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PARASITOLOGY > Trematodes: Lung Fluke > Flashcards

Trematodes: Lung Fluke Flashcards

1
Q

How many spp of Paragonimus has been identified

A

40

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2
Q

How many spp of Paragonimus is infective to human

A

6

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3
Q

How many percent does P westermani in Asia

A

90%

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4
Q

Common name of P westermani

A

Oriental lung fluke

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5
Q

Paragonimus spp in the PH

A 
P westermani
P siamensis (cats)
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6
Q

First described lung paragonimiasis

A

1879
Ringer
Autopsy in Formosa

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7
Q

First to describe Paragonimus egg in sputum

A

1880
Baelz in Japan
Manson in Formosa

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8
Q

First case of Paragonimiasis in PH

A

1907

Musgrave

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9
Q

Discovered crabs as 2nd IH

A

Nakagawa

1915

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10
Q

Nakagawa in 1917

A

Succeeded to infect Melania liberentine with miracidia

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11
Q

Color of adult Paragonimus
Size
Shape

A

Reddish-brown
7-12 mm x 4-6mm with thickness of 3.5-5mm
Coffee bean

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12
Q

The tegument of the adult paragonimus

A

Covered with single-spaced spines

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13
Q

Describe testesof adult paragonimus

A

Deeply lobed
Located opposite to each other
Almost midway b/n ventral sucjker andposterior boarder

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14
Q

Describe the ovary

A

Located anterior to the testes
Posterior to the ventral sucker
6 long unbranched lobes

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15
Q

Extensively branched

A

Vitellaria

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16
Q

Describe cercaria of paragonimus

A

Ellipsoidal
Small tail
Covered with spines

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17
Q

Present at the dorsal side of the oral sucker of the cercaria

A

Stylet

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18
Q

Describe metacercaria of paragonimus

A

Round

381-457 um

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19
Q

Describe the egg of paragonimus

A 
Yellowish-brown
Oval
80-118um x 48-60um
Flattened but prominent operculum
Posterior aboperculum
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20
Q

Diagnostic stage of Paragonimus

A

Unembryonated egg

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21
Q

Infective stage of Paragonimus

A

Metacercariae

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22
Q

Unembyonated egg embryonates in?

A

Water
Moist soil
Leeched feces

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23
Q

Time it takes for the miracidia to arise

A

2 to 7 weeks

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24
Q

1st intermediate host

A

Snails:
Antemelania asperata
Antemelania dactylus

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25
Q

Inside tye snail, the miracidium passes thru what stages?

A

One sporocyst

2 redial devnt stages

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26
Q

2nd intermediate host

A

Mountain crab:

Sundathelphusa philippina

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27
Q

Where does the metacercaria excyst?

A

Duodenum

28
Q

From the intestines where it goes?

A

Peritoneal cavity- wander and emebed in the abd wall
Diaphragm
Pleural cavity- look for another juvenile diploid worm

29
Q

Juvenile triploid worms are found in

A

Japan, Korea, Taiwan

30
Q

Time it takes for the juvenile diploid to become mature worm

A

6 weeks

31
Q

Completion of devnt of the parasites inside the definitive host

A

65-90 days

32
Q

Life span

A

20 years

33
Q

Involved in metacercariae excystation, tissue invasion and immune modulation of the host

A

Cysteine protease (27 and 28 kD)

34
Q

Where does the Cysteine protease 27 and 28 kD released?

A

Excretory bladder of the metacercariae

35
Q

Cysteine protease is most abundant in the?

A

Tegumentum of the newly excysted worms

36
Q

Cysteine protease is able to cleave?

A

IgG

37
Q

Other cysteine protease expressed

A

15, 17, 53 kD

38
Q

Most common symptoms of paragonimiasis

A

Chronic cough

Hemoptysis

39
Q

Serious sequelae of paragonimiasis

A

Chronic bronchiectasis

Pleural fibrosis

40
Q

Classic forms of ectopic paragonimiasis

A

Cutaneous and Cerebral

41
Q

Most serious complication

A

Cerebral

42
Q

Migration form pleural to cranial cavity is thru

A

Internal jugular vein

43
Q

Migration can cause

A

Congestion
Vasculitis
Capillary rupture
This may lead to exudative aseptic inflammtion, infarction, hemorrhage and necrosis of subcortical areas

44
Q

Choronic stage of cerebral paragonimiasis

A

Liquefaction necrosis, and fibrinous gliosis and leads to cortical or subcortical atrophy and secondary ventricular dilation

45
Q

Cerebral paragonimiasis may manifest as

A 
Headache
Meningismus
Seizures
Hemiparesis
Blurring of vision
Diplopia
Homonymous hemianopsia
Aphasia
46
Q

Provides the best sensitivity for microscopic exam

A

Sputum concn with 3% NaOH with repeated sputum exam up to three times on diff days

47
Q

Seen in chest radiographs

A

Infiltrative
Nodular
Cavitating lesions

48
Q

T/F

Eosinophilia is more common in acute stage while IgE levels have no correlation with the stage of the dse

A

T

49
Q

High sensitivity for both dx amd assessment of cure after therapy

A

CF

50
Q

Sensitivity of IB and ELISA

A

IB- 99%

ELISA- 96-99%

51
Q

ELISA detects

A

Pragonimus specific IgG antibody

52
Q

LAMP

A

Loop-mediated isothermal amplification
DNA polymerase with strand-displacement activity
Hot water
Mg-pyrophosphate

53
Q

Seen in the CT and MRI of cerebral pragonimiasis

A

Conglomerated, mulitiple, ring-enhancing lesions

Grape-cluster appearance

54
Q

Skull radiographs from cerebral paragonimiasis

A

Soap bubble calcifications

55
Q

Drug of choice

A

Praziquantel

56
Q

Praziquantel given at what age

A

Above 4 y/o

57
Q

Praziquantel dose

A

25 mg/kg 3x a day for 2 to 3 days

58
Q

Praziquantel vs breastfeeding

A

Do not breastfeed during tx or 72 H after tx

59
Q

Benzamidazole originally used for Fasciola hepatica

A

Triclabendazole

60
Q

Triclabendazole MOA

A

Binds to B-Tubulins of trematodes leading to the disruption and depolymerisation of the microtubule-based process

61
Q

Used for better patient compliance bec only single dose/day

A

Triclabendazole

62
Q

Can be used as an alternative drug

A

Bithionol

63
Q

Epidemiology
Infected people
At risk

A
  1. 7M infected

292. 8M at risk

64
Q

Places in the PH where Paragonimiasis is endemic

A

Mindoro, Sorsogon, Leyte
Samar, Zamboanga del Norte, Davo Oriental
Cotabato, Basilan, Camarines

65
Q

In 1950s and 1960s why is it that children are infected in JPN

A

Cray fish juice for cutaneous ailments

66
Q

Cameroon epidem

A

Adolescent women Of Bakossi

Crabs aid in fertility

PARASITOLOGY (2 decks)

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