تجميعة مقسمة⬇️:

#PA240
باقي ملاحظات المحاضرات:

المحاضرة الخامسة • para
Trichomonas vaginali
🔴Keywords in cases
Itching , frothy discharge , strawberry appearance + sever pruritic vaginitis
🔴If the female is pregnent cause pre-term-labour
🔴Culture - gold standard
🔴Both sexual partners must be treated
🔴Life cycle -> one stage -> trophozoites
صفحة 7 الجدول مش مطالبين بيه هلبا , مش حتجيبه ك cases❌ (بس قراته الجدول للعلم)

Leishmania
🔴Haemoflagellates -> digenetic -> must have "two host"
🔴Amastigote -> no flagellum
Promastigote -> flagellum in anterior
Epimastigote -> flagellum in superior
Trypomastigote -> flagellum in posterior
🔴 visceral leshmaniasis = l.donovani donovani in africa and asia not donovani chagasi
🔴Human are Accidental Host
🔴Transmission -> Only via the Sandfly bite, it is not transmitted by direct contact
🔴About leshmania true except ?
1- Infective stage seen in culture
2-Diagnostic stage seen in macrophage
3-Promastigote seen only in vector ❌
In culture and vector ✅
🔴Pathogenesis “مش مطالبين بيها هلبا
🔴Wet and dry lesion ✅✅
🔴Espundia (Mucocutaneous Leishmaniasis)
🔴 Visceral Leishmaniasis-> Pancytopenia : keyword in cases
CBC shows : Thrombocytopenia , Leukopenia and Normocytic Normochromic Anemia
🔴 Dysentery = Large Intestine
اي سؤال فيه dysentery نستبعدو اي parasite في ال small intestine

المحاضرة السادسة • Para
Trypanosoma brucei
🔴All parasites obligate intracellular except ?
Trypanosomiasis brucei ->extracellular✅
🔴It Differntiates from trypanosoma cruzi by being polymorphic
🔴Diagnostic stage = polymorphic trypomastigoid , Not monomorphic❌
🔴Pathogenesis by variable surface glygoprotein antigen (VSG)✅
🔴Poor people examined with posterior cervical triangle (winterbottom sign)
Rhodesiense -> more zoonotic subspecies
🔴Stage | hemo-lymphatic stage
Stage || cns development
🔴Parasites Examind with blood film ?
Malaria , tryponosama , leishmania

Trypanosoma cruzi
🔴Monomorphic -> c ,u or s shaped
🔴Mood of transmition -> contaminated with reduviid bugs by the feces (posterior station) , in Trypanosoma brucei occurs via saliva during tsetse fly bite (anterior station)
🔴Xenodiagnosis

Para|ملاحظات المحاضرة السابعة

🔴Merozoite: These are the daughter cells produced within the schizont. When the schizont ruptures, these merozoites are released to infect new red blood cells.

🔴 most malaria parasites immediately become active merozoites, two specific species—P. vivax and P. ovale—can remain dormant in the liver
In this inactive state, they are called hypnozoites.❗❗Mcq❗❗.

🔴P.malariae the Trophozoite is band shape ,but the Trophozoite in p.falciparum is not seen in perepheral blood.

🔴Clinical Diagnosis of Malaria
The first and most crucial step in diagnosing Malaria is taking a detailed travel history from the patient to determine if they have recently visited an endemic area.

🔴In blood transfusion-induced malaria, all asexual stages are infective except :
1-Gametocytes are not infective: Although they are present in the blood, they do not cause malaria in the recipient because their role is strictly for sexual reproduction, which only occurs in the mosquito's gut, not in human blood.
2.Sporozoites: Unlike a mosquito bite, blood transfusion does not involve sporozoites.
_Direct Blood Infection: Because only the erythrocytic (blood) stages are transferred, the parasite bypasses the liver stage entirely.

🔴If a person in Libya contracts malaria without having traveled abroad, the most likely non-mosquito-borne causes are indeed blood transfusions or the sharing of needles (intravenous drug use).

🔴Malaria Transmission Stages
-Infection of Humans (Natural):
The Sporozoite is the infective stage for humans. This occurs when an infected female Anopheles mosquito bites a person and injects these stages from her salivary glands into the bloodstream.

_Infection of Mosquitoes:
The Gametocyte is the infective stage for the mosquito. When a mosquito bites an infected human, it ingests male and female gametocytes, which then begin the sexual reproduction cycle inside the mosquito's gut.

_Infection via Blood Transfusion (Induced Malaria):
In the case of a blood transfusion from an infected donor, the infection is passed through Erythrocytic stages (merozoites or trophozoites already living in the red blood cells).
Crucial Note: In this scenario, Sporozoites are absent (because they only come from the mosquito) and Gametocytes are not the ones responsible for continuing the cycle in the new human host.

ف الملاريا الدكتورة قالت الأدوية حفظظ💊

ولكن الDose زي مثلاً (0.25-0.5mg/kg/day) قالت متجيبش فيهم

جزئية الImmunity to Malaria✨ قالت الدكتورة متجيبش فيها✨.

Para|ملاحظات المحاضرة الثامنة

🔴The Two Primary Tissue Targets of Toxoplasma gondii (brain,muscle).
🔴In Plasmodium, all stages can cause infection except for the gametocytes. In Toxoplasma gondii, all stages cause infection except for the unsporulated oocysts.

🔴Unsporulated oocysts require about 1 to 5 days to undergo sporulation and become infectious. For this reason, a pregnant woman who owns a cat should ensure the litter box is cleaned daily (well before the five-day window) to prevent the oocysts from becoming dangerous.

🔴Toxoplasma gondii is particularly significant in pregnant women and immunocompromised individuals. Because it is an intracellular and opportunistic parasite, the infection often remains mild or asymptomatic in healthy people. However, it can become life-threatening when the immune system is suppressed—such as in patients taking steroids, undergoing organ transplantation, battling cancer, or receiving chemotherapy. In these cases, the dormant (latent) infection can reactivate and lead to fatal complications.

🔴The Link Between Toxoplasmosis and Risk-Taking Behavior
There is a compelling theory that toxoplasmosis may be a contributing factor to car accidents and suicidal tendencies in humans. This is primarily because the trophozoite (specifically the bradyzoite and tachyzoite stages) has a strong tendency to infect brain tissue.
The "Fatal Attraction" Phenomenon
This behavioral shift is best observed in nature:
-The Rodent Model: When a rat is infected with Toxoplasma, it loses its innate fear of cats. In fact, it becomes attracted to the scent of cat urine.
The Goal: This "manipulation" serves the parasite’s life cycle, as it needs to return to a feline (the definitive host) to reproduce.

🔴First Trimester: The probability of infection is low because the placenta is not yet fully formed. However, if transmission occurs, it is highly likely to cause a spontaneous abortion or severe fetal damage.
Second & Third Trimesters: The probability of infection increases as the placenta matures and becomes more permeable.

🔴In the Sabin-Feldman Dye Test, methylene blue is used to stain T. gondii organisms.
The interpretation is as follows:
Positive Result: The parasites do not take up the stain (they remain colorless). This happens because specific antibodies in the patient's serum neutralize the parasite's membrane, preventing the dye from entering.
Negative Result: The parasites are stained blue, indicating that no antibodies were present to protect the cell membrane.

🔴In immunocompromised patients (such as those with HIV/AIDS), imaging typically reveals the following signs of Toxoplasmosis:


*Ring-Enhancing Lesions(❗Mcq❗):On imaging x_ray we find characteristic "ring-enhancing" lesions in the brain,Tissue Changes Around these areas, you may see atrophied tissue or small white spots (calcifications), which serve as diagnostic signs for Toxoplasma infection.






🔴الTOXOPLASMA GONDAII ركزوا عليه ف الرتن عليه3 درجات
زي مثلاً الConginital toxoplasmosisوInfection stageوالprevenation وغيرهم ركزوا عليهم.

ملاحظات جزئية النصفي✅.

سؤال جاي قبل ف التجميعات،من ضمن التعريفات يلي زادها د. الأشعل ف المحاضرة:

باقي التعريفات يلي قالها:




🔴mosquito that carries bacteria or viruses with any change in their number ,without develompent form is called
a propagative biological vector.

🔴mosquito that carries Plasmodium (malaria), in which the parasite increases in number and
changes its form, is called a cyclo-propagative biological vector.

🔴There is another type in which the parasite changes its form but does not increase in number,
called a cyclodevelopmental vector.

تجميعة للأدوية💊🐛:

🔴Giardia➡️ Metronidazole (Flagyl) is the most common +Tinidazole+Nitazoxanide+paromomycin & quinacrine (Refractory or Recurrent Cases).

🔴Cryptosporidium➡️ Nitazoxanide.

🔴Isospora belli➡️trimethoprim-sulfamethoxazole (TMP-SMX).

🔴Amoebic liver Abscess(ALA)➡️metronidazole+tinidazole +iodoquinol+diloxanide+paromomycin+luminal agent draing(if sever).

🔴Pyogenic Liver Abscess(pLA)➡️iv antibiotics,percutaneous drainge.

🔴Abscess less than 5 cm diamter in Rt lobe and more than 1cm from liver surface➡️ Metronidazole+cefoxitin.

🔴Entamoeba histolytica Asymptomatic➡️Paromomycin+Luminal amoebicide only.

🔴Entamoeba histolytica Invasive intestinal disease➡️Metronidazole+Tinidazole.

🔴Entamoeba histolytica Amebic liverabscesses➡️Metronidazole, Tinidazole,chloroquine+with surgical drainge.

🔴Balantidium coli➡️Tetracycline(most common),Metronidazole,Iodoquinol.

🔴Naegleria fowleri➡️Amphotericin B is the primary drug +Miltefosine+Azoles, such as fluconazole and voriconazole+Azithromycin+Rifampin.

🔴Acanthamoeba GAE➡️cotrimoxazole, ketoconazole, pentamidine, flucytosine and rifampin.

🔴Amoebic keratitis➡️chlorhexidine.

🔴Trichomonas vaginalis➡️Metronidazole or tinidazole.

🔴Trypanosoma cruzi➡️nifurtimox,benznidazole.

🔴trypanosomiasis brucei➡️West African trypanosomiasis➡️Treatment for acute stage➡️Pentamidine,Suramin.

🔴trypanosomiasis brucei➡️West African trypanosomiasis➡️Treatment for chronic stage➡️NECT (Nifurtimox eflornthine combination therapy),Melarsoprol.

🔴trypanosomiasis brucei➡️East African trypanosomiasis➡️Treatment for acutestage➡️Pentamidine,Suramin.

🔴trypanosomiasis brucei➡️East African trypanosomiasis➡️Treatment for chronic stage➡️Melarsoprol.

🔴trypanosomiasis brucei➡️Stage I suramin alternate pentamidine.

🔴trypanosomiasis brucei➡️Stage II eflornithine Alternate the organic arsenical melarsoprol.

🔴Leishmania➡️Systemic therapy➡️Sodium stibogluconate (antimony
sodium gluconate (Pentostam)+Oral azole+Liposomal amphotericin B.

🔴Leishmania➡️Local therapy ➡️Promomycin ointment, Intralesional antimonials.

🔴Leishmania➡️Pentavalent antimony compounds: Pentostam+Diamidine compounds: Pentamidine+Liposomal amphotricin B.

🔴malaria➡️ACTs (Artisinine- based Combination Therapy).

🔴Uncomplicated Malaria➡️COARTEM.

🔴Pregnant Uncomplicated Malaria➡️1st trimester ➡️ quinine.

🔴Pregnant Uncomplicated Malaria➡️nd and 3rd trimester ➡️ACTs.

🔴Complicated Malaria➡️V or I.M artesunate.

🔴To Preventing Relapse of malaria➡️Primaquine, chloroquine(In Pregnant or Breastfeeding women use weekly or on G6PD status).

🔴chemoprophylaxis of malaria➡️Malarone,Mefloquine,Doxycycline.
🔴Babesia➡️Quinine + Clindamycine.

🔴TOXOPLASMOSIS➡️Combination of Pyrimethamine + trisulfapyrimidines is the treatment of Choice (C/I during pregnancy).

🔴TOXOPLASMOSIS during pregnancy➡️Spiramycin.

🔴TOXOPLASMOSIS➡️Clindamycin treat encephalitis in AIDS or for sulfur-allergic patient.

السؤال هذا مهمم،الدكتورة ركزت ع شرحه ف المحاضرة ،وقالت جاباته السيم لفات،وهذا السؤال من السيم لفات ⤴️

🔴The infection was transmitted via blood transfusion rather than a mosquito bite، therefore, the parasite bypassed the liver and began multiplying directly in the blood, making the Exo-erythrocytic Schizogony (liver phase) entirely absent.

❗Nageria fowleri❗:

high protein,low sugar