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MIMM 413 > Echinococcus > Flashcards

Echinococcus Flashcards

1
Q

true or false: echinococcus is a zoonotic disease

A

-carnivore/herbivore->humans

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2
Q

adult echino parasitize the gi tract of what

A

carnivores aka they are the definitive host

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3
Q

for echino: larval stage, hydatid cyst, parasitize soft organs of what?

A

humans/herbivores/rodents which are intermediate hosts

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4
Q

what are the the 3 forms of echino larvaes that infect humans

A

-e multiocularis
-granulosus
-vogeli, oligarthrus

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5
Q

what are the characteristics of multiocularis

A

-alveolar in texture
-ulcerative
-hemorrhagic
-malignant

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6
Q

characteristics of granulosus

A

-uniocular
-benign
-25 cm

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7
Q

characteristics of vogeli, oligarthrus

A

-polycystic
-is in central and south america

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8
Q

life cycle of echino

A

-you eat the eggs
-oncosphere hatches, penetrates the intestinal wall, hydatid cyst in liver, lungs etc
-protoscolex from cyst
-scolex attaches to intestines
-adult in small intestine
-poop the eggs

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9
Q

the definitive host ingest what: cysts in organs or eggs in poop

A

cysts in organs

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10
Q

e multiocularis hosts

A

-cyst develops in rodents
-adults develop in foxes, dogs, wolves, coyotes or cats

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11
Q

what is the other name of echinococcus

A

flatworm

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12
Q

how many worms do heavily infected dogs have

A

1000

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13
Q

each tapeworm sheds how many eggs every2 weeks

A

1000

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14
Q

eggs of echino adhere to hairs aroun what

A

infected dogs anus, muzzle and paws
-contact also via soil, water, contaminated vegies, through flies or other arthropods

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15
Q

eggs of e granulosis are able to survive what

A

snow and freezing temps
-viable for 1 year in the pasture

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16
Q

eggs of echino are susceptible to what

A

desiccation

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17
Q

where are most of the echino cases

A

95% of all cases are in china

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18
Q

Adult and larval stages of Eg and Em are …..

A

morphologically
distinct; Em adult smaller

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19
Q

what are the characteristics of echico

A

-scolex(looks like t colum)
-neck
-3 segments: aka proglottids

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20
Q

what do the 3 segments contain

A

-a sac like uterus that contains up to 1000eggs

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21
Q

which parasites ova are similar

A

-e granulosus
-e multiocularis
-t solium

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22
Q

ova of echino survive to exposure of what

A

-householf disinfectants like lysol, 95% etoh or 20% formalin

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23
Q

reported cases of alveolar hydatid infection in the us through what

A

-farm cats probs aquired from wild rodents

24
Q

Cystic Echinococcosis

A
  • Cysts may grow 1-5 cm/year or persist without changes for years
  • Cysts may spontaneously rupture or collapse or disappear
  • Liver cysts appear to grow at lower rate than lung cysts
  • Symptoms occur when cyst compresses or ruptures into
    neighbouring structure
25
Q

Alveolar Echinococcosis

A
  • Initial asymptomatic period of 5-15 years – Chronic infection
  • Primarily symptoms: jaundice (1/3 cases) and/or abdominal pain
  • Fatigue, weight loss, Hepatomegaly
  • High mortality rate in non-treated patients
26
Q

what do uniocular hydatod contain

A

: hydatid fluid (1-3 liters; highly antigenic used in Casoni skin test), protoscolices, brood capsule and daughter cysts

27
Q

cyst circumscribed by what in echino

A

a thick host fibrotic tissue infiltrated with chronic inflammatory cells

28
Q

what do we know about the cyst survival mechanism unknown

A

lower cell mediated immunity

29
Q

what is the size of uniocular hydatid

A

25cm

30
Q

hydatid cyst of uniocular grows like what

A

-xenograph
-host is unable to control its growth or abrogate the infection/cyst

31
Q

what is the appearance of alveolar hydatid cyst aka e multiocularis

A

histologically vesicular - gross appearance honeycomb or like
lung alveoli

32
Q

what is the content of e multiocularis

A

Cyst content - pussy , unlike the unilocular cyst -no frank hydatid fluid

33
Q

what is the growth like for e multiocularis

A

Growth by budding: germinal cells differentiate into bud-like structure- then
vesiculate; permeate surrounding host organ parenchyma

34
Q

Human AHC usually

A

sterile aka no protoslice

35
Q

Protoscolices present in

A

rodents aka suitable intermediate host

36
Q

ALVEOLAR HYDATIDOSIS infection is …

A

chronic

37
Q

cyst growth of ALVEOLAR HYDATIDOSIS

A

Cyst growth- progressive; apparently unchecked (as yet no reported cases of
self-cure)

38
Q

primary lesion of alveolar hydatosis

A

hepatic aka tendency to metastasize

39
Q

provisional diagnosis of a liver mass in alveolar hydatidosis

A

usually misdiagnosed as hepatic carcinoma

40
Q

true or false: there are no effective chemo for alveolar hydatidosis

A

true
-case fatality rate 50-70%
-frequent cause of death: liver or kidney or liver failure

41
Q

Factors determining the clinical course in unilocular hydatidosis

A

pressure atrophy and allergic

42
Q

pressure atrophy deets

A

-by growing cyst
-hepatic (Right lobe ~ 85%)-upper right-quadrant pain, jaundice, cholangitis (pain),
– pulmonary (~ 90%; typical of Canadian strain of EG), chest pain, hemoptysis,
shortness of breath
– cerebral - seizure, increased intracranial pressure
– renal - hematuria, albuminuria, renal colic
– splenic - fragile cyst wall, polar growth to chest cavity

43
Q

allergic hydatid thing

A

leakage of hydatid fluid
-skin hives and itching
-eosinophilia
-anaphilactic shock aka a serious complication

44
Q

HYDATID DIAGNOSIS

A

Patients case history is helpful- particularly geographical origin
* Computed tomography/Magnetic Resonance Imagine scans, X-ray - detect space
occupying mass (congenital cyst; carcinoma; Eh liver abscess)-further confirmation by
serology or skin tests
* Serology (ELISA, IB, indirect hemagglutination test)
* Casoni skin test

45
Q

what is the casoni skin test

A

– Type-1 hypersensitivity (skin reaction within 30 min)
– Type-4 – (CMI) positive (in case of a burnt-out cyst or post-surgical cases)
– Positive during the very early stages of infection
– negative in patients with active infection with high Ab titer - suggests specific
suppression of CMI

46
Q

SUMMARY: HOST CONTROL MECHANISMS: hydatic disease

A
  • EARLY RESPONSE: Primary control mechanisms- CMI and Antibody-dependent Cell
    Cytotoxicity (ADCC) (IgG+MΦ, neutrophils, eosinophils).
  • Subsequently both these mechanisms are compromised-ADCC by circulating immune
    complexes (IC): IC block Fc/C3b receptors; inflammatory cells engorge IC.
  • CHRONIC PHASE
  • CMI is suppressed–reconstructed from humans and mouse models.
  • Polarized Th2 response- high serum IgG, IgE and IL-10; marked reduction in Th1 cells
    (disorganization of lymphoreticular tissues; induction of suppressor cells).
  • These events may explain the persistence of Hydatid cysts.
47
Q

EARLY RESPONSE diagnosis hydatic

A
  • EARLY RESPONSE: Primary control mechanisms- CMI and Antibody-dependent Cell
    Cytotoxicity (ADCC) (IgG+MΦ, neutrophils, eosinophils).
  • Subsequently both these mechanisms are compromised-ADCC by circulating immune
    complexes (IC): IC block Fc/C3b receptors; inflammatory cells engorge IC.
48
Q

chronic phase hydatid diagnosis

A

CMI is suppressed–reconstructed from humans and mouse models.
* Polarized Th2 response- high serum IgG, IgE and IL-10; marked reduction in Th1 cells
(disorganization of lymphoreticular tissues; induction of suppressor cells).
* These events may explain the persistence of Hydatid cysts.

49
Q

echino sylvatic hydatid disease affects what

A

wolf, caribou and moose all get the hydatid cyst but the adult wold also get the adult tape worm

50
Q

Organ localization of E.g cyst:

A

~ 90%; pulmonary by the canadian Eg strain
– ~ 80%; rt hepatic lobe in the imported cases

51
Q

Hydatid disease what is its form in north america

A

sylvatic
-present in first nations

52
Q

infection of echino is due to what

A

accidental due to ingestion of eggs

53
Q

clinical symptoms of echino take up until what

A

10-15yrs after infection

54
Q

Chemotherapy in late stages: of echino

A

generally ineffective; treatment: surgical removal of E.g cyst-
–hepactomy in E.m

55
Q
A
56
Q
A

MIMM 413 (24 decks)

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