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Senior - ID 3 > 13 - Cestodes > Flashcards

13 - Cestodes Flashcards

1
Q

How do cestodes eat?

A

Cestodes lack an intestinal tract
- absorb nutrients through integuments

Parasitic in nature

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2
Q

Cestode anatomy

A 
Head (scolex)
Neck
Segmented body
Male and female gonads 
- (proglottids)
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3
Q

Cestodes tapworms

A

Hymenolepiasis

Pork tapeworm
- taenia solium (cysticerosis)

Beef tapeworm
- taenia saginata

Fish tapeworm
- diphyllobothrium latum

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4
Q

Describe hymenolepis nana?

A

The dwarm tapeworm
Adults 15-40mm
Worldwide

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5
Q

MC of all cestodes?

A

Hymenolepis nana

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6
Q

Hymnelopis diminuta is

A

A less frequent cause of hymenolepiasis

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7
Q

Pathophys of hymenolepiasis?

A 
Ingest eggs
 - (Fecal oral)
Pass into ileum
Penetrate lamina propria
Enter gut lumen
Attach to mucosa of villus

Adjacent proglotids generate hundred’s of eggs

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8
Q

Common S/S of hymenolepiasis?

A

Asymptomatic (usually)

Restlessness
Irritability
Diarrhea
Abdominal pain
Restless sleep
Anal pruritus
Nasal pruritus
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9
Q

Symptoms of hymenolepiasis correlate with?

A

Worm burden

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10
Q

Rare s/s fo hymenolepiasis?

A 
Anorexia
Appetite increase
N/V
Bloody diarrhea
Seizures
Hives
Extremity pain
HA
dizziness
Behavioral
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11
Q

PE for hymenolepiasis?

A

Usually unrevealing

Maybe (rare)

  • abd tenderness,
  • urticaria
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12
Q

Labs for hymenolepiasis

A

Eosinophilia
Eggs in stool
Sections of worm in stool

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13
Q

Tx for hymenolepiasis

A

Priziquantel (biltricide)

Supportive

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14
Q

Taeniasis includes?

A

Tapeworms:

  • Taneia solum (pork)
  • Taneia saginata (beef)

Found WW

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15
Q

Taneia solium is mostly found?

A

Poorer communities

Rare in muslim countries (pork)

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16
Q

Taenia saginata in the US?

A

US cattle are free of the parasite

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17
Q

T Solium reminder?

A

Sunshine and pork

Slide 14

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18
Q

T saginata reminder

A 
Saggy saginata (saggy udders) 
Slide 15
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19
Q

Lifecycle of taeniasis?

A 
Adults - human intestine
Eggs into feces
 - Eaten by cows and pigs Embryos enter circulation - gut wall
Embryos encyst in muscular tissue
- humans eat the meat
Cystericerus attaches to small intestine

Matures into tapeworm

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20
Q

Tapeworm fun facts?

A

Single worm

50,000 eggs/day

May live 25yrs

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21
Q

S/S for taeniasis?

A

Usually asymptomatic

Vague GI complaints

  • abd pain
  • anorexia
  • wt loss
  • malaise
  • epigastric pain
  • diarrhea
  • Nausea
  • wt loss
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22
Q

T. Saginata and T. Solium, which is myre symptmatic?

A

T solium is less symptomatic

Worm burden dependent

23
Q

Most striking feature of taenias?

A

Passage of proglottids

24
Q

Migrating proglottids can cause?

A

Appendicitis

Cholangitis

25
PE for taeniasis?
Usually unremarkable Maybe - abd tenderness - wt loss (especially infants) - subcutaneous nodules (adults) - neurologic abnormalities
26
What causes the neurologic problems with taeniasis?
Cysticercosis
27
Labs for taeniasis?
Stool Celophane tape swab CBC (eisonophilia) Antibody detection
28
Tx for taeniasis?
Praziquantel (biltricide) Surgery
29
Surgery for taeniasis?
If its bad enough - acute abdominal surg - appendicitis - obstructed bile duct - pancreatic duct
30
What is cysticercosis?
Systemic illness | - larval form of taenia solium
31
Incidence of cystercosiss in the US?
- Immigration from endemic area - travel to endemic area - 1000 new cases per yr - southern california
32
S california ER visits?
10% of seisures in ED in S. Cali is due to cystercosis
33
Definitive hosts for cysticercosis?
Humans Intestinal adult tapeworm
34
Cysticercosis transmission?
Fecal oral from tapeworm host
35
What tissues are cystircercosis found?
``` Skin Skeletal muscle Heart Eye CNS ```
36
MC parasitic infection of CNS?
Cysticercosis
37
Neurocysticercosis S/S?
NCC - seisures (focal/generalized) - chronic HA - N/V - Vision changes - focal neurological complaints - mental status changes
38
Cysticercosis S/S?
- Freq asymptomatic - lesions at multiple sites - associated sx - ocular - cardiac - spinal lesions - asymptomatic subcutaneous nodules - calcified intramuscular nodules
39
PE for Cysticercosis?
- NO fever - nonfocal neurologic findings - papilledema - meningismus - hyperreflexia - nystagmus - visual deficits - intraocular larvae - subq nodules (resembles sebaceous cyst) - muscular pseudohypertrophy
40
Cystercycosis PE (you just said it but you need to know this i think)
Absence of fever
41
Labs/imaging for Cysticercosis?
``` CT MRI ELISA/ETIB CBC CSF Stool O/P Biopsy ```
42
Lab studies are? (Cysticercosis)
Inferior to imaging
43
O and P is found in___ but not ___
Taeniasis not cysticercosis
44
Tx for Cysticercosis?
Supportive care seizures - O2 - Anticonvulsants increased ICP - steroids - osmotic agents - diuretics Surg - remove cyst Medical tx
45
Medical tx for cysticercosis?
albendazole/priaziquantel + dexamethasone for NCC and degenerating or uncalcified cysts - Controversial
46
What is the controversy for meds treating NCC?>
Recent studies ongoing w etancerpt (ETN, And anti-TNF) that shows promise in decreasing post tx inflammation
47
Where do you find diphyllobothriasis?
Any lake, river (freshwater) Consumption of raw/undercooked fish Northern hemisphere - EU - USSR - N USA (great lakes) - Asia - Uganda - Chile
48
Diphyllobothriasis lifecycle?
Eggs discharged into freshwater environment • Egg ⇒ embryo (crustacean) ⇒ larvae ⇒ fish ⇒ human • Mature tapeworm resides in the small intestine • Eggs are discharged from proglottids • 1,000,000 eggs per day per worm • Can live up to 10 years
49
Diphyllobothriasis s/s
``` Asymptomatic Fatigue Diarrhea Dizziness Weakness (rare) Numbness of extremities Hunger Pruritus ani ```
50
D. Latum (diphyllobothriasis) has an unusual affinity for?
Vit B-12 Symptoms resemble megaloblastic anemia
51
PE for diphyllobothriasis?
``` Pallor Glossitis Dyspnea Tachycardia Weakness Hyperesthesia Paresthesias Disturbances of movement ```
52
Labs for diphyllobothriasis?
``` Stool (O and P) CBC - H/H - low - MCV - high - eosinopillia B12 - low Folate - low ```
53
Tx for diphyllobothriasis?
Vitamin supp Praziquantel (biltricide)
54
Childrens books that failed
The very hungry tapeworm

Senior - ID 3 (11 decks)

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