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Parasitology lec > Blood Flukes > Flashcards

Blood Flukes Flashcards

1
Q

Schistosoma

Type of fluke

A

Blood flukes

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2
Q

Schistosoma

Schistomes that can infect humans:

A

○ Schistosoma japonicum
○ Schistosoma mansoni
○ Schistosoma haematobium
○ Schistosoma intercalatum
○ Schistosoma mekongi

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3
Q

Schistosoma

Life span

A

30 years

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4
Q

Schistosoma

Intermediate host

A

Snails

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5
Q

Schistosoma

Infective stage

A

Forked tail cercaria

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6
Q

Schistosoma

MOT

A

Skin penetration

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7
Q

Life Cycle of Schistosoma

Humans are infected through skin penetration, usually
in contact with _____

A

water

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8
Q

Schistosoma

Final host

A

Human

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9
Q

Life Cycle of Schistosoma

Infection would usually happen early in the _____ when cercaria are being released into the water

A

morning

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10
Q

Schistosoma

Habitat

A

● Blood vessels
● Mesenteric veins (most species)

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11
Q

Schistosoma

supply blood to the intestinal tract

A

Mesenteric veins

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12
Q

Life Cycle of Schistosoma

Once skin is penetrated, circaria will find its way into the ______

A

blood vessels

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13
Q

Life Cycle of Schistosoma

Circaria release ______ that allow for
penetration to happen

A

lytic enzymes

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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

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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
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16
Q

Life Cycle of Schistosoma

Once passed out in the feces, the eggs are
________

A

embryonated

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17
Q

Life Cycle of Schistosoma

If Schistosoma eggs are recovered in feces

A

S. mansoni and S. japonicum

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18
Q

Life Cycle of Schistosoma

If Schistosoma eggs are recovered in the urine

A

S. haematobium

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19
Q

Life Cycle of Schistosoma

Egg will find its way in freshwater, and eggs will hatch releasing _______.

A

miracid

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20
Q

Life Cycle of Schistosoma

These miracidium will penetrate the ___________.

A

snail intermediate host

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21
Q

Life Cycle of Schistosoma

Inside the _____, developmental processes are initiated.

A

snail

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22
Q

Life Cycle of Schistosoma

Schistosomule will migrate to portal blood in the _____ and mature into adults in the _________

A
  • liver
  • mesenteric veins
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23
Q

Life Cycle of Schistosoma

Schistosomule becomes a mature male or female worm and be found together ________.

A

copulating

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24
Q

Life Cycle of Schistosomav

_______ will be released from the snail, ready to infect another susceptible human host.

A

Cercariae

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25
Q

Life Cycle of Schistosoma

Miracidium will become _________

A

Sporocysts

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26
Q

Life Cycle of Schistosoma

Sporocysts will become _______

A

Cercariae

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27
Q

Life Cycle of Schistosoma

In the life cycle of Schistosoma, its unique feature is it has no _____ stage

A

redia

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28
Q

Schistosoma japonicum

Ovary appearance

Female

A

pyramidal

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29
Q

Schistosoma japonicum

Longer and slender

A

Female

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30
Q

Schistosoma japonicum

Ovary location

Female

A

middle
of the body

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31
Q

Snails Involved in Schistosoma

Snail intermediate host of Schistosoma haematobium

A

Bulinus

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32
Q

Snails Involved in Schistosoma

Snails Involved in Schistosoma

A

Biomphalaria

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33
Q

Schistosoma: Important Features of Adult Worms

Among the 3 major species, ________ adult worms are the largest in size

A

S. japonicum

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34
Q

Snails Involved in Schistosoma

Snail intermediate host of Schistosoma japonicum

A

Oncomelania

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35
Q

Schistosoma japonicum

Arrangement and number of testis

Male

A

in a single
file approximately
8-6 testis

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36
Q

Schistosoma japonicum

body covering is
smooth meaning it has no ________

Male

A

no integumentary
tuberculations

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37
Q

Schistosoma: Important Features of Adult Worms

Among the 3 major species, _________adult
worms are the smallest in size.

A

Schistosoma mansoni

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38
Q

Schistosoma mansoni

Arrangement and number of testis

Male

A

zigzag row around 8-9 testis

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39
Q

Schistosoma mansoni

Ovary location

Female

A

anterior half of the
worm

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40
Q

Schistosoma mansoni

tegument appearance

Male

A

rough;
prominent integumentary
tuberculations

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41
Q

Schistosoma haematobium

Arangement and number of testis

Male

A

In groups;
4-5 testis

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42
Q

Schistosoma haematobium

ovary location

Female

A

posterior half of the
worm

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43
Q

Schistosoma haematobium

Tegument has __________

Male

A

fine
integumentary
tuberculations

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44
Q

Schistosoma: Diagnostic Stages

Diagnostic stage

A

eggs

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45
Q

Schistosoma: Diagnostic Stages

First thing to consider with fluke eggs

A

They are
non-operculated

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46
Q

Schistosoma: Diagnostic Stages

Shape

Schistosoma japonicum

A

Round to oval

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47
Q

Schistosoma: Diagnostic Stages

Size comparison

Schistosoma japonicum

A

Smallest egg among 3 species

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48
Q

Schistosoma: Diagnostic Stages

Shape

Schistosoma mansoni

A

Oval

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49
Q

Schistosoma: Diagnostic Stages

Presence of _______

Schistosoma mansoni

A

lateral spine

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50
Q

Schistosoma: Diagnostic Stages

Presents of a knob:

Schistosoma japonicum

A

lateral knob/recurved hook

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51
Q

Schistosoma: Diagnostic Stages

shape

Schistosoma haematobium

A

Oval

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52
Q

Schistosoma: Diagnostic Stages

Presence of ________

Schistosoma haematobium

A

terminal spine

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53
Q

Types of schistosomes

Common
Name

S. japonicum

A

Oriental
Blood Fluke

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54
Q

Types of schistosomes

Habitat

S. japonicum

A

Superior mesenteric
vein of the small
intestine

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55
Q

Types of schistosomes

Location of
Ovary

S. japonicum

A

Middle

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56
Q

Types of schistosomes

IH

S. japonicum

A

Oncomelania hupensis
quadrasi

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57
Q

Types of schistosomes

Egg
Production

S. japonicum

A

Greatest
(3000 eggs per worm
pair per day)

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58
Q

Types of schistosomes

Integumentary
Tuberculations

S. japonicum

A

None

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59
Q

Types of schistosomes

Eggs

S. japonicum

A

Oval with recurved
hook or knob
Smallest

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60
Q

Types of schistosomes

Eggs

S. mansoni

A

Eliptical with
lateral spine

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61
Q

Types of schistosomes

Egg
Production

S. mansoni

A

190-200
eggs/day

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62
Q

Types of schistosomes

Integumentary
Tuberculations

S. mansoni

A

Prominent

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63
Q

Types of schistosomes

Location of
Ovary

S. mansoni

A

Anterior 1/2

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64
Q

Types of schistosomes

IH

S. mansoni

A

Biomphalaria

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65
Q

Types of schistosomes

Habitat

S. mansoni

A

Inferior mesenteric
vein of the colon

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66
Q

Types of schistosomes

Habitat

S. haematobium

A

Vesical, prostatic,
uterine plexuses of
the venous circulation

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67
Q

Types of schistosomes

Common Name

S. mansoni

A

Manson’s
Blood Fluke

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68
Q

Types of schistosomes

Common Name

S. haematobium

A

Vesical Blood Fluke

69
Q

Types of schistosomes

IH

S. haematobium

A

Bulinus

70
Q

Types of schistosomes

Location of
Ovary

S. haematobium

A

Posterior 1/2

71
Q

Types of schistosomes

Egg
Production

S. haematobium

A

30 eggs/day

72
Q

Types of schistosomes

Integumentary
Tuberculations

S. haematobium

A

Fine

73
Q

Types of schistosomes

Eggs

S. haematobium

A

Eliptical with terminal
spine

74
Q

Schistosoma: Disease Manifestation (Schistosoma japonicum)

Schistosoma japonicum

A

Oriental Schistosomiasis; Snail Fever; Oriental blood fluke

Found in Asia

75
Q

Schistosoma: Disease Manifestation (Schistosoma japonicum)

migrating larval
stages

Signs and symptoms of Oriental Schistosomiasis

A

Pulmonary Schistosomiasis

76
Q

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

A

Pulmonary Schistosomiasis

77
Q

Schistosoma: Disease Manifestation (Schistosoma japonicum)

Itchiness, edema, hemorrhage at
the site of penetration

Signs and symptoms of Oriental Schistosomiasis

A

Schistosome Cercarial Dermatitis

78
Q

Schistosoma: Disease Manifestation (Schistosoma japonicum)

may manifest
through dyspnea, cough, and hemoptysis

Signs and symptoms of Oriental Schistosomiasis

A

Pulmonary Schistosomiasis

79
Q

Schistosoma: Disease Manifestation (Schistosoma japonicum)

dyspnea, cough
hemoptysis

Signs and symptoms of Oriental Schistosomiasis

A

Cor pulmonale

80
Q

Schistosoma: Disease Manifestation (Schistosoma japonicum)

Abrupt onset of fever, chills, muscle pain, headache, enlargement of liver (hepatomegaly), lymphadenopathy, dysentery/blood diarrhea

A

Katayama Syndrome/Katayama Fever

81
Q

Schistosoma: Disease Manifestation (Schistosoma japonicum)

Due to the ______

Katayama Syndrome/Katayama Fever

A

deposition of the eggs

82
Q

Schistosoma: Disease Manifestation (Schistosoma japonicum)

Acute phase:

A

Katayama Syndrome/Katayama Fever

83
Q

Schistosoma: Disease Manifestation (Schistosoma japonicum)

This will happen ____ after the initial
manifestation

Katayama Syndrome/Katayama Fever

A

months

84
Q

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

A

mesenteric veins

85
Q

Schistosoma: Disease Manifestation (Schistosoma japonicum)

Mucosal inflammation, ulceration, hyperplasia, blood loss, and lower abdominal
pain

A

Intestinal phase

86
Q

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

A

lateral knob

87
Q

Schistosoma: Disease Manifestation (Schistosoma japonicum)

Blood loss is possible due to
dysentery and the parasite capacity to digest _______

Intestinal phase

A

blood cells

88
Q

Schistosoma: Disease Manifestation (Schistosoma japonicum)

Chronic infection:

A

Hepatosplenic Schistosomiasis

89
Q

Schistosoma: Disease Manifestation (Schistosoma japonicum)

Around ______ from the time of infection

Hepatosplenic Schostosomiasis

A

18 months

90
Q

Schistosoma: Disease Manifestation (Schistosoma japonicum)

Eggs become trapped up by the ________

Hepatosplenic Schostosomiasis

A

portal of
blood flow

91
Q

Schistosoma: Disease Manifestation (Schistosoma japonicum)

The eggs in the liver can trigger an inflammatory reaction that can lead to formation of __________

Hepatosplenic Schostosomiasis

A

granulomas

92
Q

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

A
  • portal hypertension
  • enlargement of the spleen (hepatosplenomegaly)
  • liver (hepatomegaly)
93
Q

Schistosoma: Disease Manifestation (Schistosoma japonicum)

Beacuse of the abundant
production of eggs, these eggs are now blocking the ______

Hepatosplenic Schostosomiasis

A

blood vessels

94
Q

Schistosoma: Disease Manifestation (Schistosoma japonicum)

Granulomas can be associated with:

Hepatosplenic Schostosomiasis

A
  • scarring
  • fibrosis of the liver
  • symmer’s pipe
    stem fibrosis
95
Q

Schistosoma: Disease Manifestation (Schistosoma japonicum)

Because of the blockage/obstructure, it may lead to:

Hepatosplenic Schostosomiasis

A
  • Esophageal Varices
  • Massive Ascites
96
Q

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

A

esophagus

97
Q

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 _________

A

Cerebral Schistosomiasis

98
Q

Schistosoma: Disease Manifestation (Schistosoma japonicum)

In chronic cases of S. japonicum infections

A

Link to Occurrence to Colon Cancer and Liver
Cancer

99
Q

Schistosoma: Disease Manifestation (Schistosoma japonicum)

The pathology of Schistosoma is always attributed to the
______

A

eggs

100
Q

Schistosoma: Disease Manifestation (Schistosoma mansoni)

Location

A

Africa and in some parts
of South America

101
Q

Schistosoma: Disease Manifestation (Schistosoma mansoni)

Intestinal Bilharziasis Signs and Symptoms:

A
  • Schistosome Cercarial Dermatitis
  • Acute Schistosomiasis
  • Hepatosplenic Schistosomiasis
102
Q

Schistosoma: Disease Manifestation (Schistosoma mansoni)

similar to japonicum

Intestinal Bilharziasis Signs and Symptoms

A

Schistosome Cercarial Dermatitis

103
Q

Schistosoma: Disease Manifestation (Schistosoma mansoni)

Katayama-like fever (similar to
japonicum, but this is usually less
severe)

Intestinal Bilharziasis Signs and Symptoms

A

Acute Schistosomiasis

104
Q

Schistosoma: Disease Manifestation (Schistosoma mansoni)

(less severe as compared to
japonicum)

Intestinal Bilharziasis Signs and Symptoms

A

Hepatosplenic Schistosomiasis

105
Q

Schistosoma: Disease Manifestation (Schistosoma haematobium)

location

A

Middle East

106
Q

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.

A

vesical plexuses

107
Q

Schistosoma: Disease Manifestation (Schistosoma haematobium)

Usually asymptomatic; Symptoms
appear in _______

Signs and Symptoms of Urinary Bilharziasis

A

heavy infections

108
Q

Schistosoma: Disease Manifestation (Schistosoma haematobium)

Associated with

A

Urinary Bilharziasis; Egyptian Hematuria

109
Q

Schistosoma: Disease Manifestation (Schistosoma haematobium)

(difficulty in urination)

Signs and Symptoms of Urinary Bilharziasis

A

dysuria

110
Q

Schistosoma: Disease Manifestation (Schistosoma haematobium)

Early signs and symptoms include:

Signs and Symptoms of Urinary Bilharziasis

A

dysuria and hematuria

111
Q

Schistosoma: Disease Manifestation (Schistosoma haematobium)

(blood in urine)

Signs and Symptoms of Urinary Bilharziasis

A

hematuria

112
Q

Schistosoma: Disease Manifestation (Schistosoma haematobium)

Link with

Signs and Symptoms of Urinary Bilharziasis

A

Bladder Carcinoma
(Squamous Cell Carcinoma)

113
Q

Schistosoma: Disease Manifestation (Schistosoma haematobium)

can trigger irritation
or inflammatory reaction in the bladder. This leads to hematuria.

A

terminal spine

114
Q

Schistosoma: Disease Manifestation (Schistosoma haematobium)

causes ________ syndrome

Signs and Symptoms of Urinary Bilharziasis

A

Nephrotic

115
Q

Diagnosis

Primarily for S. japonicum and S. mansoni

A

Stool Exam

116
Q

Diagnosis

Stool exam performed:

A
  • Kato-Katz
  • DFS
  • FECT
117
Q

Diagnosis

Technique used in Modified Acid Fast Staining

A

Modified Ziehl–Neelsen Technique

118
Q

Diagnosis

Appropriate for S. mansoni

A

Modified Acid Fast Staining

119
Q

Diagnosis

(+) result of Modified Ziehl–Neelsen Technique

A

red coloration of mansoni eggshell

120
Q

Diagnosis

Time of collection

Detection of Eggs in Urine (in cases of S. haematobium)

A

12 pm to 3 pm

121
Q

Diagnosis

But you can also collect ______

Detection of Eggs in Urine (in cases of S. haematobium)

A

24-hour urine

122
Q

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)

A

24-hour urine

123
Q

Diagnosis

In 24 hour urine, you examine the
______ to look for eggs.

Detection of Eggs in Urine (in cases of S. haematobium)

A

sediment

124
Q

Diagnosis

Concentration Technique used

Detection of Eggs in Urine (in cases of S. haematobium)

A

Nucleopore Filtration
Technique

125
Q

Diagnosis

To increase the detection of eggs in the urine sample

Detection of Eggs in Urine (in cases of S. haematobium)

A

Nucleopore Filtration
Technique

126
Q

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)

A

Faust-Meleney’s Egg Hatching Technique

127
Q

Diagnosis

The larva or miracidium is considered to be _____ if
the egg hatches and the miracidium swims.

Faust-Meleney’s Egg Hatching Technique

A

viable

128
Q

Diagnosis

It is viable if
the miracidium is ______ near the light source

Faust-Meleney’s Egg Hatching Technique

A

concentrated

129
Q

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

A

foil

130
Q

Diagnosis

At the end of the flask/beaker, you use
a flashlight to:

Faust-Meleney’s Egg Hatching Technique

A
  • check if the egg will hatch
    to release the miracidium
  • check if the miracidium follows the light
131
Q

Diagnosis

To look for the eggs in the liver

A

Rectal or Liver Biopsy

132
Q

Diagnosis

using adult worm extracts

Immunodiagnosis

A

Intradermal Tests

133
Q

Diagnosis

Ab detection

Immunodiagnosis

A
  • Indirect Hemagglutination
  • ELISA
134
Q

Diagnosis

Detection of Ag such as:

Immunodiagnosis

A
  • CCA:Circulating Cathodic Antigen
  • CAA:Circulating Anodic Antigen
  • SEA: Soluble Egg Antigen
135
Q

Diagnosis

Confirmatory Test / Definitive Test in the
Philippines

Immunodiagnosis

A

COPT - Circumoval Precipitin Test

136
Q

Diagnosis

Patients in chronic cases may no longer excrete eggs in feces, so this serologic test is used to confirm

Immunodiagnosis

A

COPT - Circumoval Precipitin Test

137
Q

Diagnosis

The Sample used COPT - Circumoval Precipitin Test

Immunodiagnosis

A

serum

138
Q

Diagnosis

(+) Result in COPT - Circumoval Precipitin Test

Immunodiagnosis

A

Bleb or Septate Precipitates
(contain antibodies)

139
Q

Diagnosis

Place ________ or ________
Schistosoma eggs on the slide (they would serve as reagents since they have antigen)

COPT - Circumoval Precipitin Test procedure

Immunodiagnosis

A

lyophilized or freeze-dried

140
Q

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

Immunodiagnosis

A

nail polish or ground glass

141
Q

Diagnosis

Seal the edges of the coverslip with _________ or _______ (commonly used).

COPT - Circumoval Precipitin Test procedure

Immunodiagnosis

A

nail polish or melted paraffin wax

142
Q

Diagnosis

Put it in the incubator for _____ at body temperature, after incubation, exam it under the microscope

COPT - Circumoval Precipitin Test procedure

Immunodiagnosis

A

2 days

143
Q

Diagnosis

Skin test

A

Fairley Test

144
Q

Treatment

Drug of choice

A

Praziquantel

145
Q

Treatment

For S. haematobium

A

: Alternative drug is
Metrifonate

146
Q

Epidemiology

S. japonicum

A

Asia

147
Q

Epidemiology

S. manson

A

Africa

148
Q

Epidemiology

S. haematobium

A

Middle East

149
Q

Epidemiology

number of Endemic provinces

Philippine Situation

A

28

150
Q

Epidemiology

number of Endemic municipalities

Philippine Situation

A

190

151
Q

Epidemiology

National Prevalence Rate

Philippine Situation

A

4.68%

(DOH, 2017)

152
Q

Epidemiology

In the latest survey, most cases are found in

Philippine Situation

A

Oriental Mindoro

153
Q

Epidemiology

Endemic areas:

Philippine Situation

A

There are cases in most parts of mindanao:
- leyte and samar regions
- mindoro
- negros occidental
- cagayan valley

154
Q

Epidemiology

higher among what sex?

Philippine Situation

A

males

155
Q

Epidemiology

Higher among what age (adults or children)

Philippine Situation

A

adults

156
Q

Epidemiology

Occur with other ___________

Philippine Situation

A

helminthic infections

157
Q

Other Blood Flukes

Occurs in Western and Central Africa

A

Schistosoma intercalatum

158
Q

Other Blood Flukes

Snail

Schistosoma intercalatum

A

Bulinis

159
Q

Other Blood Flukes

Eggs are similar to S. haematobium; there is curvature
of spine; Presence of central bulge

A

Schistosoma intercalatum

160
Q

Other Blood Flukes

Eggs appearance

Schistosoma intercalatum

A

Hourglass

161
Q

Other Blood Flukes

Can be positive in Ziehl-neelsen Technique

A

Schistosoma intercalatum

162
Q

Other Blood Flukes

Found in Asia, primarily found in Mekong River basin in Cambodia

A

Schistosoma mekongi

163
Q

Other Blood Flukes

Eggs are smaller than S. japonicum

A

Schistosoma mekongi

164
Q

Other Blood Flukes

Milder infection compared to S. japonicum

A

Schistosoma mekongi

165
Q

Other Blood Flukes

IH

Schistosoma mekongi

A

Neotricula, Lithoglyphopsis (snails)

166
Q

Other Blood Flukes

Primarily schistosome of birds, humans can get
infected

A

Avian Schistosoma

167
Q

Other Blood Flukes

Cause swimmer’s itch, lake itch, duck itch

A

Avian Schistosoma

168
Q

Other Blood Flukes

Allergic reaction due to penetration of _______

Avian Schistosoma

A

circaria

Parasitology lec (24 decks)

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