helminths Flashcards

1
Q
  • ancylostoma duodenale and necator americanus most common type
  • common in most tropical and subtropical regions
  • most asymptomatic
  • cutaneous larvae migrans –> cough –> GI upset
  • rash –> pruritic maculopapular at site of skin penetration “ground itch”
  • serpiginous tracks of intracutaneous larval migration can be seen
A

hookworm

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2
Q

hookworm transmission

A
  1. eggs shed in feces
  2. larval development in soil
  3. skin penetration
  4. larvae migration in the body
  5. continuation of the cycle
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3
Q

hookworm symptoms

A
  • dry cough, wheezing, low fever with larvae migration through lungs
  • 1 month later: epigastric pain, diarrhea, anorexia
  • large infestations can lead to iron deficiency anemia and protein malnutrition
  • impairment in growth and development in children
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4
Q

how to diagnose hookworm

A

eggs in feces –> ova and parasite test
CBC –> microcytic anemia, eosinophilia
hypoalbuminemia
occult blood in stool

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5
Q

hookworm treatment

A

albendazole

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6
Q

cestode infection

A

tapeworm

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7
Q

taenia saginata

A

beef tapeworm

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8
Q

taenia solium

A

pork tapeworm

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9
Q

diphyllobothrium latum

A

fish tapeworm

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10
Q

hymenolepis nana

A

dwarf tapeworm

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11
Q

taeniasis symptoms

A
  • most asymptomatic
  • N/V, anorexia, epigastric pain
  • anxiety, HA, dizziness, uriticaria
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12
Q

diphyllobothriasis symptoms

A
  • most asymptomatic
  • fatigue, diarrhea, numbness, dizziness
  • megaloblastic anemia
  • competes with host for absorption of vitamin B12
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13
Q

classical manifestation of infection with D latus

A

megaloblastic anemia due to vitamin B12 deficiency

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14
Q

hymenolepiasis symptoms

A
  • most common in children (fecal oral hygiene)
  • most asymptomatic
  • heavy infection –> crampy abd pain, diarrhea, anorexia, weight loss, fatigue
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15
Q

how to diagnose tapeworm

A
  • eggs or proglottids (segment of a tapeworm) in stool (ova and parasite stool)
  • multiple stool specimens (2-3)
  • macrocytic anemia due to B12 deficiency
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16
Q

tapeworm treatment

A

noninvasive –> praziquantel

17
Q

dwarf tapeworm treatment

A

increased dose of praziquantel and repeat after 1 week

18
Q
  • infection through direct human fecal contamination of food
  • ingestion of eggs of T. Solium
  • human now acts as the intermediate host
  • leads to tissue infection with cysts
A

tapeworm cystericercosis

19
Q
  • can cause seizures, focal neuro deficits, altered cognition, psych disease
  • intracerebral, subarachnoid, spinal cord lesion, or intraventricular cysts
A

neurocystericercosis

20
Q
  • the most common manifestation include muscle or subcutaneous tissue
  • usually asymptomatic nodules 0.5 to 2.0 cm in diameter but may cause discomfort when inflamed
  • acute myopathy
A

extraneural cystericercosis

21
Q

how to diagnose tapeworm cystericercosis

A
  • neuroimaging findings and evidence of exposure
  • CT and MRI: parenchymal cysts, parenchymal calcification
  • ELISA and related immunoblot assay: antigen and antibodies
  • brain biopsy
22
Q

tapeworm cystericercosis treatment

A
  • can make neurologic symptoms worse due to inflammation around decaying cyst
  • adjunctive steroid therapy
  • cyst surgically removed
23
Q

anti parasitic therapy should not be administered in the following circumstances

A
  • untreated hydrocephalus
  • high cyst burden with diffuse cerebral edema
  • presence of calcified lesions only
24
Q

tapeworm neurocystericecosis treatment

A
  • treat for 10-14 days
  • albendazole
  • praziquantel
  • adjunct corticosteroids should be administered prior to and during anti parasitic therapy
25
Q

tapeworm extraneural cystericercosis treatment

A
  • non steroidal anti inflammatory medication
  • excision for symptomatic solitary lesions
26
Q
  • ingesting food contaminated with canine feces containing parasite eggs from tapeworms Echinococcus granulosus and E multilocularis
  • forms large cystic lesions usually in liver or lung
  • asymptomatic
  • cysts can rupture and cause severe allergic reaction with fever and hypotension
  • the fluid inside is antigenic and highly toxic and can cause a potentially fatal anaphylactic reaction in humans
A

tapeworm echinococcosis

27
Q

tapeworm echinococcosis symptoms

A
  • often incidental finding
  • abscesses
  • growing mass
  • depend on specific organ affected: abdominal pain, chest pain, biliary obstruction, etc
28
Q

how to diagnose tapeworm echinococcosis

A

imaging techniques in conjunction with serology
- ultrasound or CT
- large cyst containing daughter cysts
IgG ELISA assay
- confirmatory test

29
Q

tapeworm echinococcosis treatment

A

long course of albendazole

30
Q

enterobiasis

A

pinworms

31
Q
  • common cause of intestinal infections worldwide
  • school age children
  • caused ingestion of enterobius vermicularis eggs
A

pinworm

32
Q

how does ingestion of pinworm eggs happen

A
  1. pinworms lay eggs around the anus of an infected person, usually at night. these eggs cause intense itching, leading the person to scratch the area
  2. eggs then transfer to the fingers and under the fingernails and my spread to surfaces, toys, bedding, clothing, and other items person touches
  3. if a person touches a contaminated surface and then puts their fingers in their mouth, they can ingest the eggs, leading to infection
33
Q

pinworm lifecycle

A
  1. eggs hatch in duodenum and larvae move to cecum
  2. larva mature to adults and establish themselves in the colon
  3. lifespan of adult is about 2 months
  4. gravid females migrate nocturnally outside the anus and oviposit while crawling on the perianal area
  5. those eggs hatch and produce larva in 4-6 hours
34
Q

pinworm symptoms

A
  • asymptomatic
  • most common: perianal pruritis*
  • insomnia, restlessness, enuresis common in kids
  • impetigo from scratching
  • worm burden high –> abd pain, nausea, vomiting
35
Q

how to diagnose pinworm

A
  • perianal worms or eggs found in skin
  • “tape test”: best done at night or first thing in morning prior to bathing
36
Q

pinworm treatment

A

albendazole
repeat dose in 2 weeks bc common reinfection
treat close individuals