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parasitology: small intestine > helminths > Flashcards

helminths Flashcards

1
Q

Pathogenesis of H.heterophyes

A

1) Light infection: pass unnoticed
2)heavy infection: intestinal irritation
3)Excessive mucus secretion & hyperplasia of mesenteric lymph nodes
4)ectopic lesions by the eggs outside the intestine may occur leading to myocarditis, brain granuloma, and pulmonary embolism

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2
Q

Describe egg of H. heterophyes

A

1)Size: 30*15 micro
2)Shape: Oval, operculated, thick shelled, with post. knob
3)color: yellowish brown
4)Contents: mature ovum conataining miracidium

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3
Q

What are the intermediate hosts of H.heterophyes?

A

1st: pirenella conica snail
2nd: Tilapia nilotica=boulty & mugil cephalus=boury

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4
Q

Diagnostic stage of H. heterophyes

A

mature (embryonated) eggs in feaces

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5
Q

Infective stage of H. hetrophyes

A

Encysted metacercaria in fish muscle

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6
Q

Mode of infection of H. heterophyes

A

ingestion of encysted metacercaria with improperly cooked or inadequately salted : feseekh

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7
Q

What does paratenic host mean?

A

animals that harbor the parasite without further development

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8
Q

What is the paratenic host for D. latum?

A

Bears and other carnivores

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9
Q

Why does D. latum does not have gravid segment?

A

as eggs are expelled through the uterine pore

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10
Q

Describe egg of D. latum

A

1)Size: 70*50 micro
2)Shape: Oval, operculated, thick shelled
3)color: yellowish brown
4)Contents: immature ovum conataining germ cells

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11
Q

What are the intermediate hosts of D. latum?

A

1st: cyclops(water flea)
2nd: fresh water fish(salmon)

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12
Q

Diagnostic stage of D. latum

A

immature eggs and rarely terminate segments pass in feaces

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13
Q

infective stage of D. latum

A

plerocercoid larva

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14
Q

Clinical picture of D. latum

A

1) Light infection : asymptomatic
2)heavy infection: intestinal disturbances, megaloblastic anemia due to Vit. B12 intake by the parasite make it unavailable for the host –> later cause neurological sequale as peripheral neuropathy
3)massive infection(uncommon): intestinal obstruction –> cholangitis and cholecystitis
4)

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15
Q

D. latum treatment

A

1)Praziquental
2)Niclosamide
3)Vit. B12 IM injection

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16
Q

Define Sparganosis

A

Infection of human tissues by plerocercoid larva of D. proliferum and D. mansoni. Man acts as accidental host

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17
Q

Man act as what host in sparganosis?

A

Accidental host

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18
Q

Who is more dangerous sparganum proliferum or sparganum mansoni? explain why?

A

Sparganum proliferum as it multiplies by budding giving lateral branches and new larva

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19
Q

Clinical picture of Sparganosis

A

Symptoms depend on the tissue invaded and number of larvae
1)Skin: inflammatory tender swellings, which may form an abscess that can discharge the sparganum
2)eyes: conjuctivitis, peri-orbital edema
3)fever, urticaria, eosinophilia
4)Death of larvae cause intense local reaction

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20
Q

What are the other names of Taenia Saginata?

A

(Beef)Bald tapeworm

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21
Q

How many uterine branches are there in gravid segment of Taenia saginata?

A

15-30 lateral branches

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22
Q

How many uterine branches are there in gravid segment of Taenia solium?

A

5-10 lateral branches

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23
Q

Describe the egg of Taenia

A

Size: 30*40 micro
Shape: spherical with radially striated shell
colour: yellowish brown
contents: hexacanth oncosphere

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24
Q

Infective stage of T.saginata

A

Cysticercous bovis

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25
Q

mode of infection of T.saginata

A

ingestion of undercooked beef

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26
Q

Clinical picture of T.saginata

A

1)Maybe asymptomatic
2)white motile segment felt emerging from the anum unbidden causing irritation and peri-anal itching
3)intestinal disturbance
4)obstruction–> cholangitis and apendicitis

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27
Q

What is the stain used to identify the eggs of T.saginata

A

Ziehl-Neelsen

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28
Q

What is the stain used to identify the gravid segment of T.saginata

A

India ink

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29
Q

What is the intermediate host of Taenia Solim?

A

pig

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30
Q

What is the infective stage of T. solium

A

Cysticercus cellulosa

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31
Q

What is the most important risk in T. solium

A

cysticercosis

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32
Q

What stains are used to identify T. solium and what are the results?

A

1) eggs —> Ziehl Neelsen: does not stain
2)Gravid segment –> india ink –> stains

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33
Q

treatment of T.solium

A

1)Praziquental
2)Niclosamide
then bowel purge after two hours to prevent egg release from the gravid segment
medications induce vomiting are avoided –> to prevent cysticercosis from retrograde peristalsis

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34
Q

which host does the man act in cysticercosis?

A

blind intermediate host

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35
Q

blood picture of cysticercosis

A

high eosinophilia

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36
Q

ttt of cysticercosis

A

1)Albendazole (drug of choice) or praziqeuntal
2)corticosteroids are used to decrease the neurological reactions from disintegration of cysts
3)surgical removal if possible

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37
Q

what is the other name of H.nana?

A

Dwarf tapeworm

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38
Q

Describe egg of H.nana

A

size: 30-40 micro
shape: spherical with 2 coverings, from the inner covering 2 polar thickening arises from each arise 4-8 filaments
color: translucent
content: mature containing hexacanth oncosphere

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39
Q

Definitive host of H.nana

A

man

40
Q

Reservoir host of H.nana

A

rodents

41
Q

Intermediate host of H.nana

A

man (occasionally some insects)

42
Q

Diagnostic stage of H.nana

A

mature eggs + gravid segments

43
Q

Infective stage of H.nana

A

mature egg

44
Q

ttt of H.nana

A

1)Praziquental
2)Niclosamide: should be repeated after 2 weeks to kill the newly developed worms

45
Q

Adult morphology of Ascaris Lumbricoides

A

pale pink/creamy in colour
15-40 cm in size

46
Q

Describe egg of A.lumbricoides

A

Fertalized, unfertilized, decorticated (see page 35)

47
Q

Definitive, intermediate, reservoir hosts of A.lumbricoides

A

DH: Man
RH: NONE
IH: NONE

48
Q

Diagnostic stage of A.lumbricoides

A

immature eggs, larva and adult

49
Q

infective stage of A.lumbricoides

A

mature eggs

50
Q

Mode of infection of A.lumbricoides

A

ingestion of mature egg containing 2nd stage rhabditiform larva w/contaminated food or drink, through soiled fingers, especially in children

51
Q

How many eggs does the female A.lumbricoides release after mating?

A

200,000egg/day/worm

52
Q

Is A.lumbricoides a Geohelminthic parasite?

A

yes

53
Q

Pathogenesis & clinical picture of A.lumbricoides

A

A)Migrating larva:
1)Ascaris pneumonitis “Loeffler syndrome”: break out of alveolar capillaries causing Hge & cellular infiltrates–> fever, urticaria, blood-tinged sputum, asthamtic wheezing

2)in liver or reaching systemic circulation–> granuloma formation –> visceral larva margins

B)Adult worms:
1)GIT disturbance
2)interferes with digestion (secretion of ANTIENZYMES as an adaptive or protective mechanism) –> promote ptn energy malnutrition & Vit. A deficiency AND symptoms of lactose intolerance
3)Hypersensitivity
4)Complications:
-intestinal obstruction, volovulus, intususseption
-fever , certain drugs or anaesthetic agents cause it to migrate to abdominal or extra-intestinal
–> perforation of bowel=peritonitis
–>appendicitis
–>gastric,duodenal trauma
–> blockage of ampulla of vater=pancreatic necrosis
–>Biliary ascariasis: colic,cholangitis,cholecystitis, obstructive jaundice, biliary stone formation
–>diverticulitis
–> invade liver parenchyma=liver abscess
–> esophagus
perforation
migrate upward and come out of the mouth & external nares
crawl into trachea –> respiratory obstruction

54
Q

blood picture of A.lumbricoides

A

High eosinophilia in larval stage
little or none in adult worm ascariasis

55
Q

What are the imaging techniques to find A.lumbricoides

A

1)Barium meal; appear as cylindrical filling defect as it appears radiopaque dur to barium ingestion

2)US

3)MRCP & ERCP

56
Q

In mixed infections with ascaris what should be treated first and why?

A

Ascaris in order not to stimulate adults to migrate

57
Q

Drug of choice to treat A.lumbricoides

A

1)Albendazole
2)Mebendazole

58
Q

Infective stage of Ancylostoma Duodenale

A

(3rd stage)filariform larva

59
Q

Mode of infection of A.duodenale

A

penetration of the skin

60
Q

what larva has +ve hydrotropism, +ve thermotropism & -ve geotropism?

A

larva of A.duodenale

61
Q

Is A.duodenale a geohelminthic parasite?

A

yes

62
Q

What are the most unique symptoms of ancylostoma duodenale?

A

1)Blood loss of 0.3 cc of blood per day:
–> sucking blood
–>prolonged bleeding at the site of attachment as worm secretes anticoagulase substance
–>the worm leaves the bleeding-oozing site to another spot where it sucks more blood forming more minute ulcer

2)Hyprochromic microcytic anemia: due to chronic blood loss and depletion of iron stores

3)melena and occult blood in stool

4)Pica

63
Q

Compare btw A.duodenale and N.americanus

A

see page 47

64
Q

What is the other name of strongyloides stercoralis?

A

Dwarf threadworm

65
Q

Diagnostic stage of S.stercoralis

A

Rhabditiform larva

66
Q

Infective stage of S.stercoralis

A

filariform larva

67
Q

mode of infection of S.stercoralis

A

skin penetration

68
Q

What are the geohelminthic parasites that small intestine is their habitat?

A

1)Ascaris lumbricoides
2)ancylostoma duodenale
3)Strongyloides stercoralis

69
Q

Does S.stercoralis exert autoinfection?

A

yes externally(penetrating peri-anal skin after exiting from the anus) and internally (rhabditifrom charnge to filariform due to its presence in the intestine for a long time such as constipation)

70
Q

clinical picture of S.stercoralis

A

1)external autoinfection; cutaneous larva margins–> larva currens
2)loeffler syndrome
3)GIT disturbance
4)Weight loss
5)S.stercoralis may be present in ectopic sites as it may pass Lt side of the heart or in immunocomprimised patients (opportunistic infection)

71
Q

ttt of S.stercoralis

A

Ivermectin (drug of choice)
thiabendazole

72
Q

Infective stage of Trichostrongylus Colubriformis

A

Filariform larva

73
Q

DH of T.colubriformis

A

Herbivorous animals and occasionally man

74
Q

Diagnostic stage of T.colubriformis

A

Immature eggs in feaces

75
Q

Mode of infection of T.colubriformis

A

Ingestion of filariform larva with vegetables and water

76
Q

T/F: Filariform larva of T.colubriformis undergoes pulmonary migration for development

A

False

77
Q

DH of Capillaria philippinensis

A

Man

78
Q

RH of C.philippinensis

A

Fish eating birds

79
Q

IH of C.philippinensis

A

small fresh water fish

80
Q

Diagnostice stage of C.philippinensis

A

Egg, larva and adults in stool

81
Q

Infective stage of C.philippinensis

A

infective larva in fish intestine

82
Q

Mode of infection of C.philippinensis

A

eating raw or improperly cooked WHOLE INFECTED FISH and internal auto infection

83
Q

Pathogenesis of C.philippinensis

A

invasion of intestinal mucosa leading to enteropathy with chronic inflammatory reactions and atrophy of the villi –> malabsorption of fats, ptn, electrolytes, and sugars

84
Q

Parasitological findings of C.philippinensis

A

eggs
larva
adult
charcot-leyden

85
Q

Host of Gardia Lamblia

A

Man especially children

86
Q

Diagnostic stage of G.lamblia

A

Cyst and trophozoite

87
Q

Infective stage of G.lamblia

A

cyst

88
Q

What is the most common protozoa that causes waterborne outbreaks of diarrhoea? and why?

A

1)Gardia
due to use of inadequately treated surface water, raw sewage is mixed with water intended for drinking, recreational exposure to water in lakes and swimming pools

89
Q

Mode of infection of Gardia lamblia

A

*Heteroinfection:
-Contaminated food & vegetables
-contaminated water
-person-to-person feaco-oral
-food handlers
-insects
*autoinfection: feaco-oral

90
Q

What are the factors that increases risk of giardiasis?

A

1)Hypogammaglobulinemia
2)IgA deficiency
3)Impaired gastric acid secretion–>achlorhydria
4)blood group A
5)Malnutrition in children

91
Q

Clinical picture of G.lamblia

A

1)Duodenitis
2)Epigastric pain
3)Malabsorption
4)Steatorrhea
5)cholangitis,cholecystitis

92
Q

what stage of Gardia appear in what stool?

A

1)Trophozoites in diarrhoeic stool
2)Cyst in formed stool
shedding in stool is irregular (intermittent excretion) so multiple stool samples may be required

93
Q

Are blood or PNL present in Gardia?

A

No as it is not an invasive pathogen

94
Q

What are the examinations for duodenal content in gardia lamblia?

A

1)String test (Entero-test)
2)duodenal aspiration

95
Q

ttt of G.lamblia

A

1)Tinidazole(single oral dose)
2)Metronidazole (flagyl)
3)Atebrine

96
Q
A

parasitology: small intestine (1 decks)

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