STH 1 Flashcards
Major STH (_______)
List them
Soul transmitted helminthiasis
ascariasis, trichuriasis & hookworm
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
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
• Most common human intestinal helminthiasis is _________
ASCARIASIS
ASCARIASIS
> Commonest in ______/_______
•____,_____climes with poor sanitation
• In the temperate areas: during _____
months
tropics/subtropics
warm, humid
warm
Risk factors for ascariasis:
_____________ -eating (in Kenya);___phagy
Termite mound
Geo
The Largest human intestinal nematode
Is ??
Ascaris
Which Ascaris is bigger
Male or female
Female
Ascaris
≥ ___________ eggs/female /d >- faeces
200,000
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
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
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
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
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
Death from Ascariasis is mainly in (children or adults?)
≥ 10,500 deathst/yr. mainly in children
Serious complications of Ascariasis
intestinal ________
__________ pain, vomiting
________ obstruction, or ________ diseases
_______itis; _______itis
occasionally: _______
obstruction
gastrointestinal
biliary tract; pancreatic
appendic; periton
intussusception
Diagnosis of ascariasis
Pulmonary migratory phase: (larvae or adult ?) in _____,_______
Larvae
sputum, gastric aspirate
Diagnosis of ascariasis
Adult worms:
passed occasionally in _____, through
_____, or ______
•____________________________ (ERCP)
stool
Mouth
Nose
Endoscopic retrograde cholangiopancreatography
Visceral Larva Migrans (VLM)
> Caused by ____ of _______ roundworms (Toxocara cati & T. canis) migrating through human tissues
> Result of ________ response
L2
non-human
an inflammatory
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
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
L2
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
T
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
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