LEC 5 - Ente-Dracu Flashcards

1
Q

Enterobius Vermicularis Common Name`

A

pinworm, seatworm, society worm, social worm

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2
Q

E. vermicularis is also called

A

Oxyuris vermicularis

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3
Q

E. vermicularis causes

A

Enterobiais and Oxyuriasis

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4
Q

Greek word that means bowel

A

Enteros

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5
Q

Greek word that means life

A

bios

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6
Q

Latin word for small worm

A

vermicularis

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7
Q

E. vermicularis morphology

A

Tail end pointed, sharp like a tailor’s pin

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8
Q
  • It is an exclusive human parasite – it does not need intermediate host
  • Other species may infect animals (like horse, dogs) - But also insects – cockroach
A

Enterobius vermicularis

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9
Q
  • High risk groups of E. vermicularis
A
  • School children 5-10 yrs./old
  • Family members
  • Institutions: schools, daycare, camps, hostels
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10
Q

The prognosis of enterobiasis is good except that this parasitic disease is easily spread within the family, hence it may be described as

A

Family disease

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11
Q

The pattern of distribution is globally. It can be found anywhere in the world.

A

Cosmopolitan Parasite

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12
Q

Why does E. vermicularis prefer Temperate Climate?

A

They disintegrate if exposed sila sa direct heat like heat, kasi sa mainit na countries namamatay ung parasite.

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13
Q
  • The most prevalent helminth in USA and Western
    Europe
  • Commonly found in school aged children
  • Also seen in adult
  • Prevalence in children communities
A

E. vermicularis

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14
Q

Percent of Prevalence per country

A
  • 61% India
  • 50% England
  • 39% Thailand
  • 37% Sweden
  • 29% Denmark
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15
Q

Natural host of Sitworm

A

Human

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16
Q

First report of pinworm in naturally occurring
___________ (Chan et.al., 2004)

A

cockroaches

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17
Q

Existence of pinworm and Trichinella in cockroaches from hospitals and schools in
______

A

Hawaii

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18
Q

In 2005, Tatfeng et.al isolated pinworm ova from
what specific cockroach specie

A

Diplotera punctata

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19
Q

Infective stage of sitworm

A

egg

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20
Q

The female parasite of sitworm lays eggs in the ____________, not in the intestinal lumen. That is why the eggs of this parasite cannot be seen in the feces.

A

perianal region

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21
Q

Methods Used for E. vermicularis examination

A

1.Graham’s Scotch Tape/ Cellulose Tape
2. Anal Swab Penetration Technique

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22
Q

The egg of pinworm contains what type of layer that makes the egg stick to the perianal region?

A

albuminoid layer

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23
Q

The pinworm egg needs ________ to develop

A

Oxygen

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24
Q

It is the only intestinal nematode infection that
cannot be controlled through sanitary disposal of
human feces because eggs are deposited in the
perianal region instead of the intestinal lumen

A

Enterobius vermicularis

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25
Q

Adult worms size

A

Male worm smaller 2-5mm
Female worm 8-13 mm

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26
Q

Anterior end of adult pinworm has ____________ (wing like expansions both sides of anterior end)

A

cervical alae

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27
Q

Adult pinworm structure

A

Posterior 1/3 body
- Curved in males
- Straight and very thin (pin-like in female)

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28
Q

Pinworm lays ____ eggs and dies

A

11,000

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29
Q

Pin worm eggs Morphology

A
  • Planoconvex
  • Size: 30-50 um
  • Very sticky (adhesive) – albuminoid
  • Mature egg may contain larva
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30
Q
  • Very hardy in cold climate, high humidity
  • Easily destroyed by dry heat, sunlight
  • It can be seen in the naked eye if in clumps of
    thousand, dislodged from clothing, very light and is
    easily airborne!!
A

Enterobius vermicularis eggs

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31
Q

are inanimate objects that can carry and spread
diseases and infectious agents

A

Fomites

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32
Q

Fomites of Enterobius

A

Beddings
Blanket
Underwear

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33
Q

– intense chronic itching affecting peri-anal skin

A

Pruritus ani

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34
Q

Do not need to rely on a vector

A

Horizontal transmission

35
Q

ROT of sitworm

A
  • Ingestion of infectious eggs
  • by direct anus-to-mouth transfer by fingers –
    anus to mouth
  • perianal itch (pruritis ani) induced by the
    presence of pinworm eggs in the perianal folds
  • as a result of nail biting, poor hygiene, or
    inadequate hand-washing
36
Q

mother to son transmission

A

Vertical Transmission

37
Q

son to mother, generic term which denotes the ROT is unusual, not common

A

Retroinfection

38
Q

person to person transmission

A

Horizontal Transmission

39
Q

According to Belizario, the route of infection of pinworms are:

A
  1. through the mouth
  2. the respiratory system (by inhalation of dust
    containing Eneterobius eggs
  3. through anus (wherein the hatched larvae
    enter the anus and cause retroinfection
    when they go back into the large intestine
40
Q

pinworm larvae which hatch on the anus return to the gastrointestinal tract of the original host, ensuring continued infestation

A

Retroinfection

41
Q

eggs ‘fly’ from shaken bedsheets, towels →
inhalation

A

Airborne

42
Q

Same person scratch anus → egg stick to hand → mouth

A

Autoinfection

43
Q

: eggs stick to legs of cockroaches and ants, dog / cat fur

A

Mechanical vectors

44
Q

LIFE SPAN OF ENTEROBIUS VERMICULARIS

A
  • External environment (outside human host): viable for 3 weeks in cool temperature, moist areas
  • In (1 moulting) upper small intestine: hatched into infective larva → lower small intestine, undergo 2
    moultings (Egg – Juvenile 1 – Juvenile 2 – Juvenile 3)
  • In large intestine (cecum, appendix): Become adult worms.
  • In the large intestine the male worm fertilizes, female worm and dies, expelled in stool
  • 5 weeks after fertilization, female worms migrate to perianal to lay eggs and die, eggs stick to clothes, not in stool
45
Q

Life span of adult E. vermicularis

A

Male 50 days, Female 37-93 days → natural death

46
Q

Mild to intense itching at night (peak activity of female worms) only

A

Nocturnal pruritis ani

47
Q

frequent irritability and waking up at night
disturbed normal day activities

A

Insomnia

48
Q

SYMPTOMS of Enterobiasis

A
  • Causing appendicitis (as high as 2.39% of cases in
    developing countries)
  • Intestinal obstruction
  • Intestinal perforation
  • Eosinophilic ileocolitis
  • Extra-intestinal infections also possible (Extra-intestinal enterobiasis)
  • Most involve the female genital tract
49
Q

Dianosis of E. vermicularis

A

Pinworm Tape Test (Graham Scotch Tape Method)

50
Q

Pinworm Tape Test

A
  • Morning sample is the best before washing, toilet
  • Take samples on successive days (worms do not lay eggs every night)
  • Sticking scotch or cellophane tape to anal area
  • Place sticky side of tape to glass slide
  • View under x10 - x40 magnification
51
Q

Best time for collection on Pinworm Tape Test

A

Collect madaling araw kasi kakatapos mangitlog nung mga gravid female and di pa naligo si patient

52
Q

Other options when collecting samples for E. vermicularis

A

o Look for worm at the perianal region 2-3 hours
after sleep
o Analyze sample from under fingernails under
microscope to look for pinworms eggs

53
Q

diagnosed via colonoscopy followed by confirmation via microscopy was documented by Petro et. al. in 2005

A

Extra-Intestinal Infections

54
Q

usually require laparotomy and excision of granulomas for a conclusive diagnosis

A

Infections of the female genital tract

55
Q

via cervical smears, vaginal wet mounts, and vaginal pooled specimen is possible but difficult

A

Pre-operative diagnosis

56
Q
  • 100 mg by mouth
  • repeated for two weeks to prevent reinfection,
  • safest and most efficient therapy (96%)
  • Drug targets adult worms, blocking glucose uptake asubsequently causing death
A

Mebendazole

57
Q
  • 100 mg doses for patients under two years okd
  • 400 mg for older patients
  • Repeated for two weeks
  • Also targets adult worms, decreasing their ATP
    production and causing energy depletion,
    immobilization, and ultimately death
A

Albendazole

58
Q
  • Given at 11 mg/kg not to exceed 1g
  • Can cause side effects, which include GI distress,
    neurotoxicity and transient increases in liver enzymes
  • Serves as depolarizing neuromuscular blocking agent, inhibiting cholinesterase and resulting in paralysis of the adult worms
A

Pyrantel pamoate

59
Q

Other Therapy/Treatment for Enterobiasis

A
  • piperazine citrate, pyrvinium pamoate, oxantel,
    oxantel-pyrantel, fenbendazole, and nitrazoxamide
  • For pinworm infections of the genitourinary tract
    mebendazole, ivermectin
  • Topical insecticides containing malathion or
    ivermectin may also be applied to the skin of the
    perineum to eliminate pinworm eggs
60
Q

Other Therapy/Treatment for Enterobiasis

A
  • Treatment of the entire household is strongly
    suggested whether or not symptoms are present.
  • Pinworms are easily transmitted among members of the household.
  • Strict handwashing – after using the toilet/changing the diaper of an infected baby, also before and after eating, for two weeks
  • Bedding cleaned every 3-7 days for three week
  • Underwear and pajamas washed daily
61
Q

According to Belizario,
The drug of choice for Enterobiasis is

A

pyrantel pamoate

62
Q

PREVENTION

A
  • Keep fingernails short
  • Dry bedlinen, clothes in sunlight / dryer
  • Wash dogs and cats
  • Frequent handwashing before meals, after toilet
  • Change underwear daily
  • Apply petroleum jelly to anal area to block oxygen uptake, larva hatching / re-entering and lessen itchiness
  • Bath when you wake up to help reduce the egg
    contamination.
  • Frequent changing of night clothes are recommended.
  • Eggs are sensitive to sunlight, open blinds or curtains in bedrooms during the day.
  • Discourage nail-biting and scratching bare anal areas.
    These practices help reduce the risk of continuous self reinfection.
63
Q

an arthropod borne nematode disease

A

Dracunculiasis

64
Q

For Dracunculus medinensis, Vector serves as the _______ host while human serves as the _________ host

A

intermediate; definitive

65
Q

Common Name for Dracunculus medinensis

A

Guinea Worm, Fiery Serpent of Israelites

66
Q

Disease caused by D. medinensis

A

Dracunculiasis/Guinea Worm Disease/Disease of the Empty Granary

67
Q

Intermediate host of D. medinensis

A

Cyclops/ Copepod
- Mesocyclops spp.
- Thermocyclops vermifer
- Encyclops serrulatus (Eucyclops serrulatus)

68
Q
  • The female worms could reach _______ in length and _______ in diameter. Male worms are rarely seen and die off after mating
A

50 cm; 1.55 mm

69
Q

Color of D. medinensis

A

Slender, milky white

70
Q

T or F
Dracunculus is ovoviviparous, the larvae is discharge into the water

A

False, Dracunculus is viviparous

71
Q
A
72
Q

According to Panikers,
The adult females of D. medinensis are usually found in the__________________ of the legs, arms and back in man.

A

subcutaneous tissue

73
Q

D. medinensis - Definitive Host

A

Man

74
Q

D. medinensis - Intermediate Host

A

Cyclops, in which embryos undergo developmental changes. There is no animal reservoir.

75
Q

D. medinensis - Infective Form

A

Third-stage larva present in the hemocele of infected cyclops.

76
Q

D. medinensis - MOT

A

Humans get infected by drinking unfiltered water containing infected cyclops.

77
Q

Incubation period of D. medinensis

A

1 year

78
Q

Guinea worm infections in animals:

A
  • Animals infected with some species of nematode, Dracunculus medinensis
  • Found in domestic dogs and cats
  • Therefore, eradication program requires stopping infections in both humans and animals
79
Q

Currently there is no cure, however for the removal of the Guinea worm the best method is the ancient technique of patiently twisting it around a stick called

A

Stick therapy

80
Q

If nahila = _________. The worm dies inside the body.

A

putrefication

81
Q

PREVENTIVE MANAGEMENT OF DRACUNCULIASIS

A
  1. Ensuring wider access to safe drinking water supplies
  2. Filtration of drinking water to prevent infection
  3. Intense surveillance and control to detect every case within 24 hours of the emergence of worm
  4. Treatment of ponds with larvicide temephos that kills the water fleas and
  5. Promoting health education and behavior change.
82
Q

Clinical features of D. medinensis

A

Pruritus, uticarial rash, blister formation in skin, and cellulitis.

83
Q

Diagnosis of D. medinensis

A

Detection of adult worm and larval form in ulcer. Demonstration of deadworm by X-ray. Serology-ELISA and IFA.

84
Q

Treatment for D. medinensis

A

Antihistaminics and steroids in initial stage. Metronidazole and niridazole are useful. Surgical removal of the worm.