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state exam > helminths > Flashcards

helminths Flashcards

1
Q

intestinal nematodes

A 
ascaris lumbricoides
enterobius vermicularis
trichuris trichiura
hookworms (ancylostoma/necator)
stronglyoides stercoralis
trichostrongylus species
cappillaria philippinenesis
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2
Q

roundworms

A 
un-segmented, bilaterally symmetrical, have a digestive tract
size varies
separate sexes (males smaller)
no intermediate host
passed embroynated or embryonate in soil
five stages- four larval, one adult
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3
Q

ascaris lumbricoides

A

largest, found in intestine, larvae in lungs

vague intestinal, pneumonitis

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4
Q

ascaris life cycle

A

eggs hatch in intestine
larvae penetrate gut wall, reach lungs
develop in lung, ascend trachea and are swallowed
reach intestine grow to maturity

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5
Q

ascaris eggs

A

fertilized and unfertilized

mammilated or decorticated

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6
Q

ascaris pathogenesis

A

host immune response
larval migration
mechanical effects of adult worms
nutritional dificiencies

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7
Q

loeffler’s syndrome

A

pulmonary infiltrate in chest x-ray that clear and return, with eosinpophilia

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8
Q

enterobius vermicularis

A

most common nematode infection (pinworm)

specimen- scotch tape, pinworm paddle (4-6 to rule out)

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9
Q

e. vermicularis eggs

A

flatted on one side, doubtful in O & P

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10
Q

e. vermicularis sexes

A

female 8 -13 pointed tail

male 2.5 blunt tail

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11
Q

trichuris trichiura

A

seen with ascaris

abdominal cramps, tenesmus, RECTAL PROLAPSE

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12
Q

t. trichiura eggs

A

confused with t. vulpus (t. vulpus larger)

barrel-shaped, yellow-brown with 2 polar plugs

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13
Q

hookworm species

A

ancylostoma duodenale, necator americanus

if lots of eggs, no larvae (vs. strongyloides)

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14
Q

hookworm pathogenesis

A

acquired by SKIN PENENTRATION of larvae

larvae develop in soil and become infectious in 7-10 days

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15
Q

hookworm eggs

A

thin shell, oval
identical to strongyloides stercoralis eggs
colorless

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16
Q

hookworm larvae

A 
rhabditiform 
long buccal cavity
inconspicuous gential primordium
250-350
filariform (infective)
500-700
pointed tail
LARVAE MUST BE DIFFERENTIATED FROM STRONGYLOIDES
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17
Q

necator vs. ancylostoma

A

necator: cutting blades
ancylostoma: two pair of teeth

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18
Q

strongyloides stercoralis

A 
strongyloidiasis
SKIN PENETRATION OF LARVAE
vague intestinal, pneumonitis
prefer wet soil, tropic
can go undiagnosed (40 years after inf.
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19
Q

strongyloides stercoralis life cycle

A

2 life cycle
free-living- rhabditiform –> filariform (infective) in soil, or develop into adults that produce eggs
parasitic- penetrate skin, migrate and swallowed, adults in intestines
AUTOINFECTION- increasing worm burden, leads to disseminated strongyloidiasis (develop into filariform in host, infect intestinal mucosa)

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20
Q

hookworm vs. strongyloides

A

filariform
stronglyloides- short buccal cavity
strogyloides- prominent gential promortium
rhabditiform- esophagus

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21
Q

stronglyloides clinical disease

A 
asymptomatic
cutanoeous
pulmonary (loeffler's)
intestinal
immunosuprressive therapy- feemal worms produce eggs and larvae at a faster pace (hyperinfection)- death due to migrating worms
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22
Q

stronglyloides key points

A

rhabditiform larve are normally stool concentrate
filariform- short buccal cavity, prominent gential promortium
eggs rarely seen in stool (only heavy inf)

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23
Q

trichostronglyus

A

found in herbivores throughout the world,

eggs are ovoid similar to hookworm

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24
Q

cappilaria philippinensis

A

parasite of fish eating birds
may have auto infective cycle
eggs have inconspicuous mucoid plug

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25
Q

tissue nematoes

A 
trichinella spiralis
baylisascaris procyonis
toxcoara canis and cati
ancylosotoma braziliense and caninum
anisakis
dracunculus medinensis
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26
Q

trichinella spiralis

A

trichinosis
ingestion of raw or poorly cooked prok, bear, walrus, horse
body site: intestine/muscles, diaphragm, larynx, tongue, jaws, neck, ribs, biceps
can be fata in heavy infection
can be

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27
Q

trichinella life cycle

A

pigs and rodents (humans from raw improperly cooked meat- tissue digested, release larvae
DOESN’T LAY EGGS
LARVAE/ADULTS RARELY SEEN IN intestine

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28
Q

baylisascaris procyonis

A

human baylisascaris
ingesting infective eggs from enviro (eating dirt)
visceral and ocular larva migrans syndromes (in intermediate host)
human infection rare

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29
Q

baylisascaris procyonis life cycle

A

RACCOON- definitive host

eggs infective in soil after 2-4 weeks

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30
Q

Toxocara canis & cati

A

toxocariosis (visceral & ocular larva migrans)
ingesting eggs in soild contaminated with cat or dog feces
high eosinpophila
small intestine, liver, lungs, brain

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31
Q

toxocara diagnosis

A

biopsy not recommended, serologic test recommended, eggs not seen in humans

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32
Q

Ancylostoma braziliense & caninum

A

DOG HOOKWORMS
cutaneous larva migrans (creeping eruption)
skin penetration of infective filariform larvae

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33
Q

Anisakis & Pseudoterranova

A 
ANISAKIASIS
ingestion of third stage larve in tissue of inadequately cooked fish
2 intermediate hosts
humans- accidental
definitive- marine mammal
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34
Q

Anisakis diagnosis

A

gastroscopic examination (2 cm larvae are removed)

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35
Q

Dracunculus mednensis

A

DRACUNCULIASIS (guinea worm)
ingestion of infected copepods in contaminated water
usually in lower extremities

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36
Q

Dracunculus diagnosis

A

clinical presentation

rhabditiform larvae seen in fluid discharge (larvae discharged by adult)

37
Q

Filarial nematodes

A 
Wuchereria bancrofti
Brugia malayi
Loa loa
Onchocerca volvulus
Mansonella spp.
38
Q

Filarial info

A

arthropod-transmitted
microfilariae- found in blood or skin
eight main species infect huamans
adults produce sheathed microfilariae that reach the blood stream

39
Q

filarial morbidity

A

three species
wuchereria bancrofti, brugia malayi- lymphatic filariasis
onchocerca volvulus- onchocerciasis (river blindness)

40
Q

nocturnal periodicity

A

the phenomenon where the highest number of microfilaria occur in the blood at night

41
Q

filarial diagnosis

A

id of microfiliariaby microscopic examination in blood
+/- sheath, position of the nuclei, shape and distribution of nuclei and size
blood stain with GIEMSA

42
Q

Knott’s concentration

A

concentrate bloods
1 ml of blood, with 10 ml formalin
formalin lyses rbc and straightens microfilariacentrifuge
examine sediment

43
Q

trematodes

A 
"flukes"
parasities of vertebrate
adult vary in size
EGGS HAVE OPERCULUM
adults are HERMAPHRODITIC (except schistosomes)
two suckers- oral and ventral
snail- 1st intermediate
many utilize second intermediate
44
Q

trematode life cycle

A

eggs in feces, free-swimming MIRACIDIUM larvae escapes operculum and infects snails
develop into CERCARIAE
cercariae encyst on vegetation and become METACERCARIAE

45
Q

Trematodes categories

A

intestinal
liver
lungs
blood

46
Q

Intestinal treamtodes

A

Fasciolopsis buski
Echinostomal ilocanum
Heterophyes heterophyes
Metagonimus yokogawai

47
Q

Fasciolopsis buski

A 
giant intestinal fluke disease
aquatic plants (adult in stool in heavy infection)
eggs- broadly oval, yellow-brown
48
Q

Echinostoma ilocanum

A

mollusk

49
Q

Heterophyes heterophyes

A

freshwater fish

50
Q

Metagonimus yokogawai

A

freshwater fish

51
Q

Liver & Lung Trematodes

A

Clonorchis sinensis
Opisthorchis viverrini
Fasciola hepatica
Paragonimus spp.

52
Q

Clonorchis sinesis

A

Chinese liver fluke disease
bile duct
symptoms: usually none to acute cirrhosis
FISH

53
Q

Eggs of Liver & Lung

A

similar- definitive diagnosis based on clincal

54
Q

Opisthorchis viverrini

A

Thaliand and Laos

Freshwater fish

55
Q

Fasciola hepatica

A 
fasciolasis
aquatic plants
body site: bile duct
eggs may be in very low numbers, differentiate from buski by clinical symptoms
(adults in bile duct not in stool)
56
Q

Paragonimus westermani

A

Lung fluke disease
FISH, CRABS, CRAYFISH
Body Site: Lung
no symptoms to chronic cough

57
Q

paragonimus eggs

A

operculated w/ opercular shoulder
eggs may be coughed in sputum or swallowed and found in stool
NOT INFECTIOUS

58
Q

Blood trematodes

A

Schistosoma mansoni
Schistosoma haematobium
Schistosoma japonicum

59
Q

Schistosomes

A

Schistosomiasis
skin penetration by cercariae (not metaciracariae)
in veins of intestine and bladder

60
Q

Sympotms of schistosomiasis

A

dermatitis and hepatosplenomegaly

61
Q

Schistosoma species

A

female lies in the male gynecophoral canal
female is longer and more slender
male is more robust

62
Q

Schistosoma eggs

A

mansoni- prominent lateral projection
haematobium- terminal spine (irnary)
japonicum- spherical w/ minute lateral spine

63
Q

Schisotosome info

A

eggs can not be detected until after worms mature
biopsy or serological test may be helpful
eggs contain mature miracidia but are not infectious to human (no metacircariae)
MESENTERIC VEINS
eggs cause damage due to spine

64
Q

Cestodes intro

A

long, ribbon-like and flattened in a cross section

65
Q

Cestode regions

A

scolex, neck, strobili (chain of proglottids)

66
Q

scolex

A

attachment organ (for intestinal wall)
equipped with 4 cup-shaped suckers
some species have crown `

67
Q

Neck

A

region of growth behind scolex that contains germinative tissue
budding zones from which new proglottids are produced

68
Q

Strobila

A

entire chain of proglottids
proglottids are egg-developing untis that develop from distal end of the scolex
each proglottid contains male and female reproductive system
gravid proglottids are farthest away

69
Q

Taenia saginata “beef tapeworm”

A

ingestion of infective cysts (cysticercus

symptoms vague to none

70
Q

Taenia saginata ID

A 
5 - 10 m 
1000-2000 proglottids
scolex "unarmed" no rostellum
eggs are not infectious, identical to t. solium
15-20 branches/proglottid
71
Q

Taenia solium Taeniasis

A

eating pork contaminated with cysticercus
larvae are digested and attach to intestinal wall
adult worm produces ova in proglottids
eggs, sometimes proglottids are excreted
adult worm usually causes little problem

72
Q

Taenia solium cysticercosis

A

ingesting infective eggs in porrly cooked pork or through AUTOINFECTION
eggs hatch in small intestine and produce oncosphere larvae that migrate and develop into cysticercoid larvae (high affinity for CNS)

73
Q

Cysticercosis degree of disease

A

number of cysticerci, location, and immune response to them

seizures, abnormal behavior, disequilibrium and visual problems

74
Q

Taenia solium ID

A 
2-4 meters
800-100 proglottids
scolex "armed" rostellum w/ 2 rows of hooks
proglottids are highly infectious, 7-13
eggs are identical\
75
Q

Taenia speciation

A

scolex

proglottid (submitted in tap water, stained w/ india ink) based on uterine branches

76
Q

Diphyllobothrium latum

A

Fish tapeworm
infective larvae in freshwater fish
humans ingest undercook or raw fish containing an encysted plerocercoid larvae

77
Q

diphyllobothrium ID

A

worm has a scolex with 2 suckers
LARGEST HUMAN TAPEWORM
eggs are unembryonated
CESTODE W/ OPERCULUM

78
Q

Diphyllobothrium latum proglottid

A

wider than they are long
uterus in the center
passed in chains

79
Q

hymenolepis nana

A 
dwarf tapeworm disease
ingestion of eggs (grain beetles)
micre are usual host
more common inn children
ONLY TAPEWORM W/O OBLIGATE INTERMEDIATE HOST
smallest human tapeworm
80
Q

hymenolepis nana scolex

A

armed rostellum

81
Q

hymenolepis nana oncosphere/eggs

A

6 hooks
proglottids rarely seen in stool
POLAR FILAMENTS
EGGS ARE INFECTIOUS (vs. diminuta)

82
Q

Hymenolpis diminuta

A

rat tapeworm disease

ingestion of arthropods

83
Q

Hymenolepisdiminuta

A 
human infection rare
diagnosis based on id of eggs
eggs are thin shelled, six-hooked oncosphere
eggs are NOT INFECTIOUS
NO POLAR FILAMENTS
84
Q

Diplydium caninum

A

dog tapeworm disease

ingestion of arthropoids (fleas on dogs)

85
Q

diplydium caninum eggs/proglottids

A

proglottids have 2 genital pores (resemble cucumber seeds)
egg packets are very characteristic
not infectious to humans

86
Q

Echinococcus granulosis

A 
Hydatid disease
dogs are definitive host
sheep intermediate
Liver (60%), Lungs (20%), kidneys
symptoms depend on cyst location
87
Q

Echinococcus granulosis specimen

A

hydatid cyst fluid

88
Q

Echinococcus granulosus control

A

avoid feeding raw sheep to dog

89
Q

Echinococcus granulosus eggs

A

identical to taenia

state exam (9 decks)

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