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Questions and Answers
What is the longest incubation period amongst the listed Plasmodium species?
What is the longest incubation period amongst the listed Plasmodium species?
- P. falciparum
- P. vivax
- P. malariae (correct)
- P. ovale
Which of the following symptoms is not typically associated with Cerebral Malaria?
Which of the following symptoms is not typically associated with Cerebral Malaria?
- Abnormal behavior
- Seizures
- Nausea and vomiting (correct)
- Impairment of consciousness
What is the purpose of prophylaxis in malaria prevention?
What is the purpose of prophylaxis in malaria prevention?
- To prevent transmission of the disease
- To cure the disease
- To eliminate the parasite from the liver
- To delay symptoms by weeks to months (correct)
What is the typical duration of the incubation period for malaria?
What is the typical duration of the incubation period for malaria?
Which species of Plasmodium is associated with severe anemia due to hemolysis?
Which species of Plasmodium is associated with severe anemia due to hemolysis?
Why do residents in malaria-endemic areas often treat themselves without seeking diagnostic confirmation?
Why do residents in malaria-endemic areas often treat themselves without seeking diagnostic confirmation?
What is the significance of the liver stage in malaria?
What is the significance of the liver stage in malaria?
What is the relevance of travel history in malaria diagnosis?
What is the relevance of travel history in malaria diagnosis?
What is the term for a decrease in blood platelets?
What is the term for a decrease in blood platelets?
What is the most accurate test for diagnosing malaria?
What is the most accurate test for diagnosing malaria?
What is the term for excessive acidity in the blood and tissue fluids?
What is the term for excessive acidity in the blood and tissue fluids?
What percentage of red blood cells infected by malaria parasites is considered hyperparasitemia?
What percentage of red blood cells infected by malaria parasites is considered hyperparasitemia?
What is the term for low blood glucose?
What is the term for low blood glucose?
What is the primary goal of chemoprophylaxis?
What is the primary goal of chemoprophylaxis?
What is the most important factor to consider when assessing the risk of malaria in a traveler?
What is the most important factor to consider when assessing the risk of malaria in a traveler?
What is the estimated number of malaria cases in the US per year?
What is the estimated number of malaria cases in the US per year?
What is the primary mode of transmission of Cryptosporidiosis?
What is the primary mode of transmission of Cryptosporidiosis?
Which of the following is a characteristic of Giardia?
Which of the following is a characteristic of Giardia?
What is the primary host of Toxoplasmosis?
What is the primary host of Toxoplasmosis?
Which of the following is a symptom of Giardiasis?
Which of the following is a symptom of Giardiasis?
What is the primary mode of transmission of Fasciolopsis?
What is the primary mode of transmission of Fasciolopsis?
Which of the following groups is at higher risk of severe disease due to Cryptosporidiosis?
Which of the following groups is at higher risk of severe disease due to Cryptosporidiosis?
What is the primary mode of transmission of Toxoplasmosis?
What is the primary mode of transmission of Toxoplasmosis?
Which of the following is a characteristic of Cryptosporidium?
Which of the following is a characteristic of Cryptosporidium?
What is the estimated number of people infected with Ascaris lumbricoides worldwide?
What is the estimated number of people infected with Ascaris lumbricoides worldwide?
Which of the following is a common complication of Ascaris lumbricoides infection?
Which of the following is a common complication of Ascaris lumbricoides infection?
How do people typically get infected with Ascaris lumbricoides?
How do people typically get infected with Ascaris lumbricoides?
What is the primary symptom of Enterobius vermicularis infection?
What is the primary symptom of Enterobius vermicularis infection?
How do Enterobius vermicularis eggs spread through a household?
How do Enterobius vermicularis eggs spread through a household?
What is the preferred diagnostic method for Ascaris lumbricoides infection?
What is the preferred diagnostic method for Ascaris lumbricoides infection?
Which of the following parasites is commonly found in the US?
Which of the following parasites is commonly found in the US?
What is the typical habitat of Ascaris lumbricoides?
What is the typical habitat of Ascaris lumbricoides?
How many eggs can a female Enterobius vermicularis deposit at night?
How many eggs can a female Enterobius vermicularis deposit at night?
What is the primary mode of transmission for Enterobius vermicularis?
What is the primary mode of transmission for Enterobius vermicularis?
Acute renal failure is a rare complication of malaria.
Acute renal failure is a rare complication of malaria.
Hypoglycemia is only seen in pregnant women with severe malaria.
Hypoglycemia is only seen in pregnant women with severe malaria.
More than 50% of malaria cases in the US are caused by P. vivax.
More than 50% of malaria cases in the US are caused by P. vivax.
Serology is a reliable method for diagnosing current malaria infections.
Serology is a reliable method for diagnosing current malaria infections.
Malaria can be diagnosed by detecting antibodies in the blood.
Malaria can be diagnosed by detecting antibodies in the blood.
The PCR test is a rapid and inexpensive method for diagnosing malaria.
The PCR test is a rapid and inexpensive method for diagnosing malaria.
Cryptosporidiosis is typically spread through contaminated food.
Cryptosporidiosis is typically spread through contaminated food.
Thrombocytopenia is a rare complication of malaria.
Thrombocytopenia is a rare complication of malaria.
The style and duration of travel have no impact on the risk of malaria.
The style and duration of travel have no impact on the risk of malaria.
Giardiasis is the most common parasitic infection in the US.
Giardiasis is the most common parasitic infection in the US.
Toxoplasmosis is commonly spread through undercooked pork.
Toxoplasmosis is commonly spread through undercooked pork.
Fasciolopsis is a type of liver fluke.
Fasciolopsis is a type of liver fluke.
Cryptosporidiosis is easily treated with chlorine-disinfected water.
Cryptosporidiosis is easily treated with chlorine-disinfected water.
Giardiasis is commonly spread through oral-anal sex.
Giardiasis is commonly spread through oral-anal sex.
Toxoplasmosis is a significant risk for immunocompromised individuals.
Toxoplasmosis is a significant risk for immunocompromised individuals.
Fasciola sp. is a type of schistosome.
Fasciola sp. is a type of schistosome.
Plasmodium malariae has the shortest incubation period amongst the listed Plasmodium species.
Plasmodium malariae has the shortest incubation period amongst the listed Plasmodium species.
Malaria symptoms may include mild jaundice.
Malaria symptoms may include mild jaundice.
Cerebral malaria is characterized by normal behavior, consciousness, and seizures.
Cerebral malaria is characterized by normal behavior, consciousness, and seizures.
Hemoglobinuria is a complication of malaria due to hemolysis.
Hemoglobinuria is a complication of malaria due to hemolysis.
Pulmonary edema or acute respiratory distress syndrome may occur even before the parasite counts have decreased in response to treatment.
Pulmonary edema or acute respiratory distress syndrome may occur even before the parasite counts have decreased in response to treatment.
Travel is relevant for at least six months after return for malaria prophylaxis.
Travel is relevant for at least six months after return for malaria prophylaxis.
The liver stage of malaria can be killed by anti-parasitic drugs.
The liver stage of malaria can be killed by anti-parasitic drugs.
Residents in malaria-endemic areas often seek diagnostic confirmation before treating themselves.
Residents in malaria-endemic areas often seek diagnostic confirmation before treating themselves.
Ascaris lumbricoides infects around 2 million people worldwide.
Ascaris lumbricoides infects around 2 million people worldwide.
Enterobius vermicularis is commonly found in South America.
Enterobius vermicularis is commonly found in South America.
Taenia saginata is a type of fluke.
Taenia saginata is a type of fluke.
Schistosoma sp. are a type of nematode.
Schistosoma sp. are a type of nematode.
Ascaris lumbricoides can cause intestinal obstruction.
Ascaris lumbricoides can cause intestinal obstruction.
Enterobius vermicularis is typically diagnosed through symptoms and stool samples.
Enterobius vermicularis is typically diagnosed through symptoms and stool samples.
Ascaris lumbricoides can cause respiratory obstruction.
Ascaris lumbricoides can cause respiratory obstruction.
Dipylidium caninum is a type of tapeworm that infects humans.
Dipylidium caninum is a type of tapeworm that infects humans.
Ascaris lumbricoides can cause appendicitis.
Ascaris lumbricoides can cause appendicitis.
Enterobius vermicularis eggs can survive for up to 72 hours on clothing and bedding.
Enterobius vermicularis eggs can survive for up to 72 hours on clothing and bedding.
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Study Notes
Malaria
- Caused by Plasmodium spp.: Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, and Plasmodium ovale
- Incubation period: 7-30 days, with P.falciparum having the shortest and P.malariae having the longest incubation period
- Symptoms: fever, chills, sweating, headache, nausea, vomiting, body aches, and general malaise
- Physical findings: elevated temperature, perspiration, weakness, and enlarged spleen
- Additional findings in P.falciparum malaria: mild jaundice, enlargement of the liver, and increased respiratory rate
- Severe malaria complications: cerebral malaria, severe anemia, hemoglobinuria, pulmonary edema, and acute respiratory distress syndrome (ARDS)
Diagnosis and Treatment
- Diagnosis: blood smear, antigen detection (rapid test), PCR (most accurate), and serology (detecting antibodies by IFA or ELISA)
- Chemoprophylaxis: can delay symptoms by weeks to months for P.ovale or P.vivax
- Four questions to ask for prophylaxis: where is the traveler going, when is the traveler going, what is the style and duration of travel, and who is the traveler
Parasitic Infections
- Non-specific clinical signs
- Limited awareness in medical community
- Lack of a single broad treatment
- Clinical presentation aggravated by concurrent disease, poor sanitation
Helminths
- Types: roundworms, tapeworms, flukes
- Nematodes (roundworms): Ascaris lumbricodes
- Ascaris lumbricodes: found in moist tropical areas, 1 billion infected, 25,000 tons of eggs annually
- Ascaris lumbricodes clinical presentation: lung (pneumonitis, cough, asthma, dyspnea, pain), abdomen (distension, pain, nausea, vomiting, anal itching, anorexia, malabsorption)
- Complications: intestinal obstruction, intussusception, cholangitis, obstructive jaundice, appendicitis, intestinal perforation, peritonitis, and respiratory obstruction
Other Parasitic Infections
- Enterobius vermicularis (pinworms): common in the US, especially in children, symptoms include intense perianal itching, perineal or vaginal pain in adolescent girls
- Enterobius diagnosis: symptoms, perineal or vaginal pain, and detecting eggs on clothing and bedding
- Taenai saginata (beef tapeworm) and Dipylidium caninum (dog tapeworm)
- Flukes: blood flukes (Schistosoma sp.), liver flukes (Fasciola sp.), and intestinal flukes (Fasciolopsis)
- Protozoa: Cryptosporidiosis (300,000 cases in the US each year), Giardiasis (worldwide problem, 2nd most common parasitic infection in the US), and Toxoplasmosis (found in many animals, special hosts include pregnant women and immunocompromised individuals)
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