Parasites

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julieaburch
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88346
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Parasites
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2011-05-29 21:11:23
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Parasites
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Parasites
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  1. What are the four species of Plasmodium?
    • Plasmodium malarie
    • Plasmodium vivax
    • Plasmodium ovale
    • Plasmodium falciparum -- most severe form
  2. What is the most severe form of Plasmodium?
    Plasmodium falciparum
  3. What disease is linked to Plasmodium?
    Malaria
  4. How is Plasmodium (malaria) transmitted?
    • Bite from Anopheles mosquito
    • Trans-placentally
    • IV drug use
  5. What is the incubation period for Plasmodium vivax?
    10-17 days
  6. What is the incubation time for Plasmodium malarie?
    18-40 days
  7. What is the incubation time for Plasmodium falciparum?
    8-11 days
  8. The symptoms associated with malaria are a recurring cycle of fever, chills, and sweating due to cytokines induced by RBC waste products. Which Plasmodium type recurs in a benign tertiary (48 hr) time span?
    • Vivax
    • Ovale
  9. The symptoms associated with malaria are a recurring cycle of fever, chills, and sweating due to cytokines induced by RBC waste products. Which Plasmodium type recurs in a quartan (72 hr) time span?
    Malariae
  10. The symptoms associated with malaria are a recurring cycle of fever, chills, and sweating due to cytokines induced by RBC waste products. Which Plasmodium type recurs in a malignant tertian (no regular cycle) time span?
    Falciparum
  11. What disease are the following symptoms/cycle associated with?
    Parasites lyse out of RBCs releasing pyrogens.
    Chills, fever, nausea, and vomiting
    220-60 min later -- burning fever and severe headaches lasting for several hours
    Temperature drops and profuse sweating
    Splenomegaly, hepatomegaly, and anemia
    Malaria
  12. Which type of malaria is associated with the following symtpoms?
    Hemorrhage and necrosis in brain (cerebral malaria) and other organs
    Hemoglobinuria
    May be fatal if untreated
    Falciparum Malaria
  13. What is the drug of choice for all types of malaria except P. falciparum (due to resistance)?
    Chloroquine
  14. How is malaria diagnosed?
    Finding infected erythrocytes on thick and thin Giemsa-stained blood smears
  15. How can vivax be distinguished on blood smear from the other forms of malaria?
    Presence of Schuffner's dots
  16. Identify the parasite seen in the blood smear below:
    • Plasmodium falciparum
    • Note the high parasitemia and multiple infections of some cells
  17. How are the blood stages of malaria treated? How is it treated in the liver stage (vivax and ovale)?
    • Chloroquine
    • Primaquine
  18. How is Chloroquine resistant falciparum treated?
    • Quinine + Doxycycline
    • Quinine + Pyrimethamine-sulfadoxine
  19. What is the main prevention method for malaria?
    Prophylaxis
  20. Why do the fevers recur in malaria?
    Parasite lysis of infected red blood cells
  21. How is Babesia transmitted?
    • Tick Bite -- most commonly by the deer tick Ixodes scapularis
    • Blood Transfusion
  22. What disease is associated with the symptoms below?
    Largely asymptomatic
    Fever, chills, sweating, myalgias, fatigue, hepatosplenomegaly, and hemolytic anemia following incubation period of 1-4 weeks
    More severe in immunocompromised, splenectomized, and/or elderly patients
    Babesia (Babesiosis)
  23. How is Babesiosis diagnosed?
    Finding infected erythrocytes on thick and thin Giemsa-stained blood smear
  24. Identify the parasite from the blood smear below:
    • Babesia
    • Note the intra-erythrocytic vacuolated forms (black arrows); these are pleomorphic, non-pigmented, and can appear vacuolated
  25. How is Babesia treated?
    • Atovaquone plus Azithromycin (preferred)
    • Clindamycin plus Quinine
  26. What disease is linked to both Trypanosoma brucei gambiense and rhodesiense?
    African Sleeping Sickness (African trypanosomiasis)
  27. Which form of African trypanosomiasis is linked to West Africa? Which is linked to East Africa?
    • Gambiense: West
    • Rhodesiense: East
  28. How is African trypanosomiasis (African sleeping sickness) transmitted?
    Bite of the tsetse fly (Glossina)
  29. Why do the Parasitemia levels vary in African trypanosomiasis?
    Due to antigenic variation
  30. What disease are the following symtpoms associated with?
    Skin ulcer or chancre at site of bite
    Intermittent fever and lymphadenopathy
    Demyelinating encephalitis characterized by headache, insomnia, and mood changes
    Muscle tremors, slurred speech, and apathy develop
    Somnolence and coma followed by death due to pneumonia
    African trypanosomiasis
  31. How is African trypanosomiasis diagnosed?
    • Early during infection examine aspirates from chancre or lymph nodes for presence of parasites
    • Identification of trypomastigotes in blood smears -- may need to examine samples from various days because of varying levels of parasitemia (antigenic variation)
  32. What are the main differences between Gambiense and Rhodeniense?
    • Gambiense: West; Chronic (late CNS); Prominent Lymphadenopathy; Low Parasitemia
    • Rhodeniense: East; Acute (early CNS); Minimal Lymphadenopathy; High Parasitemia
  33. Identify the parasite based on the blood smear below:
    • African trypanosomiasis
    • Note presence of flagella
  34. For the treatment of African trypanosomiasis, there is a need to distinguish between the presence or absence of CNS disease. How is pre-CNS Gambiense treated? Rhodesiense? Post CNS?
    • Gambiense: Pentamidine
    • Rhodesiense: Suramin
    • Post CNS: Melarsoprol for both
  35. How is diphyllobothrium latum transmitted?
    Ingestion of larvae in undercooked fish from cold, clear lakes
  36. What disease are the following symptoms related to?
    Infection is normally asymptomatic but some may complain of weakness, nausea, diarrhea, salt craving, and abdominal cramps.
    Prolonged or heavy infection may lead to megaloblastic anemia bc of B12 deficiency due to parasite scavenging the vitamin
    Diphyllobothrium latum (Diphyllobothriasis)
  37. How is Diphyllobothriasis diagnosed?
    Identification of eggs in stool. Proglottids can also sometimes be found in stool
  38. What is the drug of choice for treated Diphyllobothriasis?
    Praziquantel
  39. What disease do Wucheria bancrofti and Brugia malayi (filarial worms) cause? How is this transmitted?
    • Lymphatic filariasis or elephantitis
    • Mosquito bite
  40. What disease is the following symtpoms associated with?
    Most often asymptomatic microfilaremia
    Early Stages: headache and nausea; local lymphadenitis, orchitis, and hyrocele
    Late Stages: lymphatic obstruction bc of worms resulting in lymphadema; thickening of skin and verrucous growth resulting in elephantiasis; lymphangitis and cellulitis resulting in secondary bacterial or fungal infections
    Lymphatic filariasis or Elephantitis
  41. How is Lymphatic filariasis diagnosed and treated?
    • Identification of microfilaria in blood smears
    • Diethylcarbamazine is drug of choice -- symptoms may worsen bc killed worms may activate immune responses
  42. To increase chances of detecting parasites in Lymphatic filariasis, blood should be drawn late at night to identify ___________, or in the morning to detect ___________.
    • Wucheria
    • Brugia
  43. Identify the parasite from the blood smear below:
    • Wucheria
    • Note: longer and less coiled
  44. Identify the parasite from the blood smear below:
    • Brugia
    • Note: more coiled

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