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Histopathology Lecture > Parasitic Infections > Flashcards

Parasitic Infections Flashcards

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1
Q

Which Plasmodium species is the most virulent and causes cerebral malaria?

A

Plasmodium falciparum (also causes blackwater fever).

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2
Q

What is the key pathogenic mechanism of cerebral malaria?

A

PfEMP1 on infected RBCs → cytoadherence/sequestration → vascular blockage → ischemia.

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3
Q

Which malaria species cause relapses, and why?

A

P. vivax and P. ovale (due to hypnozoites in liver).

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4
Q

How do the RBC targets differ among P. falciparum, P. vivax/ovale, and P. malariae?

A

P. falciparum: All RBC stages

P. vivax/ovale: Young RBCs

P. malariae: Old RBCs.

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5
Q

What are the clinical patterns of:
a) P. falciparum
b) P. vivax/ovale
c) P. malariae?

A

a) Malignant tertian (irregular fever)

b) Benign tertian (48-hour cycles)

c) Quartan (72-hour cycles).

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6
Q

What is seen on histopathology in cerebral malaria?

A

Capillaries plugged with parasitized RBCs + perivascular ring hemorrhages.

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7
Q

What diagnostic test confirms malaria, and what are the key findings?

A

Giemsa-stained smear (trophozoites, schizonts, gametocytes) + hemozoin pigment in organs.

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8
Q

What causes the gray-black organ discoloration in severe malaria?

A

Hemozoin-laden phagocytic cells.

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9
Q

What is the vector for Leishmaniasis?

A

Sandfly.

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10
Q

What are the four clinical forms of leishmaniasis?

A

Visceral (hepatosplenomegaly, pancytopenia)

Cutaneous (indurated ulcer)

Mucocutaneous (nasopharyngeal ulcers)

Diffuse cutaneous (widespread nodules).

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11
Q

What is the hallmark microscopic finding in leishmaniasis?

A

Macrophages filled with amastigotes (no flagella, intracellular).

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12
Q

Which form of leishmaniasis causes hepatosplenomegaly and pancytopenia?

A

Visceral leishmaniasis (also called kala-azar).

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13
Q

How does cutaneous leishmaniasis typically present?

A

Indurated papule/nodule → ulcer with raised borders (self-resolves in 6–18 months).

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14
Q

What distinguishes mucocutaneous leishmaniasis?

A

Destructive ulcers in nasal/oral mucosa (e.g., “espundia”).

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15
Q

Which form of leishmaniasis shows non-ulcerative nodules spreading systemically?

A

Diffuse cutaneous leishmaniasis (anergic form).

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16
Q

What causes Chagas disease and what is its vector?

A

Trypanosoma cruzi (Reduviid bug/”kissing bug”)

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17
Q

What are the main complications of Chagas disease?

A

Dilated cardiomyopathy, megaesophagus, megacolon

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18
Q

What causes African sleeping sickness and its vector?

A

Trypanosoma brucei (Tsetse fly)

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19
Q

What are the two subspecies of T. brucei and their locations?

A

gambiense (West Africa), rhodesiense (East Africa)

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20
Q

What are the two clinical stages of African trypanosomiasis?

A

1) Hemolymphatic (fever, lymphadenopathy)
2) Neurologic (sleep disturbances, panencephalitis)

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21
Q

How can you distinguish T. cruzi and T. brucei microscopically?

A

T. cruzi - large kinetoplast
T. brucei - small kinetoplast

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22
Q

Where would you find trypomastigotes in these infections?

A

Peripheral blood smear

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23
Q
A
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24
Q

Which Plasmodium species is the most virulent and causes cerebral malaria?

A

Plasmodium falciparum (also causes blackwater fever).

How well did you know this?
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25
What is the key pathogenic mechanism of cerebral malaria?
PfEMP1 on infected RBCs → cytoadherence/sequestration → vascular blockage → ischemia.
26
Which malaria species cause relapses, and why?
P. vivax and P. ovale (due to hypnozoites in liver).
27
How do the RBC targets differ among P. falciparum, P. vivax/ovale, and P. malariae?
P. falciparum: All RBC stages P. vivax/ovale: Young RBCs P. malariae: Old RBCs.
28
What are the clinical patterns of: a) P. falciparum b) P. vivax/ovale c) P. malariae?
a) Malignant tertian (irregular fever) b) Benign tertian (48-hour cycles) c) Quartan (72-hour cycles).
29
What is seen on histopathology in cerebral malaria?
Capillaries plugged with parasitized RBCs + perivascular ring hemorrhages.
30
What diagnostic test confirms malaria, and what are the key findings?
Giemsa-stained smear (trophozoites, schizonts, gametocytes) + hemozoin pigment in organs.
31
What causes the gray-black organ discoloration in severe malaria?
Hemozoin-laden phagocytic cells.
32
What is the vector for Leishmaniasis?
Sandfly.
33
What are the four clinical forms of leishmaniasis?
Visceral (hepatosplenomegaly, pancytopenia) Cutaneous (indurated ulcer) Mucocutaneous (nasopharyngeal ulcers) Diffuse cutaneous (widespread nodules).
34
What is the hallmark microscopic finding in leishmaniasis?
Macrophages filled with amastigotes (no flagella, intracellular).
35
Which form of leishmaniasis causes hepatosplenomegaly and pancytopenia?
Visceral leishmaniasis (also called kala-azar).
36
How does cutaneous leishmaniasis typically present?
Indurated papule/nodule → ulcer with raised borders (self-resolves in 6–18 months).
37
What distinguishes mucocutaneous leishmaniasis?
Destructive ulcers in nasal/oral mucosa (e.g., "espundia").
38
Which form of leishmaniasis shows non-ulcerative nodules spreading systemically?
Diffuse cutaneous leishmaniasis (anergic form).
39
What causes Chagas disease and what is its vector?
Trypanosoma cruzi (Reduviid bug/"kissing bug")
40
What are the main complications of Chagas disease?
Dilated cardiomyopathy, megaesophagus, megacolon
41
What causes African sleeping sickness and its vector?
Trypanosoma brucei (Tsetse fly)
42
What are the two subspecies of T. brucei and their locations?
gambiense (West Africa), rhodesiense (East Africa)
43
What are the two clinical stages of African trypanosomiasis?
1) Hemolymphatic (fever, lymphadenopathy) 2) Neurologic (sleep disturbances, panencephalitis)
44
How can you distinguish T. cruzi and T. brucei microscopically?
T. cruzi - large kinetoplast T. brucei - small kinetoplast
45
Where would you find trypomastigotes in these infections?
Peripheral blood smear
46
Who is at risk for symptomatic toxoplasmosis?
Immunocompromised patients, pregnant women, and fetuses (congenital transmission)
47
What are the two main routes of transmission?
Eating undercooked meat/contaminated food/water Contact with cat feces (litter boxes/soil)
48
What are the classic triad of congenital toxoplasmosis findings?
Hydrocephalus, chorioretinitis, intracranial calcifications
49
What's the difference between tachyzoites and bradyzoites?
Tachyzoites: Fast-replicating, acute infection Bradyzoites: Slow-growing in tissue cysts (chronic infection)
50
Where does T. gondii typically form cysts?
Brain, skeletal muscle, myocardium, and visceral organs
51
Which two nematodes cause both intestinal AND pulmonary symptoms?
1) Ascaris lumbricoides 2) Hookworms (Ancylostoma/Necator) (Hookworms cause iron-deficiency anemia)
52
What are the key features of: Enterobius vermicularis Trichuris trichiura
Pinworm - anal pruritus, daycare outbreaks Whipworm - rectal prolapse
53
What makes Strongyloides stercoralis unique?
Can autoinfect and cause hyperinfection in immunocompromised (Bonus: Larvae found in sputum)
54
Where does Trichinella spiralis encyst and what does it cause?
Skeletal muscles (nurse cells) → myositis (Bonus: Can cause eosinophilic myocarditis/pneumonitis)
55
What are the main causative organisms of lymphatic filariasis?
Wuchereria bancrofti (90%) and Brugia species (malayi/timori) (Bonus: Transmitted by mosquitoes)
56
What is the role of Wolbachia in filariasis pathogenesis?
Symbiotic bacteria that contribute to inflammation and disease progression
57
What are the two main clinical presentations of chronic infection?
Chronic lymphatic disease (lymphedema, elephantiasis, hydrocele) Tropical pulmonary eosinophilia (TPE)
58
What are the pathological hallmarks of: Chronic lymphatic filariasis Tropical pulmonary eosinophilia
Lymphatic damage → granulomas → fibrosis Meyers-Kouwenaar bodies (eosinophilic precipitates around dead microfilariae)
59
What is the causative organism and vector for onchocerciasis?
Onchocerca volvulus (Blackfly/Simulium vector)
60
What are the 3 characteristic skin manifestations?
Leopard skin (hypopigmentation) Lizard skin (lichenification) Elephant skin (thickening) (Bonus: Onchocercomas = subcutaneous nodules)
61
What are the 4 ocular complications?
Punctate → Sclerosing keratitis Iridocyclitis Glaucoma Choroidoretinal atrophy (Bonus: Leading infectious cause of blindness)
62
What is the Mazzotti reaction?
Worsening ocular/skin inflammation after ivermectin treatment due to dying microfilariae
63
What are the 4 main Schistosoma species and their geographic distributions?
S. japonicum/mekongi - Asia (Philippines) S. mansoni - Middle East/Africa/S.America S. haematobium - Africa
64
What is the hallmark pathological feature of schistosomiasis?
Granulomatous inflammation around eggs → fibrosis
65
Match species to their primary organ involvement: S. japonicum/mansoni S. haematobium
Liver (pipestem fibrosis) Bladder (squamous cell CA risk)
66
What are the characteristic tissue changes in schistosomiasis: Liver Bladder
Pipestem fibrosis (Symmers' fibrosis) Sandy patches → calcified bladder
67
What are the two forms of Chlamydia trachomatis in its life cycle?
Elementary body (infectious, inactive) Reticulate body (replicative, active)
68
Which Chlamydia form is responsible for: Host cell infection Intracellular replication
Elementary body (infection) Reticulate body (replication)
69
How can you visualize Chlamydia elementary bodies microscopically?
Giemsa or fluorescent antibody stains (Bonus: Appear as small, dense particles)

Histopathology Lecture (25 decks)

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