04 - Parasitology Flashcards

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1
Q

Term: presence of an endoparasite in host

A

infection

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2
Q

Term: presence of an ectoparasite in host

A

infestation

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3
Q

Type of parasite that needs a host at some stage of life cycle to complete development and propagation.

A

Obligate parasite

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4
Q

Type of parasite that may exist in a free-living state but becomes parasitic when the need arises

A

Facultative parasite

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5
Q

This is a type of parasite that can establish itself in a host where it does not ordinarily live in.

A

Accidental or Incidental parasite

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6
Q

Type of parasite which successfully invades a host but merely passes through the GI tract without colonizing it.

A

Spurious parasite

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7
Q

Type of host in which the parasite attains sexual maturity.

A

Definitive (or Final) host

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8
Q

Type of host which only harbors the asexual or larval stage.

A

Intermediate host

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9
Q

Type of host in which the parasite does not develop further into later stage.

A

Paratenic host

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10
Q

Type of host in which the life cycle of the parasite is allowed to continue and which become additional sources of human infection

A

Reservoir host

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11
Q

What are vectors?

2 types of vectors, and describe.

A

Vectors transmit parasites from one host to another.

  1. Biologic vector - transmits a parasite only after it has completed its development (thus, also a host)
  2. Mechanical (or Phoretic) vector - only transports the parasite
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12
Q

Term: infection wherein an infected individual is further infected with the same species, leading to massive infection

A

Hyperinfection, a.k.a. Superinfection

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13
Q

What is the cause/origin of congenital toxoplasmosis?

A

Exposure of mother to cats during pregnancy

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14
Q

enumerate: virulence factors of Entamoeba histolytica, and their functions

A
  1. lectin - mediates adherence
  2. amebapores - for penetration
  3. cysteine proteases - most important virulence factor, which produces ulceration with bleeding
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15
Q

flask-shaped colon ulcers

A

Amebic colitis

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16
Q

anchovy sauce-like aspirate

A

Amebic liver abscess

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17
Q

Identify: most invasive among the Entamoeba genus.

A

Entamoeba histolytica

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18
Q

These amebicides act on organisms in the bowel wall and the liver. Give examples

A
  • Tissue amebicides
  • chloroquine, emetines, metronidazole, tinidazole
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19
Q

These amebicides act only in the lumen of the bowel. Give examples

A

-Luminal amebicides -diloxanide furoate, iodoquinol, paromomycin

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20
Q

Drug of choice for asymptomatic luminal cysts of E. histolytica:

A

Diloxanide furoate

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21
Q

Drug of choice for severe intestinal and extraintestinal amebiasis:

A

Metronidazole

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22
Q

Pathologic effect of Giardia infection:

acute effects

chronic effects

A
  • attach and causes pathologic changes to the intestinal villi (villous flattening, crypt hypertrophy, and disruption of cytoskeleton), causing malabsorption
  • Acute infection: flatulence, abdominal pain, diarrhea
  • Chronic infection: steatorrhea, constipation, weight loss
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23
Q

Treatment of Giardiasis:

A

Metronidazole

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24
Q

How is Giardia lamblia transmitted?

A

Ingestion of food/water from sources contaminated with feces containing cysts

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25
Q

Gold standard for diagnosis of Giardia lamblia

A

direct fluorescent antibody testing

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26
Q

This parasite cause Gay bowel syndrome. Why is this so?

A

Giardia lamblia - high prevalence in homosexuals due to to their oro-anal practices

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27
Q
  • Manifestation of cryptosporidiosis
  • Cryptosporidiosis is life-threatening in what condition: and why?
A
  • self-limited non-bloody diarrhea
  • CD4 < 200, due to autoinfection
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28
Q

Treatment of cryptosporidiosis:

A

Usually self-limiting; DOC is Nitozoxanide, but in HIV patients, treatment with antiretrovirals may help the patient fight the pathogen on his own

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29
Q

Identidy: characterized by foul-smelling, greenish vaginal discharge, accompanied by itching and burning; with a characteristic strawberry cervix; What is the pathogen?

A

Trichomoniasis - cause by Trichomonas vaginalis

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30
Q

The only protozoal form of Trichomonas vaginalis

A

Trophozoite

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31
Q

How is trichomoniasis transmitted?

A

sexual intercourse (ping-pong transmission)

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32
Q

Treatment for trichomoniasis

A

Single dose 2 g oral metronidazole

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33
Q

most important parasitic disease in man

A

Plasmodium

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34
Q

What is the vector for Plasmodium?

A

Anopheles flavirostris minimus (infected female)

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35
Q

Two processes in the asexual life cycle of Plasmodium

A
  • shizogony - occurs inside the RBCs
  • gametogony
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36
Q

Process in the sexual life cycle of Plasmodium. Where does it occur?

A

sporogony - occurs inside the female mosquito (Anopheles flavirostris minimus)

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37
Q

What conditions are said to be protective against Plasmodium infection? (immune to malaria)

A

defects in RBC morphology (G6PD deficiency, sickle cell disease)

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38
Q

Term: recurrence of symptoms after a temporary abatement. Which Plasmodium species exhibit this?

A
  • Recrudescence
  • P. falciparum and P. malariae
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39
Q
  • Term: return of a disease after its apparent cessation.
  • Which Plasmodium species exhibit this?
  • In Plasmodium, how does this happen?
A
  • Relapse
  • P. ovale and P. vivax
  • due to reactivation of hypnozoites
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40
Q

Identify: Plasmodium: intermediate host / definitive host

A

humans / Anopheles flavirostris minimus

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41
Q

Gold standard for diagnosis of Plasmodium:

A

Giemsa stain:

  1. Thick smear - to screen for presence of organisms
  2. Thin smear - to identify the species of the infecting organism
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42
Q
  • Identify: Punctate granulations present in red blood cells that contain hypnozoites.
  • What Plasmodium species causes these changes?
A
  • Schuffner dots
  • Plasmodium ovale and Plasmodium vivax
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43
Q
  • Identify: coarse granulations present in red blood cells.
  • What Plasmodium species causes these changes?
A
  • Maurer dots
  • Plasmodium falciparum
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44
Q
  • Identify: fine dots present in red blood cells.
  • What Plasmodium species causes these changes?
A
  • Ziemann dots
  • Plasmodium malariae

Ziemann is a Fine Man

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45
Q

A severe complication of P. falciparum malaria, characterized by intravascular hemolysis, massive hemoglobinuria, and acute renal failure

A

blackwater fever

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46
Q

A severe form of malaria that is accompanied by septic shock.

A

Algid malaria

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47
Q

Enumerate: Usual symptoms of malaria (5)

A
  • malaise
  • joint pains
  • hemolytic anemia
  • jaundice
  • splenomegaly
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48
Q

Term: These antimalarial drugs kill schizonts in the liver. Give some examples

A
  • Tissue Schizonticides
  • primaquine
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49
Q

Term: These antimalarial drugs kill the parasitic forms only in the RBCs. Give some examples

A
  • Blood schizonticides
  • chloroquine, quinine
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50
Q

Term: These antimalarial drugs kill gametocytes in human blood. Give some examples

A
  • gametocides
  • primaquine
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51
Q

Term: These antimalarial drugs prevent sporogony and multiplication in the mosquito. Give some examples

A
  • sporonticides
  • proguanil, pyrimethamine
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52
Q

Per Plasmodium species, in terms of erythrocyte age, what erythrocytes do they target? (young vs old)

A
  • vivax - young RBCs
  • ovale - young RBCs
  • malariae - old RBCs
  • falciparum - all ages

Vata, oVata, Matanda, Futa

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53
Q

Form of heme that is non-toxic to the Plasmodium cell

A

Hemozoin

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54
Q
  • Definitive host of Toxoplasma gondii
  • DOC
A
  • domestic cat
  • sulfadiazine and pyrimethamine
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55
Q

How is Toxoplasma transmitted?

A
  • ingestion of food/water with fecal oocysts
  • transplacentally
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56
Q

Two types of trophozoites of Toxoplasma

A
  1. Tachyzoites - rapidly multiplying
  2. Bradyzoites - slowly multiplying
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57
Q

Enumerate: signs of Congenital toxoplasmosis

A
  • hydrocephalus
  • encephalitis
  • chorioretinitis
  • hepatosplenomegaly
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58
Q

vector of Trypanosoma cruzi

A

reduviid (Triatoma) bug bite

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59
Q

Tissue that is the most frequently and severely affected by T. cruzi

A

cardiac tissue

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60
Q

What is the Romana sign?

A
  • periorbital edema in acute Chagas disease
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61
Q

What is a chagoma?

A

inflammatory nodule near the bite, in acute Chagas disease

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62
Q

Enumerate: manifestations of chronic Chagas disease:

A
  • myocarditis
  • megacolon
  • megasesophagus (achalasia)
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63
Q

Treatment for Chagas disease

A

Nifurtimox

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64
Q

Causative agent of West African sleeping sickness

A

Trypanosoma brucei gambiense

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65
Q

Causative agent of East African sleeping sickness

A

Trypanosoma brucei rhodesiense

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66
Q

Which is more rapid and fatal, gambian or rhodesian sleeping sickness?

A

Trypanosoma brucei rhodesiense

Rapid Rhodesian! Fatallll

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67
Q
  • spectrum of disease caused by Trypanosoma brucei:
A
  • indurated skin ulcer (trypanosomal chancre)
  • enlargement of posterior cervical LN (winterbottom sign)
  • hyperesthesia (Kerandel sign)
  • encephalitis - Mott cells
  • somnolence
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68
Q

DOC for advanced West African sleeping sickness

A

Eflornithine

WE - PESM

West / East

Pentamidine, Eflornithine / Suramin-Melarsoprol

It SUR is nice to sleep because of MELAtonin -> Suramin-Melarsoprol

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69
Q

DOC for advanced East African sleeping sickness

A

Melarsoprol

WE - PESM

West / East

Pentamidine, Eflornithine / Suramin-Melarsoprol

It SUR is nice to sleep because of MELAtonin -> Suramin-Melarsoprol

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70
Q

DOC for early West African sleeping sickness

A

Pentamidine

WE - PESM

West / East

Pentamidine, Eflornithine / Suramin-Melarsoprol

It SUR is nice to sleep because of MELAtonin -> Suramin-Melarsoprol

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71
Q

DOC for early East African sleeping sickness

A

Suramin

WE - PESM

West / East

Pentamidine, Eflornithine / Suramin-Melarsoprol

It SUR is nice to sleep because of MELAtonin -> Suramin-Melarsoprol

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72
Q

How is African sleeping sickness transmitted?

A

bite of the tsetse fly (Glossina)

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73
Q

Term: T. brucei is able to evade the immune response, causing cyclic fever spikes (every how long?) due to the ability to change its surface coat.

A

Antigenic variation

-every 2 weeks

74
Q

Causative agent of: cutaneous Leishmaniasis

A

Leishmania tropica

CuTaneous - TropiCa

75
Q

Causative agent of: visceral Leishmaniasis

A

Leishmania donovani

donoVani - Visceral

76
Q

Another name for visceral Leishmaniasis

A

Kala-azar

77
Q

Causative agent of: mucocutaneous Leishmaniasis

A

Leishmania braziliensis

78
Q

vector of Leishmania

A

sandfly (Phlebotomus)

79
Q

Treatment for Leishmaniasis:

A

Stibulum gluconate

80
Q

Enumerate: Free-living ameba

A
  1. Acanthamoeba castellani
  2. Naegleria fowleri
81
Q

How is N. fowleri transmitted?

A

by swimming in contaminated pools/ponds

82
Q
  • Identify: the only ciliated protozoans to cause human disease.
  • What disease do they cause?
  • What is the morphology of the ulcer?
A
  • Balantidium coli
  • Balantidial dysentery
  • round-based, wide-necked intestinal ulcers
83
Q

How is Babesia microti transmitted?

A

bite of the Ixodes tick, typically while hunting or wandering in the woods

84
Q
  • morphology of Babesiosis
A
  • Maltese cross - trophozoites in tetrads
85
Q

Identify: the largest protozoan parasite

A

Balantidium coli

86
Q

Gold standard for diagnosis of Babesiosis?

A

PCR

87
Q

Enumerate: Two differential diagnoses for cryptosporidiosis

A
  • Cyclospora cayatanensis
  • Isospora belli
  • they also cause diarrhea in immunocompromised patients
88
Q

most common and largest intestinal nematode

A

Ascaris lumbricoides

89
Q

Enumerate: soil-transmitted helminths

A
  • Ascaris,
  • Hookworms (Ancylostoma and Necator), and
  • Trichuris
  • Enterobius vermicularis
90
Q

Enumerate: Parasites with transpulmonary stages

A
  • Ascaris lumbricoides
  • Ancylostoma duodenale (hookworm)
  • Necator americanus (hookworm)
  • Strongyloides stercoralis
91
Q

enumerate: diagnostic tests for Ascaris lumbricoides (2)

A
  • direct fecal smear
  • Kato-katz technique
92
Q

hypersensitivity pneumonitis (eosinophilia) caused by Ascaris lumbricoides in the lungs

A

Loeffler’s syndrome

93
Q

Enumerate: hookworms

A
  • Necator americanus
  • Ancylostoma duodenale
94
Q

Buccal organ of Necator americanus

A

cutting plate

necator = catting plate

95
Q

Buccal organ of Ancylostoma duodenale

A

teeth

96
Q

Identify: “new world hookworm”

A

Necator americanus

97
Q

Identify: “old world hookworm”

A

Ancylostoma duodenale

98
Q

Diagnostic tests for hookworms:

A

Direct fecal smear

Katokatz technique

99
Q

How much blood is being lost everyday to hookworms?

A

0.25 mL per worm per day

100
Q

This substance produced by the hookworms aids in blood-sucking:

A

Anticoagulant

101
Q

How are hookworms transmitted?

A

Hookworms penetrate throught the skin

102
Q

Serpiginous tracts of hookworms are called:

A

cutaneous larva migrans

103
Q

Common term for Trichuris trichiura:

A

whipworm

104
Q

How to diagnose Trichuris?

A

Direct fecal smear

Katokatz technique

105
Q

Morphology of Trichuris trichiura

A

barrel-shaped eggs with bipolar plugs

106
Q
  • Spectrum of disease in Trichuris infection
A
  • diarrhea
  • rectal prolapse - from increased peristalsis to expel the worms
107
Q

Most common soil-transmitted helminth in developing countries:

A

Enterobius vermicularis

108
Q

Identify: Enterobius vermicularis: intermediate host / definitive host

A

Its life cycle is confined to HUMANS ONLY

109
Q

How to diagnose Enterobius vermicularis? What will you see?

A

Graham scotch tape techinique - D-shaped cells

110
Q

Describe pathogenesis of Enterobius vermicularis:

A

Female worms release thousands of fertilized eggs on perianal skin, causing perianal pruritus -> autoinfection

111
Q
  • spectrium of disease for enterobiasis:
A
  • pruritus ani
  • eosinophilic enterocolitis
  • vulvovaginits
  • appendicitis (Oxyuriasis)
112
Q

Treatment for Enterobius vermicularis

A

Pyrantel palmoate

113
Q

How is Strongyloides stercoralis transmitted?

A

The larvae penetrate the skin.

114
Q

How to diagnose Strongyloides?

A

Harada-Mori culture

115
Q

Infection of Strongyloides on immunicompromised patients results to

A

Hyperinfection

116
Q
  • Spectrum of disease in acute Strongyloides infection:
A
  • ground itch
  • diarrhea
  • eosinophilic pneumonia
117
Q

Term for serpiginous tract of Strongyloides stercoralis:

A

larva currens

118
Q

Spectrum of disease in chronic Strongyloides infection:

A
  • serpiginous tracts
  • duodenitis
  • paradoxical asthma
  • hyperinfection syndrome
119
Q

The only nematode whose life cycle involves a migratory bird:

A

Capillaria philippinensis

120
Q

How is Capillaria philippinensis transmitted?

A

Eating undercooked fish

121
Q
  • How to diagnose Capillaria philippinensis?
  • morphology:
A
  • Direct fecal smear
  • Kato-katz technique
  • peanut-shaped eggs with flattened bipolar plugs
122
Q

Effects of acute infection of Capillaria?

A
  • borboborygmus
  • fever, abdominal pain, eosinophilia
123
Q

Effects of chronic infection of Capillaria?

A
  • severe malabsorption
  • protein-losing enteropathy
  • hypogammaglobulinemia
124
Q
  • Identify: this nematodes is able to cause the human host to have a “gurgling stomach”.
  • What is the term for this symptom?
A
  • Capillaria philippinensis
  • Borborygmus
125
Q

Most debilitating nematode infection:

A

Filiariasis

126
Q

Enumerate: two species of filarial worms

A
  • Wuchererria bancrofti
  • Brugia malayi
127
Q

Usual scenario of filarial infection:

A

-Farmer from abaca plantation

128
Q
  • Which filarial worm is smoothly curved?
  • kinky?
A
  • Wuchereria
  • Brugia
129
Q

Which filarial worm is prevalent only in South East Asia?

A

Brugia

130
Q

Mosquito vector of Wuchereria:

A
  • Aedes
  • Anopheles
  • Culex
131
Q

Mosquito vector of Brugia

A

Mansonia

132
Q

Disease caused by Wuchereria:

A

Hydrocoele

133
Q

Disease caused by Brugia:

A

Elephantiasis

134
Q

Mechanism of transmission of filarial worms:

A

mosquito bite

135
Q

A. Diagnosis of filarial worms:

B. When should blood samples be collected? Why?

A

A.

  • Thick blood smear
  • DEC provocation test, allows collection of blood specimens even at daytime

B. Between 8 PM and 4 AM - due to their nocturnal periodicity

136
Q

Explain the pathogenesis caused by the filarial worms.

A

Adult worms cause inflammation in the lymph nodes and cause obstruction of the lymphatic vessels, causing lymphedema.

137
Q

Morphology of granulomas seen in Filarial infection:

A

Meyers-Kouwenaar bodies

138
Q

Manifestations of chronic filarial infection:

A
  • hydrocoele
  • elephantiasis
  • chyluria
139
Q

What parts of the Philippines experience Bancroftian filariasis?

A

Sorsogon, Samar, Leyte, Palawan

140
Q

What parts of the Philippines experience Malayan filariasis?

A

Eastern Samar

141
Q

DOC for filariasis:

A

diethycarbamazine

142
Q

Identify: Trichinella spiralis: intermediate host / definitive host

A

pigs / humans

143
Q

Mechanism of transmission of Trichinella:

A

consumption of undercooked pork

144
Q

How to diagnose Trichinosis:

A
  • muscle biopsy (Nurse cells)
  • elevated creatine phosphokinase
  • xenodiagnosis
145
Q

Spectrum of disease in trichinosis:

A
  • periorbital edema
  • hemorrhagic phenomena (subconjunctival, splinter)
  • respiratory myositis
146
Q

DOC for trichinella

A

thiabendazole

147
Q

Leading cause of blindness in sub-Saharan Africa (what organism?)

A

Onchocerca volvulus

148
Q

Vector of Onchocerca volvulus:

A

female blackfly (Simulium)

149
Q

Clinical finding in Onchocerciasis:

A

river blindess

150
Q

What causes the Mazotti reaction?

A

inflammatory reaction to the lysis of the worms

151
Q
  • Enumerate the 3 trematodes
  • Sites of affectation
  • intermediate hosts
A
  • Schistosoma japonicum / Paragonimus westermani / Chlonorchis sinensis
  • Liver / lung / liver
  • snail / snail and crab / snail and fish
152
Q

How is paragonimiasis transmitted?

A

Consumption of raw crabs

153
Q

Treatment of choice for trematodes:

A

Praziquantel

154
Q

Common name for Schistosoma japonicum:

A

oriental blood fluke

155
Q

Intermediate host of S. japonicum:

A

Oncomelania snails

156
Q

How is schistosomiasis transmitted?

A

the cercariae penetrate the skin

157
Q

Diagnostic tests for Schistosomiasis (and morphology)

A
  • Katokatz techiniqe
  • Circumoval precipitin test (ovoid egg with small hook - lateral knob)
158
Q

Spectrum of disease in Schistosoma japonicum infection:

A
  • swimmer’s itch
  • Katayama fever
  • chronic liver disease
159
Q

Areas of endimicity of S. japonicum:

A

Leyte, Samar, Sorsogon

160
Q

Another name for Paragonimus westermani:

A

lung fluke

161
Q

Intermediate hosts of Paragonimus westermani:

A
  • snail (Antemelania asperata)
  • mountain crab (Sundathelphusa philippina)
162
Q

Diagnostic test for Paragonimus:

A

3% NaOH preparation

163
Q
  • Spectrum of disease in Paragonimiasis
  • chest X-ray:
A
  • chronic cough with bloody sputum (TB-like)
  • ring-shadowed opacity
164
Q

Two species of Asian Liver flukes:

A
  • Clonorchis sinensis
  • Opistorchis viverrini
165
Q

Intermediate hosts of Clonorchis sinensis:

A
  • snail (Parafossarulus)
  • fish (Cyprinidae)
166
Q

How is Clonorchis sinensis transmitted?

A

consumption of undercooked/raw fish

167
Q

Diagnostic tests for Clonorchis sinensis:

morphology:

A

Direct fecal smear

Potassium permanganate stain (ovoid with melon-like ridges and abopercular protruberance)

168
Q

Serious complication of chronic Clonorchis sinensis infection:

A

cholangiocarcinoma

169
Q

diagnostic stage for Taenia:

A

gravid proglottid

170
Q
  • Cestode that can cause neurocysticercosis:
  • Appearance on CT scan:
A
  • Taenia solium
  • ring-enhancing lesion
171
Q

Manifestations of T. saginatta infestation:

A

pruritus ani and intestinal obstruction

172
Q

DOC for Taenia solium

A

Praziquantel

173
Q

DOC for Taenia saginata

A

Praziquantel

174
Q
  • also known as Fish tapeworm
  • morphology:
A
  • Diphyllobothrium latum
  • sucking grooves and operculated eggs
175
Q

how is Diphyllobothrium latum transmitted?

A

Consumption of undercooked fish

176
Q

Hematologic effect of Diphyllobothrium latum infection:

A

megaloblastic anemia due to vitamin B12 deficiency (absorbed by the tapeworm)

177
Q

DOC for Diphyllobothrium latum:

A

praziquantel

178
Q

Identify: Echinococcus granulosus: intermediate host / definitive host

A

sheep or man / dogs

179
Q

Diagnostic test for Diphyllobothrium latum:

A
  • direct fecal smear
  • Katokatz
180
Q

What is the pathologic effect of hydatid cyst rupture:

A

severe anaphylaxis

181
Q
  • DOC for Echinococcus granulosis
  • Treatment of choice in hydatid cysts
A
  • Albendazole
  • Surgical resection