STH 1 Flashcards by Iseoluwa Ojo

Major STH (_______)

List them

Soul transmitted helminthiasis

ascariasis, trichuriasis & hookworm

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Major STH

• account for a (minor or major?) burden of diseases globally

• top amongst _______________ diseases in _____-age populations of ______ countries

Major

all communicable &non-communicable

school

developing

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Major STH

______ yr at highest risk or most prone to increased morbidity due to poor _________ , frequent ________, and ____-risk behaviour

• >_______ infection with ≥ ___ species

Less than or equal to 14

personal hygiene

outdoor exposure

high

1.5 billion
1

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• Most common human intestinal helminthiasis is _________

ASCARIASIS

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ASCARIASIS

> Commonest in ______/_______

•____,_____climes with poor sanitation

• In the temperate areas: during _____
months

tropics/subtropics

warm, humid

warm

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Risk factors for ascariasis:

_____________ -eating (in Kenya);___phagy

Termite mound

Geo

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The Largest human intestinal nematode
Is ??

Ascaris

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Which Ascaris is bigger

Male or female

Female

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Ascaris

≥ ___________ eggs/female /d >- faeces

200,000

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Ascaris

In _____: fertile eggs embryonate and become infective in _________

Human inf

_______ of infective eggs. Hatched larvae goes to the _________ then heads to the ____________ to reach the _____ where it moults for ______ days before it continues to the ______ and reach bronchial tree then the _______ and back to the ________\

soil; days to wks.

ingestion

intestinal mucosa

portal/syst. circulation

Lungs ; 10-14; alveolar walls

throat

Small intestine

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Pathology/Clinical features of ascaris

> Light infection is often _________; abdominal discomfort

> Pulmonary ______ migration leads to
eosinophilic pneumonitis/Loeffler’s syndrome that is characterized by (___,_____,______)

asymptomatic

larval

Cough, dyspneoa , hemoptysis

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Pathology/Clinical features of ascaris

Migrating adults (female):
• symptomatic occlusion of _________;
• ______ abscesses
• ______itis or _____itis
• acute upper abdominal pain
• _____ ———-

biliary tract

liver

cholang; pancreat

expulsion

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Intestinal phase of Ascaris

•generally (asymptomatic or symptomatic?)

•heavy infection is ________ and can lead to

Physiological abnormalities in small intestine:
•________ of nutrients
•nutritional _______
•_________ failure/________ especially in children
•adverse impairment of _________ in children

asymptomatic

Greater or equal to 20 worms

malabsorption; deficiency

Growth ; stunting

cognitive development

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Diagnosis of Ascaris

> Microscopy (stool);eggs:

•_______/_________
•(thin or thick?) -shelled

•fertile: (_____/_____)
•unfertile: (_______/_______)
• concentration procedure recommended in (light or heavy?) infection

brown/yellow-brown

Thick

round/ovoid

elongate/irregular

Light

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Death from Ascariasis is mainly in (children or adults?)

≥ 10,500 deathst/yr. mainly in children

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Serious complications of Ascariasis

intestinal ________

__________ pain, vomiting

________ obstruction, or ________ diseases

_______itis; _______itis

occasionally: _______

obstruction

gastrointestinal

biliary tract; pancreatic

appendic; periton

intussusception

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Diagnosis of ascariasis

Pulmonary migratory phase: (larvae or adult ?) in _____,_______

Larvae

sputum, gastric aspirate

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Diagnosis of ascariasis

Adult worms:

passed occasionally in _____, through
_____, or ______
•____________________________ (ERCP)

stool

Mouth

Nose

Endoscopic retrograde cholangiopancreatography

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Visceral Larva Migrans (VLM)

> Caused by ____ of _______ roundworms (Toxocara cati & T. canis) migrating through human tissues

> Result of ________ response

non-human

an inflammatory

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VLM

• Characterised by: p e r s i s t e n t _________; leucocytosis; fever; _______megaly; broncho____

•symptoms due to _____________

•individuals may not develop overt clinical dis.

eosinophilia

hepatospleno; spasm

migrating larvae often
unrecognised

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Hookworm infections

Aetiologic agents: 2 main human-inf. spp.:

List

Ancylostoma duodenale

Necator americanus

Hookworm infections

Some animal-infection

•invade/parasitize humans: A.________ sp.

•can cause CLM : A. ______; A. _______; Uncinaria stenocephala

ceylanicum

braziliense; caninum

Hookworm infections

A. caninum (larvae or adult?) : occasionally in human intestine and cause _______ that is implicated also, in __________________ (DUSN)
;

Larvae

eosinophilia enteritis

diffuse unilateral sub-acute neuroretinitis

Hookworms

Occurrence: worldwide & widely overlapping; inareas with ____,_____climates

warm, moist

Hookworms: Morphology & Development In lumen of ________ (mainly _____); attached to ______ •color is ________ , but freshly expectorated worms are frequently __________ •Eggs are found in _____

small intestine; jejunum; villi Greyish-white Reddish; faeces

Ancylostoma duodenale VS Necator Americanus Adult female size Adult male size Life span in years Number of eggs produced by females in one day Blood loss caused by the worm in ml in one day

Bigger ; smaller Bigger ; smaller 1; 3-5 10k-30k; 5k-10k 0.1-0.02

Hookworms ____ hatch after ____ days then becomes the infective ____ after ____ days It can survive for _______

LI I-2 L3 5-10 3-4 wk

Hookworms: Human inf •________ entry of infective ____ •_____ ingestion of larvae & _______ route (————- only)

percutaneous; L3 oral transmammary A. duodenale

Hookworms : life cycle >____ gets into the blood, then migrated to the ____ to the ____ then the ____ and the ____ to reach the ____ where it is coughed up and enters the ____

L3 heart lungs alveoli bronchial tree Pharynx s/intestine

Hookworms Most worms eliminated in ______ years, maximum of ______ years

I-2 3-5

Hookworms: Pathology/Clinical Features • Percutaneous L3 entry: intense _______ and _______ leading to pruritic ________ ———— rash ('_________')

itching & burning erythematous papulovesicular ground itch

Hookworms: Pathology/Clinical Features > Entry (L3) ›- GIT: ______ pain; non-specific Gl symptoms e.g.,______________ (no blood, no mucus)

epigastric acute watery diarrhoea

Hookworms Mild infection is generally (asymptomatic or asymptomatic?) ; Gl symptoms common, especially in °l inf. Heavy infection : (≥ _____ worms): •occurs in —————-> adults • impair ————- in schoolchildren; malnutrition

asymptomatic 80 school-aged children cognitive function

Hookworms: Complications, especially in schoolchildren: ____-deficiency _____cytic, ____chromic anemia _____proteinemia hookworm-induced blood loss: »» ____mL of blood/d

iron micro; hypo Hypo 9.0

Hookworms Diagnosis > Microscopy for eggs: ______ color oval/ellipsoidal (Thin or thick?)-shelled

Colourless thin

Treatment for CLM: _______,________

Ivermectin', Albendazole"

CUTANEOUS LARVA MIGRANS (CLM) Caused by ______ of animal-infective spp

CUTANEOUS LARVA MIGRANS (CLM) Diagnosed clinically ______ detected in stained biopsy sections frequent not recommended: Parasites usually not found in ___________

Larval visible track

STRONGYLOIDIASIS Aetiologic agents: Strongyloides (the ______worm): ≥ 2 human- inf. spp.: ___________ , ____________

thread Strongyloides stercoralis &S. fuelleborni

STRONGYLOIDIASIS Epidemiology, Risk factors & Transmission > Common in _____,______ climes &areas with poor globally sanitation • S. ___________ (cosmopolitan; more prevalent)

warm, humid stercoralis

__________ causes autoinfection

STRONGYLOIDIASIS

S. fuelleborni: zoonosis of_______________ (______ and _____ ); human inf. in Africa &SE/Asia

non-human primates baboons &chimps

Syrongyloidiasis: Morphology & Development It Parasitize the ________ > Only ____________ female •threaded in ______ sub-mucosa •found in man: release dozens of embryonated eggs/d »» ___

intestine parthenogenetic duodenal LI

Syrongyloidiasis: Complex life cycle •_____ is voided with faeces: Direct: to infective ____* Non-parasitic/free-living':-*» free-living male and female ; male and female copulate to give infective L3*

LI; L3

Syrongyloidiasis Auto-infection: in gut, ____ » _______ It can penetrate _______ (int. autoinf.) or ___________ (ext. autoinf.)

LI; L3 intestinal mucosa perianal skin

Syrongyloidiasis Life cycle L3* goes into the -_____ to the _____ then the _____ , _____, _____ and then coughed up through the _____ to enter the _____

skin heart lungs alveoli spaces bronchial tree pharynx s/intestine

Diagnosis of strongyloidiasis • Parasitological: requires _____ detection methods > Standard diagnostics: • concentration techniques (________,______) • stool culture methods (in _________) • DS: ~ stools, sputum, urine, lung fluids, duodenal fluids (_____ or _______ techniques) , organ biopsies

special Formol-ether, Baermann agar plates Enterotest string or duodenal aspiration

S. fuelleborni eggs can be found in stools T/F

Pathology/Clinical Features of strongyloidiasis •Light infection is frequently (asymptomatic or symptomatic?) Pulmonary ____ migration: » ________ especially in (acute or chronic?) infection

asymptomatic larval; Loeffler's syndrome Acute

Pathology/Clinical Features of strongyloidiasis > Autoinfection: leads to ________ infection that leads to _______ disease

persistent chronic

Pathology/Clinical Features of strongyloidiasis Chronic symptomatic: _ Chronic uncomplicated: abdominal pain; diarrhoea, nausea; weight loss;other subtle non-specifics; •Blood _______ (may be ____ in hyper infections & disseminated cases) •Larva currens: _____, linear to serpiginous, erythematous urticarial lesion, more commonly found in the _____,________,_______,_______ and ______

eosinophilia; absent pruritic trunk, buttocks, perineum, groin, & thighs

Pathology/Clinical Features of strongyloidiasis Chronic symptomatic: Severe complicated: in immunocompromised persons HS & DS leads to potentially life-threatening conditions: ______,________,________, abdominal pain & distension • Bacteraemia (sometimes polymicrobial: E. coli, K. pneumoniae, B. fragilis, P. aeruginosa, A. faecalis) •septicaemia, intestinal obstruction mortality rates:____% (HS) » _____% (DS)

pneumonia, meningitis, shock 15 87