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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
Q

PE for taeniasis?

A

Usually unremarkable

Maybe

  • abd tenderness
  • wt loss (especially infants)
  • subcutaneous nodules (adults)
  • neurologic abnormalities
26
Q

What causes the neurologic problems with taeniasis?

A

Cysticercosis

27
Q

Labs for taeniasis?

A

Stool
Celophane tape swab
CBC (eisonophilia)
Antibody detection

28
Q

Tx for taeniasis?

A

Praziquantel (biltricide)

Surgery

29
Q

Surgery for taeniasis?

A

If its bad enough

  • acute abdominal surg
  • appendicitis
  • obstructed bile duct
  • pancreatic duct
30
Q

What is cysticercosis?

A

Systemic illness

- larval form of taenia solium

31
Q

Incidence of cystercosiss in the US?

A
  • Immigration from endemic area
  • travel to endemic area
  • 1000 new cases per yr
  • southern california
32
Q

S california ER visits?

A

10% of seisures in ED in S. Cali is due to cystercosis

33
Q

Definitive hosts for cysticercosis?

A

Humans

Intestinal adult tapeworm

34
Q

Cysticercosis transmission?

A

Fecal oral from tapeworm host

35
Q

What tissues are cystircercosis found?

A 
Skin
Skeletal muscle
Heart
Eye 
CNS
36
Q

MC parasitic infection of CNS?

A

Cysticercosis

37
Q

Neurocysticercosis S/S?

A

NCC

  • seisures (focal/generalized)
  • chronic HA
  • N/V
  • Vision changes
  • focal neurological complaints
  • mental status changes
38
Q

Cysticercosis S/S?

A
  • Freq asymptomatic
  • lesions at multiple sites
    • associated sx
  • ocular
  • cardiac
  • spinal lesions
  • asymptomatic subcutaneous nodules
  • calcified intramuscular nodules
39
Q

PE for Cysticercosis?

A
  • NO fever
  • nonfocal neurologic findings
  • papilledema
  • meningismus
  • hyperreflexia
  • nystagmus
  • visual deficits
  • intraocular larvae
  • subq nodules (resembles sebaceous cyst)
  • muscular pseudohypertrophy
40
Q

Cystercycosis PE (you just said it but you need to know this i think)

A

Absence of fever

41
Q

Labs/imaging for Cysticercosis?

A 
CT 
MRI
ELISA/ETIB
CBC
CSF
Stool
O/P 
Biopsy
42
Q

Lab studies are? (Cysticercosis)

A

Inferior to imaging

43
Q

O and P is found in___ but not ___

A

Taeniasis not cysticercosis

44
Q

Tx for Cysticercosis?

A

Supportive care

seizures

  • O2
  • Anticonvulsants

increased ICP

  • steroids
  • osmotic agents
  • diuretics

Surg
- remove cyst

Medical tx

45
Q

Medical tx for cysticercosis?

A

albendazole/priaziquantel + dexamethasone for NCC and degenerating or uncalcified cysts
- Controversial

46
Q

What is the controversy for meds treating NCC?>

A

Recent studies ongoing w etancerpt (ETN, And anti-TNF) that shows promise in decreasing post tx inflammation

47
Q

Where do you find diphyllobothriasis?

A

Any lake, river (freshwater)

Consumption of raw/undercooked fish

Northern hemisphere

  • EU
  • USSR
  • N USA (great lakes)
  • Asia
  • Uganda
  • Chile
48
Q

Diphyllobothriasis lifecycle?

A

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
Q

Diphyllobothriasis s/s

A 
Asymptomatic 
Fatigue
Diarrhea
Dizziness
Weakness (rare)
Numbness of extremities
Hunger
Pruritus ani
50
Q

D. Latum (diphyllobothriasis) has an unusual affinity for?

A

Vit B-12

Symptoms resemble megaloblastic anemia

51
Q

PE for diphyllobothriasis?

A 
Pallor
Glossitis
Dyspnea
Tachycardia
Weakness
Hyperesthesia
Paresthesias
Disturbances of movement
52
Q

Labs for diphyllobothriasis?

A 
Stool (O and P)
CBC
- H/H - low
- MCV - high
- eosinopillia 
B12 - low
Folate - low
53
Q

Tx for diphyllobothriasis?

A

Vitamin supp

Praziquantel (biltricide)

54
Q

Childrens books that failed

A

The very hungry tapeworm

Senior - ID 3 (11 decks)

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