blood/tissue parasites

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What parasite in Phylum apicomplexa causes the disease we most concerned with?: PLASMODIUM, which causes MALARIA
What are the four species of Plasmodium?: 1. vivax
2. falciparum
3. malariae
4. ovale
what are the diseases caused by malaria?: PICCMMART
Paludism, Intermittent fever
Chagres fever,Coastal fever
Malaria, Marsh fever,
Ague, Roman fever, Tropical fever
What is the definitive host of Plasmodium? What is the intermediate host?: Definitive: Female anopheles mosquito

Intermediate: Humans, other animals
What is the Geographic distribution of malaria?: in the Malarial belt:
-Africa
-South/Central America
-Southeast Asia
what are the 2 main compoments of the Plasmodium life cycle? -in which host does each take place?: -Sporogeny = sexual, in mosquitos.
-Schizony = asexal, in humans
What terms denote species with -48 hr cycle -72 hr cycle -Which species belong to each?: 48hr = Tertian Cycle; all species except Malariae.

72hr = Quatern cycle, P.malariae
In what order are the stages of malarial infections seen on a thin smear?: -Troph
-Schizont
-Gametocytes
Which species of Plasmodium have very similar morphologies? What makes them similar?: Vivax and Ovale.
-makes RBCs Macrocytic
-species are v. motile
-Tertian (48 hr)
-Schuffner's dots are seen
-both can cause relapse
Which species don't cause relapse?: P. malariae
P. falciparum
Which species of Plasmodium causes normocytic RBCs? What other notes make it unique?: P. malariae
-also low motility
-the only QUARTERN species
-Schizonts have ROSETTE look.
Which species has crescent shaped gametocytes?: P. falciparum
What characteristics and morphology are used to I.D. P. falciparum?: -36-48 hr cycle - works faster!
-VARIOUS sized RBCs
-More than 1 parasite/cell
-Most resistant, but doesn't show relapse.
Why is P. falciparum the worst species?: becasue it infects both young and old RBCs, over 50%.
The other species only infect 2-4% of the RBCs.
What 4 things are used to treat malaria?: QMCWAP
1. Quinine/Mefloquine
2. Chloroquine
3. Wormwood extract
4. Artemisinin + Piperaquine is the Chloroquine-resistant treatment.
What are the 4 possible forms of malaria pathology/symptomology?: 1. Usual
2. Blackwater fever
3. Cerebral malaria
4. Congenital malaria
What are the USUAL COURSE symptoms?: 1. Fever/chill cycle (allergic rxtn when schizonts rupture)
2. Anemia, splenomegaly
What is Blackwater fever? What species causes it?: Acute hemolytic syndrome causing hemoglobinuria - P. falciparum
What are symptoms of Cerebral malaria, what causes it?: Confusion/disorientation, caused by P. falciparum
What species causes Congenital Malaria?: ALL species
what are 3 resistance mechanisms to malaria?: 1. Sickle cell anemia
2. Duffy blood group negative
3. others - HgF in infants, dietary deficiencies, G6PD defic., cell/humoral immunity, vaccines.
How is a thin smear prepared for malarial exam?: Normally, but stained with Giemsa.
How is a thick smear prepared?: 1. Nickel drop of blood on slide
2. Dry.
3. Slide stained w/ Giemsa to lyse RBCs
4. Look at slide for parasites
Where does Quinine kill malarial organisms? How is the drug commonly used?: In the BLOODstream - not the liver.

Often used as a prophylactic.
Which organism is Chloroquine resistant?: P. falciparum
What drug is used for cellular AND liver prophylaxis?: Malarone

also, Larium and Doxycycline
What parasite causes Babesiosis?: Babesia microti
In what geographical areas is Babesiosis seen, and how is it transmitted?: -Nantucket
-Cape Cod
-Midwest

-Transmitted via DEER TICK
-What is the Defin host of Babesia microti? -What is the intermed. host?: Defin: deer tick

Intermed: humans
Morphologically, what does B. microti resemble? What makes it unique?: Resembles P. falciparum, BUT:
-Only has rings, no granules or pigment.
-Rings form a MALTESE CROSS - a tetrad of rings.
What 5 symptoms are often seen in Babesiosis?: Fever and Chills
Splenomegaly
Hepatomegaly
Hemolysis causing Blckwtr fever
With what 3 lab techniques do I diagnose Babesiosis?: Thick smears, Thin smears, and ELISA.
What 2 medicines will I use to treat Babesiosis?: 1. Azithromycin
2. Atovaquone in combo with Malarone.
How can patients prevent babesiosis?: Keeping away from
-ticks
-blood transfusions.
What are the 2 blood/tissue flagellates that we are concerned with? What genus/phylum/order are they in? What type of organism transmits all of these?: -Leishmania
-Trypanosoma

Protozoa, Mastigophora, Kinetoplastida

All transmitted via arthropod
What two subspecies of the Kinetoplastida cause African sleeping sickness, where?: -Tryp. brucei rhodesiense - East
-Tryp. brucei gambiense - West
what organism (specific subspecies too) transmits East/West african sleep sick?: Tsetse fly, Glossina species.
what parasite causes Chagas' disease? How is the parasite transmitted?: Trypanosoma cruzi, found in C. and S. America, and Mexico.

-carried by the Reduviid bug, which poops while eating.
What are the four pathogenic species of Leishmania? What vector is common to all?: L. donovani,
L. tropica and L. mexicana
L. braziliensis

Transmitted by SANDFLY
What are the 2 developmental forms of the blood/tissue flagellates? -Which species is each in?: -Trypomastigotes - seen in Trypanosoma infections

-Amastigotes - seen in Leishmaniasis.
What two Tryp species cause AFrican sleeping sickness?: -Trypanosoma gambiense
-Trypanosoma rhodesiense
What is the infectious stage that causes african sleeping sickness?: -Metacyclic trypomastigote.
What are the hosts of tryp gambiense and rhodesiense? -vertebrate -invertebrate: -Vertebrate is human/animals
-Invert is Glossina tsetse fly
What are possible stages of Afr. sleeping sickness?: -Acute stage
-Chronic stage
What are the symptoms of African sleeping sickness, the Acute stage?: -Fly bites cause Chancres
-Trypomastigotes in blood invade lymph nodes
-Fever/night sweats
-Nodules on the neck (aka Winterbot. sign)
What is Winterbottom's sign?: -the presence of neck nodules in acute sleeping sickness.
What is the diagnostic stage of trypanosoma gambiense and rhodesiense?: -Trypomastigotes in the blood.
What are 3 chronic stage symptoms?: 1. Trypomastigotes in the CNS
2. Coma
3. Death
What are 4 methods for diagnosis of African sleeping sickness?: -Clinical symptoms (fever/sweat)
-Trypomastigotes in blood
-IgM levels (high - frequently change surf antigens)
-ELISA for Ag in blood/CSF
what are 3 drugs for treating african sleeping sickness?: 1. Suramin via IV
2. Pentamidine isothionate via intramuscular injection
3. Melarsoprol can cross BBB
What are two ways to prevent african sleeping sickness?: -Control the vector (tsetse fly) population

-Reduce the human reservoir.
what does T. cruzi cause? what vector transmits it?: Chagas disease

vector: reduviid bug
wat are the hosts of T. cruzi? -vertebrate -invertebrate: Vert: humans/animals

Invert: Reduviid bug
what are symptoms of Acute and Chronic Chagas disease?: Acute: chagoma (inflmtn), fever, rash, hepato/splenomegaly, acute myocarditis, swollen liver, spleen, and heart.

Chronic: severe cardiomyopathy and megacolonopathy.
How is Chagas disease diagnosed? What are 3 other methods?: Primarily Clinical symptoms

Also
Trypomastigotes in blood
Amastigotes in tissue
Serological tests
What is one additional, slightly weird method of diagnosing Chagas disease?: Xenodiagnosis
What is Xenodiagnosis?: Raising pure reduviid bugs, allowing them to eat blood of patient, test feces for metacyclic trypomastigotes
What 2 drugs may treat Chagas disease? What other treatment may be necessary?: 1. Bayer 250Z, Radamil

2. May surgiclly remove megaesophagus and megacolon.
How can Chagas disease be prevented?: -Controlling vector breeding by painting or using plastic boards
-Protect humans from the flies
What is the developmental form present in Leishmaniasis?: -Amastigote
What are 3 types of hosts of Leishmania?: -Vertebrate - Man
-Invertebrate - Sandfly
-Reservoir - Dogs/rodents
how is leishmania prevented? (two normal, common things): -Control vector breeding ground
-Protect humans
what are the 4 leishmania species?: -Donovani
-Mexicana and tropica
-Braziliensis
What are 3 names for Leishmania donovani infection?: Kala-azar
Visceral leishmaniasis
Dumdum fever
What does Kala-azar mean?: Black poisoning
Where is L. donovani found?: -South/Central America
-Africa
-Middle East
What are 3 ways an L. donovani infection can present?: 1. Asymptomatic
2. general fever/chills
3. Hepato and Splenomegalic
How is an infection of L. donovani diagnosed? (2 things seen in general, 2 specific tests): -Clinical manifestations
-Amastigotes in tissues like liver/spleen, bone marrow
-DNA probe
-Montenegro test
what is the montenegro test?: a test for l. donovani, by mixing a mL of serum and formaldehyde - positive if mixture turns gelatinous.
L. donovani causes visceral inf; what causes a cutaneous inf?: L. tropica and mexicana
what is the main symptom of cutaneous leishmaniasis? other names?: a sore on the forehead/face

-Oriental sore, dehli ulcer, aleppo.
whatcauses American leishmaniasis? what is the most commonly used name for it?: Leishmania braziliensis --> brazil is in south america.

Espundia
what kind of infection does L. braziliensis cause? What occurs in the pathology?: Mucocutaneous - the parasite erodes the cartilage of the lips and nose.
what are the 5 organisms of blood and tissue NEMATODES?: 1. Wuchereria bancrofti
2. Wuchereria malayi
3. Loa loa
4. Onchocerca volvulus
5. Dracunculus medinensis
what forms are present in the nematode cycles - what type of a parasite is it?: Forms: filariae (adult worm) and microfilariae (larval form)
Type: a worm the size of coarse sewing thread.
What is interesting about the blood/tissue nematode adult females?: they are ovoviparous - eggs develop within, but they give birth to living larva.
what is the diagnostic stage of all the nematodes here?: -microfilariae - it migrates in the blood and tissues, in a periodic pattern.
What 3 methods are used to prevent all of the nematode infections?: 1. controlling the vector populn
2. Treating people to reduce microfilariae
3. Protecting humans from bites.
What are 3 names for infections of Wuchereria bancrofti?: Elephantiasis
Wuchereriasis
Bancroftian filariasis
in what geographic places are Wuchereria bancrofti and malayi found?: Afria
Southeast Asia
South America
what are hosts of w. bancrofi? -definitive -intermediate: Defin: people
Intermediate: mosquitos - this is the vector that transmits it.
What 3 things morphologically set W. bancrofti apart?: -Sheath
-Acellular tip
-Nocturnal periodicity
When does W. bancrofti collect blood?: at night
What are three variations of Bancroftian filariasis, aka elephantiasis?: 1. Asymptomatic
2. Inflammatory
3. Obstructive - result of lymphatics draining to low legs.
How is Elephantiasis due to W. bancrofti diagnosed?: by the presence of microfilariae in the blood.
How is elephantiasis treated? Drug used to kill microfilariae:: -Unfortunately only by amputation.
-Hetrazan kills microfilariae.
What disease does W. malayi cause?: Malayan filariasis
What is the only difference btwn Wuchereria bancrofti and malayi?: The tip of tail - 2 cells are seen in the malayi tail, none in bancrofti.

-Also obstructive stage is not as severe.
What are 3 names of diseases caused by LOA LOA?: -Loasis
-Fugitive swellings
-Calabar swellings
what is the common name of Loa loa infection?: AFRICAN EYEWORM
where is african eyeworm found?: in Central and West african rainforests.
what symptoms does loa loa cause?: Swelling of tissues around eyes
Pain in conjunctival space
what transmits loa loa?: Deerfly vector
which nematodes cause eye disease? which causes blindness?: Loa loa and Onchocerca volvulus.

only O. volvulus causes blinding.
what are 3 names for Onchocerca volvulus infections?: -River blindness
-Onchocerosis
-Onchocerciasis
where is river blindness found?: Africa
Central and South America
what are hosts of O. volvulus? -Definitive -Intermediate: Defin: people

Intermed: Simulium (black fly)
what are the 2 symptoms of river blindness?: -Inflammation causing skin/eye nodules and lesions.

-Blindness- leading worldwide cause of blindness.
how is Onchocerca volvulus diagnosed?: By the presence of microfilariae in a skin snip.
what drug treats river blindness? How else can it be treated?: -Ivermictin

Prophylactic treatment is surgical removal of nodules.
which of the blood/tissue nematodes is the largest?: Dracunculus medinensis.
what is the common name of D. medinensis infection?: Fiery serpent infection.
Also:
Dracontiasis, dracunculosis, dracunculiasis, guinea worm.
What 3 places is fiery serpent found?: Central Africa
Middle East
India
what are the hosts of D. medinensis?: Defin: humans
Intermed: Water flea or cyclops
How is Fiery Serpent disease transmitted?: via ingestion of water flea or cyclops - NOT a bite!!
what is the major symptom of infection by d. medinensis?: Worm under the skin - crawls in when washing clothes, out when wading in water.
how is Dracunculosis diagnosed? treated? prevented?: by finding adult worms under the skin.
Treatment: pull it out on stick.
Prevent: use clean water.

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