Blood Flukes Flashcards
1
Q
Schistosoma
Type of fluke
A
Blood flukes
2
Q
Schistosoma
Schistomes that can infect humans:
A
○ Schistosoma japonicum
○ Schistosoma mansoni
○ Schistosoma haematobium
○ Schistosoma intercalatum
○ Schistosoma mekongi
3
Q
Schistosoma
Life span
A
30 years
4
Q
Schistosoma
Intermediate host
A
Snails
5
Q
Schistosoma
Infective stage
A
Forked tail cercaria
6
Q
Schistosoma
MOT
A
Skin penetration
7
Q
Life Cycle of Schistosoma
Humans are infected through skin penetration, usually
in contact with _____
A
water
8
Q
Schistosoma
Final host
A
Human
9
Q
Life Cycle of Schistosoma
Infection would usually happen early in the _____ when cercaria are being released into the water
A
morning
10
Q
Schistosoma
Habitat
A
● Blood vessels
● Mesenteric veins (most species)
11
Q
Schistosoma
supply blood to the intestinal tract
A
Mesenteric veins
12
Q
Life Cycle of Schistosoma
Once skin is penetrated, circaria will find its way into the ______
A
blood vessels
13
Q
Life Cycle of Schistosoma
Circaria release ______ that allow for
penetration to happen
A
lytic enzymes
14
Q
Life Cycle of Schistosoma
The tail is lost during penetration and the circaria without the tail is called the ______ that enters the blood vessel
A
schistosomule
15
Q
Life Cycle of Schistosoma
The female releases eggs that will be passed in the ______ or be deposited in to the ______ or ______ causing obstruction
A
- stool
- liver
- blood vessel
16
Q
Life Cycle of Schistosoma
Once passed out in the feces, the eggs are
________
A
embryonated
17
Q
Life Cycle of Schistosoma
If Schistosoma eggs are recovered in feces
A
S. mansoni and S. japonicum
18
Q
Life Cycle of Schistosoma
If Schistosoma eggs are recovered in the urine
A
S. haematobium
19
Q
Life Cycle of Schistosoma
Egg will find its way in freshwater, and eggs will hatch releasing _______.
A
miracid
20
Q
Life Cycle of Schistosoma
These miracidium will penetrate the ___________.
A
snail intermediate host
21
Q
Life Cycle of Schistosoma
Inside the _____, developmental processes are initiated.
A
snail
22
Q
Life Cycle of Schistosoma
Schistosomule will migrate to portal blood in the _____ and mature into adults in the _________
A
- liver
- mesenteric veins
23
Q
Life Cycle of Schistosoma
Schistosomule becomes a mature male or female worm and be found together ________.
A
copulating
24
Q
Life Cycle of Schistosomav
_______ will be released from the snail, ready to infect another susceptible human host.
A
Cercariae
25
# Life Cycle of Schistosoma
Miracidium will become _________
Sporocysts
26
# Life Cycle of Schistosoma
Sporocysts will become _______
Cercariae
27
# Life Cycle of Schistosoma
In the life cycle of Schistosoma, its unique feature is it has no _____ stage
redia
28
# Schistosoma japonicum
Ovary appearance
| Female
pyramidal
29
# Schistosoma japonicum
Longer and slender
Female
30
# Schistosoma japonicum
Ovary location
| Female
middle
of the body
31
# Snails Involved in Schistosoma
Snail intermediate host of Schistosoma haematobium
Bulinus
32
# Snails Involved in Schistosoma
Snails Involved in Schistosoma
Biomphalaria
33
# Schistosoma: Important Features of Adult Worms
Among the 3 major species, ________ adult worms are the largest in size
S. japonicum
34
# Snails Involved in Schistosoma
Snail intermediate host of Schistosoma japonicum
Oncomelania
35
# Schistosoma japonicum
Arrangement and number of testis
| Male
in a single
file approximately
8-6 testis
36
# Schistosoma japonicum
body covering is
smooth meaning it has no ________
| Male
no integumentary
tuberculations
37
# Schistosoma: Important Features of Adult Worms
Among the 3 major species, _________adult
worms are the smallest in size.
Schistosoma mansoni
38
# Schistosoma mansoni
Arrangement and number of testis
| Male
zigzag row around 8-9 testis
39
# Schistosoma mansoni
Ovary location
| Female
anterior half of the
worm
40
# Schistosoma mansoni
tegument appearance
| Male
rough;
prominent integumentary
tuberculations
41
# Schistosoma haematobium
Arangement and number of testis
| Male
In groups;
4-5 testis
42
# Schistosoma haematobium
ovary location
| Female
posterior half of the
worm
43
# Schistosoma haematobium
Tegument has __________
| Male
fine
integumentary
tuberculations
44
# Schistosoma: Diagnostic Stages
Diagnostic stage
eggs
45
# Schistosoma: Diagnostic Stages
First thing to consider with fluke eggs
They are
non-operculated
46
# Schistosoma: Diagnostic Stages
Shape
| Schistosoma japonicum
Round to oval
47
# Schistosoma: Diagnostic Stages
Size comparison
| Schistosoma japonicum
Smallest egg among 3 species
48
# Schistosoma: Diagnostic Stages
Shape
| Schistosoma mansoni
Oval
49
# Schistosoma: Diagnostic Stages
Presence of _______
| Schistosoma mansoni
lateral spine
50
# Schistosoma: Diagnostic Stages
Presents of a knob:
| Schistosoma japonicum
lateral knob/recurved hook
51
# Schistosoma: Diagnostic Stages
shape
| Schistosoma haematobium
Oval
52
# Schistosoma: Diagnostic Stages
Presence of ________
| Schistosoma haematobium
terminal spine
53
# Types of schistosomes
Common
Name
| S. japonicum
Oriental
Blood Fluke
54
# Types of schistosomes
Habitat
| S. japonicum
Superior mesenteric
vein of the small
intestine
55
# Types of schistosomes
Location of
Ovary
| S. japonicum
Middle
56
# Types of schistosomes
IH
| S. japonicum
Oncomelania hupensis
quadrasi
57
# Types of schistosomes
Egg
Production
| S. japonicum
Greatest
(3000 eggs per worm
pair per day)
58
# Types of schistosomes
Integumentary
Tuberculations
| S. japonicum
None
59
# Types of schistosomes
Eggs
| S. japonicum
Oval with recurved
hook or knob
Smallest
60
# Types of schistosomes
Eggs
| S. mansoni
Eliptical with
lateral spine
61
# Types of schistosomes
Egg
Production
| S. mansoni
190-200
eggs/day
62
# Types of schistosomes
Integumentary
Tuberculations
| S. mansoni
Prominent
63
# Types of schistosomes
Location of
Ovary
| S. mansoni
Anterior 1/2
64
# Types of schistosomes
IH
| S. mansoni
Biomphalaria
65
# Types of schistosomes
Habitat
| S. mansoni
Inferior mesenteric
vein of the colon
66
# Types of schistosomes
Habitat
| S. haematobium
Vesical, prostatic,
uterine plexuses of
the venous circulation
67
# Types of schistosomes
Common Name
| S. mansoni
Manson’s
Blood Fluke
68
# Types of schistosomes
Common Name
| S. haematobium
Vesical Blood Fluke
69
# Types of schistosomes
IH
| S. haematobium
Bulinus
70
# Types of schistosomes
Location of
Ovary
| S. haematobium
Posterior 1/2
71
# Types of schistosomes
Egg
Production
| S. haematobium
30 eggs/day
72
# Types of schistosomes
Integumentary
Tuberculations
| S. haematobium
Fine
73
# Types of schistosomes
Eggs
| S. haematobium
Eliptical with terminal
spine
74
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
Schistosoma japonicum
Oriental Schistosomiasis; Snail Fever; Oriental blood fluke
| Found in Asia
75
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
migrating larval
stages
| Signs and symptoms of Oriental Schistosomiasis
Pulmonary Schistosomiasis
76
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
As the schistosomule is migrating towards the superior mesenteric veins that are found in the small intestine, patients
might experience _________
| Signs and symptoms of Oriental Schistosomiasis
Pulmonary Schistosomiasis
77
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
Itchiness, edema, hemorrhage at
the site of penetration
| Signs and symptoms of Oriental Schistosomiasis
Schistosome Cercarial Dermatitis
78
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
may manifest
through dyspnea, cough, and hemoptysis
| Signs and symptoms of Oriental Schistosomiasis
Pulmonary Schistosomiasis
79
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
dyspnea, cough
hemoptysis
| Signs and symptoms of Oriental Schistosomiasis
Cor pulmonale
80
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
Abrupt onset of fever, chills, muscle pain, headache, enlargement of liver (hepatomegaly), lymphadenopathy, dysentery/blood diarrhea
Katayama Syndrome/Katayama Fever
81
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
Due to the ______
| Katayama Syndrome/Katayama Fever
deposition of the eggs
82
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
Acute phase:
Katayama Syndrome/Katayama Fever
83
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
This will happen ____ after the initial
manifestation
| Katayama Syndrome/Katayama Fever
months
84
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
Happens when the parasite is already in the ______ and the female worm is already releasing/producing eggs.
| Katayama Syndrome/Katayama Fever
mesenteric veins
85
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
Mucosal inflammation, ulceration, hyperplasia, blood loss, and lower abdominal
pain
Intestinal phase
86
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
The _____ can cause
ulceration of the intestine. As the
eggs are deposited in the
mesenteric veins, they may cause ulceration until it finds it way to the intestine
lateral knob
87
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
Blood loss is possible due to
dysentery and the parasite capacity to digest _______
| Intestinal phase
blood cells
88
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
Chronic infection:
Hepatosplenic Schistosomiasis
89
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
Around ______ from the time of infection
| Hepatosplenic Schostosomiasis
18 months
90
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
Eggs become trapped up by the ________
| Hepatosplenic Schostosomiasis
portal of
blood flow
91
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
The eggs in the liver can trigger an inflammatory reaction that can lead to formation of __________
| Hepatosplenic Schostosomiasis
granulomas
92
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
Eggs can also be deposited in the liver that can cause blockage in the portal triad and can lead to:
| Hepatosplenic Schostosomiasis
- portal hypertension
- enlargement of the spleen (hepatosplenomegaly)
- liver (hepatomegaly)
93
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
Beacuse of the abundant
production of eggs, these eggs are now blocking the ______
| Hepatosplenic Schostosomiasis
blood vessels
94
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
Granulomas can be associated with:
| Hepatosplenic Schostosomiasis
- scarring
- fibrosis of the liver
- symmer’s pipe
stem fibrosis
95
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
Because of the blockage/obstructure, it may lead to:
| Hepatosplenic Schostosomiasis
- Esophageal Varices
- Massive Ascites
96
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
Due to the pressure, the veins of
the _______ can dilate and can eventually rupture and lead to bleeding which can cause death to the patient
| Hepatosplenic Schostosomiasis
esophagus
97
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
The eggs can find their way to the CNS, which can trigger the formation of granulomas in the brain—resulting in _________
Cerebral Schistosomiasis
98
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
In chronic cases of S. japonicum infections
Link to Occurrence to Colon Cancer and Liver
Cancer
99
# Schistosoma: Disease Manifestation (Schistosoma japonicum)
The pathology of Schistosoma is always attributed to the
______
eggs
100
# Schistosoma: Disease Manifestation (Schistosoma mansoni)
Location
Africa and in some parts
of South America
101
# Schistosoma: Disease Manifestation (Schistosoma mansoni)
Intestinal Bilharziasis Signs and Symptoms:
- Schistosome Cercarial Dermatitis
- Acute Schistosomiasis
- Hepatosplenic Schistosomiasis
102
# Schistosoma: Disease Manifestation (Schistosoma mansoni)
similar to japonicum
| Intestinal Bilharziasis Signs and Symptoms
Schistosome Cercarial Dermatitis
103
# Schistosoma: Disease Manifestation (Schistosoma mansoni)
Katayama-like fever (similar to
japonicum, but this is usually less
severe)
| Intestinal Bilharziasis Signs and Symptoms
Acute Schistosomiasis
104
# Schistosoma: Disease Manifestation (Schistosoma mansoni)
(less severe as compared to
japonicum)
| Intestinal Bilharziasis Signs and Symptoms
Hepatosplenic Schistosomiasis
105
# Schistosoma: Disease Manifestation (Schistosoma haematobium)
location
Middle East
106
# Schistosoma: Disease Manifestation (Schistosoma haematobium)
S. haematobium primarily infects the ______, which are blood vessels near the urinary bladder. Hence, the eggs are released in the urine.
vesical plexuses
107
# Schistosoma: Disease Manifestation (Schistosoma haematobium)
Usually asymptomatic; Symptoms
appear in _______
| Signs and Symptoms of Urinary Bilharziasis
heavy infections
108
# Schistosoma: Disease Manifestation (Schistosoma haematobium)
Associated with
Urinary Bilharziasis; Egyptian Hematuria
109
# Schistosoma: Disease Manifestation (Schistosoma haematobium)
(difficulty in urination)
| Signs and Symptoms of Urinary Bilharziasis
dysuria
110
# Schistosoma: Disease Manifestation (Schistosoma haematobium)
Early signs and symptoms include:
| Signs and Symptoms of Urinary Bilharziasis
dysuria and hematuria
111
# Schistosoma: Disease Manifestation (Schistosoma haematobium)
(blood in urine)
| Signs and Symptoms of Urinary Bilharziasis
hematuria
112
# Schistosoma: Disease Manifestation (Schistosoma haematobium)
Link with
| Signs and Symptoms of Urinary Bilharziasis
Bladder Carcinoma
(Squamous Cell Carcinoma)
113
# Schistosoma: Disease Manifestation (Schistosoma haematobium)
can trigger irritation
or inflammatory reaction in the bladder. This leads to hematuria.
terminal spine
114
# Schistosoma: Disease Manifestation (Schistosoma haematobium)
causes ________ syndrome
| Signs and Symptoms of Urinary Bilharziasis
Nephrotic
115
# Diagnosis
Primarily for S. japonicum and S. mansoni
Stool Exam
116
# Diagnosis
Stool exam performed:
- Kato-Katz
- DFS
- FECT
117
# Diagnosis
Technique used in Modified Acid Fast Staining
Modified Ziehl–Neelsen Technique
118
# Diagnosis
Appropriate for S. mansoni
Modified Acid Fast Staining
119
# Diagnosis
(+) result of Modified Ziehl–Neelsen Technique
red coloration of mansoni eggshell
120
# Diagnosis
Time of collection
| Detection of Eggs in Urine (in cases of S. haematobium)
12 pm to 3 pm
121
# Diagnosis
But you can also collect ______
| Detection of Eggs in Urine (in cases of S. haematobium)
24-hour urine
122
# Diagnosis
For this, you would have to collect the urine samples produced by the patient in 24 hours. Then, you
concentrate or centrifuge the
samples
| Detection of Eggs in Urine (in cases of S. haematobium)
24-hour urine
123
# Diagnosis
In 24 hour urine, you examine the
______ to look for eggs.
| Detection of Eggs in Urine (in cases of S. haematobium)
sediment
124
# Diagnosis
Concentration Technique used
| Detection of Eggs in Urine (in cases of S. haematobium)
Nucleopore Filtration
Technique
125
# Diagnosis
To increase the detection of eggs in the urine sample
| Detection of Eggs in Urine (in cases of S. haematobium)
Nucleopore Filtration
Technique
126
# Diagnosis
This test determines the viability of miracidium (In order for us to determine if the larval stage inside the egg is still alive or viable)
Faust-Meleney’s Egg Hatching Technique
127
# Diagnosis
The larva or miracidium is considered to be _____ if
the egg hatches and the miracidium swims.
| Faust-Meleney’s Egg Hatching Technique
viable
128
# Diagnosis
It is viable if
the miracidium is ______ near the light source
| Faust-Meleney’s Egg Hatching Technique
concentrated
129
# Diagnosis
There is a flask or a beaker filled with water, and it is covered with ___here you put the egg)
| Faust-Meleney’s Egg Hatching Technique
foil
130
# Diagnosis
At the end of the flask/beaker, you use
a flashlight to:
| Faust-Meleney’s Egg Hatching Technique
- check if the egg will hatch
to release the miracidium
- check if the miracidium follows the light
131
# Diagnosis
To look for the eggs in the liver
Rectal or Liver Biopsy
132
# Diagnosis
using adult worm extracts
| Immunodiagnosis
Intradermal Tests
133
# Diagnosis
Ab detection
| Immunodiagnosis
- Indirect Hemagglutination
- ELISA
134
# Diagnosis
Detection of Ag such as:
| Immunodiagnosis
- CCA:Circulating Cathodic Antigen
- CAA:Circulating Anodic Antigen
- SEA: Soluble Egg Antigen
135
# Diagnosis
Confirmatory Test / Definitive Test in the
Philippines
| Immunodiagnosis
COPT - Circumoval Precipitin Test
136
# Diagnosis
Patients in chronic cases may no longer excrete eggs in feces, so this serologic test is used to confirm
| Immunodiagnosis
COPT - Circumoval Precipitin Test
137
# Diagnosis
The Sample used COPT - Circumoval Precipitin Test
| Immunodiagnosis
serum
138
# Diagnosis
(+) Result in COPT - Circumoval Precipitin Test
| Immunodiagnosis
Bleb or Septate Precipitates
(contain antibodies)
139
# Diagnosis
Place ________ or ________
Schistosoma eggs on the slide (they would serve as reagents since they have antigen)
| COPT - Circumoval Precipitin Test procedure
## Footnote
Immunodiagnosis
lyophilized or freeze-dried
140
# Diagnosis
Mix it then on the 4 corners around the sample, place _________ or __________ then cover it with coverslip. They will be serve as a “tuntungan” because if there’s none, the egg may be crushed.
| COPT - Circumoval Precipitin Test procedure
## Footnote
Immunodiagnosis
nail polish or ground glass
141
# Diagnosis
Seal the edges of the coverslip with _________ or _______ (commonly used).
| COPT - Circumoval Precipitin Test procedure
## Footnote
Immunodiagnosis
nail polish or melted paraffin wax
142
# Diagnosis
Put it in the incubator for _____ at body temperature, after incubation, exam it under the microscope
| COPT - Circumoval Precipitin Test procedure
## Footnote
Immunodiagnosis
2 days
143
# Diagnosis
Skin test
Fairley Test
144
# Treatment
Drug of choice
Praziquantel
145
# Treatment
For S. haematobium
: Alternative drug is
Metrifonate
146
# Epidemiology
S. japonicum
Asia
147
# Epidemiology
S. manson
Africa
148
# Epidemiology
S. haematobium
Middle East
149
# Epidemiology
number of Endemic provinces
| Philippine Situation
28
150
# Epidemiology
number of Endemic municipalities
| Philippine Situation
190
151
# Epidemiology
National Prevalence Rate
| Philippine Situation
4.68%
| (DOH, 2017)
152
# Epidemiology
In the latest survey, most cases are found in
| Philippine Situation
Oriental Mindoro
153
# Epidemiology
Endemic areas:
| Philippine Situation
There are cases in most parts of mindanao:
- leyte and samar regions
- mindoro
- negros occidental
- cagayan valley
154
# Epidemiology
higher among what sex?
| Philippine Situation
males
155
# Epidemiology
Higher among what age (adults or children)
| Philippine Situation
adults
156
# Epidemiology
Occur with other ___________
| Philippine Situation
helminthic infections
157
# Other Blood Flukes
Occurs in Western and Central Africa
Schistosoma intercalatum
158
# Other Blood Flukes
Snail
| Schistosoma intercalatum
Bulinis
159
# Other Blood Flukes
Eggs are similar to S. haematobium; there is curvature
of spine; Presence of central bulge
Schistosoma intercalatum
160
# Other Blood Flukes
Eggs appearance
| Schistosoma intercalatum
Hourglass
161
# Other Blood Flukes
Can be positive in Ziehl-neelsen Technique
Schistosoma intercalatum
162
# Other Blood Flukes
Found in Asia, primarily found in Mekong River basin in Cambodia
Schistosoma mekongi
163
# Other Blood Flukes
Eggs are smaller than S. japonicum
Schistosoma mekongi
164
# Other Blood Flukes
Milder infection compared to S. japonicum
Schistosoma mekongi
165
# Other Blood Flukes
IH
| Schistosoma mekongi
Neotricula, Lithoglyphopsis (snails)
166
# Other Blood Flukes
Primarily schistosome of birds, humans can get
infected
Avian Schistosoma
167
# Other Blood Flukes
Cause swimmer’s itch, lake itch, duck itch
Avian Schistosoma
168
# Other Blood Flukes
Allergic reaction due to penetration of _______
| Avian Schistosoma
circaria
