Lesson 2 Flashcards
1
Q
are simple animals that are slightly more complex than a cnidarian.
A
Flatworms (phylum Platyhelminthes)
2
Q
have a slightly more complex body plan.
A
Roundworms (phylum Nemathelminthes)
3
Q
Have elongated, cylindrical, unsegmented bodies tapering on both ends
A
Nematodes
4
Q
What do you call the characteristic of having separate set sexes?
A
Dioecious
5
Q
This nematodes has accessory reproductive organs
A
Male adult nematode/worm
6
Q
These features of male adult worm is used for copulation
A
Accessory reproductive organs
7
Q
Differentiate the tail of male and female nematodes
A
Male: curved
Female: straight and pointed
8
Q
This is the opening of both reproductive and digestive
A
Cloaca
9
Q
Lays eggs in unsegmented stage (unembryonated)
A
Oviparous
10
Q
Who are the oviparous parasites
A
HAT”: Hookworm, Ascaris, Trichuris
11
Q
Lays eggs in segmented stage (embryonated)
A
Ovoviviparous
12
Q
Who are the Ovoviviparous parasites
A
ES”: Enterobius vermicularis, Strongyloides stercoralis
13
Q
Lays full developed larva.
A
Viviparous/Larviparous
14
Q
Who are the Viviparous/Larviparous parasites
A
All tissue nematodes
15
Q
Cephalic chemoreceptors
A
Amphid
16
Q
Caudal chemoreceptors
A
Phasmids
17
Q
all nematodes have phasmid
EXCEPT who
A
TCT Trichuris-Capillaria-Trichinella (aphasmids)
18
Q
Life cycle of nematodes
A
Eggs > larvae > adult
19
Q
Main habitat of nematodes
A
Intestinal tract of man, tissues and other sites
20
Q
Which nematodes have heart to lung migration
A
ASH- Ascaris, Strongyloides, Hookworms
21
Q
Animals as natural hosts nematodes
A
no maturity in the human body
22
Q
• The most common & largest intestinal nematode of man
• AKA “giant roundworm” “large intestinal roundworm”
“Eelworm”
• soil-transmitted helminth (STH)
A
Ascaris lumbricoides
23
Q
A. lumbricoides produces PI-3 & phosphorylcholine. What does it do?
A
Potects worm during digestion
24
Q
Mouth of A. lumbricoides
A
Trilobate
25
Nematodes spreading by egg ingestion
• Ascaris lumbricoides
• Trichuris trichiura
• Enterobius vermicularis
26
Identify the a. lumbricoides stage: Unicellular embryo divides into two
L1
27
IDENTIFY THE A LUMBRICOIDES STAGE: Embryo divides and become multicellular
L2
28
IDENTIFY THE A LUMBRICOIDES STAGE;
• Developed larva
• Infective stage
L3
29
Pathway of Ascaris lumbricoides:
Small Intestine – Bloodstream – Liver (1st to infect) – Heart –
Lungs – Oropharynx
30
PATHOGENESIS AND CLINICAL MANIFESTATIONS OF ASCARIS LUMBRICOIDES
• Ascariasis (“Sandbox Infection”)
Pulmonary
• Ascaris pneumonitis
• Loeffler’s Syndrome
Intestinal
• Pot belly, Ascaris bolus (obstruction)
Extra-intestinal
• Biliary ascariasis, acute appendicitis or pancreatitis, acute
peritonitis
31
• Due to larval migration as they enter the air sacs causing
immune hypersensitivity
• Initial symptoms: difficulty of breathing, fever, eosinophilia
• Severe: dyspnea, dry productive cough, X-ray scattered
infiltration, occasional hemoptysis
Ascaris pneumonitis
32
Symptoms:
o Marked eosinophilia + pneumonitis
o Mild respiratory symptoms
o Transient migratory pulmonary infiltrates
Loeffler’s Syndrome
33
34
• Obstruction of adult worms in the intestine
• Common complaint: vague abdomina • Obstruction of adult worms in the intestine
• Common complaint: vague abdominal pain
• Moderate infections: lactose intolerance and vitamin A
malabsorption
• Heavy infections: bowel obstruction, intussusception,
bowel infarction and intestinal perforation l pain
• Moderate infections: lactose intolerance and vitamin A
malabsorption
• Heavy infections: bowel obstruction, intussusception,
bowel infarction and intestinal perforation
Pot Belly/Ascaris Bolus
35
Spx of choice for ascaris
Stool, sputum, duodenal aspirate
36
Methods for ascaris
Methods:
1. Direct Fecal Smear
- Good for chronic/high intensity infections
2. 3. Kato Katz & Kato Thick (best method)
Concentration techniques ( sedimentation and floatation)
- Formalin-ether/ethyl acetate concentration technique
37
Epidemiology ascaris
• Geographical distribution: Cosmopolitan but occurs more
in tropical regions (Southeast Asia, Africa, Central & South
America)
• Age Group: Children ages 5 to 15 years have the highest
intensities of infection
• 1.2 billion individuals are infected, (70% from Asia)
• 2,000 die annually
38
• “Pinworm”, “Seatworm”
• Old name: Oxyuris vermicularis
• Nocturnal parasite
• Causative agent of Pruritus ani (perianal
itching)
Enterobius vermicularis
39
• Asymmetrical, with one side flattened and the other side
convex (“D shaped”)
• Translucent shell consists of:
o outer triple albuminous covering
o inner embryonic lipoidal membrane
E vermicularis ova
40
• Cuticular alar expansions (cephalic alae)
o Cephalic = anterior
• Esophageal bulb
• Male → 2 to 5 mm, w/ curved tail
and a single spicule
• Female → 8-13 mm, w/ long
pointed tail
Adult envermi
41
• Has the characteristic esophageal
bulb but has no cuticular
expansion on the anterior end.
Larva of e vermi
42
E vermi
• MOT:
• Habitat:
• Infective stage:
• Diagnostic stage:
• Humans are the host
• intermediate host
Life cycle e vermi
• MOT: Ingestion of embryonated eggs (fecal-oral route),
inhalation, retroinfection
• Habitat: Large intestine (E.T)
• Infective stage: Embryonated eggs
• Diagnostic stage: Eggs on perianal folds
• Humans are the ONLY definitive host
• No intermediate host
43
• Perianal itching
• Other Symptoms: insomnia,
restlessness, poor appetite, weight
loss, irritability, grinding of teeth, &
abdominal pain
• Cases are more common on children
• Familial disease
• Autoinfection is possible
Enterobiasis-Pruritus Ani
44
PARASITES CAUSING AUTOINFECTION
“Cool CHEST”
• Capillariasis
• Cryptosporidium
• Hymenolepis nana
• Enterobius
• Strongyloides
• Teniia
45
Spx of choice for e vermi
Eggs on perianal region, stool (adults & ova)
46
Methods for e vermi
• Direct Fecal Smear
• Graham’s Scotch Tape Swab
47
EPIDEMIOLOGY for e vermi
• Occurs in both temperate and tropical regions of the world
• The only intestinal nematode infection that cannot be
controlled through sanitary disposal of human feces
• 208.8 million infected persons in the world
• Locally, prevalence is consistently higher in females (16%)
compared to males (9%). Eggs were found in nail clippings
of school children.
48
Blood suckers
Hookworm
49
New World Hookworm, American murderer
Necator americanus
50
Old World Hookworm, Germ of Laziness
Ancylostoma duodenale
51
➔Soil-transmitted helminths
➔Blood-sucking nematodes
Hookworm
52
• Same for all species
• bluntly rounded ends
• single thin, transparent hyaline shell
•“Morula ball” (2-8 cell stages)
Ova of hookworm
53
• feeding stage
• long oral cavity (buccal
cavity/capsule)
• small genital primordium
Rhabditiform Larvae(L1)
54
• infective, nonfeeding stage
• shorter esophagus
• pointed tail
Filariform Larvae (L3)
55
Buccal spears: conspicuous and parallel throughout their
lengths
N.americanus
56
inconspicuous buccal spears and transverse
striations on the sheath in the tail region.
duodenale
57
Male copulatory bursa
• N. americanus →
• A. duodenale →
Bipartite: fused & barbed spicules
Tripartite: unfused & not barbed spicules
58
Life cycle of hookworms
• MOT:
• Habitat:
• Infective stage:
• Diagnostic stage:
• Humans are the __ host
• __ intermediate host
• MOT: Skin penetration of filariform larva
• Habitat: Small intestine (“C-NASA”)
• Infective stage: Filariform larva (L3)
• Diagnostic stage: Eggs, adults, larvae
• Humans are the ONLY definitive host
• No intermediate host
59
Entry site for hookworms
• Maculopapular lesions, localized erythema
• S/S: Itching, edema, erythema,
and later papulovesicular
eruptions
•
“Dew itch” “Ground itch”
60
• Symptoms:
1. Marked eosinophilia + pneumonitis
2. Mild respiratory symptoms
3. Transient migratory pulmonary infiltrates
• Cases are rare in the tropics
Loeffler’s Syndrome
61
• Always chronic
• S/S: abdominal pain, steatorrhea, diarrhea with blood and
mucus, eosinophilia
• Due to blood loss:
o“Iron Deficiency Anemia”
o“Hypoalbuminemia”
Intestinal sickness caused by hookworms
62
Spx of choice for hookworm
Stool, sputum, duodenal aspirate
63
Methods for hookworm
1. Direct Fecal Smear
2. Kato Katz & Kato Thick
3. Concentration techniques
- Zinc sulfate floatation
- Formalin-ether/ethyl acetate concentration
4. Harada Mori Culture Technique (best method)
64
EPIDEMIOLOGY for hookworm
• Geographical distribution:
• Age Group:
• 576 to 740 million are infected, (50,000 deaths due to
anemia)
• Geographical distribution: Tropical and subtropical
countries
• Age Group: Farmers, paramilitary personnel, indigenous
and school children
• 576 to 740 million are infected, (50,000 deaths due to
anemia)
65
• AKA “Threadworm”
“Smallest intestinal nematode” (1-
2.2mm by 0.4mm)
• Soil-transmitted helminth (STH)
Strongyloides stercoralis
66
Strongyloides stercoralis isnwhat kind of nematode
Facultative
67
• With clear thin shell
• Similar to those of hookworms except
that they measure only about 50 to 58
µm by 30 to 34 µm. (smaller)
• “Chinese lantern ova”
OVA EXAMINATION for s stercoralis
68
Size & Appearance: 2.2 mm by 0.04 mm, colorless, semi-
transparent, with a finely striated cuticle
• Anterior: slender tapering anterior end
• Buccal cavity: Short with four indistinct lips
• Posterior: short conical pointed tail
PARASITIC/FILARIFORM FEMALE OF STRONGYLOIDES
69
Life cycle strongy
• MOT:
• Habitat:
• Infective stage:
• Diagnostic stage:
• __ & __ are the definitive hosts
• No intermediate host
Life cycle strongy
• MOT: Skin penetration of filariform larva
• Habitat: Small intestine (“C-NASA”)
• Infective stage: Filariform larva (L3)
• Diagnostic stage: Rhabditiform larvae
• Humans & Dogs are the definitive hosts
• No intermediate host
70
Strongyloidiasis/Entry site
• due to larval invasion of the skin
• S/S: erythema, pruritic elevated hemorrhagic papules
71
• Due to larval migration causing destruction and systemic
hypersensitivity
Pulmonary Strongyloidiasis
72
• Symptoms: blood in lungs, cough, tracheal irritation
Lobar pneumonia with hemorrhage
73
• Adult female worms reside in duodenum & jejunum
• Moderate S/S: diarrhea alternating with constipation
Intestinal Strongyloidiasis
74
• intermittent vomiting, diarrhea, constipation, and
borborygmi, anal pruritus, urticaria, and larva currens
rashes
• Recurrent asthma and nephritic syndrome
Chronic Strongyloidiasis
75
Spx choice for strongy
• Stool
• Sputum
• Urine
• duodenal aspirate (Beale’s String Test)
76
• Cosmopolitan distribution (tropics & subtropical, europe,
USA)
• 50 to 100 million people affected
• Rare in the Philippines
• Age Group: more common on male children 7 to 14 years
old
Strongy epidem
77
• AKA “whipworm”
• Aphasmid: no caudal
chemoreceptors
• Soil-transmitted helminth (STH)
• Secrete TT47
Trichurus trichiu
78
• Barrel, lemon-shaped w/
bipolar hyaline plugs
• Yellowish outer and a
transparent inner shell
• Fertilized eggs are
unsegmented at
oviposition (3,000-10,000)
• “Japanese lantern ova”
OVA EXAMINATION trichu
79
Trichu
• MOT:
• Habitat:
• Infective stage:
• Diagnostic stage:
• Humans are the definitive hosts
• No intermediate host
Trichu lc
• MOT: Ingestion of embryonated egg
• Habitat: Large intestine (“E.T”)
• Infective stage: Embryonated gg
• Diagnostic stage: Unembryonated egg, adults
• Humans are the definitive hosts
• No intermediate host
80
Light Infection (<5,000 eggs per gram of stool)
• petechial hemorrhages: due to adult worms
• predisposed to amebic dysentery (E. histolytica)
• mucosa is hyperemic and edematous; enterorrhagia is
common
Intestinal Trichuriasis
81
Heavy Infection (>5,000 eggs per gram of stool)
• Trichuris Dysentery Syndrome
• chronic dysentery and rectal prolapse
• S/S: blood streaked diarrheal stools, abdominal pain and
tenderness, nausea & vomiting, weight loss
• Anemia (blood loss of 0.8-8.6 mL per day)
Intestinal Trichuriasis
82
Spx for trichu
Stool
83
• AKA “pudoc worm”
• First reported by Chitwood et al. in 1963 in
a 29 year old male from Northern Luzon
• Aphasmid: no caudal chemoreceptors
• Acquired through eating undercooked
fish
Capillaria philippinensis
84
• similar to those of Trichuris trichiura but smaller
• Guitar, peanut-shaped with striated shells and flattened
bipolar plugs
Ova cp
85
• MOT: Ingestion of ingestion of infective larvae through
undercooked fish
• Habitat: Small intestine (C-NASA)
• Infective stage: Infective larvae
• Diagnostic stage: Unembryonated egg, adults
• Birds are the definitive hosts
• Humans are incidental hosts
• Freshwater fishes are intermediate hosts (Ipon, Birot,
Bagsang, Bagtu)
Lc cp
86
• Abdominal pain, diarrhea & borborygmi
• S/S: intermittent diarrhea, weight loss, malaise, anorexia,
vomiting, and edema
“Mystery Disease”
87
“Mystery Disease” Lab Findings:
1. Severe protein-losing enteropathy and hypoalbuminemia
2. Malabsorption of fats & sugars
3. Dec. excretion of xylose
4. Low K, Na, Ca
5. High IgE
88
Spx for cp
Stool, duodenal aspirate
89
• Location: Pudoc West, Tagudin, Ilocos Sur (1996)
• 1967 to 1990: 2,000 cases
•
“Mystery Disease”: Monkayo, Compostela Valley Province
outbreak (1998)
• Thailand, Iran, Japan, Indonesia, United Arab Emirates,
South Korea, India, Taiwan, Egypt, and Lao People’s
Democratic Republic.
Cp epi
90
•
“Capillary liver worm”
• IS: Embryonated egg
• DS: Adults & eggs in liver biopsy
• I.H: None
• D.H: Man (ingestion of embryonated egg)
Capillaria hepatica
91
• Infectious hepatitis-like infection
• Peripheral leukocytosis & eosinophilia, hepatomegaly, and
persistent fever (which may be as high as 40℃)
• Diagnosis: Liver biopsy
Hepatic capillariasis
