worms

Question 1

what is the infective stage for mosquitos of malaria

Answer 1

gametocytes

Question 2

which two species of malaria can infected RBCs at any stage
significance?

Answer 2

falciparum and Knowlesi
no limit on level of parasitemia

Question 3

describe duffy antigen negative

Answer 3

evolutionary benefit against vivax because vivid uses Duffy antigen to enter RBCs

Question 4

describe evolutionary benefit of sickle cell trait

Answer 4

increases survival during p. falciparum infection, selectively sickles infected RBCs

Question 5

describe evolutionary trait of G6PD def

Answer 5

malaria parasites grow poorly in G6PD deficient RBCs

Question 6

malaria prophylaxis in pregnancy

Answer 6

mefloquine or chloroquine

Question 7

malaria ppx for Central America and Middle East

Answer 7

chloroquine ok if sensitive area

Question 8

what to check before prescribing tafenoquine for ppx

Answer 8

G6PD

Question 9

side effect of artesunate

Answer 9

delayed onset anemia after administration

Question 10

where is there artemisn resistance

Answer 10

SE asia and parts of Africa

Question 11

treatment of p vivax

Answer 11

chloroquine for 3 days
then primaquine or tafenoquine for eradication of hyponozoites

Question 12

what to check before giving primaquine or tafenoquine

Answer 12

G6PD

Question 13

method for babesia transmission

Answer 13

transfusion related

Question 14

co-infections with babesia

Answer 14

Lyme and anaplasma

Question 15

treatment of babesia

Answer 15

azithromycin + atovaquone
clindamycin + quinine

Question 16

treatment of severe babesia

Answer 16

exchange transfusion

Question 17

severe disease of babesia can occur in what two patient populations

Answer 17

HIV or asplenia

Question 18

two stages of leishmania

Answer 18

promastigote (in sand fly)
amastigote (in macrophages in humans)

Question 19

what is the most common species of leishmania to cause mucocutaneous form

Answer 19

l. braziliensis

Question 20

new world leishmania species

Answer 20

L. mexicana complex
braziliensis
infantum chagasi

Question 21

old world leishmania species

Answer 21

tropica
major
Donovani
infantum chagasi

Question 22

species in viannia subgenus that cause mucocutaneous disease

Answer 22

braziliensis, guyanensis and panamensis

Question 23

treatment of mucocutaneous leishmania

Answer 23

miltefosine or ambisome

Question 24

contraindication against miltefosine

Answer 24

can’t use in pregnancy, patient can’t get pregnant for 5 months after treatment

Question 25

visceral leishmania species

Answer 25

Donovani and infantum chagasi

Question 26

how to diagnose visceral leishmania

Answer 26

bone marrow aspirate or splenic aspirate

Question 27

treatment of l Donovani visceral leishmania

Answer 27

miltefosine

Question 28

treatment of infantum chagasi visceral leishmania

Answer 28

ambisome

Question 29

vector of African trypanosomiasis

Answer 29

tse tse fly

Question 30

west Africa trypanosome

Answer 30

trypanosoma Brucei gambiense

Question 31

east Africa trypanosome

Answer 31

trypanosoma Bruce rhodisiense

Question 32

gambiense reservoir

Answer 32

humans

Question 33

progression time of gambiense

Answer 33

many months

Question 34

rhodesiense reservoir

Answer 34

cattle and game park animals

Question 35

progression time of rhodisiense

Answer 35

weeks

Question 36

initial presentation of HAT

Answer 36

chancre at site of bite, regional LAD

Question 37

delayed presentation of HAT

Answer 37

fever, HSM, LAD, headache, very late progression to somnolence

Question 38

lab findings in HAT

Answer 38

elevated IgM hyperGammaglobulinemia anemia thrombocytopenia

Question 39

diagnosis of HAT

Answer 39

peripheral smear FNA of affected lymph node

Question 40

side effect common to benznidazole and nifurtimox

Answer 40

Skin issues

Question 41

mimic of CNS toxo in AIDS patient

Answer 41

chagas disease

Question 42

chronic granulomatous keratitis in contact lens wearers or LASIK

Answer 42

acanthamoeba

Question 43

epi risks of cryptosporidium

Answer 43

water parks day cares cattle workers

Question 44

cyclospora presentation

Answer 44

watery diarrhea with vomiting

Question 45

cyclospora epi risks

Answer 45

raspberries lettuces herbs

Question 46

size of cryptosporidium

Answer 46

5 um

Question 47

treatment of cryptosporidium

Answer 47

nitazoxanide or paromomycin

Question 48

cyclospora size

Answer 48

10 um

Question 49

treatment of cyclospora

Answer 49

TMP-SMX

Question 50

size of cystisospora

Answer 50

20 um

Question 51

treatment of cystisospora

Answer 51

tmp-smx

Question 52

only ciliated protozoan pathogen of humans

Answer 52

balantidium coli

Question 53

flask shaped ulcers on pathology

Answer 53

entamoeba histolytica

Question 54

test of choice for e. histolytica

Answer 54

stool PCR

Question 55

diagnosis of e. histolytica with liver disease

Answer 55

serology test of choice

Question 56

treatment of asymptomatic e histolytica

Answer 56

luminal agents such as paromomycin

Question 57

treatment of symptomatic e histolytica

Answer 57

tissue agents such as metronidazole or tinidazole THEN luminal agent

Question 58

treatment of e histolytica liver abscess

Answer 58

medical therapy (tissue agent then luminal agent) usually sufficient! drainage if no response to medical therapy or dx unclear or v large abscess

Question 59

tick borne illness in gulf or SE US with characteristic eschar

Answer 59

rickettsia Parkeri

Question 60

diagnosis of rickettsia Parkeri

Answer 60

serology PCR or culture from skin biopsy or swab of the eschar

Question 61

tick borne illness with eschar but on pacific coast

Answer 61

pacific coast tick fever rickettsia philippii

Question 62

tick borne illness with multiple eschar but in Africa

Answer 62

rickettsia Africae

Question 63

tick borne illness in urban area with eschar and maculopapular rash

Answer 63

rickettsialpox or rickettsia akari

Question 64

vector for rickettsia akari

Answer 64

mouse mites

Question 65

scrub typhus organism

Answer 65

orienta tsutsugamushi

Question 66

vector of scrub typhus

Answer 66

mite (chiggers)

Question 67

scrub typhus geography

Answer 67

asia

Question 68

endemic typhus organism

Answer 68

rickettsia prowazekii

Question 69

animal association with endemic typhus/prowazekii

Answer 69

flying squirrels

Question 70

vector for prowazekii

Answer 70

body louse

Question 71

vector for rickettsia typhi

Answer 71

flea

Question 72

murine typhus organism

Answer 72

r. typhi

Question 73

HME vector

Answer 73

lone star tick

Question 74

anaplasma vector

Answer 74

ixodes scapularis

Question 75

risk for babesia

Answer 75

asplenia

Question 76

unique clinical feature of babesia

Answer 76

hemolytic anemia

Question 77

tick borne relapsing fever organism

Answer 77

borrelia hermsii

Question 78

geography of tick borne relapsing fever

Answer 78

western US

Question 79

tick borne relapsing fever reaction after treatment

Answer 79

J-H reaction

Question 80

Louse borne relapsing fever organism

Answer 80

borrelia recurrentis

Question 81

timing of rash in RMSF

Answer 81

appears several days after fever and viral like prodrome

Question 82

anaplasma affected cell

Answer 82

PMN

Question 83

ehrlichia affected cell

Answer 83

monocyte

Question 84

most common cause of blood transfusion infection in US

Answer 84

babesia

Question 85

flying squirrels

Answer 85

endemic typhus

Question 86

rodent infested urban house

Answer 86

rickettsialpox

Question 87

describe skin findings in rickettsialpox

Answer 87

tache noir first then dozens of papules/vesicles

Question 88

schistosome way of entry to humans

Answer 88

through skin

Question 89

describe cecarial dermatitis or swimmer's itch

Answer 89

urticarial plaques and itchy papules that occur upon reexposure to cercariae penetrating skin in a sensitized person

Question 90

describe acute schistosomiasis or katayama fever

Answer 90

fever, abdominal pain, eosinophilia

Question 91

clinical features of s. mansoni

Answer 91

granulomatous colitis portal hypertension

Question 92

clinical features of s. haematobium

Answer 92

granulomatous cystitis bladder fibrosis and cancer obstructive uropathy men: prostatitis, epididymitis women: endometritis, cervicitis, vaginitis

Question 93

clinical feature of s. japonicum

Answer 93

CNS disease, eggs to brain and spinal cord

Question 94

describe fasciola hepatica clinical presentation

Answer 94

acquired by eating encysted larvae on acquatic vegetation, fluke migrates to the liver, gets into biliary ducts and can cause biliary obstruction

Question 95

diagnosis of fasciola

Answer 95

eggs in stool exam or serology

Question 96

treatment of fasciola

Answer 96

triclabendazole

Question 97

clonorchis sinensis and opisthorchis viverrini acquired from

Answer 97

eating freshwater fish

Question 98

clonorchis sinensis aan opisthorchis viverrini can cause - 3

Answer 98

biliary obstruction cholelithiasis cholangiocarcinoma

Question 99

how to acquire paragonimus westermani

Answer 99

eating undercooked freshwater crabs and crayfish

Question 100

clinical features of paragonimus westermani

Answer 100

fever, cough, diarrhea during acute migration then go the lungs and can have chronic chest pain or pulmonary symptoms

Question 101

how to diagnose paragonimus westermani

Answer 101

sputum and/or stool exam for eggs

Question 102

how to acquire Taenia solium

Answer 102

eating larvae in pork

Question 103

how to acquire Taenia saginatum

Answer 103

larvae in undercooked beef

Question 104

how to acquire diphyllobothrium latum

Answer 104

ingesting fish with larvae

Question 105

lab feature seen in diphyllobothrium latum infection

Answer 105

B12 deficiency

Question 106

how humans acquire echinococcus

Answer 106

ingesting dog feces

Question 107

clinical presentation of echinococcus

Answer 107

rupture into biliary tree rupture into lung rupture into peritoneum- peritonitis

Question 108

radiologic feature of ascaris Loeffler syndrome

Answer 108

infiltrates are changing in location on different days

Question 109

two hookworm species

Answer 109

ancylostoma duodenale and nectar Americanus

Question 110

lab finding in hookworm infection

Answer 110

anemia

Question 111

trichuris trichuria

Answer 111

whipworm

Question 112

describe clinical features of trichuris

Answer 112

loose and frequent stool with tenesmus, rectal prolapse, bloody stool

Question 113

strongyloides hyper infection clinical syndrome

Answer 113

GI symptoms, wheezing, cough, fever, hypotension, Gram negative sepsis

Question 114

is eosinophilia commonly seen in strongyloides hyper infection

Answer 114

no

Question 115

treatment of choice for strongyloides

Answer 115

ivermectin

Question 116

severe nocturnal asthma in person who has lived and returned to endemic area

Answer 116

tropical pulmonary eosinophilia

Question 117

treatment of trichinella

Answer 117

albendazole and steroids

Question 118

most common cause of eosinophilic meningitis worldwide

Answer 118

angiostrongylus (rat lungworm)

Question 119

how to get angiostrongylus

Answer 119

eating parasites in snails or slugs (can be on vegetables) or prawns, shrimp, crabs

Question 120

acute abdominal pain after eating fresh or undercooked seafood (has not been frozen)

Answer 120

anisakis