Endemic Parasitic

Question 1

endemic infections

Answer 1

ascaris lumbricoides and tricuris: luzon

hookworm: visayas and mindanao

Question 2

t/f most sth infections are asymptomatic

Answer 2

true

Question 3

what is the integrated helminth control program

Answer 3

• doc: albendazole 400 mg or mebendazole 500 mg

- targets children 12 mos-12 yrs and special populations

Question 4

characteristics of ascariasis

Answer 4

• up to 200,000 eggs/day
• 10-14 d incubation
• hx of soil exposure
• 3 mos life cycle, can live up to 2 yrs

Question 5

s/sx of ascariasis

Answer 5

abdominal pain / enlargement
anemia, pallor, diarrhea
passage of worms
signs of obstruction

Question 6

life cycle of ascariasis

Answer 6

point of entry: fecal oral
infective stage: embryonated egg
host habitat: small intestines
immediate host: none / soil

Question 7

treatment for ascariasis

Answer 7

mebendazole 500 mg
albendazole 400 mg
pyrantel pamoate (young)

Question 8

most common intestinal infection in the ph

Answer 8

trichuriasis

Question 9

characteristics of trichuriasis

Answer 9

• 20,000 eggs/day
• incubation 15-30 d
• 3 mos life cycle, can live 5 years
• most common complication: rectal prolapse

Question 10

life cycle for tricuris

Answer 10

point of entry: fecal oral
infective stage: embryonated egg
host habitat: large intestine
intermediate host: non

Question 11

treatment for trichuriasis

Answer 11

mebendazole 500 mg
albendazole 400 mg
pyrantel pamoate (young)

Question 12

malaria is transmitted by __

Answer 12

anopheles mosquito

Question 13

periodicity of malaria types

Answer 13

p falciparum: malignant tertian (24-48 h)
p viviax: benign tertian (48 h)
p ovale: benign tertian (48 h)
p malariae: quartan (72 h)
p knowlesi: quotidian (everyday)

Question 14

malaria diagnosis

Answer 14

• know fever pattern, symptoms, positive malaria diagnostics
• pallor or hgb < 8 mg/dl
• standard: smear via light microscopy

Question 15

ao 2009-001

Answer 15

• first line: artemether-lumefantrine combination
• others: quinine + tetracycline / doxycycline / clindamycin
• artusinate suppository for severe / unconscious / inadequate facility

Question 16

t/f only tb has a dot program

Answer 16

false, malaria has dot

first 3 days supervised

Question 17

s/sx of leptospirosis

Answer 17

• fever, muscle pain, headache
• calf muscle pain and conjunctival suffusion
• liver, kidney, or brain involvement
• jaundice, hematuria, low urine output

Question 18

intermediate host of schistosoma sp

Answer 18

oncomelania sp (freshwater snails)

Question 19

schistosoma life cycle

Answer 19

• seeding of eggs into fresh water through feces for s. mansoni, s. japonicum, s. mekongi, or urine for s. haematobium
• worms mature in bv, liver, kidneys, intestines
• can manifest as urinary or intestinal disease, or bladder cancer
• life: 5-7 yrs, or 30 yrs

Question 20

clinical manifestation of acute schistosoma infection

Answer 20

• swimmer’s itch

- acute schistosomiasis syndrome (katayama fever)

Question 21

characteristics of katayama fever

Answer 21

• 3-8 wks after infection
• clinical manifestations = egg production
• sudden fever, urticaria, angioedema, chills, myalgia, arthralgia, dry cough, diarrhea, abdominal pain, headache

Question 22

intestinal schistosomiasis

Answer 22

cause: s japonicum

heavy infection = iron deficiency anemia, bowel strictures

Question 23

hepatosplenic schistosomiasis

Answer 23

cause: s japonicum

Question 24

pulmonary schistosomiasis

Answer 24

cause: s mansoni, s japonicum, s hematobium
- eggs lodge into pulmonary arterioles = granulomatous endarteritis
- presinusoidal hpn -> portosystemic collateral vessels
- end stage: cardiac englargement and pulmonary artery dilatation

Question 25

neuroschistosomiasis

Answer 25

• in spinal cord (acute myelopathy) or brain

- embolization of adult worms in spinal cord or cerebral microcirculation = granuloma, local destruction, scarring