Micro Test 3: Blood & Tissue Protozoa

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  1. Name 4 Blood and Tissue Protozoan Parasites
    • Plasmodium- malaria
    • Babesia- babesiosis
    • Trypanosoma- Chagas' disease, sleeping sickness
    • Leishmainia- visceral, cutaneous, mucocutaneous disease
  2. What is the causative agent of malaria?  How is it transmitted?
    • Plasmodium
    • Transmitted by female anopholes (mosquitoes)
  3. Name 4 species of Plamodium that are malarial parsites
    • P. falciparum
    • P. vivax
    • P. malariae
    • P. ovale
  4. Malignant tertian, capable of high density parasitemia progressing rapidly to massive hemolysis
    P. falciparum
  5. Benign tertian, predominant species of Malarial parasite
    P. vivax
  6. Most benign form of malarial parasite
    P. malariae
  7. Uncommon form of malarial parasite except in West Africa and isolated areas of South America and Asia
    Plasmodium ovale
  8. Plasmodium Erythrocyte Cycle:  Merozoites from liver or RBCS infect new RBCs by transforming to uninucleat trophozoites
    P. falciparum
  9. Plasmodium Erythrocyte Cycle:  Merozoites from liver or RBCS infect new RBCs by becoming multinucleated schizont or differentiating into gametocytes
    P. vivax
  10. Forms a banana-shaped gametocyte
    P. falciparum
  11. Malaria pathogenesis is related to the _____ cycle
  12. Lysis of infected RBCs is prominent in
    P. falciparum
  13. Which disease causes RBC Cytoadherence:  Infected rBC membranes altered, cells coalesce to form thrombi, stick to capillary endothelium, produce local tissue anoxia.
    P. falciparum
  14. Which malarial pigment from hemoglobin breakdown is phagocytized in the liver and spleen?  It causes organs to enlarge, kidneys to become plugged, brain capillaries to become congested and the brain to become edematous.
  15. What two forms of malaria can cause spleen rupture?
    Vivax and Quartan malaria
  16. Vivax and Quartan malaria cause
    rupture of spleen
  17. Incubation period of malaria?
    What can make incubation period shorter?
    What can delay onset?
    • 8-40 days
    • Transfusion incubation is shorter.
    • Prophylactic drugs delay onset
  18. 4 Symptoms ALL species of malaria cause
    Fever, chills, anemia, and splenomegaly
  19. Malarial Paroxysm:  Chills - Fever- Sweat
    P. vivax, ovale = ___ day cycle
    P. malariae- ___ day cycle
    • VO= 2
    • M= 3
  20. Infection with what form of malaria represents a medical emergency?
    P. falciparum (severe paroxysm of 12-36 hours with continuous fever)
  21. Parasites in the peripheral blood not completely eradicated, possible with which species?
    Recrudescence, possible with all species of plasmodium
  22. Relapsing infection:  Involves ______ in liver parenchyma cells that re-infect RBC months/years later.  Which two forms of Plasmodium have this commonly?

    P. vivax and P. ovale
  23. P. vivax and P. ovale relapsing infection involves hypnozoites in ______________ that re-infect RBC months to years later.
    Liver parenchymal cells
  24. Most common complication of malaria
    Cerebral malaria
  25. Capillary blockage in brain
    Progressively severe heacheache w/o early fever
    Sudden high fever (108 F)
    Convulsions or delirium
    Mistaken for acute alcoholism
    Rapid collapse (coma) due to anoxia, cerebral edema, increased spinal fluid pressure
    Cerebral malaria
  26. Acute intravascular hemolysis
    Hemoglobinuria, hemoglobinemia, and renal insufficiency

    Most frequent in which form of plasmodium?
    Blackwater Fever (Renal complication)

    Most common in P. falciparum (also present in Vivax and Malariae)
  27. Severe P. falciparum or repeated P. malariae infection can cause

    3 symptoms
    Renal disease

    • Proteinuria
    • Massive edema
    • Nephrotic syndrome
  28. Which two plasmodia can cause renal disease?
    P. falciparum or P. malariae
  29. Speciation is important in diagnosis or malaria because
    it determines tx!
  30. Malaria Tx:
    • Chloroquine phosphate
    • Pimaquine phosphate (Pv and Po relapses)
  31. How to treat Chloroquine resistant Pf and Pv
    Artemether-lumanfantrine (ACT)
  32. Malaria chemoprophylaxis
    Take Chloroquine phosphate durg one week before exposure, continue four weeks after return
  33. Causative agent of Babesiosis
  34. Transmission of Babesiosis
    Hard ticks, nymph stage
  35. Most Babesiosi US cases are from
    Babesia microti, a parasite of rodents

    Other cases are from B. divergens and B. duncani
  36. Pleomorphic, ring-like structures in RBCs
    Resemble early trophozoite form of P. falciparum (but RBCs are not enlarged or pale)
  37. Babesia tx
    • Clindamycin plus quinine
    • Atovaquone plus azithromycin
  38. Splenectomized person exposed to ticks has high risk of developing.
  39. Hemoflagellates are in the order ____ and the family ____
    • Order Kinetoplastidae
    • Family Trypanosomatidae
  40. A single DNA containing mitochondrial organelle where the flagellum originates
  41. Two parasitic genera in the Trypanosomatidae
    • Trypnosoma
    • Leishmania
  42. Causative agent of Chagas' Disease
    Trypanosoma cruzi
  43. Causative agent of East African sleeping sickness
    T.b. rhodesiense
  44. Causative agent of W. African sleeping sickness
    T.B. gambiense
  45. 3 species in Trypanosoma genera and what they cause
    • T. cruzi- Chaga's disease
    • T.b. rhodesiense- E. African sleeping sickness
    • T.b. gambiense- W. African sleeping sickness
  46. 3 species in Leishmania genera
    • L. donovani- Visceral leishmaniasis
    • L. tropica/major/mexicana- Cutaneous sores
    • L. braziliensis- Mucocutaneous sores
  47. Causative agent of visceral leishmaniasis
    L. donovani
  48. L. tropica/major/mexicana causes
    Cutaneous sores
  49. L. braziliensis causes
    mucocutaneous sores
  50. How is Chagas disease transmitted?
    Reduviid bug feces containing T. cruzi are scratched into bile site or enter via mucous membranes
  51. What is unique about the Trypmastigotes of T. cruzi in the peripheral blood?
    They do NOT divide
  52. What form of T. cruzi does NOT divide in the peripheral blood?
    Tryphomastigotes (flagella, undulating membrane, characteristic C-shape)
  53. A local histiocytoma with fibrous border that blocks lymphatics and causes edema (frequently on face) after infection with T. cruzi
  54. Two disease phases of Chagas
    • Acute
    • Chronic
  55. Which form of T. cruzi in Chagas lacks flagella, but has a nucleus?
    Intracellular amastigote stage
  56. Only form of T. cruzi present in chronic Chagas
    Intracellular amastigote stage
  57. Causes heart problems, CNS problems, thyroid problems, megacolon, and megaesophagus (dysphagia and constipation)
    Trypanosoma cruzi
  58. Pt. presents with travel, lymphadenopathy and myocarditis
    Acute chagas
  59. Pt. presents with travel, cardiomegaly, conduction defects, and dysphagia
    Chronic Chagas
  60. Definitive diagnosis of Acute (febrile) phase of Chagas
    Demonstration of trypomastigotes in peripheral blood
  61. T. cruzi tx?
    • Acute Phase:  Benznidazole (contraindicated in pregnancy), Nifrutimox
    • Chronic phase:  Benznidazole (drug effectiveness usually limited, but limits progression)
  62. Tramission of Leishmaniasis
    • Female sandflies
    • (Phlebotomus- Old World)
    • (Lutzomyia (Americas)
  63. Leismania amastigoes- mammalian intracellular stage:
    1)  _______ phagocytized by macrophages of the _____
    2)  Transform to intracellular amastigotes (note ___ & ___)
    3)  Proliferate in __________
    4)  Other cells can be invaded
    5)  May spread and can remain latent for years
    • 1)  Promastigotes, skin
    • 2)  nucleus and kinteoplast
    • 3)  parasitophorous vacuoles
  64. Characterized by dermal infiltrates of lymphocytes, plasma cells and macrophages filled with Leishmania
    Cutaneous leishmaniasis
  65. Cutaneous leishmaniasis tx?
    Self-limited (TH1 response -cell mediated immunity)
  66. Can you be reinfected with Cutaneous leishmaniasis
    Initial infection produces STERILE IMMUNITY to reinfection by same Leishmania sp.
  67. Forest Zoonosis Espundia
    Mucocutaneous Leishmaniasis
  68. Tissue destruction and deformity, tissue loss in nasal mucosa, hard and soft palate and nasal septum.  Caused by secondary metastasis to mucous membranes.
    Mucocutaneous Leishmanisis (L. braziliensis)
  69. Prolonged intermittent fever? 
    Associated with abdominal swelling, it's characteristic of?
    • Dromedary Fevers
    • Visceral leishmaniasis (L. donovani)
  70. Fever, hepatosplenomegaly, pancytopenia
    Visceral leishmaniasis
  71. Which form of Leishmania is an opportunistic infection of AIDS pts?
    Visceral leishmaniasis
  72. What is used for prophylactic tx of Visceral Leishmaniasis in HIV pts?
  73. Transmission of Sleeping Sickness
    Tsetse flies
  74. Rapidly fatal Sleeping Sickness w/ early CNS involvement, high parasitemia and minimal lymph node infection
    T.B. rhodesiense (E. African SS)
  75. Chronic disease ends fatally after months/yrs
    with low blood parasitemia, prominent lymphadenopathy, and late CNS involvement
    T.b. gambiense (W. Africa SS)
  76. 3 Stages of clincial trypanosomiasis
    • Blood parasitemia
    • Lymphadenitis
    • CNS invasion
  77. Winterbottom's Sign?
    Characteristic of?
    • Enlarged posteriod cervical lymph nodes
    • T.b. gambiense
  78. Trypanosomal chancre is more common in
    non-Africans with T.b. rhodesiense
  79. Delayed hyperesthesia on palms or over ulnar nerve?
    Seen in?
    • Kerandel's Sign
    • Seen in Europeans with Chronic Trypanosomiasis
  80. Sleeping Sickness Tx?
    • Early Stages (Pre CNS):  Pentamidine, Suramin
    • Later Stages (CNS invasion):  Eflornithine (DMFO), Melarsoprole
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Micro Test 3: Blood & Tissue Protozoa
2012-12-05 05:50:32
Blood Tissue Protozoa

Blood & Tissue Protozoa
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