Larva Migrans + Filariasis

Question 1

Albendazole is used to treat…

Answer 1

Treatment of hydatid disease and cysticercosis. it is also used for the treatment of ascariasis ,tricurasis and strongyloidiasis, pinworm, hookworm.

Question 2

MOA of albendazole

Answer 2

• Inhibits microtubule synthesis by binding to β –tubulin.
• Inhibits mitochondrial reductase causing reduced glucose transport. Intestinal parasites are immobilized and die slowly.
• Larvicidal in hydatid ,cysticercosis, ascariasis and hook worm infections.
• Ovicidal in ascariasis ,hookworm , trichuriasis

Question 3

Albendazole is ovicidal in…

Answer 3

…ascariasis ,hookworm, trichuriasis

Question 4

Albendazole RODA

Answer 4

Oral

Question 5

Larger class of drugs of Albendazole

Answer 5

Benzimidazole carbamate

Question 6

Absorption and metabolism of albendazole

Answer 6

• Absorption is increased with a fatty meal
• Metabolized in the liver to the active metabolite, albendazole sulfoxide

Question 7

Caution for use of albendazole and food

Answer 7

Used on empty stomach when used against intraluminal parasites but with a fatty meal when used against tissue parasites.

Question 8

Clinical use of albendazole

Answer 8

CLM
Hydatid disease
Neurocysticercosis:
Other infections: intestinal capillariasis, giardiasis & taeniasis.

Question 9

How is albendazole used in neurocysticerosis?

Answer 9

Used with corticosteroid to decrease the inflammation caused by dying organism and it also reduces the duration of course for 21 days

Question 10

Side effects of Abx (albendazole)

Answer 10

In short term(1-3 days): Mild epigastric pain,diarrhea, nausea, headache & insomnia.

In long term use: abdominal pain, headache, fever, fatigue, alopecia, increased liver enzymes, pancytopenia.

Question 11

Abx contraindications

Answer 11

Not given during pregnancy, hypersensitive people to benzimidazole drugs & children under 2 years .

Question 12

Thiabendazole pharmacological action

Answer 12

Chelating agent and form stable complexes with metals including iron, but does not bind with calcium.

Question 13

Thialbebdazole PK

Answer 13

Should be given after meals and tablets should be chewed

Question 14

Toxocariasis is an illness of humans caused by

Answer 14

larvae (immature worms) of either the
dog roundworm (Toxocara canis),
the cat roundworm (Toxocara cati)
or the fox roundworm (Toxocara canis).

Question 15

Toxocaraiasis is a major cause of

Answer 15

blindness
may provoke rheumatic,
neurologic,
or asthmatic symptoms.

Question 16

Toxocaraiasis can be asymptomatic. True or false?

Answer 16

True

Question 17

The two main clinical presentations of toxocariasis are

Answer 17

visceral larva migrans (VLM) and ocular larva migrans (OLM).

Question 18

VLM symptoms

Answer 18

The larvae invade multiple tissues (liver, heart, lungs, brain, muscle) and cause:

fever, anorexia, weight loss, cough, wheezing, rashes, hepatosplenomegaly, and hypereosinophilia.
Death can occur rarely, by severe cardiac, pulmonary or neurologic involvement.

Question 19

OLM clinical features

Answer 19

The larvae produce various
ophthalmologic lesions, which in some cases
have been misdiagnosed as retinoblastoma,
resulting in surgical enucleation.

OLM often occurs in older children or young
adults, with only rare eosinophilia or visceral
manifestations.

Question 20

Laboratory diagnosis of VLM includes

Answer 20

• Enzyme immunoassay (EIA) with larval stage antigens extracted from embryonated eggs or released in vitro by cultured infective larvae.
• Toxocara excretory-secretory (TES) antigens

Question 21

Drugs used in treating Toxocaraiasis

Answer 21

Albendazole is the drug of choice with mebendazole* as an alternatives

Question 22

CLM is caused by

Answer 22

the larvae of the non-human hookworms Ancylostoma braziliense and A. caninum.

Question 23

Hookworms causing CLM

Answer 23

Ancylostoma braziliense (dog, cat) – most common
Ancylostoma caninum (dog)
Urcinaria stenocephala (European dogs)
Bunostoma phlebotomun (cattle)

Question 24

Strongyloides species causing CLM

Answer 24

S pyoncyonis (racoon racoon)
S myoptami (nutrea nutrea)
Pelodera strongyloides

Question 25

Other organisms causing CLM

Answer 25

Gnathostoma spinergium (dog, cat)
Loa Loa (Calabar swelling)
Fasciola hepatic ( ectopicectopic migration)

Question 26

Vectors of Brugia malayi are

Answer 26

Mosquitoes of the genus Mansonia.

Question 27

Elephantiasis is due to ____, lymphatic filariasis is characterized by _____

Answer 27

the engorgement and thickening of skin; lymphedema, or fluid collection due to improper functioning of the lymph system resulting in swelling.

Question 28

DOC (drug of choice) in filariasis

Answer 28

DEC - diethyl carbamazine

Question 29

DEC kills microfilariae only. True or false?

Answer 29

False. It kills adults too.

Question 30

DEC PK

Answer 30

Rapidly absorbed from gut
Half- life is 2-3 hours
The drug should be given after meals.
It is excreted in urine as unchanged or metabolite.

Question 31

DEC MOA

Answer 31

Immobilizes microfilariae and alters their surface structure, displacing them from tissues & making them susceptible to destruction by host defense mechanism. It has immunosuppressive effects.

Question 32

Adverse effects of DEC

Answer 32

Fever, malaise, papular rash, headache, GI disturbance, cough. Chest, muscle, joint pain Leucocytosis, Retinal hemorrhage, Encephalopathy, Lymphangitis and lymphadenopathy.
It is not teratogenic.

Question 33

DEC contraindications

Answer 33

Hypertension, Renal disease patient with lymphangitis.

Question 34

Other drugs used in treating filariasis include;

Answer 34

Albendazole which kills adult worms.
Ivermectin which kills the microfilariae.

Question 35

Examples of zoonotic nematodes

Answer 35

Toxocara canis

Question 36

CLM is caused by

Answer 36

the larvae of the non-human hookworms Ancylostoma braziliense and A. caninum.