Intestinal Nematodes

Question 1

Hookworm infection

Filariform larvae in soil penetrate SKIN of feet (ground itch)

Warm moist climates

Answer 1

Ancylostoma duodenale

Necator americanus

Question 2

Ancylostoma
Necator

Definitive host

Answer 2

Human

Question 3

Ancylostoma
Necator

Infective stage

Answer 3

Filariform larvae

Question 4

Ancylostoma
Necator

Hookworm diagnostic stage

Answer 4

Eggs in feces

Question 5

Ancylostoma
Necator

Penetrate skin of soles and feet

Blood stream -> lungs -> GI tract

can cause

Answer 5

IDA from blood loss of GIT attachment of worm

Question 6

Ancylostoma
Necator

Tx

Answer 6

Albendazole
Mebendazole
Pyrantel pamoate

Question 7

Food with soil containing eggs
Cosmopolitan
Well tolerated unless infection is heavy or host is undernourished

Answer 7

Ascariasis

Question 8

Largest of intestinal nematode

Eating egg contaminated food

Larvae hatch and attach in the small instestine

Blood stream -> lungs -> alveoli -> GIT

Answer 8

Ascariasis

Question 9

Giant worm larvae ascaris infecting the lung

Worst complication of ascaris

Answer 9

Loeffler’s pneumonia

Intestinal obstruction at ileocecal valve

Question 10

Ascaris infective stage

Answer 10

Larva

Question 11

Ascaris diagnostic stage

Answer 11

Fertilized egg

Unfertilized egg

Question 12

Major damage occurs during migration of work rather than presence of the worm in the intestine

Most infection are asymptomatic
Larvae in lung can cause pneumonia
Heavy worm infestation can cause anemia and intestinal obstruction or malnutrition

Answer 12

Ascaris lumbricoides

Question 13

Ascaris tx

Answer 13

Mebendazole
Pyrantel pamoate
Ivermectin (filariasis)

Question 14

Human seatworm
Pinworm

Ingest eggs by autoinfection, inhalation or swallowing from beddings, carpet

Humans only host

Answer 14

Enteobius vermicularis

Question 15

Gravid female migrates to perianal skin to deposite embryonated eggs

Cardinal manifestation: nocturnal pruritus

Answer 15

Enterobius vermicularis

Question 16

Enterobius

Dx

Answer 16

Scotch tape/Graham Cellphone test

Question 17

Enterobius Infective state

Answer 17

Embryonated eggs

Question 18

Enterobius diagnostic stage

Answer 18

Eggs

Question 19

Children younger <12 old

Most common in US

Answer 19

Enterobius vermicularis

Question 20

Enterobius Tx

Answer 20

Mebendazole

Pyrantel pamoate

Question 21

Raw or undercooked meat, pork
Reservoir host - pigs, rats

Intestinal nematode that encyst in tissue (striated muscle)

Muscle pain
Periorbital edema
Diarrhea

Answer 21

Trichinella spiralis

Question 22

Trichinella larvae invades

Answer 22

Skeletal muscle

Question 23

Trichinella can cause

Answer 23

Heart failure

CNS

Question 24

Trichinella Diagnostic test

Answer 24

Encysted larva in muscle with poor glycogen
Muscle biopsy
Bachman intradermal test
Bentonite Flocculation test

Question 25

Trichinella spiralis Tx

Answer 25

Thiabendazole

Question 26

Whipworm Food and water contaminated with soil Humans only host Tropics

Answer 26

Trichuris trichuris

Question 27

Final habitat of trichuris

Answer 27

Cecum | Ascending colon

Question 28

Abdominal pain Bloody diarrhea Anemia Rectal prolapse

Answer 28

Trichuris trichuria

Question 29

Rectal prolapse Diagnosis via DFS Bipolar mucus plugs Japanese lantern/football shaped appearance of ova

Answer 29

Trichuris trichuria

Question 30

Causes hypochromic anemia

Answer 30

Trichuris trichuria

Question 31

Trichuris Dx

Answer 31

Egg in feces

Question 32

Trichuris trichuria tx

Answer 32

Mebendazole

Question 33

Trichuris trichuria infective stage

Answer 33

Embryonated egg

Question 34

Trichuris trichiuria infective stage

Answer 34

Unembryonated egg

Question 35

Threadworm Filariform larvae in soil penetrate skin Warm climate Autoinfection

Answer 35

Strongyloides stercoralis

Question 36

Little effect Massive superinfection with secondary bacterial infection in immunocompromised Cause hyperinfection and dissemination of worms

Answer 36

Stronglyoides

Question 37

Strongyloides Dx

Answer 37

Larvae in stool Not eggs because they get laid in the intestinal wall

Question 38

Strongyloides tx

Answer 38

Thiabendazole

Question 39

Strongyloides Dx | Stool Filter paper culture method

Answer 39

Harada mori

Question 40

Endemic in Philippines (Ilocos norte) Man only host - internal autoinfection Ingestion of raw or undercooked infected fish (kinilaw)

Answer 40

Human intestinal capillariasis | Capillaria philippinensis

Question 41

Capillariasis is associated with

Answer 41

Protein losing enteropathy Cardiomyopathy Severe emaciation Cachexia

Question 42

Ingestion through contaminated fish Abdominal pain Diarrhea Borborygmus

Answer 42

Capillaria philippinensis

Question 43

Capillaria egg on microscopy

Answer 43

Peanut shell appearance

Question 44

Capillaria tx

Answer 44

Mebendazole | Albendazole

Question 45

Capillaria infective stage

Answer 45

Larvae

Question 46

Capilaria diagnostic stage

Answer 46

Unembryonated egg

Question 47

Capillaria is associated with

Answer 47

Migratory birds | Herons

Question 48

Causes intestinal malabsorption Chronic diarrhea Borborygmus Up to 2L of stool/day -> emaciation and cachexia HF, hypokalemia, cerebral edema

Answer 48

Capillaria philippinensis

Question 49

Fever Vomiting Periorbital edema Ingestion of infected pork meat Myalgia - cyst develop into larvae, enter blood stream and form cyst in striated muscle

Answer 49

Trichinella spiralis