Parasitology 5 Flashcards

(49 cards)

1
Q

Describe the location of Leishmaniasis infection

A

blood and tissues

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2
Q

Which forms of Leishmaniasis cause only cutaneous infection?

A

L tropica

L major

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3
Q

Which forms of Leishmaniasis cause cutaneous and mucocutaneous infection?

A

L mexicana

L brazillensis

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4
Q

Which forms of Leishmaniasis cause visceral infection?

A

L chagasi
L donovani
L infantum

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5
Q

What is the vector of Leishmaniasis?

A

sand fly

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6
Q

Describe the lifecycle of Leishmaniasis

A

Vector borne- sand fly is infected when it takes a blood meal from infected host. Parasites develop in the sand fly, transmitted to a new host when fly bites again
Within humans, the leishmania is adapted to live in WBC and avoid being degraded

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7
Q

_____ and ______ are important reservoirs of Leishmaniasis

A

dogs and rodents

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8
Q

_______ transmission of Leishmaniasis has been documented in dogs

A

vertical

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9
Q

The great majority of ______ cases of Leishmaniasis occur in India, Bangladesh, Nepal, Sudan, and Brazil

A

visceral

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10
Q

Describe the epidemiology of Leishmaniasis

A
  • 350 million at risk
    ~12 million infected
    ~2 million new cases/year
    ~60,000 deaths/year

tropical and subtropical regions

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11
Q

Describe the presentation of cutaneous Leishmaniasis

A
  • Starts as a bump then an ulcerative sore at primary site; satellite lesions
  • abundant amastigotes in lesions
  • spontaneous healing with scarring
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12
Q

______ may reduce the duration of cutaneous Leishmaniasis lesions and help them heal faster

A

Fluconazole

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13
Q

Describe the presentation of mucocutaneous Leishmaniasis

A
  • metastasis months to years after primary lesion heals

- ulceration nasopharynx tissues, amastogotes in lesions

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14
Q

For both mucocutaneous and visceral Leishmaniasis, ________ leads to immunity

A

chemotherapeutic cure

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15
Q

Describe the presentation of visceral Leishmaniasis

A

Onset at 2-12 months, fever and wasting with hepatosplenomegaly

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16
Q

How is Leishmaniasis diagnosed

A

biopsy or aspirate the lesion, stain with Giemsa, look for amastigotes.
In US, CDC does DNA tests

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17
Q

Describe treatment for cutaneous Leishmaniasis

A

typically self-resolves with scarring

L. major treated with fluconazole

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18
Q

Describe treatment for mucocutaneous Leishmaniasis

A

Antimonials- not always effective and side effects

Amphotericin B is an alternate but expensive & iv daily

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19
Q

Describe treatment for visceral Leishmaniasis

A

miltefosine- drug of choice, given for 4 weeks, cures 94% Amphotericin B is an alternate

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20
Q

In eastern and southern Africa, African Trypanosomiasis is caused by Trypanosoma _________

21
Q

In western and central Africa, African Trypanosomiasis is caused by Trypanosoma ________

22
Q

What is the vector for Human African Trypanosomiasis?

23
Q

Contrast the progression of Western vs Eastern Human African Trypanosomiasis

A

Western: reservoir is human, chronic (years to progresion)

Eastern: reservoir is antelope, cattle; rapid progression in 1-4 weeks

both 100% mortality without treatment

24
Q

The African Trypanosomiasis parasite is free floating in the blood stream and undergoes __________ to avoid host immunity

A

antigenic variation

25
Describe the epidemiology of HAT
Exclusively sub-Saharan Africa Re-emerging 60 million people at risk
26
How is HAT diagnosed?
direct examination of blood, lymph, and CSF (rhodesiense)
27
What is Winterbottom's sign?
Enlargement of posterior cervical lymph nodes seen in African Trypanosomiasis
28
What drugs are used to treat early stage trypanosomiasis?
Pentamidine: useful for gambiense, well tolterated Suramin: useful for rhodesiense
29
What drugs are used to treat late stage trypanosomiasis?
Melarsoprol: discovered in 1949, used against both forms. Arsenic derivative with many side effects including fatal encephalopathy (3% to 10%). Eflornithine: Only effective against T.b. gambiense. Less toxic but infusion every 6 hr for 14 days.
30
What organism causes Chagas disease?
Trypanosoma cruzi
31
What is the reservoir for Trypanosoma cruzi?
rats, cats, dogs, wild animals
32
What is the location of Trypanosoma cruzi?
blood, lymphatics & tissues (intracellular)
33
What is the vector of Trypanosoma cruzi?
reduviid bug
34
How is Trypanosoma cruzi transmitted?
Bite of infected reduviid bug, transfusion, transplantation, IVDU, possibly vertical
35
Contrast the epidemiology of Chagas in rural vs urban settings
rural: vector/reservoir in proximity to human dwellings urban: contaminated blood supplies; IV drug use
36
How is spread of Chagas prevented?
Screen blood supply good housing vector control
37
Describe the progression of Chagas disease
Acute: 2-4 months fever, chagoma, hematogenous spread Chronic: 10-20 years, damage to nerve, muscle, heart, esophagus, colon. Death from sudden heart attack is common
38
How is Chagas diagnosed?
acute: trypomastigotes in blood chronic: xenodiagnosis Recently approved strip assay
39
How is acute chagas treated?
Benznidazole or Nifurtimox Neither FDA approved, get from CDC
40
What is the location of Trichomoniasis?
Urogenital- luminal
41
There are no ________ or ______ stages in the life cycle of Trichomoniasis
free living or encysted
42
How is Trichomonas vaginalis transmitted?
direct sexual contact, rarely non-sexual contact
43
70% of females infected with Trichomonas vaginalis are ______
asymptomatic
44
Describe signs of Trichomoniasis in women
vaginitis, burning and itching inflammation of squamous epithelia “frothy” vaginal discharge with unusual odor
45
Describe signs of Trichomoniasis in men
itching, irritation inside penis burning after urination or ejaculation mild discharge
46
List complications of Trichomoniasis
preterm delivery, LBW | increased risk of acquiring HIV
47
People who have been successfully treated for Trichomoniasis can be _______
re-infected
48
How is Trichomoniasis diagnosed?
microscopic observation of motile parasites | DNA test is available now at major centers
49
What is the treatment for Trichomoniasis?
metronidazole or tinidazole