protozoa Flashcards

(46 cards)

1
Q

Parasites are divided to

A
  1. Protozoa

2. Helminthes

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2
Q

Protozoa infections are divided to

A
  1. GI infections
  2. CNS infections
  3. Hematologic infections
  4. other infections (visceral infections and STD)
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3
Q

Protozoa GI infections - bugs and diseases

A
  1. Giardia lamblia - giardiasis
  2. Entamoeba histolytica - amebiasis
  3. Cryptosporidium - diarrhea
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4
Q

Giardia lamblia - disease and symptoms / seen in

A

Giardiasis: 1. bloating 2. flatulence
3. foul smelling, fatty diarrhea
campers + hikers

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5
Q

Giardia lamblia - transmission / diagnosis / treatment

A

cysts in water
multinucleated trophozoites or cysts in stool
treatment: metronidazole

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6
Q

Entamoeba histolytica - disease and symptoms

A

Amebasis: 1. bloody diarrhea (dysentery)

  1. liver abscess (anchovy paste exudate)
  2. RUG pain
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7
Q

Entamoeba histolytica - transmission / treatment

A

cysts in water
treatment: metronidazole
or iodoquinol for asymptomatic cyst passers
- a luminal agent, eg. paromomycin) is also recommended to eradicate intestinal colonizationcyst
- drainage is not recommended

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8
Q

Entamoeba histolytica infection - diagnosis

A
  • serology and/or
  • trophozoites with RBCs in the cytoplasm
    or cysts with up to 4 nuclei in stool
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9
Q

Cryptosporidium - disease and symptoms

A
severe nonbloody diarrhea in AIDS
Mild disease (watery diarrhea) in immunocompoment
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10
Q

Cryptosporidium - transmission / diagnosis

A

oocysts in water

diagnosis: oocysts on acid-fast stain

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11
Q

Cryptosporidium - treatment/prevention

A

prevention by filtering city water supplies
notazoxamide in immunocompetent hosts
no clear treatment for AIDS patient

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12
Q

Protozoa - CNS infection - bugs and diseases

A

Toxoplasma gondi - toxoplasmosis
Naegleria fowleri - rapidly fatal meningoencephalitis
Trypanosoma brucei - African sleeping diseas

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13
Q

Toxoplasma gondi infection and symptoms

A
  1. Congenital toxoplasmosis –> classic triad of chorioretinitis, hydrocephalus, intracranial calcification
  2. reactivation in aids –> brain abscess
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14
Q

Toxoplasma gondi transmission

A

cysts in undercooked meat (MC)
oocysts in cat feces
crosses placenta

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15
Q

Toxoplasma gondi - diagnosis

A

serology
biopsy (tachyzoite)
CT/MIR ring-enhancing lesion

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16
Q

Trypanosoma brucei - disease and symptoms

A

African sleeping disease: 1. enlarged lymph nodes

2. recurring fever 3. somnolence 4. Coma

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17
Q

African sleeping disease - transmission / diagnosis

A

Tsetse fly, a painful bit

diagnosis: Trypomastigote in blood smear

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18
Q

African sleeping disease - treatment

A

suramin for blood-borne disease

melarsoprol for CNS penetration

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19
Q

Naegleria fowleri - diagnosis

A

amoebas in spinal fluid

20
Q

Malaria - fever according to bug

A

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)

21
Q

other complications of malaria, beside general symptoms

A

occlude capillaries in brain (cerebral malaria), kidney, lung (esp with P. Falciparum)

22
Q

Malaria - relapse vs recrudescence

A

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

23
Q

Malaria - diagnosis

A
  1. Blood smear: trophozoites ring within RBCs, schizont containing merozoites
  2. Red granules (Schuffner stippling) through RBC cytoplasm seen with P. vivax/ovale
24
Q

Malaria - treatment for every situation

A
  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
25
Protozoa visceral infections - bugs and disease
1. Trypanosoma cruzi --> Chagas disease | 2. Leishmania donovani --> Visceral leishmaniasis (kala-azar), cutaneous leismaniasis
26
Leishmania donovani - disease and symptoms / aka
``` A. Visceral leishmaniasis (kala-azar): 1. spiking fevers 2. hepatosplenomegaly 3. pancytopenia B. cutaneous leismaniasis: 1. Skin ulcers ```
27
Leishmania donovani - transmission
sandfly
28
Visceral leishmaniasis (kala-azar) - diagnosis / treatment
macrphages contating amastigotes amphotericin B sodium stibogluconate
29
Trypanosoma cruzi - disease / map / transmission
Chagas disease SOUTH AMERICA transmission: Reduviid bug (kissing bug) feces, deposited in a painless bite
30
Chagas disease sign
ROMANA SIGN: unilateral periorbital swelling --> characteristic of acute stage
31
chagas disease - diagnosis / treatment
Trypomastigote in blood smear | - Benzidazole or nifurtimox
32
Protozoa sexual transmitted infections - bugs and disease / symptoms
Trichomonas vaginalis --> vaginitis --> foul-smelling, greenish discharge, itching and burning
33
bacterial vaginosis vs protozoal vaginitis according to
vaginitis: foul-smelling, greenish discharge, itching and burning Bcterial vaginosis: gray vaginal discharge with fishy smell, nonpainful
34
Trichomonas vaginalis - outside human form
cannot exits outside human because it cannot form cysts
35
Trichomonas vaginalis - diagnosis / treatment
trophozoites (motile) on wet mount strawberry cervix - Metronidazole for patient and partner (prophylaxis)
36
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)
37
Babesiosis - epidimiology / diagnosis
ixode scapularis like lyme and anaplasmosis | thin blood smear: intraerythrocytic rings (Maltese cross)
38
Babsiosis - manifestation
- flu like - if severe: ARDS, CHF, DIC, splenic rupture - anemia, thrombocytopenia, increased bilirubinm LDH, LFTs
39
Babesia - treatment
- atovaquone + azithromycin | - Quinine + clindamycin (if severe)
40
RFs for severe babesiosis
1. immonucompr 2. splenectomy 3. older than 50
41
complications of malaria in children
seizure, coma, hypoglycemia, met acidosis
42
complications of malaria in adults
jaundice, acute renal failure, acute pulm edema
43
C. parvum in immunocomprement
traveler's diarrhea - prolonged, profuse, watery - self limited in 10-14 days
44
E. histolytica - most common symptom
asymptomatic (only 10% has colitis) `
45
malaria prevention
travelers new to endemic areas require chemoprophylaxis atovaquone - proguanil, doxycycline or melfoquine (2 weeks prior to travels, continued during statyy, discont 4 weeks after returning other measures to protect from mosquitos
46
toxoplasmic encephalitis - stereotactic brain biopsy
only if not respond to antibiotic