Larvae Of Cestodes

Question 1

Mention intermediate hosts of spirimetra

Answer 1

1st: cyclops
2nd: frogs, snaked, birds, mammals, man occasionally containing larva called Sparganum mansoni, man acts as blind end host

Question 2

Enumerate modes of infection of Sparganum

Answer 2

1. Drinking water containing cyclops infected with procercoid larva
2. Eating raw or undercooked frogs or birds containing Sparganum which migrates from the frogs or birds’ tissues through intestinal mucosa to various organs
3. Applying the infected flesh of frogs & snaked as poultices to inflamed tissue as skin or eye. Sparganum will migrate to hot inflammed tissue. Common in China

Question 3

In cerebral sparganosis, …….is generally involved esp….. & in some cases extend to…..

Answer 3

Cerebral hemispheres
Fronto-parietal lobes
Cerebellum

Question 4

Mention definitive diagnostic method of sparganosis

Answer 4

Is achieved by biopsy & removal of the swelling which can be identified as Sparganum larva from its morphology

Question 5

Describe treatment of Sparganosis

Answer 5

Surgical removal of nodule containing Sparganum

Question 6

Describe preventive measure against Sparganum

Answer 6

1. Destruction of cyclops by boiling/filtering water
2. Stopping the use of raw frogs aa poultices
3. Proper cooking of frogs & birds meat

Question 7

Describe mode of infection of Cysticercosis

Answer 7

Ingestion of T.solium eggs by:
1. Heteroinfection: in food/drink contaminated by stool of infected person
2. Autoinfection: external (hand to mouth) or internal (by reverse peristalsis some detached segments migrate to stomach & free eggs which penetrate intestinal mucosa to various tissues)

Question 8

The most common presentation of neurocysticercosis is……

Answer 8

Epilsepsy

Question 9

Describe CSF finding of neurocysticercosis

Answer 9

High eosinophils, elevated protein & normal/low glucose

Question 10

Describe role of imaging in diagnosis of neurocysticercosis

Answer 10

Presence of cystic lesion demonsatrating the scolex in CT & MRI is pathognomonic
Scolex appearns as a bright nodule within a cyst producing the “hole-with-dot” appearance

Question 11

Mention serological tests of neurocysticercosis

Answer 11

ELISA & Immunoblot (on serum/CSF)

Question 12

Describe treatment of cysticercosis

Answer 12

1. Albendazole for 8 days very effective against active brain cyst OR
2. Praziquantel for 15 days
3. Steroids
4. AE
5. Surgical removal especially for cisternal, orbital & ventricular cysts

Question 13

Describe prevention of cysticercosis

Answer 13

1. Early detection & treatment of patients harbouring adult taenia soilum
2. Environmental sanitation
3. Personal hygeine
4. Protection of food/drink against contamination

Question 14

CT & MRI of CNS toxoplasmosis shwos…….

Answer 14

Single/multiple ring-enhancing lesions

Question 15

CSF analysis of toxoplasmosis shows………

Answer 15

Mild lymphocytic pleocytosis, high protein, normal/low glucose

Question 16

Treatment of toxoplasmosis

Answer 16

Pyrimethamine+sulfadiaIne+floinic acid for life or until immune reconstitution

Question 17

Signs of severe congenital infection are……
Signs that may develop later in asymptoamtic children are…..

Answer 17

Microcephaly or hydrocephalus, intraceberal calcification, chorioretinitis
Learning disabilities, mental retardation or seizures, chorioretinitis later in life

Question 18

…….are important markers of infection of newborn

Answer 18

IgM & IgA

Question 19

Describe effect if large subdural empyema

Answer 19

Mass effect, also causes thrombophlebitis in bridging veins that cross the subdural space resulting in venous occlusion & infarction of brain.

Question 20

Describe gross & micro picture of bacterial meningitis

Answer 20

G, a suppurative exudate is evident in leptomeninges over the surface of the brain, meningeal vessels are engorged & prominent, CSF is mixed with pus.
M, meningeal vessels are congested & dilated, subarachnoid space is filled with fibrin, neutrophils, pus cells & histiocytes.

Question 21

Describe effects & complications of bacterial meningitis

Answer 21

Local: inc ICT, meningeal fibrosis may obstruct foramina of Lushcka & Magendie leading to hydrocephalus in children, encephalitis, thrombosis of blood vessels
General: septicemia leads to IE or acute adrenal insufficiency “Waterhouse Friedrichsen syndrome”

Question 22

Chronic tuberculous meningitis is a cause of ……leading to…..

Answer 22

arachnoid fibrosis
Hydrocephalus

Question 23

Mention causes of brain abscess

Answer 23

1. Direct traumatic implantation
2. Local extension (mastoiditis, otitis media)
3. Hematogenous spread (ABE, suppurative lung disease via vertebral system of veins)

Question 24

Describe morphology of brain abscess

Answer 24

Acute abscess: irregular area of liquefactive necrosis surrounded by zone of congestion
Chronic abscess: has a smooth fibrous tissue capsule surrounded by zo of reaction gliosis
Ring enhacing lesions in CT/MRI

Question 25

Abscess rupture may lead to…….

Answer 25

Ventriculitis, meningitis, venous sinus thrombosis

Question 26

Mention characteristic histological features of viral encephalitis

Answer 26

Perivascular, parenchymal mononuclear cell infiltrates, microglial nodules & neuronophagia

Question 27

Mention patterns of brain injury by HIV

Answer 27

HIV-1 aseptic meningitis
HIV-1 meningoencephalitis (AIDS dementia)
Vacuolar myelopathy

Question 28

JC virus is a……., infects………resulting in……

Answer 28

Papovirus
Oligodendrocytes & astrocytes
Demyelination

Question 29

In HSV-1 infection neirond contain……

Answer 29

Cowdry type A IB