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Micro 5 > Roundworm Inf of GI > Flashcards

Roundworm Inf of GI Flashcards

1
Q

foul smelling, greasy floating stools/diarrhea=

A

giardia

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2
Q

bloody mucous containing diarrhea=

A

entamoeba

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3
Q

profuse water diarrhea=

A

cyclospora (anyone), isospora (mostly in immunodef), or cryptosporidium (anyone)

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4
Q

profuse water diarrhea w/ raspberry seeds?

A

cyclospora

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5
Q

which parasite fluoresces under UV light?

A

cyclospora oocysts

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6
Q

acid fast stain modified would show?

A

isospora and crptosporidium

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7
Q

nematodes

A

=roundworms
Non-segmented bodies
Separate sexes
Complete digestive system

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8
Q

Cestodes

A

=tapeworms
Segmented bodies
Hermaphroditic
Absorb nutrients

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9
Q

Trematodes

A

=flukes
Non-segmented (leaf)
Hermaphroditic
Primitive gut

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10
Q

enterobius vermicularis eggs look like?

A

-flat on one side

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11
Q

trichuris trichiura eggs look like?

A

-oval shaped with two “plugs” on the end

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12
Q

ascaris lumbricoides fertile eggs look like?

A

-lumpy bumpy shell

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13
Q

ascaris lumbricoides infertile eggs look like?

A

-lumpy bumpy shell

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14
Q

hookworm eggs look like?

A

boring looking - round-ovalish eggs

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15
Q

Nematodes-transmission/common areas

A
  • Usually do not cause fatal infections, do contribute to malnutrition and a diminished work capacity.
  • Most common in areas with poor sanitation, (FECAL ORAL TRANSMISSION) particularly in developing countries of the tropics
  • Children are most likely to develop symptomatic infection.
  • Most common in South Eastern US
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16
Q

Nematodes - lifecycle

A

-The life cycle consists of egg, multiple larval, and adult stages.
-Separate sexes, and the female is usually larger than the male.
-Need to be infected by 2 or more to be shedding eggs
-Adult worms do not replicate in the man.
-Identified by the characteristic morphology of their eggs.
-Some GI nematodes pass through other tissues (lungs, skin) during development.
eosinophilia

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17
Q

Anytime a helminth infection that leaves the gut patient will have??

A

ELEVATED EOSINOPHILIA LEVEL

Normal is like 1% but it would just to like 15%

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18
Q

Geohelminths acquired through

A
  • nematode infection acquired through contact with infected soil
  • Larvae or eggs require a period of time to develop in warm moist soil
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19
Q

Geohelminths - two groups:

A
  • Ascaris and Trichuris: ingestion of infectious eggs

- Strongyloides and hookworms: penetration of the skin by infectious larvae found in soil

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20
Q

Pinworm-Enterobius vermicularis - some details and lifecycle

A
  • pinworm
  • MOST COMMON HELMINTHIC INFECTION IN US
  • lifecycle: eggs laid on butthole and easily airborne and transfered, move into small intestines, larval dev, large intestines into mucosa where they mate, females lay the eggs on butthole area.
  • reinfection is common
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21
Q

Pinworm-Enterobius vermicularis transmission?

A
  • Transmission is fecal-oral
  • Ingestion of eggs
  • Reinfection is common as is transmission within families.
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22
Q

Can animal pinworms infect humans?

A

NO

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23
Q

Pinworm-Enterobius vermicularis symptoms and diagnosis:

A
  • Most infections are asymptomatic.
  • If Symptomatic infection: Perianal itching; Secondary bacterial infection; Appendicitis (?)

-Diagnosis: identification of eggs (adult worms) in perianal region.–> Flat-sided eggs on scotch – tape prep

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24
Q

Pinworm-Enterobius vermicularis - control/prevention:

A
  • Treatment is with several anti-helminthic compounds (mebendazole, pyrantel pamoate). -Usually a single dose, repeated again two weeks later.
  • Treat all household members*
  • Good hygiene and housekeeping.
25
Q

eggs of Pinworm look like?

A

flat on one side

26
Q

Whipworm-Trichuris trichiura- egg shape

A

oval shaped with two plugs on each end

27
Q

Whipworm-Trichuris trichiura-life cycle:

A
  • infected indiv shedding eggs in feces
  • eggs need to be in environment to mature - warm moist soil
  • eggs eaten later and infect idiv
  • mom and pop make more babies and female lays eggs on outside
28
Q

Whipworm-Trichuris trichiura where in the US is it mostly found?

A

Mostly tropical, but can be found in south-eastern United States.

29
Q

Whipworm - transmission

A
  • Fecal-oral ; contaminated soil.

- Warm, moist soil promotes development of eggs

30
Q

Whipworm-Trichuris trichiura - symptoms?

A

-90 % of infections are asymptomatic.
-IF Symptomatic infections:
Heavy worm burden (>200 adult worms)**
Bloody, mucus containing diarrhea
Frequent stools
Rectal prolapse in children - constantly straining
May contribute to growth retardation and anemia in children.

31
Q

Whipworm diagnosis and control/prevention

A
  • Diagnosis=look for eggs - oval shape with plugs on ends

- Control/Prevention=Proper sanitation and personal hygiene.

32
Q

Ascariasis-Ascaris lumbricoides - worm details and eggs type?

A
  • LARGEST nematode that infects man - thick as a pencil and about foot long
  • bumpy egg on outside
33
Q

Ascaris lumbricoides lifecycle:

A
  • eggs in feces
  • eggs need to mature in environment
  • break open in intestines
  • larvae will pass through mucosal wall
  • travel through lvier and make their way to lungs (GET PULMONARY EOSINOPHILIA) and up to throat = tickle in back
  • host clears throat and swallows them = then the larvae bcome mom and pops back in the intestines
34
Q

Ascaris lumbricoides patients will have what in their sputum?

A

larvae and eosinophils!

35
Q

Ascaris lumbricoides most common where in US?

A

South East

36
Q

Ascaris lumbricoides - transmission:

A
  • Fecal-oral; soil contaminated with human feces.

- Eggs need to develop in soil before they are infective

37
Q

only reservoir for A. lumbricoides? cross species?

A

HUMANS

ascaris from other animals do not affect us

38
Q

largest of intestinal roundworms?

A

Ascariasis-Ascaris lumbricoides

39
Q

Ascariasis-Ascaris lumbricoides symptoms?

A
  • Most infections are asymptomatic.

- Symptomatic disease: Range from abdominal discomfort to death (rare)

40
Q

Ascariasis-Ascaris lumbricoides- intestinal disease:

A
  • Physical presence of adult worms in small intestine
  • Abdominal pain, indigestion, loss of appetite, vomiting, diarrhea
  • Heavy infections can cause a physical obstruction.
  • In children-nutritional deficiency, growth retardation.
41
Q

Ascariasis-Ascaris lumbricoides - pulmonary disease

A
  • A combination of the physical presence of larvae and the immune response to them.
  • Mild cough, pneumonitis (inflammation of alveoli).
  • Parasite antigens are highly allergenic
  • Repeated exposure =asmatic attack
  • Eosinophilia is common
42
Q

Ascariasis-Ascaris lumbricoide - Diagnosis and Control/Prevention:

A
  • Diagnosis-eggs in stool; larvae or eosinophils in sputum

- Control / Prevention-Sanitation and Hygiene

43
Q

Hookworm- Necator americanus & Ancylostoma duodenale

A
  • eggs in feces
  • mature in soil for weeks
  • hatch in soil!
  • NEED SKIN CONTACT
  • Make their way into circulation
  • lungs –> stomach and intestines
  • eggs produced
44
Q

Necator americanus & Ancylostoma duodenale location in US/ some detials

A
  • South East US - mostly Necator americanus

- major cause of anemia in children and prego

45
Q

Necator americanus & Ancylostoma duodenale transmission

A

-larvae from fecal contaminated soil penetrate intact skin.

46
Q

Necator americanus & Ancylostoma duodenale - reservoires for hookworms?

A

No aminal reservoir for HUMAN hook worms

-cat and dog hookworms cause Cutaneous larval migrans in humans

47
Q

Cutaneous larval migrans is what and caused by?

A

is hookworm disease transfered from cat or dog to human –> not usual GI infection

48
Q

Iron-deficiency anemia

A
  • hookworm disease
  • due to blood loss from hookworm feeding. If infection is severe enough this can result in fatigue, exertional dyspnea, koilonychias (brittle, spoon shaped nails), pale sclera, and heart murmurs.
49
Q

Other issues associated with hookworms?

A
  • irondeficiency anemia - due to blood loss from hookworm feeding
  • Children with severe infection can become protein malnourished due to blood loss.
  • Penetration of the skin - moderate dermatitis (“ground itch”).
  • Pneumonia and eosinophilia may accompany larval passage through the lungs.
50
Q

Which hookworm is more pathogenic?

A

Ancylostoma consumes more blood than Necator; therefore it is usually considered more pathogenic.

51
Q

Hookworm - diagnosis

A

-presence of eggs in stool

Distinguishing between Necator and Ancylostoma requires and examination of adult worms or larvae.

52
Q

Hookworm - Prevention / Control -

A
  • Sanitation

- Wear Shoes

53
Q

Strongyloidiasis-Strongyloides stercoralis lifecycle

A

-infected indiv with adult worms + producing eggs
-eggs hatch in intestine = immature larvae
-LARVAE PASS IN STOOL
-Larvae go into soil and develop into adults
-replicate/mate in soil (CAN SURVIVE IN SOIL)
-then penetrate skin of indiv who step on them!
-into circulation—>lungs–>trachea–> swallowed===> new cycle of GI infection with adults
OR
HYPERINFECTION:
-some larvae just repenetrate from the intestines and get into the circulation again

54
Q

smallest nematode infection in humans?

A

Strongyloides stercoralis

55
Q

ONLY faculative parasite and what this means?

A

Strongyloides stercoralis - it can REPLICATE OUTSIDE OF THE HOST –> doesnt need host for survival

56
Q

Strongyloidiasis-Strongyloides stercoralis location in US

A
  • appalachia

- Eastern US

57
Q

Strongyloidiasis-Strongyloides stercoralis - transmission:

A
  • penetration of skin by infectious larvae
  • Infectious form larvae can develop in the intestine, penetrate the intestine, enter the bloodstream, and re-initiate infection (auto-infection).
58
Q

Strongyloidiasis-Strongyloides stercoralis - symptoms?

A

-Low worm burdens: little symptomology
non-specific symptoms including, epigastric pain and tenderness, bloating, and heartburn.
-Pulmonary stage of infection may provoke pulmonary inflammation (eosinophilia).
-Abrogation of immune defenses can result in hyperinfection.
-increased numbers of filariform larvae leave the intestine resulting in a worsening of intestinal (diarrhea) as well as pulmonary symptoms.
-hyperinfection can develop into disseminated infection, resulting in the migration of larvae not only to the lungs and GI tract, but also the CNS, peritoneum, liver and kidney.
-Disseminated strongyloidiasis is most frequently observed in individuals undergoing immunosuppressive therapy (glucocorticoides).

59
Q

Strongyloidiasis-Strongyloides stercoralis - diagnosis and COntrol/Prevention

A
  • Diagnosis- detection of larvae in stool.

- Control / Prevention: Sanitation and Hygiene; Wear shoes

Micro 5 (5 decks)

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