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Clinical Medicine Lecture - Professor Kramer > Infectious Disease - Helminth Infestations 1 > Flashcards

Infectious Disease - Helminth Infestations 1 Flashcards

1
Q

Hookworms infect __% of the world’s population

A

25%

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2
Q

Schistosomiasis affects ___million people worldwide, accounts for ___,___ deaths annually

A

200

100,000 deaths annually

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3
Q

Pinworm infections are more common in kids or adults?

A

kids

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4
Q

Nematoda types?

A

Trichinella
Hookworms
Pinworms

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5
Q

Cestodes type?

A

Tapeworm

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6
Q

Trematodes type?

A

Schistosomiasis

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7
Q

Severe infections may cause?

A

Anemia
Protein loss ( deficiency )
Malabsorption

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8
Q

Hookworm only host?

A

humans

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9
Q

Hookworm eggs are passed in the _____ and hatch in moist ____.

A

stool

soil

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10
Q

Hookworm larvae last for?

A

hr to weeks

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11
Q

Hookworm penetrate the ____ and migrate through the _____ to the _________ ___________ where they destroy ________? They are then carried by cilia to the _____?

A

penetrate the skin and migrate in the bloodstream to the pulmonary capillaries
destroy alveoli
carried by cilia to the mouth

*they get the blood stream and go to the lungs and cardio and then trachea and the GI tract - migration is incredible by hematogenous spread = pretty bad PNA from these guys **

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12
Q

Once swallowed hookworm larvae attach to the ______ muscle and suck blood.

A

small bowel

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13
Q

Hookworm light infection?

A

1,000 eggs/g feces

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14
Q

Hookworm moderate infection?

A

2,000 to 8,000 eggs/g feces

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15
Q

What are the two species of hookworm that commonly infect humans?

A

Ancylostoma duodenale and Necator americanus

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16
Q

How much of the worlds population is infected with hookworm?

A

25%

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17
Q

Location of hookworms?

A

Moist tropics and subtropics

Sporadic cases occur in the southeastern US

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18
Q

GI Hx?

A

Anorexia ( DECREASE APPITITE)

Diarrhea

vague pain

ulcer-like epigastric symptoms

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19
Q

Pulmonary stage Hx? earlier in infection process

A

Wheeze

Blood-tinged sputum

low-grade fever

Hx is progression of sxs

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20
Q

PE: Examination at night may reveal ?

A

may reveal worms in the anus or stool

*Dx stool or presentation in the ANUS**

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21
Q

PE: Pulmonary ?

A

wheeze

low-grade fever

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22
Q

Hookworm diagnostic study: diagnostic?

A

Stool O & P - – eggs or larva can be demonstrated

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23
Q

Hookworm labs to consider? And results?

A

Hemoccult - +

CBC - Hypochromic microcytic anemia and Eosinophilia

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24
Q

Treatment for hookworms?

A

Mebendazole in a single dose

Albendazole

pyrantel

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25
Q

Who gets treated with worms ?

A

whole family

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26
Q

Pinworm organism?

A

Enterobius vermicularis

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27
Q

Pinworm only host?

A

human

*Infection is easily passed through hands, food, drink, and fomites. Skin , pet dander, toys etc…**

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28
Q

Pinworm eggs are swallowed and hatch in the ________: larvae then pass into the _____ and mature in - weeks?

A

duodenum

cecum

3-4 weeks

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29
Q

Adult worms are loosely attached to the ______, primarily in the ____?

A

muscosa

cecum

30
Q

Pinworm gravid females pass through the anus to lay eggs on the __________?

A

perianal skin

31
Q

Pinworm Hx?

A

Many patients are asymptomatic

perianal pruritus - crawling sensation that is worse at night

Insomnia

weight loss

Enuresis - involuntary urination

irritability

32
Q

Pinworm diagnostic Physical Exam? Examination at night ?

A

may reveal worms in the anus or in the stool

Excoriations

33
Q

Screening lab for pinworm?

A

Tape test

34
Q

Diagnostic lab for pinworm?

A

O & P

35
Q

Complication of pinworm?

A

secondary skin infections (i.e.,
impetigo - staph infections)

Vulvovaginitis

Diverticulitis - not really in kids

Appendicitis - not really in kids

Cystitis

granulomatous reactions

36
Q

Pinworm treatment?

A

Mebendazole

37
Q

Pinworm prevention?

A

Hand washing after defecation and before meals must be stressed

Linens should be washed thoroughly

38
Q

Oral antihelminthic?

A

Albendazole, mebendazole, or pyrantel

given in a single dose

repeated 2 to 4 weeks later

All members of the household

should be treated concurrently

*beds, linens and carpets cleaned throughly **

39
Q

Schistosomiasis AKA?

A

Bilharzia, Snail Fever

40
Q

Schistosomiasis parasite enter through the skin or music and migrate to the _______ to mature then they enter the __, __.

A

liver

GI

GU

41
Q

Schistosomiasis Hx ( symptoms)?

A

Fever 2-8 weeks after exposure

GI, GU

42
Q

Schistosomiasis Hx - GI symptoms?

A

Abd pain

N/V

43
Q

Schistosomiasis Hx - GU symptoms?

A

Dysuria

Hematuria

44
Q

Schistosomiasis PE?

A

Nonspecific

Possible abd tenderness

45
Q

Schistosomiasis diagnostic labs?

A

Ova and parasites - eggs can be identified , heavy infections

Biopsy - rectum, colon, liver, or bladder

ELISA- available from the CDC,
99% specific for all species,
Schistosomal Ab - gotta wait 4-6 weeks

46
Q

Schistosomiasis O&P heavy infection results?

A

> 400 eggs per gram of feces or

10 mL of urine are indicative

47
Q

Schistosomiasis treatment?

A

Oral praziquantel

once may repeat in a couple weeks

*kill worm in Gi tract, not 1 pill 1 time thing, disseminated cases more than just one time - more vigorouss treatment **

48
Q

Tapeworm organism?

A

Taenia infection

49
Q

Tapeworm comes from under cooked what?

A

beef , pork, fish

50
Q

Tapeworm causes ______ in animal muscle?

A

cysts

51
Q

Tapeworm develops gravid segments and ___________ released in feces.

A

Proglottids

52
Q

Tapeworm Hx?

A

Often asymptomatic

Occasional abd pain

53
Q

Tapeworm PE?

A

Possible abd tenderness

Nonspecific

54
Q

Tapeworm dx lab?

A

O & P

55
Q

Tapeworm: labs to consider? and result?

A

CBC - look for anemia, eosinophilia ( high count)

B12 (Pernious anemia)

*these guys block B12 uptake in the GI tract so they have pernicious anemia presentation**

56
Q

Treatment for tapeworms?

A

Praziquantel (Biltricide)

Oral once
Repeat in one week

*one time and then a couple weeks later **

57
Q

Trichinosis (Trichinellosis) type of infection?

A

Nematode Trichinella infection

58
Q

Nematode Trichinella infection

occurs when there is ingestion of ____ containing cysts of ___________ , especially pork

A

meat

Trichinella

  • eventually becomes muscle cyst , “a lot of people do not know what it is cause it is so benign” **
59
Q

Trichinosis larvae invade the _____ _____ mucosa, where they mature into adult worms

A

small bowel

60
Q

After _ week female trichinosis worms release newborn ______ and they migrate through the blood to ________ ______.

A

1 week

larvae

striated muscle

61
Q

Trichinosis Hx?

A

Myalgias

Diarrhea

Abdominal pain

Constipation

nausea or vomiting

weakness

62
Q

Trichinosis PE?

A

Periorbital and facial edema

hemorrhages:
Subconjunctival
Retina
nail beds (“splinter” hemorrhages)

*very unique symptoms of the face and hands, edema of the lower lids = more advanced = conjunctival injection and retinal hemorrhages, splinters hemorrhages on the nail beds, periorbital edema **

63
Q

Trichinosis Screening labs? and results?

A

CBC - eosinophilia

Antibody titer trichinella - elevated

usually does not occur until after the third week of infection
confirms the diagnosis

64
Q

Trichinosis diagnostic labs?

A

Muscle biopsy ( multiple muscles cysts and are asymmetric) - definitive diagnosis

65
Q

Trichinosis labs to consider?

A

Creatinine kinase (ck)

Lactate dehydrogenase (LDH)

66
Q

Trichinosis complications?

A

myocarditis

encephalitis

67
Q

Trichinosis prognosis?

A

usually benign

68
Q

Uncomplicated Trichinosis treatment?

A

No Tx

Comfort measures

69
Q

Complicated Trichinosis treatment?

A

Mebendazole

70
Q

Trichinosis: treatment for myositis symptoms?

A

Oral Glucocorticoids - prednisone for 1 week

71
Q

Prevention of Trichinosis?

A

Pork

Larvae may be killed by cooking pork until it is no longer pink

or by freezing it at –15°C for 3 weeks

72
Q

Trichinosis complicated treatment?

A

Mebendazole OR albendazole are active against enteric stages of the parasite

efficacy against encysted larvae has not been conclusively demonstrated

Clinical Medicine Lecture - Professor Kramer (28 decks)

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