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Path Infectious Diseases Test #1 > Parasitic Diseases > Flashcards

Parasitic Diseases Flashcards

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1
Q

Protozoan GI infestations

A 
Entamoeba histolytica (amoeba)
Giardia lamblia (flagellate)
Cryptosporidiosis (sporozoan)
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2
Q

infectious form of Entamoeba histolytica

A

cysts which have cell wall to resist gastric acid

trophozoites are amebic form

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3
Q

What does Entamoeba histolytica do in the body?

A

lyse colonic epithelial cells

trophozoites invade crypts of the colonic glands; burrow through tunica propria; halted by muscularis mucosae

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4
Q

Entamoeba histolytica characteristially produce?

A

flask-shaped ulcers with narrow neck and broad base

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5
Q

What happens in 40% of Entamoeba histolytica cases?

A

parasites penetrate portal vessels, embolize to liver and form amebic abscesses; usually solitary; pain may be elicited on palpation of liver

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6
Q

Pathology of Entamoeba histolytica

A

involves cecum and ascending bowel; in severe cases, entire bowel may be involved
parasites resemble macrophages

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7
Q

What happens to the mucosal cells overlying Entamoeba histolytica organisms?

A

mucosal cells slough due to deprivation of blood supply; neutrophilic infiltrates result in liquefactive necrosis

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8
Q

Chronic damage with Entamoeba histolytica leads to

A

napkin-like constrictive lesions similar to colonic carcinoma due to extensive fibrosis

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9
Q

Obligate fermenters of glucose to ethanol

A

Amebae, giardia, trichomonads, and anaerobic bacteria

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10
Q

Metronidazole targets

A

ferredoxin-dependent pyruvate-oxidoreductase

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11
Q

Giardia lamblia associated with

A

IgA deficiency and immunosuppression (common intestinal parasite in AIDs patients)

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12
Q

Infectious form of giardia

A

dormant cyst

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13
Q

What does giardia cause

A

diarrhea, not dysentery

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14
Q

Where do giardia trophozoites multiply?

A

in small intestine (duodenum) via concave attachment disc

attach to mucosa but do not invade the intestinal wall

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15
Q

Characteristic morphology of giardia

A

two nuclei which resemble eyes, pear shape

really cute, looks like an old man

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16
Q

Abnormalities of the mucosa with a giardia infection

A

clubbing of villi with mixed inflammatory infiltrate of the lamina propria
follicular hypertrophy of mucosal lymphoid tissue in IgA deficient individuals

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17
Q

Cryptosporidium causes

A

transient, watery diarrhea in children
severe disease in immunosuppressed
far more severe disease in immunosuppressed individuals

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18
Q

Infectious oocytes not killed by

A

chlorine

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19
Q

What form of cryptosporidium is infectious

A

environmentally resistant oocytes

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20
Q

crypto is the only GI parasite with

A

sexual reproduction in host

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21
Q

What do Cryptosporidium do inside the body?

A

adhere to jejunum/ileum/colonic epithelium (apical brush border)
mixed inflammatory cell infiltrate in lamino propria
infect macrophages and underlyig Peyer’s patches

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22
Q

What occurs with Cryptosporidium disruption of the mucosa

A

malabsorption and secretory diarrhea

diarrhea and vomiting (3-14 days)

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23
Q

Diagnosis of Entamoeba histolytica

A

stool of aspirates (abscess)

Trophozoites or cysts

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24
Q

Diagnosis of Giardia lamblia

A

cysts of trophozoites in stool

Biopsy; “string test’

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25
Diagnosis of Cryptosporidium
biopsy; fecal smears; "string test"
26
Treatment of Entamoeba histolytica
metranidazole, iodoquinal
27
Treatment of Giardia
metranidazole, furazolidone
28
Treatment of Cryptosporidium
rarely effective; spiramycin
29
Four types of malaria
P. falciparum P. vivax P. ovale P. malariae
30
Describe pathogenesis of P. vivax and P. ovale
infect RBCs, leads to removal by spleen; mild anemia, rarely splenic rupture and nephrotic syndrome
31
What do P. falciparum sporozoites in the body?
invade liver cells rapidly form thousands of merozoites hepatocytes rupture, release merozoites
32
What do merozoites bind on RBCs
sialic residues
33
What do merozoites do within RBCs
mature into ringed trophozoite forms
34
Immature ring forms (RBCs/malaria) do what
get trapped in spleen because they're flexible
35
P. falciparum results in
severe anemia, renal failure, pulmonary edema, cerebral symptoms and death
36
What causes 80% of deaths in children with P. falciparum?
cerebral involvement
37
What leads to black water fever (hemoglobinuria) and kidney damage with P. falciparum?
hemolysis of infected erythrocytes
38
pathology of p falciparum
large spleen, liver, and kidneys pigmented liver and kidneys CNS vessels plugged with parasitizied cells focal hypoxic lesions in heart
39
What is Babesiosis
malaria-like protozoans transmitted by same deer ticks which carry Lyme disease fever and hemolytic anemia
40
Trypanosomiasis causes
African sleeping sickness | intermittent fevers, lymphadenopathy, splenomegaly, progressive brain dysfunction, cachexia and death
41
Typanosomiasis transmistted by
tsetse fly
42
What stimulates typanosome parasite growth
interferon-gamma production by CD8 cells
43
What appears at the site of a tsetse fly bite that is transmitting typanosomiasis?
large, red rubbery chancre (ulcer plus large mononuclear inflammatory infiltrate)
44
Most frequent cause of heart failure in Brazil and neighboring Latin American countries
Chaga's disease (Trypanosma cruzi)
45
How is Chaga's transmitted
person to person via "kissing bugs" which feed on sleeping inhabitants and pass infection via feces
46
chagoma
erythematous nodule at site of trypanosoma cruzi entry
47
Acute Chaga's disease involves
cardiac damage resulting from direct invasion of cardic cells; may present with fever, cardiac dilation and failure and generalized lymphadenopathy or splenomegaly
48
Pathology of chronic myocarditis
dilated heart with mural thrombi; interstitial and perivascular infiltrates are composed of lymphocytes, plasma cells and monocytes; cardiac cell necrosis and interstitial fibrosis
49
Describe the toxoplasma gondii organism
obligate intracellular protozoan
50
Toxo causes
subclinical infections but severe opportunistic disease in AIDS patients
51
Toxo oocytes are shed in?
cat feces; however, the oocytes are not infectious for 24-48 hours undercooked lamb or pork contains intracystic organisms
52
toxo enters through
gut
53
many toxo infections in AIDS patients appear to be
reactivation of dormant organisms from cysts
54
toxo is particularly damaging to fetuses when?
during the first trimester of pregnancy | disseminated and often fatal parasitemias occur in 25%
55
neonatal toxoplasmosis
destructive lesions in CNS are composed of microglial nodules extensive CNS necrosis, vascular thrombosis, and intense inflammation
56
Leishmaniasis vector
sandfly
57
Visceral forms of leishmaniasis
spread thru RES system result sin severe systemic disease hepatosplenomegaly, lymphadenopathy, pancytopenia, fever weight loss fibrotic liver, late lesions
58
black fever
hyperpigmentation of skin with leishmaniasis
59
Cutaneous forms of leishmaniasis
relatively mild with localized disease consisting of sing ulcer with surrounding granulomatous inflammation
60
mucocutaneous forms of leishmaniasis
moist, ulcerating or nonulcerating lesions which may be disfiguring
61
Naegleria
parasitic meningitis | infection from water source through cribiform plate in nose; mimics meningococcal meningitis
62
Acanthamoeba
parasitic meningitis in immunosuppressed individuals | entry through nasal mucosa, lung or skin with hematogenous dissemination
63
AIDS associated, but not disseminated parasitic infections
Amebae, giardia
64
Disseminated disease in immunosuppressed individuals
cryptosporidiosis, toxo
65
Schistosomiasis causes death usually from
hepatic granulomas and fibrosis
66
How does schistosomiasis infect hu8mans
sporocysts in fresh water snails give rise to cercaria which infect humans by penetrating through the skin
67
IL-3, IL-4, IL-5 results in induction of
IgE synthesis, mastocytosis and eosinophilia
68
what forms around schistosome egg?
calcified, pinhead granulomas | granulomas include macrophages, lymphocytes, neutrophils and eosinophils
69
Describe liver flukes (clonorchiasis)
adult flukes live in biliary ducts humans become infected by eating improperly cooked usually asymptomatic
70
Taenia saginata
beef tapeworm; ingestion of undercooked beef | no cysticercosus
71
Taenia solium
pork tapeworm ingestion of undercooked pork with encysted cysticerci attach to intestinal wall with scolices proglottids with eggs shed in feces
72
Cysticercosus
T. solium eggs ar eingested, larbae hatch and penetrate gut wall hematogenous dissemination results in cysts in CNS
73
Echinococcus
canine tapeworm hydatid cysts form in liver and lungs usually asymptomatic and chronic unless cysts rupture
74
Pinworms (Enterobius vermicularis)
small worms of intestine anal pruritis human is the only reservoir, pinworms cannot be gotten from anmals
75
Whipworms (Trichuris trichiura)
tropics local hyperemia and lesions of colonic mucosa not invasive
76
Hookworms (Necator americanus/Ancylostoma duodenale)
hookworms attach to upper levels of small intestine | larvae penetrate between toes
77
Hookworm symptomology
small itchy papule where they penetrate skin mild pneumonitis from traveling thru lungs blood loss and anemia
78
Strongyloides (Strongyloides stercoralis)
fatal disseminated disease in immunocompromsied host severe pneumonitis and duodenitis manifestations usually mild otherwise
79
Ascaris lumbricoides
extremely large worms that live unattached in lumen of small intestine
80
Symptoms and signs of ascaris
eosinophilic pneumonitis of the lung including dyspnea, dry cough, fever and eosinophilia epigastric pain, malnutrition eggs in feces
81
Small intestine parasites
hookworms, ascaris, strongyloides, giardia
82
Trinchinosis (Trichinella spiralis)
improperly cooked pork | larvae penetrate tissues, disseminate hematogenously, and encyst in muscle cells
83
signs of trinchinosis
marked eosinophilia, fever, myalgias, periorbital edema | patchy interstitial myocarditis with eosinophilia and giant cells resulting in scarring
84
Trapped trinchinella larvae in the lungs cause
allergic eosinophilic infiltrate
85
filariasis (Wuchereria bancrofti)
transmitted by mosquito | elephantiasis
86
onchocercias
filarial nematode transmitted by blackflies | major cuase of blindnes in equatorial africa

Path Infectious Diseases Test #1 (10 decks)

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