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PARASITOLOGY > Trematodes: Blood Flukes > Flashcards

Trematodes: Blood Flukes Flashcards

1
Q

5 Species of medically important Schistosoma

A 
S. japonicum
S. mansoni
S. haematobium
S. mekongi
S. intercalatum
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2
Q

Predominant Schistosoma in the PH

A

S. japonicum

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3
Q

Common name of S. japonicum

A

Oriental blood fluke

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4
Q

Disease caused by S. japonicum

A

Schistosomiasis japonica

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5
Q

S. japonicum is endemic in?

A

China
PH
Indonesia

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6
Q

When was S. japonicum eliminated in Japan (the last case reported?)

A

1977

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7
Q

History

S. japonicum was identified in a?

A

Female corpse fom Western Han Dynasty

2000 years ago

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8
Q

The disease was first described by? When?

A

Fuji

1847

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9
Q

When was the Adult S. japonicum descibed? By who?

A

Katsurada

1904

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10
Q

First case in China

A

1905

Logan

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11
Q

First case in the PH

A

1906

Wooley

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12
Q

Intermediate host of S. japonicum

A

Snails of the species Oncomelania

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13
Q

Phenotypic variation of S japonicum strains

A 
Minor morphologic char.
Infectivity to Oncomelania snails
Periodicity of cercarial emergence
Ability to develop in diff def hosts
Growth rate
Egg prodn
Pre-patent period
Pathogenicity 
Immunogenicity
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14
Q

Compare chinese from PH strains

A
  • Injection of irradiated cercariae of the Chinese strain confers resistance to the homologous strain but not to the PH strain
  • Mouse pathogenicity of the Chinese strain is lesser than that of the PH strain
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15
Q

S. japonicum in the PH found in?

A

Mindoro, Leyte, Sorsogon, Mindanao

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16
Q

Most research in the PH of the S japonicum was focused in the?

A

Leyte strain

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17
Q

Life cycle of Schistosoma

A

Recite

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18
Q

Dx stage of Schis?

A

Embryonated egg

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19
Q

Hours it takes for the embrynated egg to hatch in a fresh water?

A

2 to 4 H

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20
Q

Embryon. egg hatches to become?

A

Miracidia

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21
Q

Free swimming cilliated stage

A

Miracidia

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22
Q

Intermediate host of S. japonicum

A

Oncomelania hupensis quadrasi

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23
Q

Miracidia inside the snail transforms into?

A

Sporocyst

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24
Q

Sporocyst transforms into?

A

Cercaria

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25
Q

Time it takes for sporocyst to become cercariae

A

60 to 70 days

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26
Q

Infective stage to the definitive host

A

Cercariae

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27
Q

Cercaria loses its tail to become?

A

Schistosomula

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28
Q

Schistosomula enters

A

Subcutaneous veins and superficial lymphatic vessels into the lungs

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29
Q

Lungs to portal vein, how?

A

Intravascularly

Pleural cavity to diaphragm to liver

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30
Q

Where does the schistosomula mature

A

Portal vein

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31
Q

Which is larger? F or M

A

F

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32
Q

Female schistosome occupies what of the male?

A

Gynecophoric canal

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33
Q

Female lays how many eggs?

A

500 to 2000 eggs/day

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34
Q

Time it takes for the immature eggs to become mature and embryonated

A

10 to 12 days

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35
Q

Time deposit eggs after the penetration

A

24th to 27th day after penetration

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36
Q

Definitive hosts of S japonicum

A

Humans, cats, dogs, pigs, cows and carabaos

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37
Q

Sylvian reservoirs of S japonicum

A

Monkeys and rodents

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38
Q

Permissive hosts of S japonicum

A

Humans, rabbits and mice

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39
Q

A large series of experimental crosses was done where and when?

A

Leyte

1954 to 1957

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40
Q

Shape of japonicum eggs

A

Ovoid, round, pear-shaped

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41
Q

Color of japonicum egg

A

Pale yellow

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42
Q

Diameter of japonicum egg

A

Longer: 46 to 110 um
Shorter: 37 to 90 um

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43
Q

Ideal temp and pH for the eggs to hatch

A

25 to 31 degrees
Slightly alkaline
Sufficient oxygen

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44
Q

Eggs will not hatch if salinity is greater than?

A

0.7%

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45
Q

Miracidia remain infective for?

A

8 to 12 H

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46
Q

How does miracidia penetrate snail Oncomelania hupensis quadrasi?

A
  • movement

- lytic action of the cephalic gland secretions

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47
Q

Describe what happens to miracidia after penetration

A

Complete penetration- loses ciliated portion

Several days- transforms into primary or mother sporocyst near the point of entry

After 96 hours- become elongated sac-filled with germinal cells

At 8th day- germ cells bud off the epithelial lining and transforms into daughter sporocyst

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48
Q

In Mindoro, how many percent of the infected Oncomelania hupensis quadrasi only shed cercariae

A

6 to 10%

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49
Q

Has a body and a forked tail

A

Cercaria

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50
Q

Size of the cercaria

A

Body: 100-500 x 40-60 um
Tail trunk: 140-150 x 20-35 um
Fork: 50- 70 um

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51
Q

What suckers does the cercaria has?

A 
Oral sucker (occupies the anterior end of the body)
Ventral sucker
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52
Q

Shedding of cercariae from the time miracidia penetration may be observed as early as?

A

42nd day

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53
Q

Average day of cercariae shedding after miracidial upon miracidial penetration?

A

62 days

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54
Q

Total number of cercariae shed in a singly infected snail?

A

230

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55
Q

Total number of cercariae shed in a multiply infected snail?

A

280

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56
Q

In average, how many cercariae is shed every day?

A

2 per day

57
Q

Oncomelania hupensis quadrasi can withstand drying for how many days?

A

7 to 10 days

58
Q

Oncomelania hupensis quadrasi is taken out from the aquaterraria for ———— before crushing

A

2-4 days

59
Q

Two factors that explains why cercariae are shed at night?

A
  1. Negative effects of exposure to sunlight

2. Oncomelania is more active and mobile at night

60
Q

After release, cercaria can survive for up to?

A

24 H

61
Q

Temp preference of japonicum

A

35 +/- 3 degrees

62
Q

Penetration of cercariae is stimulated by?

A

Skin lipids

63
Q

Chemicals that repel cercariae

A

Dimethylate and niclosamide

64
Q

Upon penetration of the cercaria, what happens next?

A

Loses tail

Cercarial tegument is replaced by 5 to 7-layered membran

65
Q

In lab, how can a cercaria be transformed into a schistosomule?

A
  1. Repeated passage thru a small bore needle syringe
  2. Passage thru isolated skin
  3. Application on a surface with skin lipids or crude egg lecithin
66
Q

Schostosomule can be found on the pleural cavity at what day?

A

2nd day of infxn

67
Q

Schistosomule can be found in the parenchyma of the diaphragm on day?

A

4th day

68
Q

On what day does schistosomule found in the liver parenchyma?

A

6th day

69
Q

Correlation b/n # of lung petechiae vs numb of schistosomes recovered

A

Lung petechiae on the 4th to 6th day: number of recovered schistosomes at day 30 from portal system by perfusion

70
Q

As compared to other flukes, Schistosoma species are?

A

Dioecious

71
Q

Suckers of adults

A

Large suckers, ventral sucker, gonophore

72
Q

Describe male schistosome

A

Shorter but sturdier
12 to 20 mm x .4-.5mm
Testes are arranged in one row above the ventral suckers

73
Q

Describe the female schistosomes

A

Longer and slender
15-26mm x 0.3mm
Single pyramidal ovary located midline

74
Q

Schistosomes can live up to?

A

30 years

75
Q

Average life span of schistosomes

A

3-8 years

76
Q

Digestive system of schistosomes

A

Incomplete

77
Q

Excretory systme of schistosomes

A

Made up of flame cells

78
Q

Internal structures of schistosomes are covered with

A

Longitudinal and circular muscles

79
Q

Ingests red cells and posses

A

Protease (hemoglobinase) that breaks down globin and hgb

80
Q

Cercarial penetration accompanied by dermatitis with pruritus and localized reaction

A

Swimmer’s itch

81
Q

ERAMMEFA

A

Katayama Syndrome/ Katayama Fever/ Snail Fever

82
Q

When does Katayama fever seen

A

2 to 12 weeks following cercarial penetration

83
Q

Migration thru pulmonary circulation may cause

A

Coughing and wheezing

84
Q

Aberrant migration of maturing schistosomes may occlude the circulation of the brain casuing

A

Seizures, paresthesias, transient ischemic attacks, stroke

85
Q

Main pathology of schistosomiasis

A

Granulomatous reaction to egg deposited in the liver and other organs

86
Q

Determines the severity of infection

A

Initial quantum of cercariae that infect the host and mature to lay eggs

87
Q

Eggs deposited in what organs?

A

Liver
Lung
Intestines
Brain

88
Q

3 stages of schistosomiasis clinical course

A
  1. Incubation period
  2. Period of early egg deposition and extrusion
  3. Period of tissue proliferation
89
Q

Became the subjects for the study of early manifestations of schistosomiasis

A

American soldiers who landed in Leyte in 1944

90
Q

Pre-patent period from 337 cases

A

42 to 52 days

91
Q

T/F

In chronic stage, colonic schistosomiasis is usually ASYMPTOMATIC

A

Chrue

92
Q

Most serious consequence of chronic schistosomiasis

A

Hepatosplenic dseas

93
Q

Hepatsplenic dseas manifest as

A

Hepatosplenomegaly
Portal hyoertension
Ascites
Collateral circulation causing esophageal and gastric varices

94
Q

Pesigan

A 
2540 cases
1950-1951 DOH
31%: mild hepatsplenic dseas
9.1%: definite signs of ascites
1.4%: severe portal hypertension with prominent ascites
95
Q

Cinco

A

14%: hematemesis and melena

96
Q

Jongco and Flaminiano

A

1961

Pulmonary schistosomiasisis the most common cause of Cor Pulmonale in Fil Children

97
Q

Cerebral schistosomiasis

A

1.7 to 4.3%

1945 American soldiers in Leyte, 2% with CNS involvement

98
Q

Acute cases of CNS schistosmiasis

A 
Meningiencephalitis
Headache
Confusions
Lethargy
Coma
99
Q

Chronic cases of CNS schistosomiasis

A

Increased ICP

TUMOR

100
Q

Most specific examination of eggs since these directly visualize the parasite

A

Microscopic examination

101
Q

Microscopic techniques include?

A

Stool exam

Rectal imprint

102
Q

Has sufficient sensitivity for heavy and moderate infections but nit adequate for very light infxn (less than 10 eggs per gram)

A

Merthiolate-Iodine-Formalin Concn Technique

103
Q

Concn technique suitable for field studies

A

MIFC

104
Q

Fecal samples mixed w this soln can be kept indefinitely

Preserved protozoans

A

Merthiolate-Formalin soln

105
Q

Preferred egg count egg counting tech and used for egg qunatification

A

Kato-Katz Tech

106
Q

Most commonly used stool exam technique for evaluating epidemiology, effect of control measures, and drug trials

A

Kato-Katz techn

107
Q

Kato-Katz Tech can be kept for?

A

2 weeks

108
Q

Specimens with less than 20 eggs per gram requires

A

At least 3Kato-Katz prep to achieve a sensitivity of 92%

109
Q

Most invasive

A

Rectal snips and imprint

110
Q

T/F

Rectal snips/ imprint does not distinguish b/n treated or untreated infxn

A

Chrue

111
Q

Locally evaluated immunodiagnostic tests

A
  1. Intradermal test for immediate cutaneous hyoersensitivity
  2. Indirect Hemagllutination
  3. COPT
  4. ELISA
112
Q

Intradermal tests makes use of

A

Adult worm extract

113
Q

Indirect Hemagglutination test makes use of

A

Adult worm and egg antigen

114
Q

ELISA makes use of

A

Soluble antigen of adult worm and egg

115
Q

Most specific antigen from the multicenter evaluation of S japonicum diagnostics

A

Crude egg antigen

116
Q

Highly sensitive but not specific

A

Intradermal test

117
Q

Highly sensitive and requires specialized reagents and training but can be performed w/ minimal equipment

A

HAT

118
Q

Among the most sensitive

Need lab equipment and trained personnel

A

ELISA

119
Q

Harness ELISA for point of care and field use
Validated extensively in China
Best suited for elimination programs

A

Lateral flow assays

120
Q

T/F

Adult worm ag were found to be better than egg ag for detecting low level infxns (less than 100 eggs/gram)

A

T

121
Q

COPT positive result

A

Formation of blebs or septate precipitates attached to one or mor points on the egg surface

122
Q

Method of choice for the definitive dx of schistosomiasis in the PH

A

COPT

123
Q

COPT takes more than —- to become negative

A

2 years

124
Q

Standardized egg preps for COPT is obtained from?

A

50 - 60 day old S japonicum infxnx of rabbits

125
Q

Barrio San Antonio, Basey, Samar

A

COPT and MIFC
COPT: 70% +
Stool exam: 40% only

126
Q

Drugs used for schistosomiasis

A

Praziquantel

127
Q

Heterocyclic prazinoisoquinoline cmp

A

Praziquantel

128
Q

Active substance of praziquantel is?

A

Hygroscopic, colorless, almost odorless, crystalline powder
Melts at 136- 140 deg C
Highly soluble to chloroform and dimethyl-sulfoxide

129
Q

Experiment of praziquantel toxicity with rats and dogs

A

Rats: 1mg/kg for 4 weeks
Dogs: 180 mg/kg for 13 weeks

Both without organ damage and well tolerated

130
Q

Used for pre-exposure prophylaxis

A

Artemisinins including Artemether

131
Q

Epidem of schistosomiasis

A 
12 regions
28 provinces
190 municipalities
15 cities
2,222 brgys

Added
Gonzaga, Cagayan 2004
Calatrava, Negros Oriental 2006

132
Q

Population at risk

A

6.8 million

133
Q

Highest prevalence of infxn isin children

A

5 - 15 y/o

134
Q

More useful epidemiologic indices

A
  1. Prevalence
  2. Incidence
  3. Worm burden
135
Q

Place with highes prevalence

A

Agusan del Sur. 3.95%

136
Q

Oncomelania hupensis quadrasi attain sexual maturity?

A

If size reaches 3.5 mm

137
Q

O. h. quadrasi lays egg

A

2 eggs per 5 days for 1 month

138
Q

2 general strategies for snail control

A

Focal

Area-wide

PARASITOLOGY (2 decks)

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