TA2

Question 1

What are 3 possible treatment for candida?

Answer 1

fluconazole

or amphotericin or echinocandins

Question 2

What are two possible treatment for aspergillus?

Answer 2

voriconazole or amphotericin

Question 3

What are two treatments for zygomycetes?

Answer 3

surgical plus posaconazole or amphotericin

Question 4

What are two possible treatment for cryptococcus?

Answer 4

amphotericin +/- 5FC

OR fluconazole

Question 5

What are 3 possible treatments for histoplasma?

Answer 5

amphotericin or itraconazole or voriconazole

Question 6

What are 3 possible treatment for blastomyces?

Answer 6

amphotericin or itraconazole or fluconazole

Question 7

What is treatment for coccidioides?

Answer 7

amphotericin

plus fluconazole in immune compromised

Question 8

What are 3 possible treatments for paracoccidioides?

Answer 8

itraconazole
amphotericin B
TMP-SMX

Question 9

What is treatment for penicilium?

Answer 9

amphotericin + 5FC

Question 10

What is side effect of fluconazole? what do you use it for?

Answer 10

hepatotoxicity

mainly cryptococcal meningitis, candida

Question 11

What is side effect of itraconazole? What do you use it for?

Answer 11

hepatotoxicity, CHF, taste disturbances

mainly histoplasma, blastomyces, sporothrix

Question 12

What is side effect of voriconazole? what do you use it for?

Answer 12

visual distrubances

invasive aspergillosis

Question 13

What is side effect of posaconazole? what is it used for?

Answer 13

risk of prolonged QTc w/ quinidine, N/V, liver enzymes

zygomycetes

Question 14

What is amphotericin mainly used for?

Answer 14

• cryptococcal meningitis
• zygomycetes
• disseminated histoplasmosis
• invasive aspergillosis

Question 15

What 2 things can fluconazole not treat definitively?

Answer 15

aspergillus, mucor

Question 16

What is target of echinocandins?

Answer 16

cell wall [vs other antifungals are cell membranes]

Question 17

What do you use to diagnose/treat ascaris lumbricoides?

Answer 17

eggs with rough surface in stool

treat: mebendazole or albendazole

Question 18

What do you use to diagnose/treat necatur americanus / ancyclostoma duodenale [hookworm]?

Answer 18

• visualized eggs in stool

- mebendazole or albendazole + iron

Question 19

What do you use to diagnose/treat anyclostoma braziliense? What does it cause?

Answer 19

cutaneous larva migrans = creeping eruption, curly q rash on feet

albendazole or mebendazole

Question 20

What do you use to diagnose/treat strongyloides?

Answer 20

• larvae in stool/sputum/biopsy
• albendazole or thiabendazole
• PLUS ivermectin

Question 21

What are the parasites that are coughed up and swallowed?

Answer 21

• strongyloides
• hookworm
• ascaris

Question 22

What do you use to diagnose/treat enterobius vermicularis?

Answer 22

• scotch tape test

- mebendazole or albendazole

Question 23

What do you use to diagnose/treat trichuris trichiura?

Answer 23

• barrel shaped egg with polar plugs in stool

- mebendazole or albendazole

Question 24

What do you use to diagnose/treat toxocara canis? What is another name for it

Answer 24

toxocara = dog helminth [sandbox]
visceral larva migrans, hepatosplenomegaly, blindness

• benzimidazoles

Question 25

What do you use to diagnose/treat trichinella spiralis?

Answer 25

- elevated CPK, eosinophilia, spiral shaped larvae | - mebendazole and steroids

Question 26

What do you use to diagnose/treat wurchereria bancrofti?

Answer 26

- detect microfilariae at night | - diethylcarbamazine

Question 27

What do you use to diagnose/treat onchocerca volvulus?

Answer 27

- skin snips to find microfilariae in subcutaneous nodules | - ivermectin

Question 28

How do you treat drancuncluiasis medinsi? what is it?

Answer 28

- slow mechanical extraction of worm over days - clinical sign = foot pain, itchiness, from drinking water with crustaceans containing larvae - find larvae in stool

Question 29

How do you treat taenia solium?

Answer 29

for CNS --> albendazole + steroids | for GI --> praziquantel

Question 30

Wht should you think: barrel shaped egg with polar plug in stool?

Answer 30

trichurius trichiura = whipworm

Question 31

What diseases associated with culex mosquito?

Answer 31

- WNV - japanese encephalitis - wuchereria bancrofti - st louis encephalitis

Question 32

How do you get cysticercosis vs taepworm from taneia solium?

Answer 32

``` tapeworm = undercooked pork with larvae cysticercosis = contaminated food with eggs ```

Question 33

What do you use to treat taenia saginata?

Answer 33

praziquantel

Question 34

What do you use to diagnose/treat diphyllobothrium latum? how do you get it?

Answer 34

dx: oval/operculated eggs in feces treat: praziquantel get: consumption raw fish

Question 35

What do you use to diagnose/treat echinococcus granulosus? how do you get it?

Answer 35

- dx: water lily appearance on imaging - treat: PAIR [percutaneous, aspiration injection, respiration] or liver surgery + albendazole for lungs - get: ingest eggs from dog feces = dog tapeworm

Question 36

What should you think: brazil, vomitting blood, pale, cold, clammy, abdomen distended, superficial veins prominent, fluid wave?

Answer 36

schistosoma mansoni

Question 37

What are the four tretamodes?

Answer 37

schistosoma fasciola hepatica opistorchis paragnoimus westermani

Question 38

What do you use to diagnose/treat schistoma? how do you get it?

Answer 38

dx: eggs with operculum in feces/urine treat: praziquantel get: penetrate intact skin in water

Question 39

What do you use to diagnose/treat fasciola hepatica? how do you get it?

Answer 39

dx: migratory RUQ pain, fever, gallstones, liver abcess treat: veterinary triclabendazole get: eat watercress infected

Question 40

What do you use to diagnose/treat opistorchis sinensis? how do you get it?

Answer 40

= chinese river fluke dx: operculated egg in gallbladder treat: praziquantel get: eat raw freshwater fish

Question 41

What do you use to diagnose/treat paragonimus westermani ? how do you get it?

Answer 41

dx: cystic cavities in lungs [like TB] treat: praziquantel get: fecal oral ingestion raw shellfish in east asia

Question 42

What is mech of action benzimidazoles [alb, medb, thia]?

Answer 42

inhibit assembly microtubules and glucose --> parasite immobilization and death, also larvacidal

Question 43

Side effects of benzimidazoles?

Answer 43

- alopecia, ab pain, liver enzymes

Question 44

What do you with treat thiabendazole?

Answer 44

strongyloides

Question 45

What do you treat with albendazole?

Answer 45

round worms [ascaris, hookworm, strongyloides, enterobius, trichurius] larval forms of fat worms [neurcysticercois]

Question 46

What do you treat with mebendazole?

Answer 46

round worms

Question 47

What is mech of action ivermectin? what does it treat?

Answer 47

- neurotoxic to worm nervous system, parasite paralysis | - use: intestinal and systemic nematodes [strongyloides], onchocerciasis [river blindness]

Question 48

What is mech of action diethylcarbamizine? what does it treat?

Answer 48

- immobilized microfilariae | - use: filiarasis [wuchereria] and onchocerciasis

Question 49

What is mech of action praziquantel? use?

Answer 49

- depolarized neuromuscular block, paralizes tapeworms and flukes use: most flatworms and flukes -- T solium/saginata, d latum, schistosoma

Question 50

What is the only antimalarial that isnt a teratogen?

Answer 50

mefloquine

Question 51

What malaria drug is safe in kids?

Answer 51

atavaquone/proguanil

Question 52

What is daily dosing malaria prophylaxis?

Answer 52

doxycicline

Question 53

What is dx/treatment for entamoeba?

Answer 53

dx: trophozoite with ingested RBC in diarrhea metronidazole or tinidazole + iodoquinol to kill entamoeba cysts

Question 54

What is dx/treatment for trichomonas vaginalis?

Answer 54

dx: wet mount of discharge see motility treat: metronidazole or tinidazole + treat partner

Question 55

What is treatment for naegleria, acanthamoeba, balamuthia?

Answer 55

-- no treatment for meningoencephalitis that it causes == fatal

Question 56

What is dx/treatment for cryptosporidium? isospora/cyclospora?

Answer 56

all dx: acid fast stain, immunostain of stool treat: immune reconstitution + nitazoxanid for crypto, TMP/SMX for Iso/Cyclo

Question 57

What is treatment for giadria? dx?

Answer 57

dx: visualize with DFA treat: metronidazole or tinidazole

Question 58

What is mech of action of metronidazole/tinidazole? toxicity? use?

Answer 58

- disturbs e- balance in parasite - use for anaerobic protozoa [entamoeba, giardia, trichomonas] - tox: disulfiram life rxn if take with alcohol

Question 59

What are main drugs for leishmeniasis?

Answer 59

- amphotericin | - antimonial compounds

Question 60

What is mech of antimonial compounds? use? adverse?

Answer 60

mech: heavy metals use: leishmania adverse: cardiotox, nephrotox

Question 61

What should you think when you se kinetoplast?

Answer 61

leishmania or

Question 62

What is treatment for trypanosoma cruzi?

Answer 62

brenznidazole or nifurtimox

Question 63

What is treatment for trypanosoma brucei rhodesiense?

Answer 63

early: suramin late: melarsoprol

Question 64

What is treatment for trypanosoma brucei gambiense?

Answer 64

early: pentamidine late: melarsoprol