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66 Cards in this Set

  • Front
  • Back
What is the most common protozoal infection in man?
Toxoplasma gondii
What is the natural host of Toxo?
Mice
How do cats acquire Toxo?
By eating raw mouse meat
How do humans acquire Toxo?
1. By eating raw meat infected with it
2. By playing with cats
What is the form of Toxo that humans ingest? What happens after it is ingested?
-Ingest cysts/pseudocysts
-Tachyzoites mature and go to liver, remain for life..
Can humans pass on Toxo?
No; they are an incidental host, dead end.
Who is primarily concerning if they get a primary Toxo infection?
Pregnant females
-Most alarming if acquired in 1st trimester
When does transmission to the fetus occur most often in pregnancy?
3rd trimester
When does most morbidity occur due to Toxo transmission in pregnancy?
In the 1st trimester
What does Toxo infection do to most individuals?
Nothing
What types of symptoms when Toxo does cause symptoms most often?
Mono-like symptoms
What is the most common symptom of congenital Toxo infection?
Chorioretinitis
What symptoms result from Toxo getting reactivated due to a low CD4 count in AIDS?
CNS infection
What is the main way to diagnose Toxo?
Based on serology
-If IgM is high, recent inf.
-If IgG is present, prior
What do you have to do to test for and monitor Toxo infections in AIDs patients?
Antigen detection - their serum antibody is too low.
When does Toxo require treatment?
-Congenital
-Ocular
-Persistent disease
-AIDS
What drugs are used to treat Toxo?
Bactrim and Clindamycin
What other disease is concerning in AIDs?
Pneumocystis carinii
What is the stain for Pneumo carinii?
Silver stain
What 2 things show up on a sputum silver stain for PCP?
-Foamy material
-Cyst-like organisms
What are the only people that get Pneumocystis infections?
AIDS and immunocompromised
What type of infection does PCP cause?
Atypical lung infection
What are the 3 ways to diagnose PCP?
-Sputum (only in AIDS)
-Bronchoscopy
-Open lung biopsy
What is the treatment for PCP?
-Bactrim
-Pentamidine
-Dapsone
What is common in HIV patients with PCP?
Relapse - so give prophylaxis for life
Do most AIDS patients that get PCP die?
No not anymore
What is the milwaukee protozoan of choice?
Cryptosporidium
How is C. parvum transmitted?
Fecal-oral
What type of disease does C. parvum cause
-in normals
-in immunocompromised
Normals: Self-limiting diarrhea
HIV/AIDs: Chronic diarrhea
How is C. parvum diagnosed?
With a stool AF stain
What is the treatment for C. parvum?
Maintain hydration
What is the Malaria that causes death?
Plasmodium falciparum
What transmits P. falciparum?
The female anopheles mosquito
What form infects man?
Sporozoites
What happens immediately after the mosquito injects sporozoites into the blood?
They go to the liver and hide for a while, then re-emerge as merozoites and trophs.
What form infects red cells?
Merozoites and Trophozoites
What happens in RBCs?
Proliferation and Bursting to release many new merozoites
What are Gametocytes?
The sexual form that mature from merozoites and can get re-picked up by mosquitoes.
Where does the sexual reproduction of Plasmodium species occur?
Only in mosquitoes - so they have to acquire a male and a female to do it.
How does P. falciparum kill?
By causing cerebral malaria
How does P. falciparum get into the CNS to cause damage?
It causes RBCs to acquire protrusions that allow the RBCs to adhere to EC's on blood vessels.
What is the result of RBCs binding to ECs on blood vessels?
They cause microembolisms within the capillaries of the brain, resulting in infarcts.
Why is it hard to treat P. falciparum?
Because it has developed a lot of Chloroquine resistance
What kind of malaria relapses?
Only the milder forms - P. vivax and ovale
What kind of malaria is drug resistant?
Only P. falciparum
What are the 4 big manifestations of Malaria?
-Cyclical fevers (endemic)
-Anemia (endemic)
-Cerebral malaria
-Acute renal failure
Why do we only see cyclical fevers and anemia in infected folks in endemic areas?
Because in US citizens malaria will cause death long before those more chronic symptoms can develop
What are the 2 ways to diagnose Malaria?
-Thick smear
-Thin smear
What is a Thick smear done for?
-Identifying presence
-Differentiating species
-ONly by an experienced tech
What is a thin smear done for?
Visualization of finer forms to differentiate species and stages - in Mod to severe cases
What type of infection is a thick smear sufficient for?
Light infections
What are the 2 primary patients that M. falciparum causes disease in?
-Children
-Pregnant females
What are the 3 drugs used for prophylaxis for malaria?
-Chloroquine
-Mefloquine
-Doxycycline
Where can Chloroquine be used?
Central America
North africa
Middle East
What is used in most areas?
Mefloquine - but it has toxic side effects
What is used for people who can't take Mefloquine?
Doxycycline
What morphology is unique to P. falciparum?
Signet rings
What morphology is seen in the relapsing forms of malaria?
Schuffner's dots
What are the only 3 places you can give chloroquine?
-Central america
-North africa
-Middle east
To whom is prophylaxis for malaria given?
-Travelers
-Soldiers
What does malaria prophylaxis consist of?
-Repellants
-Nets
-Sprays
-Water management
Where is the fatality rate of malaria higher? Why?
In the US because docs are stupid
What type of parasite is malaria again?
A protozoan
What is the infectious form?
Sporozoites
What form infects RBCs?
Merozoites
Where do the merozoites come from?
The liver