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Week 6 Micro TA review > Worm Parasites Pt. II : Cestodes/Trematodes/nematodes > Flashcards

Worm Parasites Pt. II : Cestodes/Trematodes/nematodes Flashcards

1
Q

Taenia solium vs. saginata morphology

A

solium = pork, saginata = beef

T. Saginata – no scolex hooks, more uterine branches in proglottid

T. Solium – hooklets in circle in scolex and fewer uterine branches,

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2
Q

Taenia solium/saginata morphology

A

Cestode

Cestodes (flatworms with scolex – head for sucking and proglottids – infectious segments containing eggs)

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3
Q

Taenia solium/saginata pathogenesis life cycle

A

Ingestion of gravid proglottid by pig or cattle (water, food, etc) –> Release of eggs into intestine –> enter into circulation –> seeding of muscle forms larval cyst –> Human infection by the consumption of raw/under cooked meat –> attachment to intestine by scolex –> establish residency –> Fecal-Oral trasnmission —> If humans ingest the gravid proglottid (eggs) the infection will disseminate and form cysts –> Blindness, Neurocysticercosis, encephalitis

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4
Q

Taenia solium/saginata diagnosis

A

Stool sample w/ gravid proglottid uterus w/ >1000 eggs

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5
Q

Epidemiology Taenia solium/saginata

A

Worldwide, esp in areas of poverty with poor sanitation where humans in close contact w/ pigs or ingestion of raw beef. Rare in Muslim countries.

Human consumption of cysts from infected carrier (i.e., meat); carrier acquires from infected food/water (think feces)

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6
Q

1 cause of New onset adult seizures in the developing world

A

Parasitic infections

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7
Q

Remember most flatworms and flukes are treated with

A

praziquantel

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8
Q

Taenia solium vs. saginata clinical presentation

A

T. Solium:

In T. solium, disease depends on whether eat undercooked pork (tapeworm symptoms) or food/water contaminated by feces (containing ovum) of infected human (neurocysticercosis)

Larval disease –> Neurocysticercosis (CNS calcifications, dilated ventricles, hydrocephalus) –> headaches/adult-onset seizures, aseptic meningitis, blindness (ventricles dilate –> ICP↑ –> papilledema)

T. saginata

Usually asymptomatic, can cause GI upset, weight loss, dizziness, headaches, bowel obstruction, allergy against worm Ags

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9
Q

Treatment of Taenia solium/saginata

A

Praziquantel or albendazole

Treatment is controversial for neurocysticercosis b/c cysts will often die on own;

albendazole (often with steroids to avoid acute encephalitis) for 5-100 lesions (b/c larval form);

surgical removal when ventricles involved

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10
Q

Medical name for fish tapeworm

A

Diphyllobothrium latum

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11
Q

Diphyllobothrium latum properties

A

Cestode

Scolex w/ 2 ventral sucking apparatuses (bothria) to attach to bowel wall, flat/wide proglottids

Oval/operculated egg (lid-like opening at 1 end and knob at other end)

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12
Q

Diphyllobothrium latum clinical presentation

A

Macrocytic anemia (high MCV) from B12 deficiency

Can also have diarrhea, abdominal pain, vomiting, weight loss, fatigue, constipation and discomfort)

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13
Q

Diphyllobothrium latum diagnosis

A

Eggs/proglottids in feces

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14
Q

Diphyllobothrium latum epidemiology

A

Consumption of raw fish

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15
Q

Diphyllobothrium latum treatment

A

Praziquantel

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16
Q

Scientific name for dog tapeworm

A

Echinococcus granulosus

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17
Q

Echinococcus granulosus properties

A

Cestode

Larvae hatch –> penetrate small intestine –> bloodstream –> organs (liver, lungs, brain)

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18
Q

Echinococcus granulosus clinical presentation

A

Pulmonary – pulmonary densities, cough, vomica (salty taste in mouth w/ cough = rupture of hydatid cyst with spillage of scolices, leading to metastatic spread of daughter cysts)

Hepatic Echinococcosis w/ hydatid cyst

  • Active cyst wall consisting of single cell germinal layer and thicker gelatinous laminar layer (budding of germinal layer = daughter cysts)
  • Pericyst (reactive fibrous layer) around cyst
  • Expansion may rupture into biliary tree, erode through diaphragm into pleural cavity, rupture into peritoneum –> can cause anaphylaxis from parasitic Ag release
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19
Q

Echinococcus granulosus diagnosis

A

Water lily appearance on imaging (CT/MRI)

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20
Q

Echinococcus granulosus epidemiology

A

Ingestion of feces contaminated with eggs (cycles between sheep & dogs)

Endemic in regions where dogs (primary) in contact with sheep, elk, caribou (intermediate). Mediterranean, Middle East, SA, Greece, Italy, Turkey, esp. sheep farmers

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21
Q

Echinococcus granulosus treatment

A

puncture, aspiration, injection, and reaspiration (PAIR) tx in liver (prevent spilling of hydatic sand); surgical excision in lung or albendazole for unresectable

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22
Q

Echinococcus granulosus transmission

A

Humans become infected when they swallow eggs in contaminated food.

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23
Q

In which animals?

  1. T. solium
  2. T. saginata
  3. D. latum
  4. E. granulosus
A
  1. T. solium –> pork.
  2. T. saginata –> cattle.
  3. D. latum –> fish.
  4. E. granulosus –> sheep and dogs.
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24
Q

Schistosome properties

A

Nonsegmented parasites, life-cycle must pass through snail, operculated eggs. Male and Female schistosomes!!!

Trematode

25
Q

List of schistosomes

A

(S. mansoni, S. hematobium, S. japonicum, S.mekongi)

26
Q

life cycle of schistosomes

A

Cercariae (larvae) penetrate intact skin in water –> venous plexuses of GI tract, bladder –> circulation –> live in mesenteric venules and bladder –> mature, lay eggs –> usually end in stool

27
Q

Clinical Schistosomiasis

A

Manifestations depend on region, but are mainly based on inflammatory rxn to cellular infiltrates of egg

28
Q

S. Mansoni clinical presentations

A

S. Mansoni – mainly liver (brisk inflammatory rxn, chronic liver scarring, granulomatous response, “pipestem fibrosis”); can also migrate to lungs or spinal cord

29
Q

S. Hematobium clinical presentations

A

S. Hematobium – mature in the GU venous plexuses instead of portal circulation –> hematuria –> bladder wall scarring, obstruction, bladder cancer

30
Q

Avian schistosoma clinical presentation

A

intensely pruritic dermatitis (“swimmer’s itch”), remain in skin only, cannot develop into adult worms in human host

31
Q

Schistosoma transmission

A

Fresh water sources (playing in water) and contact w/ cercariae form tropics

32
Q

Geography

S. mansoni

S. hematobium

avian schistosoma

A

S. mansoni esp. in Africa/Brazil;

S. hematobium in Africa;

avian schistosoma in Canada/northern water

33
Q

Treatment schistomas

A

Praziquantel, snail control!!!!!!!!!!!!

34
Q

schistosomes pathogenesis

A

The eggs themselves do not damage the body. Rather it is the cellular infiltration resultant from the immune response that causes the pathology classically associated with schistosomiasis.

35
Q

Opistorchis (Clonorchis) sinensis properties

A

Trematode

Chinese liver fluke, operculated egg, hermaphroditic

36
Q

Opistorchis (Clonorchis) sinensis clinical presentation

A

RUQ pain, cholecystitis

Penetrates intestinal wall –> bile ducts –> chronic biliary tract inflammation –> higher risk of cholangiocarcinoma (bile duct cancer)

37
Q

Opistorchis (Clonorchis) sinensis diagnosis

A

Eggs in gallbladder

38
Q

Opistorchis (Clonorchis) sinensis transmission

A

Eating raw fresh water fish

39
Q

Opistorchis (Clonorchis) sinensis treatment

A

Praziquantel

40
Q

Fasciola hepatica properties

A

Trematode

Nonsegmented parasites, life-cycle must pass through snail, hermaphroditic, operculated eggs

41
Q

Fasciola hepatica life-cycle

A

Cercariae leave snail, attach to aquatic vegetation –> humans ingest raw watercress –> penetrate intestinal wall and liver (Glisson’s) capsule –> liver, bile ducts

42
Q

Fasciola hepatica clinical

A

RUQ pain, fever, chills, diarrhea, gallstones, liver abscesses (usually symptomatic)

43
Q

Fasciola hepatica diagnosis

A

High WBCs, eosinophils

44
Q

Fasciola hepatica transmission

A

Ingestion of raw watercress

45
Q

Fasciola Hepatica treatment

A

Fasciola is the one trematode not treated with praziquantel.

Treatment: Veterinary formulation of triclabendazole

46
Q

Paragonimus westermani properties

A

Trematode

Lung fluke: ingestion –> excyst in stomach –> penetrates intestinal wall, diaphragm, then pleural cavity –> cysts

47
Q

Paragonimus westermani clinical presentation

A

Cystic cavities in lung (mimic TB), migrating larval worms can also invade spinal cord/brain

48
Q

Paragonimus westermani diagnosis

A

Eosinophilia

Eggs in Lung Tissue biopsy

49
Q

Paragonimus westermani transmission/epidemiology

A

Fecal-oral ingestion of raw infected shellfish in East Asia (some in Central America)

50
Q

Trichinella spiralis properties

A

nematode

Spiral shaped larvae

51
Q

Trichinella spiralis pathogenesis

A

Ingestion of undercooked meat –> larvae penetrate bowel –> migrate to skeletal muscle –> inflammation

52
Q

Trichinella spiralis clinical

A

Myalgia, preorbital edema, fever

53
Q

Trichinella spiralis diagnosis

A

Muscle biopsy, serology, Eosinophilia + elevated CPK

54
Q

Trichinella spiralis epidemiology

A

Hunters eating game meat (deer, boar, etc)

Found in NA, SA, Europe, East Asia

55
Q

Trichinella spiralis treatment

A

Mebendazole and Steroids

*use steroids with treatment because cysts rupture causes a release of more antigen and an increase in symptoms. Steroids act as an immune suppressor to blunt symptoms.

56
Q

List of Cestodes

A

Taenia Solium

Taenia Saginata

Diphyllobothrium Latum (fish tapeworm)

Echinococcus Granulosa (dog tapeworm)

57
Q

List of Trematodes

A

Schistosomas: S. mansoni, S. hematobium, S. japonicum, S.mekongi

Opistorchis (Cinorchis) Sinensis

Fasciola Hepatica

Paragonimus westermani

58
Q

List of nematode

A

Trichinella spiralis

Week 6 Micro TA review (3 decks)

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