Winter Micro 22 Maleria and Babesiosis Flash Cards

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Title:	Winter Micro 22 Maleria and Babesiosis
Description:	micro
Number of Cards:	50
Save Count:	0
Author:	jessica.prentice7
Created:	2012-02-01
Tags:	micro
Private	No

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- Question
- Answer
- Side 3

- is maleria a big deal worldwide
- ya! its a HUGE killer
  
  seen in 90 countries, 40% of the world, 1 child dies every 12 sec
  
  seen in mexico, S america, africa and insia area
- what are 5 important maleria species
- Plasmodium vivax
  paslmodium falciparum
  p malariae
  p ovale
  p knowlesi
- how is maleria transmitted-
- mosquito
- what is the maleria life cycle
- female anopheles mosquito injects sporozoites (infective stage) into host while it feeds
  
  spoeozoite, trophozite, schizont, merozoite are in ExtraErythrocytic of human
  
  trophozoite, schizont, merozoite, gametocyte in RBC of human
  
  gametocyte, zygote, ookinete, oocyte, sporozoite in mosquito
- where does the sexual cycle of plasmodium occur
- in the belly of female mosquite (anopheles)
  
  the female then injects sporozoites into us, it goes to the liver nad is then a schizonts, then to vblood as merozoites, ring stages, trophozoite, schizonts, merozoites
- what are the phases of maleria infectio in human
- Exoerythrocytic Cycle (liver): sporozoites invade hepatocytes (recall the female mosquito injected the sporoxoites into us), then the merozoites escape from the liver then we get to the RBC
  
  erythrocytic cycle: in the RBC the merozoites inface RBC, eventually the RBC ruptures and merozoites invade NEW RBC
- in ther exoerythrocytic cycle the ___ invades hepatocytes
  
  then the _____ escape from the liver and we enter the _____ cycle and the ______ invade the RBC
  
  infected RBC eventrually rubtupre the RBC and ____ invade NEW RBC
- sporozoites
  merozoites
  erythrocytic
  merzoites
  merzoites
- in maleria what is the...
  
  1. ring stage
  2. vivax ring stage
  3. schizont
- 1. young troph
  2.
  3. also called segmenter bc it does ASEXUAL replication
- ok so there is a sporozite of maleria that is injected into the human. where does it go?
- LIVER
  troph
  schizont
  merozoite
  
  BLOOD:
  troph- young
  schozonit- older, segmenters, multinucleated cells, produce the merozoite
  merozoite- metamorphse into micro (male, 8) and macrogametocytes (female, 1)
  gametocyte- these are ingested by mosquitoes and there they have sexual reproduction
- ok so in a RBC there are merozoites that metamorphse into micro and macrogametes. what are these
- micro (male) make 8 microgametes
  macro (female) make 1 macrogamete
  
  **gamests are eaten by mosquitoes and fertilization takes place in the mosquitoes gut
- fertilization of maleria gametes takes place in the mosquito guts. what happens in the mosquito
- 1. in oocyst, sporogony results in sporozoites
  
  2. sporozoites then migrate to salivary glands
- when you have maleria what does the shaking and chills relate to in terms of pathogenesis
- synchronized RBC destruction
  
  you get an inflammatory response to metabolic waste products of maleria, then hypothalamus raises thermal set point
  
  bursts of TNF relates to febrile chills
- is maleria dx correctly
- often times no, it mimics gastroenteritis, pneumonia, meningitis, encephalitis, and hepatits
- in maleria,,,
  
  1. does vomit occur
  2. anemia due to
  3. chills relate to...
  4. PE, labs
- 1. vomit +
  2. anemia bc of RBC destruction
  2 chills bc of RBC desruction, bursts of TNF release
  4. splenomegaly and thrombocytopenia
- what are the extraerythrocytic phases in the human
  
  what abrout the erythrocytic phases
  
  what about whats going on in mosquito
- EE
  sporozoite- its whats injected from mosquito, infective. invades hepatocytes
  trophozoite-
  schizont-
  merozoite- escape from the liver so the erythrocytic cycle can begin, infects RBC
  
  ERYTHROCYTIC
  trophozoite-
  schizont- segmenter. asexual replication
  merozoite- invade RBC. morph into micro (male, 8) and macrogametocytes (female, 1)
  gametocyte- eaten by mosquito. fertilization of macro and micro happens in the mosquite gut
  
  MOSQUITO:
  gamete: eaten in RBC
  zygote
  ookinete
  oocyte: sporogony results in sporozoites
  sporozoite- migrates to salivary glands infectous, injected into human,
- what confers resistance to maleria
- sickle cell: abnormal Hg in ppl HZ for SS. the parasite doesnt like this and so wont infection
  
  lack of duffy AG: IL8 receptor is how the merozoite invades RBC it is NOT there in most west africans and this gives them resistance
- how does merzoite infect RBC
- IL8, duffy AG
  
  when this is fone you have resistance to maleria. common in west africans
- why would a west african man NOT be infefcted with maleria during an outbreak
- he lacks duffy AG
  
  With the exception of one, all Peace Corps
  volunteers assigned to a remote village in India
  contract vivax malaria. Which of the following
  volunteers is the person who did not become
  infected w/ P vivax?
  
  1 West African man
  2 Central American woman
  3 Italian American woman
  4 Asian American woman
  5 Mexican American man
- what are the plasmodium resevoire
  
  vector?>
- LOTS: us, promates, birds etc
  
  **several vector mosquitoes (anopheline) feed at night
- tell me a little about vivax maleria
- if you are going to get maleria this is the one to get
  
  benign, spike a fever every few (48 hrs) days
- TELL me a little about plasmodium vivax
  
  incubation
  infection
  sx
  reinfection
- incubation 2 weeks
  infects YOUNG RBC
  get a fever every 48 hours, its the life cycle of the bug- shake, chills, fever, anemia, GI upset. chills fever associated with simultaneous rupture of schizont infected RBC
  
  RARELY FATAL
  
  RELAPSE (hypnozoites) up to 5 years
- tell me more about the fever and chills assoc w.maleria
- metabolic waste, pyrogen, from plasmodium initiates an inflammatory response . the thermal set point in the hypothalamus is raised and so you shiver even though you are febrile. TNF burst correlates with/febrile attacks
- why do you shiver and have a fever w/maleria
- bc you have the bug make waste, pyrogen, which initiates inflammatory resposen which raises the hypothalamic thermal set point, then you shiver bc you are febrile
  
  TNF bursts correlate with febrile attacks
- which maleria is assoicated with a fever burst every 48 hours
- p vivax
  
  **bc of synchronized RBC destruction adn a TNF burst
- P vivax what is the...
  
  area where it is
  vector
  resevoir
  resistance
- P vivax
  
  1. found: trapics, rare in US
  2. anopheline mosquito vector
  3. resevoire: human, NOT OTHER PRIMATES, blood donor transmission
  4. resistance with SS
- where in the world is maleria common
- s america
  central africa
  india
- whats the deal with SS and maleria
- abnormal Hg, difficulty using Hg by plasmodium so Hz have LOW parasite loads
- whats more common vivax or falciparum
- falciparum
  
  vivax is second
- how can you ID vivax maleria *the one with the spike fever q 48 hrs)
- giemsa stained capillaries/venous blood
  
  dx stage is erythrocytic
  enlarged RBC
  Schuffners dots
- schuffners dots seen where
- in p vivax
- DOC for vivax
- oral chloroquine phosphate
  
  parenteral: quinidine gluconate
  
  primaquine targets hepatic stages
- whats the best control for plasmodium varivax
- CONTROL mosquitoes dont go out at night, wear DEET
  
  *prophylax w/chloroquine, mefloquine, doxy
  
  vaccine is ineffective
- tell me about plasmodium falciparum
- SUPER VIRULENT
  
  *less chills, hyperpyrexia >10^*
  anemia
  mimics other disease
  FATAL OFTEN
  
  NON relapse, incubation is less than 2 weeks
- which maleria is HUGE fever w/less chills, also <2 week incubation, no relapse
- p falciparum
  
  Malignant tertian maleria- 3 day paryxsmal intervals
- what is blackwater fever
- lots of Hg in pee
  
  AI response, AB hemolysin, to previous infection that was NOT properly treated with quinine
  
  kidneys are damaged and can result in death
- what is ID by high Hg in pee, kidney damage can be fatal
- blackwater fever
- in what type of maleria do we see capillary obstruction due to "sticky RBC"
- plasmodium falciparum
- what are the clinicl features of plasmodium falciform that makes them unique
- 1. cerebral maleria: necrosis bc of occluded sticky RBC. SUPER HIGH FEVER
  
  2. GI- vomit LOTS
  
  3. Algid Maleria- skin is cold, internal temo ig HIGH
  
  4. hypoglycemic,
  5. fatal
  6. NO RELAPSE
- where is plasmodium falciparum common
  whats the vector
  whats the reservoir
  whats resistance
  is it common
- this is the one that is fatal and HUGE fevers
  
  tropical (like all maleria)
  vector is anopheline mosquito
  reservoir is human
  SS gives resistance
  50% of worlds maleria is falciparum
- how is plasmodium falciparum ID
- dx stage is erythrocytic
  double rings per RBC
  crescent shaped gametocyte
  *MAUERS DOTS, general, NOT visible
- if you see multiple rings in maleria what kind are you leaning toward? what might the gametocyte look like
- falciparum
  
  crescent shaped gametocyte
  
  **lots of young trophozoites in the blood
- whats the tx for plasmodium falciparum
- oral: chloroquinine phosphate
  doxy, azithromycin
  
  USE SOMETHING! fatal if not treated
- how is plasmodium falciparum controlled
- same as varivax
  
  **control the mosquito, dont go out at night when they feed. wear DEET
  
  prophylax w/chloroquine, mefloquine,
  
  NO vaccines available
- tell me something about P malariae and P ovale
- Malariae: infected old RBC, recrudesence of infection possible, primate reservoir, ID w.trophs and schizonts
  
  Ovale: similar to varivax, relapse possible, common in W aftica
- tell me something about P knowlesi
- fatal w/high parasote burden
  primate reservoir (zoonotic)
  SE asia
  troph resembles P maleriae
  CDC MUST confrim ID
- what are some names for the infection caused by babesia microti
- nantucket island fever, babesoisis
- tell me a little about babesia microti
  
  infects?
  manifestations
  vector
  tx
- it infects RBC like maleria
  *causes maleria like sx- fever, chills, HA, malaise, destroys RBC
  
  **Deer tick is the vector for transmission, natural host is rodent
  
  *tx- clindamycin + quinine
- what infection is spread by deer tick nad rodents are the natural host
- babesia microti
  
  ((causes intraerythrocytic maleria like paraside the --> fever, chills, HA, etc.
  
  cases are confined to nantucket
- A man, who lives in New England, presents w/
  fever. CBC is remarkable for a parasite. Of
  note, the patient has not traveled abroad. This
  case is most likely:
  
  Babesiosis
  2 Ovale malaria
  3 Quartan malaria
  4 Falciparium malaria
  5 Benign tertian malaria
- babesioses
- An undocumented Guatemalan male is
  evaluated for a febrile illness. Blood smear
  produces a parasite. The correct diagnosis is:
  1 Babesiosis
  2 Ovale malaria
  3 Quartan malaria
  4 Falciparium malaria
  5 Vivax malaria
- vivax