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Parasitology > Trematode Laboratory > Flashcards

Trematode Laboratory Flashcards

1
Q

Order of Trematodes

A

Digenea

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2
Q

Characteristics of Trematodes

A

All are flat and leaf like except Schistosomes
All are hermaphrodites except Schistosomes
All eggs are operculated except Schistosomes
All require 2 IH except Schistosomes

All have well developed reproductive organs

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3
Q

Phylum of Trematodes

A

Phylum Platyhelminthes

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4
Q

Adult flukes are usually __.

A

unsegmented

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5
Q

Adult worm lay eggs within the __.

A

vertebrate host

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6
Q

This is the larva that develops within the eggs of adult worms and swim away after hatching.

A

miracidium

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7
Q

Every species of trematode requires this intermediate host for development.

A

mollusk/ molluscan intermediate host

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8
Q

The larva that develops from the intermediate host of trematodes.

A

cercaria

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9
Q

The forms found in the second intermediate host or encysted on vegetation are known as __.

A

metacercaria

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10
Q

MOT of trematodes

A

Oral or Ingestion except Schistosomes

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11
Q

IS of Trematodes

A

metacercaria except Schistosomes

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12
Q

Alimentary Canal of trematodes is __.

A

Incomplete

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13
Q

All trematodes possess 2 suckers except __.

A

Heterophys heterophyes

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14
Q

Liver Flukes

A

Fasciola spp. (Fasciola hepatica, Fasciola gigantica)
Clonorchis sinensis
Opisthorchis spp.
Dicrocoelium dendriticum

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15
Q

CN of Fasciola Hepatica

A

Sheep liver fluke

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16
Q

CN of Fasciola Hepatica

A

Sheep liver fluke

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17
Q

1st IH of Fasciola Hepatica

A

Lymnaea truncatula (Europe and North Asia)
L. bulmoides (North America)
L. tomentosa (Australia)
Planorbidae (Sporadic)

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18
Q

CN of Fasciola gigantica

A

Tropical Liver Fluke, Giant Liver Fluke

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19
Q

1st IH of Fasciola gigantica

A

L. auricularia (Asia)
L. acuminata (Indian Subcontinent)
L. natalensis (Africa)

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20
Q

1st IH of Fasciola spp.

A

snail hosts in the PH:
L. philippinensis
L. auricularia rubiginosa

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21
Q

2nd IH of Fasciola spp.

A

water plants:
Ipomea obscura (morning glory or kangkong) Nasturtium officinale (watercress)

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22
Q

CN of Clonorchis sinensis

A

Chinese liver fluke
Oriental liver fluke

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23
Q

1st IH of Clonorchis sinensis

A

Parafossarulus (P. manchouricus, P. anomalospiralis, and P. stratulus)
Bulinus (B. striatulus)
Semisulcospira
Alocinma (A. longicornis)
Thiara (T. granifera)
Melanoides (M. tuberculatus)

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24
Q

2nd IH of C. sinensis

A

Ctenopharyngodon idellus (freshwater or Cyprinidae fish)
freshwater shrimp

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25
Q

CN of Opisthorchis felineus

A

Cat liver flukes, Siberian liver fluke

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26
Q

CN of Opisthorchis viverrini

A

Southeast Asian liver fluke

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27
Q

1st IH of Opisthorchis spp.

A

Bithynia

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28
Q

2nd IH of Opisthorchis spp.

A

Cyprinidae
Cobitidae

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29
Q

Dicrocoelium dendriticum is also known as?

A

Fasciola dendriticium or Fasciol lanceolata

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30
Q

CN of Dicrocoelium dendriticum

A

Lanceolate fluke or Lancet fluke

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31
Q

1st IH of D. dendriticum

A

Cionella lubrica

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32
Q

Accumulated cercaria of D. dendriticum are excreted in the form of __ by the 1st IH

A

slime ball

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33
Q

2nd IH of D. dendriticum

A

Formica fusca (ants)

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34
Q

Pancreatic flukes

A

Eurytrema pancreaticum

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35
Q

1st IH of E. pancreaticum

A

Macrochlamys indica

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36
Q

2nd IH of E. pancreaticum

A

Technomyrmex deterquens (ant)
Grasshoppers

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37
Q

Intestinal Flukes

A

Fasciolopsis buski
Echinostoma ilocanum
Heterophyes heterophyes

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38
Q

CN of F. buski

A

Large or Giant Intestinal Fluke

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39
Q

1st IH of F. buski

A

Segmentina coenosus
Hippeutis cantori

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40
Q

2nd IH of F. buski

A

Trapa bicornis (water caltrop)
Eliocharis tuberosa (water chestnut)
Ipomea obscura (morning glory or kangkong) Nymphaea lotus (lotus)

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41
Q

CN of Echinostoma ilocanum

A

Garrison’s Fluke

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42
Q

1st IH of E. ilocanum

A

Gyraulus convexiusculus
Hippeutis umbilicalis

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43
Q

2nd IH of E. ilocanum

A

Pila luzonica (kuhol)
Vivipara angularis (susong pampang)

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44
Q

CN of Heterophyes heterophyes

A

Von Siebold’s Fluke

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45
Q

1st IH of H. heterophyes

A

Brackish water or marine species snails
Pironella

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46
Q

2nd IH of H. heterophyes

A

Brackish and salt water fish
tilapia
Mugil cephalus (mullet)

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47
Q

Lung Fluke

A

Paragonimus westermani

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48
Q

CN of Paragonimus westermani

A

Oriental or Chinese Lung Fluke

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49
Q

1st IH of P. westermani

A

Antemelania asperata (Brotia asperata)
Antemelania dactylus

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50
Q

2nd IH of P. westermani

A

Sundathelphusa philippina (Parathelphusa grapsoides); mountain crab or talangka)

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51
Q

Blood flukes

A

Schistosomes

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52
Q

Schistosomes that concentrates around the portal vein of the small intestine that causes hepato-intestinal schistosomiasis

A

Schistosoma japonicum

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53
Q

Schistosome that is concentrated in the mesenteric vessels of the lower intestine

A

Schistosoma mansoni

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54
Q

Schistosome that is most concentration around the urinary bladder

A

Schistosoma haematobium

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55
Q

CN of S. japonicum

A

Oriental Blood Fluke

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56
Q

CN of S. mansoni

A

Manson’s Blood Fluke

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57
Q

CN of S. haematobium

A

Vesical Blood Fluke

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58
Q

Habitat of S. japonicum

A

Superior mesenteric vein of the small intestines

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59
Q

Habitat of S. mansoni

A

Inferior mesenteric vein of the colon

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60
Q

Habitat of S. haematobium

A

Vesical, Prostatic, Uterine Plexuses of the Venous Circulation

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61
Q

Habitat of S. haematobium

A

Vesical, Prostatic, Uterine Plexuses of the Venous Circulation

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62
Q

IH of S. japonicum

A

Oncomelania hupensis quadrasi

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63
Q

IH of S. mansoni

A

Biomphalaria (Biomphalaria glabrata)

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64
Q

IH of S. mansoni

A

Biomphalaria (Biomphalaria glabrata)

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65
Q

IH of S. haematobium

A

Bulinus (Bulinus truncatus)

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66
Q

Largest adult stages among schistosomes

A

Schistosoma japonicum

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67
Q

Smallest adult stages among schistosomes

A

Schistosoma mansoni

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68
Q

Egg production of S. japonicum

A

3,000 eggs per worm pair per day (greatest)

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69
Q

Egg production of S. mansoni

A

190-300 eggs/day

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70
Q

Egg production of S. haematobium

A

30 eggs/day (lowest)

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71
Q

Integumentary tuberculation of S. japonicum

A

none

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72
Q

Integumentary tuberculation of S. mansoni

A

prominent

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73
Q

Integumentary tuberculation of S. haematobium

A

fine

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74
Q

Number of Testes of S. japonicum

A

6-8

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75
Q

Number of testes of S. mansoni

A

8-9

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76
Q

Number of testes of S. haematobium

A

4-5

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77
Q

Eggs of S. japonicum

A

Oval with recurved hook or knob
Small lateral spine

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78
Q

Smallest egg among Schistosomes

A

S. japonicum

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79
Q

Eggs of S. mansoni

A

Elliptical with lateral spine

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80
Q

Eggs of S. haematobium

A

Elliptical with terminal spine

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81
Q

Reservoir Host of S. japonicum

A

Humans and other mammals (dogs, pigs, cats, carabaos, rodents, monkeys)

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82
Q

Reservoir hosts of S. mansoni

A

Humans, non-human primates

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83
Q

Reservoir hosts of S. haematobium

A

Humans

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84
Q

Disease distribution of S. japonicum

A

China, Indonesia, Japan, PH

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85
Q

Disease distribution of S. mansoni

A

Africa, Madagascar, West Indies, Suriname, Brazil, Venezuela

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86
Q

Disease distribution of S. mansoni

A

Africa, Madagascar, West Indies, Suriname, Brazil, Venezuela

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87
Q

Disease distribution of S. haematobium

A

Africa, Middle East, India, Portugal

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88
Q

Final host of Fasciola spp.

A

Sheep, Cattle, and Other Herbivores

Humans infected occasionally

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89
Q

Reservoir hosts of Fasciola spp.

A

Hares and rabbits

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90
Q

DS of Fasciola spp.

A

Unembryonated egg

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91
Q

MOT of Fasciola spp.

A

Ingestion of undercooked or raw aquatic plants containing the metacercaria

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92
Q

Habitat of Fasciola spp.

A

Biliary passages of liver

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93
Q

A conical projection present at the anterior end of Fasciola adult is known as the __ unique to this parasite.

A

cephalic cone

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94
Q

Intestinal ceca of Fasciola spp.

A

highly branched

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95
Q

Egg of Fasciola spp is described as

A

hen-egg shaped

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96
Q

T or F. Fasciola eggs are indistinguishable, thus they are reported as Fasciola egg.

A

True

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97
Q

Acute stage of Fascioliasis

A

Triad of high fever, hepatomegaly, and marked eosinophilia
Liver Rot
Jaundice

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98
Q

Chronic stage of Fascioliasis

A

Fibrosis
Cirrhosis

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99
Q

What stage of pathogenesis is larval migration and worm maturation?

100
Q

What stage of pathogenesis is the persistence of adults in the biliary ducts?

101
Q

temporary lodgment of the Fasciola adult in the pharynx (ingestion of raw liver)

A

Halzoun or Marrara

102
Q

spurious infection resulting from ingestion of cooked livers containing eggs of Fasciola spp.

A

Pseudo fascioliasis

103
Q

Diagnosis of Fasciola spp.

A

Egg (from stool): FECT, Kato-katz

Serology: ELISA, Western Blot, CIEP

Molecular methods: : RFLPs (Restriction Fragment Length Polymorphism), DNA probe

Radiography: CT scan, Hepatic sonography, Endoscopic retrograde cholangiopancreatography (ERCP)

Laparotomy

104
Q

DOC of Fasciola spp.

A

Dichlorophenol (Bithionol)
Triclabendazole

105
Q

Characteristics of Fasciola hepatica adult

A

Cephalic cone “bay leaf” and prominent shoulders

106
Q

Testes of F. hepatica adult

A

highly branched

107
Q

Ovary of F. hepatica adult

108
Q

Uterus of F. hepatica adult

A

coiled and short

109
Q

Characteristics of Fasciola hepatica egg

A

Operculated
Immature
Contains large mass of vitelline cells

110
Q

Characteristics of Fasciola gigantica adult

A

slender
shorter cephalic cone and less developed shoulders

111
Q

Testes of F. gigantica

112
Q

Ovary of F. gigantica

A

branches longer and more numerous

113
Q

Characteristics of F. gigantica egg

A

same as F. hepatica egg but bigger

114
Q

Most important liver fluke of man

A

Clonorchis sinensis

115
Q

Final Host of C. sinensis

A

Humans and other vertebrates

116
Q

Reservoir Host of C. sinensis

A

dogs and other fish-eating canines

117
Q

DS of C. sinensis

A

Embryonated egg

118
Q

MOT of C. sinensis

A

Ingestion of raw or undercooked fish containing the metacercaria

119
Q

Habitat of C. sinensis

A

Bile ducts and bile passages, pancreatic duct, gallbladder, liver

120
Q

Characteristics of C. sinensis adult

A

attenuated anteriorly
spatulate in appearance
leaf-like shape with transparent tegument
feed on tissue, fluids, RBCs, and mucus
rounded posterior, tapering anterior

121
Q

It has the largest oral sucker among other flukes

A

Clonorchis sinensis adult

122
Q

Testes of C. sinensis adult

A

2 deeply branched and in tandem

123
Q

Ovary of C. sinensis adult

124
Q

Intestinal ceca of C. sinensis

A

simple and unbranched

125
Q

Vitellaria of C. sinensis

A

found in the middle third of the body (at the level of the uterus)

126
Q

Characteristics of C. sinensis egg

A

Operculated with opercular shoulder
Comma-shaped abopercular protuberance
Mature or embryonated

127
Q

Shape of C. sinensis

A

Pitcher-like shape
Old-fashioned bulb

128
Q

Acute stage of Clonorchiasis

A

fever and chills, fatigue, weight loss, liver enlargement, jaundice, eosinophilia

129
Q

Chronic stage of Clonorchiasis

A

periductal fibrosis
cirrhosis
portal hypertension
perforation of gallbladder

130
Q

Bile duct carcinoma due to C. sinensis

A

Cholangiocarcinoma

131
Q

Phases of Clonorchiasis

A
  1. Desquamation of epithelial cells
  2. Hyperplasia and desquamation of epithelial cells
  3. Hyperplasia, desquamation of epithelial cells, and adenomatous tissue formation
  4. Marked proliferation of periductal connective tissue (with scattered abortive acini of epithelial cells and fibrosis of wall of biliary duct)
132
Q

Diagnosis of C. sinensis

A

Stool examination: FECT, Kato-katz
Serodiagnosis: CFT, IHA, ELISA, EIA, coproovoscopy
Molecular methods: PCR
Duodenal aspirate
Liver biopsy
Entero-test
Cholangiography

133
Q

It is use to stain the eggs of C. sinensis

A

Potassium permanganate

134
Q

It is used when processing more amount of stool for C. sinensis

A

Stoll’s Dilution

135
Q

Radiological features of biliary clonorchiasis

A

Saccular dilatations of intrahepatic bile ducts
Rapid ductal tapering toward periphery
Arrowhead sign

136
Q

DOC of C. sinensis

A

Praziquantel

137
Q

Final host of Opisthorchis spp.

A

Humans and other vertebrates

138
Q

Reservoir host of Opisthorchis spp.

A

cats, dogs, pigs, other mammals (fish eating animals)

139
Q

DS of Opisthorchis spp.

A

Embryonated egg

140
Q

MOT of Opisthorchis spp.

A

Ingestion of raw or undercooked fish containing the metacercaria

141
Q

Habitat of Opisthorchis spp.

A

Bile ducts and bile passages, pancreatic duct, gallbladder, liver

142
Q

Characteristics of Opisthorchis spp.

A

Elongate and spatulate
Ventral sucker bigger than oral sucker

143
Q

Intestinal ceca of Opisthorchis spp.

144
Q

Testes of Opisthorchis spp.

A

deeply branched and in tandem

145
Q

Characteristics of O. felineus adult

A

reddish brown
paired
lobate testes arranged obliquely in tandem (with an angle)
lobed ovaries

146
Q

Characteristics of O. viverrini adult

A

deeply lobulated ovaries and testes (in tandem)

147
Q

Characteristics of O. viverrini egg

A

distinct melon-like ridges

148
Q

DOC of Opisthorchis spp.

A

Praziquantel

149
Q

Final host of D. dendriticum

A

Herbivores (ruminants), cows, sheep, and cattle

150
Q

Accidental host of D. dendriticum

151
Q

DS of D. dentriticum

A

Embryonated egg

152
Q

MOT of D. dendriticum

A

Ingestion of ants containing metacercaria

153
Q

Habitat of D. dendriticum

A

Bile duct, Liver

154
Q

Characteristic of D. dendriticum adult

A

Blade like, lancet like
Aspinous (no spines on tegument)
Ventral sucker bigger than oral sucker

155
Q

Characteristics of D. dendriticum egg

A

dark brown
operculated
Embryonated
thick shell

156
Q

Testes of D. dendriticum

A

located in anterior ⅓

157
Q

Pathogenesis of D. dendriticum

A

usually asymptomatic

heavy infections: enlargement of bile ducts and hyperplasia of epithelium, may lead to cirrhosis

158
Q

DOC of D. dendriticum

A

Praziquantel

159
Q

Final host of Eurytrema pancreaticum

A

Hogs, sheep, goat, cattle, and water buffaloes

160
Q

MOT of E. pancreaticum

A

Biliary ducts and Pancreatic ducts

161
Q

Characteristics of E. pancreaticum adult

A

Oral sucker bigger than ventral sucker
Ruffled border or body margin

162
Q

Testes of E. pancreaticum adult

A

2 notched testes

163
Q

Ovary of E. pancreaticum

A

1 notched ovary

164
Q

Characteristics of E. pancreaticum egg

A

Distinct operculum
Golden brown
Similar to lancet fluke
Embryonated

165
Q

Pathogenesis of E. pancreaticum

A

Eurytremiasis
Destruction of pancreas: cause Type I Diabetes Mellitus
Chronic granulomatous pancreatitis
Enlargement of pancreas

166
Q

DOC of E. pancreaticum

A

Praziquantel

167
Q

Final host of Echinostoma ilocanum

168
Q

Reservoir hosts of E. ilocanum

A

dogs, cats, pigs, rats (important reservoir hosts)

169
Q

DS of E. ilocanum

A

Unembryonated egg

170
Q

MOT of E. ilocanum

A

Ingestion of metacercariae encysted in snails

171
Q

Habitat of E. ilocanum

A

small intestine

172
Q

Characteristic of E. ilocanum adult

A

reddish gray
tapers at the posterior end
tegument is covered with plaque-like scales
anterior end is equipped with circumoral disk (49-51 collar spines)

173
Q

Structure the surrounds the oral sucker of E. ilocanum. This aids in the attachment and is attributed to bloody diarrhea

A

circumoral disk

174
Q

Testes of E. ilocanum adult

A

deeply bilobed and in tandem

175
Q

Intestinal ceca of E. ilocanum

A

simple and unbranched

176
Q

Characteristic of E. ilocanum egg

A

Light brown
Less prominent operculum (dot-like appearance)
thin-shelled
small minute operculum
similar to Fasciola egg

177
Q

Germ ball egg

A

Echinostoma ilocanum egg

178
Q

Pathogenesis of E. ilocanum

A

Echinostomiasis
Inflammation at site of attachment
Heaver infections: bloody diarrhea and abdominal pain
Intoxication: metabolites (causes poisoning)

179
Q

Pathogenesis of E. ilocanum

A

Echinostomiasis
Inflammation at site of attachment
Heaver infections: bloody diarrhea and abdominal pain
Intoxication: metabolites (causes poisoning)

180
Q

Only trematode whose 1st and 2nd IH are both snails

A

Echinostoma ilocanum

181
Q

DOC of E. ilocanum

A

Praziquantel

182
Q

Final host of H. heterophyes

A

Humans, birds, various fish-eating mammals

183
Q

Smallest fluke

A

Heterophyes heterophyes

184
Q

DS of H. heterophyes

A

Unembryonated egg

185
Q

MOT of H. heterophyes

A

Ingestion of metacercariae encysted in fish

186
Q

Habitat of H. heterophyes

A

small intestine

187
Q

Characteristic of H. heterophyes adult

A

pyriform (pear-shaped)
Tegument: fine scale like spines
Third sucker (gonotyl)
Fine vitelline follicles situated throughout lateral margin

188
Q

Testes of H. heterophyes

A

varied arrangement depending on species

189
Q

Ovary of H. heterophyes

A

Globular or lobed

190
Q

Characteristics of H. heterophyes egg

A

Light brown
Embryonated
No abopercular protuberance
Similar to Metagonium yokogawai, Clonorochis and Opisthorchis

191
Q

Pathogenesis of H. heterophyes

A

colicky pain and mild diarrhea
peptic ulcer diseases and acid peptide disease
formation of granulomas
deposition of eggs in vital organs (heart, brain, spinal cord)
!diagnosis most of the time after death!

192
Q

Diagnosis of H. heterophyes

A

Egg: FECT, Kato-katz
Adult: Autopsy, Cardiac heterophyiasis (mistaken as Cardiac Beri-beri)

193
Q

DOC of H. heterophyes

A

Praziquantel

194
Q

Final host of P. westermani

A

Humans and other mammals (can serve as DH and RH)

195
Q

DS of P. westermani

A

Unembryonated egg

196
Q

MOT of. P. westermani

A

Ingestion of uncooked or undercooked crabs with metacercaria

197
Q

Habitat of P. westermani

A

Lungs (encysted in lung tissue)

198
Q

Characteristics of P. westermani adult

A

Reddish brown, coffee bean shaped
Rounded anteriorly and slightly tapered posteriorly
Found in pairs or threes in fibrotic capsules of the lung
Firmly attached to the lung tissue
Presence of spines on tegument (covering)

199
Q

Intestinal ceca of P. westermani

A

wavy, branching

200
Q

Testes of P. westermani

A

2 deeply lobed (oblique)
arranged in opposite
important characteristic for parasite identification

201
Q

ovary of P. westermani

A

anterior to testes and posterior to ventral sucker
has six long unbranched lobes
lobary

202
Q

Uterus of P. westermani

203
Q

Characteristics of P. westermani egg

A

golden brown
operculated
thick-shelled
wide, flattened but prominent operculum
abopercular thickening
Unembryonated

204
Q

Pathogenesis of P. westermani

A

Lung Fluke Disease
Pulmonary Distomiasis
Endemic Hemoptysis or Parasitic Hemoptysis Paragonimiasis (signs and symptoms mistaken for TB)
Elevated eosinophils and IgE

205
Q

Early stages of P. westermani

A

asymptomatic

206
Q

Heavy infection of P. westermani

A

dry cough/chronic cough
blood stained or rust colored sputum (fishy odor)

207
Q

P. westermani can go to heart and brain (brain: meningitis, seizures)

A

Erratic Pargonimiasis

208
Q

Pathogenesis of P. westermani: slow-moving, nodular lesion in subcutaneous tissue on abdomen or chest is seen

A

Cutaneous paragonimiasis

209
Q

Pathogenesis of P. westermani: migrate from pleural cavity to cranial cavity through the jugular vein, can cause congestion, vasculitis, capillary rupture, infarction, hemorrhage, and necrosis

A

Cerebral paragonimiasis

210
Q

Adult worms of P. westermani provoke a __ reaction (leading to formation of __)

A

granulomatous; fibrotic encapsulation

211
Q

Chronic stage of P. westermani

A

chronic bronchiectasis and pleural fibrosis

212
Q

This is secreted by P. westermani for the development of young parasites (excystment, tissue invasion, and immune modulation of the host)

A

cysteine proteases

213
Q

Diagnosis of P. westermani

A

Sputum concentration with 3% sodium hydroxide

Chest radiographs

Multi-dot ELISA

Peripheral blood count

Serology and Immunology: CF test, intradermal test, double diffusion in agarose gel, and immunoelectrophoresis, IB, ELISA, complement fixation* (high sentivity)

LAMP (Loop-mediated Isothermal Amplification) test

CT scan, MRI (grape-cluster appearance, conglomerated, ring-enhancing lesions)

Lung biopsy

214
Q

Preferred specimen for P. westermani

215
Q

What is added to sputum for P. westermani detection?

A

mucolytic agent (3% NaOH)

216
Q

Stool can be examined for P. westermani detection if

A

patients swallows sputum

217
Q

DOC of P. westermani

A

Praziquantel

218
Q

Alternative drug for P. westermani

219
Q

Final host of Schistosome

220
Q

IS of Schistosomes

A

fork-tailed cercaria

221
Q

DS of Schistosomes

A

embryonated

222
Q

MOT of Schistosomes

A

Skin penetration

223
Q

Male of Schistosomes

A

testes arranged in one row above ventral sucker

224
Q

Female of Schistosomes

A

single pyramidal ovary located in midline

225
Q

Characteristics of Schistosome adult

A

Ingest RBCs
Possess a protease (hemoglobinase) that breaks down globulin and hemoglobin

226
Q

Proteast that breaks down globulin and hemoglobin in Schistosome spp.

A

Hemoglobinase

227
Q

Characteristic of Schistosome egg

A

Immature eggs passed in feces no longer mature in soil
Mature eggs in feces can survive and hatch up to a week if desiccation is slow

228
Q

Main pathology of Schistosomes is attributed to what stage?

229
Q

Pathogenesis of S. japonicum

A

Oriental Schistosomiasis, Snail Fever, Schistosomiasis japonica

230
Q

Pulmonary Schistosomiasis

A

transient period
Cor pulmonale (dyspnea, cough, hemoptysis)
abnormal enlargement of right side of heart

231
Q

Initial Phase of S. japonicum pathogenesis

A

Schistosome Cercarial Dermatitis
Petechial hemorrhages
Localized edema and pruritus

232
Q

Acute Phase of S. japonicum pathogenesis

A

Katayama Syndrome
mesenteric veins
dysentery
hepatomegaly
lymphadenopathy
fever
muscle pain
fulminating meningoencephalitis
overlapping with intestinal phases

233
Q

Intestinal Phase of S. japonicum pathogenesis

A

mucosal inflammation
hyperplasia
ulceration microabscess
blood loss
colonic involvement (ulcerations cause dysentery or diarrhea)

234
Q

Chronic infection of S. japonicum pathogenesis

A

accumulation of eggs in the portal triads (form granulomas, causes portal hypertension and hepatosplenomegaly)

!Summer’s Pipe Stem Fibrosis / Fibro-obstructive Hepatic Schistosomiasis (pathognomonic for Schistosomiasis)!

Esophageal Varices, Massive Ascites

235
Q

motor or sensory disturbances due to S. japonicum

A

Cerebral schistosomiasis

236
Q

Pathogenesis of S. mansoni

A

Intestinal Bilharziasis

Cercarial Dermatitis

Acute Schistosomiasis = Katayama like fever

Association with kidneys: Hepatosplenic Schistosomiasis (similar to S. japonicum)

Nephrotic syndrome (affects glomerulus)

Pulmonary involvement (Cor pulmonale)

Spinal cord schistosomiasis

237
Q

Pathogenesis of S. haematobium

A

Urinary Bilharziasis, Egyptian Hematuria

Light infections usually asymptomatic
Early signs and symptoms: dysuria and hematuria

Vesical mucosa: yellow sandy patches

Granuloma formation leading to fibrosis and ulceration, pseudoabscess in the bladder

Pulmonary involvement (Cor pulmonale)

Link with bladder carcinoma (squamous cell)

Nephrotic Syndrome

238
Q

When is S. haematobium best collected?

A

Best to collect urine from 12 pm to 3 pm (highest recovery)

Nucleopore Filtration Technique, Centrifugation

239
Q

Positive for Modified Acid-Fast Staining (schistosome)

A

S. japonicum and S. mansoni

240
Q

Negative for Modified Acid-Fast Staining (schistosome)

A

S. haematobium

241
Q

Diagnosis of Schistosomes

A

Rectal snips and imprints (most sensitive and invasive)

Rectal or Liver Biopsy

Immunodiagnosis/Serologic tests:
Intradermal tests (Fairley’s Test, Wheal and Flare Reaction)
Indirect hemagglutination
ELISA
Detection of Antigens (circulating cathodic antigen (CCA), circulating anodic antigen (CAA), soluble egg antigen (SEA))
COPT (Circumoval Precipitin Test)

242
Q

Positive result for COPT

A

formation of bleb or septate precipitate

243
Q

Sample for COPT

244
Q

reagent for COPT

A

Lyophilized schistosome egg (antigen)

245
Q

DOC for Schistosomes

A

Praziquantel

246
Q

Alternative drug for S. haematobium

A

Metrifonate

247
Q

Drugs that can be used for S. mansoni

A

Oxamniquine

Parasitology (3 decks)

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