protozoa Flashcards
(83 cards)
1
Q
Parasites are divided to
A
- Protozoa
2. Helminthes
2
Q
Helminthes are divided to
A
- Nematodes (roundworms)
- Cestodes (tapeworms)
- Trematodes (flukes)
3
Q
Protozoa infections are divided to
A
- GI infections
- CNS infections
- Hematologic infections
- other infections (visceral infections and STD)
4
Q
Protozoa GI infections - bugs and diseases
A
- Giardia lamblia - giardiasis
- Entamoeba histolytica - amebiasis
- Cryptosporidium - diarrhea
5
Q
Giardia lamblia - disease and symptoms
A
Giardiasis: 1. bloating 2. flatulence
3. foul smelling, fatty diarrhea
6
Q
Giardiasis is often seen in
A
campers/hikers
7
Q
Giardia lamblia - transmission
A
cysts in water
8
Q
Giardia lamblia - diagnosis
A
multinucleated trophozoites or cysts in stool
9
Q
trophozoite?
A
a growing stage in the life cycle of some sporozoan parasites, when they are absorbing nutrients from the host. (pathogenic state)
10
Q
Giardiasis - treatment
A
metronidazole
11
Q
Entamoeba histolytica - disease and symptoms
A
Amebasis: 1. bloody diarrhea (dysentery)
- liver abscess (anchovy paste exudate)
- RUG pain
12
Q
amebiasis - gross appearance
A
flask-shaped ulcer in colon
13
Q
Entamoeba histolytica - rout from colon to liver abscess
A
invades through the intestinal wall to enter to the bloodstream
14
Q
anchovy paste exudate
A
Amoebic abscesses of the liver produce brownish pus, which is described as looking like “anchovy paste”
15
Q
Entamoeba histolytica - transmission
A
cysts in water
16
Q
Entamoeba histolytica infection - diagnosis
A
- serology and/or
- trophozoites with RBCs in the cytoplasm
or cysts with up to 4 nuclei in stool
17
Q
Entamoeba histolytica infection - treatment
A
- metronidazole
2. iodoquinol for asymptomatic cyst passers
18
Q
Cryptosporidium - disease and symptoms
A
severe nonbloody diarrhea in AIDS Mild disease (watery diarrhea) in immunocompoment
19
Q
Cryptosporidium - transmission
A
oocysts in water
20
Q
Cryptosporidium - diagnosis
A
oocysts on acid-fast stain
21
Q
Cryptosporidium - treatment/prevention
A
prevention by filtering city water supplies
notazoxamide in immunocompetent hosts
no clear treatment for AIDS patient
22
Q
Protozoa - CNS infection - bugs and diseases
A
Toxoplasma gondi - toxoplasmosis
Naegleria fowleri - rapidly fatal meningoencephalitis
Trypanosoma brucei - African sleeping disease
23
Q
Toxoplasma gondi infection and symptoms
A
- Congenital toxoplasmosis –> classic triad of chorioretinitis, hydrocephalus, intracranial calcification
- reactivation in aids –> brain abscess
24
Q
Toxoplasma gondi transmission
A
cysts in undercooked meat (MC)
oocysts in cat feces
crosses placenta
25
Toxoplasma gondi - pregnant women should
avoid cats
26
Toxoplasma gondi - diagnosis
serology
biopsy (tachyzoite)
CT/MIR ring-enhancing lesion
27
Toxoplasma gondi in AIDS - CT/MIR
ring-enhancing lesion
28
Toxoplasma gondi infection - treatment
sulfadiazine + Pyrimethamine
29
Trypanosoma brucei - subspecies
1. Trypanosoma brucei rhodesiense
| 2. Trypanosoma brucei gambiense
30
Trypanosoma brucei - disease and symptoms
African sleeping disease: 1. enlarged lymph nodes
| 2. recurring fever 3. somnolence 4. Coma
31
Mechanism of recurring fever in African sleeping disease
antigenic variation
32
African sleeping disease - transmission
Tsetse fly, a painful bit
33
African sleeping disease - diagnosis
Trypomastigote in blood smear
34
African sleeping disease - treatment
suramin for blood-borne disease
| melarsoprol for CNS penetration
35
Naegleria fowleri - disease and symptoms
rapidly fatal meningoencephalitis
36
Naegleria fowleri - transmission
swiming in freshwater lakes --> enters via cribriform plate
37
Naegleria fowleri - diagnosis
amoebas in spinal fluid
38
Naegleria fowleri - treatment
amphotericin B has been effective for a few survivors
39
Protozoan hematologic infections - bugs and diseases
1. Plasmodium --> Malaria
| 2. Babesia --> Babesiosis
40
Protozoan hematologic infections - Babesia - disease and symptoms
Babesiosis --> fever and hemolytic anemias
| high risk of severe disease with asplenia
41
Babesios - area (map)
northeastern US
42
Babesios - high risk in
asplenia
43
Babesios - tranmission
ixodes tick
44
Babesiosis - treatment
Atovaquone + azithromycin
45
Babesios - diagnosis
1. Blood smear: ring form and Maltese cross
| 2. PCR
46
Plasmodium - bugs
P. vivax
P. oval
P. falciparum
P. malariae
47
Malaria - general symptoms
1. fever
2. headache
3. anemia
4. splenomegaly
48
Malaria - fever according to bug
P. vivax/ovale --> 48hr cycle (tertian: fever on first day and third day, thus fever are actually 48hr apart)
P. falciparum --> severe. irregular fever pattern
P. malariae --> 72 hr cycle (quartan)
49
malaria is AKA
blackwater fever
50
other complications of malaria, beside general symptoms
occlude capillaries in brain (cerebral malaria), kidney, lung (esp with P. Falciparum)
51
Malaria - transmission
anopheles mosquito (sporozoites)
52
Briefly describe the life cycle of plasmodia parasite
sporozoites in mosquito salive enter into human blood --> sporozoites enter liver cells and multiply and differentiate --> Merozoites are release from liver cells and enter RBCs --> Multiplication and differentiation into trophozoites and gamezytes within RBCs --> RBCs rupture releasing moro trophozoites, merozoites and gametocytes --> mosquito picks up male and female gametocytes when ingesting human blood
53
Malaria - relapse vs recrudescence
Relapse occurs in P. vivax and P. ovale infection ressults from hypnozoites --> reactivation of hypnozoites in liver
Recrudescence occurs in P. malariae and P. falciparum infections and results from incomplete eradication of the parasites
54
Malaria - diagnosis
1. Blood smear: trophozoites ring within RBCs, schizont containing merozoites
2. Red granules (Schuffner stippling) through RBC cytoplasm seen with P. vivax/ovale
55
Schuffner stippling
Red granules through RBC cytoplasm seen with P. vivax/ovale
56
Malaria - treatment for every situation
1. Chloroquine (for sensitive species)
2. Mefloquine or atovaquone/proquanil (for resistant)
3. IV quinidine or artesunate (If life threatening) --> test for G6PD
4. P. vivax/ovale add primaquine for hypnozoite --> test for G6PD
57
antimalaria drugs --> test for G6PD with which drugs
1. quinidine
2. artesunate
3. primaquine
58
Protozoa visceral infections - bugs and disease
1. Trypanosoma cruzi --> Chagas disease
| 2. Leishmania donovani --> Visceral leishmaniasis (kala-azar), cutaneous leismaniasis
59
Leishmania donovani - disease and symptoms / aka
```
A. Visceral leishmaniasis (kala-azar):
1. spiking fevers
2. hepatosplenomegaly
3. pancytopenia
B. cutaneous leismaniasis: 1. Skin ulcers
```
60
Leishmania donovani - transmission
sandfly
61
Visceral leishmaniasis (kala-azar) - diagnosis
macrphages contating amastigotes
62
Visceral leishmaniasis (kala-azar) - treatment
amphotericin B
| sodium stibogluconate
63
Trypanosoma cruzi - disease and symptoms
Chagas disease:
1. dialted cardiomyopathy with apical atrophy
2. megalcolon
3. megaesophagus
64
Trypanosoma cruzi - disease / map
Chagas disease
| SOUTH AMERICA
65
Chagas disease sign
ROMANA SIGN: unilateral periorbital swelling --> characteristic of acute stage
66
Trypanosoma cruzi - Transmission
Reduviid bug (kissing bug) feces, deposited in a painless bite
67
Trypanosoma cruzi - diagnosis
Trypomastigote in blood smear
68
Trypanosoma cruzi -treatment
Benzidazole or nifurtimox
69
Protozoa sexual transmitted infections - bugs and disease
Trichomonas vaginalis --> vaginitis
70
Trichomonas vaginalis - disease and symptoms
vaginitis:
| foul-smelling, greenish discharge, itching and burning
71
bacterial vaginosis vs protozoal vaginitis according to symptoms
vaginitis: foul-smelling, greenish discharge, itching and burning
Bcterial vaginosis: gray vaginal discharge with fishy smell, nonpainful
72
Trichomonas vaginalis - transmission
sexual
73
Trichomonas vaginalis - outside human form
cannot exits outside human because it cannot form cysts
74
Trichomonas vaginalis - diagnosis
trophozoites (motile) on wet mount
| strawberry cervix
75
Trichomonas vaginalis - treatment
Metronidazole for patient and partner (prophylaxis)
76
treatment for all protozoal infections (except malaria)
Giardiasis --> Metronidazole
amebiasis --> metronidazole, iodoquinol for asymptomatic cyst passers
cryptosporidium --> prevention by filtering city water supplies, nitazoxanide in immunocompetent, no clear treatment for aids
Toxoplasma gondi --> Sulfadiazine+pyrimethamine
Naegleria fowleri --> Amphotericin B
Trypanosoma brucei --> Suramin for blood-borne disease or melarsoprol for CNS penetration
Babesia --> atovaquone + azithromycin
Tripanosoma cruzi --> Benzidazole or nifurtimox
Leishmania donovavi --> amphotericin sodium stibogluconate
trichomonas vaginalis --> Metronidazole for patient and partner (prophylaxis)
77
Malaria - treatment for every situation
1. Chloroquine (for sensitive species)
2. Mefloquine or atovaquone/proquanil (for resistant)
3. IV quinidine or artesunate (If life threatening) --> test for G6PD
4. P. vivax/ovale add primaquine for hypnozoite --> test for G6PD
78
protozoa infection in asplenia
Babesia
79
Chloroquine - mechanism of action
Blocks detoxification of heme into hemozoin --> Heme accumulates and is toxic to plasmodia (block polymerase)
80
Chloroquine - clinical use
plasmodium species other than P. falciparum (resistance)
81
Chloroquine - P. falciparum (why)
resistance -->membrane pump that decreases intracellular concentration in drugs
82
P. falciparum - treatment
artemether/lumefantrine or atovaquone/proquanil
83
Chloroquine - toxicity
1. Retinopathy
| 2. Pruritus (esp in dark-skinned individuals)
