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53 Cards in this Set

  • Front
  • Back
For any given patient, what does the burden of protozoal disease depend on? (2 factors)
Host immune status
Virulence of the parasite
For any given patient, what does the burden of helminth disease depend on?
The duration and level of exposure
Most helminths do not multiply in humans. What are 2 exceptions?
1. Strongyloides stercoralis. Larvae in bowel can reenter through skin, causing autoinfestation.

2. Echinococcus (dog tapeworm). Multiply within hydatid cyst in humans. If hydatid cyst is ruptured during surgery, many new cysts can form.
What parasite infection is characterized *in immunocompetent patients* by linear urticarial rash at the site of infection (larva currens) and an eosinophilic pneumonia?
Strongloides
How does the clinical picture in Strongloides differ between immunocompetent and immunocompromised patients? How is the diagnosis different?
Immunocompetent: linear urticarial rash at infection site; eosinophilic pneumonia
Dx by serology; few larvae in stools

Immunocompromised: hyperinfection leading to GRAM NEGATIVE SEPSIS; pneumonia, meningitis, endocarditis, no eosinophilia.
Dx by larvae in stools
What helminthic disease, most common in children, has eggs that are immediately infections? It involves perianal pruritis --> children itch, then put hand to mouth
Enterobius (pinworm)
How is Enterobius diagnosed?
Scotch tape of perianal area, look for eggs
What helminthic infection, also common in children, involves eggs that must mature in the environment before they become infections? This infection can cause rectal prolapse and bloody diarrhea.
Trichuris (whipworm)
What helminthic infection involves worms that can migrate, thereby causing pancreatitis, intestinal obstruction, appendicitis, or jaundice? Are the eggs immediately infectious, or do they need to mature in the environment?
Ascardis lumbricoides

Eggs must mature in environment.
How are Necator and Acyclostoma transmitted?
These are hookworms: larvae perforate skin, migrate to lungs
What are the hookworms (2), and what symptom are they noted for?
Necator and Acyclostoma.

Cause iron deficiency anemia due to chronic bleeding in jejunal mucosa (because it sucks the blood for food)
1. What helminth has eggs that are infectious immediately?
2. What helminths (2) have eggs that must mature in the environment?
1. Enterobius (pinworm)

2. Ascaris lumbrocoides; Trichuris (whipworm)
What helminth is transmitted by eating poorly cooked pork or wild boar?
Trichinella spiralis
What roundworm is spread by a mosquito vector? What does it cause?
Lymphatic filariasis; Wuchereria bancrofti
What helminth causes river blindness?
Onchocera volvulus
What is the vector for river blindness? What is the pathologic process?
Vector = blackfly

Microfilariae go to eyes and when they die cause pruritis, dermatitis, skin atrophy, and river blindness.
What is the intermediate host of the flukes?
Freshwater snails
How are the Schistosomiasis species transmitted?
Swimming larvae penetrate human skin!
Katayama fever is caused by what helminth?
Schistosoma mansoni and japonicum
1. Schistosoma mansoni leads to what disease in people with no previous exposure?
2. Chronic exposure to Schistosoma mansoni leads to a chronic inflammatory response involving what organ?
1. Katayama fever
2. Eggs embolize to liver --> portal hypertension
The eggs of Schistosoma species have what distinctive feature?
Hooks
Schistosoma haematobium causes tons of problems with what organ?
Bladder

Bladder calcifications
Recurrent UTIs
Squamous cell carcinoma of the bladder
Small freshwater carp, esp. in Asia, are known to carry what helminth? What organ does it infect?
Clonorchis sinensis

Recurrent cholangitis
Cholangiocarcinoma
What parasite can be transmitted by eating crab or sushi? What does it cause?
Paragonimus westermani (Lung fluke)
Causes a cavitary pneumonia, hemoptysis that looks like TB
Tapeworms are also known scientifically as...?
Cestodes
Eggs of Echinococcus spread to what organ?
Liver
What helmiths are transmitted by larvae that infect the host through the skin?
--Strongyloides (larva currens rash)
--Schistosoma species (male wraps around female)
--Necator and Acyclostoma (the hookworms)
What helminths are transmitted through ingestion of eggs?
--Enterobius (pinworm) -- kids scratch anus and put fingers in mouth; immediately infectious
--Taenia solium (human feces; immediately infectious, cysticercosis)
--Trichuris (whipworm); egg needs to mature
-- Ascaris lumbrocoides; egg needs to mature
--Echinococcus (dog tapeworm, from dog feces)
Are eosinophil levels high in protozoal infections? Helminth infections?
Protozoa infections = no eosinophilia

Helminth infections = eosinophila
What infectious nematode can be found free-living in the soil?
Strongyloides
What helminths can be acquired by eating meat with larvae?
Trichinella (pork; larvae and adults in humans)
Taenia saginata (beef; tapeworm in humans)
Taenia solium (pork; tapeworm in humans. If eggs are ingested instead of larvae --> cysticercosis)
What helminths can be acquired by eating fish with larvae?
Diphyllobothrium (freshwater fish; B12 deficiency)
Clonorchis (esp. carp, causes biliary disease)
What helminth is acquired by eating raw crab or sushi?
Paragonimus (lung fluke)
What infection is associated with eosinophilia, myalgia, and head swelling (facial and periorbital edema)?
Trichinella spiralis
Acute illness in Katayama fever is precipitated by what immunogenic event? How is it diagnosed?
Acute illness occurs when eggs are released into the blood. Eggs are not yet present in the stools. Schistosomas serology is positive.
How are fluke infections treated? (Schistosoma, Paragonimus, Chlonorchis)
Praziquantel
Which helminths cause *fever* and *eosinophilia*?
All ACUTE Fluke infections:
Schisosomiasis
Chlonorchis
Paragonimus
Fasicola

Only ONE Nematode:
Trichinella

Remember: Fever = Flukes with T(richella)
Which helminths cause Loeffler's syndrome (eosinophilic pulmonary infiltrates)?
HAS Loeffler's!

Hookworms
Ascaris
Strongyloides
Which helminth causes hemoptysis and an overall TB-like picture?
Paragonimus
There are 11 warning signs of primary immunodeficiency. You begin to suspect that a patient may have primary immunodeficiency after he or she manifests how many of them?
2 of the 11 warning signs
Which protozoa are transmitted through a fecal-oral route?
Entamoba histolytica
Giardia lamblia
Cryptosporidium (large outbreak in Milwaukee in 1990s)
What is the vector for leishmaniasis?
Sandflies
Congenital toxoplasmosis infections

1. At what stage of pregnancy is the risk of infection highest?
2. At what stage of pregnancy are infections the most severe?
1. Highest risk of infection: late pregnancy
2. Highest severity of infection: early pregnancy
What protozoa can cause a bloody diarrhea, along with a spectrum of GI problems ranging from acute necrotozing colitis to toxic megacolon?
Entamoeba histolytica
What protozoa can cause an invasive disease in which it travels from the GI tract to the liver, and forms abscesses and "anchovy-paste pus" in the liver?
Entamoeba histolytica
What protozoa can cause a watery diarrhea and is especially prone to infecting AIDS patients? In AIDS it can cause colitis, and extraintestinal infections including cholangitis, pancreatitis, and cholecystitis.
Cryptosporidium parvum
Which protozoa is a macrophage parasite?
Toxoplasmosis
Which malarial protozoa can cause nephrotic syndrome?
P. malariae
Which protozoa can cause a spectrum of infection types, ranging from serious pathology of the visceral organs to cutaneous and mucocutaneous forms?
Leishmaniasis
--Visceral = Kala Azar (black fever)
--Cutaneous = pizza like painless ulcer ("Oriental sore")
--Mucocutaneous = Latin America, severe damage to nose, palate, upper airways
What parasite causes a mononucleosis syndrome, and chorioretinitis?
Toxoplasma
There are 2 types of influenza vaccines. What are they, and how are they administered?
1. Live attenuated (intranasal)
2. Killed (injection)
Which enveloped DNA virus carries its own polymerase, so that it need not depend on host polymerase for DNA replication?
Herpes viruses
CMV and Roseola can remain latent in what type of cells?
WBCs