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Immunology > Platyhelminthes > Flashcards

Platyhelminthes Flashcards

1
Q

Tapeworm found in fish

A

Diphyllobothrium latum

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1
Q

Pathology of Echinococcosis

A

Hydatid cysts in liver (50-70%) and lungs (20-30%) but also spleen, kidney, bone and CNS

Latent periods up to 20 years

Disease onset when hydatid cysts cause pain or rupture

Cyst rupture can seed new sites by release of protoscolices

Anaphylaxis associated with rupture can be fatal

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2
Q

Transmission of Taenia solium

A

Intestinal (adult) - Ingest raw pork, Lung (larva) - Ingest free eggs

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2
Q

Location of Echinococcus granulosus

A

Liver, lungs, etc.

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2
Q

Location of Echinococcus granulosus

A

Tissues mainly lungs and liver, but also spleen, kidneys, heart, bone, and CNS

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2
Q

Describe the life cycle of* Echinococcus granulosus*

A

Basic cestode lifestyle; humans as intermediate host only

Requires intimate contact with dogs

Humans are a dead end host

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3
Q

Immunity of Diphyllobothrium latum

A

No clincally relevant immunity…reinfection is possible

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3
Q

Location of Schistosoma haematobium

A

Bladder

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3
Q

Katayama syndrome is associated with which pathogen?

A

Schistosomiasis. intense fever with onset of oviposition

14-84 days (middle onset/1-2 months)

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4
Q

What is a scolex?

A

The anterior end of adult tapeworms, used to attach to the gut wall of definitive hosts

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4
Q

Which of the Schistosoma species lay the most eggs per day?

A

Schistosoma japonicum = 1000 eggs/day

(Schistosoma mansoni and Schistosoma haematobium = 100 eggs/day)

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5
Q

Describe transmission of Trematoda

A

Transmission can be invasive or ingestive

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6
Q

Transmission of Diphyllobothrium latum

A

Undercooked fish containing plerocercoid

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6
Q

Describe the chronic onset (5-15 years) of Schistosomiasis pathology from S. haematobium

A

Eggs lodge in tissues in the bladder

Egg secretions lead to eosinic inflammatory response and granulomas

Extensive fibrosis of bladder leads to mucosal thickening & ulceration which leads to l_oss of bladder function_

Bladder cancer

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7
Q

Describe the body of a tapeworm (Cestoda)

A

Flattened, segmented bodies

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8
Q

Prevention of Echinococcosis

A

De-worm dogs, proper disposal of livestock internal organs

Good hygiene

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9
Q

Name the 4 species in Cestoda that we need to know

A
  • Taenia saginata*
  • Taenia solium*
  • Diphyllobothrium latum*
  • Echinococcus granulosus*
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10
Q

What is taeniasis and how is it acquired?

A

Tapeworm in the intestine from eating undercooked pork, ingesting cysticerci (larva)

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10
Q

Describe the chronic onset (5-15 years) of Schistosomiasis pathology from S. mansoni and S. japonicum

A

Eggs lodge in tissues in the intestine and liver

Egg secretions lead to eosinic inflammatory response and granulomas

Severe liver disease leading to periportal (liver) fibrosis which can lead to portal hypertension / hepatosplenomegally / megaesophogus which can lead to rupture of gastric or esophageal varices

Liver and colon cancer

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11
Q

Epidemiology of Diphylobothrium latum

A

Found globally in temperate zones where fish is a major part of the diet

Was brought to the New World by European immigrants

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12
Q

Treament of Schistosomiasis

A

Praziquantel in single or multiple dose

Potentiates active immune system killing of adult worms

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13
Q

Location of Schistosoma mansoni

A

Intestine (eggs migrate to descending colon)

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14
Q

Describe Trematoda (fluke) digestion

A

Simple digestive system, a single opening serves as mouth and anus

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15
Q

What is plerocercoid larva?

A

last larval form found in the second intermediate host of many Cestoda with aquatic life cycles (Diphyllobothrium latum)

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15
Q

Immunity against Schistosomiasis

A

Adults masked by absorption of host serum proteins

Immunity primarily involved in pathology

Evidence for immunity to reinvasion in endemic areas, immune killing of schistosomula

Intensive effort under way for a vaccine

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16
Q

Greek translation of Platyhelminthes

A

platy = flat, helminth = worms

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18
Q

What are proglottids?

A

Segments of the tapeworm bodies

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20
Q

Location of Diphyllobothrium latum

A

Intestinal

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20
Q

What is cysticercosis and how is it acquired?

A

Larva in muscle, eyes, brain from eating tapeworm eggs

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20
Q

What is a procercoid larva?

A

an elongate larval stage of some tapeworms (Diphyllobothrium latum) that usually develops in the body of a freshwater copepod

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21
Q

Intermediate hosts of Diphyllobothrium latum?

A

copepod that infects fish

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22
Q

What is the immunity against Taenia solium?

A

Humoral response to adult worms thus reinfection is possible

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23
Q

Tapeworm found in pork

A

Taenia solium

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24
Q

Diagnosis of Diphyllobothrium latum

A

Same as beef and pork tapeworm

Easily discriminated from Taenia ssp by egg and proglottid

Pernacious anemia, raw fish diet in endemic areas indicatve

25
Q

Which Schistosome eggs are isolated from urine?

A

S. haematobium

26
Q

Pathology of Diphyllobothrium latum

A

Like beef tapeworm

Adults absorb 80-100% of dietary B12

B12 deficiency, anemia, occasionally neurological symptoms

27
Q

Describe the early onset (0-2 weeks) of Schistosomiasis pathology

A

Most people have no symptoms when first infected

Rash from invading cercaria, many exposures leads to hypersensitivity

Rash subsides: fever, headache, nausea as the schistosomula migrate

29
Q

Class for flukes

A

Trematoda

31
Q

Describe the body of a fluke (Trematoda)

A

Broad, flattened body

32
Q

Describe alveolar echinococcosis

A

Caused by Echinococcus multiocularis

Humans are usually exposed when hunters feed internal organs to domestic dogs

Wild animal cycles: wild canines and game animals in wilderness of North America, Europe, Asia

33
Q

Tapeworm found in beef

A

Taenia saginata

34
Q

How can Taenia solium presence be diagnosed?

A

Self: active proglottids

Clinical:

  • observation of proglottids or eggs in stool (proglottid morphology discriminates from T. saginata & D. latum)
  • contrast studies show ribbon-like strucutre from intestine
  • Cysticercosis by X-ray, calcified dead larva
  • CAT/MRI, viable cysticerci
35
Q

Diagnosis of Schistosomiasis

A

Observation of eggs in feces or urine most common

Serology now available

36
Q

Transmission of Taenia saginata

A

Ingest raw beef

37
Q

Definitive host of* Echinococcus granulosus*

A

Wild & domestic canines

38
Q

Treatment of Echinococcosis

A

Percutaneous drainage with instillation of hypertonic saline or alcohol

Surgical removal, avoiding rupture

If inoperable, treat with albendazole (28 day), low cure rate

39
Q

What are the intermediate hosts of Taenia solium?

A

Pigs (or humans)

40
Q

Transmission of Schistosomiasis

A

Invasive, aquitic free-living cercaria penetrate skin

41
Q

Which Schistosome eggs are isolated from the stool?

A

S. mansoni and S. japonicum

43
Q

Transmission of Echinococcus granulosus

A

Ingest free eggs

44
Q

Schistosoma mansoni adult worms travel in which veins?

A

Inferior mesenteric veins

45
Q

Class for tapeworms

A

Cestoda

47
Q

Location of Taenia solium

A

Intestinal (adult), Any tissue, i.e. lungs (larva/cysticerci)

48
Q

Definitive Host of Schistosoma organisms

A

Humans

50
Q

Describe Cestoda (tapeworm) digestion

A

No internal digestive system, nutrients are absorbed across the cuticle

52
Q

Describe the maturation process of Cestoda (tapeworms)

A

Segments (proglottids) mature from anterior to posterior, specialized for hermaphroditic reproduction

53
Q

What are the definitive hosts of Taenia solium?

A

Humans

54
Q

How did Echinococcus arise in the US?

A

It is not endemic in the US, but immigration and transportation increases have caused a rise throughout North America

54
Q

Intermediate host of* Echinococcus granulosus*

A

Wild & domestic ungulates (hoofed animals)

Humans

55
Q

How can eggs of Schistosoma organisms incite chronic inflammation?

A

The eggs canf low into the portal vein tributaries and become trapped in the terminal portal venules, where they incite chronic inflammation

56
Q

Describe the pathology of Cysticercosis

A

1) Muscle may cause lumps but usually no symptoms
2) Brain cause neurocysticercosis - symptoms depend upon where and how many cysticerci there are

57
Q

Definitive host of Diphyllobothrium latum

A

Humans

58
Q

Name the 3 species in Trematoda that we need to know

A
  • Schistosoma mansoni*
  • Schistosoma japonicum*
  • Schistosoma haematobium*
59
Q

Prevention of Schistosomiasis

A

Reduce source (treat infected individuals)

Dispose of waste properly

Control of intermediate hosts: molluscicides environmentally damaging

Avoid contact with infested water: difficult in rural areas

61
Q

Name the two classes of Platyhelminthes

A

Cestoda (tapeworms), Trematoda (flukes)

62
Q

Location of Taenia saginata

A

Intestinal

63
Q

Treatment of Taenia solium

A

Praziquantel, niclosamide, or albendazole, single dose effective for adult worms but prolonged treatment of cysticerci

Dexamethasone used to reduce inflammation during treatment, especially true in the CNS, treatment can induce seizures

65
Q

Immunity against Echinococcosis

A

Circulating antibodies to hydatid cyst antigens

Pathology more than protection

67
Q

Diagnosis of Echinococcosis

A

Residence in endemic area, animal husbandry/hunting

CAT scan/ultrasound

Often presents as slow growing tumor

Serology is used for confirmation

68
Q

Transmission of Schistosoma spp.

A

Cercaria penetrate skin

69
Q

Location of Schistosoma japonicum

A

Intestine (eggs migrate to small intestine)

70
Q

What is Hydatid Disease?

A

from* Echinococcus granulosus* hydatid cysts in liver, lungs, etc.

71
Q

Intermediate host of Schistosoma organisms

A

Snails

72
Q

Schistosoma japonicum adult worms travel in which veins?

A

Superior mesenteric veins

73
Q

Transmission of Echinococcus granulosus

A

Ingestion of eggs from dogs

75
Q

Describe the pastoral cycle of Hydatid disease

A

Domestic grazing livestock (sheet) are in contact with dogs. The dogs must eat internal organs.

76
Q

Location of Schistosoma spp.

A

Veins to gut/bladder

77
Q

Describe the symptoms of Cystericercosis (neurocysticercosis)

A

Confusion, difficult with balance, brain swelling, excess fluid around the brain (hydrocephalus), seizures, headaches, and mortality

78
Q

Describe the middle onset (1-2 months) of Schistosomiasis pathology

A

Symptoms mostly from immune response to eggs

Katayama syndrome (intense fever)

Intestinal schistosomiasis causes abdominal pain, diarrhea, blood in stool

Urogenital schistosomiasis is haematuria (blood in urine)

80
Q

What are coracidia?

A

larvae of Diphyllobothrium latum that hatch and get eaten by freshwater crustaceans such as copepod

81
Q

Epidemiology of Schistosomiasis

A

240 million infected globally

public or agricultural water supply contaminated with human waste

Presence of appropriate snail intermediate hosts

Peak infection rate in second decade: children playing in water

Pathology proportional to worm burden

82
Q

Schistosoma haematobium adult worms travel in which veins?

A

Venous plexus (bladder)

83
Q

Describe the symptoms/pathology of Taeniasis

A

Often asymptomatic or causes abdominal discomfort, occasionally nausea, vomiting, diarrhea, weight loss, & obstruction

84
Q

Treatment of Diphyllobothrium latum

A

As in Taenia ssp, praziquantel or niclosamide, single dose

Vitamin B12 supplement when deficiency is evident

Immunology (9 decks)

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