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Micro I > Helminthic Infections of the GI System > Flashcards

Helminthic Infections of the GI System Flashcards

1
Q

What organism has an elongated cylindrical body that tapers at either end, is covered by a multi-layered cuticle and has 2 separate sexes?

A

Nematodes (roundworms)

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2
Q

What 2 nematode life cycle forms exist in the environment?

A

Eggs and larvae

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3
Q

What 2 nematode life cycle forms exist in humans?

A

Larvae and adults

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4
Q

What is the causative agent of enterobiasis?

A

Enterobius vermicularis (pinworm disease)

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5
Q

What is the most common helminthic disease in the US?

A

Enterobius vermicularis

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6
Q

Why is there an increased chance of relapse with Enterobius vermicularis?

A

Life cycle is direct and short, eggs require short time to become infectious

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7
Q

How is infection with Enterobius vermicularis transmitted?

A

Person to person (eggs deposited on perianal region) or indirectly from environment

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8
Q

What populations/ environments is Enterobius

vermicularis most common in?

A

Children, temperate climates

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9
Q

What is the role of gravid females in Enterobius vermicularis?

A

Migrate at night to perianal region to deposit eggs

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10
Q

Deposited eggs of Enterobius vermicularis become infectious for how long? And how long can the eggs survive in indoor environments?

A

Infectious in 4-6 hours, can survive in indoor environments for 2-3 weeks

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11
Q

Pt presents with itching in the anal region (pruritis ani). What should you be concerned for?

A

Enterobius vermicularis

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12
Q

What can heavy infections with Enterobius vermicularis lead to? (3)

A

Secondary bacterial infections, disturbed sleep, abd pain

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13
Q

How is infection with Enterobius vermicularis diagnosed?

A

Presence of eggs on perianal skin via cellophane tape method

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14
Q

How is infections via Enterobius vermicularis controlled?

A

All household members treated at same time to minimize spread, handwashing

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15
Q

How are Ascaris lumbricoides (large intestinal roundworm) and Trichuris trichiura (whipworm) transmitted?

A

Contaminated soil ingestion

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16
Q

What is the largest intestinal nematode of humans?

A

Ascaris lumbricoides

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17
Q

How many eggs are released by an adult female Ascaris lumbricoides?

A

~200,000 per day

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18
Q

How does Ascaris lumbricoides infect humans?

A

Ingestion of fertilized eggs (larvae) from contaminated soil travel from the GI to the lungs/trachea where they are re-swallowed and mature and duodenum.

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19
Q

Although typically asx, what should you be concerned of if a pt presents with Pulmonary-Leoffler’s syndrome, intestinal-abd pains, and complications such as intestinal or duct obstruction?

A

Ascaris lumbricoides (extensive disease)

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20
Q

How is infection with Ascaris lumbricoides diagnosed?

A

Microscopic detection of eggs in stool sample

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21
Q

What worms are small with a whiplike morphology and have “egg capsules”?

A

Trichuris trichiura

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22
Q

How does Trichuris trichiura infect human?

A

Ingestion of embryonate eggs from contaminated soil and larvae are released into the duodenom. Eggs hatch and mature in the colon.

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23
Q

Why do you have a decreased number of relapses with Trichuris trichiura?

A

Slower life cycle (unembryonated aggs are passed in the stool and must mature in the environment before infecting humans)

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24
Q

Where do the larvae of Trichuris trichiura mature?

A

Colon

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25
Q

Where do the eggs of Trichuris trichiura mature?

A

Soil

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26
Q

What determines the extent of disease for Ascaris lumbricoides, Trichuris trichiura, and hookworms?

A

Worm buden

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27
Q

If a pt presents with frequent painful passage of stool (w mucus, water, blood) and rectal prolapse, what should you be concerned about?

A

Trichuris trichiura (heavy infection)

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28
Q

Heavy infection with Trichuris trichiura might lead to what in children?

A

Suffer growth retardation and anemia

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29
Q

How is infection with Trichuris trichiura diagnosed?

A

Presence of eggs in stool sample

30
Q

What type of worms are Necator americanus and Ancylostoma duodenale?

A

Hookworms

31
Q

What do hookworms feed on?

A

Blood from intestinal mucosa (leads to anemia)

32
Q

Infective eggs of hookworms mature and hatch where?

A

Soil

33
Q

How do hookworms enter the body?

A

Infective stage larvae (filariform) penetrate skin

34
Q

In addition to worm burden, extent of disease from hookworms is also dependent on what?

A

Adequacy of the host’s nutrient intake

35
Q

If you note blood-filled, pruritic lesions at the site of penetration, what should you be concerned for?

A

Hookworms (“ground itch”)

36
Q

Why can hookworm infections progress quickly?

A

Infection of blood

may observe anemia

37
Q

How is a hookworm infection diagnosed?

A

Presence of eggs in stool sample

38
Q

What is the causative agent of Strongyloidiasis?

A

Strongyloides stercoralis

39
Q

What organism is a “threadworm” bc adult worms are ~2mm and have 2 multiplication cycles?

A

Strongyloides stercoralis

40
Q

What are the 2 multiplication cycles of Strongyloides stercoralis?

A

In host (parasitic) or in soil (free living)

  1. Infective larvae in the soil penetrates human skin. Larvae then travels through blood to lungs/oropharynx, swallowed and matures in duodenum. After reproduction, female releases larvae in feces.
  2. Released larvae mature in the soil
41
Q

Where is Strongyloides stercoralis more prevalent?

A

Tropical/ subtropical areas, poor sanitation

42
Q

How do Strongyloides stercoralis enter the body?

A

Infective larvae in soil penetrate skin

43
Q

How does infective larvae Strongyloides stercoralis infect humans?

A

Penetrates the skin

Infections usually door to poor sanitation

44
Q

The clinical characteristics of Strongyloides stercoralis are related to what?

A

Visible route of larval migration from site of infection

45
Q

Pt presents with non-specific erythematous rash to bottom of left foot and intestinal sxs (diarrhea, pain, constipation, and malabsorption). What are you concerned for?

A

Strongyloides stercoralis

Rash due to site of infection from infective larvae that then travel into circulatory system

46
Q

Autoinfection with Strongyloides stercoralis can occur and result in what?

A

Chronic infection that persists for years (high number of relapse)

47
Q

In what populations can infection with Strongyloides stercoralis be life threatening?

A

Defect in cell mediated immunity

48
Q

What helminth has “egg” or oval capsules?

A

Trichuris trichiura

49
Q

What is the infective form of Trichuris trichiura?

A

Embryonated eggs

50
Q

Once a hook word has penetrated the skin, how do they mature?

A

Travel via bloodstream to lungs/oropharynx, where they are swallowed and mature in duodenum

51
Q

What is the infective form of hook worms?

A

filariform

52
Q

Why does Strongyloides stercoralis activate the immune system while other worms cause an allergic response?

A

Most worms without virulence factors to trigger immune system, so they activate allergic response (eosinophilia).

Strongyloides stercoralis has external virulence factors that body mounts an immune attack against

53
Q

What helminth has a flattened, leaflike body, sucks, and is hermaphroditic (both M/F)?

A

Trematodes (flukes)

54
Q

An infection of Taenia solium (tapeworm) will come from eating what contaminated/undercooked food?

A

Pork

55
Q

An infection of Taenia saginate (tapeworm) will come from eating what contaminated/undercooked food?

A

Beef

56
Q

What is the 2 intermediate and 1 definitive hosts for trematodes (fluke)

A

Intermediate: Cattle (Taenia. saginata), Pigs (Taenia. solium)
Definitive: humans

*Infective eggs are ingested by cattle/pigs and larvae develop into their muscle. Human can become infected if meat is not cooked correctly. Human’s release proglottids (segments of the worm) in the feces which contains infectious eggs.

57
Q

What helminth posses a scolex (head structure) which contains a sucks and proglottids (segment of worm containing complete sexual maturation system)?

A

trematodes (fluke)

58
Q

Are eggs released from trematodes (fluke) immediately infectious?

A

Yes

59
Q

Is ingestion of contaminated pork w/ cysticerci (larvae) of Taenia solium more or less serious than ingestion of pork w/ Taenia solium infective eggs?

A

Less severe.

Serious infection, cysticercosis can develop if infective eggs are ingested by humans, vs ingestion of larvae.

60
Q

Cysticercosis is often asx, but can lead to what?

A

Serious episodes of sequlae depending on infected site.

61
Q

Infection w/ what will lead to worms traveling within the body resulting visible worms in the eye, under the skin, in the brain, blindness, seizure

A

Ingestion of infective Taenia solium eggs from undercooked pork (Cysticercosis)

62
Q

How can trematodes (fluke) infection be dx?

A

Presence of eggs or proglottids in stool sample. Histologic demonstration is definitive

63
Q

Because proglottids release high number of eggs, this can lead to what with regard to trematodes (fluke) infection?

A

Large infection very quickly

64
Q

What form of tape worm releases eggs singly, not in proglottids ?

A

Diphyllobothrium latum (Fish tapeworm)

65
Q

Where are Diphyllobothrium latum (fish tapeworms) typically found?

A

Great lakes region, Alaska

66
Q

Where are infective Diphyllobothrium latum (fish tapeworm) larvae found?

A

In the muscles of fish

67
Q

How does a human get a Diphyllobothrium latum (fish tapeworm) infection?

A

Ingestion of poorly cooked fish

68
Q

What does the life cycle of a Diphyllobothrium latum (fish tapeworm) require?

A

Fresh water for eggs to hatch in and ingestion of larvae by small water animal (ex. crustacean) that is then ingested by larger water animal (ex. small), etc. resulting in the development of the fish tapeworm

69
Q

What vitamin does an adult fish tapeworm complete for in human?

A

Vitamin B12

70
Q

How is infection with Diphyllobothrium latum (fish tapeworm) dx? (3)

A
  1. Clinical presentation with anemia and positive hx of fish ingestion
  2. Presence of eggs in stool
  3. ID of adult worm w/ GI scope

Micro I (9 decks)

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