(F) Cestodes: Cont. of Cyclophyllidea (module-based) Flashcards by ASHLEY JARED DEFENSOR

It has a cosmopolitan distribution but more common in warm than cold countries
a common tapeworm of man in Hawaii
It is the only tapeworm that does not need, or utilize, an intermediate host.

HYMENOLEPIS NANA

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HYMENOLEPIS NANA

AKA

dwarf tapeworm

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HYMENOLEPIS NANA

Adult worm inhabits where?

be espisipik

upper 2/3rd of the ileum

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HYMENOLEPIS NANA

TOF. It has a lifespan of several days.

F (weeks)

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HYMENOLEPIS NANA: MORPHOLOGY

Adult worms measure up to?

40mm long

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HYMENOLEPIS NANA: MORPHOLOGY

Scolex
* Rhomboid scolex with how many cup-like suckers?
* (short/long) rostellum with (number) of spines ARRANGED in a SINGLE RING

4
Short (20-40 spines)

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HYMENOLEPIS NANA: MORPHOLOGY

Which does not belong in the immature segment
A. Short and narrow
B. Broad proglottids
C. Most distal segments are pointy
D. NOTA

C (all are correct except C, it is rounded)

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HYMENOLEPIS NANA: MORPHOLOGY

In what segment are three (3) rounded testes, a bi-lobed ovary, and saccular uterus are found?

Mature segments

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HYMENOLEPIS NANA: MORPHOLOGY

30 - 47 um in diameter
Spherical or sub-spherical, oncosphere (hexacanth embryo) enclosed in an inner envelope with 2 polar thickenings having 4 - 8 polar filaments each

Egg

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HYMENOLEPIS NANA: MORPHOLOGY

The presence of what part is diagnostic and serves to differentiate H. nana egg from that of H. diminuta?

located in the egg

polar filaments

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HYMENOLEPIS NANA: MORPHOLOGY

No. of polar filaments

4-8

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HYMENOLEPIS NANA: LIFE CYCLE

MOT of Man

Ingestion of viable embryonated eggs
Person-to-person contact
Hand-to-mouth transfer
Vector (possibly, accidental intermediate host)
Contaminated food or water

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HYMENOLEPIS NANA: LIFE CYCLE

The embryonated eggs hatch where in the body?

stomach or small intestine

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HYMENOLEPIS NANA: LIFE CYCLE

After hatching, the freed oncosphere penetrates the villi of the anterior part of the small intestine where, after a few days, it develops into a?

cysticercoid larva

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HYMENOLEPIS NANA: LIFE CYCLE

Days of Maturation

2 weeks

larva na siya kaya pwede na siya magproduce ng egg

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HYMENOLEPIS NANA: LIFE CYCLE

How are eggs released if there is no uterine pore?

Apolysis

Disintegration of most distal proglottids (kung nasaan yung gravid segment)

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HYMENOLEPIS NANA: CLINICAL MANIFESTATION

TOF. Generally, the infection is usually well tolerated even among patients with heavy worm load and clinical manifestation is often due to allergic reactions.

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HYMENOLEPIS NANA: CLINICAL MANIFESTATION

Patients may manifest? (6)

headache
dizziness
anorexia
pruritus of nose and anus
periodic diarrhea
abdominal distress

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HYMENOLEPIS NANA: CLINICAL MANIFESTATION

Children may manifest (4)

lack of appetite
abdominal pain
with or without diarrhea
vomiting, and dizziness

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HYMENOLEPIS NANA

Lab diagnosis

DFS

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HYMENOLEPIS NANA

Treatment and Prevention available

Treatment: niclosamide, praziquantel and paromomycin
Measures: improve the hygiene habits, especially among children, environmental sanitation, proper and safe human waste disposal, and effective methods of rodent control

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HYMENOLEPIS DIMINUTA

AKA

commonly called the rat tapeworm

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HYMENOLEPIS DIMINUTA

MOT

accidental ingestion of an intermediate host (may be present in foods, flour, or hands that contains the cysticercoid larva)

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HYMENOLEPIS DIMINUTA

Intermediate hosts

Fleas

fleas fleas fleas

Ctenocephalides canis (dog flea), Ctenocephalides felis (cat flea), Xeonpsylla cheopis and Nosopsyllus fasciatus (rat flea), and Pulex irritans (human flea)

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# HYMENOLEPIS DIMINUTA: LIFE CYCLE Inhabit

Small intestine

# HYMENOLEPIS DIMINUTA: LIFE CYCLE MOT of intermediate host

intermediate hosts ingest the mature eggs that may have been discharged in the environment together with the feces (by the definitive host)

# HYMENOLEPIS DIMINUTA: LIFE CYCLE The liberated oncosphere penetrates what part of the insect to mature into an infective stage to the definitive host?

hemocele

# HYMENOLEPIS DIMINUTA: CLINICAL MANIFESTATION TOF. Well tolerated by man always.

F (oftentimes)

# HYMENOLEPIS DIMINUTA: CLINICAL MANIFESTATION TOF. Most infected individuals are symptomatic.

F (a simp)

# HYMENOLEPIS DIMINUTA: CLINICAL MANIFESTATION Some patients may experience (anorexia/obesity)

anorexia ## Footnote kainin mo raw to para pumayat ka

# HYMENOLEPIS DIMINUTA LAB DIAGNOSIS

Diagnosis can be conformed thru recovery of eggs in fecal specimens.

# HYMENOLEPIS DIMINUTA Treatment and Prevention

* Treatment: Praziquantel and niclosamide * Measures: (1) Avoid exposure to the intermediate host (2) Control measures to eradicate the intermediate host (3) Proper disposal of human excreta (4) Rodent control (5) Early diagnosis and prompt treatment of infected individuals

* causes dipylidiasis or dog tapeworm infection * common tapeworm of dogs and cats throughout the world

DIPYLIDIUM CANINUM

# DIPYLIDIUM CANINUM AKA

double pored dog tapeworm

# double pored dog tapeworm Adult worm inhabits where?

small intestine of the definitive host

# DIPYLIDIUM CANINUM: LIFE CYCLE Eggs that hatch in the intestine of these arthropods develop into?

procercoid larva

# DIPYLIDIUM CANINUM: LIFE CYCLE MOT

Ingestion of cysticercoid larva | in the body of the arthropod intermediate host

# DIPYLIDIUM CANINUM: LIFE CYCLE Days of Maturation in man

3-4 weeks

# DIPYLIDIUM CANINUM: LIFE CYCLE The procercoid larva later transform into what stage in the body of the adult flea?

cysticercoid larva

# DIPYLIDIUM CANINUM: LIFE CYCLE definitive hosts

Dogs Cats Man (occasionally)

# DIPYLIDIUM CANINUM: LIFE CYCLE Intermediate host

* Ctenocephalides canis * Ctenocephalides felis * Pulex irritans * Trichodectes canis (dog louse)

# DIPYLIDIUM CANINUM: LIFE CYCLE All cases were among children ingesting the infected dog or cat fleas because?

they kiss or are licked by infected pets

# DIPYLIDIUM CANINUM: CLINICAL MANIFESTATION Symptoms among children (mild)

* light intestinal disturbances, (indigestion, abdominal pain, loss of appetite, diarrhea) * Anal itchiness due to migrating segments

# DIPYLIDIUM CANINUM: LAB DIAGNOSIS

* Recovery and identification of eggs, contained in a capsule (diagnostic) in direct fecal smear and/or the gravid (may also include mature) segments will confirm the diagnosis

# DIPYLIDIUM CANINUM: Treatment and prevention

* Treatment: Niclosamide and praziquantel * Preventive measures: control of dog and/or cat fleas, regular cleaning of dogs, cats, and other animals in or near the house, early diagnosis and prompt treatment of infected persons and proper disposal of human excreta

* Causes unilocular echinococcosis or hydatid disease among humans * Man does not harbor adult worms. * Human infection is limited * Most extensive and intensive enzootic endemic regions are sheep and/or cattle raising countries * Prevelance depends on intimate association of humans with infected dogs * Dog owners have a greater risk of infection than non-owners or dogs * Adult worms are attached at the mucosal wall of the small intestine of dogs, wolves, jackals, coyotes, foxes, and other carnivores

Echinococcus granulosus

# Echinococcus granulosus AKA

hydatid worm

# Echinococcus granulosus: Life Cycle Definitive host

Dog

# Echinococcus granulosus: Life Cycle MOT

Ingestion on the viscere of an intermediate host infected with hydatid larvae

# Echinococcus granulosus: Life Cycle Intermediate host

Sheep, goat, camel, ox, hog, cattle, man and other suitable intermediate hosts

# Echinococcus granulosus: Life Cycle Hatch (Inter. host)

Duodenum of the intermediate host

# Echinococcus granulosus: Life Cycle There two types of cycle:

1. Pastoral 2. Sylvatic

# Echinococcus granulosus: Life Cycle MOT to huamns

* ingestion of the eggs, which is chiefly a hand-to-mouth transfer

# Echinococcus granulosus: Pathogenesis Cysts may be distributed in? | organ

Liver ## Footnote may include secondary peritoneal invasion, lungs, kidneys, bones, brain, and other tissues such as muscle, spleen, eyes, heart, and thyroid

# Echinococcus granulosus: Pathogenesis adjacent tissues undergo atrophy and pressure necrosis occurs due to?

growing cyst ## Footnote which can also cause vascular constriction

# Echinococcus granulosus: Pathogenesis * evoke inflammatory reactions to surrounding tissues that produce encapsulating fibrous adventitia. * impairs an organ mainly due to mechanical pressure

Unilocular cyst

# Echinococcus granulosus: Clinical Manifestation

# Echinococcus granulosus: Clinical Manifestation Cyst at the dome of the liver grows slowly and persists even as long as how many years before producing noticeable symptoms?

# Echinococcus granulosus: Clinical Manifestation Pressure on bile ducts may result to?

obstructive jaundice and on the ureters

# Echinococcus granulosus: Clinical Manifestation triad of manifestations in cases of biliary duct obstruction includes

* Jaundice * Fever * Eosinophilia

# Echinococcus granulosus: Clinical Manifestation Early manifestations

slight hemoptysis, cough, dyspnea, transient thoracic pain, palpitation, tachy-cardia, and pruritus. ## Footnote familiarize ka lang kapag mga ganito ok

# Echinococcus granulosus: Clinical Manifestation may produce intermittent pain, hematuria, and kidney dysfunction | anong cyst

Renal cyst

# Echinococcus granulosus: Clinical Manifestation

# Echinococcus granulosus: Clinical Manifestation increase intracranial pressure and Jacksonian type of epilepsy A. Osseous hydatid B. Renal cyst C. Brain cyst D. Splenic cyst

may produce dull pain and bulging of the ribs, whereas spotty areas of dullness and resonance on percussion may be demonstrated with pelvic cysts

splenic cyst

# ECHINOCOCCUS GRANULOSUS Laboratory Diagnosis

* Radiologic examinations such as X-ray, CT-scan, and ultrasonography * Demonstration of protoscolices, brood capsules and/or daughter cysts after surgical removal * Hydatid fragments in sputum or urine * Serologic tests can also be used, this include E.L.I.S.A., H.I.A., Indirect Fluorescent Antibody (IFA), and IEP (Immune electrophoresis).

Lifecycle: D. granulosus 1. Intermediate host are chiefly herbivores, in whose organs and tissues, the larval form becomes unilocular hydatid cyst. 2. Occurs in wolves 3. The most important host is sheep. 4. Hydatid cyst develops in wild ungulates (moose and reindeer) and human are less likely to become infected as accidental host. A. Sylvatic B. Pastoral

BABA