DA WORMS Flashcards
Young kid comes in to the clinic with an itchy asshole. What is the most likely parasite? What type of worm is it?
Enterobius vermicularis (Pinworm)
Nematode (Roundworm)
Young kid comes in to the clinic with an itchy asshole. How can the diagnosis be made?
MORNING scotch tape test
Sample from under the finger nails
NOT a stool sample
Young kid comes in to the clinic with an itchy asshole. Where do the ingested parasites hatch? mature?
Pinworms hatch in the small intestine
Pinworms mature in the lumen of the cecum
Young kid comes in to the clinic with an itchy asshole. Should the family/schoolmates/daycare be concerned?
Yes…eggs remain viable on surfaces for 2-3 weeks
Young kid comes in to the clinic with an itchy asshole. What are some other symptoms this kid may experience?
Insomnia
Abdominal pain (–> anorexia??)
Irritability (I’d be pretty pissed off too if I had an itchy asshole and it hurt to eat…)
Rarely peritoneal granulomas and vulvovaginitis
Young kid comes in to the clinic with an itchy asshole. You ask the mother if the kid had had a cough in the last month or so. What do you expect the answer to be?
No…although most (all other?) parasite life cycles involve time in the lungs, the enterobius vermicularis DON’T
Kid comes in with epigastric pain. He really likes playing in the tobacco field barefoot. A couple weeks ago he had a cough…and now he is in the clinic. What parasites could possibly be causing this kid’s infection?
Necator (hookworms)
Stronyloides
Trichuris (whipworms)
Ascaris (Giant roundworms)…kinda
Kid comes in with epigastric pain. He really likes playing in the tobacco field barefoot. A couple weeks ago he had a cough…and now he is in the clinic. His mom says that he has been tired lately, so you do a CBC…obviously the kid’s anemic. What are the two parasites that come to your mind?
Hookworms (necator)
Whipworms (trichuris)
Kid comes in with epigastric pain. He really likes playing in the tobacco field barefoot. A couple weeks ago he had a cough…and now he is in the clinic. His mom says that he has been tired lately, so you do a CBC…obviously the kid’s anemic. So you ask the mom if her son had complained of anything else in the last month, she says that about a month ago he kept itching his feet and when she looked at them there were red blisters. What is causing the kid’s anemia?
Well first off, the kid obviously picked up hookworms…hookworms are blood suckers
Kid comes in with epigastric pain. He really likes playing in the tobacco field barefoot. A couple weeks ago he had a cough…and now he is in the clinic. His mom says that he has been tired lately, so you do a CBC…obviously the kid’s anemic. So you ask the mom if her son had complained of anything else in the last month…she can’t think of anything. So you ask him if there has been anything out of the ordinary. He says that he has watery red poop…his mom’s not happy…shit happens…the kid’s going to be okay. What do you expect to find in this kid’s stool sample? What other physical characteristic could be seen in a person with this infection?
This kid has a whipworm infection…he’s going to have barrel-shaped eggs in his poop…to go along with the blood…that poor mom’s going to have a hard time forgiving herself for not knowing that…
Whipworm infections can cause clubbed fingers
Kid comes in with epigastric pain and a red rash on his butt/thighs. He really likes playing in the tobacco field barefoot and about a month ago he had a rash on his feet. A couple weeks ago he had a cough…and now he is in the clinic. What is the likely causative agent? What is different about this worm?
Strongyloides
There was something about auto-infection in immunosupressed
A Missionary comes in to the office one month after getting back from Vietnam. She says that she expected her abdominal pain to get better when she got back to the US and started eating healthier food, but that just hasn’t been the case. She says that she never had a really bad fever or anything like that while she was over there. So you ask her to poop in a bucket, to get her blood drawn for a blood smear, and to get ready for an abdominal ultrasound. What do you expect to be found in the poop? blood smear? ultrasound?
She likely has Ascaris…Giant Roundworms
She will have eggs with thick shells in he poop, Charcot-Leyden crystals (Eosinophil signs) in the blood smear, and there will be 10 inch worms in her intestine
A pig farmer comes in with stomach pain (the last month), sore arms that he swears are bigger (the last week or so), and headaches (last couple of days). So you ask him about this that and the other thing, and he says that he likes eating his pork rare…not wanting to burn out all the natural flavors. You politely roll your eyes and ask him to poop in a bucket. What do you expect from the stool sample? What do you tell him to be prepared for?
Taenia eggs and/or proglottids (sections of the tapeworm)
He’s going shit out a 10-30’ worm
A self proclaimed sushi self comes in complaining that she’s been really tired lately. No fever…maybe some abdominal pain, but it could just be gas. So you do a CBC…sure enough she has macrocytic anemia. What parasite could be causing the problems? What would you expect to see in a stool sample? Does she have anything to worry about?
Diphyllobothrium (fish tapeworm) is pulling B12 out of the system
Eggs and/or proglottids
Something to worry about?? Not life or death…but I wouldn’t want to poo out a 30+ foot worm
A sheep farmer comes in complaining of a multitude of pains. He says that the pains has mostly been around his diaphragm, but he’s been coughing lately and has had headaches. He also says it’s just him and his dog at home. You’re kinda flummoxed so you get blood work done and get an abdominal x-ray. What could be seen on the x-ray that would indicate a parasite infection? What kind of worm is it?
There would be lots of tiny cysts/bubbles in various organs
Echinococcus
