Term
| What is the first step in approach to diagnosing diarrhea? |
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Definition
| having diarrhea, nausea, vomitting |
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Term
| When diagnosing diarrhea, what is the next step after confirming diarrhea? |
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Definition
| Assess the duration and severity |
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Term
How long must the duration of diarrhea be to be diagnosed as infectioius diarrhea?
what do the severity symptoms include? |
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Definition
-duration >1day
-symptoms:dehydration, fever, blood, weight loss |
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Term
| When exploring the history of a patient with possible infectious diarrhea, what do you look at? |
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Definition
| history of fever, blood, seafood, weight loss, antibiotics, travel, outbreak, sexual experience, abdominal pain, immunosupression |
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Term
| What type of sample do you obtian to identify infectious diarrhea? |
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Definition
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Term
What testing do you perform on stool if:
-No WBC
-possible Vibrio, C.Perfringens, S. aureus, B. cereus
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Definition
Non- inflammatory
-perform culture and or toxin testing |
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Term
What testing to perform if stool shows:
-No WBC
-possible Giardia coccidians, Microsporidia, helminthes |
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Definition
Non inflammatory
-O&P exam and special staining |
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Term
What testing for stool specimen if:
-No WBC
-Possible rotavirus or Norwalk virus |
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Definition
Non-inflammatory
-EIA or PCR |
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Term
What testing for stool if:
-WBC present
-Possible Shigella, Salmonella, C.Jejuni, E.coli, C.diff |
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Definition
Inflammatory
-requires culture and toxin testing for C. diff
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Term
What test for stool with:
-WBC present
- possible E.histolytica
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Definition
Inflammatory
-requires O&P exam |
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Term
| What are the three different ways to collect 3 stool specimens? |
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Definition
-3 specimens, one every day
- 3 specimens, one every other day
-3 specimens in a ten day period |
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Term
| When a patient is hospitalized for >3 days, is an O&P exam necessary? why or why not? |
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Definition
| No, is infectious diarrhea is present within a hospital setting it is more than likely due to antibiotics. |
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Term
| -sodium acetate- acetic acid- formalin (SAF), total fix |
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Definition
| Universal fixative for stool preservation |
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Term
| 5% or 10% buffered formalin and mercury or non-mercury based Poly vinyl alcohol – LVA fixative |
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Definition
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Term
| when diagnosing infection with intestinal parasites what three tests can you run |
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Definition
- O&P exam on fresh, unpreserved stool
-O&P exam of preserved stool
-Antigen detection assays |
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Term
Fresh stools / Unpreserved stools
↓
0.85% NACL or Iodine (1-2 drops)
↓
Direct wet smear
↓
Helminth eggs /larvae
Protozoan trophozoites / cysts |
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Definition
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Term
-formalin ethyl acetate concentration method
-Trichrome stained slide |
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Definition
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Term
| detects protazoan cysts, helminth eggs/larvea in preserved stool |
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Definition
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Term
In preserved stool:
- detects trophozites and cysts
-Used to assess the presence of human cells(WBC/RBC) and charco-laden crystals |
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Definition
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Term
-perform of fluid, no particulates
-limited to cryptosporidium, giardia, entamoeba histolytica/ entamoeba dispar
-all kits have same sensitivity/specificity
-requires color judgement or interpretation
-false negative due to low organism number |
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Definition
| EIA and cartridge immunoassay |
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Term
-perform on concentrated stool
-limited to cryptosporidium, giardia
-single or batch testing
-requires flourescent microscope
-requires color judgement or interpretation
-false negatives from low organism numbers |
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Definition
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Term
| includes both metabollicaly independent free living species, and parasitic species that have a metabolic dependence on one or more host species to continue their life cycle |
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Definition
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Term
-as a group they are referred to as roundworms
-vary in size from a few millimeters to more than a meter in length
-seperate sexes w/ male being smaller than female
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Definition
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Term
-male has a curved or coiled posterior end with copulatory spicules and in some species bursa
-adult anterior may have oral hooks, teeth or plates in the buccal capsule for the purpose of attachment |
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Definition
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Term
-no intermediate host
-non infective eggs or larvea are shed in the stool
-eggs may be immediately infective by being ingested
-eggs or larvea may require a period of external development to reach the infective stage
-insect may transmit eggs or larvea to new host
-infective filariform larvea develop (in soil 1-3 weeks)
-larvae penetrate skin or ingested for infection to occur |
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Definition
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Term
| associated with blood and tissue eosinophilia |
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Definition
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Term
| name the helminths that infects man and animals (3) |
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Definition
nematodes(roundworms)
tremadoes (flukes)
cestodes(flatworms) |
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Term
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Definition
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Term
-cosmopolitan distribution
-most common in temperate climate
-Most common in children, with transmission to family members |
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Definition
| epidemiology of enterobius vermicularis (pinworm) |
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Term
| clinical manifestations include an itchy butt and sleep disorder |
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Definition
| enterobius vermicularis (pinworm) |
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Term
-children are infected by oral intake of infective eggs
-larvea hatch in intestine and migrate to rectum
-adult femal lays eggs in night in the perinial folds
-eggs become embryonated and infective by 6 hours
-anal area become itchy and so eggs spread to fomites or directly into the mouth. Reinfection and super infection are common
-One adult femal produces 11,000 eggs before drying |
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Definition
| Life cycle of enterobius vermicularis (pin worm) |
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Term
-Eggs are flat on one side and convex on the other
-measure 50-60 um by 20-30 um
-adult worm 1 cm long
-tissue sections(appendix) may demonstrate worms
-scotch tape prep collection |
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Definition
| Enterobius vermicularis (pinworm) |
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Term
- most common soil transmitted helminh
-largest intestinal roundworm (30 cm) |
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Definition
| epidemiology of ascaris lumbricoides |
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Term
-infective egg ingested and hatches in gut
-larvae migrate through liver and lungs into trachea
-larvae are swallowed and mature (2mos) in gut
-worms mature and mate(1 yr span)
-non infective eggs are laid
-eggs are shed and become infective in soil |
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Definition
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Term
-adult worms migrate into the bile duct, pancreatic duct or appendix
-occasionally they penetrate bowel wall (during treatment)
-may see intestinal obstructin or perforation with pancreatitis, appendicitis, or biliary obstruction
-during migratory phase it causes pneumonitis |
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Definition
| clinical manifestations of ascaris lumbricoides |
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Term
-finding eggs in stool
-fertalized eggs are 60um, unfertilized 90 um
-Adult worms, when passed in stool, measure 30-35 cm and are peachy tan in color |
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Definition
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Term
Definition
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Term
| rectal prolapse with "coconut cake" appearance and diarrhea |
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Definition
| clinical manifestation of trichuris trichura |
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Term
-infective eggs are ingested by mouth
-eggs hatch and larvae reside in colon
-larvae mature three months in gut and then mate
-adults live in appendix and colon (ten years)
-mature female lays 5000-7000 eggs per day
-eggs mature in 3 weeks in soil and become infective |
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Definition
| trichuris trichura (whipworm) |
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Term
-demonstration of eggs in stool
-have bipolar plugs (50-54um by 22-23um)
-Adult worms when passed in stool have whiplike tail |
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Definition
| trichuras trichura (whipworm) |
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Term
Definition
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Term
-infective filariform larvae penetrate skin of bare foot of individual
-larvae migrate to lungs and trachea
-larvae are coughed up and swallowed
-worms mature in duodenem 1-2 mos then mate
-eggs are laid and passed in the feces
-eggs embryonate and hatch in 24 hours
-rhabditform larvae hatch and mature in 1wk to infective filariform larvae |
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Definition
| Hookworms, nectaer americanus and ancylostoma duodenale |
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Term
-anemia- each worm consumes .5ml of blood a day
-weakness, fatigue, growth retardation
-causes pnuemonitis during migratory phase of larvae
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Definition
| clinical manifestations of hookworms nectaer americanus and ancylostoma duodenale |
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Term
-finding thin shelled eggs which measure 57-76um and 35-47um
-Larvae may be seen if patient is constipated or if specimen sits too long before going into perservative
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Definition
| diagnosis of hookworms nectaer americanus and ancyclostoma duodenale |
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Term
-filariform larvae penetrate skin of human host
-only females cause infection
-females lay several eggs/day
-infections occur in warm subtropical regions, and parts of Kentucky
-super infection seen in immunocompromised patient |
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Definition
| strongyloides stercoralis (threadworm) |
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Term
-initial manifestation may be asymptomatic or be cutaneous
-Pnuemonitis and respiratory failure during migratory phase through lung
-Loeffler's syndroom with eosinophilia
-super infection w/ GN sepsis and meningitis |
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Definition
| strongyloides stercoralis (threadworm) clinical manifestation |
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Term
-finding rhabdiatform larvae in stool(short buccal capsule and large genital primordium)or the filariform larvea (slit in tail)
-duodenal aspirate may reveal thin wall unembryonated eggs or rhabditform larvae
-duodenal or small bowl biopsy may reveal adult worms and eggs in the intestinal crypts |
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Definition
| strongyloides stercoralis (threadworm) |
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Term
Definition
| strongyloides stercoralis |
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Term
ØInfections acquired by ingesting larvae encapsulated in infected animal muscle( pork or bear)
ØLarvae encyst in gut and mature in 1 week
ØAbout 3000 minute larvae are produced during the adult’s 4 month life span
ØLarvae penetrate gut wall to reach blood vessels
ØHematogenous spread to key skeletal muscles
• Tongue
•Diaphragm
•Masseter muscle
ØInfective larvae coil 2 ½ times and then become walled off by host immune reaction
ØLarvae may eventually die and become calcified in the muscle tissue
Man is the last host, since we are rarely eaten to pass on the parasite to another host |
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Definition
| trichenella spiralis (trichinosis) |
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Term
-muscle pain
-periorbital edema
-fever
-marked eosinophilia
|
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Definition
clinical manifestation of trichinella spiralis
(trichinosis) |
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Term
| diagnostic testing for trichinella spiralis |
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Definition
| serology, tissue biopsy demonstrating larvae |
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Term
Definition
| Trichinella spiralis (trichinosis) with H&E stain |
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Term
Definition
| Trichinella spiralis (trichinosis) |
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Term
Definition
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Term
| what is the objective in treatment of parasites |
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Definition
-stopping growth, reproduction and transmission
-kill parasites with out inducing harmful host response and and expel parasite from host |
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Term
Definition
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