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Parasitology Lec > Trypanosoma cruzi > Flashcards

Trypanosoma cruzi Flashcards

1
Q

Epidemiology

• - Latin America, Central America, South America

•_____ million affected; 10,000-12,000 die annually

• Transmission:

– Majority:______

–(4)

A

10M

vector borne

Blood transfusion
needle-prick
transplacental
organ transplantation

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2
Q

Disease by T. cruzi

A

American Trypanosomiasis,
Chagas Disease

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3
Q

Vector/s by T. cruzi

A

Reduviid bugs

Triatoma
Panstrongylus
Rhodnius

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4
Q

Infective Stage by T. cruzi

A

Metacyclic trypomastigote

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5
Q

Diagnostic Stage by T. cruzi

– Blood smear:_____

– Tissues:______

A

Trypomastigote

Amastigote

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6
Q

Multiplication: T. cruzi (HA;VE)

– Human: Binary Fission as______

– Vector: Longitudinal fission as_____

A

amastigote

epimastigote

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7
Q

Reservoir Host of T. cruzi

A

Domestic animals
armadillo
racoons
rodents
marsupials
some primates

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8
Q

Infection of T. cruzi: intracellular

– Common:

– Others:

A

myocytes, cells of reticuloendothelial system

skin, gonads, intestinal mucosa, placenta, esophagus

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9
Q

• Dark brown to black with small tan edge around its abdominal region

• Wings are held flat over the back at rest

• Head:
____segmented antennae
____segmented beak that extends backward below the body

A

Triatoma

4

3

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10
Q

Triatoma CN

A

Triatomine/Kissing Bug, Reduviid Bug

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11
Q

Forms in the Life Cycle of Trypanosoma cruzi

A

• Amastigote

• Epimastigote

• Trypomastigote

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12
Q

T. cruzi stages in Human

A

Trypomastigote
Amastigote

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13
Q

Forms of T. cruzi

Vector

• Midgut:

Trypomastigote ->_______

• Hindgut:______

A

epimastigote

Metacyclic trypomastigote

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14
Q

T. cruzi

• Round or ovoid in shape

• 1.5 to 4 um diameter

• In small groups of cystlike collections in tissue

– Intracellular in humans

• Replicating form in human host

A

Amastigote

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15
Q

Amastigote in humans

•______ in shape

• 1.5 to 4 um diameter

• In small groups of ____like collections in tissue

– Intracellular in humans

•______ form in human host

A

Round or ovoid

cyst

Replicating

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16
Q

T. cruzi

Amastigote

• No exterior flagellum and undulating membrane
-– movement ->______

• Found in_____ and _____ (skin, gonads, intestine mucosa)

A

rotation

macrophages and MYOCARDIUM

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17
Q

T. cruzi

Trypomastigote

• NO____ capability

•_____ infective

– Invertebrate vector:____ trypomastigote

– Vertebrate host (human):____ trypomastigote

A

replicative

Extracellular

metacyclic

blood

18
Q

T. cruzi

Trypomastigote

Shape: Unique(3)-shaped

A

C, S or U

19
Q

• Replicating form in human host

A

Amastigote

20
Q

T. cruzi

Trypomastigote

Undulating membrane: narrow with #______ undulations, single threadlike flagellum originating near the prominent kinetoplast

A

2-3

21
Q

T. cruzi

Epimastigote

•______ of vector

• Mobile, presenting intense replicative activity by longitudinal binary division

A

Midgut

22
Q

T or F

Trypomastigotes don’t multiply in the blood

A

True

23
Q

• _______ inside the host -> engulfed by macrophages

• Multiply inside the macrophages as_____ (binary fission)

A

Metacyclic trypomastigote

amatigotes

24
Q

• Amastigotes ->________ and are released in 4-5 days

• Released trypomastigotes enter the bloodstream

– ready to replicate once they enter another cell OR

– ingested by the insect vector

A

Trypomastigotes

25
Q

• Trypomastigote ingested by vector -> pass through the posterior portion of the midgut ->________

• Epimastigotes multiply through longitudinal binary fission

A

Epimastigote

26
Q

• Infective ________ appear in the insect’s rectum -> passed through the feces

A

metacyclic trypomastigotes

27
Q

•_______ gain entry into the human host

– broken skin

– mucous membranes

A

Trypomastigotes

28
Q

Pathogenesis:_______

• Focal or diffuse inflammation mainly affecting the skin and myocardium

– Non specific symptoms such as fever, malaise, nausea, vomiting, and lymphadenopathy

– Cutaneous manifestations are usually seen in the site of inoculation

Undetected and undiagnosed in most individuals

A

Acute Phase

29
Q

• Furuncle-like lesions associated with induration, central edema and regional lymphadenopathy

• Appears on the site of entry of parasite.

A

Chagoma

30
Q

• Swelling of the eyelid if the parasite penetrates the conjunctiva

• Unilateral, painless, bipalpebral edema with conjunctivitis, may involve lacrimal gland and lymphadenopathy

• Resolves after 12months

A

Romana’s Sign

31
Q

Pathogenesis:______

• Maybe autoimmune-mediated

• Fibrotic reactions to the parasite&raquo_space;> injury to the myocardium, cardiac conducting pathways (SA and AV node) and even in the enteric nervous system

A

Chronic Phase

32
Q

Pathogenesis: Chronic Phase

________: primary organ affected

– Less severe: Chest pain, palpitation, dizziness, syncopal episodes, abnormal ECG results

– Severe: Cardiomegaly, congestive heart failure, arrhythmia, thromboembolism, cardiomyopathy à left ventricular apical aneurysm

A

Heart

33
Q

Pathogenesis: Chronic Phase

•______:

– Chronic constipation with megacolon

– Achalasia with megaesophagus

A

GIT

34
Q

Diagnosis:______

• Complete patient history
– Exposure to the insect vector, travel history
– Place of residence and work
– Recent blood transfusion in the endemic area

• Definitive diagnosis during acute phase
– Direct visualization of the parasite in the thick and thin blood smear using GIEMSA stain
– Tissue biopsy, CSF and lymph can also be submitted

A

Acute Phase

35
Q

Other Tests in the Acute Phase

A
  1. Concentration Method: Microhematocrit
  2. Xenodiagnosis
36
Q

– Laboratory reared triatomine bugs are allowed to feed on suspected patients and later (1month after) on examined for the presence of metacyclic trypomastigotes (intestinal contents)

A

Xenodiagnosis

37
Q

Diagnosis: Chronic Phase
(4)

*WHO recommends that at least____ of the tests above should be positive before a diagnosis of Chagas disease should be made

A

• ELISA
• Indirect Hemagglutination
• PCR
• Indirect Immunofluorescence

two

38
Q

Other Diagnostic Modality

• Cardiac Involvement:

A

ECG
Echocardiography

39
Q

Management

• Acute Phase

–_______ Adverse effect: weight loss, anorexia and antabuse effect (severe hangover is patient will drink alcohol)

–_______ Adverse effect: rash, bone marrow suppression, and peripheral neuropathy

•______________: halt (not reverse) progression of cardiomyopathy

A

Nifurtimox

Benznidazole

Allopurinol and Itraconazole

40
Q

Management

• Chronic Phase – Symptom-specific management

• Cardiac

–______: Temporary or Permanent
–______

• GIT

–__________
–_____

A

Pacemaker
Antiarrhythmic drugs

Laxatives and soft diet
Surgery

Parasitology Lec (29 decks)

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