43 Questions
What is the term for the stage that occurs between the 2nd and 4th day?
Red Hepatization
What is the term for the stage that occurs between the 5th and 8th day?
Grey Hepatization
What is the term for the condition characterized by inflammation of the lungs and bronchi?
Septic Bronchopneumonia
What is the term that describes the appearance of the liver in a diseased state?
Grossly
What is the relationship between Red Hepatization and Grey Hepatization?
Red Hepatization occurs before Grey Hepatization
What is the primary purpose of cell culture and animal inoculation with biopsy material?
For research purposes
What is indicated by the detection of IgM in serological diagnosis?
Active and congenital infection
What is the significance of a rising titre in serological diagnosis?
Active infection
What is the purpose of the Frenkel test?
To diagnose acute systematic toxoplasmosis
What is the treatment for congenital infection and acute systematic toxoplasmosis?
Pyrimethamine and sulphadiazine or trisulphapyrimidine
What is the main purpose of health education for pregnant women with regard to Toxoplasma?
To prevent infection from contaminated food or drink
What is the causative agent of malaria disease?
Plasmodium
How many species of Plasmodium can cause malaria in humans?
Four
What is the infective stage of Plasmodium transmitted through a female anopheles mosquito bite?
Sporozoite
What is the site of the exo-erythrocytic cycle of Plasmodium in humans?
Liver
What is the role of humans in the life cycle of Plasmodium?
Intermediate host
What happens to some merozoites in the liver cells?
They develop into hypnozoites
What is the stage of the parasite that feeds on red blood cell haemoglobin?
Trophozoite
What is the cycle that occurs in the female anopheles mosquito?
Sexual cycle
What is the form of Leishmania that is infective to humans?
Promastigote form
What is the primary mode of transmission of Leishmania tropica?
Bite of an infected female sand fly
What is the characteristic of the ulcer in the second stage of Leishmania tropica infection?
It becomes indurated with a red zone
What is the diagnostic stage of Leishmania in chronic cases?
Promastigote form
What is the recommended treatment for early non-inflamed lesions of Leishmania tropica?
Intra-lesional injection of pentavalent antimonial
What is the purpose of local application of heat in the treatment of Leishmania tropica?
To kill the parasites
What is the recommended dose of systemic pentavalent antimonial for Leishmania tropica?
20 mg/kg/day for 10 days
What is the primary method of controlling Leishmania tropica?
Control of sand flies
What happens to the red blood cells that contain the schizont?
They release merozoites which invade new red cells
What happens to the male and female gametocytes in the mosquito's stomach?
They develop and form sporozoites that migrate to the salivary gland of the mosquito
What is the sequence of stages in a malarial paroxysm?
The cold stage, the hot stage, the sweating stage
What is the duration of the hot stage in a malarial paroxysm?
4-6 hours
Why do patients with malaria experience anaemia?
Due to the destruction of red blood cells
What is the purpose of destroying the gametocytes in the treatment of malaria?
To prevent mosquito infection
What is the purpose of examination of thick and thin blood films in the diagnosis of malaria?
To identify the different stages of the parasite
Why is a combination of drugs often needed to treat malaria?
Because a single drug is not effective against all stages of the parasite
What is the purpose of primaquine therapy?
To prevent relapse in P.vivax and P.ovale
What is the dosage of chloroquine for emergency parental LM injection?
1.5 gm maximum
What is the duration of primaquine therapy?
14 days
Why should primaquine be given with caution to black persons?
Because of glucose 6 phosphate dehydrogenase deficiencies
What is the purpose of proguanil?
To arrest the growth of gametocytes in mosquito gut
What is the geographical distribution of toxoplasmosis?
Worldwide
What is the role of the cat in toxoplasmosis?
Both intermediate and definitive host
What is the nature of Toxoplasma?
Intracellular protozoan parasite
Study Notes
Toxoplasmosis
- Diagnosis: Direct methods rarely used; serological diagnosis detects IgM (active and congenital infection) and IgG (rising titre indicates active infection, stable/decreasing titre indicates chronic latent infection)
- Treatment: Combo of pyrimethamine and sulphadiazine/trisulphapyrimidine for 4-6 weeks; spiramycin for 4-6 weeks; care in handling cats, proper cooking of meat, and health education for pregnant women
Leishmaniasis
- Life cycle: Parasite changes to promastigote form in vector, multiplies, and migrates to buccal cavity; when infected sand fly bites a person, it regurgitates promastigotes into skin
- Transmission: Biological transmission by infective female sand fly; mechanical transmission by contact with ulcerated lesions
- Symptoms: Small red papule at bite site, ulceration, and healing within 2 months to 1 year
- Diagnosis: Microscopic examination of smears from ulcer edge reveals amastigote form
- Treatment: Intra-lesional injection of pentavalent antimonial or 5% mepacrine; systematic pentavalent drug for inflamed/ulcerated lesions, lymphatic involvement, or multiple lesions
- Control: Treatment of patients, control of sand flies, and health education
Malaria
- Causative agent: Plasmodium (four species: vivax, ovale, malariae, and falciparum)
- Transmission: Bite of female anopheles mosquito, blood transfusion, and congenital infection
-
Life cycle:
- Asexual cycle (schizogony) in man: exo-erythrocytic cycle (liver phase) and erythrocytic cycle (blood cycle)
- Sexual cycle in female anopheles mosquito
- Symptoms: Malaria paroxysms (cold, hot, and sweating stages), anaemia, and enlarged spleen and liver
- Diagnosis: Clinical picture, laboratory diagnosis (thick and thin blood film), and serological diagnosis
- Treatment: Chloroquine, quinine sulphate, primaquine, and proguanil (arrests growth of gametocytes in mosquito gut)
- Control: Mosquito control, treatment of patients, and chemoprophylaxis of healthy humans entering endemic areas
Identify the different stages of pneumonia, including Red Hepatization and Grey Hepatization, and their corresponding timelines. Understand the gross pathology of Septic Bronchopneumonia.
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