Micro/id Set 6

Front 1

T/F: All 4 species of Plasmodium that cause malaria are transmitted by the Anopheles mosquito

Back 1

T

Front 2

T/F: Sporozoites are injected from the mosquito into the bloodstream of a human

Back 2

T

Front 3

T/F: A few sporozoites infect liver cells where they, divide for about 1-2 weeks to form thousand of merozoites within schizonts that ultimately infect RBCs (the exo-erythrocytic cycle)

Back 3

T

Front 4

T/F: P. vivax and P.ovale can remain dormant in the liver for months to years and then suddenly re-appear and cause symptoms.

Back 4

T

Front 5

T/F: In the erythrocyte, the merozoites divides over 2-3 days then the RBC bursts and releases the progeny

Back 5

T

Front 6

T/F: Merozoites are then sucked up by the mosquito where they undergo the sporogenic cycle (i.e. the portion of the life cycle that takes place in the mosquito)

Back 6

T

Front 7

T/F: PCR is the most common way diagnosis is made

Back 7

F: PCR is used for research and useful for MDR study, do a thick (WBC count) and thin (RBC count) smear

Front 8

T/F: People are symptomatic with malaria when the organism is in the erythrocytic stage

Back 8

T

Front 9

T/F: The pyrogenic density is higher for P. vivax than P. falciparum

Back 9

F: lower

Front 10

T/F: In the US, the most common reason why someone gets malaria is: an individual from an endemic country who has been living in the US for a long time and who return to the mother land and does NOT take malaria prophylaxis.

Back 10

T

Front 11

T/F: Parasite burden correlates well with peripheral parasitemia in P. falciparum infections

Back 11

T

Front 12

T/F: Both T-cells and B-cells are important in trying to contain the infection

Back 12

T

Front 13

T/F: Partial immunity to infection occurs after years of exposure and re-exposure to the parasite

Back 13

F: to disease not infection (from prolonged and repeated exposure

Front 14

T/F: Pregnant women have increased susceptibility to Plasmodium falciparum malaria; in malaria-endemic countries, P. falciparum contributes to 8-14% of low birth weight, which in turn decreases the chance of a baby’s survival

Back 14

T

Front 15

T/F: Differently from the human host, the mosquito vector does not suffer from the presence of the parasites.

Back 15

T

Front 16

T/F: Humans infected with malaria parasites can develop a wide range of symptoms. These vary from asymptomatic infections (no apparent illness), to the classic symptoms of malaria (fever, chills, sweating, headaches, muscle pains), to severe complications (cerebral malaria, anemia, kidney failure) that can result in death.

Back 16

T

Front 17

T/F: The severity of the symptoms depends on several factors, such as the species (type) of infecting parasite and the human's acquired immunity and genetic background.

Back 17

T

Front 18

T/F: Plasmodium falciparum can cause severe malaria because it multiples rapidly in the blood, and can thus cause severe blood loss (anemia).

Back 18

T

Front 19

T/F: P. vivax only exceptionally causes death (most often due to rupture of an enlarged spleen).

Back 19

T

Front 20

A medical emergency in the non-immune host (someone traveling to an endemic area, who is not from an endemic area of malaria and is thus non-immune, and who has NOT taken his/her prophylactic meds) occurs in which of the following malaria species: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae?

Back 20

Plasmodium falciparum

Front 21

Sequestration of mature parasites occurs in which of the following malaria species: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae?

Back 21

Plasmodium falciparum & malariae

Front 22

Severe malaria occurs in which of the following malaria species: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae?

Back 22

Plasmodium falciparum

Front 23

Asexual cycle duration 72 hours occurs in which of the following malaria species: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae?

Back 23

Plasmodium malariae

Front 24

Infects all stages of RBCs occurs in which of the following malaria species: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae?

Back 24

Plasmodium falciparum

Front 25

Infection older cells only occurs in which of the following malaria species: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae?

Back 25

plasmodium malariae

Front 26

Infection of the young RBCs (the reticulocytes) occurs in which of the following malaria species: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae?

Back 26

plasmodium vivax, plasmodium ovale

Front 27

Hypnozoite stage occurs in which of the following malaria species: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae?

Back 27

plasmodium vivax, ovale

Front 28

Relapse occurs in which of the following malaria species: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae?

Back 28

plasmodium vivax, ovale

Front 29

Duffy blood group antigen is required for merozoite invasion of RBCs in which of the following malaria species: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae?

Back 29

plasmodium vivax

Front 30

Production long-lasting infections and if left untreated can persist asymptomatically in the human host for years, even a lifetime occurs in which of the following malaria species: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae?

Back 30

plasmodium vivax, ovale

Front 31

Multiple infections of RBC more common than in other species (multiple ring types within a single RBC as seen on a Wright stained peripheral blood smear) occurs in which of the following malaria species: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae?

Back 31

plasmodium falciparum

Front 32

Endemic in the United States: Cutaneous leishmaniasis, Mucocutaneous leishmaniasis, Visceral leishmaniasis, Acute (primary) toxoplasma infection, Reactivation toxoplasma infection, Trichomonas vaginalis?

Back 32

trichomonas vaginalis

Front 33

Mononucleosis-like syndrome (sore throat, fatigue, lymphadenopathy) : Cutaneous leishmaniasis, Mucocutaneous leishmaniasis, Visceral leishmaniasis, Acute (primary) toxoplasma infection, Reactivation toxoplasma infection, Trichomonas vaginalis?

Back 33

acute/primary toxoplasma infection

Front 34

Ring-enhancing brain lesions in patients with AIDS: Cutaneous leishmaniasis, Mucocutaneous leishmaniasis, Visceral leishmaniasis, Acute (primary) toxoplasma infection, Reactivation toxoplasma infection, Trichomonas vaginalis?

Back 34

reactivation toxoplasma infection

Front 35

Chorioretinitis and CNS sequelae in fetus: Cutaneous leishmaniasis, Mucocutaneous leishmaniasis, Visceral leishmaniasis, Acute (primary) toxoplasma infection, Reactivation toxoplasma infection, Trichomonas vaginalis?

Back 35

primary toxoplasma infection

Front 36

Ingestion of undercooked meat: Cutaneous leishmaniasis, Mucocutaneous leishmaniasis, Visceral leishmaniasis, Acute (primary) toxoplasma infection, Reactivation toxoplasma infection, Trichomonas vaginalis?

Back 36

primary toxoplasma infection

Front 37

Sandfly transmission: Cutaneous leishmaniasis, Mucocutaneous leishmaniasis, Visceral leishmaniasis, Acute (primary) toxoplasma infection, Reactivation toxoplasma infection, Trichomonas vaginalis?

Back 37

leishmaniasis

Front 38

Exposure when cleaning cat litter: Cutaneous leishmaniasis, Mucocutaneous leishmaniasis, Visceral leishmaniasis, Acute (primary) toxoplasma infection, Reactivation toxoplasma infection, Trichomonas vaginalis?

Back 38

primary toxoplasma infection

Front 39

Kala-azar: Cutaneous leishmaniasis, Mucocutaneous leishmaniasis, Visceral leishmaniasis, Acute (primary) toxoplasma infection, Reactivation toxoplasma infection, Trichomonas vaginalis?

Back 39

visceral leishmaniasis

Front 40

Non-tender hepatosplenomegaly: Cutaneous leishmaniasis, Mucocutaneous leishmaniasis, Visceral leishmaniasis, Acute (primary) toxoplasma infection, Reactivation toxoplasma infection, Trichomonas vaginalis?

Back 40

visceral leishmaniasis

Front 41

The cat is a definitive host: Cutaneous leishmaniasis, Mucocutaneous leishmaniasis, Visceral leishmaniasis, Acute (primary) toxoplasma infection, Reactivation toxoplasma infection, Trichomonas vaginalis?

Back 41

toxoplasma

Front 42

Leishmania braziliensis: Cutaneous leishmaniasis, Mucocutaneous leishmaniasis, Visceral leishmaniasis, Acute (primary) toxoplasma infection, Reactivation toxoplasma infection, Trichomonas vaginalis?

Back 42

mucosal leishmania

Front 43

Slow healing ulcer on hand: Cutaneous leishmaniasis, Mucocutaneous leishmaniasis, Visceral leishmaniasis, Acute (primary) toxoplasma infection, Reactivation toxoplasma infection, Trichomonas vaginalis?

Back 43

cutaneous leishmania

Front 44

Exists in the trophozoite stage only: Cutaneous leishmaniasis, Mucocutaneous leishmaniasis, Visceral leishmaniasis, Acute (primary) toxoplasma infection, Reactivation toxoplasma infection, Trichomonas vaginalis?

Back 44

trichomonas vaginalis

Front 45

Promastigotes phagocytised by macrophages: Cutaneous leishmaniasis, Mucocutaneous leishmaniasis, Visceral leishmaniasis, Acute (primary) toxoplasma infection, Reactivation toxoplasma infection, Trichomonas vaginalis?

Back 45

Leishmaniasis, Leishmania donovani, visceral leishmaniasis

Front 46

Sexual transmission: Cutaneous leishmaniasis, Mucocutaneous leishmaniasis, Visceral leishmaniasis, Acute (primary) toxoplasma infection, Reactivation toxoplasma infection, Trichomonas vaginalis?

Back 46

trichomonas vaginalis

Front 47

Treated with flagyl: Cutaneous leishmaniasis, Mucocutaneous leishmaniasis, Visceral leishmaniasis, Acute (primary) toxoplasma infection, Reactivation toxoplasma infection, Trichomonas vaginalis?

Back 47

trichomonas & giardia

Front 48

T/F: Cryptosporidium is distributed worldwide

Back 48

T

Front 49

T/F: Entamoeba cyst turns to trophozoite in GI tract of man

Back 49

T

Front 50

T/F: Entamoeba causes nonbloody, watery diarrhea

Back 50

F: bloody diarrhea

Front 51

T/F: Entamoeba infection is limited to the intestines

Back 51

F: liver brain abscess

Front 52

T/F: Entamoeba does occur in the United States

Back 52

T

Front 53

T/F: One looks for Entamoeba trophozoites in stool to make diagnosis

Back 53

T

Front 54

T/F: Sensitivity of stool examination in diagnosing Entamoeba is >95%

Back 54

F: 50% … use serology

Front 55

T/F: Cryptosporidium can cause diarrhea in both immunocompetent and immunocompromised patients

Back 55

T

Front 56

T/F: Person-to-person spread is possible with cryptosporidium

Back 56

T

Front 57

T/F: Chronic severe diarrhea due to cryptosporidium tends to occur in patients with AIDS who have a CD4 count <50 cells/µl

Back 57

T

Front 58

T/F: Cryptosporidium can contaminate water wells

Back 58

T

Front 59

T/F: Cryptosporidium causes a bloody diarrhea

Back 59

F: secretory

Front 60

T/F: The majority of patients infected with cryptosporidium have fever

Back 60

F: fever in 1/3

Front 61

T/F: The AFB smear on stool is necessary to visualize cryptosporidium oocysts

Back 61

T

Front 62

T/F: Cryptosporidium is the most common fecal parasite responsible for diarrhea in the U.S.

Back 62

F: giardia lamblia

Front 63

T/F: Person-to-person transmission is possible with Giardia infection

Back 63

T

Front 64

T/F: Non-bloody diarrhea, with abdominal cramps and flatulence are common with Giardia

Back 64

T

Front 65

T/F: Children in day care centers are at risk for Giardia lamblia

Back 65

T

Front 66

T/F: Stool ova and parasite exam with AFB smear is necessary for identification of Giardia

Back 66

F

Front 67

What are nematodes: roundworms, flukes, or tapeworms?

Back 67

Nematodes=Roundworms

Front 68

What are trematodes: roundworms, flukes, or tapeworms?

Back 68

Trematodes= FLUKES

Front 69

What are cestodes: roundworms, flukes, or tapeworms?

Back 69

Cestodes=TAPEWORMS

Front 70

Hookworm. Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 70

Ancylostoma

Front 71

Whipworm. Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 71

Trichuris

Front 72

Pinworm. Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 72

Enterobius

Front 73

Most common helminth in the US. Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 73

Enterobius

Front 74

Anemia leading to mental retardation in children. Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 74

Ancylostoma

Front 75

Intestinal obstruction. Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 75

Ascaris

Front 76

Hyperinfection occurs in the T-cell deficient host. Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 76

Strongyloides

Front 77

Larva currens. Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 77

Strongyloides

Front 78

Scotch tape test (ouch!) . Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 78

Enterobius

Front 79

Perianal itching. Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 79

Enterobius

Front 80

Rectal prolapse in children (mostly) . Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 80

Trichuris

Front 81

Pulmonary eosinophilia (Loeffler’s Syndrome) . Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 81

Ascaris

Front 82

Mode of transmission to humans is ingestion of eggs. Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 82

Ascaris, Trichuris, Enterobius

Front 83

Mode of transmission to humans is skin penetration. Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 83

Ancylostoma, Strongyloides

Front 84

Mode of transmission to humans is insect bite. Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 84

Filiriasis (Wuchereria Bancrofti - mosquito, Brugia malayi - mosquito, Onchocera volvulus - black fly, Loa - deer fly)

Front 85

Elephantiasis. Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 85

Filiriasis (Wuchereria, Brugia)

Front 86

Dermatitis, nodules and eye lesions. Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 86

Filiriasis (Onchocerca, Loa Loa)

Front 87

Calabar swelling. Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 87

Filiriasis (Loa Loa)

Front 88

Adult worm in the human eye. Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 88

Filiriasis (Loa Loa)

Front 89

Microfilariae in blood. Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 89

Filiriasis (Wuchereria, Brugia, Loa, Onchocera)

Front 90

Microfilariae in skin. Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 90

Filiriasis (Loa, Onchocerca)

Front 91

Microfilariae in the eye. Choose from the following: Ascaris, Ancylostoma, Trichuris, Strongyloides, Enterobius, Filiriasis (Wuchereria/ Brugia/ Loa/ Onchocerca)

Back 91

Filiriasis (Loa, Onchocerca)

Front 92

T/F: Cercaria of Schistosomes penetrate human skin

Back 92

T

Front 93

T/F: Fresh water becomes contaminated by Schistosoma eggs when infected people urinate or defecate in the water.

Back 93

T

Front 94

T/F: Schistosoma parasites can penetrate the skin of persons who are wading, swimming, bathing, or washing in contaminated water.

Back 94

T

Front 95

T/F: Within several weeks, worms grow inside the blood vessels of the body and produce eggs

Back 95

T

Front 96

T/F: Eggs travel to the liver or pass into the intestine or bladder. Rarely, eggs are found in the brain or spinal cord and can cause seizures, paralysis, or spinal cord inflammation.

Back 96

T

Front 97

T/F: Symptoms of schistosomiasis are caused by the body's immune response to the eggs produced by worms, not by the worms themselves.

Back 97

T

Front 98

T/F: The diagnosis is made by finding the eggs in stool or urine. Stool examination should be performed when infection with S. mansoni or S. japonicum is suspected, and urine examination should be performed if S. haematobium is suspected.

Back 98

T

Front 99

T/F: Pathology of S. mansoni and S. japonicum schistosomiasis includes: Katayama fever, hepatic perisinusoidal egg granulomas, periportal fibrosis, portal hypertension, and occasional embolic egg granulomas in brain or spinal cord.

Back 99

T

Front 100

T/F: Schistosoma mansoni is found in parts of South America and the Caribbean, Africa, and the Middle East; S. haematobium in Africa and the Middle East; and S. japonicum in the Far East. 

Back 100

T

Front 101

T/F: Many infections are asymptomatic.  Acute schistosomiasis (Katayama's fever) may occur weeks after the initial infection, especially by S. mansoni and S. japonicum.  Manifestations include fever, cough, abdominal pain, diarrhea, hepatospenomegaly, and eosinophilia.

Back 101

T

Front 102

T/F: In the US, swimmer’s itch is caused by non-human bird cercariae that penetrate the skin (in other words, none of the HUMAN species of schistosomiasis are found in the US)

Back 102

T

Front 103

T/F: Taenia solium= pig tapeworm

Back 103

T

Front 104

T/F: Taenia saginata= cattle tapeworm

Back 104

T

Front 105

T/F: Taenia saginata taeniasis produces only mild abdominal symptoms.  The most striking feature consists of the passage (active and passive) of proglottids.  Occasionally, appendicitis or cholangitis can result from migrating proglottids. 

Back 105

T

Front 106

T/F: The most important feature of Taenia solium taeniasis is the risk of development of cysticercosis.

Back 106

T

Front 107

T/F: Microscopic identification of eggs and proglottids in feces is diagnostic for taeniasis, but is not possible during the first 3 months following infection, prior to development of adult tapeworms. 

Back 107

T

Front 108

T/F: Humans are infected by ingesting raw or undercooked infected meat

Back 108

T

Front 109

T/F: The tapeworm that causes cysticercosis is found worldwide. Infection is found most often in rural, developing countries with poor hygiene where pigs are allowed to roam freely and eat human feces.

Back 109

T

Front 110

T/F: Cysticerci in the muscles generally do not cause symptoms.

Back 110

T; asymptomatic b/c cysticerci die and become calcified

Front 111

T/F: Although rare, cysticerci may float in the eye and cause blurry or disturbed vision.

Back 111

T

Front 112

T/F: Of greatest concern is cerebral cysticercosis (or neurocysticercosis), which can cause diverse manifestations including seizures, mental disturbances, focal neurologic deficits, and signs of space-occupying intracerebral lesions.  Death can occur suddenly.

Back 112

T

Front 113

T/F: The definitive diagnosis of cysticercosis consists of demonstrating the cysticercus in the tissue involved.  Demonstration of Taenia solium eggs and proglottids in the feces diagnoses taeniasis and not cysticercosis.  While suggestive, it does not necessarily prove that cysticercosis is present. 

Back 113

T

Front 114

T/F: There is only one cause of eosinophilia: INFECTION

Back 114

F, allergy

Front 115

T/F: Only parasitic infections cause eosinophilia

Back 115

F, allergy

Front 116

T/F: When caused by parasites, eosinophilia is mostly caused by protozoa

Back 116

F, helminths

Front 117

T/F: Acute bacterial infections may suppress eosinophilia due to underlying parasitic infections

Back 117

T

Front 118

T/F: Corticosteroids (e.g. prednisone) can suppress eosinophilia.

Back 118

T

Front 119

T/F: Sustained high levels of eosinophils can cause damage to the heart

Back 119

T

Front 120

Define prophylaxis vs. treatment

Back 120

prophylaxis = preventive; treatment = disease already exists

Front 121

What are some conditions where IMMEDIATE antibiotic use is warranted?

Back 121

Known focus: acute meningitis; pneumonia; acute endocarditis; epidural abscess with evidence of cord compromise; Unknown focus: neutropenia and cancer w/fever; asplenic; immunosupressed w/fever; toxic-appearing w/unstable vital signs

Front 122

What are some conditions where watchful waiting is best?

Back 122

fever of unknown origin; vertebral osteomyelitis w/o neurological symptoms; weight loss and mass-like lesion in right middle lobe of lung

Front 123

Which organisms growing in blood cultures are NEVER considered to be contaminants?

Back 123

S. aureus [coagulase (+)]; Gram (-) rods; Yeast

Front 124

Which organisms are usually considered to be contaminants?

Back 124

Coagulase (-) Staph; Gram (+) rods

Front 125

Which are sometimes considered to be contaminants and sometimes pathogenic (i.e. 50/50)?

Back 125

Strep viridans; Enterococcus

Front 126

When should you stop antibiotics that are started empirically?

Back 126

culture results negative; if MRSA and Pseudomonas; no requirement for completion - just stop

Front 127

We’ve been telling patients for years: make sure you take ALL your antibiotics that are prescribed for the ENTIRE duration of therapy. Parts of this statement are right, and parts of it may be wrong. Which parts?

Back 127

You should take ALL your antibiotics, but the duration is variable (7 day course is arbitrary and studies have shown efficacy for 3 or 5 day courses)

Front 128

Treatment of helminths infections targets which mechanisms in the organisms?

Back 128

motility, energy generation

Front 129

How do albendazole and mebendazole work?

Back 129

interfere with generation of energy from glucose by blocking glucose transport and inhibiting succinate DH activity; also selectively disrupt microtubules in worms

Front 130

How does atovaquone work?

Back 130

atovaquone, binds to cytochrome b in P/falciparum and is a potent and selective inhibitor of mitochondrial electron transport. pyrimidine biosynthesis (an obligatory pathway in malaria parasite) is inhibited and mitochondrial membrane potential collapses.

Front 131

How does proguanil work?

Back 131

proguanil is metabolized to cycloguanil, a selective inhibitor of dihydrofolate reductase,

Front 132

How do atovaquone and proguanil work together?

Back 132

together, synergistic à dramatically reduces the appearance of atovaquone-resistant parasites , proguanil & atovaquoe à synergistically collapses mito transmembrane potential, cycloguanil & atovaquoe à multiple blockade in pyrimidine biosynthesis

Front 133

What is the drug of choice for prophylaxis against chloroquine-resistant P. falciparum but it can cause CNS symptoms?

Back 133

Mefloquine

Front 134

What is the drug of choice for prophylaxis OR treatment of MDR P. falciparum malaria?

Back 134

malarone (atovaquone + proguanil)

Front 135

What is the drug of choice to prophylaxe against and treat P. ovale and P. malariae but NOT P. falciparum due to widespread resistance?

Back 135

Chloroquine

Front 136

What is the oldest chemotherapeutic drug still in use; used to treat chloroquine-resistant P. falciparum?

Back 136

Quinine

Front 137

What drug(s) cause fatal cutaneous reactions; widespread resistance limits use?

Back 137

Fansidar (pyrimethamine & sulfadoxine)

Front 138

What is the only antimalarial with significant reliability against exoerythrocytic stages? Causes hemolytic anemia in patients with G6PD deficiency

Back 138

primaquine

Front 139

Know the currently recommended chemotherapeutic regimens for malaria: What is the malaria triad?

Back 139

*** MALARIA TRIAD: DOXY CLINDA TETRA

Front 140

What drugs are used for prophylaxis against malaria?

Back 140

chloroquine (if to an area sensitive to P/ falciparum), Doxycyline, Malarone, Mefloquine (if to an area resistant to Chloroquine), + primaquine upon return (if exposed to vivax/ovale), Treatment for Mild/moderate infection (oral), chlorquine (if sensitive), Malarone (or Coartem, or quinine) (+doxycycline/tetracycline/clindamycin) if resistant, + primaquine when recovered, if exposed to vivax/ovale, Treatment for severe illness (IV): Quinidine or quinine (+ doxycycline, tetracycline, or clindamycin), + primaquine when recovered, if exposed to vivax/ovale

Front 141

What is the mechanism of action of metronidazole?

Back 141

aromatic NO2 group accepts an electron from reductive metabolism process (production of ferredoxin), generating nitro-radial anion (only in anaerobes) à when 2 nitro radical anion froms collide, they create a reactive comples à that causes alkylation and stand breakage of DNA

Front 142

What is metronidazole used for?

Back 142

Used for anaerobes (e.g. bacteroides), entamoeba, trichomonas, giardia

Front 143

How do we treat an asymptomatic carrier of E. histolytica?

Back 143

asymptomatic: luminal agents only (paromycin, diloxanide fuorate)

Front 144

How do we treat tissue invasive forms of E. histolytica disease?

Back 144

tissue invasive: luminal & tissue agents (metronidazole, tinidazole)

Front 145

How does pentamidine work?

Back 145

multifactorial: disorganize mitoDNA, inhibit mito Topo, hind ribosomes, hin phospholipid synth… , used for PCP prophylaxis in HIV patients

Front 146

What organism causes plague?

Back 146

Yersinia pestis

Front 147

How are the disease manifestations of plague dependent on the mode of transmission?

Back 147

bubonic plague - flea bite; septicemic plague - flea; pneumonic plague - aerosols

Front 148

What is a characteristic staining pattern of the plague organism?

Back 148

bipolar, like safety pin

Front 149

Name some important tick-borne infections

Back 149

lyme disease, babesiosis, Tickettsia, Rocky Mountain Spotted Fever

Front 150

When do most cases of Lyme disease occur?

Back 150

bimodal: mostly may-july; secondary peak in late fall

Front 151

What are the clinical manifestations early of Lyme disease?

Back 151

early: erythema migrans and/or draining lymphadenopathy, fever, meningitis, neuritis, cardiac arrhythmias, arthralgias and arthritis

Front 152

What are the clinical manifestations late of Lyme disease?

Back 152

oligoarticular arthritis, chronic arthritis, chronic pain, pethargy, encephalopathy

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How can we diagnose Lyme disease?

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history of tick exposure, residence in endemic region; typical clinical manifestations; serologic diagnosis (elisa, western blot)

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How can we prevent Lyme disease?

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antibiotics (amoxicillin, doxycycline, cefuroxime, ceftriaxone); vaccine no longer produced; avoid tick areas, promptly remove ticks, prophylactic doxycycline

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What ticks transmit Lyme?

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Various species of Ixodes

Front 156

What ticks transmit RMSF? (only known ticks!)

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Dermacentor variabilis (American dog tick); Dermacentor andersoni (Rocky Mountain wood tick);

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What are the clinical manifestations of RMSF?

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fever, headache myalgias, rash, shock, GI, renal, cardiopulmonary, CNS

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What are factors that increase the mortality rate among patients with RMSF?

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treatment after day 5 of illness, use of chloramphenicol compared to doxycycline or tetracycline