Filariasis

Question 1

Where do adult filaria live?

Answer 1

Body cavities, lymphatics, subcutaneous tissues

Question 2

Where do microfilaria live?

Answer 2

Blood or dermis

Question 3

True or false: Filaria doesn’t require an insect or crustacean vector

Answer 3

False, it requires a vector

Question 4

What is the geographic distribution of Wuchereria bancrofti?

Answer 4

All tropics

Question 5

What is the vector of Wuchereria bancrofti?

Answer 5

Mosquito

Question 6

What is the type of disease that Wuchereria bancrofti causes?

Answer 6

Lymphatic filariasis

Question 7

What is the geographic distribution of Brugia malayi?

Answer 7

Southeast Asia

Question 8

What is the vector of Brugia malayi?

Answer 8

Mosquito

Question 9

What is the type of disease caused by Brugia malayi?

Answer 9

Lymphatic filariasis

Question 10

What is the geographic distribution of Loa loa?

Answer 10

Timor, Indonesia

Question 11

What is the vector of Loa loa?

Answer 11

Deer fly

Question 12

What is the type of disease caused by Loa loa?

Answer 12

Eye worm

Question 13

Onchocerca volvulus is a parasite found in Africa, Yemen, Central and South America. What area of the body does it affect?

Answer 13

The skin

Question 14

What is the vector of Onchocerca volvolus?

Answer 14

Black fly

Question 15

What is the type of disease caused by Onchocerca volvulus?

Answer 15

River blindness

Question 16

True or false: The length of male worms is larger in Wuchereria bancrofti than Brugia malayi

Answer 16

True

Question 17

True or false: The adult female worm is smaller than the adult male worm

Answer 17

False, the adult female worm is larger than the adult male worm

Question 18

What is the prominent feature of microfilaria?

Answer 18

Presence of sheath in the tail

Question 19

What is the life cycle of Wuchereria bancrofti/Brugia malayi?

Answer 19

Night biting mosquito takes up microfilaria
Microfilaria develop into stage 3 larvae in the thorax muscles of mosquito
Night biting mosquito injects infective larvae into human
Larvae migrate to lymphatics, where the adults develop, mate and release microfilaria into peripheral blood

Question 20

What causes lymphangitis and elephantiasis?

Answer 20

Larvae migrating to the lymphatics

Question 21

What causes tropical pulmonary eosinophilia in some sensitized hosts?

Answer 21

Microfilaria released into peripheral blood

Question 22

Identify the clinical signs of WB with their category
a. No symptoms
b. Lymphangitis, filarial fever
c. Elephantiasis, chyluria
d. Eosinophilia

Answer 22

a. Asymptomatic
b. Inflammatory
c. Obstructive
d. Tropical pulmonary eosinophilia

Question 23

What is the pathology of lymphatic filarial disease?

Answer 23

Lymphedema and elephantiasis from lymphatic dilatation

Question 24

Which clinical phase are the following pathologies describing?
a. Blockage of lymphatic ducts leading to inflammation of lymph nodes
b. From infection to appearance of microfilaria
c. Females reach maturity and microfilaria are released

Answer 24

a. Obstructive phase
b. Incubation phase
c. Inflammatory (acute) phase

Question 25

Associate the descriptions with their pathological conditions linked with lymphatic filariasis a. Milky fluid due to presence of white lymph from a ruptured dilated lymphatic vessel in the excretory urinary tract b. Caused by the death of the adult worm c. Serous fluid in cavity of Tunica Vaginalis testis caused by lymphatic dysfunction d. White lymph fluid in the cavity of the Tunica Vaginalis testis from ruptured dilated lymph vessel

Answer 25

a. Chyluria b. Acute filarial lymphangitis c. Hydrocele d. Chylocele

Question 26

Which of the following are diagnostic techniques for WB and BM? a. Thick or thin smear b. Knotts concentration technique c. Millipore filtration d. All of the above

Answer 26

d

Question 27

True or false: Loa loa is best detected in the night

Answer 27

False, it is best detected in the day

Question 28

How do we detect the presence of microfilaria?

Answer 28

Finger pricks and skin snips

Question 29

ELISA against which antibody can be used to detect tropical eosinophila syndrome?

Answer 29

IgG4

Question 30

Which antibodies are antifilarial?

Answer 30

IgG and IgE

Question 31

Which drug targets microfilaria by phagocytosis?

Answer 31

Diethylcarbamazine (DEC)

Question 32

Which drug acts to inhibit the polymerization of beta-tubulin and microtubule formation?

Answer 32

Albenzadole

Question 33

Which drug acts by hyperpolarization of glutamate sensitive channels?

Answer 33

Ivermectin

Question 34

A combination of which drugs allows 99% reduction in transmission?

Answer 34

DEC and Ivermectin

Question 35

Which immune response is activated in filariasis?

Answer 35

Th2 response

Question 36

Anti-filaria IgG is present in higher levels for which individuals?

Answer 36

Individuals with microfilaria in the blood, but no clinical disease

Question 37

IgG1 is more present in CP or MF patients?

Answer 37

CP patients

Question 38

IgG4 is more present in CP or MF patients?

Answer 38

MF patients

Question 39

What is the life cycle of Loa loa?

Answer 39

Red fly day bites and takes up microfilaria 1st-3rd stage larvae develop and migrate to proboscis Red fly bites and injects 3rd stage filariform larvae Adults develop and cause Calabar swellings Microfilaria released during the daytime into peripheral blood

Question 40

What is the life cycle of Onchocerca volvulus?

Answer 40

Microfilaria taken up by black fly bite 1st-3rd stage larvae develop in proboscis Black fly injects 3rd stage larvae into skin Larvae develop into adults in subcutaneous nodules Microfilaria released and migrate throughout subcutaneous tissue and eye causing blindness

Question 41

Edema, skin nodules and eye lesions are clinical signs of which disease?

Answer 41

River blindness

Question 42

What is the pathology of river blindness?

Answer 42

Inflammatory responses to microfilaria mediated by eosinophils

Question 43

True or false: Blindness in the river blindness disease occurs instantly

Answer 43

False, it takes 7-9 years

Question 44

What is lichenification?

Answer 44

Discoloration and cracking of the skin following a secondary bacterial infection from itching

Question 45

What is pannus formation?

Answer 45

Slow progressive degenerative disease of the cornea

Question 46

What is the country with the highest number of blind people due to onchocerciasis?

Answer 46

Chad

Question 47

What test is done if the skin snip is negative for detection of O. volvulus?

Answer 47

Mazzoti test

Question 48

Which antibody is detected in O. volvulus?

Answer 48

IgG4

Question 49

What is the treatment for river blindness?

Answer 49

Nodulectomy, chemotherapy

Question 50

Which drug is used to treat river blindness?

Answer 50

Ivermectin