Tissue invasive nematodes II

Question 1

Threadlike, tissue-invasive roundworms transmitted by insect vectors?

Answer 1

Filariae

Question 2

Lymphatic filarial infections transmitted by mosquitos

Answer 2

Wuchereria bancrofti

Brugia malayi

Question 3

Nematode infection transmitted by Chrysops (deer) flies

Answer 3

Loa Loa (eyeworm)

Question 4

Adult worms live in tissue nodules and are transmitted by blackflies

Answer 4

Onchocerca volvulus (river blindness)

Question 5

Treatment of both lymphatic filariasis and loa loa

Answer 5

DEC

Question 6

Drugs to avoid in eye worm infections with high microfiliaria blood levels

Answer 6

DEC and Ivermectin

Question 7

Treatment for Onchocerciasis

Answer 7

Ivermectin

Question 8

Filarial infection with no known non-human reservoir

Answer 8

Wuchereria bancrofti

Question 9

Range of lymphatic filariasis

Answer 9

W. Bancrofti tropics worldwide

B. spp. Asia

Question 10

4 Clinical manifestations of Lymphatic filariasis

Answer 10

Asymptomatic microfilaremia
Lymphangitis
Lymphatic obstruction
Tropical pulmonary eosinophilia

Question 11

What is unique about filarial lymphangitis?

Answer 11

Retrograde

Question 12

What causes paroxysmal nocturnal asthma, pulmonary infiltrates, peripheral eosinophilia, elevated serum IgE, and high filarial antibody titers?

Answer 12

Tropical pulmonary eosinophilia

Question 13

When do blood levels of lymphatic microfilariae peak?

Answer 13

Midnight

coincides with mosquito biting activity

Question 14

Methods of definitively diagnosing lymphatic filariasis

Answer 14

ID microfilariae in nighttime blood
Detect circulating W. bancrofti antigen
ID adult worm by biopsy or US

Question 15

Edema and lymphatic drainage problems necessitates aggressive topical treatment in lymphatic filariasis to prevent what?

Answer 15

bacterial skin infections

Question 16

Where is onchocerciasis volvulus endemic?

Answer 16

Along rivers in equatorial Africa and central America

Question 17

Adult worms dwell in subcutaneous nodules for 10-15 years

Answer 17

Onchocercaisis volvulus

Question 18

Clinical manifestations of Onchocerciasis infection?

Answer 18

Skin-nodules, pruritis, rash, depigmentation
Eye-keratitis, chorioretinitis
Hanging groin, elephantiasis

Question 19

What are the two methods of diagnosing Onchocerciasis?

Answer 19

Serology (anti-filiarial or oncho. specific)

Parasitologic (skin snips or nodulectomy)

Question 20

What is the mechanism of action of Ivermectin?

Answer 20

paralyses worms by opening ion-gated Cl- channels

Question 21

What drugs must be used together to eradicate an Onchocerca infection?

Answer 21

Ivermectin -kills microfilariae

Doxycycline -kills Wolbachia brachtig

Question 22

Calabar swellings suggest infection with what?

Answer 22

Loa loa

Question 23

Where are adult loa worms found?

Answer 23

Subcutaneous tissue

Question 24

When should you look for microfilariae in blood to diagnose eye worm?

Answer 24

Noon

correlated to Deer fly activity

Question 25

If a patient with loa loa fails DEC what is the back up?

Answer 25

Albendazole

Question 26

What’s the most common cause of eosinophilic meningitis?

Answer 26

Angiostrongylus cantonensis

rat lungworm

Question 27

What state has the highest incidence of Angiostrongylus infections?

Answer 27

Hawaii

Question 28

Symptoms of Angiostrongylus infection?

Answer 28

Headache
Paresthesias
Stiff neck
Photophobia
rare: fever

Question 29

Findings of eosinophilia, leukocytosis, increase in muscle enzymes and IgE, and a muscle biopsy showing L1 Larvae

Answer 29

Trichinellosis

Question 30

What causes visual and ocular larva migraines in 2-5 year olds and 10-15 year olds, respectively?

Answer 30

Toxocara canis and catis

Question 31

Worm that buries into gastric mucosa causing pain and an allergic reaction?

Answer 31

Anisakis simplex