Blood flukes

Question 1

Three species of schistosomes that parasitize humans are regarded important. What are they?

Answer 1

• Schistosoma japonicum
• Schistosoma mansoni
• Schistosoma haematobium

Question 2

Less common species of schistosomes are ____ found in Africa and ____ found in the Mekong Basin.

Answer 2

Schistosoma intercalatum; Schistosoma mekongi

Question 3

Although these flukes reside in the blood vascular system, eggs are generally found in what sample?

Answer 3

stool

Question 4

The eggs of what Schistosoma are occasionally seen in stool but usually seen in urine?

Answer 4

Schistosoma haematobium

Question 5

Female worms are long and ____, with a body almost circular in cross sections.

thin and delicate

Answer 5

slender

Question 6

The body of male worms is flattened behind the ventral sucker, as it is incurved ventrally to form a ____ in which the female reposes.

Answer 6

gynecophoral canal

Question 7

Among the two Schistosome, which is longer?

male or female

Answer 7

female

but thinner cla

male is thicker due to gynecophoroal canal (for reproduction)

Question 8

What structure of Schistosoma eggs assist in the retention of eggs in the blood vessels?

Answer 8

spines

+++ dinidilate ng worms vessels b4 oviposition so that eggs are laid and wedged firmly into the small vessels

Question 9

The miracidium inside a Schistosoma egg produces an ____ that diffuses through the egg shell and helps to digest the overlying tissue.

Answer 9

enzyme

Question 10

In blood flukes, the action of the ____ produced by the miracidium, together with necrosis via the spines, works to liberate the egg from the tissues into the lumen of the intestine or bladder.

Answer 10

enzyme

Question 11

What stages are not present in the life cycle of Schistosoma

Answer 11

redia and metacercaria

Question 12

The cause of pathology of Schistosoma is what?

eggs or adult worms

Answer 12

eggs

Question 13

The cercaria of schistosomes have a ____ tail and anterior glands that assist in skin penetration.

Answer 13

forked

Question 14

Upon skin penetration, the tail is lost and is now referred to as what?

cercaria minus tail = ?

Answer 14

Schistosomula

Question 15

The cercaria minus the tail remains in the subcutis for about how many days?

Answer 15

about 2 days

Question 16

After blood vessel invasion, flukes are carried to the lungs then to the ____ where they begin their growth.

Answer 16

Liver

liver sinusoids

Question 17

After ____ weeks, the maturing worms commence a migration against the floow of blood in the portal system to their final location in mesenteric or vesicular veins.

Answer 17

two

final locations in the host will differ for each species

Question 18

Habitat of Schistosoma mansoni

Answer 18

inferior mesenteric vein

in the region of the lower colon

Question 19

____ is the smallest of the schistosomes that infect humans

Answer 19

Schistosoma mansoni

Question 20

Diagnosis of schistosomiasis during the ____ period of the disease is based on the recover of eggs in the stool.

acute or chronic

Answer 20

acute

Question 21

In the ____ stage of the schistosomiasis, eggs may not be found in the stool. Biopsy may be of value ‘coz eggs can be demonstrated in the tissues.

acute or chronic

Answer 21

chronic

Question 22

common name of Schistosoma mansoni

Answer 22

Manson’s blood fluke

Question 23

Intermediate host of Schistosoma mansoni

Answer 23

Biomphalaria spp.

Question 24

Intermediate host of Schistosoma japonicum

Answer 24

Oncomelania hupensis quadrasi

Question 25

common name of *Schistosoma japonicum*

Answer 25

Oriental blood fluke

Question 26

Among the **schistosomes**, which is the _most virulent_ as it lays the *most number of eggs* and is *highly zoonotic*?

Answer 26

*Schistosoma japonicum*

Question 27

Habitat of *Schistosoma japonicum*

Answer 27

superior mesenteric vein | adjacent to the **small intestine**

Question 28

Urinary schistosomiasis is generally caused by what *Schistosoma*?

Answer 28

*Schistosoma haematobium*

Question 29

Common name of *Schistosoma haematobium*

Answer 29

Vesical blood fluke | or Bladder fluke (Zeibig)

Question 30

Habitat of *Schistosoma haematobium*

Answer 30

Vesical, Prostatic, and Uterine venous plexuses

Question 31

The *Schistosoma haematobium* eggs that are deposited in the walls of the bladder may break through and escape with the ____. | what sample?

Answer 31

urine

Question 32

Diagnosis of *Schistosoma haematobium* is readily made by the recovery of eggs via ____ or ____ of the urine. | what is done sa wiwi?

Answer 32

centrifugation or sedimentation

Question 33

Intermediate host of *Schistosoma haematobium*

Answer 33

*Bulinus* spp.

Question 34

What do you call the **schistosome** that resembles *S. japonicum* in _adult structure_?

Answer 34

*Schistosoma mekongi*

Question 35

Intermediate host of *Schistosoma mekongi*

Answer 35

*Neotricula aperta* spp.

Question 36

Common name of *Schistosoma mekongi*

Answer 36

Mekongi blood fluke

Question 37

The eggs of what parasite **closely resemble** *Schistosoma haematobium* but *can be differentiated by a slight bend* in the _terminal spine_?

Answer 37

*Schistosoma intercalatum*

Question 38

Common name of *Schistosoma intercalatum*

Answer 38

- Cattle Schistosome - Forest Schistosome

Question 39

The eggshell of what Schistosome is Ziehl-Neelsen negative? | Ziehl-Neelsen = acid-fast din pala :oo ## Footnote [ZN](https://www.ajtmh.org/view/journals/tpmd/94/4/article-p699.xml)

Answer 39

*Schistosoma haematobium* ## Footnote All the other ones are positive (walang nakalagay s mekongi and malayensis tho)

Question 40

Intermediate host of *Schistosoma intercalatum*

Answer 40

*Bulinus* spp.

Question 41

After cercaria skin penetration of *Schistosoma*, what do you call the rxn that may be seen? | characterized as petechial hemorrhages + localized edema nd pruritus

Answer 41

Cercarial dermatitis | Swimmer's itch (swamp itch)

Question 42

Migration of the worms throughout the lungs may cause cough or ____.

Answer 42

hemoptysis | cough w/ blood

Question 43

**After the liver**, when the flukes reach the mesenteric or vesical venules and lay eggs, what stage of schistosomiasis is seen? | acute or chronic

Answer 43

acute

Question 44

When the developing schistosomes reach the liver, acute ____ may develop | inflammation of the liver

Answer 44

hepatitis

Question 45

The acute stage infection by *S. mansoni* and *S. japonicum* may be characterized by what symptoms?

Answer 45

diarrhea or dysentery

Question 46

The acute stage infection by *S. haematobium* may be characterized by what symptoms?

Answer 46

hematuria at the end of micturition (peeing) | sometimes dysuria (pain during micturition)

Question 47

What do you call the **systemic hypersensitivity rxn** that is an _early clinical manifestation of first infection or heavy infection_ with schistosomes? There is significant mortality at this stage of the disease. | hypersensitivity rxn = fever/syndrome

Answer 47

Katayama fever

Question 48

Katayama fever is more common in what schistosome?

Answer 48

*Schistosoma japonicum* ## Footnote *S. mansoni* pweds but katayama is under schistosomiasis japonicum (sa book)

Question 49

What is the **most common chronic infection** in patients w/ *S. mansoni* or *S. japonicum*, also occurs regularly in *S. haematobium* infections? | schistosomiasis where?

Answer 49

Hepatic schistosomiasis

Question 50

What disease is **more common** also in *_S. mansoni_* and *_S. japonicum_* infections and *involves the intestinal tract and is suggestive of granulomatous colitis*, w/ abdominal cramps and tenderness and intermittent bloody mucoid stools? | schistosomiasis where?

Answer 50

Intestinal schistosomiasis

Question 51

____ schistosomiasis is seen with *Schistosoma haematobium* and is characterized by _dysuria and hematuria_.

Answer 51

Urinary schistosomiasis

Question 52

What is usually the first sign of urinary schistosomiasis?

Answer 52

Terminal hematuria

Question 53

What are conditions that are **usually found** in _urinary schistosomiasis_? | eosinop & bacteria in urine?

Answer 53

eosinophiluria & bacteriuria

Question 54

What is **usually seen with heavy *Schistosoma haematobium* infections** where there is *heavy egg concentrations* that promote _urothelial carcinogenesis_?

Answer 54

Bladder cancer | usually a squamous cell carcinoma

Question 55

**Pulmonary involvement** *may be seen in all forms* of schistosomiasis but is _more common_ with ____ infections.

Answer 55

*Schistosoma haematobium* ## Footnote egg deposition in the lungs leads to pulmonary fibrosis and cor pulmonale

Question 56

Cerebral manifestations of schistosomiasis are most commonly seen in ____ infections.

Answer 56

*Schistosoma japonicum*

Question 57

If *S. japonicum* is usually seen in cerebral schistosomiasis, **which of the *Schistosoma*** _frequently affect the spinal cord_?

Answer 57

- *Schistosoma mansoni* - *Schistosoma haematobium*

Question 58

**Transverse myelitis**, usually in the ____ area, is _seen in spinal cord involvement_ and is associated with *S. mansoni*. | what region ng spine

Answer 58

lumbar area

Question 59

Upon **initial reaction**, which of the cells _release histamine_ that is *cercaria-provoked through a marked dermal rxn*?

Answer 59

mast cells

Question 60

What are the **two types of antibodies** *involved in the elimination of schistosomula* in the body and is _seen in immunocompetent hosts_? ## Footnote immunocompetent hosts = previously infected n so they have panlaban na

Answer 60

- IgG - IgE

Question 61

What **develops around the eggs** and is _responsible for much of the pathology_ associated with schistosomiasis?

Answer 61

granulomas

Question 62

Eggs of ____ may bypass the liver entirely. Venous blood from the vesical, prostatic, and uterine plexuses enters the hypogastric vein, from whence it goes by way of the common iliac vein to the vena cava, the right heart, _and the lungs_

Answer 62

*Schistosoma haematobium*

Question 63

What is the **common site** of *S. haematobium* infection in _women_?

Answer 63

uterine cervix ## Footnote granulomatous inflammation of the cervix is a common manifestation

Question 64

What is the **common site** of *S. haematobium* infection in _males_?

Answer 64

urethra, prostate, seminal vesicles | even the spermatic cord & penises

Question 65

Which of the schistosomes may invade the placenta and cause placentitis?

Answer 65

- *Schistosoma haematobium* - *Schistosoma mansoni*

Question 66

Drug of choice for schistosomiasis

Answer 66

Praziquantel | Oxamniquine

Question 67

What is the preferred sx for the diagnosis of *S. haematobium*?

Answer 67

Urine

Question 68

What do you call the test that serves as a confirmatory test for schistosomiasis?

Answer 68

Circumoval precipitin test | COPT

Question 69

What are the reagents used in circumoval precipitin test?

Answer 69

Lyophilized eggs ## Footnote from reservoir hosts (rabbits)

Question 70

The formation of a ____ depicts a positive result for circumoval precipitin test.

Answer 70

bleb | bleb formation ## Footnote wherein antibodies are present in px sample. u have an antibody specific to schistosomes and will react to form blebs

Question 71

circumoval precipitin test process | no need to memo i think

Answer 71

- serum & reagent in slide - incubation at 37^o for 1-2 days - bleb observation

Question 72

What do you call the condition wherein adult schistosomes are always together to produce more eggs?

Answer 72

perpetual copulation

Question 73

Spine description of the egg of *Schistosoma mansoni*

Answer 73

Prominent lateral spine

Question 74

Spine description of the egg of *Schistosoma japonicum*

Answer 74

minute lateral spine | rudimentary spine (curved hook)

Question 75

Spine description of the egg of *Schistosoma haematobium*

Answer 75

conspicuous terminal spine | malaki ## Footnote same cla ni intercalatum (kaya u test via acid-fast: Ziehl-Neelsen)

Question 76

How many eggs per cycle are produced by *Schistosoma japonicum*?

Answer 76

50-100 | 3k per day

Question 77

How many eggs per cycle are produced by *Schistosoma mansoni*?

Answer 77

1-4 | 190-300 per day

Question 78

How many eggs per cycle are produced by *Schistosoma haematobium*?

Answer 78

20-30 | 30 per day