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Preventive And Social Medicine II > CN3 Filarial Worms > Flashcards

CN3 Filarial Worms Flashcards

1
Q

What are creamy white, long, and filiform in shape?

A

Adult Wuchereria worms

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2
Q

Which Wuchereria worm is larger, male or female?

A

Female (8-10cm)

Bcs male is 2-4cm only

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3
Q

Where are adult male and female W. bancrofti worms found?

A
  • Tightly and coiled in nodular dilatations in lymph vessels

* Sinuses of lymph glands

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4
Q

What gains entrance to the peripheral circulation where they are picked up by the vector?

A

Microfilariae - adult female filarial worm produces

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5
Q

What measures 270-290um and is enclosed in a hyaline sheath which is much longer than the microfilaria itself?

A

Wuchereria bancrofti

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6
Q

What measures 13-23 mm in length and 43-55 mm?

A

13-23 mm - male brugia

43-55 mm - female brugia

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7
Q

What is the mean length of Brugia malayi?

A

222um

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8
Q

What is the difference between the cephalic space or the breadth bread of W. bancrofti and B. malayi?

A

W. bancrofti 1:1

B. malayi 2:1

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9
Q

When the sheath is stain in gemsia what color will they produce?

A

W. bancrofti - unstained

B. malayi - pink

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10
Q

What has a single row of nuclei that does not reach the tail’s end?

A

Wuchereria bancrofti

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11
Q

It has two nuclei which bulge the cuticle and it is conspicuously placed

A

B. malayi

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12
Q

Does W. bancrofti have a terminal nuclei?

A

Nada

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13
Q

Innenkôrper length of W. bancrofti and B. malayi

A

W. bancrofti - 34um

B. malayi - 30.7um

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14
Q

LC of W. bancrofti and B. malayi as to its Mosquito Phase

On arrival in a blood meal in the stomach of an appropriate host, the microfilariae lose the sheath in the first how many hours?

A

2-6 hrs

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15
Q

LC of W. bancrofti and B. malayi as to its Mosquito Phase

Some of them work their way by use of hook at the cephalic end of the body through the wall of the proventriculous and cardiac portion of the midgut and then the course of how many hours?

A

4-7 hours have reached the thoracic muscles

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16
Q

LC of W. bancrofti and B. malayi as to its Mosquito Phase

During the next two days they metamorphose into what?

A

Short sausage shaped organism

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17
Q

LC of W. bancrofti and B. malayi as to its Mosquito Phase

What is the measurement of the short sausage shaped organism?

A

124-250 in length by 10-17um diameter

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18
Q

LC of W. bancrofti and B. malayi as to its Mosquito Phase

By the fifth or sixth day, the taoo has atrophied to a mere stump, the intestinal tract has become well-differentiated and a body cavity has developed although the genital primordial is what?

A

Still inconspicuous

Meanwhile the first true sheath has been shed

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19
Q

LC of W. bancrofti and B. malayi as to its Mosquito Phase

After the shed the larvae now measures 225-300 by 15-30 um and how many subterminal caudal papillae?

A

3 subterminal caudal papillae

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20
Q

LC of W. bancrofti and B. malayi as to its Mosquito Phase

During the early part of the second week, a second ecdysis occurs and the worms rapidly elongate into the what?

A

Filiform (3rd stage) mature larva

- 1.4-2mm by 18-23um

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21
Q

LC of W. bancrofti and B. malayi as to its Development in Human Host

The microfilariae discharged by the mature females may be expected to appear in the peripheral blood and how many months?

A

8-12 mos

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22
Q

Can filariasis without microfilaremia happen?

A

Yuh

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23
Q

LC of W. bancrofti and B. malayi as to its Development in Human Host

The adult worms in infected individuals are coiled up in nodal dilatations of the lymphatic vessels and most frequently where?

A
  • In the cortex of the LN
  • In the testicular tissues
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24
Q

What is the only known natural definitive host of w bancrofti?

A

Man

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25
Q

LC of W. bancrofti and B. malayi as to its Development in Human Host sequence

A

Blood meal –> Rupture of Mosquito’s proboscis –> Escape of Mature Larva –> Inoculation of the Human Host

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26
Q

In the bicol region what is more frequently encountered?

A

Hydrocoeles

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27
Q

What is the most widespread lymphatic filarial parasite?

A

W. bancrofti

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28
Q

What is the principal vector for malaria in the philippines and is also the vector for in the mount province, sulu, and palawan?

A

Anopheles minimus var. flavirostris

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29
Q

What breeds in water accumulated in the axils of abaca and banana plants and is the mosquito vector in other provinces?

A

Aedes poecilus

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30
Q

What mosquito vectors breeds in freshwater swamps?

A

Mansonia bonnae

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31
Q

What mosquito vectors breeds in rice fields?

A

Mansonia uniformis

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32
Q

What are important reservoir hosts that may transmit infection to humans?

A

Cats by cat-mosquito-man cycle

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33
Q

Animals show direct evidence that infection with bravia can selectively induce what? This may contribute to immune unresponsiveness to filariasis.

A

CD4+ lymphocyte apoptosis

34
Q

What have been associated with tropical pulmonary eosinophilia (TPE), granulomas all the skin, and allergic reactions following destruction by drugs?

A

Microfilariae

35
Q

What is a classic example of occult filariasis in which microfilaria are not found in the blood but may be found in the tissues?

A

TPE

36
Q 
It is characterized by:
• paroxysmal cough hypereosinophilia (3,000 - 5,000 cells per mm3)
• elevated ESR
• bronchopulmonary markings 
• diffuse military lesions
• high IgE titer
• good response to diethylcarbamazine
A

TPE

37
Q

What are the early manifestations of filariasis?

A
  • fever
  • lymphadenitis
38
Q

Recurrent attacks are characterized by what?

A
  • funiculitis
  • arms & legs swelling and redness
  • tenderness in affected area (even draft of air is painful)
  • vomiting and headache (few days to wks)
39
Q

The signs and symptoms reflect the immunologic phenomenon caused by sensitization to the products of living or dead worms and are called

A

ADL adenolymphangitis

40
Q

Acute episodes of this is one of the symptoms and this acute clinical manifestation is characterised by recurrent attacks of fever associated with inflammation of the lymph nodes and or lymph vessels

A

adenolymphangitis (ADL)

41
Q

This is seen in individuals who grew up outside regions and demic for this filarial parasites and who got infected by them after migration to the endemic regions

A

Expartriate Syndrome

42
Q

Expartriate Syndrome symptoms

A 
Hives
Rashes
Bld eosinophilia
Lymphadenitis
Lymphangitis
43
Q

This is due to immunological hyperesponsiveness to the mature or matured worms

A

Expartriate Syndrome

44
Q

It is due to chronic proliferative overgrowth of fibrous tissue around the dead worms

A

Chronic stage

45
Q

Chronic stage changes lead to what?

A

Lymphatic obstruction
Recurrent attacks of dermatolymphangioadenitis
Lymphedema
Elephantiasis or hydrocoele

46
Q

The progression in the pathology of elephantiasis is greatly due to what?

A

Bacterial or fungal superinfection

47
Q

Development of slow chronic filarial disease

A

Preceded by chronic oedema at first pitting
Then chronic non pitting edema
And repeated acute inflammatory episodes

48
Q

How soon can you see lymphedema and elephantiasis?

A

Lymphedema - as early as 6 months

Elephantiasis - as early as 1 year

49
Q

What can also be noted in male and female in the chronic stage?

A

Male: chronic epididymitis, funiculitis, lymphedematous thickening of the scrotal and spermatic cords

Female: lymphedema of the vulva

50
Q

Which is more severe, bancroftian filariasis or malayan filariasis?

A

Deformities resulting from bancroftian filariasis

51
Q

Rupture of lymphatic seen the kidneys may produce what?

A

Chyluria or milky urine

52
Q

What is the periodicity of the microfilaria of the brugia malayi?

A

Subperiodic

53
Q

What is the best time to collect blood smears for the diagnosis of brugia malayi infection?

A

At night but they may also be taken during the day using the diethylcarbamazepine provocative test

54
Q

Demonstration of microfilaria on peripheral blood film or wet smears taken between what time?

A

8pm to 4am owing to their nocturnal periodicity

55
Q

What is the case of infection is low intensity, what can be used?

A

Filtration using a nuclear pore filter or Knott’s method for concentration

56
Q

What antigen detection techniques are used to detect circulating filarial antigens (CFA)?

A
  • PCR for detection of filarial DNA
  • Rapid format immunochromatographic test for w bancrofti antigens
57
Q

What is the drug of choice for bancroft filariasis?

A

Diethylcarbamazine citrate (DEC) 6 mg/kg BW, orally for. 12 days in divided doses after meals

58
Q

What is the drug of choice for brugian filariasis?

A

Diethylcarbamazine citrate (DEC) 3 mg/kg/day up to a total of 36-72mg/BW

59
Q

What can be another treatment for filariasis?

A

Ivermectin in single oral dose of 200-400ug/kg BW

60
Q

the swelling is no longer reversible
overnight, and the patient may still experience acute attacks.

A

Stage 2

60
Q

the swelling increases during the day but is
reversible once the patient lies flat in bed.

A

Stage 1

61
Q

presence of shallow skin folds, these are folds
where the base can still be seen when the patient moves the leg or foot and the fold “opens up.” Lines or creases not seen in the normal leg are already considered shallow folds.

A

Stage 3

62
Q

there are knobs present in the affected area;
these are lumps or protrusions in the skin that
predispose the area to trauma

A

Stage 4

63
Q

has deep skin folds, where the base can no longer be seen when the patient moves the leg, but only when the folds are actively “opened” by hand

A

Stage 5

64
Q

mossy lesions are present, brought about by the clustering of small elongated or rounded growths. These usually leak translucent fluid, putting the area at risk for secondary bacterial infection

A

Stage 6

65
Q

the patient is unable to adequately or independently perform activities of daily living
due to the extent of the patholgy. The infected
area is foul-smelling and the affected individual frequently experiences acute attacks

A

Stage 7

66
Q

The most common chronic manifestation of LF is

A

lymphedema, which on progression leads to elephantiasis

67
Q

What is the most common acute
manifestation of LF, defined as localized pain,
lymphadenitis and/or lymphangitis and/or
cellulitis and local warmth, with or without
systemic manifestations of fever, nausea, and
vomiting?

A

ADLA (Acute Dermatolymphangiodenitis)

68
Q

What results in the obstruction of the lymphatics of the tunica vaginalis?

A

Hydrocele or chylocele

69
Q

Clear or strawcolored hydrocele fluid typically accumulates in the closed sac of the testis, and rarely, the fluid may have a milky appearance caused the presence of lymph—a condition known as

A

chylocele

70
Q

What is a common chronic
disease manifestation of Bancroftian filariasis
since W. bancrofti worms have been shown
ultrasonographically to prefer localization in
scrotal lymphatics

A

hydrocele

71
Q

What are the genital manifestations of chronic Bancroftian
filariasis?

A

Chronic epididymitis, funiculitis,
lymphedematous thickening of the scrotal skin,
and thickening of the spermatic cord

72
Q

What is a classic example of occult filariasis in which the typical clinical manifestations are not present, and microfilaria are not found in the blood but may be found in the tissues?

A

Tropical pulmonary eosinophilia (TPE)

73
Q

The syndrome,
which is brought about by immunologic
hyper-responsiveness to filarial infection, is
characterized by paroxysmal nocturnal cough,
hypereosinophilia (3,000-5,000 cells per mm3
of blood, levels unrelated to the severity of
symptoms), elevated erythrocyte sedimentation
rate, evidence of diffuse miliary lesions or
increased bronchovascular markings, extremely
high titers of filarial antibody (IgE), and good
therapeutic response to DEC. In most cases,
lung function is impaired, with a reduction in
vital capacity, total lung capacity, and residual
volume. It is commonly misdiagnosed as asthma
or tuberculosis.

A

TPE

74
Q

Chronic symptoms may delay
diagnosis, and if untreated, this may progresses to
chronic pulmonary fibrosis and respiratory
failure.

A

TPE

75
Q

Due to the nocturnal
periodicity of most W. bancrofti strains, wet
smears or thick blood smears are taken between

A

8pm - 4am

76
Q

What test stimulates microfilariae into coming out to the peripheral
circulation, allowing blood smear collection
even during daytime?

A

DEC provocative
test (3 mg /kg DEC single dose)

77
Q

Which among the following may correctly demonstrate the microfilariae?

A

Biopsy of enlarged lymph nodes immediately proximal to an infected lymphatic tract

78
Q

Persistence of severe pruritus in the skin
infested with human itch mites will result to
_________.

A

Excoriation

79
Q

Treatment of filarial infections

A

A single dose of Diethylcarbamazine
and Ivermectin of either together
with an oral dose of Albendazole is
given

80
Q
A

Preventive And Social Medicine II (32 decks)

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