Parasites

Question 1

What is the 3rd leading parasitic cause of death in the world?

Answer 1

Entamoeba histolytica

Question 2

What are the symptoms of a Entamoeba histolytica infection?

Answer 2

AMOEBIASIS (lower GI):

• Bloody, mucousy diarrhea
• Fever
• Abdominal pain
• Liver abscess

Question 3

What is the mode of transmission of Entamoeba histolytica?

Answer 3

Oral-fecal

Human is the only source

Question 4

What is the treatment of Entamoeba histolytica?

Answer 4

• Metronidazole in the tissue
• Iodoquinol, Diodoquin, Furamide in the bowel lumen

Question 5

What is the most common enteric parasite in US/Canada?

Answer 5

Giardia lamblia

Question 6

What are the symptoms of a Gardia Lamblia infection?

Answer 6

Upper GI:

• Diarrhea
• Flatulence
• Abdominal cramps
• Decreased appetite, + weight loss, + nausea
• NO fever

Question 7

What is the mode of transmission of Giardia lamblia?

Answer 7

• Oral-fecal
• Zoonosis

Question 8

What is the treatment of Giardia lamblia?

Answer 8

• Metronidazole
• Quinacrine

Resistance is an increasing problem

Question 9

What are the symptoms of Cryptosporidium?

Answer 9

Diarrhea 2-3 weeks (chronic in AIDS or other immune compromise), cholecystitis, respiratory distress

Question 10

What is the mode of transmission of Cryptosporidium?

Answer 10

• Person-person and oral-fecal
• Zoonosis (bovine)

Question 11

What is the treatment of Cryptosporidium?

Answer 11

• HIV-neg: nitazoxanide optional
• HIV-pos: ART

Question 12

Where does Cyclospora come from?

Answer 12

Raspberries, basil from Guatemala, Mexico

Question 13

What are the 3 Systemic protozoa?

Answer 13

1. Toxoplasma
2. Leishmania (flagellates)
3. African Trypanosomiasis (flagellates

Question 14

What are the 4 types/clinical features of toxoplasma?

Answer 14

1. Lymphadenopathic/acute
2. Ocular
3. Neonatal (splenomegaly)
4. Immunocompromised

Question 15

How is toxoplasma transmitted ?

Answer 15

1. Fecal oral from cat
2. Oral (raw/undercooked meat)
3. Transplacental during infection

Question 16

What are the 3 types of Leishmania?

Answer 16

1. Cutaneous
2. Mucocutaneous
3. Visceral

Question 17

How are Leishmania and African Trypanosomiasis transmitted?

Answer 17

Zoonosis reservoir, mosquito vector

Question 18

What are the symptoms of malaria?

Answer 18

• Chills
• Rigors
• Fever
• Perspiration
• Fatigue
• Headache
• Delirium
• Confusion
• Coma
• Shortness of breath
• Jaundice
• Anemia
• Splenomegaly

Question 19

What is the treatment of malaria?

Answer 19

NEED TO KNOW WHERE IT IS FROM TO KNOW IS RESISTANT

• Oral Quinine (if they are clinically well and tolerance PO)
• IV Artusunate (IV)

Question 20

How is malaria transmitted?

Answer 20

FUCKING MOSQUITOS: Humans are only reservoir

Question 21

What are the intestinal Helminths genus parasites that have a fecal oral transmission?

Answer 21

1. Trichuris (whipworm)
2. Enterobius (pinworm)
3. Ascaris (roundworm)

Question 22

How is Strongyloides (threadworm) transitted?

Answer 22

Contact with feces contaminated soil

VERY DANGEROUS BECAUSE: “Autoinfective cycle” (multiplies inside the host) and can live for 70 years

Question 23

How do we diagnose Strongyloides (threadworm)?

Answer 23

• Agar plate culture
• Serology

Question 24

How do we treat Strongyloides (threadworm)?

Answer 24

• Ivermectin
• Albendazole

Question 25

Which systemic nematodes presents in carnivore because of raw meat ingestion?

Answer 25

Trichinella (Trichinosis)

Question 26

How do we diagnose Trichinella (Trichinosis)?

Answer 26

* Symptoms * Eosinophilia * CK * Serology * Biopsy

Question 27

How do we treat Trichinella (Trichinosis)?

Answer 27

* Albendazole * Prednisone

Question 28

Which systemic nematodes requires an insect of crustaean vector to be transmitted?

Answer 28

Filaria (systemic roundworm)

Question 29

Which Trematodes are transmitted in WATER?

Answer 29

* Schistosomiasis (blood flukes) * *Opisthorchis viverini* (Liver flukes) * *Clonorchis sinensis* (Liver flukes) * *Fasciola hepaticum* (Liver flukes) * *Metorchis conjunctus* (Liver flukes) * Diphyllobothrium spp. (Fish tapeworms)

Question 30

What is the treatment of choice for Trematodes parasites?

Answer 30

Praziquantel

Question 31

Which trematodes causes B12 deficiency?

Answer 31

Diphyllobothrium spp. (Fish tapeworms)

Question 32

What are the parasites associated with severe Eosinophilia?

Answer 32

Those that INVADE tissues: * Filaria * Schistosomiasis * Strongyloidiasis * Trichinella * Loa Loa

Question 33

What are the most common illnesses prevalent in the tropics that present with fever in the returned traveler?

Answer 33

1. Malaria 2. Dengue 3. Typhoid

Question 34

What is the most common cause of traveller's diarrhea?

Answer 34

* ETEC * Shigella * Campy * Salmonella * Rotavirus * Giardia * E. Histo * Crypto * Cylospora

Question 35

Traveller of prolonged Diarrhea, what's the most likely diagnosis?

Answer 35

POST-INFECTIOUS IBS

Question 36

What are the “spora” type of parasites that cause watery diarrhea and require a special stain?

Answer 36

* Microsporidium spp * Cryptosporidium spp * Cyclospora cayetanensis * Isospora belli