Sketchy Micro: Intestinal Nematodes

Question 1

Describe the transmission of Enterobius vermicularis.

Answer 1

E. vermicularis (represented by the vermin lady climbing on the walls), also called pinworms, climbs down to the anus and lays eggs at night. These eggs cause itching, and people might itch their butts and then put their fingers back in their mouths.

(Think of the rat lady above the egg-shaped stones near the anus-like hole. Also, the rat babies are eating crackers by the eggs to symbolize the fecal-oral route.)

Question 2

How can Enterobius vermicularis be diagnosed?

Answer 2

If you press tape on the anus in the morning, then eggs will stick to it.

(Think of the vermin lady’s tale.)

Question 3

What drug treats Enterobius infection?

Answer 3

• Pyrantel pamoate (like the superhero kicking the vermin lady with the “PAM” sign in the air)
• Albendazole, which can treat all of the intestinal nematodes (like the bent pipes on the walls)

Question 4

What hookworms are found in the southern U.S.?

Answer 4

Ancylostoma duodenale and Necator americanus (like the anklets and necklace worn by the superhero who is swinging in on a HOOK)

Question 5

How do hookworms get into the GI tract?

Answer 5

It’s insanely complicated: they infect the soles of the feet in those walking barefoot and then ascend to the lungs via the blood and then get swallowed.

(This is represented by the red boots worn by the superhero and the U-turn arrow on his chest.)

Question 6

Necator americanus and Ancylostoma duodenale can cause what hematologic sequela?

Answer 6

Iron-deficiency anemia (like the iron dangling from his hook rope)

Question 7

List two things that can help you diagnose hookworm infection.

Answer 7

• Eosinophilia (like the eo-slingshot boy with his bi-lobed slingshot and pink pebbles)
• Ova in stool (like the America Man’s grenades)

Question 8

What other organism has a life cycle similar to Ancylostoma duodenale or Necator americanus but is ingested instead of stepped on?

Answer 8

Ascaris lumbricoides (like the Lumber Man who also has the U-turn arrow on his chest but is not wearing red boots)

Question 9

A. lumbricoides causes what two unique complications?

Answer 9

• Respiratory symptoms (like the bronchial tree on the Lumber Man’s shirt)
• Blockage of the ileocecal valve (like the blocked rubble behind the Lumber Man)

Question 10

How can you diagnose A. lumbricoides?

Answer 10

• Ova in stool (like the acorns)

* Eosinophilia (pink granules by his feet)

Question 11

Strongyloides stercoralis also infects people by ____________________.

Answer 11

larvae infecting the feet (like the Strong Man’s red boots) and then passing up to the lungs (like the U-turn arrow on his chest)

Question 12

How does the life cycle of S. stercoralis differ from A. duodenale and N. americanus?

Answer 12

It does not shed ova in stool. Instead, its eggs burrow into the GI tract and then auto-infect the host by going back up to the lungs. Larvae, however, will be shed in the stool.

(Think of the larval worms in the ground by Strong Man’s feet.)

Question 13

What two drugs can treat Strongyloides stercoralis infection?

Answer 13

• Albendazole (like the bent pipes above Strong Man)

* Ivermectin (like the “no dumping / drains to rIVER” sign next to his high kick)

Question 14

_______________ is often found in undercooked pork.

Answer 14

Trichinella spiralis (like the TRICky pork villain with the spiral on his shirt)

Question 15

What are symptoms of trichinosis?

Answer 15

• Fever (pig sweating)
• Periorbital edema (red glasses on pig)
• Vomiting (green vomit coming out of pig’s mouth)
• Myalgia, because the larva travel to the striated muscle cells and form cysts (like the mines that Porky planted on the wall that looks like striated muscle)