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MIMM 413 > Echinococcus > Flashcards

Echinococcus Flashcards

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1
Q

true or false: echinococcus is a zoonotic disease

A

-carnivore/herbivore->humans

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2
Q

adult echino parasitize the gi tract of what

A

carnivores aka they are the definitive host

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3
Q

for echino: larval stage, hydatid cyst, parasitize soft organs of what?

A

humans/herbivores/rodents which are intermediate hosts

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4
Q

what are the the 3 forms of echino larvaes that infect humans

A

-e multiocularis
-granulosus
-vogeli, oligarthrus

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5
Q

what are the characteristics of multiocularis

A

-alveolar in texture
-ulcerative
-hemorrhagic
-malignant

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6
Q

characteristics of granulosus

A

-uniocular
-benign
-25 cm

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7
Q

characteristics of vogeli, oligarthrus

A

-polycystic
-is in central and south america

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8
Q

life cycle of echino

A

-you eat the eggs
-oncosphere hatches, penetrates the intestinal wall, hydatid cyst in liver, lungs etc
-protoscolex from cyst
-scolex attaches to intestines
-adult in small intestine
-poop the eggs

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9
Q

the definitive host ingest what: cysts in organs or eggs in poop

A

cysts in organs

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10
Q

e multiocularis hosts

A

-cyst develops in rodents
-adults develop in foxes, dogs, wolves, coyotes or cats

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11
Q

what is the other name of echinococcus

A

flatworm

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12
Q

how many worms do heavily infected dogs have

A

1000

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13
Q

each tapeworm sheds how many eggs every2 weeks

A

1000

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14
Q

eggs of echino adhere to hairs aroun what

A

infected dogs anus, muzzle and paws
-contact also via soil, water, contaminated vegies, through flies or other arthropods

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15
Q

eggs of e granulosis are able to survive what

A

snow and freezing temps
-viable for 1 year in the pasture

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16
Q

eggs of echino are susceptible to what

A

desiccation

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17
Q

where are most of the echino cases

A

95% of all cases are in china

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18
Q

Adult and larval stages of Eg and Em are …..

A

morphologically
distinct; Em adult smaller

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19
Q

what are the characteristics of echico

A

-scolex(looks like t colum)
-neck
-3 segments: aka proglottids

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20
Q

what do the 3 segments contain

A

-a sac like uterus that contains up to 1000eggs

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21
Q

which parasites ova are similar

A

-e granulosus
-e multiocularis
-t solium

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22
Q

ova of echino survive to exposure of what

A

-householf disinfectants like lysol, 95% etoh or 20% formalin

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23
Q

reported cases of alveolar hydatid infection in the us through what

Study These Flashcards
A

-farm cats probs aquired from wild rodents

24
Q

Cystic Echinococcosis

Study These Flashcards
A
  • Cysts may grow 1-5 cm/year or persist without changes for years
  • Cysts may spontaneously rupture or collapse or disappear
  • Liver cysts appear to grow at lower rate than lung cysts
  • Symptoms occur when cyst compresses or ruptures into
    neighbouring structure
25
Alveolar Echinococcosis
* Initial asymptomatic period of 5-15 years – Chronic infection * Primarily symptoms: jaundice (1/3 cases) and/or abdominal pain * Fatigue, weight loss, Hepatomegaly * High mortality rate in non-treated patients
26
what do uniocular hydatod contain
: hydatid fluid (1-3 liters; highly antigenic used in Casoni skin test), protoscolices, brood capsule and daughter cysts
27
cyst circumscribed by what in echino
a thick host fibrotic tissue infiltrated with chronic inflammatory cells
28
what do we know about the cyst survival mechanism unknown
lower cell mediated immunity
29
what is the size of uniocular hydatid
25cm
30
hydatid cyst of uniocular grows like what
-xenograph -host is unable to control its growth or abrogate the infection/cyst
31
what is the appearance of alveolar hydatid cyst aka e multiocularis
histologically vesicular - gross appearance honeycomb or like lung alveoli
32
what is the content of e multiocularis
Cyst content - pussy , unlike the unilocular cyst -no frank hydatid fluid
33
what is the growth like for e multiocularis
Growth by budding: germinal cells differentiate into bud-like structure- then vesiculate; permeate surrounding host organ parenchyma
34
Human AHC usually
sterile aka no protoslice
35
Protoscolices present in
rodents aka suitable intermediate host
36
ALVEOLAR HYDATIDOSIS infection is ...
chronic
37
cyst growth of ALVEOLAR HYDATIDOSIS
Cyst growth- progressive; apparently unchecked (as yet no reported cases of self-cure)
38
primary lesion of alveolar hydatosis
hepatic aka tendency to metastasize
39
provisional diagnosis of a liver mass in alveolar hydatidosis
usually misdiagnosed as hepatic carcinoma
40
true or false: there are no effective chemo for alveolar hydatidosis
true -case fatality rate 50-70% -frequent cause of death: liver or kidney or liver failure
41
Factors determining the clinical course in unilocular hydatidosis
pressure atrophy and allergic
42
pressure atrophy deets
-by growing cyst -hepatic (Right lobe ~ 85%)-upper right-quadrant pain, jaundice, cholangitis (pain), – pulmonary (~ 90%; typical of Canadian strain of EG), chest pain, hemoptysis, shortness of breath – cerebral - seizure, increased intracranial pressure – renal - hematuria, albuminuria, renal colic – splenic - fragile cyst wall, polar growth to chest cavity
43
allergic hydatid thing
leakage of hydatid fluid -skin hives and itching -eosinophilia -anaphilactic shock aka a serious complication
44
HYDATID DIAGNOSIS
Patients case history is helpful- particularly geographical origin * Computed tomography/Magnetic Resonance Imagine scans, X-ray - detect space occupying mass (congenital cyst; carcinoma; Eh liver abscess)-further confirmation by serology or skin tests * Serology (ELISA, IB, indirect hemagglutination test) * Casoni skin test
45
what is the casoni skin test
– Type-1 hypersensitivity (skin reaction within 30 min) – Type-4 – (CMI) positive (in case of a burnt-out cyst or post-surgical cases) – Positive during the very early stages of infection – negative in patients with active infection with high Ab titer - suggests specific suppression of CMI
46
SUMMARY: HOST CONTROL MECHANISMS: hydatic disease
* EARLY RESPONSE: Primary control mechanisms- CMI and Antibody-dependent Cell Cytotoxicity (ADCC) (IgG+MΦ, neutrophils, eosinophils). * Subsequently both these mechanisms are compromised-ADCC by circulating immune complexes (IC): IC block Fc/C3b receptors; inflammatory cells engorge IC. * CHRONIC PHASE * CMI is suppressed--reconstructed from humans and mouse models. * Polarized Th2 response- high serum IgG, IgE and IL-10; marked reduction in Th1 cells (disorganization of lymphoreticular tissues; induction of suppressor cells). * These events may explain the persistence of Hydatid cysts.
47
EARLY RESPONSE diagnosis hydatic
* EARLY RESPONSE: Primary control mechanisms- CMI and Antibody-dependent Cell Cytotoxicity (ADCC) (IgG+MΦ, neutrophils, eosinophils). * Subsequently both these mechanisms are compromised-ADCC by circulating immune complexes (IC): IC block Fc/C3b receptors; inflammatory cells engorge IC.
48
chronic phase hydatid diagnosis
CMI is suppressed--reconstructed from humans and mouse models. * Polarized Th2 response- high serum IgG, IgE and IL-10; marked reduction in Th1 cells (disorganization of lymphoreticular tissues; induction of suppressor cells). * These events may explain the persistence of Hydatid cysts.
49
echino sylvatic hydatid disease affects what
wolf, caribou and moose all get the hydatid cyst but the adult wold also get the adult tape worm
50
Organ localization of E.g cyst:
~ 90%; pulmonary by the canadian Eg strain – ~ 80%; rt hepatic lobe in the imported cases
51
Hydatid disease what is its form in north america
sylvatic -present in first nations
52
infection of echino is due to what
accidental due to ingestion of eggs
53
clinical symptoms of echino take up until what
10-15yrs after infection
54
Chemotherapy in late stages: of echino
generally ineffective; treatment: surgical removal of E.g cyst- --hepactomy in E.m
55
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MIMM 413 (24 decks)

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