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General Parasitology > Intestinal Nematodes > Flashcards

Intestinal Nematodes Flashcards

1
Q

Adenophora class

A

T. trichura & T. spiralis

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2
Q

Truchuris trichura AKA

A

also known as the “whip worm”

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3
Q

T. trichura adults live inside

A

the large intestine and rectum

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4
Q

Embryonation of T. trichura eggs occurs in:

A

moist, warm, shady soil

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5
Q

Infection of T. trichura

A

ingesting embryonated eggs on salad vegetables, fruit, in water or in soil

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6
Q

T. trichura Larvae to adults:

A

Larvae hatch in small intestine and become adults in the cecum

Adults burrow inside mucosa, where they consume RBCs

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7
Q

2 requirements for the worm to become a serious health problem

A

poor sanitation (human feces are deposited on the soil)

physical factors that allow their survival and development (warm climate, high rainfall and humidity, moist soil and dense shade)

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8
Q

T. trichura adults pass ________

A

unembryonated eggs in feces

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9
Q

_____ may coexist with _____

A

Trichuris

Ascaris

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10
Q

It’s the 2nd most common infecting nematode in the US

A

Trichuris

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11
Q

Pathogenesis in Trichuris

A

Trauma to the mucosa can cause chronic hemorrhage that may result in anemia and bloody stools

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12
Q

Symptoms on Trichuris

A

Abdominal pain, insomnia, vomiting, prolonged diarrhea, weight loss, nausea, rectal prolapse

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13
Q

Dx of Trichuris

A

ID of a worm or egg in the stool

Eggs have 2 distinct opercular plugs

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14
Q

Treatment of Trichuris

A

Albendazole and mebendazole

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15
Q

Prevention and control of Trichuris

A

thorough washing of salad vegetables

Washing hands

Sanitary disposal of feces

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16
Q

smallest nematode parasite of humans

A

Trichinella spiralis

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17
Q

Trichinella spiralis causes a ____ infection called _____

A

Zoonotic

Trichinosis

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18
Q

Trichinella spiralis is _____ in host specificity

A

Low

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19
Q

In Trichinella spiralis uterus is filled with _______ in _______ region; _____ region contains ___________

A

developing eggs; posterior

anterior; fully developed, hatching juveniles

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20
Q

In trichinella Life cycle is unusual in that the same animal serves as:

A

both definitive and intermediate host: larvae and adults are found in different organs

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21
Q

human infection of T. spiralis is contracted from:

A

the consumption of poorly cooked pork, infected with larvae (nurse cells)

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22
Q

T. spiralis larvae to adults:

A

Larvae are swallowed, reach SI where they excapsulate, molt and then enter the intestinal mucosa

Copulation occurs, Males die after. Females give birth and then die shortly after

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23
Q

After juveniles are birthed:

T. spiralis

A

Juveniles are carried away by the hepatoportal system –> the liver –> the heart –> lungs –> arterial system, which distributes them throughout the body

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24
Q

Through out migration (T. spiralis):

A

Juveniles can become lodged in any tissue

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25
Q

If T. spiralis juvenile end up in striated muscle tissue:

A

diaphragm, jaws, larynx, eyes, tongue

they penetrate individual muscle fibers and begins to grow, eventually forming a nurse cell

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26
Q

Most susceptible are muscles to least

A

eye and tongue, then the jaw muscles, then diaphragm, and finally muscles of the arms and legs

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27
Q

After ~1 year:

T. spiralis

A

host reactions begin to calcify the cyst walls and eventually the worms themselves

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28
Q

Sylvatic trichinosis

A

occurs between wild carnivores and their prey. Bears, foxes and raccoons are often infected

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29
Q

Urban trichinosis

A

It occurs primarily as a triangle between humans, rats, and pigs

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30
Q

Trichinosis triangle

A

rats maintain infection via cannibalism
Pigs get infected by eating rats
humans get infected by eating pigs

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31
Q

Trichinosis is rare in:

A

jews, hindus, muslims and vegetarians

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32
Q

Pathogenesis of T. spiralis in 3 stages:

A

(1) mild during penetration of adult females into the mucosa
(2) severe during migration of juveniles, (constituting the primary symptoms)
(3) moderate during penetration and encystment in muscle cells

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33
Q

Symptoms of stage 1 in T. spiralis

A

intestinal inflammation and pain, nausea, vomiting, sweating and diarrhea

red blotches on skin, facial edema, fever

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34
Q

Symptoms of stage 2 in T. spiralis

A

damaged blood vessels, pneumonia, pleurisy, encephalitis, meningitis, nephritis, deafness, and loss of vision

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35
Q

Death occurs via:

A

myocarditis or heart and kidney failure and respiratory complications

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36
Q

Symptoms of stage 3 in T. spiralis:

A

intense muscular pain

difficulty breathing and swallowing, and cardiovascular, excretory, and nervous disorders

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37
Q

dx in T. spiralis:

A

Immunological tests

Xenodiagnosis

38
Q

Treatment of T. spiralis:

A

mebendazole (against muscle larvae) & pyrantel pamoate (against adult worm)

39
Q

Prevention and Control

A

Fully cook pork before eating

Education on fully cooking pork before serving

Laws preventing feeding of uncooked waste to pigs have greatly reduced the disease in the US

40
Q

Hook works spp

A 
Ancylostoma duodenale (old-world)
Necator americanus (new-world)
41
Q

Buccal capsule in A. duodenale

A

2 pairs of teeth on the ventral wall of its capsule

42
Q

Buccal capsule in N. americanus

A

pair of dorsal and a pair of ventral cutting plates surrounding the smaller buccal capsule

43
Q

Life cycle of hookworms (eggs - L3 stage)

A

eggs are passed in feces
in the proper envt, they will develop and hatch into rhabditiform larvae (L2) (feeding stage)
molts into filariform larvae (L3) (non-feeding stage) which moves to surface when soil is wet where they penetrate human skin

44
Q

Migration (hookworms)

A

human skin –> lymphatic system –> lungs (via heart and pulmonary circulation) –> alveoli –> glottis –> coughed up and swallowed

45
Q

Once adult hook worms are swallowed:

A

They arrive in SI and attach to mucosal lining where they molt into L4 stage they feed off of blood and sexually mature

46
Q

4 factors lead to hookworm infection:

A

shaded sandy and loamy soil

moisture in form of precipitation

poor sanitation

contact with contaminated soil

47
Q

3 stages of hookworm disease:

A

1) Invasive
2) Pulmonary
3) Intestinal

48
Q

Invasive:

hookworm

A

hemorrhage and swelling with intense itching at entry site

Secondary infection possible

ground itch

49
Q

Pulmonary:

hookworm

A

pneumonitis, burning sensation in the chest, dry cough, and other symptoms of bronchial pneumonia

50
Q

Intestinal:

hookworm

A

most important period of pathogenesis.

Cause bleeding and ulceration of mucosa

Anemia resulting in geophagy

Intermittent abdominal pain

loss of appetite

51
Q

Heavy infection of hookworm:

A

malnutrition, anemia and mental dullness

52
Q

Chronic malnutrition from hookworm infection often causes irreversible damage, resulting in:

A

weakness, stunned growth and below-average intelligence

53
Q

Dx of hookworm

A

presence of eggs or worms in feces

Smear of feces on filter paper stored in tube allows to observe hatching larvae

54
Q

Treatment (hookworm)

A

Mebendazole

Iron therapy

55
Q

Prevention (hookworm)

A

Wear shoes

Wear protective clothing while gardening

Washing salad vegetables or fruits well

56
Q

Control (hookworm)

A

Control involves an increase in sanitary conditions

regular chemotherapeutic campaigns

proper elimination of dog feces for N. a.

broad public education

57
Q

Creeping eruptions

A

Caused by A. braziliense (cat) or A. caninum (dog)

Penetrate human skin but are incapable of migrating to the intestine

Cause trauma to the skin before they are killed by immune system

58
Q

Largest nematodes

A

Ascaris lumbricoides

59
Q

Ascaris lumbricoides eggs in uterus

A

Uteri may contain > 27 million eggs at a time, with 200,000 being laid per day

60
Q

Ascairs eggs have a ______ outer layer which allows them to be _______

A

Mammilated

Resilient

61
Q

Ascaris lifecycle

A

Unembryonated eggs passed in feces, in soil they develop if optimal conditions are present

62
Q

Although the eggs are resistant to ____ temperature, ________, and strong _____, _________ is retarded by such factors

A

low
desiccation
chemicals
embryonation

63
Q

Infection with Ascaris occurs when

A

embryonated eggs are swallowed with contaminated food and water

64
Q

Once Ascaris eggs are ingested

A

Eggs containing 2nd stage larva hatch in the small intestine, penetrate mucosa/submucosa, enter lymph/circulatory system and migrate from liver –> right heart –> lungs

65
Q

During ascaris migration:

A

many worms get lost and accumulate in every possible organs of the body, causing acute tissue reactions

66
Q

Ascaris in lungs:

A

juveniles molt twice and emerge from pulmonary capillaries –> alveoli –> trachea –> glottis –> SI via coughing and swallowing

67
Q

Ascaris in SI:

A

4th stage larvae mature and sexually reproduce

68
Q

Proposed reasons why ascaris travels back to intestine where they originated

A

(1) migration simulates an intermediate host

(2) ancestor was a skin penetrator for which the migration (L2 -> L3 -> L4) was a developmental necessity

69
Q

Prevention/control for Ascaris

A

Organism is difficult to control because eggs are so resistant and eggs can be carried by wind-borne dust

Avoid/wash raw vegetables

Proper disposal of feces

Regular chemotherapy to carriers

70
Q

Pathogenesis in Ascaris (lungs)

A

When juveniles emerge from capillaries they cause hemorrhage

71
Q

Ascaris causes what type of pneumonia

A

Loeffler’s pneumonia - small pools of blood clog air spaces, accumulation of WBCs and dead epithelium add to respiratory congestion

72
Q

In heavy intestinal Ascaris infections:

A

In children, protein malnutrition is common.

Intestinal obstruction results in severe abdominal pain, loss of appetite, nausea and vomiting

73
Q

Dx for Ascaris

A

ID of eggs in feces as well as egg counts

Xray of abdomen

74
Q

Treatment for Ascaris

A 
None for juveniles 
piperazine citrate for adults 
Albendazole and mebendazole
Surgery 
IV fluids
75
Q

Enterobius vermicularis AKA

A

Pin worm or Seat worm

76
Q

Does Enterobius vermicularis have an intermediate host?

A

NO

77
Q

Adult Enterobius vermicularis live in:

A

ileocecal region of intestine

78
Q

Enterobius vermicularis adults commonly travel throughout:

A

GI tract (stomach to anus)

79
Q

Infection of E. vermicularis usually occurs via:

A

ingestion of eggs containing 3rd stage juvenile

80
Q

Adult E. vermicularis feed off of :

A

Bacteria and epithelial cells

81
Q

Life cycle (E. vermicularis):

A

Gravid female migrates out of the anus and lays sticky eggs at night

82
Q

Female and male survival (E. vermicularis)

A

Males die after copulation females die shortly after they lay eggs or sometimes burst open while laying eggs

83
Q

Eggs deposited on the anal skin in E. vermicularis:

A

Causes pruritus - intense itching and swelling

84
Q

Eggs can be ______

A

Inhaled

When inhaled, eggs may remain in the nose until they hatch

85
Q

retroinfection

A

If the perianal or vaginal folds are unclean for long periods, the attached eggs may hatch and juveniles wander into the anus and back into the intestine

86
Q

If E. vermicularis is ingested:

A

the larvae slowly move down the small intestine, molting twice to become adults by the time they arrive at the SI-LI junction

87
Q

Heavy infections of E. vermicularis in children result in:

A

sleeplessness, weight loss, hyperactivity, grinding of teeth, abdominal pain, and vomiting

88
Q

e most common nematode parasitizing humans in the U.S.

A

E. vermicularis

89
Q

Dx of E. vermicularis

A

finding eggs and worms

Examining under flash light either early or at night

90
Q

Treatment of E. vermicularis

A

Albendazole and mebendazole

91
Q

How to confirm treatment in E. vermicularis:

A

cellophane tape is pressed against the perianal skin, then removed and pressed against a glass slide for exam.

Negative results for 7 consecutive days means the patient is cured

92
Q

Prevention and control in E. vermicularis:

A

Frequent washing of hands, bed sheets and clothes in hot water are strongly recommended.

Since eggs can survive for days in moist, cool home, everyone in the infected household should be properly treated

General Parasitology (19 decks)

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