
Transmission: Ingestions of cysts from food/H2O, pig reservoir

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25
G. lamblia - Clinical presentation, incubation, Transmission
Clin: Foul smelling diarrhea, mucous filled stool, no blood, abdominal pains, can be asympt Incubation: 10 days (1-4 weeks) Transmission: Ingestion of cysts from food/H2O
26
D. fragilis - Clinical presentation, incubation, Transmission
Clin: Asymptomatic Incubation: days to weeks Transmission: Ingestion of trophs (no cyst forms). Transmitted via helminth eggs
27
Cryptosporidium - Clinical presentation, Transmission/Onset, Treatment
Clin: Acute gastroenteritis Trans/Onset: 1 wk to months Treat: Self limiting
28
Cyclospora cayetanensis - Clinical presentation, Transmission/Onset, Treatment
Clin: Small intestine infection, low grade fever, malaise to GI symptoms Trans/Onset: Ingestion of oocyst from contaminated food/H2O. Oocysts RESISTANT to chlorine Treat: Trim/Sulfa
29
Cystoisospora belli - Clinical presentation, Transmission/Onset, Treatment
Clin: "Travelers diarrhea", severe in immunocomp. (extraintestinal) Trans/Onset: Ingestion of oocyst from raw/undercooked food Treat: trim/sulfa
30
Sarcocystis - Clinical presentation, Transmission/Onset, Treatment
Clin: Intestinal or muscular infection Trans/Onset: Ingestion of infected meat Treat: Supportive care
31
Modified Acid-Fast Positive Intestinal Protozoa
Cryptosporidium Cyclospora cayetanensis Cystoisospora belli Sarcocystis
32
Roundworm - Name and Clinical
Name: Ascaris lumbricoides Clinical: Worm burden, pneumonitis, small bowel obstruction, ectopic liver/pancreas
33
Roundworm - Lab Diagnosis
Eggs or worms in stool O&P
34
Roundworm - Transmission and Rx
Trans: Ingestion of emryonated eggs Rx: Mebendazole, Albendazole
35
Pin worm - Name and Clinical
Name: Enterobius vermicularis Clinical: Pruritus ani, weight loss, abd pain, ectopic genital tract
36
Pin worm - Lab Diagnosis
Eggs in stool, SCOTCH TAPE TEST
37
Pin worm - Transmission and Rx
Trans: Direct ingestion of eggs from perianal region Rx: Mebendazole, albendazole
38
Hookworm - Name and Clinical
Name: Necator americanus, Ancylostoma duodenale Clinical: Pruitic rash “ground itch” at site of entry, pneumonitis, intestinal
39
Hookworm - Lab Diagnosis
Eggs in stool, larvae rare but can hatch them from the eggs
40
Hookworm - Transmission and Rx
Trans: Direct skin penetration of active filariform larvae Rx: Mabendazole, albendazole, Iron supplement
41
Strogyloides - Name and Clinical
Name: Strongyloides stercoralis Clinical: “Larva currens” rash, pulmonary “loeffler’s syndrome”, intestinal, hyperinfection
42
Strongy - Lab Diagnosis
Larvae on stool, rarely eggs, Migration plate!, serology
43
Strongy - Transmission and Rx
Trans: Direct skin penetration of active filariform larvae Rx: Ivermectin
44
Whipworm - Name and Clinical
Name: Trichuris trichuria Clinical: Mild gastrointestinal symptoms, rectal prolapse
45
Whipworm - Lab diagnosis
Eggs in stool
46
Whipworm - Transmission and Rx
Trans: Ingestion of embyonated eggs Rx: Mabendazole, albendazole
47
How to differentiate Strongy from Hookworm?
Strongy has a short buccal cavity and a large genital promordium (short and sexy)
48
How to differentiate the species of Hookworm?
Must be larvae and compare mouths, also geography: Ancylostoma has teeth (old world) Necator has cutting plates (new world)
49
Faciolopsis buski - organ infected, geography, transmission
Site: Intestinal and liver Geo: Asia, India Trans: Pig
50
Fasciola hepatica - organ infected, geography, transmission
Site: Intestinal and liver Geo: Worldwide Trans: water plants
51
Clonorchis sinesis - organ infected, geography, transmission
Site: Liver Geo: Far east Trans: Freshwater fish
52
Opsithorchis species - organ infected, geography, transmission
Site: Liver Geo: Thailand, Europe Trans: Freshwater fish
53
Paragonimus westermani - organ infected, geography, transmission
Site: Lung Geo: Far east, Africa, South america Trans: Crabs, crayfish
54
Paragonimus kelcottii - organ infected, geography, transmission
Site: Lung Geo: Mid-west USA Trans: Crabs, crayfish
55
Schistosoma mansoni - organ infected, geography, transmission
Site: Veins (intestine) Geo: S. america, Caribbean, Africa, Middle East Trans: Skin penetration in water
56
Schistosoma japonicum - organ infected, geography, transmission
Site: Veins (intestine) Geo: Asia Trans: Skin penetration in water
57
Schistosoma haematobium - organ infected, geography, transmission
Site: Veins (bladder) Geo: Africa, Middleeast Trans: Skin penetration in water
58
Schistosoma intercalatum - organ infected, geography, transmission, features
Site: Veins (rectum) Geo: W. Africa Trans: Skin penetration in water Feat: longer terminal spine than S. haematobium
59
Schistosoma mekongi - organ infected, geography, transmission, features
Site: Veins Geo: Cambodia, Laos Trans: skin penetration, dog reservoir Features: no spine
60
Plasmodium species (5)
``` P. falciparum P. vivax P. ovale P. malariae P. knowlesi ```
61
Areas with choloroquine resistance in P. falciparum
Caribbean, Central america
62
P. falciparum - RBCs (age and size), Stages seen, features, schizonts/gametocytes, periodicity
``` RBCs: any, normal Stages: rings and gametocytes Feats: multiple rings, delicate chromatin, 2 dots (headphones), applique Schi/Gams: Banana shaped gametocyte Period: 36-48 hrs ```
63
P. vivax - RBCs (age and size), Stages seen, features, schizonts/gametocytes, periodicity
``` RBCs: young, bigger Stages: all Feats: Schuffner's dots, ameboid cells Schi/Gams: 12-24 schizonts Period: 48 hrs ```
64
P. ovale - RBCs (age and size), Stages seen, features, schizonts/gametocytes, periodicity
``` RBCs: young, normal to big Stages: all Feats: Schuffner's dots, fimbrionated cell edge Sci/Gams: 8-12 schizonts Period: 48 hrs ```
65
P. malariae - RBCs (age and size), Stages seen, features, schizonts/gametocytes, periodicity
``` RBCs: old, small to normal Stages: all Feats: banding troph form Schi/Gams: 6-12 in daisy head Period: 72 hrs ```
66
P. knowlesi - RBCs (age and size), Stages seen, features, schizonts/gametocytes, periodicity
``` RBCs: any, normal Stages: all Feats: multiple rings, 2 chromatin dots (headphones) Schi/Gams: 10-16 schizonts Period: 36-48 hrs ```
67
Plasmodium species with late liver stages and what that causes
P. vivax and P. ovale, causes relapse, need to treat for longer and with primiquine
68
Four clinical forms of leishmaniasis
Cutaneous, visceral, mucocutaneous, Disseminated
69
Diagnosis of leishmaniasis by stain and acceptable specimens
Geimsa stain, biopsy, blood, bone marrow
70
Features of Leishmania on stain, what it can be confused with
``` Intracellular organisms (amastigotes), can be confused with Histoplasma Look for KINETOPLAST ```
71
Media used to culture Lesihmania
Novy-MacNeal-Nicolle (NNN) medium
72
L. donovani - Disease and specimen type
Disease: all 4 Spec: bone marrow, spleen, skin and/or mucosal macrophage
73
L. infantum.chagasi - Disease and specimen type
Disease: visceral Spec: bone marrow, spleen
74
L. tropica - Disease and specimen type
Disease: cutaneous Spec: skin macrophage
75
L. major - Disease and specimen type
Disease: cutaneous Spec: skin macrophage
76
L. braziliensis - Disease and specimen type
Disease: cutaneous, mucocutaneous Spec: skin and/or mucosal macrophage
77
L. mexicana - Disease and specimen type
Disease: cutaneous, mucocutaneous, diffuse cutaneous Spec: skin macrophage
78
L. panamensis - Disease and specimen type
Disease: cuntaneous Spec: skin macrophage
79
Three Trypanosoma species
T. cruzi T. brucei rhodesiense T. bruci gambiense
80
T. cruzi - Disease, vector, geography
Dis: Chaga's disease Vect: Reduvid bug Geo: S. america
81
T. brucei rhodesiense - Disease, vector, geography
Dis: ACUTE, african sleeping sickness, myocarditis Vect: Tse Tse fly Geo: E. africa
82
T. brucei gambiense - Disease, vector, geography
Dis: CHRONIC, african sleeping sickness, CNS meningitis Vect: Tse Tse fly Geo: W. aftrica
83
Diagnosis of Trypanosomes and specimen types
Diagnosis: Serology (at CDC) or ELISA for blood donors, SMEAR Spec: Blood, CSF and chancre (T. brucei), lymph node aspirate, tissue
84
Lab diagnosis of Trichomonas vaginalis
Wet mount of vaginal secretions or urethral discharge, must see movement of trophs (distinguish from PMNs), pouch culture, waived rapid tests, PCR
85
What is the primary clinical presentation of infection with free living amoeba?
Primary amoebic meningoencephalitis
86
Lab diagnosis of infection with free living amoeba
Primarily clinical, PCR, EM, culture on to plate with E.coli lawn (see tracts as amoeba move and eat bacteria)
87
Brugia malayi - Disease, vector, periodicity
Dis: Elephantitis Vect: Mosquito (Mansonia and Aedes) Period: 9-10PM
88
Loa loa - Disease, vector, periodicity
Dis: Eye worm Vect: Deep fly Period: Midday
89
Wuchereria bancrofti - Disease, vector, periodicity
Dis: Elephantitis Vect: Mosquito (Culex, Anopheles, Ades, Mansoina) Period: 9-10PM
90
Onchocerca volvulus - Disease, vector, periodicity
Dis: River blindness Vect: Black fly No periodicity
91
Mansonella perstans - Disease, vector, periodicity, geography
Dis: Blood infection Vector: Midge No periodicity Geo: Africa, South America
92
Mansonella streptocerca - Disease, vector, periodicity, geography
Dis: Blood infection Vector: Midge No periodicity Geo: Africa
93
Mansonella ozzardi - Disease, vector, periodicity, geography
Dis: Blood infection Vector: Midge No periodicity Geo: South and Central America
94
Gnathostoma - definitive host, intermediate host, disease, Dx
Def host: Dogs, cats Int host: Cyclops Dis: visceral, creeping eruptions Dx: larvae on histopath
95
Angiostrongylus - definitive host, intermediate host, disease, Dx
Def host: Rodents Int host: Mollusks Dis: Meningitis, meningoencephilitis, eye infection Dx: CSF, eye fluid, worm ID, serology
96
Dirofilaria immitis (dog heartworm) - definitive host, intermediate host, disease, Dx
Def host: Dog Int host: Mosquito Dis: Asymptomatic, pulmonary Dx: Histopath
97
Capillaria - definitive host, intermediate host, disease, Dx
Def host: Fish-eating birds Int host: Fish Dis: GI Dx: Eggs in stool
98
Anisakis - definitive host, intermediate host, disease, Dx
Def host: Fish Int host: N/A Dis: GI Dx: endoscopy, radiography, surgery
99
Trichinella - definitive host, intermediate host, disease, Dx
Def host: Pig, bear, wild animals Int host: Pig, bear, wild animals Dis: GI, fever, edema, marked eosinophilia Dx: penetrating larvae in tissue, serology
100
Toxocara (dog/cat roundworm) - definitive host, intermediate host, disease, Dx
Def host: Dogs, cats Int host: N/A Dis: visceral and ocular larva migrans Dx: larvae in tissue, serology
101
Dracunculus medinensis (guinea worm) - definitive host, intermediate host, disease, Dx
Def host: Copopods in water Int host: N/A Dis: Tissue damage by worm migration, blister formation Dx: Worm protruding from blister
102
Baylisascaris (racoon roundworm) - definitive host, intermediate host, disease, Dx
Def host: Racoon Int host: Dis: Meningitis Dx: biopsy (poor), serology at CDC
103
Ancylostoma ( dog/cat hookworm) - definitive host, intermediate host, disease, Dx
Def host: Gods, cats Int host: Dis: cutaneous larva migrans Dx: eggs in stool
104
Taenia saginata - Intermediate host, life span, worm length, proglottid morphology
Int host: Cow Life span: 25 yrs Length: 4-12 m Proglots: 15-20 lateral branches
105
Taenia solium - Intermediate host, life span, worm length, proglottid morphology
Int host: Pig Life span: 25 yrs Length: 1.5-8 m Proglots: 7-13 lateral branches
106
Diphyllobothrium latum - Intermediate host, life span, worm length, proglottid morphology
Int host: Fish, copopods Life span: 25 yrs Length: 4-10 m Proglots: width greater than length, rosette shaped central uterus
107
Hymenolepsis nana - Intermediate host, life span, worm length, proglottid morphology
Int host: Arthropods Life span: multiple years Length: 2.5-4 cm Proglots: rare, Dx eggs in stool
108
Hymenolepsis diminuta - Intermediate host, life span, worm length, proglottid morphology
Int host: Arthropods Life span: <1 yr Length: 20-60 cm Proglots: rare, Dx eggs in stool
109
Echinococcus granulosis - Types of disease
Cystic disease, hydatid disease
110
Echinococcus multilocularis - Types of disease
Alveolar disease, hydatid diease
111
What is the major clinical concern for patients suspected of having Echinococcus?
Anaphylactic shock or dissemination
112
Parasites that do NOT cause eosinophilia?
Leishmania Plasmodium Trypansosoma
113
Amblyomma americanum (Lone Star Tick) vector - pathogens and diseases
E. chaffeensis and E. ewingii (Erlichiosis) F. tularensis (Tularemia) Unknown (STARI)
114
Ornithodoros (Soft Ticks) vector - pathogens and diseases
Borrelia species (Endemic relapsing fever)
115
Ixodes scapularis (Deer Tick) vector - pathogens and diseases
B. microti (Babesia) B. burgdorferi (Lyme) A. phagocytophilum (Anaplasmosis) Powassan virus (Powassan disease)
116
Dermacentor variabilis (American Dog Tick) vector - pathogens and diseases
F. tularensis (Tularemia) | R. rickettsii (RMSF)
117
Lice vector - pathogens and diseases
``` R. prowazekii (Epidemic typhus) R. quintana (Trench fever) Borellia recurrentis (Epidemic relapsing fever) ```
118
Flea vector - pathogens and diseases
Y. pestis (Plague) | R. typhi (Murine/Endemic typhus)
119
Anopheles vector - pathogens and diseases
Plasmodium sp. (Malaria)
120
Aedes vector - pathogens and diseases
Flaviviruses (Dengue, Yellow fever)
121
Mosquito vector - pathogens and diseases
Brugia, Wucheria (Filariasis)
122
Midge vector - pathogens and diseases
Mansonella (Filariasis)
123
Tse tse fly vector - pathogens and diseases
Trypansosoma brucei (African Sleeping Sickness)
124
Black fly vector - pathogens and diseases
Onchocerca volvulus (Onchocerciasis)
125
Deer fly vector - pathogens and diseases
Loa loa (filariasis, eye worm)
126
Fly vector - pathogens and diseases
F. tularensis (Tuleremia)
127
Sandfly vector - pathogens and diseases
Leishmania sp (Leishmaniasis)
128
Reduvid bug vector - pathogens and diseases
Trypanosoma cruzi (Chaga's disease)
129
Parasites identified in erythrocytes
Plasmodium | Babesia
130
Parasites identified in leukocytes
Leishmania | Toxoplasma
131
Parasites identified in whole blood
Trypanosomes | Microfilariae
132
Parasites identified in bone marrow
Leishmania Plasmodium Microfilariae
133
Parasites identified in CNS
``` T. solium Echinococcus Naeglaria Achanthamoeba Balmuthia Toxoplasma Trypanosoma Microsporidia ```
134
Parasites identified in cutaneous ulcers
Leishmania | Acanthamoeba
135
Parasites identified in the GI tract
``` Entamoeba B. hominis Giardia D. fragilis B. coli Cryptosporidium Cyclospora Cystoisospera Ascaria E. vermicularis T. trichuria Hookworm S. stercoralis H. nana/diminuta Clonorchis Paragonimus Schistosoma ```
136
Parasites identified in liver/spleen
Echinococcus E. histolytica Leishmania
137
Parasites identified in lungs
``` Cryptosporidium Echinococcus Paragonimus Toxoplasma Helminth larvae S. stercoralis ```
138
Parasites identified in muscle
Trichinella T. solium Onchocerca T. cruzi
139
Parasites identified in urogenital specimens
S. haematobium T. vaginalis Microfilariae Microsporidia
140
Parasites identified in skin
Onchocerca Leishmania Microfilariae
141
Parasites identified in ocular specimens
Acanthamoeba Toxoplasma Loa loa
142
Parasites treated with Metronidazole
E. histolytica | Giradia lamblia
143
Parasites treated with Albendazole
``` Ancylostoma Ascaris E. vermicularis Gnathostoma Hookworm Trichostrongylus Taenia Echinococcus Filariasis Microsporidium ```
144
Parasites treated with Mebendazole
Angiostrongylus Capillaria Trichinella T. trichuria
145
Parasites treated with Ivermectin
S. stercoralis | Onchocerca
146
Parasites treated with Praziquantel
Cestodes | Trematodes (not F. hepatica)
147
Parasites treated with Chloroquine
Plasmodium
148
Parasites treated with Tetracycline
B. coli | D. fragilis
149
Parasites treated with Trim/Sulfa
Cyclospora | Cystoisospora
150
Parasites treated with Ampho B
Amebic meningoencephalitis
151
Parasites treated with Pentavalent animonial
Leishmania
152
Parasites treated with Clindamycin
Babesia (plus quinine)
153
Parasites treated with Niturtimox
T. cruzi
154
Parasites treated with Suramin
African trypanosoma

Parasites (4 decks)

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