Term
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Definition
Transmitted by bite of infected Anopheles mosquito;
Bite introduces sporozites of plasmodia into bloodstream;
Asexual reproduction takes place in humans;
Sporozites infect parenchymal hepatocytes & multiply in stages, becoming hepatic vegetative forms: schizonts;
Schizonts rupture & release merozoites, which infect erythrocytes; |
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Term
| Clinical Presentation of Malaria |
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Definition
Cyclic fevers: q48-72 hrs
Prodrome:
- HA, malaise, anorexia, fatigue, myalgias;
Paroxysm:
- cold phase (lasts 15 min-4 hrs): pallor, cold shaking chills, cyanosis of lips & nail bed, cutis anserine "goose skin";
- Hot Phase (lasts several hrs): fever to 104.9 F w/ minimal diaphoresis, tachycardia, hypotension, cough, HA, back pain, N/V/D, abd pain, altered consciousness;
- Post-hot phase: sweating phase (fever resolves), marked fatigue, marked drowsiness, sleep, warm, dry skin |
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Term
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Definition
rapid diagnosis;
initiation of timely anti-malarial drugs to eradicate infection within 48-72 hrs;
Avoid complications of malaria; |
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Term
| Malaria Prophylaxis for Areas WITHOUT resistant P. falciparum |
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Definition
| chloroquine 500 mg weekly |
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Term
| Malaria Prophylaxis for Areas WITH MULTI-DRUG Resistant P. falciparum |
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Definition
Malarone (atovaquone-proguanil) 1 tab (250mg/100mg) daily
OR
Doxycycline 100 mg daily |
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Term
| Malaria Prophylaxis for Areas WITH CHLOROQUINE-resistant P. falciparum |
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Definition
mefloquine 250 mg weekly;
- Make sure pt doesn't stop drug on vacation due to altered mental status |
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Term
| Malaria Terminal Prophylaxis of P. vivax & P. ovale infections |
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Definition
| primaquine 26.3 mg daily x 14 days after travel |
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Term
| Tx of Chloroquine-RESISTANT Malaria (P. falciparum) |
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Definition
A) atovaquone/proguanil (Malarone)
OR
B) artemether-lumefantrine (Coartem)
OR
C) Quinine sulfate + doxycylcine/tetracycline/clindamycin
OR
D) mefloquine (Lariam) - NOT PREFERRED |
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Term
| Tx of Chloroquine-SENSITIVE P. falciparum Malaria |
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Definition
Chloroquine phosphate (Aralen)
OR
Hydroxychloroquine (Plaquenil) |
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Term
| Tx of Chloroquine-Resistant P.vivax Malaria |
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Definition
A) Quinine sulfate + doxycycline/tetracycline + primaquine
OR
B) Atovaquone-proguanil (Malarone) + primaquine
OR
C) mefloquine + primaquine |
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Term
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Definition
| quinidine gluconate + doxycycline/tetracycline/clindamycin |
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Term
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Definition
caused by Entamoeba histolytica;
- contaminated water, "Monteczuma's Revenge"
- highest incidence: mentally retarded pts, homosexuals, AIDS, Native Americans, new immigrants from endemci area (Mexico, India, South Africa, Central America, South America) |
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Term
| Amebiasis Clinical Presentation |
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Definition
General:
- malaise
- abdominal cramps
- abdominal discomfort
- flatulence
- bloody diarrhea with mucus;
Liver Abscess:
- right upper quadrant pain
- hepatomegaly
- liver tenderness |
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Term
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Definition
E. histolytica or trophozites in stool;
Monoclonal abs |
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Term
| Goals of Amebiasis Therapy |
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Definition
Resolution of S/Sx;
Eradication of infection |
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Term
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Definition
Minimal Sx:
- metronidazole 750 mg PO TID x 10 days
Moderate-Severe Sx:
- metronidazole 750 mg PO TID x 10 days followed by: iodoquinol & paromomycin |
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Term
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Definition
caused by Giardia lamblia;
- most common parasitic infecton of intestinal tract that causes diarrhea;
- children > adults;
- ingestion of G. lamblia cysts in fecally-contaminated food or water; |
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Term
| Giardiasis Clinical Presentation |
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Definition
Acute:
- diarrhea
- cramp-like abdominal pain
- bloating
- flatulence
Chronic:
- large amounts of stool
- foul-smelling, light-colored, fatty stool
- weight loss
- vitamin ADEK deficiency
- vit. B12 deficiency |
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Term
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Definition
| metronidazole 250 mg PO TID x 5-7 days |
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Term
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Definition
caused by protozoan from Leishmania genus;
- highest incidence: summer months;
- Major Reservoirs: dogs, foxes, squirrels, rodents --> Must BITE humans to infect |
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Term
| Leishmaniasis Pathophysiology |
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Definition
transmitted via bite from an infected sandfly;
exists as an aflagellated extracellular form in humans & animals; |
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Term
| Leishmaniasis Clinical Presentation |
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Definition
Visceral:
- Sx begin w/in 3-8 months of exposure
- begins as papule that may ulcerate
- disseminates to involve spleen, liver, bone marrow, & lymphatic nodes;
- fever, chills, malaise, weight loss, abdomnial distention, & hepatosplenomegaly;
Cutaneous:
- begins 2-8 wks after sandfly bite
- bite progresses to a raised ulcer that may persist for months to yrs
Mucocutaneous:
- mutilating infections which involve the nose, soft palate, & trachea |
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Term
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Definition
Goals: prevent morbidity associated w/ dx;
DRUG OF CHOICE:
- sodium stibogluconate (Pentostam) 20 mg/kg/day x 20-28 days;
ADRs:
- myalgias, joint stiffness, N/V/D, cardiac arrhythmias, elevated amylase/lipase, pancreatitis, elevated liver enzymes; |
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Term
| Alternative Tx for Leishmaniasis |
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Definition
azole antifungals;
amphotericin B;
pentamidine |
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Term
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Definition
caused by giant roundworm Ascaris lumbricoides;
more common in areas w/ poor sanitation;
Children > adults |
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Term
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Definition
inhabits lumen of small intestine;
females lay eggs which pass with stool;
embryos are formed -> ingestion of eggs occurs;
eggs hatch in small intestine & embryos penetrate small intestine & migrate w/ venous blood to heart to reach the lungs;
embryos then break through alveoli & pass up the bronchi & trachea to be swallowed & returned to intestines to mature |
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Term
| Clinical Presentation of Ascariasis |
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Definition
pulmonary symptoms;
GI obstruction;
malabsorption; |
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Term
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Definition
Albendazole 400 mg PO x 1;
Mebedazole 100 mg PO BID x 3 days;
mebendazole 500 mg x 1;
ivermectin 150-200 mcg/kg PO once |
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Term
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Definition
pinworm caused by Enterobius vermicularis;
Majority in children; |
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Term
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Definition
transmitted via fecal-oral route;
gravid females migrate to rectum at night to lay eggs |
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Term
| Enterbias Clinical Presentation |
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Definition
irritation of the perianal region caused by migrating females or eggs;
2ndary bacterial infection (Staph. or Strep.) due to irritation & scratching |
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Term
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Definition
| Scotch tape exam for eggs |
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Term
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Definition
Pyrantel pamoate 11 mg/kg x 1;
Mebendazole 100 mg PO x 1 & may repeat in 2 wks;
Albendazole 400 mg x 1 then repeat in 2 wks; |
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Term
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Definition
caused by Sarcoptes scabes;
affects both humans & animals |
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Term
| Clinical Presentation of Scabies |
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Definition
Inability to sleep;
Severe itching;
typically affects the interdigital & popliteal folds, axillary folds, umbilicus, scrotum, & ankles;
Scratching may lead to secondary bacterial infections;
Pruritus may last for 2-4 wks secondary to mite parts being left in the skin; |
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Term
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Definition
conformation of burrows in skin;
skin scrapping which demonstrate the mite; |
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Term
| Goals of Scabies Treatmetn |
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Definition
eradicate S. scabei;
relief of symptoms of infection |
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Term
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Definition
| wash all bedding & clothing |
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Term
| Pharmacologic Tx of Scabies |
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Definition
Permethrin 5% cream applied to whole body after scrubbing affected area with soap & water --> leave on for 8-14 hrs;
Alternatives:
- ivermectin
- lindane
- crotamiton |
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