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MIMM 413 > Filaria > Flashcards

Filaria Flashcards

1
Q

true or false: filaria is a roundworm

A

true it is a nematode

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2
Q

where do adult filaria live

A

in body cavities, lymphatics and subvutaneous tissues

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3
Q

microfilaria (embyos) live where

A

live in blood or dermis

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4
Q

what are the vectors of filaria

A

they require an insect or custacean

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5
Q

how long is the microfilaria

A

150-350 u long

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6
Q

how long is the filaria

A

2-12cm long and 4-10u wide

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7
Q

which are the parasites of filaria that live in the blood

A

-wucheria bancrofti
-brugia malayi
-brugia timori
-loa loa
-mansonella ozzardi
-mansonella perstans

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8
Q

what is the geographic distribution, vector and tyoe of disease of wucheria bancrofti

A

-all tropics
-mosquito
-lymphatic filiarisis

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9
Q

what is the geographic distribution, vector and tyoe of disease of brugia malayi

A

-south east asia
-mosquito
-lymphatic filiarisis

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10
Q

what is the geographic distribution, vector and tyoe of disease of brugia timori

A

-timor, indonesia
-mosquito
-lymphatic filiaisis

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11
Q

what is the geographic distribution, vector and tyoe of disease of loa loa

A

-african forest areas
-deer fly
-eye worm

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12
Q

what is the geographic distribution, vector and tyoe of disease of mansonella ozzardi

A

-new world caribbean
-midge
-eye worm

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13
Q

what is the geographic distribution, vector and tyoe of disease of mansonella perstans

A

-all tropics
-midge
-eye worm

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14
Q

what are the filaria that live in the blood

A

-onchocerca volvulus

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15
Q

what is the geographic distribution, vector and tyoe of disease of onchocerca volvutus

A

-africa, yemen, central and south america
-black fly
-river blindness

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16
Q

Lymphatic group: filaria

A

Wuchereria bancrofti
Brugia malayi
Brugia timori

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17
Q

cutaneous group filaria

A

Loa loa
Onchocerca volvulus

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18
Q

body cavity group filaria

A

Mansonella persitans
Mansonella ozzardi

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19
Q

true or false: wucheria bancrofti cause elephantiasis

A

yeah aka lymphatic filariasis

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20
Q

what is the lenght if male and female wucheria

A

Males: Length 4-5 cm
Females: Length 6-10 cm

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21
Q

true or false: microfilaria in wucheria had a sheath in the tail

A

truewhat

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22
Q

what is the host of wucheria

A

humans

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23
Q

what is the lenght of brugia

A

Males: 1-2 cm long
Females: 8-10 cm long

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24
Q

what is the vector of wuheria

A

Mosquito (many species)
eg. Anopheles, Aedes, Culex

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25
Q

true or false: brugia has a sheath in the tail

A

true

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26
Q

what is the definitive host of brugia

A

humans and monkeys

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27
Q

what is the vector of brugia

A

mosquitoes, many species such as aedes and culex

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28
Q

what is the global distribution of lymphatic filariasis

A

33% in India
33% in Africa
33% in Asia,Pacific,Americas

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29
Q

how many people are infected with filariasis

A

120 million
-90% develop bancroftian filariasis

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30
Q

how many people develop the pathology of bancroftian filariasis

A

44 million

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31
Q

what are the 4 phases of wucheria bancrofti

A

-asymptomatic
-inflammatory
-obstructive
-tropical pulmonary eosinophilia

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32
Q

inflammatory wucheria

A
  • lymphangitis - arms 25%
  • legs 11%
  • epididymitis, funiculitis 42%
  • ‘filarial fever’
  • orchitis
  • filarial abscess
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33
Q

obstructive wucheris

A

-elephantiasis
-chyluria
-hydrocele

34
Q

true or false: the incubation phase in filaria is mostly asymptomatic

A

true
it is upuntil there is the appearance of microfilaria

35
Q

what causes the acute or inflammatory phase

A

females reach maturity and release microfilaria

36
Q

what happens during the acute or inflammatory phase of filariasis

A
  • Intense lymphatic inflammation, chills, fever, and toxemia.
  • Swollen lymph nodes. lymphadenitis, orchitis, hydrocele, epidymitis
37
Q

what causes the obstructive phase of filariasis

A

-blockage of lymphatic ducts
-inflammation of lymph nodes and walls

38
Q

what happens in the obstructive phase in filariasis

A
  • Lymph node backs up and passes into surrounding tissue
  • followed by fibrosis, chyluria, elephantiasis
39
Q

what is chylocele

A
  • white lymph fluid in the cavity of the Tunica vaginalis testis
  • caused by rupture of dilated lymp
40
Q

what is acute filarial lumphangitis

A

-afl
-caused by the death of the adult worm

41
Q

what is hydrocele

A
  • collection of serous fluid in the cavity of the Tunica vaginalis testis
  • caused by lymphatic dysfunction
42
Q

what is chyluria

A
  • Milky fluid due to the presence of white lymph from a ruptured dilated lymphatic vessel in the excretory urinary tract
43
Q

what are the factors of the pathogenesis of lymphatic filarial disease

A

-inflammatory/immune mediators
-other factors
-death of parasite/wolbachia
-secundary bacterial/fungal infections

44
Q

what is a sign of an acute attack of filariasis

A

skin is tense and red

45
Q

what is the diagnosis for filaria

A
  • presence of microfilariae
  • finger prick (blood smears)
  • skin snips
  • circulating filarial antigen (CFA) (Wuchereria)
  • IgG4 ELISA tropical eosinophilia syndrome
  • Antifilarial antibodies (IgG and IgE)
  • IgG4 to recombinant antigen
46
Q

what are the treatment for filariasis

A

-diethylcarbamazine aka dec
-albendazole
-vermectin

47
Q
  • Diethylcarbamazine (DEC)
A
  • Sensitizes microfilaria to phagocytosis
  • Optimal dose does not clear all the microfilaria and only a proportion of adult worms are killed
  • 70-80% reduction in transmission using DEC
48
Q

Albendazole

A

-for wucheria
-* It acts by inhibiting the polymerization of beta-tubulin and microtubule formation
Treatment
* Specific for parasite tubulin

49
Q

Ivermectin

A

*Acts by hyperpolarization of Glutamate-sensitive channels. Glu-Cl receptors (specific to parasite receptors) and chloride channel permeability
* 90% reduction in transmission using Ivermectin
* Up to 99% reduction in transmission using DEC + Ivermectin

50
Q

Chemotherapeutic control: of wucheria: the 3 main objective

A
  • Reduced mortality
  • Reduced transmission
  • Interrupt transmission (vector control)
51
Q

true or false: vector control is hard for filaria

A

true

52
Q

Global Programme to Eliminate Lymphatic Filariasis (WHO): objectives

A
  • To interrupt the transmission of infection
  • single dose; two-drug regimen
  • to alleviate and prevent suffering and disability
  • secondary infections
53
Q

international elimination program for lymphatic filariasis, it relies on what?

A

On breaking transmission through yearly mass treatments of entire communities with the anthelmintic drugs Albendazole (Glaxo SmithKline ) in combination with Diethylcarbamazine
or Ivermectin (Merck Co.)

54
Q

Filarial molecules activate both….

A

pro inflammatory and anti inflammatory reactions

55
Q

which tyoe of response does filariasis promotes

A

th2

56
Q

true or false: in asymptomatic microfilaria people, there were higher blocking levels of igg compaired to those that have the chronic lymphatic pathology

A

true

57
Q

igg1 and igg4 significated the difference between what groups

A

the groups that had:
-microfilaria but no clinical disease: had more igg4
-and those that have chronic lymphatic pathology had less: igg1
-

58
Q

IgG4 levels correlate with blocking activity in …… serum

A

those that have microfilaria in blood but no clinical presentation

59
Q

Depletion of IgG4 leads to reduction in blocking
activity in MF sera by ….

A

53-81%

60
Q

Lymphatic Filariasis was targeted for elimination in …

A

1997
we still have it lol
but our treatments work well
there is barely any transmission: 1% for moderate and 5% for high rate

61
Q

what are the other named of loa loa

A

“Loiasis”
“eye worm”
“Calabar Swellings

62
Q

what does onchocerca volvulus cause

A

river blindness

63
Q

how many people are infected with loa loa

A

30 million

64
Q

how many people are affected by river blindness

A
  • 270,000 with blindness
    -500,000 with severe visual impairment
65
Q

how many microfilaria does onchocerca sheds per day

A

1900

66
Q

signs of onchocerca infection

A

-skin lesions
-skin nodules
-eye lesions

67
Q

what are the skin lesions form loaloa

A

edema
pruritus
papules
scab-like eruptions
altered pigmentation
lichenification

68
Q

what are the eye lesions fue to loaloa

A

punctate keratitis
pannus formation
corneal fibrosis
glaucoma
optic atrophy

69
Q

loaloa pathology is associated with

A

Is associated with a long-standing host inflammatory response to proteins from live, dead and/or dying microfilaria

70
Q

inflammatory response of loaloa is mediated by what

A

eosinophils

71
Q

When O. volvulus invades the cornea it causes inflammation of the…

A

sclera, cornea, iris and retina

72
Q

fibrosis leads to blindness ….

A

7-9 years later

73
Q

Dermatitis

A

Itching lead to secondary bacterial infection followed by thickening, discoloration and
cracking of the skin: Lichenification

74
Q

what is pannus formation

A

a slow progressive degenerative disease of the cornea

75
Q

in burkina faso: about 46% of infected men and 35% of women were blind due to …..

A

onchocercasis

76
Q

which country has the highest number of blind in the world due to onchocercasis

A

chad

77
Q

diagnosis of loa loa

A

-microfilaris: skin snip
-if negative the mazzotti test is used: DEC patch=itching
* Detection of filarial antigen
* Detection of anti-filarial antibodies –O. volvulus IgG4
* Complete blood cell count – eosinophilia

78
Q

treatment for loaloa

A

-nodulectomy:
-chemotherapy

79
Q

chemo therapy for loaloa

A

-Diethylcarbamazine is more toxic
-Ivermectin:
Well-tolerated
Action on microfilariae
Reduces fecundity in adult
female worms

80
Q
A

MIMM 413 (24 decks)

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