MEDICAL PARASITOLOGY: PROTOZOANS – AMEBA, FLAGELLATES, CILIATES AND APICOMPLEXANS Flashcards
(422 cards)
1
Q
o Kingdom Protista
o Unicellular organisms that possess 2 nucleus/nuclei, cytoplasm, limiting membrane, and organelles
o Eukaryotic
o Cytoplasm has 2 region
o Do not possess a cell wall
o Possess locomotory structures
o Manner of reproduction:
- Sexual
- Asexual
- both
A
Protozoan
2
Q
What are the 2 regions of cytoplasm of protozoans?
A
- Endoplasm
- Ectoplasm
3
Q
- Inner region
- for nutrition, food synthesis and storage (metabolism)
A
Endoplasm
4
Q
- Outer region
- for protection, ingestion, and organelles for locomotion
A
Ectoplasm
5
Q
What are the locomotory structures?
A
- Pseudopodia (Falsely locomotion)
- cilia
- flagella
6
Q
What protozoans that does not have locomotor structures?
A
Apicomplexa (malaria)
7
Q
What protozoans that does have complicated life cycle because they undergo both sexual and asexual manner of reproduction?
A
Apicomplexa (malaria)
8
Q
What are the manner of reproduction?
A
- Sexual
- Asexual
- both
9
Q
locomotion for SUBPHYLUM SARCODINA: Ameba
A
pseudopodia
10
Q
SUBPHYLUM SARCODINA: Ameba Inhabit in the large intestine except
A
Entamoeba gingivalis
11
Q
all SUBPHYLUM SARCODINA: Ameba undergo encystation except
A
Entamoeba gingivalis
12
Q
This process where trophozoites would transform to become cyst
A
Encystation
13
Q
The Mode of reproduction of SUBPHYLUM SARCODINA: Ameba
A
Asexual
14
Q
- found in oral cavity/mouth
- no cyst stage
- Infective stage: trophozoite stage
A
o Entamoeba gingivalis
15
Q
It is in the edge of the nucleus of entamoeba
A
peripheral chromatin
16
Q
It is used to differentiate the members of entamoeba
A
Peripheral chromatin
17
Q
the Infective stage of SUBPHYLUM SARCODINA: Ameba is the cyst except
A
Entamoeba gingivalis
18
Q
All are commensals/nonpathogenic except
A
Entamoeba hystolytica
19
Q
Vegetative stage, Motile and Feeding stage of intestinal ameba
A
Trophozoite
20
Q
Non-motile and Resistant stage of intestinal ameba
A
Cyst
21
Q
Stool consistency of the intestinal ameba trophozoite
A
watery/diarrheic stool
22
Q
Stool consistency of the intestinal ameba cyst
A
formed stool
23
Q
Stain/s that can be added in wet mount to identify the intestinal ameba trophozoite
A
- Quensel’s Stain
- Buffered Methylene Blue
24
Q
Stain/s that can be added in wet mount to identify the intestinal ameba cyst
A
- Lugol’s Iodine
- D’ Antoni
25
the only pathogenic member ameba
Entamoeba histolytica
26
Final host of E. coli and E. histolytica
man
27
Mode of transmission of E. coli and E. histolytica
Ingestion of cyst
28
habitat of E. coli and E. histolytica
Large Intestine
29
usual size of E. coli trophozoite
20-25 um
30
usual size of E. histolytica trophozoite
15-20 um
31
movement of E. coli trophozoite
Non-progressive; sluggish
32
movement of E. histolytica trophozoite
Progressive; Unidirectional movement
33
describe the pseudopodia of E. histolytica trophozoite
Finger-like; hyaline
34
describe the pseudopodia of E. coli trophozoite
Blunt; granular
35
no. of nucleus of E.coli trophozoite and E. histolytica trophozoite
1
36
describe the peripheral chromatin of E. coli trophozoite
Coarse, Rough, Uneven (CRU)
37
describe the peripheral chromatin of E. histolytica trophozoite
Fine, Smooth, Even (FES)
38
Karyosome is composed of
RNA
39
describe the karyosome of E. histolytica trophozoite
Centrally located; small
40
describe the karyosome of E. coli trophozoite
Eccentric; Large
41
Diagnostic/distinguising characteristics of E. coli trophozoite
- Ingested debris, bacteria, yeast
- Dirty looking
42
Diagnostic/distinguising characteristics of E. histolytica trophozoite
- Clean looking
- Ingested RBC
43
Usual size of E. histolytica cyst
12-15 um
44
Usual size of E. coli cyst
15-25 um
45
No. of nuclei of E. histolytica cyst
Up to 4 nuclei;
- quadrinucleate (mature form)
46
No. of nuclei of E. coli cyst
Up to 8 nuclei
47
describe the karyosome of E. coli cyst
Eccentric
48
describe the karyosome of E. histolytica cyst
Centrally located
49
It is the energy source Made up of RNA (crystalline RNA)
Chromotoidal bar
50
describe the Chromotoidal bar of E. histolytica cyst
Cigar/sausage shape
51
describe the Chromotoidal bar of E. coli cyst
Splintered/broom stick appearance
52
What are the other inclusion of E. coli cyst and E. histolytica cyst
Glycogen vacuoles
53
2 amoebas that commonly encountered in stool specimens
- Entamoeba histolytica
- Entamoeba coli
54
Non-pathogenic ameba that are morphologically similar to Entamoeba histolytica (same in the appearance and size)
* Entamoeba dispar
* Entamoeba moshkovskii – also known as Laredo strain
* Entamoeba bangladeshi
55
E. histolytica and the other 3 non-pathogenic ameba that are morphologically similar can be differentiated through
- molecular methods
- zymodeme analysis
- isoenzyme analysis
56
90% of Entamoeba histolytica infections are ______
asymptomatic
57
10% of Entamoeba histolytica infections are ______
Symptomatic
58
What disease if the stool is:
- watery, mucoid
- Presence of trophozoites
- Fishy odor
- Few Bacilli (few bacteria)
Amebic dysentery: Bloody diarrhea
59
Identify the disease if the stool is:
- watery, mucoid
- Presence of trophozoites
- Fishy odor
- Many Bacilli (many bacteria)
- and caused by Shigella
bacillary dysentery
60
disease manifestation of E. histolytica
- Amebic dysentery: Bloody diarrhea
- Formation of flask shaped ulcers
- Colitis (fulminant colitis)
- Amebomas
61
manifestation of disease in E. histolytica mistaken for carcinomas (mass like lesions with abdominal pain)
Amebomas
62
The most common site of Extraintestinal amebiasis
Liver
63
Extraintestinal amebiasis can infect and destroy the liver causing
Amebic Liver Abscess (ALA)
64
Other organs affected by Extraintestinal amebiasis: (result to abscess formation)
- Brain
- Lungs
65
What are the Virulence factors of E. histolytica
- GalNac Lectin
- Amebapore
- Cysteine Proteinases
66
Virulence factor of E. histolytica that causes attachment to the target cells
GalNac Lectin
67
Virulence factor of E. histolytica that causes formation of holes/pores
Amebapore
68
Virulence factor of E. histolytica that causes spread of the parasite; tissue destruction
Cysteine Proteinases
69
Stool examination used to diagnose the movement of E. histolytica
DFS (Direct Fecal Smear)
70
Concentration Techniques used to recovers cystic stages of E. histolytica
Formalin Ether Concentration Technique (FECT)
71
Stool examination used for Confirmation of Intestinal Protozoans
Permanent Stained Smear
72
stool adhesive used in Permanent Stained Smear
Polyvinyl alcohol
72
Fixative used in Permanent Stained Smear
Schaudinn’s
73
classic stain used for better nuclear detail in Permanent Stained Smear
Iron hematoxylin
74
Stains that are used in Permanent Stained Smear
- Iron hematoxylin
- Trichrome stain
75
Culture media used for lab diagnosis of E. histolytica
- Boeck’s
- Rice Egg Saline
- Diamond
- Balamuth’s Egg Yolk Infusion
- Robinson’s and Inoki
76
Recommended culture media for lab diagnosis of E. histolytica
Robinson’s and Inoki
▪ More sensitive than microscopy
▪ Not routinely used
77
Anchovy sauce like
Liver Aspirates
78
Treatment forMetronidazole E. histolytica
- Metronidazole
- Iodoquinol
- Diloxanide Furoate
79
treatment used for invasive amebiasis
Metronidazole
80
treatment used for asymptomatic cyst carriers
Diloxanide Furoate
81
small race of E. histolytica
Entamoeba hartmanni cyst
- Similar to Entamoeba histolytica but smaller in
size
82
Movement of Entamoeba hartmanni trophozoite
sluggish; non-progressive
83
* Nucleus: 1
* Central karyosome with evenly distributed peripheral chromatin
* Movement: progressive; unidirectional
o Can be acquired by a person who has direct contact with pigs and monkeys, working in a pig farm
Entamoeba polecki trophozoite
84
* Nucleus: 1
* Karyosome: Central with evenly distributed peripheral chromatin
* Chromotoidal bars –angular or pointed ends
* Presence of glycogen mass
Entamoeba polecki cyst
85
morphologically similar to E. polecki
E. chattoni
86
* Nucleus: 1
o Large eccentric karyosome is surrounded by achromatic granules
o No peripheral chromatin
* Large glycogen vacuole
Iodamoeba butschlii cyst
87
Describe the karyosome of Iodamoeba butschlii cyst
“Basket of Flowers appearance”
88
* Nucleus: 1
o Central karyosome surrounded by refractile, achromatic granules
o No peripheral chromatin
* The cytoplasm is coarsely granular, vacuolated
- amoeba of pigs
Iodamoeba butschlii trophozoite
89
Movement of Iodamoeba butschlii trophozoite
sluggish and non-progressive
90
* Oval
* Nucleus: 2-4
* Blot-like karyosome
* Eccentric; prominent; cross eyed cyst
* No peripheral
Endolimax nana cyst
91
* Nucleus: 1
* Blot-like karyosome; no peripheral chromatin (crosseyes cyst)
- very small ameba/protozoan
Endolimax nana trophozoite
92
Movement of Endolimax nana trophozoite
sluggish
93
* Nucleus: 1
* Centrally located karyosome
* Pseudopod: varying appearance
* May ingest bacteria, debris and WBC
* Non-pathogenic: may be seen in patients with pyorrhea alveolaris
Entamoeba gingivalis trophozoite
94
Parasite that has no cyst stage
Entamoeba gingivalis
95
Gums infection caused Entamoeba gingivalis
pyorrhea alveolaris
96
Parasite found in the environment inhabiting lakes,
pools, tap water, air conditioning units and heating units
Opportunistic Amebae/Free-living pathogenic ameba/Facultative parasite
97
Facultative parasite usually invade ____ if ever they become parasitic
CNS
98
3 commonly Opportunistic amebae
- Naegleria fowleri,
- Acanthamoeba spp.,
- Balamuthia spp.
99
Certain bacteria that has symbiotic relationship with Opportunistic Amebae
Legionella
100
bacteria that is found in air-conditioning units
Legionella
101
Most pathogenic and Most virulent Ameboflagellate
Naegleria fowleri
102
What is the mode of transmission of Naegleria fowleri
entry to Olfactory epithelium, respiratory tract, skin and sinuses during swimming in contaminated pools, water, ponds, or lakes.
103
Infective stage of Naegleria fowleri
Trophozoite
104
Naegleria fowleri Trophozoite is biphasic. What are the two forms of Naegleria fowleri Trophozoite?
- Ameba (Limax form)
- Flagellate form
105
What form of Naegleria fowleri can be found in clinical specimen, biopsies or tissue specimen?
Limax form
106
Disease Manifestation and Pathology of Naegleria fowleri
Primary Amoebic Meningoencephalitis (PAM)
107
Virulence factor of Naegleria fowleri used to attached to the tissues and also release enzymes that can destroy the brain
Amebostomes
108
Diagnosis of Naegleria fowleri
- CSF examination
- Culture
- Molecular techniques (PCR, Immunofluorescence (IF)
109
What is the result of CSF examination if there is a presence of N. fowleri?
- elevated WBC
- no presence or very few bacteria
110
Treatment for patient with N. fowleri
Amphotericin B with Clotrimazole
111
Opportunistic ameba Larger or bigger than Naegleria fowleri.
Acanthamoeba spp.
112
mode of transmission of Acanthamoeba spp
entry through nose or break in the skin
113
infective stage of Acanthamoeba spp
Cyst and Trophozoite
114
It is a spinny projection found in the pseudopodia of the acanthamoeba
Acanthapodia
115
no. of nucleus of Acanthamoeba spp.
1
116
Describe the double cell wall of Acanthamoeba spp.in cyst stage
o Outer: wrinkled
o Inner: polygonal/ polyhedral
117
Chronic type of disease and the progression is slow caused by Acanthamoeba spp.
- Immunocompromised patients are affected
Granulomatous Amoebic Encephalitis (GAE)
118
Risk factor of Amebic keratitis
used of the contaminated contact lens solution
119
Usually seen in AIDS patients
- caused by Acanthamoeba spp.
Cutaneous lesions; Sinusitis
120
Diagnosis for N. fowleri
o Brain biopsy
o Corneal scrapings (Calcofluor white)
o Skin biopsy
o CSF exam
o Staining of Cyst with Periodic Acid Schiff (PAS)
o Indirect Immunofluorescence
121
Treatment
Fluorocystine
Ketoconazole
Amphotericin B
122
Mode of transmission of Balamuthia mandrillaris
entry thru nose, skin
123
The disease caused by Balamuthia mandrillaris
Granulomatous Amoebic Encephalitis (GAE)
124
irregular; finger-like, broad pseudopodia opportunistic ameba
Balamuthia mandrillaris trophozoite
125
It is the stage the Balamuthia mandrillaris which has outer irregular wall and inner round wall
Balamuthia mandrillaris cyst
126
Diagnosis for Balamuthia mandrillaris
- Brain biopsy
- IF
127
Class Zoomastigophora
- Intestinal and urogenital flagellates
- Hemoflagellates
128
All inhabit the large intestine except
Giardia lamblia, Trichomonas vaginalis, Trichomonas tenax
129
All undergo encystation except
Trichomonas species
130
Infective stage of INTESTINAL AND UROGENITAL FLAGELLATES
cyst except Trichomonas
131
All are commensals in INTESTINAL AND UROGENITAL FLAGELLATES except
Giardia lamblia, Trichomonas vaginalis, Dientamoeba fragilis
132
Mode of reproduction of INTESTINAL AND UROGENITAL FLAGELLATES
asexual reproduction through binary fission
133
- Also known as G. duodenalis and G. intestinalis
- it affects humans and animals
- pathogenic intestinal flagellate
Giardia lamblia
134
Important reservoir of Giardia lamblia
Beavers
135
diagnostic stage of Giardia lamblia
Cyst, Trophozoite
136
Infective stage of Giardia lamblia
Cyst
137
MOT of Giardia lamblia
ingestion of cyst
138
Parasite that has Pear, pyriform, Bilaterally symmetrical shaped and an appearance of Old Man’s Face with Glasses/“Someone is looking at you”, Curved spoon (side view)
Giardia lamblia Trophozoite
139
no. of nuclei of Giardia lamblia Trophozoite
2
140
no. of flagella of Giardia lamblia Trophozoite
8 or 4 pairs of flagella
141
Giardia lamblia Trophozoite used or employed this for attachment and act as Virulence factor
Ventral sucking disk
142
describe the Parabasal body/ Median body of the Giardia lamblia Trophozoite
(2) hammer shaped/ claw hammer
143
What is the motility of Giardia lamblia Trophozoite?
“Falling Leaf” motility
144
* Oval
* Football shape with 4 nuclei, parabasal bodies, axoneme
o A group of axoneme would eventually become an axostyle
Giardia lamblia cyst
145
What are the disease caused by Giardia lamblia
Giardiasis
* Beaver fever
* Traveler’s Diarrhea
* Gay Bowel Syndrome
146
Symptom of Giardiasis
Explosive Watery Diarrhea
147
What are the chronic disease caused by Giardia lamblia?
* Steatorrhea
* Weight loss
* Malaise
* Foul smelling stools: “Rotten eggs” odor because of malabsorption
148
Lab diagnosis for Giardia lamblia
* Stool exam
* Duodenal aspirates
* Entero-test; (Beale’s String Test)
* Serology
* Molecular methods
* Biopsy
149
This procedure will ask the patient to swallow the capsule with string and then the loose end of the string taped on the face of the patient and wait 4 hours. After 4 hours, string will be pulled out
- If the string become color green that means it reach in the duodenum
Entero-test; (Beale’s String Test)
150
treatment for Giardia lamblia
Metronidazole
151
Parasite that is Non pathogen/Commensal flagellate residing the colon
Chilomastix mesnili
152
appearance of Chilomastix mesnili trophozoite
Asymmetric; pear shaped
153
No. of flagella of Chilomastix mesnili trophozoite
4
154
What is the Motility of Chilomastix mesnili trophozoite
Boring/Corkscrew
155
It is the mouth of the Chilomastix mesnili trophozoite
Cytostome
156
What is the appearance of Cytostomal fibril of Chilomastix mesnili?
“Shepherd’s Crook” appearance"
157
What is the appearance of posterior part of Chilomastix mesnili?
spiral groove/twisted jaw appearance
158
What is the appearance of the Chilomastix mesnili cyst?
Nipple/ Lemon Shaped
159
The Nipple/ Lemon Shaped of the Chilomastix mesnili cyst is also called as?
Hyaline knob
160
- It is Pathogenic (Diarrhea)
- Formerly under the ameba
- NO visible flagella
Dientamoeba fragilis
161
No. of nuclei in cystic stage of Dientamoeba fragilis
2
162
The appearance of 2 nuclei in Dientamoeba fragilis trophozoite
Rosette like (fragmented chromatin 3-5 granules/nucleus)
163
Mode of transmission of Dientamoeba fragilis
via helminth eggs; Oral-fecal
o Those people who had Ascaris or Enterobius infections, possible they can also be infected Dientamoeba
164
How to diagnose Dientamoeba fragilis Trophozoite
permanent stained smear
165
Treatment for Dientamoeba fragilis
Iodoquinol
166
Diseases caused by Dientamoeba fragilis
Intermittent diarrhea, abdominal pain; eosinophilia; pruritus in the anal area
167
Closest relative of Dientamoeba
Trichomonas
168
* Oval trophozoite; 1 nucleus
* 3 anterior flagella & 1 posterior flagella
* Jerky motility
Enteromonas hominis trophozoite
169
No. of nuclei in Enteromonas hominis cyst
2/4 nuclei
170
* 1 anterior and 1 posterior flagella
* Cleft like cytostome
* Jerky motility
Retortamonas intestinalis trophozoite
171
Apperance of Cytostomal fibril of Retortamonas intestinalis
“Bird’s beak”
172
SUBPHYLUM MASTIGOPHORA: Flagellates that has No cyst stage; possess 4-5 flagella (trophozoite stage)
Trichomonas spp.
173
the most pathogenic trichomonas spp.
T. vaginalis
174
What is the habitat of Trichomonas vaginalis?
Urogenital Area
175
Mode of transmission of Trichomonas vaginalis
Intimate contact, Infant deliver, contaminated underwear, and towels
176
a wave-like structure on the lateral part of the trophozoite and is used for motility
- 1/2 of the body
Undulating Membrane
177
o dot-like structure throughout the body.
o iron-rich (iron-loving)
o can only be found in T. vaginalis
Siderophil granules:
178
leading non-viral STD worldwide caused by T. vaginalis
: Trichomoniasi
179
Disease manifestation of T. vaginalis infection in females
Vaginal pruritus, Strawberry cervix, Frothy discharge
180
Disease manifestation of T. vaginalis infection in males
asymptomatic, occasionally Non-gonococcal urethritis, prostatitis
181
Virulence factors of T. vaginalis
adhesins, cell detaching factor
182
inflammation of cervix with reddish dots (petechial spots)
Strawberry cervix
183
Formerly known as T. hominis
Commensal (non-pathogenic) but may be misdiagnosed as T. vaginalis especially in children if there is fecal contamination of urine
Pentatrichomonas hominis
184
Habitat of Pentatrichomonas hominis
Colon
185
Mode of transmission of Pentatrichomonas hominis
ingestion of trophozoite
186
describe the nucleus of the Pentatrichomonas hominis
Rounded (no peripheral chromatin)
187
Undulating Membrane of Pentatrichomonas hominis
Full body length
188
Smallest among the 3 Trichomonas species
Trichomonas tenax
189
Habitat of Trichomonas tenax
Mouth (tartar or teeth)
190
Mode of transmissionof Trichomonas tenax
direct contact (kissing, sharing of utensils)
191
describe the nucleus of Trichomonas tenax
ovoidal
192
Undulating Membrane of Trichomonas tenax
2/3 of the body
193
Disease manifestation of Trichomonas tenax
periodontal diseases
respiratory infections
194
Lab diagnosis for Trichomonas spp.
- Wet mounts if vaginal and urethral discharge, stool exam, mouth scrapings
- stained smears (giemsa or Pap's)
- Culture (gold standard)
- Antigen detection (rapid detection for T. vaginalis)
- Serology
- Molecular methods
195
* Flagellates that are found in the blood and other fluids (CSF) and in tissues
* Vector borne parasites
Hemoflagellates
196
Medical important genera of hemoflagellates
o Trypanosoma
o Leishmania
197
four morphological forms of hemoflagellates (based on the location of kinetoplast and flagella)
- Amastigote (Donovan Leishman)
- Promastigote (Leptomonas)
- Epimastigote(Crithidia)
- Trypomastigote
198
Energizing structure of hemoflagellate made up of DNA.
Kinetoplast
199
Only the epimastigote and trypomastigote are seen in the life cycle of_____
Trypanosoma brucei infections
200
Only the promastigote and amastigote are seen in _____
Leishmania infections
201
Diagnostic stages (found in humans) in hemoflagellates
amastigote and trypomastigote
202
Infective stage of Trypanosoma cruzi
metacyclic trypomastigote
203
Infective stage of Trypanosoma brucei
metacyclic trypomastigote
204
Infective stage of Leishmania
promastigote
205
Stage of hemoflagellate that has:
- No flagella
- Intracellular
- Found on the host cell
Amastigote
206
Stage of hemoflagellate that has:
- Anterior flagella
- Kinetoplast: anterior to the nucleus
- Nucleus: found in the center of the slender stage
Promastigote
207
Stage of hemoflagellate that has:
- Anterior flagella
- Undulating membrane: 1/2 of the body
- Kinetoplast: anterior to the nucleus
- Nucleus: posterior part of the parasite.
- Body is wider than promastigote
Epimastigote
208
- Anterior flagella
- Undulating membrane: full body length
- Kinetoplast: posterior to the nucleus
- Has U-, C-, or S-shaped appearance
- Contain granules (known as volutins granules)
Trypomastigote
209
Habitat of Trypanosoma cruzi
reticuloendothelial system, cardiac muscle, CNS
210
Vector of Trypanosoma cruzi
reduviid bug/Kissing Bug (Triatoma)
211
mode of transmission of Trypanosoma cruzi
Feces of vector entering the bite wound; blood transfusion, organ transplants; transplacental
212
disease commonly found in south africacaused by Trypanosoma cruzi
American Trypanosomiasis or Chagas disease
213
signs of infection include the development of Chagoma, Romaña’s sign, and others are fever and lymphadenopathy
Acute phase of chagas disease
214
painful reddish nodule at the site of the bite of reduviid bug
Chagoma
215
periorbital swelling after the bite of reduviid bug
Romaña’s sign
216
after 10-20 years of trypanosoma infection.
o Enlargement of the vital organs (heart, esophagus, colon).
o Common cause of death involves heart diseases
Chronic phase of chagas disease
217
Lab Diagnosis for Chagas disease
- Giemsa staining of CSF, Blood, Lymph
- Xenodiagnosis
- Culture
- Serology
218
Treatment for chagas disease
- Nifurtimox
- Benznidazole
219
use of kissing bug. Patient is allowed to be bitten by
the bug. If the parasite develops in the bug after a few weeks, the patient is positive
Xenodiagnosis
220
Common culture method for diagnosis of Chagas disease
Novy MacNeal Nicolle
221
Common serology method for diagnosis of Chagas disease
Machado Guerreiro (complement fixation technique)
222
Stages used to diagnose Trypanosoma cruzi in chagas disease
- Trypomastigote
- Amastigote (tissues) commonly encountered
in chronic phase.
222
Stages used to diagnose Trypanosoma cruzi in chagas disease
- Trypomastigote
- Amastigote (tissues) commonly encountered
in chronic phase.
223
agent of African Sleeping Sickness
Trypanosoma brucei
224
vector of Trypanosoma brucei
Tse-tse fly (Glossina spp.)
225
Example of Glossina spp.
- G. pallidipes
- G. morsitans
- G. palparis
226
habitat of Trypanosoma brucei
blood, lymph, CSF
227
Agent of Rhodesian/East African Sleeping
Sickness
Endemic in S. and E. Africa
Trypanosoma brucei rhodesiense
228
agent of Gambien/West African Sleeping Sickness
o Endemic in W. and C. Africa
Trypanosoma brucei gambiense
229
o Acute rapidly progressing
o CNS stage takes place early (<9mos)
o Minimal lymphadenopathy
o Anthropozoonotic: animals (most common) and humans are affected
o High parasitemia
Rhodesian/East African Sleeping Sickness
230
o Prominent lymphadenopathy
o Chronic progression
o Anthroponotic: humans are affected
o Low parasitemia
Gambien/West African Sleeping Sickness
231
Laboratory diagnosis of Trypanosoma brucei
- Trypanosomal chancre (early sign)
- Winterbottom’s sign
- Kerandel’s sign
- In-vitro autoagglutination in blood
- Elevated serum and CSF IgM
- Mott cells in CSF (morula cells)
232
painful ulceration caused by Trypanosoma brucei
Trypanosomal chancre
233
▪ cervical lymphadenopathy
▪ enlargement of lymph nodes
▪ swelling or bumps on the neck region
Winterbottom’s sign
234
Delayed sensation to pain result to Trypanosoma brucei infection
Kerandel’s sign
235
Diagnostic stage of Trypanosoma brucei
Trypomastigotes in bite lesion, blood, CSf, lymph node
aspirate
236
Diagnosis for Trypanosoma brucei
o Concentration of Buffy Coat; quantitative buffy coat (QBC)
o Serology – IHAT, ELISA, Rapid tests
o Molecular methods
o Animal inoculation and Culture
237
Treatment for Trypanosoma brucei infection
Pentamidine
Suramin
Melarsoprol
(MelaSun Po)
238
intracellular protozoan
Leishmania
239
Vector of Leishmania spp.
Sand fly
240
GENUS of Leishmania spp.
- Phlebotomus spp.
- Lutzomiya spp.
241
MOT of Leishmania spp.
Bite of vector; blood transfusion, contact, contamnation of bite wounds
242
Leishmania spp. that:
Target:
- Endothelial cells of skin capillaries; phagocytic monocytes
- Lesions on the skin are painless but highly disfiguring
Disease: Cutaneous Leishmaniasis, Old world Leishmaniasis, Aleppo Button, Delhi boil, Baghdad boil,
Jericho boil ( Si ALEPPO pumunta ng DELHI para bumili ng BAG kasama si JERICHO)
L. tropica
243
New World Cutaneous Leishmaniasis
- L. mexicana,
- L. braziliensis
244
Leishmania spp. that:
Target
Mucocutaneous junstionc (nasal septum, mouth, pharynx)
Disease:
Mucocutaneous Leishmaniasis (American, New world Leishmaniasis)
L. braziliensis
245
Leishmania spp. that:
Target:
Endothelial cells of Reticuloendothelial System
* Causes splenomegaly
Disease:
Visceral Leishmaniasis (Kala-azar, Dumdum fever, Black
fever)
The most severe/virulent
L. donovani
246
Diagnostic stage of Leishmania
Intracellular amastigotes
247
Amastigotes can be mistaken for _____ of Histoplasma capsulatum especially in cases of dumdum fever
yeast cells
248
Laboratory Diganosis of Leishmania
- Demonstration of lesions
- Biopsies (skin, tissue)
- Examination of BM spleen, lymph node
- Montenegro skin test (Leishmanin Skin test)
- Formol-Gel test
- Serology: IFAT
- Culture
- Molecular methods
249
detection of hypergammaglobulinemia in patients with
kala-azar
Formol-Gel test
250
Common culture medium for Laboratory Diganosis of Leishmania
Novy MacNeal Nicolle
Schneider’s drosophilia medium w/ 30% fetal bovine
serum
251
Treatment for Leishmania
Antimony compounds (Sodium stibogluconate, n-methyl-glucamine antimonite)
252
largest protozoan infecting man; medically important
ciliate
Balantidium coli
252
largest protozoan infecting man; medically important
ciliate
Balantidium coli
253
Final host of Balantidium coli
Man
254
Reservoir host of Balantidium coli
pigs
255
MOT of Balantidium coli
Ingestion of cysts
256
Habitat of Balantidium coli
Colon (cecum)
257
Infective stage of Balantidium coli
cyst
258
It is called Anterior Tapered
Balantidium coli trophozoite
259
Motility of B. coli trophozioite
“Thrown ball or rotary”
260
hair-like structures surrounding the whole parasite
Cilia
261
describe the Cytostome B. coli trophozioite
funnel-shaped mouth
262
anus; where waste products of B. coli are released
Cytopyge
263
nucleus that is kidney-shaped
Macronucleus
264
nucleus that is primarily used for reproduction
Micronucleus
265
It is for osmoregulation of B. coli
Contractile vacuoles
266
Describe the wall of B. coli trophozoite
Double-walled; refractive cyst wall enclosing the cilia
267
Manifestation of Balantidiasis/ Balantidial
dysentery
o Bloody diarrhea
o Flask shaped ulcers (wide and rounded ulcers)
o Extraintestinal may spread may occur (usually spread in the lungs, urogenital area, and mesenteries)
268
What is Virulence factor of B. coli?
Hyaluronidase
269
Lab Diagnosis for B. coli
Stool exam and Biopsy
270
Treatment for B. coli
Metronidazole
271
* Intracellular parasites
* Presence of the Apical complex:
PHYLUM APICOMPLEXA
272
used by Phylum apicomlexa for gaining entry of host cells
Apical complex
273
Reproduction of Phylum apicomlexa
Alternating asexual and sexual Generation (can happen in 1 or 2 hosts depending on the spp.)
274
most important parasitic disease in man
bad air
MALARIAL PARASITES
275
most important and most virulent;
#1 cause of malaria in the Philippines
Plasmodium falciparum
276
most widespread/ prevalent; except in Antarctica
Plasmodium vivax
277
least common malarial parasite
Plasmodium ovale
278
Malarial parasite that has long paroxysmal cycle and incubation period
Plasmodium malariae
279
zoonotic (malaria of monkeys)
o Endemic area: South-East Asia
o can be mistaken for P. malariae in microscopy (certain RBC stages)
Plasmodium knowlesi
280
diagnosis for malarial parasite
Molecular method (preferably)
281
It is Sexual reproduction that happens in the final host
sporogony
282
It is asexual reproduction that happens in the intermediate host
schizogony
283
Major malarial vector in the Philippines
Night biter
Female Anopheles minimus flavirostris
284
Habitat of malarial parasite in humans:
RBCs, liver cells (humans)
285
Infective stage of malarial parasite to mosquito
Gametocytes (Macrogametocytes, Microgametocytes)
286
Infective Stage of malarial parasite to Man (Transmission Stage)
Sporozoites
287
Mode of Transmission of malarial parasite
Mosquito bite; Blood transfusion; Congenital
288
Female anopheles mosquito bites humans and injects ____
sporozoites
289
Sporozoites must reach liver to become ____ and reproduce (around 40 minutes or less than an hour depending on the reference)
merozoites
290
Hypnozoites are seen in
P. vivax and P. ovale
291
It is caused by Hypnozoites
reactivation of hypnozoites
RELAPSE
292
Some merozoites enter the blood circulation to infect
RBCs
293
Merozoites of malaria in asexual cycle enter the blood circulation to invade RBCs to become:
ring forms
294
female gametocyte
Macrogametocyte
295
male gametocyte
Microgametocyte:
296
release sporozoites migrate to salivary glands of mosquito
ready to infect a susceptible human
Oocyst of malaria in sexual cycle
297
Most cases of malaria occur in
Africa
298
Symptoms and complications of malarial infection
o Paroxysms (chills, fever, sweating)
o Anemia
o Splenomegaly
o Blackwater fever (P. falciparum) o Cerebral malaria (P. falciparum)
o DIC
o Proteinuria: Nephrotic syndrome
o Occurrence of relapse and recrudescence
299
Malarial pigment
the more pigment, the more severe the malaria is
hemozoin
300
infected RBCs become adherent to the blood vessels that causes other stages (schizonts) to not be observed under the microscope
Cytoadherence (P. falciparum)
301
Malignant tertian
Malaria/Subtertian
Malaria or estivoautumnal
malaria
Plasmodium falciparum
302
Paroxysmal cycle of Plasmodium falciparum
36-48 hours
303
RBC infected by Plasmodium falciparum
All forms
304
Size of Parasitized RBC in Plasmodium falciparum
Normal
305
Parasite that has: (ring form)
- Delicate small ring
- May have 2 chromatin dots
- Common multiple rings in an RBC
- Accole/applique forms – ring forms in the periphery
Plasmodium falciparum
306
Parasite that the Developing Trophozoite has:
Heavy ring forms;
not commonly seen
Plasmodium falciparum
307
Schizont of Plasmodium falciparum
8-36 merozoites ; rarely seen
308
describe the Microgametocyte of P. falciparum
Sausage shaped; diffuse chromatin (sabog)
309
describe the macrogametocyte of P. falciparum
rescent shaped; compact chromatin
310
describe the Stippling of P. falciparum
Maurer’s clefts (comma-like red dots)
311
Benign tertian malaria
Plasmodium vivax
312
Paroxysmal cycle of Plasmodium vivax
44-48 hrs
313
RBC infected by Plasmodium vivax
reticulocytes
314
Size of Parasitized RBC of Plasmodium vivax
Enlarged RBC (1.5-2 times)
315
RBC stages in Plasmodium vivax
All stages present
316
Describe the Ring Forms of Plasmodium vivax
Ring 1/3 diameter of RBC
Heavy chromatic dot
Signet ring appearance
317
Developing Trophozoite of Plasmodium vivax
Ameboid (bizarre looking, irregular shaped)
318
Developing Trophozoite of Plasmodium vivax
12-24 merozoites
319
Microgametocyte of Plasmodium vivax
Round; large pink to purple chromatin mass surrounded
by a pale halo
320
Macrogametocyte of Plasmodium vivax
Round; eccentric chromatin mass
321
Stippling of Plasmodium vivax
Schuffner’s (eosinophilic)
- More common
322
Ovale tertian malaria
Plasmodium ovale
323
Paroxysmal cycle of Plasmodium ovale
48 hours
324
RBC infected by Plasmodium ovale
Young (reticulocytes)
325
Size of RBC Parasitized Plasmodium ovale
Oval, some may be larger than normal; presence of fimbriated or serrated (pangil) edges in RBCs
326
Presence of RBC stages in Plasmodium ovale
All stages present
327
Describe the Ring Forms Plasmodium ovale
Larger rings; similar to P. vivax
328
Describe the Developing Trophozoite of Plasmodium ovale
Ring shaped; non ameboid; similar to P. vivax
329
Schizont of Plasmodium ovale
8 merozoites
329
Microgametocyte of Plasmodium ovale
Smaller than P. vivax
330
Macrogametocyte of Plasmodium ovale
Smaller than P. vivax
331
Stippling of Plasmodium ovale
James ; Schuffner’s (in some references)
332
Quartan malaria
Plasmodium malariae
333
Paroxysmal cycle of Plasmodium malariae
72 hours
334
RBC infected of Plasmodium malariae
Old (senescent)
335
Size of RBC Parasitized by Plasmodium malariae
Normal
336
Presence of RBC stages in Plasmodium malariae
Few rings, mostly trophozoites and schizonts
337
Ring Forms of Plasmodium malariae
Smaller rings (1/8 of cell)
Heavy chromatin dot
(Bird’s Eye appearance)
338
Developing Trophozoite in Plasmodium malariae
Band shaped trophozoite;
basket forms may be seen
339
Schizont of Plasmodium malariae
6-12 merozoites; rosette or fruit pie appearance
340
Microgametocyte of Plasmodium malariae
Smaller than P. vivax
*same pics with P. ovale
341
Macrogametocyte of Plasmodium malariae
Smaller than P. vivax
*same pics with P. ovale
342
Stippling of Plasmodium malariae
Ziemann’s
343
Spx for Lab diagnosis of malaria
o Capillary blood w/o AC (more preferred)
o Whole blood: EDTA (pero this is not preferred)
344
Best time/period for collecting the malarial specimen
collect blood at height of fever or every 6-8 hours
345
The GOLD STANDARD laboratory diagnosis for alarial infection
Microscopy
346
Smear prep. for malarial count
Thick smear:
347
Size of the thick smear
2 cm or 2.5 cm diameter
348
Dehemoglobinize using _____
Distilled water to lyse RBCs
349
Smear prep for malarial Species identification
Thin smear
350
Fixative of Thin smear
Methanol
351
Stain used for smear prep
Giemsa (pH 7.2)
pH must diluted (adjusted using PBS – Phosphate Buffered Saline)
352
Alternative stain for smear prep
Wright’s
353
Stain used for Quantitative Buffy coat (QBC)
acridine orange stain
354
anticoagulant used for Quantitative Buffy coat (QBC)
oxalate
355
Positive indicator for Quantitative Buffy coat (QBC)
(+) bright green and yellow under fluorescence microscope
356
Antigen detect in Rapid Diagnostic Tests (Immunochromatographic Methods)
- HRP-II
- Parasite LDH
- Aldolase
357
antigen that is Specific for P. falciparum
- histidine rich protein II
358
Antigen that is nonspecific P. falciparum
Parasite LDH
359
Test for for low parasitemia and mixed infections
Molecular: PCR
360
Culture media for Malarial infection
RPMI1640
361
Treatment for malarial infection
o Chloroquine: Main stay drug (has resistance as a disadvantage)
o Artemether Lumefantrine: for falciparum malaria
o Doxycycline: prophylaxis
362
Intracellular parasites that causes malaria-like infections
Babesia microti
363
Definitive host of Babesia microti
Ticks (Ixodes spp.)
363
Intermediate hosts of Babesia microti
white footed mouse, deer, livestock, cattle
364
accidental hosts of Babesia microti
human
365
MOT of Babesia microti
bite of an infected tick (forest), blood transfusion; vertical transmission
366
Morphology of merozoites of Babesia microti
maltese cross or bunny ears
367
Ring forms of Babesia microti may be mistaken as _____
P. falciparum
368
Disease manifestation of Babesia microti
Babesiosis, Texas cattle fever, Nantucket fever, Redwater fever
S/S: flu-like, malaise, hepatomegaly, splenomegaly; usually selflimiting
369
B. microti severe infections in certain cases:
splenectomized individuals, immunecompromised,
coinfection with Lyme disease or (Borrelia)
370
Diagnosis of B. microti
o Microscopy
o Serology
o Molecular methods
371
Treatment of B. microti
Pyrimethamine and Sulfadiazine
372
Tissue Coccidians
Toxoplasma gondii
373
Definitive host of Toxoplasma gondii
Members of Felidae family
374
Intermediate host of Toxoplasma gondii
birds, rodents, pigs
375
Accidental or Dead End host of Toxoplasma gondii
Humans
376
Infective stages of Toxoplasma gondii
oocyst and tissue cysts
377
MOT of Toxoplasma gondii
o Ingestion of infected and undercooked meat
o Consumption of food or water contaminated with cat feces
o Blood transplant/organ transfusion
o Vertical transmission (torch testing)
378
Parasite stages in humans of Toxoplasma gondii
- Tachyzoites
- Bradyzoites
379
(elongated)rapidly multiply and infect cells of the intermediate hosts and non-intestinal epithelial cells of cats
Tachyzoites
380
multiply slowly
- Develop mostly in neural and muscular tissues
- May also develop in visceral organs
Bradyzoites
381
Disease manifestation of T. gondii
o Usually asymptomatic among immunocompetent
o Immunocompromised: encephalitis; retinochoroiditis, lymphadenopathy (AIDS), splenomegaly; brain focal lesions
o Congenital defect to the newborn
▪ Stillborn, abortion, encephalitis, hydrocephalus,
chorioretinitis, cerebral calcifications
382
Laboratory Diagnosis for T. gondii
- Sabin Feldman
- Frenkel test (skin test)
- ELISA, HAT, FAT
- TORCH testing
- Examination of tissue sections, CSF
- Molecular methods
383
Classic serologic test used for diagnosis of T. gondii
Sabin Feldman test
384
Spx used for Sabin Feldman test
Serum + live toxoplasma + methylene blue
385
Reagent for Sabin Feldman test
Methylene blue
386
Positive result of Sabin Feldman test
nonuptake of dye
387
AKA: C. parvum
Cryptosporidium hominis
388
size of Oocyst of C. hominis
4-6 um
389
infective once released
- contains 4 sporozoites
Oocyst
390
disease manifestation of C.hominis
Outbreaks or diarrhea; low infective dose
o Lalabas yung sporozoites because of its thin-walled oocyst
391
Treatment for C. hominis
Nitazoxanide; for AIDS – no effective Rx
391
Treatment for C. hominis
Nitazoxanide; for AIDS – no effective Rx
392
Intestinal Coccidians inhabit ____
small intestine (enterocytes –intestinal cells)
393
MOT of Intestinal Coccidians
ingestion of sporulated oocysts
394
AKA: Cyanobacterium like body
autofluorescence
Cyclospora cayetanensis
395
size Oocyst of Cyclospora cayetanensis
8-10 um
396
contains 2 sporocysts unsporulated/immature when released
Oocyst of Cyclospora cayetanensis
397
Disease manifestation of C. cayetanensis
Diarrhea implicated after consumption of contaminated fruits such as raspberries; basil, baby lettuce, snow peas
398
Treatment for C. cayetanensis
Trimethoprim-sulfamethoxazole (TMP-SXT)
399
Laboratory Diagnosis for Partially Acid Fast Intestinal Coccidians
- Stool examination
a. Concentration techniques: Sheather’s sugar Flotation, FECT
b. Staining method: Modified Kinyoun Method (most costefficient)
- Other tests: molecular methods; serology; phase contrast microscopy
400
AKA: Isospora belli
Cytoisospora belli
401
describe the oocyst of Cytoisospora belli
ellipsoid/spindle shaped
o contains 2 sporocysts
o unsporulated/immature when release
402
Disease manifestation C. belli
Diarrhea; least common
403
Rx for C. belli
TMP-SXT
404
Sacrocystis in Beef
Sacrocystis hominis
405
Sarcocystis in pork
Sarcocystis suihominis
406
MOT of Sarcocystis
ingestion of uncooked meat containing mature sacrocysts
407
Diagnostic stage of Sarcocystis
Oocysts in stool; Sacrocyst in muscle
408
Manifestations of Sarcocystis
severe diarrhea, fever, weight loss, muscle pain
409
Lab test for sarcocystis
Zinc Sulfate Concentration for stool; biopsy (muscle)
410
NOW considered and fungus
Microsporidia
411
Microsporidia that Causes diarrhea among immunocompromised patients
Encephalitozoon and Enterocytozoon
412
Diagnosis for microsporida
detection of spores in stool, tissue biopsy (PAS, Silver stain, Giemsa); Modified trichrome; antigen detection, IF, PCR
413
* Formerly classified as a yeast
* Commensal of GI tract
* Zoonotic
Blastocytis hominis
414
no. of nucleus of Blastocytis hominis
(2-4) – found in periphery
415
MOT of Blastocytis hominis
Ingestion of thick-walled cysts
416
Forms of Blastocytis hominis
o Classic vacuolated form (central-body form)
o Granular forms
o Multivacuolar
o Avacuolar
o Ameboid form
