Term
| How is amebiasis transmitted? |
|
Definition
| *ingestion* of fecally contaminated food or water, such as fertilizers and water sources. Person to person transmission is also possible. |
|
|
Term
| What organism is the only host for amebiasis? |
|
Definition
| humans are the only host. |
|
|
Term
| How is amebiasis classified? |
|
Definition
| intestinal: subdivided by degree of s/s, and extraintestinal: hepatic, skin, and perianal. |
|
|
Term
| In an asymptomatic amebiasis infection, how do the parasite and host coexist? |
|
Definition
| parasite and host live in a relationship in which one organism derives food or other benefits from another organism w/o hurting or helping it. |
|
|
Term
| What is an organism that lives on or inside another organism (the host) and causes harm to the host? |
|
Definition
|
|
Term
| How do parasites generally enter the body? |
|
Definition
|
|
Term
| If you have a family member with a symptomatic parasitic infection, what else do you probably have? |
|
Definition
| an entire asymptomatic family |
|
|
Term
| Where are parasitic infections common? |
|
Definition
| in rural parts of africa, asia, and latin america and less prevalent in industrialized countries |
|
|
Term
| How prevalent is e. hystolytica among parasitic infections? |
|
Definition
|
|
Term
| If you suspect a parasitic infection, what tests should you order? |
|
Definition
| order O&P: ova and parasites. if you order a stool culture, you could miss the parasites. |
|
|
Term
| What is hyperperistalsis? |
|
Definition
| "bubble gut": increased bowels sounds, abdominal tenderness, bloating |
|
|
Term
| What are the signs of mild to moderate colitis? |
|
Definition
| A few semi-formed stools with no hematochezia or melena, with abdominal cramping, flatulence, and fatigue. |
|
|
Term
| What kind of stool is bright red? |
|
Definition
|
|
Term
| What kind of stool is black? |
|
Definition
|
|
Term
| What are the s/s of severe colitis? |
|
Definition
| 10-20 liquid stools w/scant hematochezia and very little fecal material present. Necrotic tissue present in tools. Fever. Tender abdominal examination w/possible hematomegaly. |
|
|
Term
| What does a stool guiac detect? |
|
Definition
|
|
Term
| What abnormality can be present anywhere in the large bowel, and is most commonly in the area of greatest fecal stasis and presents with formed stools with bloody exudate and possible mild diarrhea? |
|
Definition
| localized ulcerative colonic lesions (intestinal amebiasis) |
|
|
Term
| What presents with pain, obstruction, and significant hemorrhage with single or multiple masses of granulation tissue? |
|
Definition
| localized granulomatous colonic lesions: intestinal amebiasis |
|
|
Term
| What is the most extraintestinal complication of amebiasis, occuring in 9% of intestional infections with 1% mortality? |
|
Definition
| hepatic abscess- hepatic amebiasis (most common) |
|
|
Term
| What are 3 clinical findings of hepatic amebiasis? |
|
Definition
| high fever, severe pain, heptomegaly |
|
|
Term
| What is the most common sequellae of extraintestinal amebiasis? |
|
Definition
|
|
Term
| What commonly produces perianal ulcers? |
|
Definition
| amebic skin infections: extraintestinal amebiasis |
|
|
Term
| What are lab finding of intestinal amebiasis? |
|
Definition
| stool specimins: ova and parasites- obtain 3 fresh samples: Ag or Ab identification (only in severe cases). (Also colonoscopy with no colon cleansing) |
|
|
Term
| How can amebiasis be prevented? |
|
Definition
| 1. drink bottled water. 2. carbonated drinks (avoid fountains or ice cubes, filtered water or use iodine tablets) 3. Avoid fresh fruit (make sure you peel it!) 4. Pasteurized dairy products? 5. avoid street vendors |
|
|
Term
| How is intestinal amebiasis tx? |
|
Definition
| 1. maintain hydration status and pain control. 2. dx testing to r/o complications (ab/pelvic ct; colonoscopy). 3. Multi-drug tx for 2-4 weeks (re-evaluate pt until stool spec clear of parasite and Ag: metronidazole (flagyl)- effective for e. histolytica, paromomycin sulfate (humatin)- effective for e. histolytica cysts) |
|
|
Term
| What medications are effective for E. Histolytica? |
|
Definition
| Metronidazole (flagyl), and Paromycin sulfate (humatin) |
|
|
Term
| How long should a multi-drug tx for intestinal amebiasis last? |
|
Definition
| 2-4 weeks. re-evaluate pt until stool specimens clear of parasite and Ag |
|
|
Term
| What widespread disease is a major cause of underdevelopment in children, with eggs present in soil and humans as the only known host? |
|
Definition
|
|
Term
| What presents with an erythematous, maculopapular or vesicular, pruritic dermatitis at point of transmission? |
|
Definition
|
|
Term
| On what does severity of hookworm disease depend? |
|
Definition
| severity depends on no of invading larvae |
|
|
Term
| What is the host of hookworm disease? |
|
Definition
| humans are the only known host |
|
|
Term
| Where are hookworm eggs found? |
|
Definition
|
|
Term
| What might a sputum gram stain of a pt with hookworm reveal? |
|
Definition
| positive for WBCs and nematode larvae |
|
|
Term
| What's problem with bringing up sputum and sending it to the lab? |
|
Definition
contamination with normal microbes of lab.
V8L is much cleaner and gives better sample |
|
|
Term
| During what stage of hookworm disease does the larvae migrate through the lungs on their way to the duodenum and jejunum? |
|
Definition
|
|
Term
| Pt presents w/dry cough, wheezing, blood-tinged sputum, and fever. What might they have? |
|
Definition
| hookworm: pulmonary stage |
|
|
Term
| What are the symptoms of a minimal hookworm infection during intestinal attachment s/p 2+ weeks of infection? |
|
Definition
|
|
Term
| What are the symptoms of a severe hookworm infection during intestinal attachment s/p 2+ weeks of infection? |
|
Definition
| anorexia, diarrhea, epigastric abdominal pain, anemia, protein loss, hypoalbuminemia |
|
|
Term
| What do the following lab findings indicate: stool specimens (ova and parasites), hypochromic microcytic anemia, low serum iron? |
|
Definition
|
|
Term
| Why might a broad spectrum IV Abx be continued after sputum and stool cultures are negative for parasites? |
|
Definition
| stool cultures might continue to reveal larvae, which will require extended time for broad spectrum IV antiparasite medications |
|
|
Term
| What are 2 tx for hookworm disease? |
|
Definition
| anthelmintics (very effective, may need repeat tx for heavy ova infection). ferrous sulfate if anemia present (causes constipation) |
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|
Term
| What is a very common infection in children w/multiple pts in same household that involves oral transmission of eggs through food, drink, or contact? |
|
Definition
| pinworm infection/enterbiasis |
|
|
Term
| "My butt itches." Pull down their pants, what's waving at you? |
|
Definition
|
|
Term
| What is the most prevalent nematode infection worldwide? |
|
Definition
| enterbiasis/"pinworm infection" |
|
|
Term
|
Definition
| visual ID of worms or eggs in perianal region. scotch tape the anus, hold tape up to light, see pinworms and eggs (Yates has never had to do this b/c pinworms are so obvious) |
|
|
Term
| How are pinworms transmitted? |
|
Definition
| oral transmission of eggs through food, drink, or contact |
|
|
Term
| What organism causes nocturnal perianal pruritis? |
|
Definition
| caused by pinworms or deposited eggs |
|
|
Term
|
Definition
| consider tx/evaluating all members of the pts household. mebendazole (vermox) 1x dose of 100 mg PO. reinfection is common (yates uses double dose- once in hospital, and prescription for one refill) |
|
|
Term
| How is malaria transmitted? |
|
Definition
| transmitted from human to human by an infected mosquito |
|
|
Term
| What is the incubation period of malaria? |
|
Definition
|
|
Term
| How long can untx malarial infections last? |
|
Definition
|
|
Term
| Over the last 4-6 hours I've had an episode of shaking chills, fever and diaphoresis. Also, I have malaise, HA, dizziness, N/V, abdominal, cramps myalgia, and arthralgia. What do I have? |
|
Definition
|
|
Term
| What should be considered in every febrile pt that has a hx of travel to underdeveloped areas? |
|
Definition
|
|
Term
| Glemstastained thick and thin blood films are the mainstay of dx of what disease? |
|
Definition
| malaria- very difficult to properly identify |
|
|
Term
| How can malaria be prevented? |
|
Definition
| determine the risk of exposure to determine if prophylaxis is needed. use insect repellent. wear long sleeved shirts and long pants. use bed-nets while resting and sleeping. |
|
|
Term
|
Definition
| multiple medications and drug combinations available: numerous areas of drug resistance: chloriquine, quinine widely- malaria is widely resistant |
|
|
Term
| What is an intracellular protozoan found worldwide in humans, animals, and birds, and most commonly found in cats? |
|
Definition
|
|
Term
| What is transmitted by ingestion of raw or undercooked meat, contaminated food or water, and transplacental infection? |
|
Definition
|
|
Term
| What can be transmitted through poor handling of cat litter or contaminated soil? |
|
Definition
|
|
Term
| How do over 80% of toxoplasmosis infections present? |
|
Definition
|
|
Term
| What presents with fever, malaise, HA, cervical lymphadenopathy, myalgia, arthralgia, neck stiffness, sore throat, hepatosplenomegaly, and retinochoroiditis. |
|
Definition
|
|
Term
| How does toxoplasmosis commonly present maternally in pregnancy? |
|
Definition
| commonly asymptomatic, present in 1% of pregnant women |
|
|
Term
| What are fetal clinical findings in pregnancy of toxoplasmosis? |
|
Definition
| spontaneous abortion or stillbirth, and neurological or opthalmic complications |
|
|
Term
| What are lab findings of toxoplasmosis? |
|
Definition
| dx based on serologic testing of 2 blood samples 3-4 weeks apart. confirmatory dx requires 2 high titers. |
|
|
Term
| How can toxoplasmosis be prevented? |
|
Definition
| 1. cook meat thoroughly. 2. proper washing and cleaning of hands, kitchen surfaces, and utensils. 3. decrease exposure to cat feces (cover sand boxes). 4. change litter boxes frequently |
|
|
Term
| What is lymphadenophathic tx of toxoplasmosis? |
|
Definition
| typically not tx unless severe |
|
|
Term
| What is the tx for retinochoroiditis in toxoplasmosis? |
|
Definition
| opthalmic consult w/ 4 medication therapy |
|
|
Term
| What is the tx timeframe for immunocompromised toxoplasmosis? |
|
Definition
| meds of 4-6 weeks after s/s resolve (may require meds for 6 mos) |
|
|
Term
| What are distinctive bacteria which have long helically coiled cells and flagella? |
|
Definition
|
|
Term
| What are 5 spirochetal infections? |
|
Definition
| lyme disease. rocky mt spotted fever. ehricholosis. leptospirosis. syphilis. |
|
|
Term
| What is the most common vector-borne disease in the US? |
|
Definition
|
|
Term
| Lyme disease has a higher incidence of transmission if tic has fed for how long? |
|
Definition
| more than 72 hrs (24 hrs more commonly used as clinical guideline) |
|
|
Term
| How frequently is lyme disease misdiagnosed? |
|
Definition
|
|
Term
| What stage of lyme disease involves flu-like symptoms and erythema migrans? |
|
Definition
| stage 1 (early localized infection) |
|
|
Term
| What stage of lyme disease involves Bell's palsy and/or meningitis that can develop 2 weeks or several mos later? |
|
Definition
| stage 2 (early disseminated infection) |
|
|
Term
| What stage of lyme disease involves arthritis 3 mos to years after initial infection (pt describe jt aches)? |
|
Definition
| stage 3 (late persistent infection) |
|
|
Term
| What lab findings indicate lyme disease? |
|
Definition
| confirmation of specific B. burgdorferi serum Ag (false neg in 50% of early cases- may be lab mistakes/errors). Much more accurate in later cases |
|
|
Term
| How is lyme disease clinical dx? |
|
Definition
| *positive exposure in endemic areas. clinical manifestations of the disease |
|
|
Term
| What are clinical mainfestations of lyme disease? |
|
Definition
| *erythema migrans and flulike symptoms (HA, arthralgia, myalgia, fatigue) |
|
|
Term
| What is the tx for stage 1 lyme disease? |
|
Definition
| *doxycycline, and amoxicillin |
|
|
Term
| What is the tx of stage 2 lyme disease? |
|
Definition
| doxycycline +/- ceftriaxone IV |
|
|
Term
| What is tx of stage 3 lyme disease? |
|
Definition
|
|
Term
| Which stage of lyme disease is early localized infection? |
|
Definition
|
|
Term
| Which stage of lyme disease is early disseminated infection? |
|
Definition
|
|
Term
| How is lyme disease tx in late persistent infection? |
|
Definition
|
|
Term
| What is the prognosis of pts with lyme disease? |
|
Definition
| pts usually respond w/prompt resolution of symptoms. consider co-infections w/pts that are not responding appropriately. |
|
|
Term
| Where do most cases of rocky mt spotted fever occur? |
|
Definition
|
|
Term
| Where and when is rocky mt spotted fever usually reported? |
|
Definition
| eastern 1/3 of us from april-sept (1000 cases/yr w/3-5% mortality) |
|
|
Term
| How long after bite from infected tick does rocky mt spotted fever present? |
|
Definition
|
|
Term
| What causes fever, chills, HA, N/V, myalgia, insomnia, occasional cough, and worsens w/onset of lethargy, delirium, seizures and coma? |
|
Definition
|
|
Term
| What disease presents w/a rash that begins as faint macules that progress to macular/papular and then become petechial |
|
Definition
|
|
Term
|
Definition
| doxycycline PO or IV, chloramphenicol (pregnancy) |
|
|
Term
| What can tx pretty much all tick borne illnesses? |
|
Definition
|
|
Term
| What involves gradually increasing fever and HA, malaise, and pleomorphic(different sizes) rash? |
|
Definition
|
|
Term
| Where can exposure in endemic areas for erlichiosis occur? |
|
Definition
|
|
Term
| How is erlichiosis dx and tx? |
|
Definition
| lab testing, doxycylcin PO or IV. do not withold meds while waiting dx testing. |
|
|
Term
| What protozoal infection of the intestines is the most common in the US? |
|
Definition
|
|
Term
| What is caused by the fecal contamination of food and water by animals and humans and is common in daycare, adult institutions, campers, and the immunocompromised? |
|
Definition
|
|
Term
| Does giardiasis have bloody or non-bloody diarrhea? |
|
Definition
|
|
Term
| Does schistosomiasis have bloody or non-bloody diarrhea? |
|
Definition
|
|
Term
| What is a well-documented trematode (fluke) infection in 74 countries? |
|
Definition
|
|
Term
| What presents with pruritis, chills, cough, myalgia beginning 1-2 mos after contamination? |
|
Definition
|
|
Term
| How do pts aquire schistosomiasis? |
|
Definition
| contamination is through contact w/snails in fresh water streams, canals, lakes, and reservoirs |
|
|
Term
| How many different types of tapeworms commonly infect humans? |
|
Definition
|
|
Term
| What is commonly asymptomatic but vague GI complaints are occasionally present? |
|
Definition
| tapeworm (cestode) infection |
|
|
Term
| How is tapeworm (cestode) infection usually identified? |
|
Definition
|
|
Term
| What is a cestode infection? |
|
Definition
|
|
Term
| How high is the mortality of schistosomiasis? |
|
Definition
|
|
Term
| Book ?: What are the most common causes of death in children with malaria? |
|
Definition
| cerebral malaria and severe anemia |
|
|
Term
| Book ?: What would rash and lymphadenopathy suggest in a pt w/fever in an area endemic to malaria? |
|
Definition
| rash and lymphadenopathy are not typical in malaria, and thus suggestive of another cause of fever. |
|
|
Term
| Book ?: What population is responsible for most deaths from malaria? |
|
Definition
| young children. (pregnant women are also at an increased risk for severe falciparum malaria). |
|
|
Term
| Book ?: What is the most common cause of fever in much of the tropics and in travelers seeking medical attention after return from endemic areas? |
|
Definition
|
|
Term
| Book ?: Are pinworm eggs usually found in the stool? |
|
Definition
|
|
Term
| Book ?: How do most infants with toxoplasmosis present at birth? |
|
Definition
| most appear normal at birth, but they may have subtle abnormalities and progress to s/s of congenital toxo later in life |
|
|
Term
| Book ?: What is the most common late presentation of congential toxo? |
|
Definition
|
|
Term
| Book ?: What is the most common manifestation of toxoplasmosis in advanced AIDS pts? |
|
Definition
| encephalitis, w/multiple necrotizing brain lesions |
|
|
Term
| Book ?: How is tapeworm dx usually made? |
|
Definition
| id of characterisic eggs or proglottids in stool |
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