Blood Trematodes (Flukes) - SCHISTOSOMA

Question 1

Intermediate host of S. JAPONICUM

Answer 1

Oncomelania hupensis quadrasi

Question 2

Intermediate host of S. MANSONI

Answer 2

Biomphalaria glabrata

Question 3

Intermediate host of S. HAEMATOBIUM

Answer 3

Bulinus truncatus

Question 4

Infective stage

Answer 4

CERCARIAE

skin penetration by cercariae

adult flukes living in mesenteric or bladder veins lay eggs that cause granulomas

Question 5

Site affected S. JAPONICUM

Answer 5

IMV and SMV of SMALL intestines

Question 6

Site affected S. MANSONI

Answer 6

IMV of LARGE intestines

Question 7

Site affected S. HAEMATOBIUM

Answer 7

veins of urinary bladder

Question 8

Diagnostic tests

Answer 8

FECALYSIS (Kato-Katz technique) - demonstration of parasite eggs

CIRCUMOVAL PRECIPITIN TEST(COPT) - detects circulating schistosome antigen

RECTAL IMPRINT - biopsy of rectal tissue w/ the aid of proctoscopy

Question 9

ACUTE SCHISTOSOMIASIS

Answer 9

cercarial dermatitis (swimmer’s itch)

KATAYAMA FEVER - systemic hypersensitivity, serum sickness like syndrome

Question 10

CHRONIC SCHISTOSOMIASIS ( S. japonicum and S. mansoni)

Answer 10

pseudopolyps in the colon
liver GRANULOMAS – PRESINUSOIDAL obstruction, hepatomegaly and PORTAL HPN

GI hemorrhage, massive splenomegaly

LIVER UTZ: CLAY PIPESTEM FIBROSIS W/ LACELIKE PATTERN

EXSANGUINATION FROM RUPTURED ESOPHAGEAL VARICES - MCC of DEATH

Question 11

CHRONIC SCHISTOSOMIASIS ( S. haematobium)

Answer 11

PAINLESS HEMATURIA and fibrosis of the bladder

Hydronephrosis

Associated w/ SQUAMOUS CELL CARCINOMA OF THE BLADDER

Question 12

Eggs of S. japonicum

Answer 12

SMALL lateral spine knob

Question 13

Eggs of S. mansoni

Answer 13

LATERAL PROMINENT lateral spine

Question 14

Eggs of S. haematobium

Answer 14

LARGE TERMINAL SPINE

Question 15

Treatment for Schistosomiasis

Answer 15

PRAZIQUANTEL

Question 16

Areas of Endemicity (Schistosomiasis)

Answer 16

Sorsogon
Samar
Leyte
Oriental Mindoro
Bohol
All of Mindanao EXCEPT Misamis Oriental

Question 17

The single most important epidemiological factor in schistosomiasis

Answer 17

HUMAN WASTE in water containing the intermediate host