Parasitology: Parasitic Worms Flashcards

1
Q

A patient presents with anal pruritis.

The Scotch Tape test is positive.

Diagnosis? How is it spread?

A

Enterobius vermicularis (pinworm, subset of roundworm)

Fecal-oral spread.

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2
Q

How to treat Enterobius vermicularis (pinworm)

A

Bendazoles or pyrantel pamoate

(because worms are bendy)

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3
Q

Patient presents with intestinal discomfort.

Microscopic examination of the feces reveals eggs.

Diagnosis and spread?

A

Ascaris lumbricoides (giant roundworm)

Fecal-oral spread.

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4
Q

How would you treat Ascaris lumbricoides (giant roundworm)?

A

Bendazoles or pyrantel pamoate

(because worms are bendy)

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5
Q

A landscaper presents with vomiting, diarrhea, and epigastric pain. He says he usually works barefoot.

You’re suspicious of a parasitic disease.

Likely diagnosis and spread?

A

Strongyloides stercoralis, a roundworm

Larvae in soil penetrate the skin.

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6
Q

Treatment for Strongyloides stercoralis?

A

Ivermectin or albendazole.

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7
Q

Patient presents with fatigue and abdominal discomfort.

A CBC confirms microcytic anemia.

What are some parasitic worms that can cause these symptoms?

How are they spread?

A

Hookworms (a subset of roundworm):

  • Ancylostoma duodenale*
  • Necator americanus*

Larvae penetrate skin.

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8
Q

How to treat hookworm infections? (Ancylostoma duodenale, Necator americanus)

A

Bendazoles or pyrantel pamoate.

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9
Q

A patient presents with blindness and black skin nodules.

He confirms a recent black fly bite.

Diagnosis?

A

Onchocera volvulus, a roundworm

Causes hyperpigmented skin and river blindness (black flies, black skin nodules, “black sight”)

Allergic reaction to microfilaria possible.

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10
Q

Treatment for Onchocera volvulus?

A

Ivermectin (ivermectin for river blindness)

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11
Q

Patient presents complaining of seeing “something floating in his eye”.

Upon examination, you see small worms in her conjunctiva.

Diagnosis? Spread?

A

Loa loa, a roundworm

Either a swollen skin infection or worms in conjunctiva.

Spread by deer fly, horse fly, or mango fly.

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12
Q

How to treat loa loa?

A

Diethylcarbamazine

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13
Q

Patient presents with elephantitis.

You suspect a roundworm infection.

Diagnosis? Spread?

A

Wuchereria bancrofti

Spread by female mosquito. Can take 9 months-1 year to become symptomatic.

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14
Q

Treatment for Wuchereria bancrofti?

A

Diethylcarbamazine

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15
Q

A young child presents with infection of several organs with a roundworm.

Diagnosis? Spread?

A

Toxocara canis, a roundworm.

Disseminated infection called Visceral larva migrans

Spread by fecal-oral route.

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16
Q

How to treat Toxocara canis?

A

Albendazole or mebendazole.

17
Q

What are the roundworms that cause infection when ingested?

A

Enterobius - Anal pruritis, Scotch Tape test

Ascaris - Intestinal infection

Toxocara - Cisceral larva migrans

“You’ll get sick of you EAT these!”

18
Q

What are the nematodes/roundworms that cause infection when exposed to the skin?

A

Strongyloides - Vomiting, diarrhea, epigastric pain

Ancylostoma - Anemia, hookworm

Necator - Anemia, hookworm

“These get in your feet from the SANd.”

19
Q

What nematodes that cause infection when spread by insect bites?

A

Loa loa: Worm in conjunctiva, deer, horse, and mango flies

Onchocerca: Black flies, black nodules, black sight

Wuchereria bancrofti: Female mosquito, elephantitis

“Lay LOW to avoid getting bitten”

20
Q

Patient presents with intestinal discomfort.

He ate at a pig roast recently.

Most likely parasitic worm? How is it spread?

A

Taenia solium - a cestode/tapeworm

Causes intestinal infections when larvae cysts are eaten from uncooked pork.

21
Q

Patient presents with numerous seizures.

MRI finds several brain cysts.

Possible infectious worm? Spread?

A

Taenia solium - a cestode/tapeworm

This syndrome is called cystericerosis (neurocystericosis when in brain)

Ingestion of eggs can result in this syndrome.

22
Q

How to treat Taenia solium?

A

Praziquantel

Albendazole for neurocystericerosis.

23
Q

A patient presents with fatigue.

A CBC shows macrocytic anemia.

He admits to loving sushi.

Possible worm infection? Route of transmission?

A

Diphyllobothrium latum, a cestode/tapeworm.

Ingestion of larvae from raw freshwater fish. Vitamin B12 deficiency induced from tapeworm competition in intestine.

24
Q

How to treat Diphyllobothrium latum?

A

Praziquantel.

25
A dog handler presents with unrelenting abdominal pain. An abdominal CT shows multiple cysts in the liver. The surgeons preinject the patient with ethanol before beginning a removal procedure. Diagnosis? What's with the ethanol?
*Echinococcus granulosus* Caused by ingestion of eggs from dog feces. Hydatid cysts in liver - anaphylaxis can result if antigens are released (ethanol kills cysts before removal to avoid this complication).
26
How to treat *Echinococcus granulosus*?
Albendazole.
27
Patient presents with abdominal pain and splenomegaly. Biopsy of the liver shows granulomas, fibrosis, and inflammation. Possible parasitic infectious agent? Spread?
*Schistosoma* - a trematode (fluke) Snails are host; cercariae penetrate skin of humans Chronic infection can cause squamous cell carcinoma of the bladder (painless hematuria)
28
How to treat *Schistosoma*?
Praziquantel.
29
Patient presents with horrible RUQ pain. He admits to enjoying undercooked fish. You diagnose cholelithiasis. Diagnosis? Source? Important association?
*Clonorchis sinensis*, a trematode (fluke) Acquired from undercooked fish. Causes biliary tract inflammation -\> pigmented gallstones Associated with cholangiocarcinoma.
30
How to treat *Clonorchis sinensis*?
Praziquantel.