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ID test III > helminths > Flashcards

helminths Flashcards

1
Q

enterobius vermicularis

A

aka pinworms

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2
Q

enterobius vermicularis - pathogenesis

A

Larvae hatch in the small intestine, move to the large intestine where they mature and mate in and near the cecum. The gravid females migrate to the perianal area to deposit their eggs.

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3
Q

pinworms- mode of transmission

A

fecal-oral, Pinworms do not require extrinsic incubation or an intermediate host. The eggs resist drying and hence may be transmitted in dust or on clothes

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4
Q

pinworms diagnosis

A

made by finding ova in a cellophane-tape slide preparation or sediment of a saline rinse from a swab of the perianal area. Also, adult female worms that are 8 to 13 mm in length, may be found as they migrate to the perianal area.

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5
Q

pinworms sx

A

(i) allergy to secretions may lead to severe pruritus (itching) and secondary bacterial infection, with sleep loss and fatigue (ii) worms can migrate into the vagina and cause granuloma (iii) very rarely, worms can penetrate the bowel wall and migrate to the peritoneum, liver and lungs.

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6
Q

pinworms treatment

A

bendazoles (worms are “bendy)

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7
Q

Trichuris trichiura

A

aka whipworm- the anterior two thirds is thin while the posterior third is bulbous, giving the appearance of a whip

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8
Q

trichuris trichiura transmission/ pathogenesis

A

Eggs develop 2-3weeks in soil to become infectious. After consumption, larvae hatch in small intestine, move to large intestine where they mature and mate in and near the cecum. The gravid females migrate to the perianal area to deposit their eggs

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9
Q

whipworm sx

A

Light infections are asymptomatic. Heavy infections may cause: (i) Abdominal pain and distension accompanied by bloody or mucoid diarrhea (ii) appendicitis (iii) prolapsed, edematous rectum (iv) Children carrying more than about 200 worms may have chronic dysentery, severe anemia and growth retardation.

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10
Q

whipworm treatment

A

vermox

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11
Q

Ascaris lumbricoides

A

aka giant roundworms. one of the largest human parasites.

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12
Q

Ascaris lumbricoides transmission

A

soil, fecal oral

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13
Q

Ascaris lumbricoides diagnosis

A

Ova in feces, Eosinophilia in pulmonary stage or in ectopic infection - Not present in intestinal infection

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14
Q

ascaris lumbricoides pathogenesis

A

Eggs require 2 or 3 weeks in the soil to become infective. When swallowed, they hatch in the duodenum. The larvae penetrate the wall, enter blood or lymphatic vessels > liver and heart > pulmonary circulation > alveoli where they grow and molt. After about 3 weeks, they migrate through the airways, are coughed up and swallowed. Upon their return to the intestine, which is 2 or 3 months after the eggs were ingested, they mate and their egg laying begins

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15
Q

Ascaris lumbricoides sx

A

pneumonitis (inflammation in the lung) may be induced as the larvae break out into the alveoli. Sudden asthma attacks in non-asthmatics should be viewed with suspicion. Heavy infections of adult worms may cause intestinal obstruction.

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16
Q

Hookworms

A

Rare in US except for southeast where Ancylostoma duodenale and Necator americanus are more common.

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17
Q

hookworms pathogenesis

A

Eggs mature > hatch into rhabditiform larvae in feces > larvae molt twice > form infective filariform larvae in a week > penetrate human skin > enter circulation > travel to lungs/ penetrate airways > migrate to trachea > swallowed > in small intestine, attach, suck blood and tissue fluid and mate. Duodenale may live 5 years. Americanus 18 yeras

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18
Q

Hookworms sx

A

No sx unless the worm burden is high and the patient’s diet is deficient in iron or protein or both. The most important manifestations of severe hookworm infection are iron-deficiency anemia

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19
Q

Hookworm treatment

A

mebendazole

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20
Q

Strongyloides stercoralis life cycle

A

eggs hatch in intestinal mucosa > rhabditiform larvae produced are passed in feces > adults may mate in soil > infective filariform larvae develop > penetrate skin > enter circulation > travel to lungs/ penetrate airways > migrate to trachea > swallowed

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21
Q

strongyloides stercoralis autoinfection

A

can result from transformation of rhabditiform to filariform larvae in the gut, followed by penetration into the circulation to renew the cycle

22
Q

Strongyloides sx

A

Massive larval invasion of the lungs, liver, and brain causes severe symptoms of dyspnea and abdominal pain. Gram-negative sepsis may supervene unless the disease is recognized.

23
Q

who is most severely affected by strongyloides

A

Immunosuppressed patients, especially those receiving high-dose corticosteroids or those with Aids, are more likely to suffer autoinfection and disseminated disease.

24
Q

structure of tapeworms

A

aka cestodes- consist of an anterior attachment organ (the Scolex) and a strobila, which is a chain of segments (proglottids). Growth occurs by proliferation of proglottids, which have male and female repro organs, and the terminal portion is usually filled with eggs.

25
Q

Hymenolepis nana - who is affected, diagnosis

A

dwarf tapeworm- children. Ova with polar filaments in feces

26
Q

hymenolepis nana life cycle, sx

A

Ingested eggs, no intermediate host necessary. With large number, there may be abdominal pain, diarrhea, headache, anorexia

27
Q

Taenia saginata

A

beef tapeworm

28
Q

taenia solium

A

pork tapeworm

29
Q

beef and pork tapeworm life cycles

A

embryonated eggs ingested by pig or cattle > larvae develop in flesh (cysticercus- contains single scolex) > human eats undercooked meat > scolex attaches to intestine wall and produces proglottids > human is definitive host

30
Q

Pork vs beef tapeworm

A

For the pork tapeworm, but not the beef tapeworm, cysticercosis may occur in the human (i.e. the human becomes a secondary host). The larvae penetrate the intestinal wall and may be carried in the circulation to any part of the body.

31
Q

pork and beef tapeworm sx

A

Both: intestinal infection. Pork only: cerebral and neurocysticercosis

32
Q

pork and beef tapeworm diagnosis

A

Passage of proglottids in feces- pt usually recognizes infection. Since the ova of Taenia species look the same, the number of lateral uterine branches is determined in the proglottids using India ink. T. saginata has 12 or more, T. solium has less than 12.

33
Q

pork and beef tapeworm Sx

A

Abdominal discomfort, hunger, indigestion and eosinophilia occur. In cysticercosis many infections remain asymptomatic, but cerebral edema, granuloma, hydrocephalus, epilepsy, stroke and other manifestations occur.

34
Q

pork and beef tapeworm transmission

A

pork tapeworm can be passed person to person. Beef tapeworm can not. Both can be acquired by undercooked meat

35
Q

Diphyllobothrium latum

A

fish tapeworm

36
Q

Fish tapeworm life cycle

A

eggs pass in human feces or fish eating mammals > hatch into ciliated coracidium larvae > ingested by copepods (crustaceans) > second stage larva develop > fish eat infected copepods > third larvae stage n fish > humans eat infected fish > larvae grows to adulthood in small intestine

37
Q

fish tapeworm sx

A

Usually none. If the worm attaches by chance in the proximal jejunum, Vitamin B12 deficiency indistinguishable from pernicious anemia may occur.

38
Q

fish tapeworm treatment

A

niclosamide

39
Q

echinococcus granulosus

A

hydatid cyst

40
Q

hydatid cyst transmission

A

ingesting eggs from the feces of carnivores NOT eating their meat.

41
Q

hydatid cyst life cycle

A

Ova is ingested > eggs hatch in intestine > larvae migrate to many organs where they form tumor-like hydatid cysts (liver and lung most common) >

42
Q

Hydatid cyst sx

A

comparable to those associated with a slow growing tumor, with an inflammatory reaction in surrounding tissues. Remarkable, there may be very extensive involvement of an organ without symptoms. Rupture of cysts leads to metastasis, with secondary echinococcosis appearing sooner or later

43
Q

Trichinosis- cause, transmission, diagnosis, sx

A

Caused by trichinella spiralis- acquired by ingestion but dz occurs due to presence of larvae in heart, skeletal muscle and brain. Acquired by ingesting uncooked pork or wild animals. Diagnosis by immunological tests or muscle biopsy. Sx: myalgia, headache, malaise, fever, periorbital edema

44
Q

Guinea worm- cause, life cycle

A

Caused by dracunculiasis- drinking copepod infested water. Larvae develop into adult worm in intestine > migrate through subcutaneous tissue > cause ulcer > migrates out of body through skin. Almost entirely eradicated

45
Q

elephantiasis

A

Wuchereria bancrofti - causes lymphatic filariasis. Worms lie in pairs in lymphatic vessels for 10 yrs > eggs reach blood > pulmonary vessels by day, overflow to periphery by night. Mosquitos transmit dz. Also causes elephatiasis - swollen limbs and scrotum.

46
Q

Loa loa

A

transmitted by horse fly. Swelling in skin, worm in conjuctiva

47
Q

Onchocerciasis

A

caused by Onchocerca volvulus - hyperpigmented skin, river blindness, allergic reaction to microfilaria possible. Transmitted by black fly. (black flies, black skin nodules, black sight).

48
Q

trematodes

A

aka flatworms or flukes- Trematodes are mostly hermaphroditic, and many are capable of self-fertilization.

49
Q

Schistosoma

A

S. haemotobium (bladder), S. mansoni and S. Japonicum (gut/ hepatic). Snails are host. Larvae Penetrates skin of humans. Causes dermatitis (swimmers itch), Katayama fever and chronic fibro-obstructive sx. Diagnose by ova in urine

50
Q

see table in notes

A

ok

ID test III (9 decks)

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