Term
| coccidian parasite of felines- what is? |
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Definition
| toxoplasma gondii-protozoa |
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Term
| toxoplasma - how get, what forms? |
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Definition
| generally ingest oocyst (egg) from cat feces (cat gets from tissue cyst from other mammal), emerges as tachyzoite, invades GI or any mammalian cell, evades immune system by forming cyst (healthy immune keeps in check) |
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Term
| toxoplasma - disease course usually - and disease course in other populations |
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Definition
1. generally asymptomatic 80-90%, otherwise lymphadenopathy mono like; can get in eye, muscle, pneumonia or brain but generally 2. immunocompromised (AIDS most commonly CNS, then lung, then eye, NON-AIDS heart, then lungs then CNS
3. pregnant women get birth defects especially if 1st or 2nd trimester - hepatosplenomegaly, chorio retinitis, seizure, anemia, encephalitis, hydrocephalus |
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Term
| toxoplasmosis eye involvement - where? difference btw congenital and early in life infection |
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Definition
| cause of 25% of posterior uveitus in US - congenital manifestation age 10-30 (before 40), BILATERAL w/ old scars and macular involvement and if got early in life 30-50 - UNILATERAL, no old scars and macular sparing |
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Term
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Definition
-direct immunoflourescensce or finding of tissue cyst on biopsy not proof of sx, need to see live tachyzoites
-Sabin feldman test - gold standard- get tachyzoites and mix patient serum, if have ab to them they will not stain w/ methylene blue
-ring enhancing lesion in brain if AIDS |
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Term
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Definition
| in healthy person w/ mono sx no tx, pyrimethamine + folinic acid (b/c causes bp suppression) and sulfadiazine or clindamycin |
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Term
| amebiasis caused by? how get? |
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Definition
| entamoeba histolytica - pseudopod forming protozoan (AKA looks like amoeba)-fecal oral route, bad water in developing nations |
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Term
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Definition
| asymptomatic (E. dispar) gradual onset of small volume, frequent blood tingent stools (like ulcerative colitis), colicky hypogastric pain, tenesmus, infrequently fulminant colitis and occasionally liver abscess w/ accompanying RUQ pain, eosinophilia |
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Term
| entamoeba histolytica life cycle |
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Definition
| organisms in cysts w/ glycogen granule can live a while, in stomach HCL releases, surface lectin binds galactose on colon cell surface and kills cells by direct contact by phospholipase (borrows into submucosa but generally no further and spreads out so get little craters), get diarrhea (bloody mucusy), if gets invasive/overgrowth you get fulminant colitis or hepatic involvement eosinophilia |
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Term
| entamoeba histolytica can be mistaken for? what do both look like? |
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Definition
| can be mistaken for e dispar (normal flora), have dead center nucleolous (karyosome), histolytica has RBC in it b/c phagocytoses, e. dispar doesn't |
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Term
| best test for amebiasis? other ways you can find |
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Definition
| best test is Ab test, will be positive if invasive intestinal or liver abscess; can also find in stool or find ag in stool w/ >90% for colitis |
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Term
tx for amebiasis 1. asymptomatic e. histolytica
2. symptomatic |
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Definition
| 1. paromomycin (aminoglycoside) (no tx for e. dispar) 2. metronidazole or tinidazole |
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Term
| Cyptosporidiosis - caused by? what is it? |
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Definition
| crytosporidium parvum - protozoa |
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Term
cryptosporidium - ubiquitous enteric pathogen of all age groups, zoonotic infection, water borne, Warmer months, some person to person spread
1. serious problem w/ which group?
2. how cause ilness |
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Definition
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Term
| cryptosporidiosis findings (AIDS vs. healthy) |
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Definition
watery diarrhea in healthy self limited intermittent but in AIDS can be voluminous (12-17L/day)
abdominal cramps, low grade fever, fatique, N&V |
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Term
| cryptosoridiosis best dx? |
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Definition
| best - ag in stool, or modified ACID fast stain of oocysts in stool |
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Term
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Definition
| nitazoxanide (blocks ferredoxin ETC), and non specific anti diarrheal |
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Term
| Giardiasis - cause? what is? |
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Definition
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Term
Giardiasis - 1 life cycle
- worldwide, most common intestinal parasite, cold mountainous regions, russia and some person to person spread |
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Definition
| 1. drink cyst, trophozoite comes out (funnel shaped looks like has eyes but nucleus), lands on small bowel and covers villi, causes malabsorbptive diarrhea |
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Term
| giardiasis clinical findings |
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Definition
| 10% asymptomatic, acute self limited diarrhea --> chronic diarrhea --> malabsorption, weight loss, flatulence, bloating, malodorus stools, fever, anorexia--- b/c SI not absorbing get bacterial overgrowth in colon |
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Term
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Definition
| best stool ag; stool exam from troph or cysts (increase sensitivity w/ more trials), also string test or duodenal aspirate on endoscopy |
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Term
| giardiasis tx main 2; others? |
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Definition
| metronidazole 250mg tid 5-7 days; tinidazole 2g once (not w/ ETOH or during 1st trimester); nitazoxanide BID 3 days, alternative paromycin, furazolidine, albendazole |
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Term
| cysticerocosis caused by (what is?)? how get? |
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Definition
| taenia solium (it is a platyhelminth (flat worm) group - cestode-tapeworm no GI tract, absorb nutrients directly)- get from eating food infected w/ EGGS |
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Term
| adult tapeworm disease from? sx? humans definitive host |
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Definition
eating cysts w/ larvae (not eggs) of t. solium (pork) or t. saginata (beef) (noninvasive) -
generally asympomatic - abdominal discomfort, wt. loss, bloating, N&V, proglottid migration, B12 deficiency w/ D. latum (fish tapeworm) |
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Term
| Echinococcus AKA? from? sx? tx? |
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Definition
| AKA hydatid disease, from humans eating eggs from dog feces (definitive host-this is dog tapeworm), from echinococcus multilocularis (causes alveolar hydatid disease (mainly lungs) or echinococcus granulosus (hydatid disease) mainly liver - antimicrobial injection into cyst, long term albendazole, remove cyst |
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Term
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Definition
| praziquantel or niclosamide (disrupt ETC)single dose |
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Term
| cysticercosis 1. sx 2. dx 3. tx |
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Definition
1. brain mass, arachnoiditis, seizure from nowhere in mex immigrant
2. imaging
3. CONTROVERSIAl, if find larvae albendazole + dexamethazome x 8d, if have co ecisting intestinal t. solium niclosamide |
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Term
| round worms include ascaris and trichuris |
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Definition
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Term
ascaris lumbricoides - most common human helminth, 4 million in US (mainly south east) 1 billion worldlwide
1. how get? |
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Definition
| 1. poor sanitation and use of human feces as fertilizer, hand to mouth (children eating dirt), leafy vegetables from night soil |
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Term
| ascaris lumbricoides life cycle |
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Definition
| eggs in soil, ingest, invade SI and grow, male and female meat in SI and make eggs, sometimes gets in bloodstream, goes to lung, molts and forms larvae which cough up and swallow |
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Term
| Ascariasis clinical findings |
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Definition
| 1 worm - asymptomatic, many worms vague abdominal symptoms, N&V, diarrhea, steatorrhea, eosinophilia, can cause bowel obstruction (see on barium swallow), appendicitis, pancreatitis, obstructive jaundice (aberrant locations) |
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Term
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Definition
| eggs in stool (there are TONS of them), recognition of worms spontaneously expelled (cough up ear, out nose) |
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Term
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Definition
| albendazole 1x, mebendazole for 3 days, pyrantel pamoate |
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Term
| visceral larva migrans from? |
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Definition
| also called toxocariasis - toxocara cati or toxocara canis (dog and cat versions of ascaris) |
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Term
| visceral larvae migrans - what happens? clinical sx/dx? what age? |
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Definition
| ingest eggs from cat/dog, goes to small intestine, larvae penetrate mucosa and migrate to liver or others but cannot complete lifecycle, get inflammation and eosinophilic granulmoas, b/c RES deals w/ it get fever, hepatosplenomegaly, hyperglobulinemia, demonstrate larvae in tissues, if kids a little older might get occular (usually unilateral)- get in kids 1-4 |
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Term
| visceral larva migrans tx? |
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Definition
| usually self limiting, albendazole 3-5 days, mebendazole 5 days, if ocular involvement CORTICOSTEROIDS |
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Term
| Trichuris trichiura - AKA, life cycle, sx-diff with ascaris? dx? |
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Definition
| whip worm, 3rd most common nematode, esp in tropics and rural southeast, eat eggs from soil, mature in colon, sew self into crypts of lieberkuhn, male and female meet and make eggs, gotta mature for 3 weeks in soil to become embryonated- usually asymptomatic, vague abdominal pain, anorexia, growth retardation, complications -> appendicitis, severe colitis (toxic megacolon), rectal prolapse - diff w/ ascaris is no extra intestinal cycle, dx by eggs in stool |
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Term
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Definition
| albendazole - 3 days, mebendazole 3 days |
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Term
| Hookworm disease caused by? (2) |
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Definition
| Necator americanus, ancylostoma duodenale - among most common intestinal parasites |
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Term
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Definition
| filariform larvae in grass through feet, go to lungs, cough up, swallow, bite intestinal villus and release anticoagulants and proteolytic enzymes and feed on blood adults mate in SI and lay eggs, which embryonate and hatch in soil to rhabditiform larvae, mature to filariform, repeat |
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Term
| hookworm disease clinical findings/sx/dx |
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Definition
| ground itch, eosinophilia (during time in blood) iron deficiency anemia (each worm loss of .2mL/day), N&V, diarrhea, abdominal pain, weight loss; dx - find eggs in stool |
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Term
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Definition
| "pyrantel pamoate or mebendazole or albendazole" - add Fe |
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Term
| cutaneous larva migrans caused by? rx (2)? |
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Definition
| ancylostoma caninum, and braziliense (dog and cat hookworm), rx ivermectin or albendazole |
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Term
Strongyloides stercolais- less prevalent then hookworms but parallels distribution, pretty serious - poor sanitation and custodial institutions
-life cycle? |
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Definition
| soil transmitted like hookworm (filariform larva gets in), autoinfection possible b/c INVADE small intestine and hatch there and rhabtidiform come out, some turn into filariform larvae in small intestinecan do the whole lung thing and can then invade mucosa -adult parasite is parthanogenetic (eggs-> adults w/o ferilization), have 2 life cycles direct parasitic (homogonic) and indirect free living (heterogonic) |
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Term
| strongyloidiasis - sx, signs, dx |
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Definition
| asymptomatic 1/3, pruritic rash, abd pain, N&V, diarrhea, malabsorption, eosinophilia DX RHABDITIFORM LARVAE in stools (not eggs!), |
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Term
| disseminated strongyloidiasis in immune compromised - clinical picture |
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Definition
| abd pain, N&V, ileus, cough, hemoptysis, diffuse lung infiltrates, shock GNR SEPSIS, meningitis b/c carry e. coli out of intestine - might find eggs larvae in stool, sputum, other body fluids |
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Term
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Definition
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Term
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Definition
| enterobius vermicularis, most common helminthic infection in US and europe, school children 5-14, |
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Term
| enterobius vermicularis life cycle/clinical findings |
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Definition
| Ingest egg, goes to colon, mates, female lays eggs on anus (no extraintestinal) - has ala wings, down whole body findings pruritis ani, appendicitis, salpingitis |
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Term
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Definition
| dx scotch tape test for eggs, rx mebendazole or pyrantel pamoate - repeat in 2 weeks, cure rate 90-100% |
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Term
| Trichinella spiralis - worldwide, commonly pigs, horses, walrus etc., <100 cases yr/US 1. life cycle? |
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Definition
| ingest meat containing larvae --> develop into adults in small intestine, mate, invade mucosal cells, enter bloodstream, go to any muscle |
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Term
trichinosis - usually subclinical, fever, myalgia, weakness, maliase, periorbital edema, headache, rash, edema, diarrhea, nausea, subconjunctival hemorrhage, splinter hemorrhages, eosionphilia
1. dx?
2. tx? |
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Definition
1. eosinophilia, increased CPK and LDH (muscle enzymes), Abs in 3rd week, muscle biopsy,
2. no satisfactory tx against encysted worms, if known ingested me mebendazole or albendazole for intestinal worms, corticosteroids for critically ill pts |
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