Exercise No. 8b PHYLUM PLATYHELMINTHES Class Trematoda - Monoecious Flukes Flashcards
(166 cards)
1
Q
Leaf-shaped
A
Fasciola hepatica
2
Q
Pointed anterior, rounded posterior (“bottle-neck” appearance)
A
Clonorchis sinensis
3
Q
Resembles C. sinensis
A
Opisthorchis felineus and Opisthorchis viverrini
4
Q
Lancet-shaped
A
Dicrocoelium dendriticum
5
Q
Elongate-ovoidal in shape
A
Fasciolopsis buski
6
Q
Attenuated at both ends
A
Echinostoma ilocanum
7
Q
Narrow anterior, rounded posterior (“pyriform”)
A
Heterophyes heterophyes
8
Q
Resembles H. heterophyes
A
Metagonimus yokogawai
9
Q
When active: spoonshaped; At preserved state:70-100 x 50-60 pm oval, flattened, coffee-bean-shaped
A
Paragonimus westermani
10
Q
Integument: scales vary in size, pattern & distribution, but posterior is aspinose
A
Fasciola hepatica
11
Q
Integument: aspinose
A
-Clonorchis sinensis
-Opisthorchis felineus and Opisthorchis viverrini
-Dicrocoelium dendriticum
12
Q
Integument: Spinose
A
Fasciolopsis buski
13
Q
Integument: with spines and scales
A
Echinostoma ilocanum
14
Q
Integument: scales are narrow and closely set, numerous in the anterior
A
Heterophyes heterophyes
15
Q
Integument: scale-like spines
A
Paragonimus westermani
16
Q
Oral sucker, 0.5 mm
Ventral sucker, 2-3 mm
A
17
Q
Uterus, coiled
A
-
-
-Fasciolopsis buski
18
Q
Vitellaria, highly branched in the lateral and posterior
A
Fasciolopsis buski
19
Q
Vitellaria, medium-sized follicles in posterior % lateral fields
A
Echinostoma ilocanum
20
Q
Vitellaria, large, polygonal follicles in each lateral posterior third
A
Heterophyes heterophyes
Metagonimus yokogawai
21
Q
.
A
22
Q
Genital sucker, armed w/spines
A
Heterophyes heterophyes
23
Q
Vitellaria, branched, lateral for the entire length of the body
A
Paragonimus westermani
24
Q
Ceca, unbranched
A
Fasciolopsis buski
25
Circumoral disk with horseshoe-shaped crown of 49-51 hooks
Echinostoma ilocanum
26
Ovary, branched
Fasciola hepatica
27
Ovary, round or lobed
Echinostoma ilocanum
28
Ovary, subglobose
Heterophyes heterophyes
Metagonimus yokogawai
29
Ovary, lobed
Paragonimus westermani
30
Testes, highly dendritic
In tandem in the 2nd & 3rd fourths
Fasciola hepatica
31
Testes, deeply lobed or branched in tandem in the posterior 3rd fields
Clonorchis sinensis
32
Testes lobed oblique to each other in the posterior 4th
Opisthorchis felineus and Opisthorchis viverrini
33
Testes, slightly lobed, oblique to each other
Dicrocoelium dendriticum
34
Testes, highly dendritic
In tandem in posterior 1/2
Fasciolopsis buski
35
Testes, lobed
In tandem in posterior 1/2
Echinostoma ilocanum
36
Testes, ovoid, side by side in the posterior fifth
Heterophyes heterophyes
37
Testes, ovoid obliquely side by side in posterior 5th
Metagonimus yokogawai
38
Testes, lobed, oblique to each other or nearly side by side at the posterior third
Paragonimus westermani
39
Ovoid, hen's egg- shaped
Fasciola hepatica
40
broadly ovoid ("old- fashioned electric bulb")
Clonorchis sinensis
41
elongate-ovoid, narrower than C. s/nens/sova
Opisthorchis felineus and Opisthorchis viverrini
42
asymmetrically ovoidal
Dicrocoelium dendriticum
43
hen's egg-shaped, identical to F. hepatica, thin, transparent shell
Fasciolopsis buski
44
straw-colored, ovoid
Echinostoma ilocanum
45
ovoid, less distinct opercular shoulder
Heterophyes heterophyes
46
Similar to H. heterophyes
Metagonimus yokogawai
47
shape varies greatly, some asymmetrical, thick shell
Paragonimus westermani
48
light yellowish-brown
-Fasciola hepatica
-Clonorchis sinensis
-Opisthorchis felineus and Opisthorchis viverrini
49
dark brown
Dicrocoelium dendriticum
50
thin, transparent shell
Fasciolopsis buski
51
straw-colored
Echinostoma ilocanum
52
Yellowish-brown to dark golden brown
Paragonimus westermani
53
small, flat operculum at one end
Fasciola hepatica
54
convex operculum fits a circular rim of shell, small knob at the abopercularend
Clonorchis sinensis
55
operculum fits into a thickened rim of shell, minute thickening at the abopercular end
Opisthorchis felineus and Opisthorchis viverrini
56
broad convex operculum
Dicrocoelium dendriticum
57
small, slightly convex operculum
Fasciolopsis buski
58
small operculum
Echinostoma ilocanum
59
less distinct opercular shoulder
Heterophyes heterophyes
60
flattened operculum, thickened opercular rim, and abopercular end is generally thicker than the sides
Paragonimus westermani
61
Ovary central
Schistosoma japonicum
62
Ovarv anterior half
Schistosoma mansoni
63
Ovary posterior half
Schistosoma haematobium
64
Tegument smooth
Schistosoma japonicum
65
Tegument coarsely tuberculated
Schistosoma mansoni
66
Tegument slightly tuberculated
Schistosoma haematobium
67
6-8 testes
Schistosoma japonicum
68
8-9 testes
Schistosoma mansoni
69
4-5 testes
Schistosoma haematobium
70
Lateral knob
Schistosoma japonicum
71
Lateral spine
Schistosoma mansoni
72
Terminal spine
Schistosoma haematobium
73
50-100 ova in uterus
Schistosoma japonicum
74
1-4 ova in uterus
Schistosoma mansoni
75
20 - 30 ova in uterus
Schistosoma haematobium
76
Definitive diagnosis: demonstration of characteristic eggs in feces or aspirated bile from duodenum
77
Definitive diagnosis: demonstration of characteristic eggs in feces or aspirated bile from duodenum
-Dibothriocephalus latus (Diphyllobothrium latum)
-Clonorchis sinensis
-Opisthorchis felineus and Opisthorchis viverrini
78
Definitive diagnosis: demonstration of characteristic eggs in feces
Dicrocoelium dendriticum
Echinostoma ilocanum
79
Definitive diagnosis: demonstration of characteristic eggs in feces of the worms after administration of a purgative or anthelmintic drug
Fasciolopsis buski
80
Definitive diagnosis: detection of characteristic eggs in feces
Heterophyes heterophyes and Metagonimus yokogawai (The heterophyids)
81
Definitive diagnosis: detection of characteristic eggs in sputum
Paragonimus westermani
82
best method of diagnosis for Dibothriocephalus latus (Diphyllobothrium latum)
Microscopic examination
83
Eggs of [?] are indistinguishable.
F. hepatica and F. buski
84
Differential diagnosis must be made to differentiate between TRUE INFECTION form SPURIOUS INFECTION.
Dibothriocephalus latus (Diphyllobothrium latum)
85
result from ingestion of infected herbivore liver harboring the eggs which are passed out in the feces without any morphological changes
SPURIOUS FASCIOLIASIS
86
The following steps may be performed:
1. Ask the patient if he has taken/ included liver in his previous diet.
2. Advice him to have a liver-free diet for 2 – 3 days and recollect a stool sample
3. Patient’s stool sample is reexamined and, if
(+) eggs in the feces: TRUE INFECTION
(-) eggs in the feces: SPURIOUS INFECTION
87
Blood picture.
Examination of peripheral blood reveals eosinophilia.
Dibothriocephalus latus (Diphyllobothrium latum)
88
Serodiagnosis.
a. Antibody detection
b. Antigen detection
Dibothriocephalus latus (Diphyllobothrium latum)
89
Serological tests such as immunofluorescence, ELISA, immunoelectrophoresis and complement fixation are helpful for detection of specific antibody in light infections.
Dibothriocephalus latus (Diphyllobothrium latum)
90
ELISA becomes positive within 2 weeks of infection and is negative after treatment.
Dibothriocephalus latus (Diphyllobothrium latum)
91
is of diagnostic importance during chronic fascioliasis
Antigen detection
92
Fasciola coproantigen may be detected in stool.
Antigen detection
93
Dibothriocephalus latus (Diphyllobothrium latum) Imaging
a. Ultrasonography
b. computed tomography (CT) scan
c. endoscopic retrograde cholangiopancreatography (ERCP)
d. percutaneous cholangiography
94
Detecting moderate to heavy infections:
a. Kato thick smear b. Stoll’s dilution c. Quantitative FECT
Clonorchis sinensis
95
Eggs do not float in concentrated saline.
Clonorchis sinensis
96
Eggs of C. sinensis are difficult to differentiate from those of
H. heterophyes, M. yokogawai, and O. felineus species.
97
Blood examination.
Examination of peripheral blood smear may reveal leukocytosis with eosinophilia.
Clonorchis sinensis
98
Immunodiagnosis
Several serological tests for antibody detection have been described but extensive cross-reactions limit their utility.
Clonorchis sinensis
99
Clonorchis sinensis Immunodiagnosis
a. Complement fixation
b. Gel precipitation
c. IHA with a saline extract of etherized worms
d. ELISA
100
has been reported to be sensitive and specific
IHA with a saline extract of etherized worms
Clonorchis sinensis
101
Fecal antigen detection
ELISA
Clonorchis sinensis
102
Intradermal allergic (hypersensitivity) tests
Clonorchis sinensis
103
Detecting moderate to heavy infections:
a. Kato thick smear b. Stoll’s dilution c. Quantitative FECT
Opisthorchis felineus and Opisthorchis viverrini
104
Eggs do not float in concentrated saline.
Opisthorchis felineus and Opisthorchis viverrini
105
Eggs of are difficult to be differentiate on morphological grounds from those of C. sinensis, H. heterophyes, M. yokogawai,.
Opisthorchis felineus and Opisthorchis viverrini
106
useful for specific identification of O. viverrini
Polymerase chain reaction (PCR)
107
Similar with Fascioliasis, differential diagnosis must also be performed in order to differentiate true infection from spurious infection which may arise from ingestion of the parasite’s egg in contaminated cattle liver.
Dicrocoelium dendriticum
108
History of residence in endemic areas suggests diagnosis
Fasciolopsis buski
109
The eggs of [?] are indistinguishable.
F. buski and F. hepatica
110
Examination of peripheral blood
Eosinophilia is often present
Fasciolopsis buski
111
Immunodiagnosis
Serodiagnosis is of no value.
Fasciolopsis buski
112
first documented in humans in 1987, and has since been reported in Northern and Central Luzon
Artyfechinostomum (Echinostoma) malayanum
113
In 2005, a study in Siargao Island, Surigao del Norte, showed A. malayanum in [?] of individuals suffering from gastrointestinal disturbance.
11.4%
114
All infected patients has a history of having eaten [?] prepared raw with coconut milk and lime juice.
snails (kuhol and kiambuay)
115
Kato Thick method
has a higher sensitivity compared to FECT (31.0% vs. 13.6%)
Heterophyes heterophyes and Metagonimus yokogawai (The heterophyids)
116
careful inspection of the egg’s features must be observed in order to differentiate it from those of C. sinensis and Opisthorchis species
Kato Thick method,
117
may be useful as a sensitive diagnostic tool, particularly for low-intensity heterophyid infections
PCR
118
o stool o gastric washing o abscess o pleural effusions o tissue material
Paragonimus westermani
119
Serology is of particular importance in eggnegative cases and in cerebral paragonimiasis.
Paragonimus westermani
120
Parasite-specific immunoglobulin E (lgE) and antiparagonimus antibodies can be detected in serum.
Paragonimus westermani
121
carried out with a saline extract of adult Paragonimus westermani or other suitable antigen gives an immediate sensitivity reaction in infected persons
Intradermal test
122
remains positive long after recovery, thereby indicating past infection
Intradermal test
123
used for the diagnosis indicates an active infection
Complement fixation test
124
highly sensitive
IHA and ELISA tests
125
tests become negative within 3-4 months after successful treatment
IHA and ELISA tests
126
reveals abnormal shadows (nodular, cystic, and infiltrative) in the middle and lower lung fields similar to pulmonary tuberculosis
Chest X-ray
127
presence of shadows of tunnels and “burrows” in the lung bases resemble bronchiectasis
Chest X-ray
128
chest
also helps in diagnosis of pulmonary and cerebral lesions
CT scan
129
"Soap-bubble'' like appearance may be seen in cerebral cysts
CT scan
130
Microscopic examination of stool samples to demonstrate characteristic eggs of S. japonicum and S. mansoni may be accomplished by routine parasitologic methods and/or quantitative techniques to determine worm burden; similar to those techniques employed in the diagnosis of helminthiasis.
Examination of stool
131
Microscopic examination of urine is used to demonstrate characteristic eggs of S. haematobium. This may be accomplished by one of the following methods:
1. Urine sedimentation
2. Urine filtration
Examination of urine
132
T or F
When schistosome eggs are recovered from either urine or stool, they should be carefully examined to determine viability.
T
133
T or F
An individual who has undergone successful treatment form schistosomiasis continuously pass out residual eggs which are non-viable, hence may indicate good, previous treatment.
T
134
On the other hand, the presence of living [?] within the eggs indicates an active infection that may require therapy.
miracidia
135
At the end of micturition, the [?]contracts facilitating extrusion of eggs deposited in the walls of the bladder.
urinary bladder
136
The sample should consist of a single terminal urine specimen of at least
10 mL
137
The viability of the miracidia can be determined in two ways
1. Flame cell activity2. Miracidial hatching test
138
Schistosome miracidia possess primitive excretory cells known as flame cells. If eggs are viable (i.e. containing viable miracidia) the cilia of the flame cells may be seen on a wet smear by using high dry power and are usually actively moving.
Flame cell activity
139
, the miracidia may be released from the eggs recovered in stool or urine.
Miracidial hatching test
140
Histopathology
Schistosomiasis may also be diagnosed by demonstration of characteristic schistosome eggs during microscopic examination of biopsy materials obtained from the [?] (for intestinal schistosomiasis), or the [?] (for urinary schistosomiasis).
rectal valve
urinary bladder
141
Detection of schistosome antigens may be performed using a patient’s [?] (for S. haematobium).
serum or urine
142
Two circulating antigens related to gut of adult schistosomes:
(1) circulating anodic antigen (CAA)
(2) circulating cathodic antigens (CCAs) can be demonstrated by dipstick assay and ELISA using urine obtained form a suspected individual
143
The test is very sensitive and specific but is available only in specialized laboratories
Antigen detection
144
Soluble egg antigens (SEAs) can be demonstrated in serum.
Antigen detection
145
Several tests have been described to detect specific antibodies in serum samples of infected individuals. The most common are:
I. Circumoval Precipitin Test (COP/COPT)
II. FAST-ELISA (Falcon Assay Screening Test-Enzyme-linked Immunosorbent Assay)
146
o employed to detect antischistosomal antibodies in patients serum using lyophilized eggs or purified live (viable) eggs identified under the microscope as antigens
Circumoval Precipitin Test (COP/COPT)
147
The procedure involves reacting 1 drop (about 0.025 ml) of the antigen suspension with 3 drops (about 0.075 ml) of patient’s serum into a well of a slide.
Circumoval Precipitin Test (COP/COPT)
148
The reaction well is overlaid with a coverslip and incubated at 34 degrees C for 24 hours.
Circumoval Precipitin Test (COP/COPT)
149
The slide is examined under the microscope for reaction.
Circumoval Precipitin Test (COP/COPT)
150
The appearance of blebs of precipitate around the eggs is considered as a positive result.
Circumoval Precipitin Test (COP/COPT)
151
COPT is considered useful in the diagnosis of intestinal schistosomiasis.
Circumoval Precipitin Test (COP/COPT)
152
This method employs the use of purified , species-specific microsomal antigens of adult schistosome worms to detect antibodies in the patient’s serum.
FAST-ELISA (Falcon Assay Screening Test-Enzyme-linked Immunosorbent Assay)
153
A positive reaction (greater than 9 units/µl serum) indicates infection with schistosome species.
FAST-ELISA (Falcon Assay Screening Test-Enzyme-linked Immunosorbent Assay)
154
The specificity of the FAST-ELISA is 99%, and its sensitivity is 99% for S. mansoni, 95% for S. haematobium, and approximately 50% for S. japonicum infection
FAST-ELISA (Falcon Assay Screening Test-Enzyme-linked Immunosorbent Assay)
155
Abdomen
may show bladder and ureteral calcification in infections with S. haematobium
a. X-ray
156
may show hydroureter and hydronephrosis in urinary schistosomiasis and hepatosplenomegaly and periportal fibrosis in chronic intestinal schistosomiasis
b. Ultrasonography (USG)
157
also useful in indirect diagnosis of urinary bilharziasis
c. Intravenous pyelogram (TVP) and cystoscopy
158
Aside from the three medically significant schistosomes previously mentioned, 2 more schistosome species have been found to infect man. They are:
Schistosoma lntercalatum
Schistosoma mekongi
159
o was first noted in 1934 in West-Central Africa
Schistosoma lntercalatum
160
o The eggs are similar to S. haematobium in general shape and in possessing a terminal spine, but are usually longer (140-240 µm), often have an equatorial (central) bulge and are shed in stool, not urine and are acid-fast.
Schistosoma lntercalatum
161
o It produces few symptoms involving the mesenteric portal system.
Schistosoma lntercalatum
162
o Diagnosis is established by the detection of the egg in feces and rectal biopsy.
Schistosoma lntercalatum
163
was first recognized in 1978 in Thailand and Cambodia, along the Mekong river
Schistosoma mekongi
164
Man, acquires infection in the same way as in S. japonicum, serves as the definitive host together with dogs.
Schistosoma mekongi
165
The eggs are closely related in morphology to S. japonicum but are generally smaller (50-80 µm by 40-65 µm).
Schistosoma mekongi
166
They also contain a small, inconspicuous spine and are shed in stool.
Schistosoma mekongi
