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Parasitology [LAB] > Exercise No. 8b PHYLUM PLATYHELMINTHES Class Trematoda - Monoecious Flukes > Flashcards

Exercise No. 8b PHYLUM PLATYHELMINTHES Class Trematoda - Monoecious Flukes Flashcards

1
Q

Leaf-shaped

A

Fasciola hepatica

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2
Q

Pointed anterior, rounded posterior (“bottle-neck” appearance)

A

Clonorchis sinensis

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3
Q

Resembles C. sinensis

A

Opisthorchis felineus and Opisthorchis viverrini

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4
Q

Lancet-shaped

A

Dicrocoelium dendriticum

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5
Q

Elongate-ovoidal in shape

A

Fasciolopsis buski

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6
Q

Attenuated at both ends

A

Echinostoma ilocanum

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7
Q

Narrow anterior, rounded posterior (“pyriform”)

A

Heterophyes heterophyes

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8
Q

Resembles H. heterophyes

A

Metagonimus yokogawai

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9
Q

When active: spoonshaped; At preserved state:70-100 x 50-60 pm oval, flattened, coffee-bean-shaped

A

Paragonimus westermani

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10
Q

Integument: scales vary in size, pattern & distribution, but posterior is aspinose

A

Fasciola hepatica

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11
Q

Integument: aspinose

A

-Clonorchis sinensis
-Opisthorchis felineus and Opisthorchis viverrini
-Dicrocoelium dendriticum

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12
Q

Integument: Spinose

A

Fasciolopsis buski

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13
Q

Integument: with spines and scales

A

Echinostoma ilocanum

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14
Q

Integument: scales are narrow and closely set, numerous in the anterior

A

Heterophyes heterophyes

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15
Q

Integument: scale-like spines

A

Paragonimus westermani

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16
Q

Oral sucker, 0.5 mm
Ventral sucker, 2-3 mm

A
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17
Q

Uterus, coiled

A

-
-
-Fasciolopsis buski

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18
Q

Vitellaria, highly branched in the lateral and posterior

A

Fasciolopsis buski

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19
Q

Vitellaria, medium-sized follicles in posterior % lateral fields

A

Echinostoma ilocanum

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20
Q

Vitellaria, large, polygonal follicles in each lateral posterior third

A

Heterophyes heterophyes
Metagonimus yokogawai

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21
Q

.

A
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22
Q

Genital sucker, armed w/spines

A

Heterophyes heterophyes

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23
Q

Vitellaria, branched, lateral for the entire length of the body

A

Paragonimus westermani

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24
Q

Ceca, unbranched

A

Fasciolopsis buski

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25
Q

Circumoral disk with horseshoe-shaped crown of 49-51 hooks

A

Echinostoma ilocanum

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26
Q

Ovary, branched

A

Fasciola hepatica

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27
Q

Ovary, round or lobed

A

Echinostoma ilocanum

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28
Q

Ovary, subglobose

A

Heterophyes heterophyes
Metagonimus yokogawai

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29
Q

Ovary, lobed

A

Paragonimus westermani

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30
Q

Testes, highly dendritic
In tandem in the 2nd & 3rd fourths

A

Fasciola hepatica

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31
Q

Testes, deeply lobed or branched in tandem in the posterior 3rd fields

A

Clonorchis sinensis

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32
Q

Testes lobed oblique to each other in the posterior 4th

A

Opisthorchis felineus and Opisthorchis viverrini

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33
Q

Testes, slightly lobed, oblique to each other

A

Dicrocoelium dendriticum

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34
Q

Testes, highly dendritic
In tandem in posterior 1/2

A

Fasciolopsis buski

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35
Q

Testes, lobed
In tandem in posterior 1/2

A

Echinostoma ilocanum

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36
Q

Testes, ovoid, side by side in the posterior fifth

A

Heterophyes heterophyes

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37
Q

Testes, ovoid obliquely side by side in posterior 5th

A

Metagonimus yokogawai

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38
Q

Testes, lobed, oblique to each other or nearly side by side at the posterior third

A

Paragonimus westermani

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39
Q

Ovoid, hen’s egg- shaped

A

Fasciola hepatica

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40
Q

broadly ovoid (“old- fashioned electric bulb”)

A

Clonorchis sinensis

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41
Q

elongate-ovoid, narrower than C. s/nens/sova

A

Opisthorchis felineus and Opisthorchis viverrini

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42
Q

asymmetrically ovoidal

A

Dicrocoelium dendriticum

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43
Q

hen’s egg-shaped, identical to F. hepatica, thin, transparent shell

A

Fasciolopsis buski

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44
Q

straw-colored, ovoid

A

Echinostoma ilocanum

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45
Q

ovoid, less distinct opercular shoulder

A

Heterophyes heterophyes

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46
Q

Similar to H. heterophyes

A

Metagonimus yokogawai

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47
Q

shape varies greatly, some asymmetrical, thick shell

A

Paragonimus westermani

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48
Q

light yellowish-brown

A

-Fasciola hepatica
-Clonorchis sinensis
-Opisthorchis felineus and Opisthorchis viverrini

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49
Q

dark brown

A

Dicrocoelium dendriticum

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50
Q

thin, transparent shell

A

Fasciolopsis buski

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51
Q

straw-colored

A

Echinostoma ilocanum

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52
Q

Yellowish-brown to dark golden brown

A

Paragonimus westermani

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53
Q

small, flat operculum at one end

A

Fasciola hepatica

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54
Q

convex operculum fits a circular rim of shell, small knob at the abopercularend

A

Clonorchis sinensis

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55
Q

operculum fits into a thickened rim of shell, minute thickening at the abopercular end

A

Opisthorchis felineus and Opisthorchis viverrini

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56
Q

broad convex operculum

A

Dicrocoelium dendriticum

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57
Q

small, slightly convex operculum

A

Fasciolopsis buski

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58
Q

small operculum

A

Echinostoma ilocanum

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59
Q

less distinct opercular shoulder

A

Heterophyes heterophyes

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60
Q

flattened operculum, thickened opercular rim, and abopercular end is generally thicker than the sides

A

Paragonimus westermani

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61
Q

Ovary central

A

Schistosoma japonicum

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62
Q

Ovarv anterior half

A

Schistosoma mansoni

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63
Q

Ovary posterior half

A

Schistosoma haematobium

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64
Q

Tegument smooth

A

Schistosoma japonicum

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65
Q

Tegument coarsely tuberculated

A

Schistosoma mansoni

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66
Q

Tegument slightly tuberculated

A

Schistosoma haematobium

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67
Q

6-8 testes

A

Schistosoma japonicum

68
Q

8-9 testes

A

Schistosoma mansoni

69
Q

4-5 testes

A

Schistosoma haematobium

70
Q

Lateral knob

A

Schistosoma japonicum

71
Q

Lateral spine

A

Schistosoma mansoni

72
Q

Terminal spine

A

Schistosoma haematobium

73
Q

50-100 ova in uterus

A

Schistosoma japonicum

74
Q

1-4 ova in uterus

A

Schistosoma mansoni

75
Q

20 - 30 ova in uterus

A

Schistosoma haematobium

76
Q

Definitive diagnosis: demonstration of characteristic eggs in feces or aspirated bile from duodenum

A
77
Q

Definitive diagnosis: demonstration of characteristic eggs in feces or aspirated bile from duodenum

A

-Dibothriocephalus latus (Diphyllobothrium latum)
-Clonorchis sinensis
-Opisthorchis felineus and Opisthorchis viverrini

78
Q

Definitive diagnosis: demonstration of characteristic eggs in feces

A

Dicrocoelium dendriticum
Echinostoma ilocanum

79
Q

Definitive diagnosis: demonstration of characteristic eggs in feces of the worms after administration of a purgative or anthelmintic drug

A

Fasciolopsis buski

80
Q

Definitive diagnosis: detection of characteristic eggs in feces

A

Heterophyes heterophyes and Metagonimus yokogawai (The heterophyids)

81
Q

Definitive diagnosis: detection of characteristic eggs in sputum

A

Paragonimus westermani

82
Q

best method of diagnosis for Dibothriocephalus latus (Diphyllobothrium latum)

A

Microscopic examination

83
Q

Eggs of [?] are indistinguishable.

A

F. hepatica and F. buski

84
Q

Differential diagnosis must be made to differentiate between TRUE INFECTION form SPURIOUS INFECTION.

A

Dibothriocephalus latus (Diphyllobothrium latum)

85
Q

result from ingestion of infected herbivore liver harboring the eggs which are passed out in the feces without any morphological changes

A

SPURIOUS FASCIOLIASIS

86
Q

The following steps may be performed:

A
  1. Ask the patient if he has taken/ included liver in his previous diet.
  2. Advice him to have a liver-free diet for 2 – 3 days and recollect a stool sample
  3. Patient’s stool sample is reexamined and, if
    (+) eggs in the feces: TRUE INFECTION
    (-) eggs in the feces: SPURIOUS INFECTION
87
Q

Blood picture.
Examination of peripheral blood reveals eosinophilia.

A

Dibothriocephalus latus (Diphyllobothrium latum)

88
Q

Serodiagnosis.
a. Antibody detection
b. Antigen detection

A

Dibothriocephalus latus (Diphyllobothrium latum)

89
Q

Serological tests such as immunofluorescence, ELISA, immunoelectrophoresis and complement fixation are helpful for detection of specific antibody in light infections.

A

Dibothriocephalus latus (Diphyllobothrium latum)

90
Q

ELISA becomes positive within 2 weeks of infection and is negative after treatment.

A

Dibothriocephalus latus (Diphyllobothrium latum)

91
Q

is of diagnostic importance during chronic fascioliasis

A

Antigen detection

92
Q

Fasciola coproantigen may be detected in stool.

A

Antigen detection

93
Q

Dibothriocephalus latus (Diphyllobothrium latum) Imaging

A

a. Ultrasonography
b. computed tomography (CT) scan
c. endoscopic retrograde cholangiopancreatography (ERCP)
d. percutaneous cholangiography

94
Q

Detecting moderate to heavy infections:
a. Kato thick smear b. Stoll’s dilution c. Quantitative FECT

A

Clonorchis sinensis

95
Q

Eggs do not float in concentrated saline.

A

Clonorchis sinensis

96
Q

Eggs of C. sinensis are difficult to differentiate from those of

A

H. heterophyes, M. yokogawai, and O. felineus species.

97
Q

Blood examination.

 Examination of peripheral blood smear may reveal leukocytosis with eosinophilia.

A

Clonorchis sinensis

98
Q

Immunodiagnosis
 Several serological tests for antibody detection have been described but extensive cross-reactions limit their utility.

A

Clonorchis sinensis

99
Q

Clonorchis sinensis Immunodiagnosis

A

a. Complement fixation
b. Gel precipitation
c. IHA with a saline extract of etherized worms
d. ELISA

100
Q

has been reported to be sensitive and specific
IHA with a saline extract of etherized worms

A

Clonorchis sinensis

101
Q

Fecal antigen detection
ELISA

A

Clonorchis sinensis

102
Q

Intradermal allergic (hypersensitivity) tests

A

Clonorchis sinensis

103
Q

Detecting moderate to heavy infections:
a. Kato thick smear b. Stoll’s dilution c. Quantitative FECT

A

Opisthorchis felineus and Opisthorchis viverrini

104
Q

Eggs do not float in concentrated saline.

A

Opisthorchis felineus and Opisthorchis viverrini

105
Q

Eggs of are difficult to be differentiate on morphological grounds from those of C. sinensis, H. heterophyes, M. yokogawai,.

A

Opisthorchis felineus and Opisthorchis viverrini

106
Q

useful for specific identification of O. viverrini

A

Polymerase chain reaction (PCR)

107
Q

Similar with Fascioliasis, differential diagnosis must also be performed in order to differentiate true infection from spurious infection which may arise from ingestion of the parasite’s egg in contaminated cattle liver.

A

Dicrocoelium dendriticum

108
Q

History of residence in endemic areas suggests diagnosis

A

Fasciolopsis buski

109
Q

The eggs of [?] are indistinguishable.

A

F. buski and F. hepatica

110
Q

Examination of peripheral blood
 Eosinophilia is often present

A

Fasciolopsis buski

111
Q

Immunodiagnosis
 Serodiagnosis is of no value.

A

Fasciolopsis buski

112
Q

first documented in humans in 1987, and has since been reported in Northern and Central Luzon

A

Artyfechinostomum (Echinostoma) malayanum

113
Q

In 2005, a study in Siargao Island, Surigao del Norte, showed A. malayanum in [?] of individuals suffering from gastrointestinal disturbance.

A

11.4%

114
Q

All infected patients has a history of having eaten [?] prepared raw with coconut milk and lime juice.

A

snails (kuhol and kiambuay)

115
Q

Kato Thick method
 has a higher sensitivity compared to FECT (31.0% vs. 13.6%)

A

Heterophyes heterophyes and Metagonimus yokogawai (The heterophyids)

116
Q

careful inspection of the egg’s features must be observed in order to differentiate it from those of C. sinensis and Opisthorchis species

A

Kato Thick method,

117
Q

may be useful as a sensitive diagnostic tool, particularly for low-intensity heterophyid infections

A

PCR

118
Q

o stool o gastric washing o abscess o pleural effusions o tissue material

A

Paragonimus westermani

119
Q

Serology is of particular importance in eggnegative cases and in cerebral paragonimiasis.

A

Paragonimus westermani

120
Q

Parasite-specific immunoglobulin E (lgE) and antiparagonimus antibodies can be detected in serum.

A

Paragonimus westermani

121
Q

 carried out with a saline extract of adult Paragonimus westermani or other suitable antigen gives an immediate sensitivity reaction in infected persons

A

Intradermal test

122
Q

 remains positive long after recovery, thereby indicating past infection

A

Intradermal test

123
Q

used for the diagnosis indicates an active infection

A

Complement fixation test

124
Q

 highly sensitive

A

IHA and ELISA tests

125
Q

 tests become negative within 3-4 months after successful treatment

A

IHA and ELISA tests

126
Q

reveals abnormal shadows (nodular, cystic, and infiltrative) in the middle and lower lung fields similar to pulmonary tuberculosis

A

Chest X-ray

127
Q

presence of shadows of tunnels and “burrows” in the lung bases resemble bronchiectasis

A

Chest X-ray

128
Q

 chest
 also helps in diagnosis of pulmonary and cerebral lesions

A

CT scan

129
Q

 “Soap-bubble’’ like appearance may be seen in cerebral cysts

A

CT scan

130
Q

Microscopic examination of stool samples to demonstrate characteristic eggs of S. japonicum and S. mansoni may be accomplished by routine parasitologic methods and/or quantitative techniques to determine worm burden; similar to those techniques employed in the diagnosis of helminthiasis.

A

Examination of stool

131
Q

Microscopic examination of urine is used to demonstrate characteristic eggs of S. haematobium. This may be accomplished by one of the following methods:
1. Urine sedimentation
2. Urine filtration

A

Examination of urine

132
Q

T or F

When schistosome eggs are recovered from either urine or stool, they should be carefully examined to determine viability.

A

T

133
Q

T or F
An individual who has undergone successful treatment form schistosomiasis continuously pass out residual eggs which are non-viable, hence may indicate good, previous treatment.

A

T

134
Q

On the other hand, the presence of living [?] within the eggs indicates an active infection that may require therapy.

A

miracidia

135
Q

At the end of micturition, the [?]contracts facilitating extrusion of eggs deposited in the walls of the bladder.

A

urinary bladder

136
Q

The sample should consist of a single terminal urine specimen of at least

A

10 mL

137
Q

The viability of the miracidia can be determined in two ways

A
  1. Flame cell activity2. Miracidial hatching test
138
Q

Schistosome miracidia possess primitive excretory cells known as flame cells. If eggs are viable (i.e. containing viable miracidia) the cilia of the flame cells may be seen on a wet smear by using high dry power and are usually actively moving.

A

Flame cell activity

139
Q

, the miracidia may be released from the eggs recovered in stool or urine.

A

Miracidial hatching test

140
Q

Histopathology

Schistosomiasis may also be diagnosed by demonstration of characteristic schistosome eggs during microscopic examination of biopsy materials obtained from the [?] (for intestinal schistosomiasis), or the [?] (for urinary schistosomiasis).

A

rectal valve
urinary bladder

141
Q

Detection of schistosome antigens may be performed using a patient’s [?] (for S. haematobium).

A

serum or urine

142
Q

Two circulating antigens related to gut of adult schistosomes:

A

(1) circulating anodic antigen (CAA)
(2) circulating cathodic antigens (CCAs) can be demonstrated by dipstick assay and ELISA using urine obtained form a suspected individual

143
Q

The test is very sensitive and specific but is available only in specialized laboratories

A

Antigen detection

144
Q

Soluble egg antigens (SEAs) can be demonstrated in serum.

A

Antigen detection

145
Q

Several tests have been described to detect specific antibodies in serum samples of infected individuals. The most common are:

A

I. Circumoval Precipitin Test (COP/COPT)
II. FAST-ELISA (Falcon Assay Screening Test-Enzyme-linked Immunosorbent Assay)

146
Q

o employed to detect antischistosomal antibodies in patients serum using lyophilized eggs or purified live (viable) eggs identified under the microscope as antigens

A

Circumoval Precipitin Test (COP/COPT)

147
Q

The procedure involves reacting 1 drop (about 0.025 ml) of the antigen suspension with 3 drops (about 0.075 ml) of patient’s serum into a well of a slide.

A

Circumoval Precipitin Test (COP/COPT)

148
Q

The reaction well is overlaid with a coverslip and incubated at 34 degrees C for 24 hours.

A

Circumoval Precipitin Test (COP/COPT)

149
Q

The slide is examined under the microscope for reaction.

A

Circumoval Precipitin Test (COP/COPT)

150
Q

The appearance of blebs of precipitate around the eggs is considered as a positive result.

A

Circumoval Precipitin Test (COP/COPT)

151
Q

COPT is considered useful in the diagnosis of intestinal schistosomiasis.

A

Circumoval Precipitin Test (COP/COPT)

152
Q

This method employs the use of purified , species-specific microsomal antigens of adult schistosome worms to detect antibodies in the patient’s serum.

A

FAST-ELISA (Falcon Assay Screening Test-Enzyme-linked Immunosorbent Assay)

153
Q

A positive reaction (greater than 9 units/µl serum) indicates infection with schistosome species.

A

FAST-ELISA (Falcon Assay Screening Test-Enzyme-linked Immunosorbent Assay)

154
Q

The specificity of the FAST-ELISA is 99%, and its sensitivity is 99% for S. mansoni, 95% for S. haematobium, and approximately 50% for S. japonicum infection

A

FAST-ELISA (Falcon Assay Screening Test-Enzyme-linked Immunosorbent Assay)

155
Q

 Abdomen
 may show bladder and ureteral calcification in infections with S. haematobium

A

a. X-ray

156
Q

 may show hydroureter and hydronephrosis in urinary schistosomiasis and hepatosplenomegaly and periportal fibrosis in chronic intestinal schistosomiasis

A

b. Ultrasonography (USG)

157
Q

 also useful in indirect diagnosis of urinary bilharziasis

A

c. Intravenous pyelogram (TVP) and cystoscopy

158
Q

Aside from the three medically significant schistosomes previously mentioned, 2 more schistosome species have been found to infect man. They are:

A

Schistosoma lntercalatum
Schistosoma mekongi

159
Q

o was first noted in 1934 in West-Central Africa

A

Schistosoma lntercalatum

160
Q

o The eggs are similar to S. haematobium in general shape and in possessing a terminal spine, but are usually longer (140-240 µm), often have an equatorial (central) bulge and are shed in stool, not urine and are acid-fast.

A

Schistosoma lntercalatum

161
Q

o It produces few symptoms involving the mesenteric portal system.

A

Schistosoma lntercalatum

162
Q

o Diagnosis is established by the detection of the egg in feces and rectal biopsy.

A

Schistosoma lntercalatum

163
Q

 was first recognized in 1978 in Thailand and Cambodia, along the Mekong river

A

Schistosoma mekongi

164
Q

 Man, acquires infection in the same way as in S. japonicum, serves as the definitive host together with dogs.

A

Schistosoma mekongi

165
Q

 The eggs are closely related in morphology to S. japonicum but are generally smaller (50-80 µm by 40-65 µm).

A

Schistosoma mekongi

166
Q

 They also contain a small, inconspicuous spine and are shed in stool.

A

Schistosoma mekongi

Parasitology [LAB] (15 decks)

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