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20 Cards in this Set

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Giardia lamblia
flagellate of the duodenum and jejunum that is the causative agent of giardiasis
Heart-shaped symmetrical form of Griardia lamblia. Cysts are ingested via fecal oral route and mature into trophozites in the body.
Mildly pathogenic, can cause irritation of the bowel and chronic or acute diarrhea. Immunosuppressed individuals can have severe disease. Treated by metronidazole.
flagellates producing trichomoniasis in humans. Cause mild inflammation; severity determined by pH, physiology, and bacterial flora. Transmitted sexually and symptoms include white/yellow discharge and tenderness of the genitals. Less severe in male patients. Infection rates up to 40%. Treated with metronidazole.
Mechanism of action specific to anaerobic organisms with e- transport proteins with low redox potentials. Inhibits and conversion of pyruvate and phosphate to acetyl phosphate.
Given orally, IV, supp. Cross BBB and placenta. Excreted in urine (80%), 15% unchanged. Mild toxicity (metalic taste, diarrhea, nausea).
Trypanosoma: African sleeping sickness and American Chagas' disease (Trypanoma cruzi)
Leishmania: a number of species causing cutaneous (oriental sore), mucocutaneous (espundia), and visceral (kalazar) leishmanias.
African sleeping sickness and Chagas' disease.
African sleeping sickness transmitted via tsetse fly. Double life cycle, both reproduce via binary fission.
Clinical manifestations: Three stages - trypanosomal chancre; hemolymphatic stage characterized by fever, lymphoadenopathy and puritis; meningoencephalitic stage during invasion of CNS causing headache, somnolence, abnormal behavior, coma and death.
American Chagas' disease: transmitted through triatomine bug, double life cycle. Local lesion may appear at site of inoculation. Usually asymptomatic but may present with fever, anorrexia, lymphadenopathy, mild hepatosplenomegaly, and mycarditis. Most acute phases resolve in 2-3 mo to asymptomatic chronic phase. Symptomatic chronic stage may appear years later, includingcardiomyopathy, pathologies of digestive tract and weight loss. Chronic disease and its complications can be fata.
Treatment of trypanosoma
Should be started as soon as possible. Pentamidine isethionate (Lomidine) and suramin (Germanin) are drugs of choice to treat hymolymphatic stage of W. and E. ASS respectively. Melarsoprol is drug of choice for late disease.
Pentamidine (Lomidine)
Treatment for hemolymphatic stage of W. african sleeping sickness. Mechanism of action not well defined. Taken up by transporters for adenine and adenosine. Interferes with polyamine biosynthesis. SE include pain and necrosis and site of injection. Fainting, breathlessness, tachycardia and vomiting correlated to drop in BP
Suramin (Germanin)
Drug of choice for E. African sleeping sickness. Developed from blue dyes. Effective for both strains of trypanosomiasis prior to CNS involvement. Administer slow IV, serious effects include onconsciousness, nausea, vomiting. MOA unknown.
Arsenical drug used on meningoencephalitic phase of african sleeping sickness. MAO and toxicities due to sulfhydryl grps.
Treatment of Chagas' disease
Treatment only effective if given during acute phase. Benznidazole and nifurtimox are drugs of choice.
In chronic stage, tx is management of symptoms.
Used for chagas disease; is suppressive, not curative. MOA is activation to anion radical causing bacterial DNA breakdown.
Vector-borne disease transmitted by sandflies and caused by Leishmania sp.
Cutaneous leishmaniasis characterized by cutaneous lesions on areas where sandflies have fed. Swollen glands near the site may be involved.
Visceral leishmaniasis symptoms include fever, weight loss, enlarged spleen and liver. Low RBC, WBC, and platelet counts. Is becoming an increasing opportunistic infection w/ HIV.
Treatment of leishmaniasis
Consult CDC. Sodium stibogluconate is drug of choice.
Sodium stibogluconate
Pentavalent compound w/ multiple uncharacterized forms used in tx of leishmaniasis. MOA unknown.
Entamoeba histolytica
Intestinal amoeba found throughout N.A. Clinical features include asymptomatic infection, invasive intestinal amoebiasis, and invasive extraintestinal amoebiasis.
Treatment of entamoeba histolytica
Asymptomatic infections: iodoquinol, paromomycin, or dioxanide furoate.
Symptomatic intestinal disease: metronidazole or tinidazole, immediately followed by treatment with one of the asymptomatic drugs above.
Toxoplasma gondii
Parasite that can be transmitted by cats. Infection of pregnant mother can cause infants with subclinical infections to develop ocular lesions in 2nd or 3rd decade of life. Treatment with pyrimethamine-sulfadoxine, atovaquone. Prophylactically TMP-SMX.
Pneumocystis jiroveci
Currently considered a fungus. Inhaled can cause PCP causing symptoms such as dyspnea, nonproductive cough, fever. Chest x-ray may show bilateral infiltrates. TMP-SMX is drug of choice. Atovaquone also used for mild-moderate disease in TMP-SMX intolerant patients. Atovaquone inhibits mitochondrial respiratory chain.