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Parasitology > نظري كتاب الدكتور > Flashcards

نظري كتاب الدكتور Flashcards

1
Q

What is the definition of human parasitology?

A

The study of organisms which parasitize humans.

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2
Q

Which organisms are included in the broad definition of parasitology?

A

Viruses, bacteria, fungi, protozoa, and metazoa.

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3
Q

What is the primary focus of human parasitology?

A

Protozoa, helminthes, and arthropods that depend on host animals.

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4
Q

What are temporary parasites or micro-predators?

A

Certain insects and mites that may not be classified strictly as parasites.

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5
Q

Which discipline studies insects as a group?

A

Entomology.

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6
Q

What are the primary vectors of interest in human parasitology?

A

Insects that are vectors of parasitic infections.

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7
Q

What is a parasite?

A

An organism that lives at the expense of another, deriving nourishment and causing harm.

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8
Q

What are the three types of symbiotic relationships?

A
  • Mutualism
  • Commensalism
  • Parasitism
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9
Q

What happens in mutualism?

A

Both organisms benefit from the relationship.

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10
Q

What is commensalism?

A

One partner benefits while the other is unaffected.

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11
Q

What characterizes parasitism?

A

One organism benefits while the other is injured.

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12
Q

Fill in the blank: A parasite derives nourishment or shelter from its _______.

A

[host]

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13
Q

True or False: Parasitology includes the study of viruses and bacteria.

A

False

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14
Q

What is the harm caused by parasites to humans?

A

Injury or damage to the host.

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15
Q

What is the role of human immunity against parasites?

A

To defend the body against parasitic infections.

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16
Q

What is the significance of understanding the characteristics of parasitic diseases?

A

To effectively diagnose and treat infections.

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17
Q

What is an ectoparasite?

A

An organism that lives on the outside of the body of the host (infestation)

Examples include fleas and ticks.

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18
Q

What is an endoparasite?

A

An organism that lives within the body of the host (infection)

Examples include tapeworms and protozoa.

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19
Q

Define an obligate parasite.

A

An organism which is completely dependent on the host

Examples include certain types of roundworms.

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20
Q

What is a facultative parasite?

A

An organism capable of living both a free and a parasitic existence

Examples include some fungi and bacteria.

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21
Q

What is an opportunistic parasite?

A

An organism which produces disease only in immuno-compromised patients

Examples include certain fungi and bacteria.

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22
Q

What is a coprozoic or spurious parasite?

A

An organism which has passed through the alimentary tract without infecting the host

Examples include certain non-pathogenic organisms.

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23
Q

What role does a host play in parasitism?

A

Supplies the parasite with nourishment and shelter; it is the injured partner

Hosts are essential for the survival of parasites.

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24
Q

What is a definitive (final) host?

A

The host that harbors the adult/mature or sexually reproductive stage of a parasite

This is crucial for the parasite’s life cycle.

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25
Q

What is an intermediate host?

A

The host that harbors the larval/immature or asexually reproductive stage of a parasite

Classified into 1st I.H., 2nd I.H., and 3rd I.H. based on priority.

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26
Q

What is a reservoir host?

A

A vertebrate host that harbors the same species of parasite at the same stage as a human host

Important source of infection in epidemiology.

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27
Q

What is a paratenic host?

A

An animal that harbors the parasite in an arrested state of development, allowing the parasite to continue its life cycle in a suitable host

Acts as a transporting agent for the parasite.

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28
Q

What is a vector in parasitology?

A

Usually an arthropod that transmits the parasite to its host

Examples include mosquitoes and ticks.

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29
Q

Define a carrier.

A

A person or animal that harbors a parasite without apparent clinical symptoms and serves as a potential source of infection

Carriers can play a significant role in disease transmission.

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30
Q

What is zoonosis?

A

Animal diseases that can be transmitted to humans

Infected animals are called reservoir hosts.

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31
Q

What does larva migrans refer to?

A

Larvae living in abnormal hosts where they cannot grow into adults but can wander throughout the host’s body

This can cause local and systemic pathological effects.

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32
Q

What is the life cycle of a parasite?

A

The process of a parasite’s growth, development, and reproduction, which proceeds in one or more different hosts depending on the species of parasites.

The life cycle can vary significantly among different types of parasites.

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33
Q

Define infective stage in parasitology.

A

A parasitic stage that can invade the human body and grow, living within it.

This stage is crucial for the continuation of the parasite’s life cycle.

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34
Q

What is meant by infective route?

A

The specific entrance through which the parasite invades the human body.

Different parasites have distinct routes of entry.

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35
Q

Explain infective mode.

A

The mode by which the parasite invades and infects the human body, such as penetration of skin or ingestion of eggs.

Examples include cercariae of Schistosoma and eggs of Ascaris.

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36
Q

What is alternation of generation in parasites?

A

The regular alternations of sexual and asexual reproductions in the life cycles of some parasites.

An example is the life cycle of Plasmodium.

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37
Q

Differentiate between endoparasite and ectoparasite.

A

Endoparasite lives inside the host, while ectoparasite lives on the surface of the host.

Both types can cause various effects on their hosts.

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38
Q

What is a temporary parasite?

A

A parasite that associates with a host for a limited period.

Temporary parasites do not complete their life cycle within the host.

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39
Q

Define permanent parasite.

A

A parasite that spends its entire life cycle within or on a host.

Examples include certain types of worms.

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40
Q

What is the difference between obligatory and facultative parasites?

A

Obligatory parasites require a host for their life cycle, while facultative parasites can live independently or with a host.

This distinction affects their adaptability and survival strategies.

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41
Q

What is an accidental parasite?

A

A parasite that infects a host that is not its usual host.

This can lead to unexpected outcomes for both the parasite and the host.

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42
Q

Define opportunistic parasite.

A

A parasite that takes advantage of a host’s weakened immune system.

Opportunistic infections are common in immunocompromised individuals.

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43
Q

Differentiate between final host and intermediate host.

A

Final host is where the parasite reaches maturity and reproduces; intermediate host is where the parasite develops but does not reproduce.

Many parasites have complex life cycles involving multiple hosts.

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44
Q

What does free living mean in the context of parasites?

A

Organisms that do not depend on a host for survival or reproduction.

Free-living organisms can be part of the ecosystem without being parasitic.

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45
Q

Define symbiosis.

A

A close biological interaction between two different biological organisms.

Symbiosis can be mutualistic, commensal, or parasitic.

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46
Q

What is commensalism?

A

A type of symbiosis where one organism benefits while the other is neither helped nor harmed.

An example is barnacles on whales.

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47
Q

Define mutualism.

A

A type of symbiosis where both organisms benefit from the interaction.

An example is bees pollinating flowers.

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48
Q

What is parasitism?

A

A type of symbiosis where one organism benefits at the expense of another.

This relationship can lead to damage or disease in the host.

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49
Q

What is a host in parasitology?

A

An organism that harbors a parasite.

Hosts provide nutrients and a living environment for parasites.

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50
Q

Define carrier in the context of parasites.

A

An individual that harbors a parasite but does not exhibit symptoms of the disease.

Carriers can spread the parasite to others.

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51
Q

What is a patient in parasitology?

A

An individual who is infected by a parasite and exhibits symptoms of the disease.

Patients require medical intervention for treatment.

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52
Q

What is a reservoir host?

A

A host that harbors a parasite and facilitates its transmission to other hosts.

Reservoir hosts can be crucial for maintaining the lifecycle of the parasite.

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53
Q

Define zoonosis.

A

A disease that is transmitted from animals to humans.

Zoonotic diseases can arise from various types of parasites.

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54
Q

What is a paratenic host?

A

A host that carries a parasite but does not support its development.

Paratenic hosts can still play a role in the transmission cycle.

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55
Q

What is larva migrans?

A

A condition caused by the migration of larval parasites through the host’s tissues.

This can lead to various symptoms depending on the affected tissues.

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56
Q

What are mechanical effects of parasites on host tissues?

A

Physical damage caused by parasites, e.g., biliary ascariasis and larva migrans.

These effects can lead to significant health issues.

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57
Q

How do parasites deprive nourishment from hosts?

A

By extracting nutrients, such as blood from hosts, e.g., hookworms.

This can lead to malnutrition and anemia.

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58
Q

What is a toxic effect of parasites?

A

The introduction of venom or harmful substances into the host’s body, e.g., from mosquitoes, spiders, and ticks.

This can result in various symptoms, including allergic reactions.

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59
Q

What are immuno-pathological lesions?

A

Tissue damage resulting from the immune response to parasites, e.g., liver cirrhosis from bilharziasis.

These lesions can cause chronic health issues.

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60
Q

What is the intensity and specificity of human immunity against parasites compared to bacteria and viruses?

A

Usually at a lower level

Human immunity against parasites is generally less intense and specific than that against bacteria and viruses.

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61
Q

What is meant by non-sterilizing immunity in the context of human parasitology?

A

Premunition: Concomitant immunity

This refers to the protection from super-infection as long as the parasites remain in the body.

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62
Q

Why is premunition important in endemic areas?

A

Limits the severity of infection with parasites like Plasmodium, Schistosome, and hookworms

This phenomenon can help control the impact of chronic infections in populations.

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63
Q

List the general characteristics of parasites.

A
  • Chronic diseases
  • No effective vaccine
  • No practical chemotherapy
  • Affect young
  • Affect underprivileged
  • Vector-borne

These characteristics highlight the challenges in managing parasitic infections.

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64
Q

What factors influence the geographic distribution (GD) or endemicity of parasites?

A
  • Presence of a suitable host
  • Habits of the host
  • Escape from the host
  • Favorable conditions outside of host
  • Economic and social conditions

These factors determine where parasites thrive and spread.

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65
Q

What are the required factors for the presence of diseases in a population (prevalence)?

A
  • Source: infected persons
  • Mode of transmission
  • Susceptible host
  • Carriers
  • Animals

Understanding these factors helps in controlling disease spread.

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66
Q

What are the three key links of disease transmission?

A
  • Source of infection
  • Route of transmission
  • Susceptible people

Each link is crucial for understanding how diseases spread among populations.

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67
Q

Fill in the blank: The source of infection can include _______.

A

[infected persons]

Infected individuals are primary sources for transmission of parasites.

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68
Q

True or False: Vectors are a mode of transmission for parasites.

A

True

Vectors play a significant role in the transmission of various parasitic diseases.

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69
Q

What are some routes of transmission for parasites?

A
  • Excrement
  • Secretion
  • Blood

Understanding these routes can aid in preventing infections.

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70
Q

List potential portals of entry for parasites into susceptible individuals.

A
  • Mouth
  • Skin or wound
  • Mucosa
  • Placenta
  • Food, water, finger

These entry points highlight the various ways parasites can infect a host.

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71
Q

Fill in the blank: Direct or indirect contact can be a route of transmission for _______.

A

[parasites]

Both direct and indirect contacts are significant in spreading parasitic infections.

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72
Q

What is the definition of a parasite?

A

A living organism that acquires some of its basic nutritional requirements through its intimate contact with another living organism.

Parasites can be unicellular (protozoa) or multicellular (metazoa).

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73
Q

What are the two main types of parasites?

A
  • Ectoparasite
  • Endoparasite

Ectoparasites live on the external surface of a host, while endoparasites live within a host.

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74
Q

What is an endoparasite?

A

A parasite that lives within another living organism, e.g., malaria, Giardia.

Endoparasites depend on their host for survival and reproduction.

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75
Q

What is an ectoparasite?

A

A parasite that lives on the external surface of another living organism, e.g., lice, ticks.

Ectoparasites can cause irritation and may transmit diseases.

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76
Q

What is a eukaryote?

A

A cell with a well-defined chromosome in a membrane-bound nucleus.

All parasitic organisms are eukaryotes.

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77
Q

What are protozoa?

A

Unicellular organisms, e.g., Plasmodium (malaria).

Protozoa are one of the simplest forms of life and can cause various diseases.

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78
Q

What are metazoa?

A

Multicellular organisms, e.g., helminths (worms) and arthropods (ticks, lice).

Metazoa include more complex organisms that can also act as parasites.

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79
Q

What are the three main methods for diagnosing parasitic diseases?

A
  • Clinical diagnosis
  • Laboratory diagnosis
  • Radiological diagnosis

These methods help identify the presence of parasites in the body.

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80
Q

What are two treatments for parasitic diseases?

A
  • Chemotherapy
  • Adequate nutrition

Treatment often requires medication to eliminate the parasites and support the host’s health.

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81
Q

What are the three strategies for the prevention and control of parasitic diseases?

A
  • Health Education
  • Environmental sanitation / Reduction in sources
  • Vector control

Effective control measures can significantly reduce the incidence of parasitic infections.

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82
Q

True or False: All parasitic organisms are prokaryotes.

A

False

Parasitic organisms are eukaryotes, not prokaryotes.

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83
Q

Fill in the blank: An _______ is a parasite that lives within another living organism.

A

endoparasite

Endoparasites can include organisms like Giardia and malaria.

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84
Q

Fill in the blank: An _______ is a parasite that lives on the external surface of another living organism.

A

ectoparasite

Ectoparasites can cause discomfort and transmit diseases to their hosts.

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85
Q

What is a host in the context of parasitology?

A

The organism in, or on, which the parasite lives and causes harm

This term is crucial for understanding the relationship between parasites and their hosts.

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86
Q

Define definitive host.

A

The organism in which the adult or sexually mature stage of the parasite lives

This host is essential for the reproduction of the parasite.

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87
Q

What is an intermediate host?

A

The organism in which the parasite lives during a period of its development only

This host is not where the parasite reaches maturity.

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88
Q

What is zoonosis?

A

A parasitic disease in which an animal is normally the host but which also infects man

This highlights the potential for cross-species transmission of parasites.

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89
Q

What is a vector in parasitology?

A

A living carrier (e.g., an arthropod) that transports a pathogenic organism from an infected to a non-infected host

An example is the female Anopheles mosquito that transmits malaria.

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90
Q

What are the types of parasites?

A

Obligatory, Facultative, Incidental, Aberrant, Endoparasite, Ectoparasite

Each type has distinct characteristics regarding its relationship with the host.

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91
Q

What is an obligatory parasite?

A

Requires a host to complete its life cycle

These parasites cannot survive without a host.

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92
Q

Define facultative parasite.

A

Capable of free-living or parasitism

These parasites can survive independently or in a host.

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93
Q

What is an incidental parasite?

A

Can utilize a different host

This type of parasite may infect hosts that are not its usual target.

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94
Q

What is an aberrant parasite?

A

Found in an unusual host or location

These parasites may cause unexpected infections.

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95
Q

What is an endoparasite?

A

Lives inside a host

These parasites often have more complex life cycles due to their internal environment.

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96
Q

Define ectoparasite.

A

Lives on or outside of a host

Examples include fleas and ticks.

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97
Q

What is mutualism?

A

Both benefit

This is a type of symbiotic relationship.

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98
Q

What is commensalism?

A

One benefits while the other is unharmed

This relationship does not harm the host.

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99
Q

What is parasitism?

A

One benefits at the expense of the other

This is the defining characteristic of parasitic relationships.

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100
Q

What are the three minor sciences included in medical parasitology?

A

Helminthology, Protozoology, Entomology

These sciences focus on different groups of parasites and their characteristics.

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101
Q

List the classes under the Phylum Platyhelminthes.

A

Class Trematoda, Class Cestoidea

These classes include flukes and tapeworms, respectively.

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102
Q

What are the two main groups (phyla) included in Helminthology?

A

Phylum Platyhelminthes, Phylum Nemathelminthes

Platyhelminthes refers to flatworms, while Nemathelminthes refers to roundworms.

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103
Q

What is the classification of the subclass for tapeworms?

A

Subclass Cestoda

Tapeworms are categorized under the class of Cestoidea.

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104
Q

Fill in the blank: The first drug written for treatment in parasitology is called the _______.

A

drug of choice

This term refers to the preferred medication used for treating a specific parasitic infection.

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105
Q

What should be studied very well in relation to pathogenesis, clinical picture, and diagnosis?

A

They are very important aspects of medical parasitology

Understanding these elements is crucial for effective diagnosis and treatment.

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106
Q

Which class includes roundworms?

A

Class Nematoda

Roundworms are part of the Nemathelminthes phylum.

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107
Q

What is the focus of studying general distribution in medical parasitology?

A

Knowing whether the parasite is present in Yemen or not

Understanding the geographical distribution helps in recognizing potential infections.

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108
Q

List the classes under the Phylum Nemathelminthes.

A

Class Nematoda

This phylum primarily consists of roundworms.

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109
Q

True or False: Helminthology includes the study of arthropods.

A

False

Helminthology focuses on helminths, not arthropods, which are studied under Entomology.

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110
Q

What should be reviewed to gain more information about the morphology of helminths?

A

The practical part

Practical study aids in understanding the physical characteristics of helminths.

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111
Q

What is the primary method suggested for studying medical parasitology?

A

Read, describe, discuss, and practice

Active engagement with the material enhances understanding and retention.

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112
Q

What is the kingdom classification for medically important trematodes?

A

Animalia

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113
Q

What phylum do trematodes belong to?

A

Platyhelminthes

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114
Q

What class do flukes fall under?

A

Trematoda

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115
Q

What is the subclass of most medically important trematodes?

A

Digenea

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116
Q

List the orders under the subclass Digenea.

A
  • Strigeidida
  • Opisthorchida
  • Plagiorchiida
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117
Q

What family does Schistosoma belong to?

A

Schistosomatidae

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118
Q

Name one species of Schistosoma.

A

Schistosoma haematobium

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119
Q

What are the general features of class Trematoda?

A
  • Flattened dorso-ventrally
  • Bilaterally symmetrical
  • Unsegmented
  • Provided with suckers
  • Having a protective cuticle
  • Muscle fibers present for movement
  • Nervous and excretory systems present
  • Digestive system includes an oral sucker
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120
Q

True or False: Trematodes have a respiratory and circulatory system.

A

False

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121
Q

What type of reproductive system do most trematodes have?

A

Hermaphrodite

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122
Q

Fill in the blank: The life cycle of trematodes includes stages such as adults, eggs, ______, and cercaria.

A

sporocyst

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123
Q

What are the three types of flukes based on their habitat?

A
  • Liver flukes
  • Intestinal flukes
  • Lung flukes
  • Blood flukes
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124
Q

Name one liver fluke species.

A

Fasciola hepatica

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125
Q

Which genus does Clonorchis belong to?

A

Opisthorchiidae

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126
Q

What is the primary method of fertilization among trematodes?

A

Cross-fertilization

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127
Q

Fill in the blank: The digestive system of trematodes starts with the mouth, which is surrounded by an ______.

A

oral sucker

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128
Q

List the types of flukes classified under intestinal flukes.

A
  • Fasciolopsis buski
  • Heterophyes heterophyes
  • Metagonimus yokogawai
  • Echinostoma ilocanum
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129
Q

What is the function of the muscle fibers in trematodes?

A

Help in the movement of the parasite

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130
Q

True or False: Trematodes have a complex circulatory system.

A

False

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131
Q

What is the family name of the lung fluke Paragonimus?

A

Troglotrematidae

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132
Q

What is the causal agent of Fascioliasis?

A

Fasciola hepatica and Fasciola gigantica

Fasciola hepatica is prevalent in sheep-raising countries, while Fasciola gigantica is found in cattle-raising countries.

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133
Q

What type of disease is Fascioliasis?

A

Plant-borne trematode zoonosis

It is a parasitic disease that can also infect humans accidentally.

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134
Q

What are the common names for the disease caused by Fasciola spp.?

A

Fascioliasis, Fasciolosis, Distomatosis

These terms are used interchangeably to describe the same condition.

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135
Q

What is the systematic position of Fasciola spp.?

A

Trematodes

Fasciola spp. belong to the class of flatworms known as trematodes.

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136
Q

What is the geographic distribution of Fascioliasis?

A

Common in sheep and cattle raising regions

The distribution correlates with livestock farming practices.

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137
Q

Who are the intermediate, definitive, and reservoir hosts of Fasciola spp.?

A

Intermediate: snails; Definitive: herbivores (sheep, cattle); Reservoir: humans

Humans can accidentally become infected.

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138
Q

What is the habitat of Fasciola spp.?

A

Freshwater environments

These environments are conducive to the life cycle of the parasites.

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139
Q

What is the mode of infection by Fasciola spp.?

A

Ingestion of contaminated water or vegetation

The larvae enter the host through the digestive system.

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140
Q

What aspects should be discussed regarding the pathogenesis of Fascioliasis?

A

Immunopathology, pathology, and clinical features

Understanding these aspects is crucial for diagnosis and treatment.

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141
Q

How is Fascioliasis diagnosed?

A

Through clinical features and laboratory tests

Diagnosis often involves detecting eggs in stool samples.

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142
Q

What are proper prevention and control strategies for Fascioliasis?

A

Improved sanitation, controlling snail populations, educating livestock owners

These strategies reduce the risk of transmission.

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143
Q

Fill in the blank: Fascioliasis is caused by _______.

A

Fasciola hepatica and Fasciola gigantica

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144
Q

True or False: Humans are the primary hosts for Fasciola spp.

A

False

Humans are accidental hosts; the primary hosts are herbivores.

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145
Q

What phylum does Fasciola belong to?

A

Platyhelminthes

Fasciola is classified under the phylum Platyhelminthes, which includes flatworms.

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146
Q

What class is Fasciola categorized under?

A

Termatoda

Termatoda is a class of parasitic flatworms.

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147
Q

What are the two species of Fasciola mentioned?

A
  • Fasciola hepatica
  • Fasciola gigantica

These species are significant in sheep and cattle raising countries.

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148
Q

What is the size of an adult Fasciola?

A

About 60 x 15 mm (6 x 1.5 cm)

The adult form of Fasciola is characterized by its leaf-like shape.

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149
Q

Describe the morphological features of the adult Fasciola.

A
  • Leaf-like shape
  • Oral sucker
  • Larger ventral sucker
  • Male reproductive system with two branched testes
  • Branched ovary

These features are important for its parasitic lifestyle.

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150
Q

What is the size of the Fasciola egg?

A

About 150 × 80 µm

The egg is operculated and oval in shape.

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151
Q

What color is the Fasciola egg?

A

Yellow

The color of the egg can help in identifying the species.

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152
Q

What does the content of a Fasciola egg contain?

A

Immature embryo

This indicates the developmental stage of the Fasciola before it hatches.

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153
Q

True or False: Fasciola occurs worldwide.

A

True

Fasciola is found in Europe, the Middle East, Africa (including Egypt), and Asia.

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154
Q

Fill in the blank: Fasciola hepatica is commonly found in _______.

A

sheep raising countries

This species is specifically adapted to infect sheep.

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155
Q

Fill in the blank: Fasciola gigantica is commonly found in _______.

A

cattle raising countries

This species primarily affects cattle.

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156
Q

What is the definitive host for Fasciola?

A

Human and herbivorous animals

Definitive hosts are the organisms in which the parasite reaches maturity and reproduces.

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157
Q

What is the infective stage of Fasciola?

A

Metacercaria

Metacercariae are encysted stages of the parasite that can infect the definitive host.

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158
Q

What is the role of the intermediate host in the life cycle of Fasciola?

A

Lymnaea cailliaudi and L. truncatula

These snails serve as the habitat for the larval stages of the parasite.

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159
Q

What is the first stage of the Fasciola life cycle?

A

Egg

The life cycle begins when the eggs are excreted in the feces of the definitive host.

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160
Q

How long does it take for Fasciola eggs to mature in water?

A

Two weeks

This maturation leads to the hatching of the miracidium.

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161
Q

What is the sequence of larval stages in the Fasciola life cycle?

A

Miracidium, sporocyst, redia, cercaria

This sequence occurs inside the intermediate host, the snail.

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162
Q

What happens to cercariae after they leave the snail?

A

They encyst on water plants and grass

This encystment forms metacercariae, which are the infective stage.

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163
Q

How long can encysted metacercariae survive?

A

About 6 months

This survival period allows them to remain viable until they are ingested by the definitive host.

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164
Q

What is the diagnostic stage of Fasciola?

A

Embryonated eggs in stool

Detection of these eggs helps in diagnosing Fasciola infections.

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165
Q

True or False: The adult Fasciola lives in the bile ducts of the definitive host.

A

True

Adult Fasciola reside in the biliary system of their hosts.

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166
Q

Fill in the blank: The life cycle of Fasciola includes the stages ______, miracidium, sporocyst, redia, cercaria, and adult.

A

Egg

The egg stage is the starting point of the Fasciola life cycle.

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167
Q

What occurs in the intestine after ingestion of metacercariae?

A

The cyst dissolves and metacercariae penetrate the liver

This process allows the parasite to reach the bile ducts where it matures.

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168
Q

How long does it take for metacercaria to reach the bile ducts after ingestion?

A

6-8 weeks

This duration is necessary for the parasite to migrate through the peritoneal cavity.

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169
Q

What is the parenchymal phase in the pathogenesis of Fasciola?

A

Migration of immature flukes through hepatic tissue and peritoneum causes mechanical destruction and allergic reactions leading to necrosis

This phase lasts from a few days to 3 months and is associated with inflammatory reactions largely mediated by eosinophils.

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170
Q

What are the key features of the biliary phase in Fasciola infection?

A

Flukes mature and feed on blood in biliary ducts, causing hyperplasia, hypertrophy, and biliary obstruction

This phase can last from months to years and involves inflammatory responses and activity of proline enzyme excreted by the flukes.

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171
Q

What causes pressure atrophy on adjacent liver tissue during Fasciola infection?

A

Periductal fibrosis

This leads to necrosis and inflammation, resulting in tissue atrophy and abscess formation.

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172
Q

What is the incubation phase of Fasciola infection?

A

Time from ingestion of metacercariae to appearance of first symptoms

This phase lasts from a few days to 3 months, depending on the number of ingested metacercariae and the immune status of the host.

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173
Q

What are the major manifestations during the invasive or acute phase of Fasciola infection?

A

Fever, abdominal pain, GIT disturbances

GIT disturbances may include loss of appetite, flatulence, nausea, diarrhea, and urticaria.

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174
Q

True or False: There are reports concerning resistance to fasciolosis in humans.

A

False

No reports concerning resistance to fasciolosis in humans are available.

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175
Q

Fill in the blank: The spontaneous healing in Fasciola infection may result from the __________ process and calcification.

A

inflammatory

This healing process appears to occur frequently.

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176
Q

What may happen to flukes that migrate out of the intestine?

A

They may lose their way and form ectopic lesions

This can lead to complications in the host.

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177
Q

What is a possible outcome of minute abscesses forming around eggs trapped in the parenchyma?

A

Inflammation and further necrosis

This can contribute to the overall pathology of Fasciola infection.

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178
Q

What are the common clinical manifestations of Fascioliasis?

A
  • Respiratory symptoms (very uncommon): cough, dyspnea, chest pain
  • Hemoptysis
  • Hepatomegaly
  • Splenomegaly
  • Ascites
  • Anaemia
  • Jaundice can last for months
  • Biliary obstruction
  • Biliary colic
  • Epigastric pain
  • Cholangitis & cholecystitis
  • Right upper-quadrant abdominal tenderness
  • Fibrous adhesions to adjacent organs
  • Lithiasis of the bile ducts or gallbladder is frequent
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179
Q

What is the definitive host for Fasciola?

A

Human

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180
Q

Which animals serve as reservoir hosts for Fasciola?

A

Herbivorous animals

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181
Q

What is the intermediate host for Fasciola?

A

Snail Lymnaea

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182
Q

What is the infective stage of Fasciola?

A

Encysted metacercaria

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183
Q

What is the diagnostic stage of Fasciola?

A

Eggs in stool

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184
Q

How is Fasciola infection transmitted?

A

Ingestion of encysted metacercaria in water or plants

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185
Q

What is the common name for the disease caused by Fasciola?

A

Fascioliasis or liver rot

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186
Q

What is the size of the immature egg stage of Fasciola?

A

140 x 70 um

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187
Q

Describe the appearance of Fasciola eggs.

A
  • Oval
  • Operculated
  • Thin shelled
  • Yellowish brown
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188
Q

What are common habitats for Fasciola?

A

Bile ducts of the liver

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189
Q

What are the two species of Fasciola mentioned?

A
  • Fasciola hepatica
  • Fasciola gigantica
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190
Q

Where is Fasciola hepatica commonly found?

A

Sheep raising areas in Europe, Middle East (particularly Egypt), Central & South Africa

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191
Q

Where is Fasciola gigantica commonly found?

A

Cattle raising areas in South-East Asia & Africa including Egypt

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192
Q

True or False: Jaundice can last for months in Fascioliasis.

A

True

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193
Q

Fill in the blank: The _______ phase of Fascioliasis can last for months to years.

A

chronic/obstructive

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194
Q

What complications can arise from Fascioliasis?

A
  • Biliary obstruction
  • Biliary colic
  • Cholangitis
  • Cholecystitis
  • Fibrous adhesions
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195
Q

What is the intermediate host for Fasciola gigantica?

A

Lymnaea cailliaudi (snail)

This snail species is essential for the life cycle of Fasciola gigantica.

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196
Q

What is the intermediate host for Fasciola hepatica?

A

Lymnaea truncatula (snail)

This snail species is essential for the life cycle of Fasciola hepatica.

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197
Q

What is the infective stage of Fasciola?

A

Encysted Metacercaria

This stage is crucial for the transmission of Fasciola to the definitive host.

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198
Q

How is Fasciola typically transmitted to humans?

A

Eating contaminated vegetables or drinking contaminated water

This mode of infection highlights the importance of proper food and water hygiene.

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199
Q

What is a significant consequence of immature flukes migrating through liver tissue?

A

Destruction, necrosis & hemorrhage of the parenchyma

This indicates the damaging effects of Fasciola infection on liver tissue.

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200
Q

What causes hyperplasia of biliary epithelium in Fasciola infection?

A

Mechanical obstruction, inflammatory responses & the activity of proline excreted by the flukes

This results in fibrous thickening of the bile ducts.

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201
Q

What can form around eggs trapped in the liver parenchyma due to Fasciola infection?

A

Minute abscesses

This is a pathological manifestation of the infection.

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202
Q

What is a possible outcome of inflammation and calcification in Fasciola infection?

A

Spontaneous repair

This indicates the body’s ability to heal despite the infection.

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203
Q

What can happen to flukes that migrate out of the intestine?

A

They may lose their way and form ectopic lesions

This complicates the clinical picture of Fasciola infection.

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204
Q

What are the clinical manifestations of Fasciola infection? (List at least three)

A
  • Diarrhea & digestive disturbance
  • Enlarged tender liver
  • Cholangitis, cholecystitis and obstructive jaundice

These symptoms are indicative of liver and biliary system involvement.

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205
Q

What is a common hematological finding in Fasciola infection?

A

Marked peripheral eosinophilia up to 80%

Eosinophilia is often associated with parasitic infections.

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206
Q

Fill in the blank: The life cycle of Fasciola includes adult worms in _______.

A

[bile ducts]

This is where adult Fasciola reside in the definitive host.

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207
Q

What are the two main clinical methods for diagnosing infections?

A

Clinical signs & symptoms and diet history

Laboratory tests are also critical for confirming the diagnosis.

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208
Q

What is a direct laboratory method for detecting Fasciola infection?

A

Detection of eggs in faeces or duodenal aspirate

This method has limitations, as eggs may only be detectable 3-4 months after infection.

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209
Q

What are the reasons for the limitations of egg detection in chronic Fasciola infection?

A
  • Eggs may be undetectable in chronic phase
  • Spurious infection can occur
  • Eggs disappear after a liver-free diet

Spurious infection occurs when eggs are found due to ingestion of infected animal liver.

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210
Q

What is the first-line treatment for Fasciola infection?

A

Triclabendazole

Bithionol is an alternative treatment.

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211
Q

List two prevention and control measures for Fasciola infection.

A
  • Mass treatment of infected animal reservoir
  • Pure water supply

Additional measures include snail control and proper washing or cooking of aquatic vegetables.

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212
Q

What is the recommended method for treating aquatic vegetables to kill encysted metacercariae?

A
  • Soak in vinegar for 5 minutes
  • Use potassium permanganate for 10-15 minutes

These methods help ensure food safety.

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213
Q

What are some indirect laboratory methods for diagnosing Fasciola infection?

A
  • ELISA
  • Immuno-fluorescence
  • Counter immunoelectrophoresis

These tests are highly sensitive and can detect early and chronic infections.

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214
Q

What imaging techniques are used for the radiological diagnosis of Fasciola infection?

A
  • Ultrasonography
  • Endoscopic retrograde
  • Percutaneous cholangiography

These imaging techniques help visualize the infection’s impact on the body.

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215
Q

What is Halzoun?

A

Parasitic pharyngitis caused by ingestion of infected sheep or goat livers

This condition leads to oedematous congestion of the pharynx and related areas.

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216
Q

What causes the condition known as Halzoun?

A

Ingestion of fresh raw sheep or goat livers infected with Fasciola or tongue worms (Linguatula serrata)

The resulting infection can cause suffocation symptoms.

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217
Q

Fill in the blank: Infection occurs by ingestion of the _______ stage in improperly cooked sheep viscera.

A

nymph

This highlights the importance of proper cooking in preventing infection.

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218
Q

What is the common name for Clonorchis sinensis?

A

Chinese liver fluke

This organism is associated with the disease Clonorchiasis.

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219
Q

In which geographical areas is Clonorchiasis prevalent?

A

Large areas of China, Japan, Korea, Vietnam, and the USA (in Asian immigrants)

Clonorchiasis is often contracted through the ingestion of improperly cooked or pickled freshwater fish.

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220
Q

What is the definitive host for Clonorchis sinensis?

A

Human

Humans are the primary host for this liver fluke.

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221
Q

Where does Clonorchis sinensis primarily localize in the host?

A

Bile ducts (biliary tract)

The fluke typically localizes in the more distal portions of the biliary tract.

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222
Q

What type of animals serve as the reservoir host for Clonorchis sinensis?

A

Fish-eating animals like dogs and cats

These animals can harbor the parasite and contribute to its lifecycle.

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223
Q

What is the diagnostic stage of Clonorchis sinensis?

A

Mature egg stage

The mature egg is used for diagnosing Clonorchiasis.

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224
Q

What are the dimensions of the mature egg of Clonorchis sinensis?

A

30 x 15 µm

This size is characteristic of the eggs produced by the adult fluke.

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225
Q

Describe the appearance of the mature egg of Clonorchis sinensis.

A

Oval, operculated, thick-shelled with a small knob at the abopercular end

The operculum rests on ‘shoulders’ and the egg is yellowish brown.

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226
Q

What is the lifespan of adult Clonorchis sinensis worms?

A

Up to 30 years

This long lifespan can contribute to chronic infections in hosts.

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227
Q

What is the most common intermediate host for Clonorchis sinensis in endemic areas?

A

Parafossarulus manchouricus

This snail species plays a critical role in the life cycle of the fluke.

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228
Q

True or False: Bithynia sp. is another common intermediate host for Clonorchis sinensis.

A

True

Bithynia sp. also serves as an intermediate host in the lifecycle of Clonorchis sinensis.

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229
Q

Fill in the blank: The treatment for parasitic pharyngitis ‘Halzoun’ includes gargling with _______.

A

strong alcoholic drinks

This is one of the suggested treatments for the condition.

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230
Q

What is the recommended control measure to prevent Clonorchiasis?

A

Proper cooking of animal tissues

Ensuring food safety is crucial in preventing infections caused by Clonorchis sinensis.

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231
Q

What is one of the treatments for laryngeal obstruction caused by Halzoun?

A

Tracheostomy

This procedure may be necessary in severe cases of obstruction.

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232
Q

What is the morphology of Clonorchis sinensis eggs?

A

Similar to eggs of Heterophyes and Metagonimus, may have a small comma-shaped process (knobbin) at the abopercular end, operculum resting on ‘shoulders’

The eggs are the diagnostic stage of the parasite.

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233
Q

What are the dimensions of adult Clonorchis sinensis?

A

1-2.5 cm by 0.3-0.5 cm

This size allows it to live in the bile ducts of its host.

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234
Q

Describe the shape of adult Clonorchis sinensis.

A

Broadest in the mid-part, tapering towards both ends

This shape is typical for many trematodes.

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235
Q

How long can Clonorchis sinensis live?

A

Up to 30 years

This longevity contributes to chronic infections in hosts.

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236
Q

What is the life cycle of Clonorchis sinensis?

A

Mature eggs pass with faeces, ingested by snail (1st I.H.), develop into sporocyst, rediae, cercariae, penetrate cyprinoid fish (2nd I.H.), encyst as metacercaria

The life cycle involves both intermediate hosts and a definitive host.

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237
Q

What is the infective stage of Clonorchis sinensis?

A

Encysted metacercaria

This stage is crucial for transmission to the definitive host.

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238
Q

What is the mode of infection for Clonorchis sinensis?

A

Eating undercooked or raw fish containing encysted metacercaria

Proper cooking can prevent infection.

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239
Q

What happens when the encysted metacercaria is ingested by the definitive host?

A

It escapes from the cyst and migrates to the common bile duct, where it matures within a month

This process leads to the establishment of the parasite in the host.

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240
Q

What is the first intermediate host (I.H.) in the life cycle of Clonorchis sinensis?

A

Snail

The snail is essential for the development of the larval stages of the parasite.

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241
Q

What is the second intermediate host (I.H.) for Clonorchis sinensis?

A

Cyprinoid fish

These fish play a critical role in the transmission of the parasite to humans.

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242
Q

What is the life cycle of Clonorchis sinensis?

A

Free-swimming cercariae, metacercariae in fish, eggs ingested

The life cycle includes several stages: eggs are ingested, leading to the development of various larval forms.

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243
Q

What are the two main stages in the life cycle of Clonorchis sinensis?

A

Infective stage (A), Diagnostic stage (d)

The infective stage involves metacercariae, while the diagnostic stage involves eggs.

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244
Q

What are the symptoms of light infections of Clonorchis sinensis?

A

Asymptomatic

Light infections typically do not present noticeable symptoms.

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245
Q

What symptoms may occur with heavier infections of Clonorchis sinensis?

A
  • Fever
  • Diarrhea
  • Epigastric pain
  • Anorexia
  • Liver enlargement and tenderness

Heavier infections can lead to more pronounced clinical manifestations.

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246
Q

What complications can arise from heavy worm burdens of Clonorchis sinensis?

A
  • Localized biliary obstruction
  • Intrahepatic stone formation
  • Cholangitis
  • Multiple liver abscesses
  • Cholecystitis
  • Cholelithiasis

These complications are due to the worms’ invasion and long-term infection.

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247
Q

What changes occur in the bile ducts due to heavy infections of Clonorchis sinensis?

A
  • Thickening of bile ducts
  • Localized dilatation
  • Hyperplasia of small mucinous glands

These changes may persist even after the infection has become very light.

248
Q

What type of cancer has been associated with Clonorchis sinensis infection?

A

Adenocarcinoma (cholangiocarcinoma)

This type of cancer can arise from hyperplastic mucosa of the bile duct in infected individuals.

249
Q

What are the two main diagnostic methods for Clonorchis sinensis?

A
  • Direct: Recovery of eggs from feces
  • Indirect: Complement fixation test (CFT)

Direct methods involve identifying eggs in feces or duodenal aspirates.

250
Q

True or False: Eggs of Clonorchis sinensis appear in feces immediately after infection.

A

False

Eggs appear in the feces after approximately one month post-infection.

251
Q

Fill in the blank: Clonorchis sinensis is a type of _______.

A

[helminth]

Helminths are parasitic worms, which include flatworms like Clonorchis sinensis.

252
Q

What is the treatment for Clonorchis sinensis?

A

Praziquantel

Praziquantel is an anthelmintic medication used to treat infections caused by various types of parasitic worms.

253
Q

List the methods for prevention and control of Clonorchis sinensis.

A
  • Proper cooking of fish
  • Periodic examination and treatment
  • Avoid defecating in water
  • Snail control

These methods aim to reduce the risk of infection by controlling the life cycle of the parasite.

254
Q

What is the common name for Heterophyes heterophyes?

A

Intestinal fluke

Heterophyes heterophyes is a type of intestinal fluke that can infect humans.

255
Q

Where is Heterophyes heterophyes commonly found?

A

Middle and far east, China, Philippines, south Europe, and Egypt in brackish water

This distribution indicates regions where the parasite is endemic.

256
Q

What is the definitive host for Heterophyes heterophyes?

A

Human

Humans serve as the primary host for the life cycle of Heterophyes heterophyes.

257
Q

Where does Heterophyes heterophyes inhabit in the human body?

A

Between the villi of the small intestine

This location allows the parasite to absorb nutrients from the host.

258
Q

What type of animals serve as the reservoir hosts for Heterophyes heterophyes?

A
  • Fish-eating animals
  • Cats
  • Dogs
  • Birds

These animals can harbor the parasite and contribute to its transmission.

259
Q

What is the size of the mature egg stage of Heterophyes heterophyes?

A

30 × 15 um

This measurement indicates the dimensions of the eggs produced by the parasite.

260
Q

Describe the characteristics of the eggs of Heterophyes heterophyes.

A
  • Oval
  • Operculated
  • Thick shelled
  • Yellowish brown

These characteristics help in identifying the eggs during diagnostic examinations.

261
Q

What is the family classification of Heterophyes heterophyes?

A

Heterophyidae

This classification groups Heterophyes heterophyes with other related intestinal flukes.

262
Q

Fill in the blank: The diagnostic stage of Heterophyes heterophyes is the _______.

A

mature egg stage

The mature egg stage is critical for diagnosis through laboratory tests.

263
Q

What are the risk groups for intestinal flukes?

A
  • Fishermen
  • Boatmen
  • Hunters
  • Mining prospectors
  • Rangers
  • Other persons closely associated with marine life

These individuals are likely to consume raw fish, increasing their risk of infection.

264
Q

What is the first intermediate host for intestinal flukes?

A

Snail ‘Pirenella conica’

This snail is critical in the life cycle of the intestinal fluke.

265
Q

What are the second intermediate hosts for intestinal flukes?

A
  • Tilapia Nilotica (Bolty)
  • Mugil Cephalus (Boury)

These fish species serve as hosts for the encysted metacercariae.

266
Q

What is the infective stage of the intestinal fluke?

A

Encysted Metacercaria

This stage is responsible for infecting humans when they consume contaminated fish.

267
Q

How do humans become infected with intestinal flukes?

A

By eating inadequately cooked or freshly salted fish

Consumption of fish that has not been properly prepared increases the risk of infection.

268
Q

Describe the life cycle of the intestinal fluke.

A
  • Adult flukes inhabit the small intestine
  • Eggs are excreted in feces
  • Eggs are ingested by 1st intermediate host (snail)
  • Miracidia emerge and develop into sporocysts and rediae
  • Cercariae are released into water
  • Cercariae encyst in 2nd intermediate host (fish)
  • Humans ingest the metacercariae
  • Metacercariae excyst in the duodenum
  • Adult worms embed in the small intestine

This cycle illustrates the transmission and development of intestinal flukes from eggs to adult worms.

269
Q

What happens to the metacercariae once ingested by humans?

A

They excyst in the duodenum and attach to the wall of the small intestine

This attachment occurs between the villi, allowing the flukes to mature into adult worms.

270
Q

True or False: Adult flukes are found in the large intestine.

A

False

Adult flukes inhabit the small intestine, not the large intestine.

271
Q

Fill in the blank: The _______ is the definitive host for intestinal flukes.

A

[fish-eating mammals and birds]

These animals can also become infected by consuming contaminated fish.

272
Q

What are the key stages in the life cycle of intestinal flukes?

A
  • Eggs
  • Miracidia
  • Sporocysts
  • Rediae
  • Cercariae
  • Metacercariae
  • Adult flukes

Each stage plays a crucial role in the transmission and lifecycle of the parasite.

273
Q

What inflammation occurs at the site of attachment of adult flukes in the intestinal mucosa?

A

Mild irritation, colicky pains, mucus diarrhea, and superficial necrosis of the mucus coat

Adult flukes provoke inflammation leading to various gastrointestinal symptoms.

274
Q

What potential cardiac issue can arise from heterophyid eggs filtering through the intestinal wall?

A

Cardiac insufficiency due to granulomas around the eggs

Granulomas form around the eggs, leading to complications in heart function.

275
Q

What neurological complications can occur if eggs are carried to the brain?

A

Seizures, neurologic deficits, or cerebral hemorrhage

The presence of eggs in the brain can lead to severe neurological outcomes.

276
Q

What are the symptoms of severe infection by intestinal flukes?

A

Discomfort, colic pain, mucous diarrhea, and eosinophilia

Severe infections lead to more pronounced symptoms and immune responses.

277
Q

What is the first step in diagnosing intestinal flukes?

A

Clinical and diet history in endemic areas

Understanding the patient’s background is crucial for diagnosis.

278
Q

What laboratory finding is key for diagnosing intestinal flukes?

A

Finding characteristic eggs in the feces

Eggs are difficult to differentiate from those of Clonorchis and Opistorchis.

279
Q

What treatment is commonly used for intestinal flukes?

A

Praziquantel

Praziquantel is effective against various fluke infections.

280
Q

Fill in the blank: Proper cooking and _______ of fish can help in the prevention of intestinal flukes.

A

salting

Cooking and salting fish are essential preventive measures.

281
Q

What should fishermen do to help prevent the spread of intestinal flukes?

A

Periodic examination and treatment, and avoid defecating in water

Regular health checks and hygiene practices are critical for controlling fluke infections.

282
Q

True or False: Eggs from intestinal flukes may find their way into circulation and cause ectopic lesions.

A

True

Ectopic lesions can occur when eggs enter the bloodstream.

283
Q

What may excessive mucous secretion and hyperplasia of the mesenteric lymph nodes indicate?

A

Severe fluke infection

These symptoms are associated with significant irritation and immune response.

284
Q

What is the first intermediate host of lung flukes?

A

Snail “Semisulcospira”

The first intermediate host is crucial for the life cycle of lung flukes.

285
Q

What are the second intermediate hosts for lung flukes?

A

Crabs, crayfish or shrimps

These hosts play a significant role in the transmission of lung flukes to humans.

286
Q

What is the infective stage of lung flukes?

A

Encysted Metacercaria

This stage is essential for the infection of definitive hosts.

287
Q

How is infection by lung flukes acquired?

A

Eating improperly cooked crabs, crayfish or shrimps

Proper cooking is necessary to prevent infection.

288
Q

What is the scientific name of the lung fluke?

A

Paragonimus westermani

This species is responsible for paragonimiasis.

289
Q

What is the disease caused by Paragonimus westermani?

A

Paragonimiasis

This disease primarily affects the lungs.

290
Q

In which regions is Paragonimus westermani commonly found?

A

Asia (South-East), Africa (Nigeria & Cameroon) and South America

These regions are endemic for lung fluke infections.

291
Q

What is the definitive host for Paragonimus westermani?

A

Human

Humans are the primary hosts where the adult flukes reside.

292
Q

Where in the human body do lung flukes typically reside?

A

Lungs, encapsulated in pockets or cystic structures adjacent to the bronchi

This location leads to respiratory symptoms associated with paragonimiasis.

293
Q

What are the reservoir hosts for Paragonimus westermani?

A

Cats, dogs, pigs & monkeys

These animals can also harbor the flukes and contribute to transmission cycles.

294
Q

What is the diagnostic stage of Paragonimus westermani?

A

Immature egg stage

Identifying eggs in feces or sputum is key for diagnosis.

295
Q

What are the dimensions of the immature eggs of Paragonimus westermani?

A

90 × 55 um

The size of the eggs aids in their identification under a microscope.

296
Q

Describe the appearance of the immature eggs of Paragonimus westermani.

A

Oval, operculated & thick shelled, brown

These characteristics help differentiate them from other egg types.

297
Q

What is the size of the adult Paragonimus westermani?

A

1 x 0.5 cm in breadth

This size is typical for adult lung flukes.

298
Q

What shape does the adult Paragonimus westermani resemble?

A

Ovoid, robust, resembling a coffee bean

This shape is a distinctive feature of lung flukes.

299
Q

What color is the adult Paragonimus westermani?

A

Reddish brown

Coloration can vary slightly but typically falls within this range.

300
Q

What are the anatomical features of the adult Paragonimus westermani?

A

Lobed ovary, anterior to 2 branching testes, possess oral and ventral sucker

These features are important for reproduction and attachment.

301
Q

What is the habitat of adult lung flukes?

A

Inside the human lungs

Adult lung flukes live in the lungs of infected humans.

302
Q

How do lung fluke eggs exit the human body?

A

They are coughed up with sputum or swallowed and passed out in the faeces

Eggs escape from the cyst into the alveoli and are expelled through coughing or defecation.

303
Q

What is the time frame for lung fluke eggs to mature in water?

A

2-7 weeks

Once in water, lung fluke eggs develop into mature forms within this time.

304
Q

What is the first intermediate host for lung flukes?

A

Snails (Semisulcospira)

The miracidium seeks out snails as its first intermediate host.

305
Q

What stages do lung flukes undergo in their first intermediate host?

A
  • Sporocyst
  • 1st generation redia
  • 2nd generation redia
  • Cercaria

These stages represent the transformation of lung flukes within the snail.

306
Q

What is the second intermediate host for lung flukes?

A

Mountain crab (Sundathelphusa philippina)

The cercaria encysts as metacercaria in this crab.

307
Q

How do humans acquire lung fluke infections?

A

By ingesting infected and improperly cooked crab

Consumption of the infected crab leads to human infection.

308
Q

What happens to cercariae after they leave the snail?

A

They search for their second intermediate host

This stage involves the cercaria looking for a host to encyst.

309
Q

Describe the pathogenesis of lung fluke infections.

A
  • No recognizable symptoms during migration
  • Inflammatory reaction as parasites grow
  • Fever, necrosis, and hemorrhage of lung parenchyma

The symptoms vary depending on the number of parasites present.

310
Q

What are the clinical manifestations of lung fluke infection?

A
  • Cough develops when cysts rupture
  • Increased sputum production
  • Blood-tinged sputum with dark brown eggs and Charcot-Leyden crystals

Symptoms can resemble pulmonary tuberculosis.

311
Q

True or False: The severity of symptoms in lung fluke infections is independent of the number of parasites present.

A

False

The severity and progression of symptoms depend on the number of parasites.

312
Q

Fill in the blank: Adult lung flukes produce _______ that escape into the alveoli.

A

eggs

Eggs are produced by adult lung flukes and are essential for the life cycle.

313
Q

What occurs with longstanding lung fluke infections?

A

Increasing fibrosis of the lungs

Chronic infections lead to structural changes in lung tissue.

314
Q

What is a consequence of cyst rupture in lung fluke infections?

A

A cough develops

This cough may be accompanied by increased sputum production.

315
Q

What is the pathogenesis of lung flukes?

A

Worms provoke granulomatous reactions that lead to fibrotic encapsulation of the worms

Aberrant migration may cause larvae to lodge in ectopic sites leading to necrosis and hemorrhage.

316
Q

What are the clinical manifestations of lung flukes?

A
  • Chronic productive cough with brownish purulent sputum containing streaks of blood and parasitic eggs
  • Chest pain
  • Eosinophilia (20-25%)
  • Pleural effusion may occur

These symptoms help in the clinical diagnosis of lung fluke infections.

317
Q

What is the first-line treatment for lung flukes?

A

Praziquantel or Bithionol (Dichlorophenol)

Bithionol is sometimes less preferred due to side effects.

318
Q

Fill in the blank: Good cooking of ________, crayfish & shrimps is essential in the prevention and control of lung flukes.

A

crabs

319
Q

What are the methods of prevention and control for lung flukes?

A
  • Treatment of cases
  • Good cooking of crabs, crayfish & shrimps
  • Health education
  • Snail control

Paratenic hosts, such as pigs and small animals, can transmit infection if consumed by humans.

320
Q

How is lung fluke infection diagnosed clinically?

A

Clinical signs and diet history in endemic areas

Understanding the patient’s exposure to endemic regions is crucial.

321
Q

What laboratory tests are used to diagnose lung fluke infection?

A
  • Detection of eggs in faeces or sputum
  • Adult worms may be expectorated after treatment
  • Immunodiagnostic tests: CFT & ELISA detect early & chronic infections

These tests help confirm the presence of lung flukes.

322
Q

What radiological exams can show signs of lung fluke infection?

A

Plain x-ray of chest & CT show nodular or ring shadows and cavities

Radiological findings can indicate complications from lung fluke infections.

323
Q

What is the kingdom classification of Schistosoma?

A

Animalia

Schistosoma belongs to the kingdom Animalia.

324
Q

What phylum does Schistosoma belong to?

A

Platyhelminthes

This phylum includes flatworms.

325
Q

In which class is Schistosoma categorized?

A

Trematoda

Trematoda includes flukes, which are parasitic flatworms.

326
Q

What subclass does Schistosoma fall under?

A

Digenea

Digenea is a subclass of flukes with complex life cycles.

327
Q

What order is Schistosoma classified under?

A

Strigeidida

Strigeidida encompasses various trematodes.

328
Q

What family does the genus Schistosoma belong to?

A

Schistosomatidae

This family includes blood flukes.

329
Q

What was discovered by Leiper between 1915 and 1918 regarding Schistosoma?

A

Relation to snail intermediate hosts and mode of infection

This discovery was crucial for understanding the life cycle of Schistosoma.

330
Q

Which treatment for Schistosoma was introduced by McDonagh in 1918?

A

Tartar emetic

Tartar emetic was one of the early treatments for schistosomiasis.

331
Q

Who discovered two different species of Schistosoma in Egypt in 1893?

A

Manson

Manson’s work was key in identifying species diversity in Schistosoma.

332
Q

What significant finding did Theodore Bilharz make in 1851?

A

Discovered the worms and their relation to the disease in Cairo

This discovery led to the naming of bilharziasis, a disease caused by Schistosoma.

333
Q

What is a key characteristic of Schistosoma regarding sex?

A

Separate sexes

Schistosoma is dioecious, meaning male and female worms are distinct.

334
Q

What unique anatomical feature do Schistosoma’s intestinal caeca have?

A

Intestinal caeca reunite

This feature distinguishes Schistosoma from other flatworms.

335
Q

Where is the genital pore located in Schistosoma?

A

Posterior to the ventral sucker

This is an anatomical feature specific to Schistosoma.

336
Q

How many testes do Schistosoma typically have?

A

More than two

This is part of their reproductive anatomy.

337
Q

Does Schistosoma have a redial stage?

A

No redial stage

This distinguishes Schistosoma from other trematodes with a redial stage.

338
Q

What is a notable feature of Schistosoma eggs?

A

Eggs with spine, non-operculated

The spines on the eggs can aid in identification of the species.

339
Q

What does the term ‘Schistosoma’ mean?

A

Schisto ‘split’ soma ‘body’

Refers to the unique morphology of the organism.

340
Q

What are the key differences between Schistosoma and other trematodes?

A
  • Has separate sexes
  • Lives in blood
  • Has non-operculated eggs
  • Has no Redia stage
  • Has no encysted metacercaria

These characteristics distinguish Schistosoma from other trematodes.

341
Q

What is the primary disease caused by Schistosoma?

A

Schistosomiasis

Also referred to as Bilharziasis.

342
Q

List the species of Schistosoma that primarily infect humans.

A
  • S. haematobium
  • S. mansoni
  • S. japonicum
  • S. intercalatum
  • S. mekongi
  • S. malayensis

S. malayensis is a newly described species that rarely infects humans.

343
Q

Which organ does S. haematobium primarily infect?

A

Genitourinary

This species is particularly associated with urinary tract infections.

344
Q

Which organ does S. mansoni primarily infect?

A

Intestinal

S. mansoni is known for causing intestinal schistosomiasis.

345
Q

Geographical distribution of S. japonicum includes which regions?

A
  • China
  • Philippines
  • Southern Japan
  • Central Indonesia

S. japonicum is still endemic in these areas.

346
Q

True or False: S. intercalatum is widely distributed across Africa.

A

False

S. intercalatum has limited foci in West and Central Africa.

347
Q

Fill in the blank: The Mekong Basin is primarily associated with __________.

A

S. mekongi

This species is found in Cambodia.

348
Q

Where is S. haematobium primarily found geographically?

A
  • Yemen
  • Africa
  • Near East
  • Middle East

This species has a broad distribution in these regions.

349
Q

Where is S. mansoni primarily distributed?

A
  • Yemen
  • Africa
  • Arabia
  • South America
  • Caribbean

This species is notably found in both Africa and the Americas.

350
Q

S. mekongi is primarily found in which geographical area?

A

Mekong Basin of Cambodia

This species has a very specific endemic region.

351
Q

What is the significance of S. malayensis?

A

It is a newly described species that rarely infects humans.

Its significance lies in its rarity and classification.

352
Q

What distinguishes Schistosomes from other trematodes?

A

Schistosomes are separate sexes and do not hermaphrodite

Male Schistosomes are flat, while females are cylindrical.

353
Q

What type of eggs do Schistosomes produce?

A

Eggs have spines and are not operculated

This differentiates them from other trematodes, such as Fasciola and Heterophyes.

354
Q

What is the infective stage of Schistosomes?

A

Furcocercous Cercaria not encysted metacercaria

This stage penetrates the skin of the host.

355
Q

What is the mode of infection for Schistosomes?

A

Skin penetration, not by ingestion

356
Q

What are Schistosomes commonly referred to as?

A

Blood flukes

357
Q

What is the definitive host for Schistosoma species?

A

Man

358
Q

Where does Schistosoma haematobium typically reside in the body?

A

Vesical and pelvic plexus of veins

359
Q

What disease is associated with Schistosoma haematobium infection?

A

Jary bilharziasis or Schistosomiasis

360
Q

Where does Schistosoma mansoni inhabit in the human body?

A

Inferior mesenteric plexus of veins

361
Q

What is the disease caused by Schistosoma mansoni?

A

Intestinal bilharziasis

362
Q

Where does Schistosoma japonicum typically reside?

A

Superior and inferior mesenteric plexus of veins

363
Q

What are the reservoir hosts for Schistosoma mansoni?

A

Rodents and monkeys

364
Q

What is the reservoir host for Schistosoma japonicum?

A

Domestic animals

365
Q

Fill in the blank: The adult flukes of Schistosomes live in the _______.

A

blood vessels of man

366
Q

True or False: Schistosoma haematobium has a redia stage inside the snail.

A

False

367
Q

What are the sexes of helminths?

A

Separate

368
Q

Describe the morphology of the adult female helminth.

A

Cylindrical

369
Q

Describe the morphology of the adult male helminth.

A

Flattened, folded (gynaecophoric canal)

370
Q

What types of suckers do adult helminths have?

A

Oral & ventral (smaller in females)

371
Q

What is notable about the digestive system of adult helminths?

A

No muscular pharynx; intestinal caeca reunite in a single caecum

372
Q

What are the dimensions of S. haematobium?

A

20x0.2 mm

373
Q

Where is the ovary located in S. haematobium?

A

Post 1/3

374
Q

What is the size and shape of S. mansoni eggs?

A

14x0.15 mm, oval

375
Q

Where is the ovary located in S. mansoni?

A

Anterior 1/3

376
Q

What is the size and shape of S. japonicum eggs?

A

26x0.3 mm, ovoid

377
Q

What is the ovary position in S. japonicum?

A

In the middle

378
Q

How do S. haematobium eggs appear in urine?

A

140x60 μm, oval with terminal spine

379
Q

How do S. mansoni eggs appear in stool?

A

150x60 μm, oval with lateral spine, translucent, non-operculated

380
Q

What is the size and shape of mature S. japonicum eggs?

A

85x65 μm, ovoid with minute knob

381
Q

What is the size and configuration of testes in S. haematobium?

A

10x1 mm, 3-5 testes in a line, fine tubercles

382
Q

What is the size and configuration of testes in S. mansoni?

A

8x1 mm, 6-9 testes in cluster, coarse tubercles

383
Q

What is the size and configuration of testes in S. japonicum?

A

15x0.5 mm, 6-8 testes in a line, no tubercles

384
Q

What is the infective stage of Schistosoma?

A

Cercaria

Cercaria is characterized by a body and a forked tail with penetration glands.

385
Q

What are the components of cercaria?

A

Body and forked tail

The forked tail includes the tail stem and fork, along with pairs of penetrating glands.

386
Q

What aids in skin penetration by cercaria?

A
  • Proteolytic enzymes
  • Surface tension of drying water
  • Movement of the tail

These factors facilitate the cercaria’s ability to penetrate human skin.

387
Q

Which activities put people at risk of Schistosoma infection?

A

Agricultural, domestic, and recreational activities

These activities expose individuals to infested water.

388
Q

What is secreted by a miracidium in Schistosoma eggs?

A

Soluble egg antigen (SEA)

The SEA is secreted through microtubules on the shell of the eggs.

389
Q

What is the mode of infection for Schistosoma?

A

Skin penetration by cercaria from contaminated water

This occurs primarily through canals.

390
Q

What is the role of proteolytic enzymes in cercaria infection?

A

Aid in skin penetration

These enzymes are secreted by the penetration glands of cercaria.

391
Q

True or False: S. haematobium is associated with Bulinus truncatus.

A

True

S. haematobium uses Bulinus truncatus as its intermediate host.

392
Q

Fill in the blank: The forked cercaria of Schistosoma is composed of a body and a _______.

A

forked tail

The forked tail includes the tail stem and fork.

393
Q

Which snail species is the intermediate host for S. mansoni?

A

Biomphalaria alexandrina

This snail species is crucial for the lifecycle of S. mansoni.

394
Q

Which snail species is the intermediate host for S. japonicum?

A

Oncomelania

This species plays a significant role in the transmission of S. japonicum.

395
Q

What is the infective stage of Schistosoma mansoni?

A

Cercaria

Cercariae are released by snails into water and are free-swimming.

396
Q

What is the mode of infection for Schistosoma species?

A

Penetration of the skin

This occurs when cercariae come into contact with human skin.

397
Q

What is the diagnostic stage of Schistosoma?

A

Egg

Eggs are excreted in urine or feces, depending on the species.

398
Q

What is the first step in the life cycle of Schistosoma mansoni?

A

Miracidia penetrate snails

Miracidia hatch from eggs and infect freshwater snails.

399
Q

List the three intermediate hosts for different Schistosoma species.

A
  • Biomphalaria (S. mansoni)
  • Oncomelania (S. japonicum)
  • Bulinus (S. haematobium)

These snails are crucial for the development of the parasite.

400
Q

What happens to cercariae during penetration?

A

They lose their tails and become schistosomula

This transformation allows them to migrate through the skin.

401
Q

After skin penetration, where do schistosomula migrate next?

A

Subcutaneous venules

They then enter pulmonary circulation and subsequently the heart.

402
Q

What is the path of schistosomula after entering the heart?

A

To the systemic circulation and then to the portal vein

This route leads them to the liver for maturation.

403
Q

What is a key feature of the life cycle of Schistosoma species?

A

Paired adult worms migrate to venous plexus

Adult worms reside in the mesenteric or vesical veins.

404
Q

Fill in the blank: The eggs of Schistosoma hatch releasing _______.

A

miracidia

This process occurs in water, allowing the lifecycle to continue.

405
Q

True or False: The infective stage of Schistosoma mansoni is the cercaria stage.

A

True

Cercariae penetrate the skin to initiate infection.

406
Q

What is the lifespan of schistosomula in the skin before migrating?

A

5-10 hours

During this time, they undergo transformation.

407
Q

What is the first life cycle stage of Schistosoma?

A

Miracidium

The miracidium hatches from an egg and infects the first intermediate host, usually a snail.

408
Q

What organism serves as the intermediate host for Schistosoma?

A

Snail

The snail hosts the larval stages of Schistosoma and plays a crucial role in its life cycle.

409
Q

What happens to Schistosoma eggs in urine?

A

They do not hatch unless diluted with fresh water

This is specific to S. haematobium, which requires specific conditions for egg hatching.

410
Q

What is the route taken by S. mansoni eggs after being laid?

A

They pass through the inferior mesenteric veins to the rectum and then to the external environment with feces

S. mansoni is known for its specific migration pattern through the bloodstream.

411
Q

In which part of the body do adult Schistosoma worms reside?

A

In the blood vessels of the liver and the urogenital system

Adult worms can reside in different locations depending on the species.

412
Q

Fill in the blank: The larval stage that penetrates human skin is called _______.

A

Cercaria

Cercariae are released from the snail and actively penetrate the skin of humans.

413
Q

True or False: Schistosomulae reach systemic circulation after penetrating human skin.

A

True

After penetration, schistosomulae enter the bloodstream and migrate to their habitats.

414
Q

What is the role of the female Schistosoma in the reproductive process?

A

Carried in the gynaecophoric canal of the male

In Schistosoma species, females are often found within the males’ structure, aiding in reproduction.

415
Q

What is the final destination of S. haematobium eggs?

A

Urinary bladder

Eggs are laid in the perivascular tissue and eventually reach the lumen of the urinary bladder.

416
Q

What is the term for the life cycle stage of Schistosoma that develops after cercariae penetrate the skin?

A

Schistosomula

Schistosomulae are the juvenile forms that migrate through the body after entering the host.

417
Q

How do Schistosoma eggs exit the human body?

A

Through urine or stool

The exit method depends on the species of Schistosoma.

418
Q

What is the infective stage of Schistosoma mansoni?

A

Cercaria

Cercariae are released by snails into water and are free-swimming.

419
Q

What is the mode of infection for Schistosoma species?

A

Penetration of the skin

This occurs when cercariae come into contact with human skin.

420
Q

What is the diagnostic stage of Schistosoma?

A

Egg

Eggs are excreted in urine or feces, depending on the species.

421
Q

What is the first step in the life cycle of Schistosoma mansoni?

A

Miracidia penetrate snails

Miracidia hatch from eggs and infect freshwater snails.

422
Q

List the three intermediate hosts for different Schistosoma species.

A
  • Biomphalaria (S. mansoni)
  • Oncomelania (S. japonicum)
  • Bulinus (S. haematobium)

These snails are crucial for the development of the parasite.

423
Q

What happens to cercariae during penetration?

A

They lose their tails and become schistosomula

This transformation allows them to migrate through the skin.

424
Q

After skin penetration, where do schistosomula migrate next?

A

Subcutaneous venules

They then enter pulmonary circulation and subsequently the heart.

425
Q

What is the path of schistosomula after entering the heart?

A

To the systemic circulation and then to the portal vein

This route leads them to the liver for maturation.

426
Q

What is a key feature of the life cycle of Schistosoma species?

A

Paired adult worms migrate to venous plexus

Adult worms reside in the mesenteric or vesical veins.

427
Q

Fill in the blank: The eggs of Schistosoma hatch releasing _______.

A

miracidia

This process occurs in water, allowing the lifecycle to continue.

428
Q

True or False: The infective stage of Schistosoma mansoni is the cercaria stage.

A

True

Cercariae penetrate the skin to initiate infection.

429
Q

What is the lifespan of schistosomula in the skin before migrating?

A

5-10 hours

During this time, they undergo transformation.

430
Q

What is the first life cycle stage of Schistosoma?

A

Miracidium

The miracidium hatches from an egg and infects the first intermediate host, usually a snail.

431
Q

What organism serves as the intermediate host for Schistosoma?

A

Snail

The snail hosts the larval stages of Schistosoma and plays a crucial role in its life cycle.

432
Q

What happens to Schistosoma eggs in urine?

A

They do not hatch unless diluted with fresh water

This is specific to S. haematobium, which requires specific conditions for egg hatching.

433
Q

What is the route taken by S. mansoni eggs after being laid?

A

They pass through the inferior mesenteric veins to the rectum and then to the external environment with feces

S. mansoni is known for its specific migration pattern through the bloodstream.

434
Q

In which part of the body do adult Schistosoma worms reside?

A

In the blood vessels of the liver and the urogenital system

Adult worms can reside in different locations depending on the species.

435
Q

Fill in the blank: The larval stage that penetrates human skin is called _______.

A

Cercaria

Cercariae are released from the snail and actively penetrate the skin of humans.

436
Q

True or False: Schistosomulae reach systemic circulation after penetrating human skin.

A

True

After penetration, schistosomulae enter the bloodstream and migrate to their habitats.

437
Q

What is the role of the female Schistosoma in the reproductive process?

A

Carried in the gynaecophoric canal of the male

In Schistosoma species, females are often found within the males’ structure, aiding in reproduction.

438
Q

What is the final destination of S. haematobium eggs?

A

Urinary bladder

Eggs are laid in the perivascular tissue and eventually reach the lumen of the urinary bladder.

439
Q

What is the term for the life cycle stage of Schistosoma that develops after cercariae penetrate the skin?

A

Schistosomula

Schistosomulae are the juvenile forms that migrate through the body after entering the host.

440
Q

How do Schistosoma eggs exit the human body?

A

Through urine or stool

The exit method depends on the species of Schistosoma.

441
Q

What occurs during the stage of invasion in schistosomiasis haematobium?

A

Cercarial dermatitis occurs

This stage is characterized by skin irritation due to cercariae penetration.

442
Q

What are the clinical manifestations during the stage of migration in schistosomiasis haematobium?

A

Lung: verminous pneumonitis, cough, sputum & haemoptysis; Liver & spleen: hepatosplenomegaly; Toxic & allergic manifestations: fever, headache, muscle pain, eosinophilia

These symptoms arise from the migration of the schistosoma larvae through various organs.

443
Q

What is bilharzial corpulmonale?

A

Common in schistosomiasis haematobium; Granuloma formation around eggs and fibrosis; Obliteration of pulmonary arterioles leading to pulmonary hypertension

This condition can result in right ventricular hypertrophy and right-sided heart failure.

444
Q

What are the effects of egg deposition in schistosomiasis haematobium?

A

Acute stage = open lesion; Terminal haematuria; Polyuria, urgency, and frequency of micturition

These symptoms are due to injury of venules by egg spines during bladder contraction.

445
Q

What complications arise during the chronic stage of schistosomiasis haematobium?

A

Kidney: hydronephrosis, pyonephrosis, renal failure; Ureter: stricture and hydroureter; Bladder: polyp, ulcer, sandy patches, calcification, cancer; Urethra: fistula and stricture; Genital organs: pseudoelephantiasis of penis, granuloma in prostate, seminal vesicle, ovary, uterus

These complications result from long-term inflammation and damage caused by schistosoma eggs.

446
Q

True or False: The stage of egg deposition in schistosomiasis haematobium is associated with chronic complications.

A

True

This stage leads to various complications due to ongoing inflammation and damage.

447
Q

Fill in the blank: During the stage of migration in schistosomiasis haematobium, the liver and spleen show _______.

A

hepatosplenomegaly

This enlargement is a response to the parasitic infection.

448
Q

What leads to right-sided heart failure in schistosomiasis haematobium?

A

Pulmonary hypertension caused by granuloma formation and obliteration of pulmonary arterioles

This condition is a consequence of the migration of schistosoma eggs to the lungs.

449
Q

What is a key symptom of the acute stage of egg deposition in schistosomiasis haematobium?

A

Terminal haematuria

This occurs due to injury to bladder venules by egg spines.

450
Q

What are the clinical manifestations of Schistosomiasis haematobium in endemic areas?

A

Haematuria, dysuria, urgency, and frequency

These symptoms indicate irritation and inflammation of the urinary tract.

451
Q

In mild cases of Schistosomiasis haematobium, how is haematuria manifested?

A

Haematuria manifested after muscular activity

This can occur due to increased pressure on the bladder.

452
Q

What is a symptom of seminal vesicle infection in Schistosomiasis haematobium?

A

Blood in seminal fluid

This indicates that the infection may have spread to the reproductive system.

453
Q

Which diagnostic technique can remain positive for a period after treatment of Schistosomiasis haematobium?

A

Indirect haemagglutination test (IHAT)

This test detects antibodies rather than eggs.

454
Q

What is the purpose of using radiology in diagnosing Schistosomiasis haematobium?

A

To detect bladder and ureteral changes

Techniques like X-ray and ultrasonography are used.

455
Q

What are the advantages of ultrasonography in diagnosing urinary conditions?

A

Non-invasive, simple, portable, and no biological hazards

It can help in grading hydronephrosis and identifying bladder wall lesions.

456
Q

What is the first step in diagnosing Schistosomiasis haematobium in acute cases?

A

Examination of the last drop of urine for detection of eggs

This is effective when eggs are easily detectable.

457
Q

What is the method used to detect eggs in chronic cases of Schistosomiasis haematobium?

A

Biopsy from mucosa of urinary bladder

This helps in identifying eggs and histopathological lesions.

458
Q

What is the primary treatment for Schistosomiasis haematobium?

A

Praziquantel

The recommended dose is 40 mg/kg body weight, administered once orally.

459
Q

What is the dosage and administration method for Merazide in treating Schistosomiasis?

A

Two 300 mg capsules taken one hour before breakfast for 3 successive days

Merazide is derived from the Commiphora plant.

460
Q

What type of treatment may be necessary for irreversible lesions caused by Schistosomiasis haematobium?

A

Surgical treatment

This may be required when other treatments are ineffective.

461
Q

Fill in the blank: The positive result of chemical reagent strips for haematuria indicates _______.

A

active infection in endemic areas

This is a crucial indicator for further diagnosis.

462
Q

What endoscopic procedures are done for diagnosing Schistosomiasis?

A

Cystoscopy for S. haematobium; Colonoscopy and Sigmoidoscopy for S. mansoni

These procedures help detect lesions and allow for biopsy.

463
Q

What is the initial stage of Schistosomiasis mansoni invasion?

A

Stages of invasion and migration are similar to S. haematobium.

This includes the stages of egg deposition and subsequent tissue changes.

464
Q

What occurs during the acute stage of Schistosomiasis mansoni?

A

Egg deposition in pelvic colon and rectum leading to erosion of mucosa and inflammation.

This stage is characterized by open lesions due to egg deposition.

465
Q

What are the long-term effects of chronic Schistosomiasis mansoni?

A

Tissue fibrosis leading to sandy patches, bilharzial nodules, polyps, strictures, fistulas, and rectal prolapse.

These changes result from eggs trapped in the wall.

466
Q

What are the clinical manifestations during the acute intestinal phase of Schistosomiasis mansoni?

A

Dysentery, colic, fever, anorexia, and weight loss.

Dysentery is characterized by the passage of stool with mucus and blood.

467
Q

What are the chronic irreversible effects of Schistosomiasis mansoni?

A

Abdominal pain, diarrhea, dysentery, intestinal polyposis, and hypertrophic osteoarthropathy.

Severe bloody dysentery can lead to protein and weight loss.

468
Q

What is Symmer’s fibrosis in the context of Schistosomiasis mansoni?

A

Granuloma formation around eggs leading to hepatic periportal fibrosis and portal hypertension.

This condition results in open portosystemic anastomosis and esophageal varices.

469
Q

What happens when portal pressure exceeds systemic pressure in Schistosomiasis mansoni?

A

Eggs pass to blood to the lungs, leading to bilharzial corpulmonale.

This complication arises from the migration of eggs into pulmonary circulation.

470
Q

What are the signs of hepatosplenic schistosomiasis?

A

Early firm enlargement of the liver with or without splenomegaly, portal hypertension, ascites, hematemesis, and bleeding esophageal varices.

The liver may become distended up to 1-2 cm in diameter due to these complications.

471
Q

True or False: Melena in Schistosomiasis mansoni is due to the rupture of veins in the rectum.

A

True.

Melena refers to black, tarry stools indicative of gastrointestinal bleeding.

472
Q

What is the direct method for laboratory diagnosis of Schistosomiasis mansoni?

A

Stool examination by direct smear method or by concentration method

Includes Kato thick faecal smear for egg counting, rectal mucosa biopsy, and rectal swab.

473
Q

What is the purpose of Kato thick faecal smear in diagnosing Schistosomiasis mansoni?

A

Egg counting to assess the intensity of infection

This method helps determine the severity of the infection.

474
Q

What are the indirect methods of diagnosing Schistosomiasis mansoni?

A

Similar to S. haematobium

Specific indirect methods were not detailed in the provided content.

475
Q

What blood examination findings are associated with Schistosomiasis mansoni?

A

Anaemia due to:
* Blood loss resulting in iron deficiency anaemia
* Hypersplenism leading to pancytopenia
* Liver cell failure causing prolonged prothrombin time with bleeding

These conditions reflect the systemic impact of the infection.

476
Q

List personal prophylaxis measures for Schistosomiasis mansoni.

A
  • Wearing of boots and gloves
  • Use of repellants
  • Mass treatment

Personal measures are crucial for reducing infection risk.

477
Q

What are environmental sanitation measures for preventing Schistosomiasis mansoni?

A
  • Clean water supply
  • Sanitary latrines
  • Proper sewage disposal
  • Construction of canals away from villages

Sanitation plays a key role in controlling the spread of the disease.

478
Q

What treatment is specifically used for Schistosomiasis mansoni?

A

Oxamniquine (vancil) for S.m.

Administered at 10-15 mg/kg orally, in two doses per day with 8-hour intervals.

479
Q

What is the nature of Schistosomiasis as a disease?

A

It is a preventable disease but non-curative once complications occur

Health education is essential for prevention.

480
Q

What health education measures are recommended to prevent Schistosomiasis mansoni?

A
  • Avoid urination or defecation in water canal
  • Avoid washing or swimming in water canal
  • Rapid drying of wet skin to prevent cercarial penetration

These practices help minimize exposure to the infectious agents.

481
Q

What are the physical methods for snail control in preventing Schistosomiasis mansoni?

A
  • Dryness of canals
  • Clearance of weeds to prevent feeding of snails
  • Wine screens at inlets of canals to collect snails

Reducing snail populations is crucial in breaking the lifecycle of the parasite.

482
Q

What biological method is mentioned for controlling snails?

A
  • Toxic plants to snails (e.g., Balanites aegyptiaca)
  • Natural enemies to snails (e.g., ducks, birds, Marisa spp.)

Utilizing natural predators and toxic plants can help manage snail populations.

483
Q

What are the characteristics of an ideal molluscicide for snail control?

A
  • Cheap
  • Easy to apply
  • Effective in low concentration with residual effect
  • Non-toxic to man, animals, fishes, and plants

These criteria are essential for safe and effective use.

484
Q

What is Bayluscide used for in the context of Schistosomiasis mansoni?

A

A molluscicide that kills snails, their eggs, miracidia, and cercariae at 2 p.p.m.

Effective in controlling the snail population that harbors the schistosome larvae.

485
Q

What is portal hypertension?

A

Increased blood pressure in the portal venous system

Often associated with liver disease and can lead to complications such as varices.

486
Q

What are the signs of hypersplenism?

A
  • Moderate anemia
  • Neutropenia
  • Thrombocytopenia

Hypersplenism is a condition where the spleen is overactive, leading to the destruction of blood cells.

487
Q

What are the metabolic products associated with schistosomiasis?

A

Toxic and allergic manifestations such as:
* Urticaria
* Fever
* Headache
* Muscle pain

These symptoms arise from the body’s reaction to the parasites and their eggs.

488
Q

What is verminous pneumonitis?

A

A lung condition caused by parasitic infections, leading to symptoms like cough and hemoptysis

It includes inflammation of the lungs due to the presence of the parasites.

489
Q

What characterizes the first stage of schistosomiasis?

A

Stage of invasion (1-4 days)

This initial stage involves the penetration of cercariae into the host.

490
Q

What occurs during the acute stage of schistosomiasis?

A

Stage of egg deposition and extrusion (1-2 months)

This stage involves the deposition of eggs in the venous plexus, causing various symptoms.

491
Q

What are common symptoms during the acute stage of schistosomiasis?

A
  • Generalized malaise
  • Fever
  • Rigors
  • Urticaria
  • Abdominal pain
  • Liver tenderness

These symptoms result from the body’s immune response to the eggs and other metabolic products.

492
Q

What is the primary cause of papules in schistosomiasis?

A

The penetration of cercariae

This leads to local dermatitis and irritation.

493
Q

Fill in the blank: The stage of egg deposition and extrusion occurs during _____ weeks.

A

1-2 months

494
Q

True or False: Schistosomiasis can cause liver enlargement and tenderness.

A

True

This is a common manifestation due to the immune response to the parasite.

495
Q

What syndrome is caused by a large number of eggs and proximity to the liver in S. japonicum infection?

A

Katayama Syndrome

Also called acute toxoemic schistosomiasis, characterized by fever, chills, diarrhea, and generalized lymphadenopathy.

496
Q

What are the main symptoms of Katayama Syndrome?

A
  • Fever
  • Chills
  • Diarrhea
  • Generalized lymphadenopathy

These symptoms result from the immune response to schistosome antigens in the bloodstream.

497
Q

What occurs in the chronic stage of schistosomiasis?

A

Tissue reaction around deposited Schistosoma eggs

Involves granuloma formation and delayed-type hypersensitivity.

498
Q

What type of hypersensitivity is involved in S. mansoni infection?

A

Delayed-type hypersensitivity

This immune response is associated with tissue damage and granuloma formation around eggs.

499
Q

What are the three factors that lead to egg extrusion from veins in S. haematobium infection?

A
  • Pressure within the venule
  • Effect of the spine
  • Oozing lytic secretion of the miracidium

These factors contribute to the eggs escaping into perivascular tissue.

500
Q

What are the symptoms of S. haematobium infection related to the bladder?

A
  • Terminal hematuria
  • Frequency of micturition
  • Burning pain

These symptoms are due to egg extrusion and tissue damage in the bladder wall.

501
Q

What is the primary complication of S. mansoni infection affecting the intestinal wall?

A

Dysentery with blood and mucus in stool

This occurs due to egg extrusion and subsequent tissue damage in the intestinal wall.

502
Q

What pathological changes occur in the affected organ due to schistosomiasis?

A
  • Granuloma development
  • Attraction of inflammatory cells
  • Deposition of fibrous tissue
  • Damage and fibrosis of the organ

These changes can lead to loss of organ function over time.

503
Q

What complications may arise from egg trapping in the bladder wall due to S. haematobium infection?

A
  • Hydronephrosis
  • Hydroureter
  • Stone formation
  • Cancer of the bladder

Long-term complications can arise from chronic inflammation and tissue damage.

504
Q

What is the term for tissue damage caused by the immune response to Schistosoma eggs?

A

Granuloma formation

This occurs in various tissues where the eggs are deposited.

505
Q

Fill in the blank: The inflammatory response to schistosome antigens leads to _______.

A

Tissue damage

This damage is due to the immune complexes circulating in the bloodstream.

506
Q

What is the chronic stage of tissue reaction in Schistosoma haematobium infection?

A

Eggs fail to fix to venule wall and are swept by blood. Eggs trapped in bladder wall are extruded in urine, causing embolic lesions.

507
Q

What are the effects of eggs trapped in the bladder wall in Schistosoma haematobium infection?

A

Causes embolic lesions in the liver.

508
Q

What happens to eggs in Schistosoma mansoni infection?

A

Eggs fail to fix to venule wall and are swept by blood. Eggs trapped in intestinal wall are extruded in stool, causing embolic lesions.

509
Q

What are the consequences of eggs trapped in the intestinal wall in Schistosoma mansoni infection?

A

Causes portal hypertension and embolic lesions in the lung.

510
Q

What is Cor-pulmonale?

A

Right-sided heart failure due to enlargement of the right ventricle from high blood pressure in the arteries of the lung.

511
Q

What are the diagnostic signs of Schistosomiasis?

A

Hepatosplenomegaly, portal hypertension, oesophageal varices, ascites.

512
Q

What is the clinical history suggestive of Schistosomiasis?

A

History of contact with infected water.

513
Q

What laboratory tests are used to diagnose Schistosomiasis?

A

Detection of eggs in urine or stool, blood examination, serological tests.

514
Q

What radiological imaging techniques are used for diagnosing Schistosomiasis?

A

Endoscopy.

515
Q

Fill in the blank: In Schistosoma infection, eggs trapped in the bladder wall can lead to _______.

A

embolic lesions.

516
Q

True or False: Schistosomiasis can cause pulmonary hypertension.

A

True.

517
Q

What is the effect of trapped eggs in the right ventricle in normal conditions?

A

Enlarged right ventricle.

518
Q

What is a significant complication of Schistosoma mansoni infection?

A

Bilharzial cor-pulmonale.

519
Q

What are direct parasitological methods used for in laboratory diagnosis?

A

Detection of eggs in urine and stool

Specifically, for S. mansoni and S. haematobium

520
Q

What is the Kato thick faecal smear used for?

A

Egg counting to assess the intensity of infection

It is a direct method for detecting parasitic eggs.

521
Q

What are the two types of anaemia associated with schistosomiasis?

A
  • Iron deficiency anaemia
  • Haemolytic anaemia
  • Eosinophilia
  • Leucocytosis

Anaemia can result from egg extrusion and hypersplenism.

522
Q

What serological tests are used for diagnosing schistosomiasis?

A
  • IHAT (Indirect Haemagglutination test)
  • ELISA (Enzyme-linked immunosorbent assay)
  • IFAT (Indirect Fluorescent Antibody test)

These tests detect anti-Schistosoma antibodies or antigens in patient serum.

523
Q

What is the role of the Indirect Haemagglutination test (IHAT) in schistosomiasis diagnosis?

A

Detection of anti-Schistosoma antibodies using sensitized sheep RBCs

This test is a serological method for diagnosis.

524
Q

Fill in the blank: The __________ assay is a serological test that uses enzyme-linked antibodies to detect anti-Schistosoma antibodies.

A

[ELISA]

525
Q

What are the radiological imaging findings associated with Schistosomiasis haematobium?

A
  • Calcified bladder
  • Hydroureter
  • Stenosed ureters
  • Hydronephrosis

These findings help in the diagnosis of the disease.

526
Q

True or False: Eosinophilia is a common laboratory finding in schistosomiasis.

A

True

527
Q

What is the significance of detecting anti-Schistosoma antibodies in a patient’s serum?

A

It indicates exposure to schistosomiasis

This is part of the immunodiagnostic tests.

528
Q

What is the shape and color of S. haematobium eggs?

A

Terminal spine, oval, thin shell, translucent

These characteristics are important for identification.

529
Q

What can direct parasitological methods detect?

A
  • S. mansoni eggs in stool
  • S. haematobium eggs in urine

These methods are crucial for confirming schistosomiasis infection.

530
Q

What does hypersplenism lead to in the context of schistosomiasis?

A

Haemolytic anaemia

This condition is a result of increased destruction of red blood cells.

531
Q

What is the typical onset of chronic manifestations in schistosomiasis?

A

Insidious onset

Chronic manifestations of schistosomiasis generally develop slowly over time.

532
Q

Which schistosome species cause intestinal tract and liver disease?

A
  • S. mansoni
  • S. mekongi
  • S. intercalatum
  • S. japonicum

These species are known to impact the intestinal and liver systems.

533
Q

Which schistosome species is associated with urinary tract disease?

A

S. hematobium

S. hematobium primarily affects the urinary tract rather than the intestinal or liver systems.

534
Q

What is the treatment of choice for all schistosome species?

A

Praziquantel (Biltricide)

Praziquantel is recommended by the WHO for treating schistosomiasis.

535
Q

What is the recommended dosage of Praziquantel for schistosomiasis?

A

40 mg/kg single oral dose

This dosage is effective for all schistosome species.

536
Q

What are some side effects of Praziquantel?

A
  • Slight abdominal discomfort
  • Nausea
  • Headache
  • Slight drowsiness

These side effects are generally mild and transient.

537
Q

What is the dosage of Oxamniquine for S. mansoni?

A

30 mg/kg for 2 days

Oxamniquine is specifically used for treating S. mansoni.

538
Q

What is the treatment protocol for S. haematobium?

A

Metriphonate: 10 mg/kg every 2 weeks for 3 doses

Metriphonate is used specifically for S. haematobium but is facing resistance issues.

539
Q

Why is Metriphonate not recommended by the WHO?

A

Due to recent widespread resistance

Resistance to Metriphonate has led to its lack of recommendation for use.

540
Q

What is a significant concern regarding antischistosomal drugs?

A

They are mutagenic and potentially carcinogenic

Antischistosomal drugs pose risks and are not recommended for use during pregnancy.

541
Q

What is the primary method for preventing and controlling schistosomiasis?

A

Mass treatment and follow up of infected persons

This method is crucial for reducing transmission rates.

542
Q

List two protective measures against schistosomiasis.

A
  • Health education
  • Pure water supply

These measures help reduce exposure to contaminated water.

543
Q

What personal prophylaxis can be taken for individuals exposed to schistosomiasis?

A
  • Wearing boots and gloves
  • Quick drying of exposed skin
  • Application of alcoholic preparations

These actions help minimize the risk of cercarial penetration.

544
Q

Name one chemical method used to control snails in schistosomiasis prevention.

A

Copper sulphate 10 - 20 parts per million

Copper sulphate is an effective molluscicide.

545
Q

What is the Kato technique used to diagnose?

A

Schistosomiasis mansoni

The Kato technique is a fecal examination method used specifically for this diagnosis.

546
Q

What syndrome occurs most frequently in S. haematobium infection?

A

Katayama syndrome

This syndrome is associated with acute schistosomiasis.

547
Q

What is the major cause of morbidity in schistosomiasis?

A

Deposition of eggs in tissues

This leads to inflammatory responses and damage to organs.

548
Q

True or False: Swimmer’s itch occurs frequently with non-human schistosomes.

A

True

Swimmer’s itch is typically associated with cercariae from non-human schistosomes.

549
Q

Fill in the blank: Personal prophylaxis includes the use of _______ to prevent cercarial penetration.

A

repellants

Common repellants include dimethyl or dibutyl phthalate.

550
Q

What are two biological methods of snail control?

A
  • Introduction of natural predators (ducks, birds)
  • Plantation of toxic plants (Balanites Aegyptiaca)

These methods help reduce snail populations without harmful chemicals.

551
Q

What is one physical method for controlling snails in water canals?

A

Clearing canals from weeds

This deprives snails of food sources.

552
Q

Which schistosome species is most frequently associated with Katayama syndrome?

A

S. japonicum

While S. haematobium is also noted, S. japonicum has a significant association.

553
Q

What is a common treatment concentration for sodium pentachlorophenate in molluscicides?

A

5 - 10 parts per million

This concentration is effective for controlling snail populations.

554
Q

Name one environmental modification method used to make habitats unsuitable for snails.

A

Increasing the velocity of water by increasing slopes of canals

This can disrupt the snail’s breeding and feeding patterns.

555
Q

Fill in the blank: The use of _______ to prevent cercarial penetration includes quick drying of exposed skin.

A

alcoholic preparations

These preparations help protect against skin penetration by cercariae.

556
Q

What are the two orders into which tapeworms can be classified?

A

Pseudophyllidea and Cyclophyllidea

557
Q

What are the three main parts of an adult tapeworm?

A
  • Head (Scolex)
  • Neck
  • Proglottids (strobila, segments)
558
Q

What is the function of the scolex in tapeworms?

A

Organ of attachment to the intestinal mucosa of the definitive host

559
Q

What structural feature do Cyclophyllidea tapeworms possess on their scolex?

A

4 cup-shaped suckers

560
Q

What is the apical protrusion found in some Cyclophyllidea like Taenia solium called?

A

Rosellum

561
Q

True or False: The rostellum of Cyclophyllidea is always armed with hooks.

A

False

562
Q

How does the scolex of Pseudophyllidea differ from that of Cyclophyllidea?

A

Pseudophyllidea scolex possesses a pair of longitudinal grooves called bothria instead of suckers

563
Q

What is the role of the neck in a tapeworm?

A

Region of growth, contains stem cells from which new proglottids are formed

564
Q

What types of proglottids are present in the body of a tapeworm?

A
  • Immature
  • Mature
  • Gravid
565
Q

What are the reproductive characteristics of tapeworms?

A

Tapeworms are hermaphrodites; every mature segment contains both male and female reproductive organs.

566
Q

What is observed in the immature segments of tapeworms?

A

The reproductive organs are not well developed.

567
Q

What is contained in the gravid segments of tapeworms?

A

The uterus is filled with eggs.

568
Q

Do tapeworms have a body cavity or alimentary canal?

A

No, tapeworms do not have a body cavity or alimentary canal.

569
Q

How do tapeworms absorb nutrients?

A

Nutrients are absorbed via the cuticle.

570
Q

What type of systems do tapeworms possess?

A

Rudimentary excretory and nervous systems.

571
Q

What is the embryo inside the egg of Cyclophyllidea called?

A

Oncosphere (hexacanth embryo).

572
Q

What are the characteristics of the oncosphere in Cyclophyllidea?

A

It is spherical and has 3 pairs of hooklets.

573
Q

How is the egg of Pseudophyllidea characterized?

A

The egg is operculated.

574
Q

What type of clinical disease can be caused by tapeworms?

A

The adult worm can cause mild disease or be asymptomatic, while the larval form can produce serious illness.

575
Q

What are potential complications when larvae of tapeworms lodge in the CNS or eyes?

A

Serious illness and complications.

576
Q

Fill in the blank: The eggs of Cyclophyllidea and Pseudophyllidea are ________ from each other.

A

different

577
Q

True or False: Tapeworms have a fully developed digestive system.

A

False

578
Q

What is the classification order of Diphyllobothrium latum?

A

Pseudophyllidea

Diphyllobothrium latum is categorized under the order Pseudophyllidea.

579
Q

What is the habitat of the adult Diphyllobothrium latum in humans?

A

Small intestine

The adult worm resides in the small intestine of humans.

580
Q

What type of larva does Diphyllobothrium latum have in humans?

A

Plerocercoid larva

The Plerocercoid larva can be found in subcutaneous tissues and other organs.

581
Q

What are the two main classifications of tapeworms according to their habitat?

A

Cylophyllidea and Pseudophyllidea

These classifications distinguish between different types of tapeworms based on their habitat.

582
Q

Name one tapeworm from the Cyclophyllidea order.

A

Taenia saginata

Other examples include Taenia solium, Hymenolepis nana, and H. diminuta.

583
Q

What is the primary habitat of Taenia saginata?

A

Small intestine

This tapeworm primarily inhabits the small intestine of humans.

584
Q

What disease is caused by Diphyllobothrium latum?

A

Diphyllobothriasis

This disease is also known as fish tapeworm infection.

585
Q

Where is Diphyllobothrium latum commonly distributed?

A

Central and Northern Europe, Siberia, Japan, North America, Central Africa

It is notably absent in Yemen.

586
Q

What is the reservoir host for Diphyllobothrium latum?

A

Dogs, cats, and many wild animals

These animals can harbor the tapeworm and contribute to its lifecycle.

587
Q

Fill in the blank: Man acts as the ______ for Taenia saginata.

A

D.H. (Definitive Host)

In this context, ‘man’ harbors the adult stage of the worm in the intestine.

588
Q

What type of larva does the Echinococcus granulosus form in humans?

A

Hydatid cyst

These cysts are most commonly found in the liver, followed by the lungs and other organs.

589
Q

True or False: Man can act as both D.H. and I.H. for Taenia solium.

A

True

Man can harbor the adult stage in the intestine and the larval stage in tissues.

590
Q

What is the larval stage of Taenia solium called?

A

Cysticercus cellulosae

This larval form can be found in human tissues.

591
Q

What is the largest tapeworm inhabiting the small intestine of humans?

A

D. latum

D. latum is also known as Diphyllobothrium latum.

592
Q

What is the maximum size of the adult D. latum?

A

Up to 10 m or more

Adult D. latum can grow significantly in length.

593
Q

Describe the scolex of D. latum.

A

Spatulate or spoon-shaped, about 2-3 mm long and 1 mm broad

The scolex has 2 slitlike longitudinal dorsoventral sucking grooves called bothria.

594
Q

What is the morphology of the neck of D. latum?

A

Thin and unsegmented

The neck connects the scolex to the strobila.

595
Q

How many proglottids does the strobila of D. latum consist of?

A

3000-4000 proglottids

The strobila is the body of the tapeworm composed of numerous segments.

596
Q

What are the dimensions of D. latum eggs?

A

About 65 X 45 µm

The eggs are operculated at one end and have a thick shell.

597
Q

Describe the shape and color of D. latum eggs.

A

Ovoid and yellowish brown

The eggs contain immature ova and are passed in feces.

598
Q

What is unique about the mature segment of D. latum?

A

Broader than long

This characteristic differentiates it from other tapeworms like Taenia.

599
Q

Where are the testes located in the D. latum adult?

A

Distributed in the dorsolateral part

The distribution of reproductive organs is crucial for understanding tapeworm biology.

600
Q

What shape is the uterus of D. latum?

A

Rosette shaped, convoluted tube

The uterus opens via the uterine pore located mid-ventrally.

601
Q

What are the three stages of larval development in D. latum?

A
  • First stage embryo or larva (coracidium)
  • Second stage larva (procercoid)
  • Third stage larva (plerocercoid)

Each larval stage has distinct morphological characteristics.

602
Q

What is the characteristic of the coracidium stage?

A

Ciliated stage

The coracidium is the first stage of larval development.

603
Q

Describe the procercoid larva of D. latum.

A

Elongated, solid with spherical caudal end including 6 hooks

The procercoid is the second larval stage.

604
Q

What features characterize the plerocercoid larva?

A

Elongated, with an anterior invaginated scolex

The plerocercoid is the third and final larval stage before maturation.

605
Q

What is the first step in the life cycle of D. latum?

A

Unembryonated eggs are passed in faeces of infected human

This initiates the cycle of infection for D. latum.

606
Q

What happens after the eggs of D. latum embryonate?

A

Eggs embryonate in water

This is crucial for the development of the larvae.

607
Q

Which organism ingests the coracidia that hatch from D. latum eggs?

A

Crustaceans (Cyclops)

Coracidia are the first larval stage of D. latum.

608
Q

What develops in the body cavity of crustaceans after they ingest coracidia?

A

Procercoid larvae

This stage is essential for further transmission of D. latum.

609
Q

How do procercoid larvae become plerocercoid larvae?

A

Infected crustaceans are ingested by small freshwater fish

This is a key transition in the life cycle.

610
Q

What is the infective stage of D. latum for humans?

A

Plerocercoid larva

Humans become infected by consuming undercooked or raw fish.

611
Q

How does a human acquire D. latum infection?

A

Ingesting undercooked or raw infected fish containing plerocercoid larvae

This leads to the attachment of the larvae to the intestinal wall.

612
Q

In what time frame does the plerocercoid larva mature in the human intestine?

A

3-5 months

This duration is necessary for the larva to reach maturity.

613
Q

Where do adult D. latum develop in humans?

A

In the small intestine

This is where they continue their life cycle.

614
Q

What do proglottids release after maturing in humans?

A

Immature eggs

These are passed in human faeces, continuing the cycle.

615
Q

What is the mode of infection for D. latum?

A

Ingestion of undercooked/raw infected fish

This is the primary way humans contract the infection.

616
Q

What are the two stages identified in the D. latum life cycle?

A

Infective Stage: plerocercoid larva, Diagnostic Stage: eggs

These stages are crucial for understanding the infection process.

Parasitology (5 decks)

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