Parasitic Infections in Blood and Lymph

Question 1

What are the blood and lymph infective protozoans?

Answer 1

Plasmodium sp.
Babesia sp.
Trypanosoma sp.

Question 2

What are the blood and lymph filarial nematodes?

Answer 2

Wuchereria bancrofti
Brugia malayai
Onchocerca

Question 3

Which trematode infects the blood?

Answer 3

Schistosomes

Question 4

What cause malaria?

Answer 4

Plasmodium

Question 5

Where does plasmodium live in the host?

Answer 5

Inracellular in hepatocytes and RBCs

Question 6

Which species of plasmodium effect humans?

Answer 6

P. vivax
P. ovale
P. malariae
P, falciparum

Question 7

What is the life cycle pattern of plasmodium?

Answer 7

A mosquito uptake a exflaggellated gamete which grows into a zygote, oocyst and then sporozoite
A female mosquito goes to drink blood from a human releasing the sporozite into the blood where it becomes a liver schizont
It will cycle between schizont and trophocyte by way of merozoites
It will become a gametocyte from a merozoite that does’t hate you and a mosquito drink it up

Question 8

What is the incubation period for malaria?

Answer 8

1 to 2 weeks

Question 9

What are the clinical signs of malaria?

Answer 9

Flu-like illness, headache, anorexia

Classic sighs of cycled fever, chills and rigor

Question 10

Why is fever caused due to hemolytic anemia in malaria?

Answer 10

RBCs explode so hemoglobin and debris release the parasite antigen (GPI) leading to host secretion of TNF and IL-1

Question 11

What are the fever cycles for the different types of plasmodiums?

Answer 11

Vivax and ovale: 48 hours
Malariae: 72 hours
Falciparum: at random

Question 12

Which plasmodium can cause CNS or renal involvement?

Answer 12

Falciparum

Question 13

Which plasmodium enjoy killing baby RBCs to breed their nastiness?

Answer 13

Vivax and ovale

Question 14

Which plasmodium replicates in mature RBCs?

Answer 14

Malariae

Question 15

Which plasmodium can form hypnozoites in the liver?

Answer 15

Vivax and ovale

Question 16

What drug is needed if hypnozoites are present?

Answer 16

Primaquine

Question 17

Which is the most severe plasmodium infection? Why?

Answer 17

Falciparum
Many strain are resistant to chloroquine
Replicates in erthrocytes at any age
More parasite replication

Question 18

What is the parasite antigen of P. falciparum expressed on infected RBCs and what does it bind to?

Answer 18

pfEMP-1

ICAM-1

Question 19

Due to the antigen presentation in P.falciparum, what happens when the RBCs block small vessels?

Answer 19

Block blood supply to organs leading to organ damage

Question 20

What are the severe clinical manifestations of P.falciparum?

Answer 20

Cerebral malaria
Blackwater fever (renal damage)
Fetal and mother death in pregnancy

Question 21

What is used for indication of malaria and what can you see?

Answer 21

Giemsa stained blood smears

Ring form, gametocytes, trophozoites, schizonts

Question 22

If you happen across a chloroquine-resistant form of P. falciparum, what can you use instead?

Answer 22

Mefloquine
Quinine+doxycycline
Quinine+clindamycin

Question 23

What drugs would you use for P. falciparum and P. malariae?

Answer 23

Chloroquine

Question 24

What drug would you use for P. vivax and P. ovale?

Answer 24

Chloroquine+primaquine

Question 25

How can malaria be prevented?

Answer 25

Mosquito control Avoid mosquito bites Chemoprophylaxis

Question 26

In chemoprophylaxis use, what drugs should be taken to avoid malaria?

Answer 26

The same as the drug taken if you get malaria | P falciparium: same as previously mentioned plus atovaquone+proguanil = Malarone

Question 27

What type of parasite causes babesiosis?

Answer 27

Babesia microti - protozoan

Question 28

What is the vector for Babesia microti?

Answer 28

Ticks (Ixodes dammini)

Question 29

What is the reservoir for babesia microti?

Answer 29

Mice Immature ticks feed on mice, adults feed on deer Nymphs and adults will also feed on humans

Question 30

What is the pathogenesis of babesiosis?

Answer 30

Bite of infected tick, babesia replicates in erythrocytes, RBC lysis to release merozoites, 1-4 week incubation, fever chills head ache fatigue weakness, hemolytic anemia or renal failure

Question 31

How is babesiosis diagnosed?

Answer 31

Demonstration of parasite in thick and thin blood smears

Question 32

What is the treatment for babesiosis?

Answer 32

Clindamycin plus quinine | Atovaquone plus azithromycin

Question 33

What is the cause of Chaga's disease?

Answer 33

Trypanosoma cruzi (prorozoan)

Question 34

What is the vector and reservoir for T. cruzi?

Answer 34

Triatomid bugs | Armadillos, rodents, dogs

Question 35

What are the acute clinical manifestations of Chaga's disease

Answer 35

Generally asymptomatic Fever, anorexia, lymphadenopathy, mild hepatosplenomegaly, myocarditis Chagoma - nodular lesion at inoculation site Romana's sign - chagoma near eye (unilateral periocular swelling)

Question 36

What are the chronic manifestations of Chaga's disease?

Answer 36

Amastigotes replicate in various cell types Megaesohagus or megacolon Cardiomyopathy

Question 37

What is antigenic mimicry?

Answer 37

The parasite mimics the antigens of the heart muscle causing the immune system to attack to parasite but become confused and being attacking the heart as well

Question 38

How is Chaga's disease diagnosed?

Answer 38

Finding trypomastigotes in blood or amastagotes in biopsies of lymph nodes, spleen, liver or bone marrow

Question 39

What is the treatment for Chaga's disease?

Answer 39

Chronic not reversible | Some drugs for acute

Question 40

What causes African sleeping sickness?

Answer 40

Trypanocomes brucei

Question 41

What is the vector and reservoir of T. brucei?

Answer 41

``` Tsetse fly Wild ungulates (antelopes) ```

Question 42

What are the two species of T. brucei in Africa?

Answer 42

T. brucei gambiense (West and Central) | T. brucei rhodesiens (East and South)

Question 43

What is the the pathogenesis of sleeping sickness?

Answer 43

Bit of Tsetse fly, T. brucei replicates in blood and lymph, fever-lymphpadenopathy-pruritus, enters CNS after weeks/month, alter mental and sensory status, difficultly walk and talk, coma and death

Question 44

How is T. brucei diagnosed?

Answer 44

Detection of trypomastigotes in blood, CSF and lymph films

Question 45

How is T. brucei treated?

Answer 45

Suramin for blood and lymph phases | Malarsoprol for CNS

Question 46

What are the different species of Schistosoma (blood flukes?

Answer 46

S. haematobium S. manosi S. japonicum

Question 47

What is the life cycle of a Schistosoma?

Answer 47

Eggs hatch in the water as miracidum enter cell which develops into a cercaria released from the snail and burrow through skin which then develops into an adult and lays eggs in the blood and eventually are released in urine or feces

Question 48

Where is S. haematobium found, where are adults found and where are eggs expelled from?

Answer 48

Africa and Middle East Bladder vessels Urine

Question 49

Where are the adults of S. mansoni and S. japonicum found as adults and where are the eggs expelled from?

Answer 49

Venous plexus of intestines | Stool

Question 50

What are the clinical manifestations of schitosomiasis?

Answer 50

``` Allergic dermatitis associated with cercarial penetration of skin Katayama fever (immune rxn to egg production) Granulomatoud lesions interfere with organ function ```

Question 51

What is the treatment for Schitosomiasis?

Answer 51

Praziquantel

Question 52

How can Schitosomiasis be controlled?

Answer 52

Education, improved snaitation, bio-control agents, molluscicides, drain marshes

Question 53

What are the filariasis parasites?

Answer 53

Wuchereria bancrifti Brugia malayi Onchocerca volvulus Loa loa

Question 54

Which Filariasis causes elephantiasis?

Answer 54

Wuchereria bancrifti | Brugia malayi

Question 55

What does Onchocercosis cause and what is the vector?

Answer 55

``` River blindness due to microfilariae in eye Black fly (Simulium) ```

Question 56

What are the clinical manifestations of Onchocercosis?

Answer 56

Due to inflammatory response to microfilariae | Nodules on skin, depigmentation, thickening, itching

Question 57

How do you diagnose Onchocercosis?

Answer 57

Demonstration of microfilariae in skin snip prep

Question 58

What is the treatment of Onchocercosis?

Answer 58

Surgical removal of nodules containing adult worms | Ivermectin

Question 59

What can be used for prophylaxis against Onchocercosis?

Answer 59

Ivermectin and diethylacarbanizine

Question 60

What is Loiasis (loa loa) transmitted by?

Answer 60

Mango flies or deer flies (chrysops)

Question 61

What is the pattern of movement of the Loa loa?

Answer 61

Adult worms live in connective tissue under the skin and between facial layer over somatic muscle Thousands of microfilariae produced daily Adult migrate frequently and can pass across the eye