Micro - Evals 6 Flashcards

1
Q

VIRUSES AFFECTING CVS AND LYMPHATICS

A
Paramyxovirus
Arbovirus
Flavivirus - Dengue, Yellow Fever
Alphavirus - Chikungunya
Togavirus - Rubella virus
Picornavirus - Poliovirus and Coxsackievirus
Herpesvirus - CMV and EBV
Filovirus
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2
Q

Type of viremia that is responsible for viral spread of Paramyxovirus to the salivary glands, testes, ovaries, pancreas and CNS

A

Primary viremia

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3
Q

Type of viremia that is responsible for generalized viral spread of Paramyxovirus to the salivary glands and other glands, as well as the other body sites including the kidneys

A

Secondary viremia

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4
Q

Incubation period of Paramyxovirus

A

2-4 weeks

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5
Q

Primary characteristic of mumps infection

A

Gopher-like swelling of the cheeks

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6
Q

Prognosis of mumps

A

Self-limiting

Anti-pyretics can be given

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7
Q

Site of primary replication of mumps virus

A

Nasal or URT

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8
Q

Complications of mumps

A

Orchitis and epididymitis
Pancreatitis
Viral meningitis
Hearing loss

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9
Q

Most important in diagnosing mumps

A

History and PE

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10
Q

Samples used for serologic testing for mumps

A

Saliva - present after 1 week since onset
Urine - present upto 2 weeks since onset
CSF

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11
Q

Timing of collection of sample

A

Within a few days of onset of disease

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12
Q

Prevention of mumps

A

Live attenuated mumps vaccine

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13
Q

Virus families under Arboviruses

A

Bunyaviridae
Flaviviridae
Togaviridae

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14
Q

Diseases caused by Arboviruses

A

Mild undifferentiated fevers
Severe encephalitis
Life-threatening hemorrhagic fever

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15
Q

Virus responsible for Crimean-Congo hemorrhagic fever

A

Nairovirus

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16
Q

Most important vectors of Arboviruses

A

Mosquitoes
Ticks
Flies
Gnats

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17
Q

Incubation period of Arboviruses

A

1 week

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18
Q

Characteristics of morbiliform rash

A

Maculopapular

Secondary to endothelial cell damage and increased vascular permeability

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19
Q

Flaviviruses are sensitive to

A

Heat
UV radiation
Disinfectants

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20
Q

Glycoproteins in Flavivirus lipid envelope

A

M and E glycoproteins

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21
Q

E glycoprotein biologic properties

A

Viral cellularity attachment
Endosomal membrane function
Display of sites mediating hemaglutination and viral neutralization

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22
Q

Most prevalent flavivirus infection and biggest Arbovirus problem in the world

A

Dengue

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23
Q

Transmission of dengue

A

Man-arthropod-man

Also vertical transmission, passively acquired antibodies, pre-existing heterologous dengue antibody

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24
Q

Principal mosquito vector of Dengue and Chikungunya

A

Aedes aegypti (polka-dotted day-biters)

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25
Q

Syndrome produced by heterologous immunity to dengue

A

Dengue-Hemorrhagic Fever or Dengue Shock Syndrome

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26
Q

Site of viral replication of Flavivirus

A

Monocytes

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27
Q

Increased vascular permeability in DHF-DSS may be due to

A

Increased levels of soluble TNF
IFN-gamma
Complement system activation

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28
Q

Dengue type 1: ?

Dengue type 2: ?

A

Dengue type 1: Dengue fever

Dengue type 2: Dengue hemorrhagic fever

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29
Q

Cause of immunopathologic response if DHF

A

Virus-antibody complex

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30
Q

Characteristic symptoms of Breakbone fever

A

Myalgia and deep bone pain
Saddleback form fever
Scarlatiniform rash
Severe frontal headache and retro-orbital pain (adults)

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31
Q

Differentiating feature of DHF from Dengue fever

A

It has defervescence within 2-7 days

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32
Q

Characteristic features of DSS

A

Shock and hemoconcentration

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33
Q

Laboratory diagnosing test with high sensitivity and high specificity

A

Rapid immunochromatographic test

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34
Q

Contraindicated drug when treating Dengue

A

Aspirin to prevent Reye’s syndrome and hemostatic problems

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35
Q

Prevention of Dengue

A
Mosquito eradication (4 o'clock habit)
No effective vaccine
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36
Q

Transmission of Yellow Fever (2 cycles)

A

Urban yellow fever

Jungle yellow fever

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37
Q

Human-to-human transmission by A. aegypti

A

Urban yellow fever

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38
Q

Infected monkeys-to-humans transmission by Haemagogus

A

Jungle yellow fever

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39
Q

Clinical presentation of frank yellow fever

A

Sever hemorrhagic manifestations
Oliguria
Hypotension

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40
Q

Diagnosis of yellow fever

A

Usually clinical

If available: viral isolation, postmortem, serology

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41
Q

Prevention of yellow fever

A

Live attenuated vaccine

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42
Q

Three major groups of Alphavirus

A

West African
Central African
Asian

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43
Q

Common physical symptoms of Chikungunya

A

Redness of eyes

Difficulty looking at light

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44
Q

Prevention of Chikungunya

A

Piricardin containing insect repellants

Treating clothes with permethrin

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45
Q

Host of Togavirus

A

Humans only

No invertebrate host

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46
Q

Togavirus transmission

A

Aerosol droplets

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47
Q

Drug that inhibits Togavirus

A

Amantadine

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48
Q

Immunity from Togavirus

A

Life long immunity but reinfections can still occur

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49
Q

Clinical features of Rubella

A

Maculopapular rash
Lymphadenopathy
Fever
Athropathy

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50
Q

Risk of Rubella during pregnancy

A

Precoception: minimal
0-12 weeks: 100% risk; spontaneous abortion
13-16 weeks: deafness and retinopathy
After 16 weeks: normal development

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51
Q

Classical triad of Congenital Rubella Syndrome

A

Cataracts
Heart defects
Sensorineural deafness

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52
Q

Prevention of CRS

A

Terminate pregnancy

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53
Q

Diagnosis of Rubella

A

Serial rising titers of antibody - HAI, EIA

Placental biopsy and specific IgM fetal blood

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54
Q

Falling rubella antibody titer indicates

A

Passively acquired maternal antibody

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55
Q

Rising rubella antibody titer indicates

A

Rubella infection

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56
Q

Rubella IgM in newborn infant serum

A

Transplacental infection

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57
Q

Prevention of Rubella infection

A

Antenatal screening

Live attenuated vaccine - women should not get prenant at least 3 months after vaccination

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58
Q

Non-enveloped Picornavirus that causes acute enteroviral infection of the spinal cord that may cause neuromuscular paralysis but are mostly subclinical

A

Poliovirus

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59
Q

Poliovirus serotypes that cause severe disease

A

Serotypes 1 and 3

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60
Q

Only reservoir of Poliovirus

A

Humans, most commonly children

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61
Q

Poliovirus transmission

A

Fecal-oral route

Flies as mechanical vectors

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62
Q

Incubation period of Poliovirus

A

1-2 weeks

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63
Q

Antibodies occur in

A

Large intestine and tonsils
Serum
Confers life long immunity

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64
Q

Polio must be differentiation of these diseases in order to be diagnosed

A

GBS
Infant botulism
Encephalomyelitis

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65
Q

Prevention

A

Salk vaccine

Sabin vaccine

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66
Q

Inactivated polio vaccine

A

Salk vaccine

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67
Q

Oral polio vaccine

A

Sabin vaccine

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68
Q

Coxsackievirus commonly causes

A

Transient neonatal infection

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69
Q

Coxsackievirus transmission

A

Fecal contamination

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70
Q

Incubation period of coxsackievirus

A

2-9 days

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71
Q

Diseases caused by CoxA virus

A

Herpangina
Acute hemorrhagic conjunctivitis
Aseptic meningitis
Hand-foot-and-mouth disease

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72
Q

Diseases caused by CoxB virus

A

Pleurodynia
Aseptic meningitis
Severe generalized disease of infants
Myocarditis and pericarditis

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73
Q

Mainstay in diagnosing Coxsackievirus

A

Viral isolation

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74
Q

Herpesvirus transmitted via intimate contact

A

Cytomegalovirus

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75
Q

Common symptoms of CMV

A

Hepatomegaly, spenomegaly, jaundice, capillary bleeding, microcephaly, ocular inflammation

76
Q

Disease caused by CMV

A
CMV Mononucleosis
Disseminated CMV
CMV pneumonitis
Perinatal CMV
Congenital CMV infection
Cytomegalic Inclusion DIsease
77
Q

Most common congenital viral infection

Second most common cause of mental handicap

A

Congenital CMV infection

78
Q

Treatment of CMV

A

Gancyclovir
Foscarnet
Hyperimmune CMV Ig

79
Q

Principal mode of transmission of EBV

A

Direct oral contact
Contamination with saliva
Also fomites and arthropods

80
Q

Diseases caused by EBV

A
Infectious Mononucleosis/Kissing Disease
Burkitt's lymphoma
Nasopharyngeal carcinoma
EBV induced lymphoproliferative diseases
EBV associated lymphomas
81
Q

Notable sign of Infectious Mononucleosis

A

Sudden leukocytosis

82
Q

Constant feature of Nasopharyngeal carcinoma

A

High antibody titers to EBV

83
Q

Drug that reduces EBV shedding from the nasopharynx

A

Acyclovir

84
Q

Filovirus that caused 2014 West African outbreak

A

Zaire Ebola virus

85
Q

Suspected transmission of Filovirus

A
Fruit bats
Human-to-human via direct contact
Healthcare workers
Mourners of infected cadavers
Sexually
Breastfeeding
86
Q

Incubation period for Filovirus

A

2-21 days

87
Q

PARASITES AFFECTING CVS AND LYMPHATICS

A
Plasmodium
Wuchereria
Brugia
Trypanosoma
Leishmania
Schistosoma
Babesiosis
88
Q

Most common protozoan disease affecting man

A

Plasmodium - Malaria

89
Q

Malarial paroxysm

A

Cyclic fever
Chills
Sweating

90
Q

Mode of transmission of Plasmodium

A

Vector-borne - pregnant female Anopheles

Needle-sharing

91
Q

TRUE or FALSE.

Malaria is not a major problem in the Philippines.

A

True

92
Q

Host of Plasmodium

A

Humans and mosquitoes

93
Q

Infective stage of Plasmodium to man

A

Sporozoites

94
Q

Schizont development occurs during this stage

A

Liver stage

95
Q

Entry point of Plasmodium into the liver

A

Sentinel Kupffer cell

96
Q

Most common victims of Malaria

A

Pregnant women

Children

97
Q

Main mode of transmission of Plasmodium

A

Natural transmission

98
Q

Mode of transmission without sporozoites, exo-erythrocytic cycle or liver phase and hypnozoites

A

Induces transmission

99
Q

Vectors in Malarial transmission

A
Anopheles flavirostris
Anopheles litoralis
Anopheles maculatus
Anopheles balbancensis
Anopheles mangyanus
100
Q

Primary malarial vector in the Philippines

A

Anopheles flavirostris

101
Q

Malarial vector commonly found in brackish water in Palawan

A

Anopheles litoralis

102
Q

Parts of proboscis

A

2 pairs of cutting stylets

1 pain of hollow tubes

103
Q

Contents of mosquito’s saliva

A

Anti-hemostatic enzymes

Anti-inflammatory subtance

104
Q

RoleS of mosquitoes in Malaria

A

Definitive host

Biological vector

105
Q

Role of man in Malaria

A

Intermediate host

106
Q

Parasite ligand and host receptor for entry of sporozoites into liver cells

A

Parasite ligand: CSP

Host receptor: Unknown

107
Q

Parasite ligand and host receptor for entry of merozoites into RBC (P. falciparum)

A

Parasite ligand: EBA175

Host receptor: Glycophorin A

108
Q

Parasite ligand and host receptor for entry of merozoites into RBC (P. vivax)

A

Parasite ligand: Pv153

Host receptor: Duffy factor

109
Q

Parasite ligand and host receptor for cytoadherence of P. falciparum-infected RBC to endothelium

A
Parasite ligand: PfEMP-1
Host receptor: CD36 (endothelium and platelets)
Parasite ligand: KAHRP
Host receptor: ICAM-1 (brain)
Parasite ligand: PfEMP-2
Host receptor: CSA (placenta)
110
Q

3 patholophysiologic changes in Malaria

A

RBC lysis
Knob formation of infected RBC
Metabolic effect (hypoglycemia and acidosis)

111
Q

Histopathologic changes in organs affected

A

Vascular congestion
Edema
Malarial pigment (HEMOZOIN) deposition

112
Q

Cytokines involved in the pathogenesis of malaria

A

TNF
IL-1b, IL-6, IL-8
Interferon-y
NO

113
Q

Effects of cytokines in low concentrations

A

Protective
Inhibit growth of parasites
Hemostatic agent

114
Q

Clinical features of Malaria

A
Malarial proxysms
Jaundice
Pallor and dizziness
Changes in sensorium
Tachycardia
Dry and pale lips
Enlarged spleen and liver
115
Q

Malarial paroxysm that is usually mild without complications seen in P. vivax and P. ovale, every 48 hours

A

Benign Tertian

116
Q

Malarial paroxysm that is usually severe with complications seen in P. falciparum, every 48 hours

A

Malignant Tertian

117
Q

Malarial paroxysm that is periodical every 72 hours seen in P. malariae

A

Quartan

118
Q

Malarial paroxysm that is periodical every 24 hours seen in P. falciparum and P. knowlesi

A

Quotidian

119
Q

Induces fever in Malaria

A

Hemozoin either directly from RBC lysis or indirectly through GPI

120
Q

Cause of anemia in Malaria

A

Maturing schizonts either from direct RBC lysis or increased utilization of hemoglobin

121
Q

Factors that lead to hypoglycemia in Malaria

A

Limited food intake
Increase glucose consumption
Increase Quinin-induces insulin resistance
Inhibition of gluconeogenesis

122
Q

Result of hypoglycemia in Malaria

A

Compensatory glycogenolysis

123
Q

Laboratory features of Malaria

A

Decreased Hgb and Hct

Ring-like parasite in blood smear

124
Q

Small infected RBC

A

Mature RBC

Due to P. falciparum, P. malariae, P. knowlesi

125
Q

Large infected RBC

A

Younger RBC

Due to P. falciparum P. vivax, P. ovale

126
Q

Diagnostic test of choice of Plasmodium species identification

A

Thin smear

127
Q

Number of chromatin dots in trophozoite and schizont

A
Trophozoite = 1-2 chromatin dots
Schizont = 2-4 chromatin dots
128
Q

Amoeboid and compact form
Schuffner’s dots
Fine stippling

A

P. vivax

129
Q

Band form
James or Ziemann’s dots
Regular daisy-like apperance of merozoites

A

P. malariae

130
Q

Number of merozoites

A

P. falciparum = maximum of 32 meroizoites
P. vivax = maximum 24 merozoites
P. ovale and P. malariae = maximum of 12 merozoites

131
Q

Maurer’s cleft/dots
Acole forms
Multiple parasitism
Banana-shaped gametocyte, may have Laveran’s bibs

A

P. falciparum

132
Q

Amoeboid and compact form
Schuffner’s dots
Fine stippling
Irregular rosette-like clusters of merozoites

A

P. ovale

133
Q

Band form
No stippling
Multiple parasitism

A

P. knowlesi

134
Q

Deadliest and causes most severe form of malaria

A

P. falciparum

135
Q

Causes recrudescence

A

P. falciparum and P. malariae

136
Q

Laboratory test that detects histidine-rich proteins 2 in a strip of filter paper

A

ParaSight F

137
Q

Causes relapse

A

P. vivax and P. ovale

138
Q

Causes reinfection

A

All types

139
Q

End stage of Lymphatic filariasis

A

Elephantiasis

140
Q

Agents that cause filariasis

A

W. bancrofti
B. malayi
B. timori

141
Q

Transmission of filarial worms

A

Oviviparous female mosquito bites

142
Q

Clinical feature

A

Unrecognized recurrent lymphedema

143
Q

Diagnostic stage of filariasis

A

Microfilariae/L1

144
Q

Infective stage to humans

A

L3

145
Q

Role of mosquitoes

A

Intermediate host

Biological vector

146
Q

Common filarial vectors

A

W. bancrofti: Anopheles, Aedes, Culex

B. malayi: Anopheles, Mansonia

147
Q

Day biting mosquito

A

Aedes

148
Q

Night biting mosquitoes

A

Culex and Mansonia

149
Q

Causes occult filariasis

A

B. malayi

150
Q

Causes scrotal enlargement and lymphedema or elephantiasis

A

W. bancrofti

151
Q

TRUE or FALSE.

Presence of worms can elicit both humoral and cell-mediated

A

True

152
Q

Most common change occuring at the lymphatics

A

Polypoid endolymphangitis

153
Q

Effect of dead or dying adult worms in the tissues

A
Fibrinoid necrosis
Filarial granuloma (Meyers-Kouvenaar bodies)
154
Q

Pathognomonic feature of filariasis seen as a pronounced eosinophilic infiltration in nodular patterns around the worm

A

Filarial granuloma (Meyers-Kouvenaar bodies)

155
Q

Clinical form of lymphatic filariasis with microfilarimia

A

Asymptomatic
Acute
Chronic

156
Q

Clinical form of lymphatic filariasis without microfilarimia

A

Occult

157
Q

Patient has hidden damage to the lymphatic system and kidneys

A

Asymptomatic

158
Q

Patient has attacks of filarial fever increasing with severity, pain and inflammation of lymph nodes and ducts, nausea and vomiting

A

Acute

159
Q

Elephantiasis, hydrocele in males, enlarged breast in females

A

Chronic

160
Q

Hypersensitivity reaction to the worm

A

Occult

161
Q

Most common manifestation of lymphatic filariasis

A

Asymptomatic

162
Q

Manifestation of occult filariasis

A

Pulmonary tropical eosinophilia syndrome

163
Q

Clinical presentation of Pulmonary Tropical Eosinophil syndrome

A

Pulmonary symptoms
Radiologic changes
Nonspecific weight loss
Increase IgE, eosinoohilia and increased antimalarial AB

164
Q

Conditions that lead to elephantiasis

A

Chronic edema in subcutaneous tissue
Proliferation of fibrous CT
Thickening of epidermis

165
Q

Diagnosis of filariasis

A

Identification of microfilariae in blood smear by microscopic examination

166
Q

Methods of microfilariae detection

A

Wet smear
Thick blood film
Blood concentration techniques

167
Q

Morphology of W. bancrofti during microscopy

A
With hyaline sheath
Short cephalic space
Regular with graceful curve
Round, larger, well-separated body nuclei
No nuclei, pointed tip
168
Q

Morphology of B. malayi during microscopy

A
With hyaline sheath
Long cephalic space
Irregular with kinking curves
Small, overlapping body nuclei
Two widely spaced nuclei, blunted tip
169
Q

Imaging technique characterized by dancing worms

A

Ultrasonography

170
Q

Imaging technique that use radioloactive opaque dye

A

Lymphangiography

171
Q

Imaging technique that use radiolabeled albumin

A

Lymphoscintigraphy

172
Q

Gold standard biochemical test in diagnosing filariasis

A

ELISA

173
Q

Drug of choice for filariasis

A

Diethylcarbamazine

174
Q

Alternative treatment for filariasis if the patient has eye involvement

A

Ivermectin

175
Q

Preventive mass drug administration

A

Albendazole with Diethylcarbamazine

Albendazole with Ivermectin

176
Q

Developmental stage of blood flagellates seen in tissue samples

A

Amastigote

177
Q

Developmental stage of blood flagellates seen in blood samples

A

Trypomastigote

178
Q

Causative agent of African sleeping sickness

A

T. brucei

179
Q

Life cycle/Development of Trypanosoma spp.

A

Heteroxenous

180
Q

Asexual reproduction of Trypanosoma

A

Binary fission

181
Q

Evading mechanism of T. brucei

A

Antigenic variation

182
Q

Distinctive features of T. brucei

A

Changes from slender trypanosome into a stumpy form

VSG switching which allows second wave of parasitemia

183
Q

Characteristics of T. b. gambiense

A
Gambian trypanosomiasis, W. African sleeping sickness
Humans are primary reservoir
Winterbottom sign
Chronic/late CNS manifestation
Low parasitemia
Meingo-encephalitism
Lymph fluid is best microscopy specimen
184
Q

Characteristics of T. b. rhodesiense

A

Rhodesian trypanosimiasis, E. African sleeping sickness
Animals are primary reservoir
More fatal and aggressive
High parasitemia
CNS involvement glomerulonephritis or myocarditis

185
Q

Infective stage of Trypanosoma spp.

A

Metacyclic trypomastigote

186
Q

Diagnostic stage of Trypanosoma spp.

A

Trypomastigotes

187
Q

Stage of African sleeping sickness characterized by the presence of Trypanosomal chancre and Winterbottom sign

A

Stage 1 Hemolymphatic