Sketchy: Super Worms

Question 1

Cue:

• “No dumping, drains to the river” sign

Answer 1

• tx for Strongyloides stercoralis = IVERmectin
• river = iver

Question 2

Cue:

• small, round rocks around the round hole in the wall with mice eating nearby

Answer 2

• rocks = eggs
• round hole = anus
• mice eating = fecal-oral route of transmission

Question 3

Cue:

• long, thin, translucent cape on Vermin lady

Answer 3

dx of Enterobius vermicularis aka pinworm = scotch-tape on anus to visualize eggs on microscopy

Question 4

At night, Enterobius vermicularis aka pin worm females migrate to the _____ to lay their eggs.

Answer 4

anus

Question 5

If a pt is immunocompromised, the inflammation from a Strongyloides stercoralis infection can lead to ____ and _____.

Answer 5

hyperinfection and dissemination of the worms

Question 6

Cue:

• kid dressed in pink firing a slingshot and granules everywhere

Answer 6

eosinophilia (slingshot = bi-lobed nuclei)

Question 7

How is Trichinella spiralis acquired?

Answer 7

ingesting cysts from undercooked pork or bear meat

Question 8

What is the tx for Ascaris lumbricoides?

Answer 8

Albendazole

Question 9

What is the tx for hookworms?

Answer 9

• alBENDazole
• pyrantel PAMoate

Question 10

What are the SEs/CIs for Albendazole?

Answer 10

• SE = obstruction from worms
• CI in pregnant women

Question 11

How are hookworms diagnosed?

Answer 11

eggs in the stool

Question 12

Cue:

• arrow on American superhero dude’s chest

Answer 12

pathogenesis: enters soles of feet –> bloodstream –> lungs –> coughed up –> swallowed –> small intestine –> adulthood

Question 13

Cue:

• American Man grenades in a puddle of water

Answer 13

diagnose hookworms by visualizing eggs in the stool

Question 14

What worm can cause an intestinal obstruction? At which location is most common?

Answer 14

• Ascaris lumbricoides
• the ileocecal valve

Question 15

How does Albendazole work?

Answer 15

it causes microtubule dysfunction –> immobilizes the worms

Question 16

Cue:

• red pipes on a striped wall with cysts causing an explosion

Answer 16

• red stripes = bloodstream
• striped wall = striated muscle
• cysts = Trichinella spiralis cysts in the muscle
• explosion = inflammation

Question 17

Cue:

• Strong Guy superhero wearing red boots with arrow on chest

Answer 17

• Strongyloides stercoralis
• boots = larvae enter thru bare feet
• arrow = feet –> blood stream –> lungs –> coughed up –> swallowed –> GI tract infection

Question 18

Cue:

• American superhero dude with ankle, neck, and arm rings wearing red boots swinging from a hook

Answer 18

• Neck and American = Necator americanus
• ankle = Ancyclostoma duodenale
• red boots = hookworm larvae penetrate skin of soles of feet
• hook = hookworm

Question 19

What is the tx for Trichinella spiralis?

Answer 19

Albendazole

Question 20

Cue:

• Porky Trickster wearing a spiral suit and large red glasses

Answer 20

• spirals = Trichinella spiralis
• pork meat
• red glasses = periorbital edema

Question 21

Cue:

• bent metal bars on side of the tunnel

Answer 21

albendazole = tx for Enterobius vermicularis aka pinworm

Question 22

Cue:

• PAM!

Answer 22

Pyrantel pamoate = tx for Enterobius vermicularis aka pinworm

Question 23

What are Necator americanus and Ancyclostoma duodenale, and where are they found?

Answer 23

• hookworms
• rural, southern US

Question 24

How is Strongyloides stercoralis diagnosed?

Answer 24

LARVAE (not eggs) in the stool

Question 25

How is Ascaris lumbricoides diagnosed?

Answer 25

eggs in the stool

Question 26

Cue:

• Vermin Lady crawling out of a round hole

Answer 26

• vermin lady = Enterobius vermicularis aka pin worm
• round hole = anus

Question 27

Which worm can auto-infect its host?

Answer 27

Strongyloides stercoralis

Question 28

What is the tx for Strongyloides stercoralis?

Answer 28

• alBENDazole
• ivermectin

Question 29

What is the tx for Enterobius vermicularis aka pinworm?

Answer 29

Pyrantel pamote or albendazole

Question 30

Cue:

• an iron hanging from the hook shot

Answer 30

hookworms can cause iron deficiency anemia (microcytic, hypochromic)