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Parasites > More helminths and ectoparasites > Flashcards

More helminths and ectoparasites Flashcards

1
Q

How to treat crusted scabies?

A

Topical pemethrin daily for 1 week then twice weekly

PLUS

ivermectin 1,2,8,9,15 (maybe 22 and 29)

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2
Q

treatment for normal scabies?

A

Permethrin apply for 8 hours then repeat 1 wk later

OR

malathion apply for 24 hours then repeat 1 week later

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3
Q

What causes larva currens?

Diagnosis?

Treatment?

A

strongyloides stercoralis

Diagnosis: enterotest (string test/duodenal aspirate) coz stool microscopy notoriuously insensitie (<50%)

Tx: ivermectin stat x2

or albendazole 400mg bd 3-7 days

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4
Q

What causes hookworm infection?

treatment?

A

Ancylostoma duodenale/necator americanus

Tx: albendazole stat/mebendazole 3 days

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5
Q

What causes cutaneous larva migrans?

How to differentiate it clinically from larva currens?

treatment?

A

Ancylostoma braziliense/ancylostoma caninum

Cutaneous larva migrans is slower (1cm/hr) whilst larva currens is faster (1cm/5min)

Tx: ivermectin

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6
Q

What causes visceral larva migrans?

Treatment?

A

Toxocara canis/toxacara cati

Tx:albendazole BD for 2 weeks

if pulmonary/cns/cardiac, add steroids

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7
Q

What causes ocular toxocariasis?

How does it present?

treatment?

A

toxacara canis/toxocara cati

Presentation: child/adult w puppy exposure, visual impairment and white elevated granuloma on eye

(may have uveitis/papilitis/endophthalmitis)

Tx: albendazole+steroids

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8
Q

What is the scientific name for pinworm?

where does it reside?

Treatment?

A

Enterobius vermicularis

resides in caecum & colon

Tx; albendazole/mebendazole stat, repeat at 2 weeks

(used to get it at Bangi)

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9
Q

The roundworms are generally treated with albendazole.

Very few are treated with ivermectin - which are

these?

Which ones are for DEC?

A

The few roundworms treated with ivermectin are

onchocerciasis and all the ones with ‘larva’ in their name:

  • larva currens (strongyloides)
  • cutaneous larva migrans (ancylostoma braziliense, ancylostoma caninum)
  • visceral larva migrans (toxocara canis/cati)

DEC: lymphatic filiriasis, loaisis

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10
Q

What is the treatment for trichuris trichiura?

Where does it reside in humans?

A

Albendazole 3 days

Lives in Caecum or colon

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11
Q

What causes trichinosis?

Clinical manifestations?

Treatment?

A

Trichinella (roundworm group) from pigs/rats

cysts disseminate in blood stream and seed skeletal muscle

Tx: usually mild and self-limiting

if cns/cardiac/pulmonary=albendazole bd for 2wks+steroids

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12
Q

pt with lymphatic filiriasis on blood smear taken between 10pm to 2am.

<2500 loa-loa microfilariae/ml

How to treat?

A

DEC daily for 12 days

plus doxycycline 4-6wks

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13
Q

pt with lymphatic filiriasis on blood smear taken between 10pm to 2am.

>2500 loa-loa microfilariae/ml

How to treat?

A

doxy 4-6 weeks

or

albendazole 21 days

(albendazole affects adult worms only, not microfilariae)

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14
Q

What causes Calabar swellings?

A

Loa-loa worm

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15
Q

pt with lymphatic filiriasis, also got con-comitant onchocerciasis.

How to treat?

A

ivermectin first,

then DEC+doxy for LF

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16
Q

Which transmits Loa loa?

Treatment?

A

Chrysops fly (tabanid, horse or deer fly)

Tx: DEC 21 days to kill microfilariae

(doesn’t kill adult worms, have to wait for adult worms to die).

17
Q

Treatment for Onchocerca volvolus?

A

ivermectin (kills microfilaria and adult worms)

plus

DOXYCYCLINE (due to Wolbachia)

18
Q

Treatment for taenia solium/saginata intestinal infection

A

stat praziquantel or stat niclosamide

19
Q

pt has operculated egg isolated from stool. reports dizziness, salt craving. has megaloblastic anaemia.

Japanese who loves seafood.

Possible causative organism?

Treatment?

A

Diphyllobothrium latum (fish tapeworm)

treatment: stat praziquantel or niclosamide

20
Q

Which is the only tapeworm that can be transmitted from human-to-human?

Treatment?

A

Hymenolepsis nana (dwarf tapeworm)

diagnosed by eggs (which have characteristic double membrane)

Tx: praziquantel higher dose 25mg/kg stat

or niclosamide daily for 1 week

21
Q

Schistosoma intercalatum. Which area?

what does it cause?

Treatment?

A

Central and West Africa

Intestinal schistosomiasis

stat praziquantel

22
Q

chinese liver fluke. What’s the causative organism?

Ingested at which stage?

How to treat?

A

Clonorchis sinensis.

adult worms inhabit bile capillaries, deposit eggs,

which are released into water and eggs ingested by snails. Inside snail, eggs hatch into miracidia. miracidia multiply into cercariae that pass into water, encyst on fish as metacercariae. HUMANS INGEST METACERCARIAE.

Tx: high-dose praziquantel 25mg/kg tds for 2 days

23
Q

Which Opisthorcis species is associated with cholangiocarcinoma in Thailand?

A

Opisthorcis viveriini

(dog liver fluke)

24
Q

Pt likes to eat pickled crabs. One day, she reports fever, pleuritic chest pain, cough productive of brown sputum, intermittent haemoptysis. cough showed below. A few days later she developed lung abcess.

What is the diagnosis? How to treat?

A

Paragonimus westermaani (lung fluke).

Adults live in lungs, eggs are released which are coughed up/swallowed and enter feces. In water,eggs release miracidia which infect intermediate snail host. after 3-5 months, snail releases cercaria which infect crustaceans (crabs&crayfish) and encyst in their tissue.

Tx: praziquantel tds for 2 days, or biothonol

25
Q
A
26
Q

Which two intestinal flukes are due to metacercaria encysted onto aquatic plants?

Treatment for each?

A

Fasciola hepatica - triclabendazole stat

fasciolopsis buski - praziquantel tds for 1 day

27
Q

Child in South America presents with symptoms mimicking appendicitis, with eosinophilia. house has rats. eats from family farm contaminated with slugs.

Which fluke,and what treatment?

A

Rat lung worm = angiostrongylus cantonensis

Tx: laparatomy to remove infected tissue

OR DEC with tiabendazole

28
Q

Anisakiasis. pt presents with symptoms of gastric anisakiasis (abdo pain, nausea, vomitting) 48 hours after ingestion. What causative agent, and how to treat?

A

Phocanema

treatment: usually improve spontaneously.

may be faster if worms removed endoscopically.

29
Q

Causes of eosinophilic meningitis

A

Rat Gnawed Pig Shit To Coccyx

(Ratlungworm,Gnathostomiasis, neurocystercicosis, schistosomiasis, toxocariasis, coccidiodomycosis-paracoccidiodomycosis)

30
Q

Furunculoid Myiasis is caused by….

Ophthalmomyiasis is caused by…

Wound myasis is caused by…

A

Furunculoid myiasis

  • Tumbu fly (africa) - cordylobia anthropophaga
  • botfly - Latin America - dermatobia homin

Ophthalmomyiasis - Oestrus ovis (sheep botfly)

Wound myiasis - C.hominivorax (new world screwworm) or C.bezziana (old world screwworm)

31
Q

3 diseases caused by human lice (pediculosis) and their treatment.

A
  • Epidemic typhus - R.prowazekii - doxycycline7days (even if kid given mortality)
  • Trench fever - Bartonella quintana - fever, rash, splenomegaly/endocarditis. tx: 4-6wks macrolide+doxy. if endocarditis:surgery and very prolonged Ax.
  • Relapsing fever- Borrelia recurrentis - stat doxy
32
Q

The flukes are generally treated with praziquantel, except few (at least 3). Which are these?

A
  • Fasciola hepatica - triclabendazole stat
  • Capillaria philippinensis (capillariasis) - mebendazole
  • Eosinophilic meningitis due to rat lung worm (angiostrongyliasis cantonensis) = steroids/albendazole 14days +-therapeutic LP
33
Q

How do anti-helminthics work?

A

Disrupting tegument and intestine by preventing microtubule formation. this affects glucose uptake by adult and larval stages.

34
Q

what is tropical pulmonary eosinophilia?

Treatment?

A

hypersensitivity reaction to lymphatic filiriasis worms (Wucheria bancrofti and brugia malayi)

often seen in visitors to areas (NOT LOCALS)

Treatment: DEC. consider steroids if on-going alveolitis/fibrosis (exclude strongyloides first)

35
Q

What is Loeffler’s syndrome?

Treatment?

A

Transient respiratory illness associated with blood eosinophilia and respiratory shadowing.

caused by larval migration of worm through resp tract (Ascaris, hookworm, strongyloides)

tx; as per individual species. if results negative, empirically albendazole for 3 days.

36
Q

How to treat katayama fever?

A

stat praziquantel, then rpt at 6-8weeks. initial serology may be negative. diagnosis is clinical.

37
Q

Schistosomiasis - which species to which snail?

A

S.haematobium - bulinus

S.japonicum - oncomelania

S.mansoni - biomphalaria

Parasites (2 decks)

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