LUNG, INTESTINAL FLUKE

Question 1

(Lung fluke, oriental lung fluke)

Answer 1

Paragonimus westermani

Question 2

Paragonimus westermani . Other species

Answer 2

Paragonimus philippinensis (humans), Paragonimus siamensis (cats),
Paragonimus miyazaki (mammals) (Japan), Paragonimus skrjabini (dogs, cats, humans)
Paragonimus hueitungensis (felines) (China), Paragonimus heterotrema (mammals)
(China, Southeast Asia)

Question 3

Egg: it is oval in shape, yellowish brown, bile-stained, thick egg walls

Answer 3

Paragonimus westermani

Question 4

Paragonimus westermani. Egg. Size

Answer 4

measures 80-118 um in length and 48-60 um in width

Question 5

Paragonimus westermani. Adults. color and resembles ?

Answer 5

reddish brown in color and resembles
coffee beans

Question 6

Paragonimus westermani. Adults. Size

Answer 6

measures 7.5-12 mm in length
and 4-6 mm in width

Question 7

Paragonimus westermani. Eggs per day

Answer 7

9000-18000 eggs per day

Question 8

Paragonimus westermani. the infective stage to humans

Answer 8

Metacercaria:

Question 9

Paragonimus westermani. 1st Intermediate hosts:

Answer 9

SNAILS (Antemelania asperata, Antemelaniadactylus/Brotia asperata, Sulcospira quangtriensis, Paludomusspp

Question 10

Paragonimus westermani. 2nd Intermediate hosts:

Answer 10

CRAB (Sundathelpusa philippina formerly Parathelpusa grapsoides) and CRAYFISH (superfamilies Astacoidea and Parastacoidea)

Question 11

Human infection with ______ occurs by eating inadequately cooked or pickled crab or crayfish that harbor
metacercariae of the parasite

Answer 11

P. westermani

Question 12

P. westermani, Definitive host:

Answer 12

Man

Question 13

P. westermani. First intermediate host

Answer 13

Fresh water snail, belonging to the genera
Semisulcospira and Brotia.

Question 14

Paragonimus westermani. Second intermediate host

Answer 14

Fresh water crab or cray fish

Question 15

Paragonimus westermani. Infective form

Answer 15

Metacercariae encysted in crab or cray fish

Question 16

Paragonimus westermani.Mode of infection:

Answer 16

Man acquires infection by eating undercooked
crab or cray fish containing metacercariae.

Question 17

P. westermani .mostly are gastrointestinal symptoms: abdominal pain, fever, cough, eosinophilia, urticaria, internal organ complications including hepatosplenomegaly

Answer 17

Acute phase:

Question 18

P. westermani. * it mainly involves respiratory complications and it usually produces a
dry cough that progresses into rust-colored sputum with foul fish odor
most pronounced in morning (misdiagnosis of tuberculosis)

Answer 18

Chronic phase

Question 19

P. westermani. Chronic phase can cause ___ lesions which can progress to fibrosis

Answer 19

granulomatous lesions

Question 20

parasite that can cause ectopic infection, it can also cause jacksonian epilepsy (focal
partial seizure)

Answer 20

P. westermani

Question 21

P. westermani. most serious complication

Answer 21

cerebral involvement

Question 22

P. westermani. Diagnostic stage

Answer 22

Detection of fertilized eggs in sputum (gold
standard)/stool/pleural effusions

Question 23

In diagnostic stage of P. westermani. How many % of NaOH is added into sputum

Answer 23

• 3% NaOH

Question 24

P. westermani. CT Scan and MRI shows

Answer 24

a “grape cluster” or “soap bubble calcifications”

Question 25

P. westermani. * CT scan/MRI: shows a “grape cluster” or “soap bubble calcifications” mostly on ____ part of brain

Answer 25

posterior part of brain

Question 26

Giant intestinal fluke

Answer 26

Fasciolopsis buski

Question 27

Fasciolopsis buski. Characte risitic

Answer 27

Largest fluke of man

Question 28

Garrison’s fluke

Answer 28

Echinostoma ilocanum

Question 29

Von Selbold fluke, Dwarf Intestinal fluke

Answer 29

Heterophyes heyerophyes

Question 30

DEADLIEST Smallest fluke of man

Answer 30

Heterophyes heyerophyes

Question 31

Yokogawai fluke

Answer 31

Metagonimus yokogawai

Question 32

Attenuated at both ends, circumoral disk with horseshoe- shaped crown of 49-51 hooks

Answer 32

Echinostoma ilocanum

Question 33

Resembles H. heterophyes, scaly spines distributed over the anterior end

Answer 33

Metagonimusyokogawai

Question 34

Fasciolopsis buski. 1st Intermediate host

Answer 34

Snail (Segmentina, Hippeutis)

Question 35

Fasciolopsis buski. 2nd Intermediate host

Answer 35

Aquatic plants Trapa natans (water caltrop) Eliocharis tuberos (water chestnut) Zizania (water bamboo)

Question 36

Echinostoma ilocanum. 2nd Intermediate host

Answer 36

Snail Pila luzonica (kuhol) Vivipara angularis(suso)

Question 37

Echinostoma ilocanum. 1st Intermediate host

Answer 37

Snail ( Hippeutis, Gyrraulus)

Question 38

Heterophyes heyerophyes. 1st Intermediate host

Answer 38

Snail (Pironella, Crithidia)

Question 39

Heterophyes heyerophyes. 2nd Intermediate host

Answer 39

Fish Acanthagobius

Question 40

Metagonimus yokogawai. 1st Intermediate host

Answer 40

Snail ( Thiara, Semisulcospira, Libertina)

Question 41

Metagonimus yokogawai. 2nd Intermediate host

Answer 41

Fish Odontobutis obscurus Salmo perryi

Question 42

Fasciolopsis buski. Def host

Answer 42

Dogs, Swine, Man

Question 43

Echinostoma ilocanum. def host

Answer 43

Man, Dogs, Cats

Question 44

Heterophyes heyerophyes. Def host

Answer 44

man

Question 45

Metagonimus yokogawai. Def host

Answer 45

Man

Question 46

Egg. Immature * identical with F. hepatica but larger and slightly convex operculum

Answer 46

Fasciolopsis buski

Question 47

Egg. Immature * ovoid, straw colored with small operculum

Answer 47

Echinostoma ilocanum

Question 48

Egg. Mature *Indistinguishable with Metagonimus

Answer 48

Heterophyes heyerophyes

Question 49

Egg. Mature *Indistinguishable with Heterophyes

Answer 49

Metagonimus yokogawai