PARA INTESTINAL NEMA Flashcards
The most common intestinal nematode of
man
A. lumbricoides
The unholy trinity of parasites
T. trichura, A. lumbricoides, Hookworm
A. lumbricoides has a so-called “______________________” of somatic muscle arrangement in which
cells are numerous and project well into the
body cavity
polymyarian type
The A. lumbricoides adults reside in but do not attach to the ______________________
mucosa of the small intestines
protects the ascaris worms from digestion
pepsin inhibitor 3 (PI-3)
ascaris worms secrete ___________ to suppress lymphocyte proliferation.
phosphorylcholine
At oviposition, the fertile eggs of A. lumbricoides have an ovoid mass
of protoplasm, which will develop into larvae
in about ____ days.
14
Infective stage of A. lumbricoides
fully embryonated egg
eggs of A. lumbricoides hatch in the _______________
lumen of the small intestine
The migration pattern of the A. lumbricoides larvae
hepato-tracheal migration
Migration of the A. lumbricoides larvae from the liver to the lungs takes about ____ days
14
development of egg-laying adult A. lumbricoides worms takes about _______ weeks after egg ingestion
9 to 11
lifespan of A. lumbricoides adult worms
1 year
A female Ascaris produces about ______________
eggs per day
200,000
In the soil, it takes
about ________ weeks for A. lumbricoides eggs to develop into the
infective stage (embryonation) under favorable
conditions with suitable temperature, moisture,
and humidity
2 to 3
The embryonated eggs of A. lumbricoides can survive in moist shaded soil for a ___________ to about ____________ in tropical and sub-tropical
areas, but for much longer in ______________
few months, two years, temperate regions
The most frequent complaint of patients of ascariasis is
_______________________.
vague abdominal pain
Moderate infections of ascariasis
may produce ________________ and ___________________
lactose intolerance, vitamin A malabsorption
Diagnostic stage of A. lumbricoides
Fertilized egg and unfertilized egg, adult worm
The A. lumbricoides worms may invade bile
ducts through the ________________ and enter the gallbladder or liver
ampulla of Vater
provides quantitative
diagnosis in terms of the intensity of helminth
infection in eggs per gram (epg) of stool that is
useful in monitoring the efficacy of treatment in
clinical trials, as well as public health programs.
Kato-Katz technique
___________ is less sensitive compared to the Kato
thick Smear and Kato-Katz techniques
DFS
treatment for ascariasis
albendazole, mebendazole, and pyrantel pamoate
bind to the parasites’
b-tubulin resulting in the disruption of parasite
microtubule polymerization
albendazole and mebendazole
Monitoring of A. lumbricoides is
recommended every _________________
2 years
Reinfection of A. lumbricoides is
usually observed __________________ post-treatment
and full reinfection appears at _________________
after treatment
four months, 6 or 7 months
also known as the whipworm
Trichuris trichura
T. trichura is classified
as _________________, based on the arrangement of
somatic muscles in cross-section where the cells
are small, numerous, and closely packed in a
narrow zone.
holomyarian
The T. trichura worms have an attenuated
anterior three-fifths traversed by a narrow
esophagus resembling a ___________
string of beads
A female T. trichura worm lays approximately _________________________ per day.
3,000 to 10,000 eggs
T. trichura egg appears like a ________________________
lemon or football-shaped with plug-like translucent
polar prominences
Trichuris eggs in
soil are more susceptible to __________________
desiccation
Trichuris Larvae are not usually described probably
because soon after the embryonated eggs
are ingested, the larvae escape and penetrate
_________________ where they remain for __________________
intestinal villi, 3 to 10
days
Trichuris worms inhabit the________________________
cecum and the colon
The Trichuris worms secrete a pore-forming
protein, called the _________ that allows them to imbed their entire whip-like portion into the
intestinal wall.
TT47
The process of T. trichura eggs to adult worm takes ____________
12 weeks
The Trichuris female worms have a lifespan of about _______
2 years
T. trichura infective stage
Embryonated eggs
T. trichura diagnostic stage
unembryonated eggs
The anterior portions of the Trichuris worms,
which are embedded in the mucosa, cause
______________________
petechial hemorrhages
Infections
with over _____________ T. trichiura eggs per gram of
feces are usually symptomatic
5,000
infection of Trichuris worms with over _________________ can result in anemia in children
800 worms
Anemia is strongly correlated to heavy
intensity trichuriasis, and blood loss from such
infections can range from ________________ per day
0.8 to 8.6 ml
This method is highly
recommended in the diagnosis of trichuriasis
Kato thick smear method that uses about 20 to 60
mg of stool sample
___________________ been shown to be
more sensitive in the diagnosis of trichuriasis
compared with Kato-Katz and ether/ethyl
acetate concentration techniques.
FLOTAC technique
The drug of choice in the treatment of
trichuriasis is _________________________
mebendazole given 100 mg twice a day for 3 days
A contraindication for mebendazole
and albendazole for trichuriasis is ______________________________
hypersensitivity and early
pregnancy
Trichuris is most prevalent in _________________________ regions, and least prevalent in the
_______________________________ regions
East Asia and Pacific Island
Middle East and North African
Among the different age groups, children _______________
of age are most frequently infected with Trichuris, and have
the highest intensities of infection
5 to 15 years
2 hookworm species that infect humans
Necator americanus
Ancylostoma doudenale
All hookworms have the ___________________ type
of somatic muscle with two to five cells arranged
per dorsal or ventral half.
meromyarian
The posterior end of N. americanus, the male
has a _____________________ _____________, which are used for copulation
broad, membranous caudal bursa with rib-like rays
The adult A. duodenale is _______________
than N. americanus
slightly larger
the head of the ______________________
adult continues in the same direction as the
curvature of the body
A. duodenale
The hookworm life cycle
is direct and begins with the __________________ while attached to the mucosa of the
small intestines
adult worms copulating
In the soil, the embryo of hookworm within the egg develops rapidly and hatches after _____________ into the ___________________
1 to 2 days, rhabditiform larva
After ________
days, the hookworm larva undergoes two stages of molting and transforms into the _________________________
7 to 10, non-feeding filariform larva (L3)
Infective stage of the Hookworm
filariform larva (L3)
The pathology of hookworm infection
involves: ___________________________________________________
(a) the skin at the site of entry of the
filariform larvae
(b) the lung during larval
migration
(c) the small intestine, the
habitat of the adult worms
Penetration of the hookworm filariform larvae through
the skin produces _________________and
_______________________
maculopapular lesions,localized erythema
hookworm itching is often severe, and it is known as ________________ as
it is related to contact with soil, especially on
a dewy morning
“ground itch” or “dew itch,”
If the hookworm larvae migrating through the
lungs are abundant, ________________________
may result
bronchitis or pneumonitis
Diagnostic stage of hookworm
Eggs in feces
Studies have shown _________________________ in A. duodenale infection compared with
N. americanus infection.
greater blood loss per worm per day
_________________ is another manifestation
of hookworm infection, where there is low level
of albumin due to combined loss of blood,
lymph, and protein
Hypoalbuminemia
Final diagnosis of hookworm infection
depends on the identification of _______________________
parasite ova in the feces
_____________ technique is of value only when
the hookworm infection is quite heavy.
Direct fecal smear
The __________________
may increase detection rates of hookworm since
more stools are examined using these
techniques
Kato thick or Kato-Katz method
the drug of choice, is
larvicidal and ovicidal against N. americanus
and A. duodenale
Albendazole
method of human infection in necatoriasis is purely _______________, in
ancylostomiasis, it is both __________________________________
percutaneous
percutaneous and
through the oral route
_______________________ aka threadworm is the only species of this genus
which is naturally pathogenic to humans.
Strongyloides stercoralis
The parasitic life cycle of S. stercoralis begins when
filariform larvae infect humans through the
________.
skin
Infective stage of Strongyloides stercoralis
Filariform larvae
Diagnostic stage of Strongyloides stercoralis
Rhabditiform larvae
___________________ occurs when rhabditiform
larvae pass down the large intestine and develop
into filariform larvae.
Autoinfection
There are three phases of acute infection
in strongyloidiasis:
(a) invasion of the skin by
filariform larvae
(b) migration of larvae through the body
(c) penetration of the intestinal mucosa by adult female worms
Infection intensity of S. stercoralis that causes diarrhea
alternating with constipation
Moderate infection
Infection intensity of S. stercoralis that causes cochin china diarrhea
Heavy Infection
is considered one of the most successful methods
in S. stercoralis parasite identification
Harada-Mori culture
provides the best results in chronic uncomplicated strongyloidiasis with
regard to efficacy and tolerability
ivermectin
_____________________ aka human pinworm is the causative agent of enterobiasis or oxyuriasis
Enterobius vermicularis
Enterobius vermicularis is classified as
_________________, based on the arrangement of the
somatic muscles where there are two to five cells
per dorsal or ventral half
meromyarian
is the most common
helminth parasite identified in temperate
regions, where environmental sanitation is in place
human pinworm
The translucent
shell of E. vermicularis consists of _____________________________ and _______________________________________
an outer triple albuminous
covering for mechanical protection
an inner
embryonic lipoidal membrane for chemical
protection
Inside the e. vermicularis egg is a tadpole like embryo that becomes fully mature outside the
host within __________
4 to 6 hours.
Adult E. vermicularis worms are found in the _______________________
cecum and adjacent portions of the small and large intestines
Adult female
worms migrate to the perianal area, usually in
the ______________________
evening hours
A single female E. vermicularis lays from
an average of ______________ eggs/per day
11,105
E. vermicularis eggs on the perianal region become
fully embryonated within _________
6 hours
E. vermicularis eggs are resistant to disinfectants
but succumb to ________________________
dehydration in dry air within a day
in moist conditions, these E. vermicularis eggs
can remain viable for up to _________
13 days
____________________ to the anus causes irritation of the perineal region
Migration of egg-laying females
Diagnosis of E. vermicularis
is confirmed by finding adult worms or eggs on
________________________
microscopic examinations
The method of laboratory
diagnosis of E. vermicularis is the _____________________ which gives the highest percentage of positive results, and the greatest number of eggs seen
Graham’s scotch adhesive tape swab (perianal cellulose tape swab),
The drugs of choice for Enterobiasis
mebendazole 100
mg PO single dose or albendazole 400 mg PO
single dose
It is the only intestinal nematode
infection that cannot be controlled through
sanitary disposal of human feces
E. vermicularis
___________________ is a zoonotic disease, and is characterized by abdominal pain,
chronic diarrhea, and gurgling stomach
Intestinal capillariasis
The esophagus of C. philippinensis
has rows of secretory cells called _______________,
and the entire esophageal structure is called a
_________________
stichocytes, stichosome
C. philippinensis Female worms produce characteristic
eggs, which are ____________________________
peanut-shaped with striated shells and flattened bipolar plugs
C. philippinensis eggs must reach the water
in order to be ingested by _____________________________
small species of
freshwater or brackish water fish
The C. philippinensis eggs hatch in the intestines of the fish and
grow into the _______________________
infective larvae
Infective stage of the C. philippinensis
Infective larvae
Diagnostic stage of the C. philippinensis
Unembryonated egg
natural hosts of C. philippinensis
Fish-eating birds
incidental hosts of C. philippinensis
humans
Persons with C. philippinensis usually have ____________________________________
abdominal pain and borborygmi
C. philippinensis infection Histologically, the intestines also show
________________, and ______________________.
flattened and denuded villi, dilated mucosal glands
The drug of choice for the treatment of intestinal capillariasis is _________________________________
mebendazole, 200
mg twice a day for 20 days
Capillaria philippinensis is a nematode
from the superfamily ____________________, to which Trichuris and Trichinella belong
Trichinelloidea
natural
hosts of the nematode Capillaria philippinensis
Fish-eating birds
