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Medical Parasitology > Lesson 3 - Trematodes > Flashcards

Lesson 3 - Trematodes Flashcards

Trematodes

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USMLE® Step 1 flashcards
1
Q

Oriental fluke; Blood flukes.

Reside in the mesentric and portal veins.

Adult schistosomes exist as separate sexes (others are hermaphrodites)

Can cause schistosomiasis (aka bilharzias, bilharziasis, or snail fever).

A

Schistosoma japonicum / S. mansoni / S. haematobium

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2
Q

Snail: Oncomelania hupensis quadrasi

A

Schistosoma japonicum

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3
Q

Affects veins of small intestine, liver

A

Schistosoma japonicum

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4
Q

Diagnostic feature of eggs: Small lateral spine (‘knob’)

A

Schistosoma japonicum

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5
Q

Snail: Biomphlaria glabrata

A

S. mansoni

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6
Q

Affects veins of colon

A

S. mansoni

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7
Q

Diagnostic feature of eggs: Large, prominent lateral spine

A

S. mansoni

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8
Q

Snail: Bulinus truncatus

A

S. haematobium

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9
Q

Affects veins of Urinary Bladder

A

S. haematobium

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10
Q

Chronic Schistosomiasis:
Painless hematuria and fibrosis of the bladder. Hydronephrosis. Associated with squamous cell carcinoma of the bladder.

A

S. haematobium

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11
Q

Diagnostic feature of eggs: large terminal spine

A

S. haematobium

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12
Q

Intestinal Schistosomiasis

Acute schistosomiasis:
- Cercarial dermatitis (swimmer’s itch)
- Katayama fever

A

Schistosoma japonicum / S. mansoni / S. haematobium

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13
Q

Chronic Schistosomiasis:
- Pseudopolyps in colon
- Liver granulomas leading to presinusoidal obstruction, hepatomegaly, and portal hypertension.
- Gastrointestinal hemorrhage, massive splenomegaly

A

Schistosoma japonicum / S. mansoni

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14
Q

Liver UTZ: clay pipestem fibrosis with lacelike pattern.
MCC of death: exsanguination from ruptured esophageal varices.

A

Schistosoma japonicum / S. mansoni

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15
Q

Diagnostic Test:
- Fecalsys (kato-katz)
- Circumoval precipitin test (COPT)
- Rectal imprint

A

Schistosoma japonicum / S. mansoni / S. haematobium

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16
Q

Adult flukes living in mesentric or bladder veins la eggs that cause granulomas

A

Schistosoma japonicum / S. mansoni / S. haematobium

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17
Q

Japanese Lung fluke, Hermaphrodite

A

Paragonimus westermani

18
Q

Snail: Antemelania asperata
Mountain crab: Sundathelphusa philippina

A

Paragonimus westermani

19
Q

Infective stage - Larvae (metacercariae)

Transmitted by ingestion of raw crabmeat/crayfish

A

Paragonimus westermani

20
Q

Affects the Lungs. Adult flukes live in the lungs.

A

Paragonimus westermani

21
Q

Paragonimiasis

Within the lung, the worm exists in a fibrous capsule communicating with a bronchiole - granulomatous reaction. Secondary bacterial infection frequently occurs.

A

Paragonimus westermani

22
Q

Main symptom: chronic cough with blood sputum

CXR: ring shadow opacity

Closely resembles tuberculosis

A

Paragonimus westermani

23
Q

Diagnostic test: 3% NaOH preparation

A

Paragonimus westermani

24
Q

Diagnostic feature of eggs: Operculated / unembryonated egg in sputum or feces

A

Paragonimus westermani

25
Q

Chinese Liver fluke / Oriental liver fluke, Hermaphrodite

A

Clonorchis sinensis

26
Q

Snail: Parafossarulus
Fish: Cyprinidae

A

Clonorchis sinensis

27
Q

Infective stage: Larvae (metacercariae)

Transmitted by ingestion of undercooked fish.

A

Clonorchis sinensis

28
Q

Affects the Liver, especially the common bile duct. Adult flukes live in the liver.

A

Clonorchis sinensis

29
Q

Inflammatory response can cause hyperplasia and fibrosis of the biliary tract.

A

Clonorchis sinensis

30
Q

Acute disease:
- Fever, eosinophilia, lymphadenopathy, tender hepatomegaly.

Chronic disease:
- Hepatobiliary disease
- Pancreatitis
- Cholangiocarcinoma (Klatskin tumor)
- Neurocirculatory dystonia

A

Clonorchis sinensis

31
Q

Diagnostic Test:
- Direct fecal smear
- Potassium permanganate stain (showing melon-like ridges with abopercular protuberance)

A

Clonorchis sinensis

32
Q

Treatment of Choice: PRAZIQUANTEL

A

Schistosoma japonicum, S. mansoni, S. haematobium, Paragonimus westermani, Clonorchis sinensis

33
Q

Sheep liver fluke
- Humans are infected by eating watercress (or other aquatic plants)
- Symptoms are due primarily to the presence of the adult worm in the biliary tract.

A

Fasciola hepatica

34
Q

In early infection, RUQ pain, fever, and hepatomegaly can occur but most infections are asymptomatic.

Months or years later, obstructive jaundice can occur.

Halzuon is a painful pharyngitis caused by the presence of adult flukes on the posterior pharyngeal wall.

A

Fasciola hepatica

35
Q

Drug of choice is TRICLABENDAZOLE

A

Fasciola hepatica

36
Q

Giant Intestinal fluke

Intestinal parasites of humans and pigs that is endemic to Asia and India. Humans are infected by eating aquatic vegetation that carries the cysts.

Pathologic findings are due to damage of the intestinal mucosa by the adult fluke.

A

Fasciola buski

37
Q

Most infections are asymptomatic, but ulceration, abscess, formation, and hemorrhage can occur.

Worm intoxication: anasarca and coma resulting from accumulation of toxins.

A

Fasciolopsis buski

38
Q

Intestinal parasite of people living in Africa, the Middle East, and Asia, who are infected by eating raw fish containing cysts.

Pathologic findings are due to inflammation of the intestinal epithelium as a result of the presence of the adult flukes.

A

Heterophyes heterophyes

39
Q

Mimics peptic ulcer disease.

A

Heterophyes heterophyes

40
Q

PRAZIQUANTEL is the treatment of choice.

A

Fasciolopsis buski / Heterophyes heterophyes

Medical Parasitology (3 decks)

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