(M) Nematodes: Adenophorea & Secernentea [A. lumbricoides] (module-based) Flashcards by ASHLEY JARED DEFENSOR

Helminths, either parasitic or free-living, are worms classified under?

METAZOA

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phyla

nematodes or roundworms

Nematoda

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phyla

hair-snakes or gorgiid worms

Nematomorpha

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Phyla

trematodes (flukes), cestodes (tapeworms), turbellaria

Platyhelminthes

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Phyla

thorny-headed worms

Acanthocephala

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Most of the medically important helminths are under the phylum (2)?

nematoda and platylheminths

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TOF. Species of phylum Nematoda have separate sexes while Platyhelminthes are mostly hermaphroditic.

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All platylhelminthes are hermphroditic except for?

blood flukes (schistosoma)

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Other species are provided with cup like structures called the

suckers or acetabula (present among flukes and tapeworms)

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How many eggs can A. lumbricoides produce?

200,000 per day

Not all these eggs, however, will be able to withstand the adverse conditions in the environment thus, not all of them are able to reach maturity.

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The eggs, laid larvae, or the larvae that hatched from the eggs, encounter unfavorable conditions in the environment that may destroy them. These conditions include

familiarize nalng

desiccation, fermentation, overgrown by other organisms such as bacteria and/or fungi, too much water, extreme heat, inability to find or failure to be taken by the appropriate host, death of the host, and man-made barriers for their survival

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considered true roundworms
free- living and exist everywhere in vast number
Some species are exclusive parasites of lower form of animals while others are found among humans only
provided with elongate and cylindrical bodies and with separate sexes

Nematodes

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Nematodes

Majority of parasitic nematodes inhabits the?

intestinal tract of a man

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Nematodes

TOF. The life history of nematodes may be direct (no intermediate host needed), or indirect (need intermediate host/s).

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Nematodes

Pattern fo development

egg - larva - adult

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Nematodes

Majority of roundworms undergoes 4 larval transformations, each of which is characterized by a?

molting process

In most instances, transformation from 3rd to 4th larval form, before becoming adult, takes place in the body of the definitive host. Thus, it takes 4 moltings before maturity.

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Nematodes

Autoinfection can also occur with some nematodes like?

Strongyloides stercoralis, and Enterobius vermicularis

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Nematodes

Integument system of roundworms consists of non-nucleated cuticula, which is secreted by the?

part of the skin sya

underlying hypodermis

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Nematodes

TOF. They are no circular muscle fibers, and they move, mainly, through pseudopodia.

F (body flexion)

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Nematodes

TOF. Some intestinal nematodes have structures such as** teeth, plates, hooks, stylets, or spines** for attachment.

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. Some species can maintain their position in the lumen of the intestine through continuous flexion and relaxation of the longitudinal muscle fibers to counteract the peristalsis of the intestinal tract, which can cause them to be expelled out. The body cavity is called?

pseudocele

no mesothelial lining cells

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Sperm cells are discharged through the

cloaca

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The esophagus may be classified, based on shape and structure, into five types, namely:

filariform
rhabditiform
spiruroid
stichsoma
strongyliform

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Long, slender, simple, and muscular, seen among Strongyloidea

Filariform

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muscular with three parts: proximal bulb, narrow isthmus, and distal body or corpus, as seen among free-living rhabditoids, parasitic oxyuroids, and free-living and non-infective strongyloids

Rhabditiform

with muscular anterior and glandular posterior, seen in most of the spiruroidea and filaroidea

Spiruroid

long, slender embedded in a row of emboidal esophageal glandular cells (stichocytes), seen among trichinelloidea

Stichosoma

with short, muscular buccal structure with a waist, seen among ancylostomatidae

Strongyliform

The excretory system consists of

* excretory gland cells * lateral canals * excretory pore

is situated at the mid-ventral portion of the cephalic or cervical region.

excretory pore

is composed of fibers with dorsal, ventral, and lateral longitudinal trunks with transverse commissures, whereby the most important is the circum-esophageal ring (around the esophagus)

nervous system

TOF. Most part of nematodes’ existence is under anaerobic condition thus, they have no respiratory- or circulatory structures, they are in an anaerobic environment, anyway.

have curved tail end and are, usually, provided with special structures such as copulatory spicule or bursa, which aid during copulation.

Males of most species

TOF. females are smaller than males.

F (opposite)

Among bursate nematodes, the perianal or caudal cuticle is extended into an umbrella-like structure called

bursa

TOF. Sperm cells, oftentimes, are amoeboid instead of flagella type.

enumarate sp. female reproductive system may be single

Trichinella spiralis, Trichuris trichiura

female reproductive system may be double

Ascaris, Enterobius, and hookworms

this worms discharge eggs in the intestinal tract and are evacuated with the feces to be deposited in the environment

Oviparous worms

Embryonated eggs of Ascaris lumbricoides or Trichuris trichiura enter the body of man via the

oral route

# portal of entry Eggs of Enterobius vermicularis are

usually inhaled (nasal route) or to a lesser extent, may also be ingested (oral route)

infective larval stages of hookworms or Strongyloides stercoralis enter the body through

skin penetration

The infective stages of filaria worms enter the human body through percutaneous (skin) route via

bites of insect vectors

The type of transmission through non-essential, but advantageous intermediate host is referred as?

parathenesis

transport host (non-essential intermediate host) is called

parathenic host

(3) can pass through the placenta or mammary glands resulting to infection of the unborn baby

Strongyloides stercoralis, Ancylostoma species, and Toxocara species ## Footnote Infective larval forms of some species

All nematodes are provided with a pair of lateral, tiny, receptors?

amphids or lateral organs

What region is the amphids located?

which are in the cephalic or cervical region

Nematodes without caudal glands have a pair of lateral post-anal glands called

caudal chemoreceptors

Species with caudal chemoreceptors are classified as

Secernentea (Phasmids)

Species without caudal chemoreceptors are classified as

Adenophorea (Aphasmids)

Most Adenophorea are non-parasitic and free-living. Only three are parasitic to man, namely:

Trichuris trichiura, Trichinella spiralis and Capillaria philippinensis.

gross appearance has cosmopolitan distribution but more in warm, moist regions of the world | what am i

Trichuris trichiura

# T. trichiura AKA

whipworm

# T. trichiura Inhabits

* anterior end embedded, the walls of the cecum * walls of the appendix * colon * or lower part of the ileum

# T. trichiura TOF. Incidence is higher among children than adults

# T. trichiura diagnosed co- existing with

A. lumbricoides

# T. trichiura TOF. Grossly, the worm has narrower anterior 4/5th than the posterior thus called whip worm.

F (3/5)

# T. trichiura MALE OR FEMALE 35-40mm, tail end more or less straight, genitalia consist of single sacculate ovary, oviduct, and uterus, and vulva at the ventral anterior part of the fleshy tail end.

FEMALE

# T. trichiura MALE OR FEMALE 30-45mm, tail end coiled to 360O, genitalia consist of sacculate testis, vas deferens, and ejaculatory duct that empty into the cloaca, and a lancet- shaped spicule, covered with a sheath, situated at the most terminal part of the posterior region

MALE

# T. trichiura Shape of the egg

football or barrel shaped

# T. trichiura No. of layer, color of the egg, and other morphology

3-layered shell, outermost of which is brown in color, with protruding bipolar mucus plugs and laid unsegmented (without embryo)

# T. trichiura The female worm, anterior part attached to the cecal wall, lays unsegmented (fertilized without embryo) eggs in?

feces and deposited into the soil when the infected person defecates

# T. trichiura deposited in moist, warm, and shaded soil, embryonate for a period of about three weeks

eggs

# T. trichiura infective stage to man

embryonate egg

# T. trichiura This may remain viable for weeks or months in the soil

Embryonate egg

# T. trichiura What can damage the eggs?

Direct sunlight, desiccation, marked changes in oxygen and moisture, and other factors

# T. trichiura Man acquires the infection through ingestion of the

embryonated eggs that contaminate foods, drinks, or fingers

# T. trichiura this stage maybe carried by insects or animals like rat, flies, cockroaches, and humans on their bodies or fingers and mechanically transfer the eggs to the foods or drinks

egg

# T. trichiura Where do ingested eggs hatch in the body?

smoll intestine

# T. trichiura Where does the released larvae enter?

crypts of the lower ileum and colon ## Footnote Later, the larvae enter the epithelium of the cecum (also at the adjacent sites)

# T. trichiura Maturation takes approximately

3 months

# T. trichiura TOF. The adult worms copulate, and female lays eggs in the cecum.

# T. trichiura

# T. trichiura What part of the worm is embedded in the walls of the cecum

anterior part

# T. trichiura While what portion of the worm is lying free in the lumen allowing copulation and discharge of eggs

posterior part

# T. trichiura

# T. trichiura TOF. moderate to severe infection may be asymptomatic for a long, long time.

F (mild to moderate)

# T. trichiura Patients, developing diarrhea due to the parasite, may have

edematous and friable intestinal mucosa

# T. trichiura . The worms suck blood from the?

intestine

# T. trichiura This develops due to blood loss from the friable mucosa, not because of the amount of blood sucked by the parasites.

anemia

# T. trichiura TOF. Disease destruction is due to mechanical and/or allergic processes.

F (production)

# T. trichiura It is possible that the worms mechanically irritate plexuses of nerves in the intestinal walls resulting to?

relaxation of the anal sphincter muscles

# T. trichiura In severe infection, this may lead to

rectal prolapse

# T. trichiura Presence of this exudates from the colon is suggesting allergic response.

osinophilic infiltrates as well as Charcot- Leyden crystals

# T. trichiura Laboratory diagnosis

eggs in direct fecal smears and/or in concentrated feces or identification of expelled adults

# T. trichiura first-line treatment

Mebendazole

# T. trichiura Other treatment for T. trichiura

albendazole

Trichinella spiralis also known as? causing?

Trichina worm and causing trichinosis

cosmopolitan distribution but is less important as an infection of man in the tropics and the Orient than it is in Europe and the United States

TRICHINELLA SPIRALIS

# TRICHINELLA SPIRALIS What gender is/are are tiny and thread-like

both

# TRICHINELLA SPIRALIS The uterus of the gravid female containes

stichosomes (gland-like cells lining the esophagus)

# TRICHINELLA SPIRALIS found in tissue sections of infected individuals, has the coiled larva (or larvae) interspersed between muscle fibers, surrounded with fibrous tissues and eosinophilic cells.

Encysted larva

# TRICHINELLA SPIRALIS What does the gravid female inhabit?

walls of the lower part of the duodenum or the duodenojejunal junction | of man, rats, and pigs)

# TRICHINELLA SPIRALIS What does the gravid female deposit?

L2 larvae in the mucosa of the small intestine

# TRICHINELLA SPIRALIS This stage enter the intestinal lymphatic, go to the peripheral circulation, then to different parts of the body and lodged in glycogen poor tissues to encyst (end-stage cycle in man)

Larvae

# TRICHINELLA SPIRALIS This are the constantly active muscles like the myocardium, respiratory, and skeletal muscles.

Glycogen poor tissues

# TRICHINELLA SPIRALIS present in raw or inadequately cooked pork, are ingested by man.

Encysted larva

# TRICHINELLA SPIRALIS infective stage

Encysted larva

# TRICHINELLA SPIRALIS Digestive enzymes lyse the cyst capsules, and the freed larvae enter the walls of the intestine to become adults that copulate and the larviparous females produce?

L2 larvae

# TRICHINELLA SPIRALIS This animal may acquire the parasites through eating left over of infected pork in abattoirs or may eat carcasses of dead, infected rats

buRAT

# TRICHINELLA SPIRALIS Trichinosis causes

localized inflammation and necrosis of muscle tissues.

# TRICHINELLA SPIRALIS preferred sites of the larvae to encyst

Muscles poor in glycogen

# TRICHINELLA SPIRALIS Common sites where they are located

diaphragm, intercostal muscles, and other tissues that are constantly active

# TRICHINELLA SPIRALIS Destruction and absorption of host tissues and larvae cause

generalized toxemia

# TRICHINELLA SPIRALIS Numerous encysted larvae can cause widening of the gaps between muscle fibers resulting to

pseudohypertrophy of muscles

# TRICHINELLA SPIRALIS with epigastric abdominal pain, vomiting, nausea, and/or diarrhea.

1. Stage of invasion

# TRICHINELLA SPIRALIS fever, myalgia, edema around the eyes, and tiny hemorrhages underneath the nails.

Stage of larval migration

# TRICHINELLA SPIRALIS muscle pains, fever.

Stage of encystation

# TRICHINELLA SPIRALIS generalized edema due to toxemia, muscle pains, fever, and mental apathy.

Stage of tissue repair and recovery

# TRICHINELLA SPIRALIS Diagnosis is based on what demonstration that can be obtain through biopsy

encysted in stained muscle tissue sections

# TRICHINELLA SPIRALIS Serologic tests

precipitation, complement fixation, Bentonite flocculation test, and Bachmann intradermal test

# TRICHINELLA SPIRALIS Fresh muscle biopsy material maybe pressed between two slides after digestion method to demonstrate the?

unstained larvae

# TRICHINELLA SPIRALIS TOF. Trichinosis is not self-limiting within a few month.

# TRICHINELLA SPIRALIS first line of treatment

albendazole or mebendazole

# TRICHINELLA SPIRALIS The first line of treatment are both anti- parasitic drugs are effective in eliminating what stages?

adults and larvae.

# TRICHINELLA SPIRALIS may be given in cases of allergic reactions when the larvae enter muscle tissue or when dead since larvae release chemicals in the muscle tissue

Corticosteroids

# TRICHINELLA SPIRALIS Prevention

adequate cooking of meat and meat products, rodent control, and adequate meat inspection by authorities

* superstitious local folks had attributed the disease as caused by bad spirits. * quite several patients died of unknown causes in the past * it was named, at that time, Mystery disease, while others called it Pudok’s disease * epidemic proportions during the years 1967 to 1970 * It also occurs on some islands of Leyte and some parts of Thailand * some reported cases also from Taiwan, Japan, Egypt, and Iran

CAPILLARIA PHILIPPINENSIS

# Capillaria philippinensis The first proven case of human infection was in 1963, in a male patient from?

Ilocos Norte ## Footnote who died with a diagnosis of malabsorption syndrome

Capillaria philippinensis causing the so-called

pudok's disease

# CAPILLARIA PHILIPPINENSIS Intermediate host

Fish

# CAPILLARIA PHILIPPINENSIS The fish intermediate host include

Hypseleotris bipartita, Ambassis miops, and Eliotris melanosoma.

# CAPILLARIA PHILIPPINENSIS .5 – 4.3mm long, body divided into two parts – the anterior with the esophagus and esophageal glands (stichosomes), and the posterior having the intestine and reproductive system.

Females

# CAPILLARIA PHILIPPINENSIS 2.3 – 3.17mm, with a long chitinous copulatory spicule originating in the later part of the posterior end and extends beyond the terminal part of the posterior portion. The spicule usually has a thin membrane attached (overhanging sheath).

Male

# CAPILLARIA PHILIPPINENSIS 45 x 21μm, laid unsegmented, has slightly constricted mid-part (peanut-shaped) with flattened bipolar mucus plugs and with pitted shell

Egg

# CAPILLARIA PHILIPPINENSIS They inhabit (burrowed) into the mucosa of the small intestine, mainly the jejunum (stage)

adult worms

# CAPILLARIA PHILIPPINENSIS Female worms are considered both?

larviparous and oviparous

# CAPILLARIA PHILIPPINENSIS Where does embryonation takes place?

eggs in bodies of water

# CAPILLARIA PHILIPPINENSIS this fishes ingest the embryonated eggs, larvae are liberated, and encyst in the flesh of the fish that later become L3 larvae

Fishes, locally known as bagsang, bagsit, and birut,

# CAPILLARIA PHILIPPINENSIS infective stage to man

# CAPILLARIA PHILIPPINENSIS Humans acquire the infection through

eating raw infected fish

# CAPILLARIA PHILIPPINENSIS TOF. The larvae is digested, and cyst capsule are released

F (opposite)

# CAPILLARIA PHILIPPINENSIS organisms invade?

small intestine, particularly the jejunum

# CAPILLARIA PHILIPPINENSIS depending on the number of worms, causes

severe enteropathy

# CAPILLARIA PHILIPPINENSIS characterized with massive loss of water and electrolytes resulting to deranged intestinal function that leads to malabsorption

severe enteropathy

# CAPILLARIA PHILIPPINENSIS This manifestation can easily happen in this disease

Electrolyte imbalance and dehydration

# CAPILLARIA PHILIPPINENSIS What leaks into the intestinal tract?

plasma proteins

# CAPILLARIA PHILIPPINENSIS atients may manifest with gurgling sounds of the abdomen due to massive peristalsis

Borborygmi

# CAPILLARIA PHILIPPINENSIS Most of the adult worms, larvae and eggs are located between the?

mucosa and basement membrane of the intestinal glands

# CAPILLARIA PHILIPPINENSIS TOF. no inflammatory cells around the parasites.

# CAPILLARIA PHILIPPINENSIS What parameters in the body decreases?

Serum proteins and electrolytes (sodium and potassium) ## Footnote due to muscle wasting, abdominal distention, and edema

# CAPILLARIA PHILIPPINENSIS Laboratory diagnosis

DFS and intestinal biopsies

# CAPILLARIA PHILIPPINENSIS The typical stage found in DFS

egg and in severe infections the larvae and adult worm

# CAPILLARIA PHILIPPINENSIS Serological tests

None ## Footnote walang available eh

# CAPILLARIA PHILIPPINENSIS Treatment of Capillaria philippinensis infection

mebendazole and albendasole

# CAPILLARIA PHILIPPINENSIS How is mebendazole given?

200 mg twice a day for 20 days or until asymptomatic and there are no eggs present in the stool samples of the patient.

# CAPILLARIA PHILIPPINENSIS How is Albendazole given?

400 mg, can be given once a day for 10 days.

# CAPILLARIA PHILIPPINENSIS PREVENTION

cook fish thoroughly before eating, avoid eating raw fish, and use sanitary toilet for disposal of human waste.

* also known as giant intestinal roundworm * most common helminth infection of man * worldwide distribution, (WHO Classification of Helminthes), and is soil transmitted. * Incidence of infection among children is greater than adult individuals

Ascaris lumbricoides

# Ascaris lumbricoides the most common helminth infection of man

ascariasis

# Ascaris lumbricoides grossly, are flesh-colored with cylindrical body, tapered posterior with a lateral whitish streak line along the entire length and with 3 lips at the anterior part (mouth).

Adults

# Ascaris lumbricoides 20-35cm x 3-6mm diameter, vulva at mid-ventral near the junction of the anterior and middle 3rd of the body. ## Footnote The vulva is continuous with a single vagina that branches to form a pair of genital tubules, each of which consists of uterus, seminal receptacle, oviduct, and ovary that are coiled in the middle and posterior 3rd of the body.

female

# Ascaris lumbricoides 15-31cm long x 2-4mm diameter, curved posterior, genital system consists of a long, single tubule made up of testis, vas deferens, and ejaculatory duct located at the posterior half of the body and opens into the cloaca.

MAle

# Ascaris lumbricoides 88-94 x 39-44μm, elongate with relatively thin middle shell layer, with little or no outer mammillated shell, and contains disorganized refractile masses of lecithin, and can’t undergo embryonation.

Unfertilized egg

# Ascaris lumbricoides 45-75 x 35-50μm, broadly ovoid with thick eggshell

Fertilized egg

# Ascaris lumbricoides Fertilized egg consist of 4 layers

* Uterine layer * Vitelline layer * Chitinous layer * Ascaroside or lipid layer

# Ascaris lumbricoides consists of acid mucopolysaccharide and protein, giving the egg the mamillated (or with cortications) appearance and yellowish brown in color

uterine layer

# Ascaris lumbricoides consists of lipoproteins

vitalline and ascaroside layer

# Ascaris lumbricoides consists of proteins

chitinous layer

# Ascaris lumbricoides without the outermost shell layer, thus it is colorless, contains a mass of coarse lecithin granules, which can develop in- to the embryonated stage when placed in shaded, environment soil, with moisture and good source of carbon, such as trash or dried plants and leaves.

Fertilized egg decorticated

# Ascaris lumbricoides hatches in the small intestine with the released larva penetrates the intestinal wall, enters venous circulation, passes through the liver, and enter the right side of the heart.

segmented egg

# Ascaris lumbricoides to become an adult worm, the larva in the stomach goes to the

small intestine

# Ascaris lumbricoides Where does the mating takes place?

small intestine ## Footnote which are discharged into the feces of human host

# Ascaris lumbricoides the final habitat

the small intestine

# Ascaris lumbricoides before reaching the final habitat, the parasite must pass through the so-called

blood-lung phase cycle

# Ascaris lumbricoides Pathogenic

both larva and adults

# Ascaris lumbricoides ause tiny hemorrhages in the alveoli, which incite cellular infiltration and consolidation

Migratory larvae

# Ascaris lumbricoides TOF. Fever, cough, eosinophilia, dyspnea, and rales may be present.

# Ascaris lumbricoides The lung condition is referred to as

Loeffler's pneumotitis

# Ascaris lumbricoides Sputum may show plenty of

eosinophils, Charcot-Leyden crystals, and at rare times the larvae.

# Ascaris lumbricoides may have intermittent colicky abdominal cramps, loss of appetite, and protruding abdomen (pot-belly appearance).

Children

# Ascaris lumbricoides Allergic manifestations may appear such as

asthma-like symptoms and urticaria

# Ascaris lumbricoides may cause protein-calorie malnutrition or impairment of growth

Heavy worm burden

# Ascaris lumbricoides Erratic worms may go to the epiglottis to cause edema that may lead to airway obstruction and therefore,

asphyxia

# Ascaris lumbricoides Worms may be entangled to each other resulting to a ball of worms or Ascaris bolus, which may cause

intestinal obstruction

# Ascaris lumbricoides worm is also able to perforate intestinal wall that will result to

peritonitis

# Ascaris lumbricoides worm in the peritoneum can enter the liver to produce

Ascaris liver abscess

# Ascaris lumbricoides dult worms that passed out in the anus or in the mouth can be a sign of

erraticism

# Ascaris lumbricoides To confirm Ascaris Loeffler’s pneumonitis

demonstration of larvae in the sputum, or gastric washings, with eosinophils and Charcot-Leyden crystals

# Ascaris lumbricoides Fecal smears for intestinal ascariasis can demonstrate (what morphologies)

finding the eggs, unfertilized and/or fertilized (not embryonated in fecal smears

# Ascaris lumbricoides X-ray of abdomen may show the so- called

tramway sign (railroad track-like)

# Ascaris lumbricoides can also be requested and may show the string sign, wherein the adult worms ingest the contrast material

Barium swallow

# Ascaris lumbricoides drug of choice for Ascaris infection

albendazole and mebendazole

# Ascaris lumbricoides the drug of choice is given for how many days?

usually given for 1-3 days

# Ascaris lumbricoides or heavy infestation, surgery may be required to remove worms, such as

Ascaris bolus

# Ascaris lumbricoides or heavy infestation, surgery may be required repair damage they've caused like?

intestinal perforations, bile duct blockage, and appendicitis

# Ascaris lumbricoides Drainage may also be done for?

liver abscess

# Ascaris lumbricoides

(M) Nematodes: Adenophorea & Secernentea [A. lumbricoides] (module-based) Flashcards

T. trichiura, T. spiralis, C. philippinensis & A. lumbricoides 165-172