Filaria, Capillaria, Trichinella Flashcards
(113 cards)
1
Q
Medically important filarial species in the Philippines
A
Wuchereria bancrofti
Brugia malayi
Usually in Mindanao and Bicol
2
Q
Common names of
Wuchureria
Brugia
A
Wuchureria: Bancrofti’s Filarial worm
Brugia: Malayan Filarial Worm
3
Q
Intermediate host of
Wuchureria bancrofti:
Brugia malayi:
A
Wuchureria bancrofti: Anopheles, Aedes, Culex
Brugia malayi:
Mansonia bonneae, M. uniformis
4
Q
Habitat of adult:
Wuchureria bancrofti:
Brugia malayi:
A
Wuchureria bancrofti: Lower lymphatic
Brugia malayi: upper lymphatic
5
Q
Infective stage of
Wuchureria bancrofti:
Brugia malayi:
A
IS to FH: L3
IS to IH: Microfilariae
6
Q
MOT of
Wuchureria bancrofti:
Brugia malayi:
A
both skin penetration
7
Q
Periodicity of
Wuchureria bancrofti:
Brugia malayi:
A
Wuchureria bancrofti: nocturnal (10pm - 2am)
Brugia malayi:
Periodic-nocturnal / Subperiodic
8
Q
Cephalic space of (length : width)
Wuchureria bancrofti:
Brugia malayi:
A
Wuchureria bancrofti: 1:1
Brugia malayi: 2:1
longer than its width
9
Q
Sheath affinity to Giemsa:
Wuchureria bancrofti:
Brugia malayi:
A
Wuchureria bancrofti: Unstained
Brugia malayi: Stained-pink
10
Q
Body/somatic nuclei of
Wuchureria bancrofti:
Brugia malayi:
A
Wuchureria bancrofti: regularly shaped
Brugia malayi: overlapping / irregular
11
Q
Terminal nuclei of
Wuchureria bancrofti:
Brugia malayi:
A
Wuchureria bancrofti: NO TERMINAL NUCLEI
Brugia malayi: two nuclei
12
Q
Appearance of
Wuchureria bancrofti:
Brugia malayi:
A
Wuchureria bancrofti: Graceful curve
Brugia malayi: Kinky / stiff
13
Q
Pathology of
Wuchureria bancrofti:
Brugia malayi:
A
Wuchureria bancrofti: Bancroftian Filariasis
Brugia malayi: Malayan Filariasis
14
Q
Lymphatic Filarial worms can cause
A
Elephantiasis
15
Q
Elephantiasis habitat
A
Scrotal area, legs
16
Q
stage released in the bloodstream
seen in blood smears
A
Microfilariae
17
Q
Staining of Wuchereria bancrofti in
H&E stain:
Giemsa stain:
A
H&E stain: slightly /lightly stained
Giemsa stain: darkly stained
18
Q
WUCHERERIA BANCROFTI
● Periodicity
A
Nocturnal (10pm-2am)
8 pm – 4 am (Belizario)
▪Only seen at night unless DEC is administered (pinainom)
▪ tablet para lumabas anytime or during day time
19
Q
Vectors of WUCHERERIA BANCROFTI
A
Mosquitoes – Anopheles flavirostris, Aedes poecilus, Culex
20
Q
Vector of WUCHERERIA BANCROFTI that
▪ Causes dengue (same species)
▪ Breeds in water or axils of abaca and banana
A
Aedes poecilus
21
Q
Vector of WUCHERERIA BANCROFTI that
▪ Principal vector for malaria, too
A
Anopheles flavirostris
22
Q
Vector of WUCHERERIA BANCROFTI that
▪ Major vectors in urban areas
▪ Breeds in drains, sewage, beaches
A
Culex
23
Q
Vectors of Brugia malayi
A
Mansonia bonnae
Mansonia uniformis
24
Q
Vector of Brugia malayi that
Breeds in freshwater swamps
A
Mansonia bonnae
25
Vector of Brugia malayi that
Breeds in rice fields
Mansonia uniformis
26
TRUE OR FALSE
| Vectors of Brugia malayi are noght biters
TRUE
Both are night biters (5 pm – 11 pm)
27
Periodicity of Brugia malayi
Subperiodic
| o Seen in the bloodstream any time of the day
28
Diagnosis
●Microscopy of Giemsa-Stained Blood Smears (Recommended)
● Knott’s Concentration Technique
● Filtration using Millipore
● DEC Provocative Test
o paiinumin iyan ng tablet 100 mg then 20-50 minutes pede mo na kunan ng blood
● Antigen Detection Test
29
Lymphatic filariasis is commonly known as
Elephentiasis
30
Manifestations of Elephantiasis
```
Malaki legs
Convolutions
Enlargement of breast
Lymph edema
Hydrocele (fluid in scrotum)
```
31
Procedure of Knott's concentration technique
```
Collect blood
Mix with 2% formalin
Centrifuge
Decant the supernatant
Put sediment with parasite in slide
Air dry
Apply Giemsa stain (or wright stain)
Observe
```
32
What should be considered in observing parasites in Knott's concentration technique
differentiate: nuclei, color ng sheath, anterior portion, cephalic space
33
Adult male worm ahs characterized with chitinized spicule and long spicule sheath.
C. philippinensis
o spicule for copulation
o counterpart ng spicule ay penis of the male
o unique with Capillaria is that spicule is sheathed
o take note sheath is gne body coffin
34
The habitat of C. philippinensis
Small intestine
35
TRUE OR FALSE: Cooking meat to 170F or freezing
| for 20 days at 50F will kill larvae
TRUE
o Raw food (like sushi) – has high chance to acquire
parasitic infection from eating contaminated meat.
o A way to kill parasite without cooking (like sushi) is
freezing them
o Freezing will kill parasites
36
Xenodiagnosis can be used to diagnose infection with.
Trichinella spiralis
o what is the other protozoan that can be use to
diagnosed Xenodiagnosis? trypanosoma cruzi
o Xenodiagnosis is procedure to use animals to
diagnose certain infection
37
TRUE OR FALSE: Trichinella spiralis can infect human muscle.
TRUE
Trichinella spiralis is also known as muscle worm
because it can infect the muscles
38
Capillaria Philippinensis was discovered in
Pudoc, Ilocos Sur, Philippines
39
Before, Capillaria Philippinensis was called
Mystery worm, the agent of the mystery disease Because the egg of capillaria
philippinesis resembles the egg of trichuris trichura (due to the bipolar plugs)
40
Capillaria Philippinensis egg is mistaken as
Trichuris trchiura
41
who discovered Capillaria Philippinensis
Nelia Salazar (1963 –UP manila)
42
Common name of Capillaria philippinensis
Pudoc worm
43
Final host of Capillaria philippinensis
birds and humans
44
Incidental / accidental hosts of Capillaria
Humans but we still harbor the sexual stage / adult stage
45
Intermediate hosts of Capillaria philippinensis
brackish and freshwater fish (small fishes)
46
People in northern region acquired this parasite because
they are fond of kinilaw (uncooked fish soaked in vinegar)
47
TRUE OR FALSE
Vinegar can kill bacterias and parasites
FALSE
Vinegar can kill bacteria but not parasite
48
habitat of Capillaria philippinensis
small intestine of birds and humans
49
diagnostic stage of Capillaria philippinensis
ova (egg) in the stool
in severe cases egg, larvae and adult stages are also seen
50
Infective stage of Capillaria philippinensis
Larva in intermediate host (no specific name)
51
Source of infection of Capillaria philippinensis
Food borne
52
Mode of Transmission of Capillaria philippinensis
ingestion
53
portal of entry of Capillaria philippinensis
mouth
54
What are the intermediate hosts of Capillaria philippinensis
```
● guppy – Poecilia reticulata
● Bukto – Chonophotus melanocephalus
● Bagsang – ambassis miops
● Ipon – sicyopterus sp,
●Birut?
```
55
TRUE OR FALSE
a dried fish can no longer harbor larva stage and is therefore not infectious
TRUE
56
TRUE OR FALSE
The larvae is still viable even though the fish has been
caught for several days.
TRUE
57
TRUE OR FALSE
| Morphology of adult male has a curved tail
FALSE
you will not see a curved posterior tail.
58
Morphology of adult male includes
Chitinous Spicule
Spicule sheath (unique in C. philippinensis)
Presence of Stichocytes
59
– accessory reproductive structure
in male nematodes; useful in identification of species.
▪ usually found in the posterior portion
HAS A LONG SPICULE
Copulatory spicule
Chitinous spicule
60
Esophageal gland that contains stichocytes
stichosome
61
What differentiates Capillaria from other nematodes is the
| presence of
stichosome
62
Morphology of adult female includes
Eggs
| Stichosome
63
The spicule of an adult male is made up of
chitin which is why it is also termed as Chitinous spicule
64
2 types of capillaria female
typical female (oviparous)
atypical female (oviviparous / larviparous)
65
typical female (oviparous) has eggs of around
8-10 or more in a single row
66
atypical female (oviviparous) has eggs that are
segmented eggs / embryonated eggs
40-45 eggs
67
Which of the two is capable of autoinfection wherein you are the source of your own infection?
Atypical demale
the larva that is laid continues the cycle making the larva mature again
68
Capillaria philippinensis egg
thick, striated egg shell
flattened bipolar plugs
Peanut / guitar-shaped
69
Diagnostic tests of Capillaria philippinensis
●DFS
●Concentration technique (FECT)
● examination of duodenal aspirate
● Kato-Katz
● ELISA test
o we detect the Capillaria coproantigen. However,
this coproantigen cross-reacts with Trichinella spiralis which means they (the antigens) are almost the same
70
Coproantigens of Capillaria philippinensis cross-reacts with that of the
Trichinella spiralis
71
Pathology of Capillaria Philippinensis
Pudoc disease, Mystery disease
```
●microulceration, depression of intestinal villi
● Borborygmi / Borborygmous
● Abdominal pain
● Diarrhea (main pathology)
● Weight loss
● Malabsorption
● Low plasma electrolyte concentration
```
72
Treatment
Albendazole and Mebendazole
73
Common name of the Trichinella spiralis
Trichina worm / muscle worm
74
Final host of the Trichinella spiralis
Swine and other vertebrates (secondary hosts)
others are bears, boars, oso
common among carnivores
75
Habitat of Trichinella spiralis
adult - small intestine
larvae - striated muscle
76
Diagnostic stage of Trichinella spiralis
Encysted larvae (muscle tissue)
77
sample used in diagnosis of Trichinella spiralis
muscle tissue - muscle biopsy
78
Infective stage of Trichinella spiralis
Encysted larvae (muscle tissue)
79
Sources of infection in Trichinella spiralis
Food-borne / zoonotic
80
TRUE OR FALSE
Trichinella spiralis cannot be transferred via human-to-human transmission (would only be possible through cannibalism)
TRUE
81
Accidental hosts of the Trichinella spiralis
Humans
82
T. spiralis is also called the ____ of infection
end alley
83
Who are the dead-end host / accidental host
humans
the larva in our muscle cannot be acquired by another mammal
84
can be observed assisting the larva
nurse cells
85
Life cycle of the trichinella spiralis
1. ingestion of undercooked meat
2. Encysted larva will be released into the small intestine where maturation will happen
3. Male and female will undergo reproduction (female will become gravid and it will migrate to the submucosal limning of the small intestine and lay larva)
4. Laid larva will proceed to the bloodstream and once it reaches a crtain tissue, it will undergo encystation and will become encysted larva
86
Laboratory diagnosis of the Trichinella spiralis
●Muscle tissue biopsy (Deltoid & gastrocnemius)
●Ultrasound / Radiographic procedure
●Chemical assays (check isoenzyme CK-MM found in skeletal muscle)
High CK-MM=destruction muscle but this is not specific
● Species identification (PCR, Western blot assay)
● Beck’s Xenodiagnosis (no longer performed)
● Serological tests (detects antibodies against T. spiralis antigen)
Bentonite Flocculation Test
▪ in-vitro (outside the body) test
▪ collect serum then add reagent
▪ positive result: presence of clumping / flocculation
●Bachman intradermal test
87
Female trichinella spiralis are
a. oviparous
b. larviparous
b. larviparous
88
TRUE OR FALSE
There is no egg stage in this life cycle
TRUE
89
Why do we make use of radiographic procedure or X-rays in detection of trichinella spiralis?
because hyperinfection of T.spiralis larva can be calcified in the striated muscle
90
Skin test for trichinosis
Indirect method
bachman intradermal test (in vivo test)
1:5000 or 1:10000 dilution of larval antigen
trichinella larva is suspended in saline, saline is injected intradermally. observe of hypersensitive reaction whcich is triggered if we are re-exposed
Wheal (redness) and flare (swelling) = type 1 hypersensitivity reaction (immediate reaction)
91
Phases of clinical conditions (pathology) of trichinella spiralis
o Enteric phase
o Invasion phase
o Convalescent phase
92
What phase of clinical conditions includes
corresponds to the incubation and intestinal invasion
➢ In human digestion, the meat you eat will release
the Trichinella spiralis larva into the intestine and will mature rapidly to become an adult.
➢ Adult female (larviparous) will migrate to your
intestinal mucosa which will lay the larva into
submucosa.
Enteric phase
93
What phase of clinical conditions includes
corresponds to larval migration and muscle invasion
➢ The intent larva will enter the bloodstream. It will encyst in the striated muscle.
➢ We can see this through the microscopic
examination of tissue biopsy.
■ Muscle fiber will contain our coiled larva
■ Nurse cell will provide nutrition to your
encysted larva in the striated muscle
➢ Over time, it will form granuloma due to reaction of immune cell and it will be calcified around this cell
Invasion phase
94
Role of the nurse cell
assists the encysted larva by providing nutrition
95
What phase of clinical conditions includes
corresponds to encystment and encapsulation
➢ Humans are not traditional hosts as compared to
swine or bears. Life cycle does not occur and
cycle ceases with encystation of the larva.
➢ This type of parasite is just waiting to be eaten
by another mammal to continue its cycle.
➢ It usually happens in swine and wild bears that
can continue the cycle.
Convalescent phase
96
Pathologies of Trichinella spiralis
```
●Meningitis and Meningoencephalitis
●can also cause intestinal disorder
●Encysting and encapsulating eosinophilia ●Periorbital swelling
●Muscle tenderness, pain - common
●Edema generalized weakness
●Diarrhea (may be rare)
```
97
What are the muscle enzymes
Lactate dehydrogenase (LD)
Aldolase
Creatine phosphokinase (CK)
98
TRUE OR FALSE
Filarial worms are tissue nematodes
TRUE
99
Anthropod-transmitted parasite of the circulatory and lymphtic system
Filarial worms
100
How many larval molts in the life cycle of the filarial infection
5 larval molts
3 in insect vector
2 in human host
101
adult filarial worms reside in
lympathic system
102
life cycle of filarial worms
1. Infective L3 is deposited in blood and would reach the lymphtic system
2. a 6 or 12 months perior is required for sexual maturity. The parasite undegoes 2 molts and the adult worm develops (L5). Adult worms reside in lymphatics or lymph nodes
3. Adult female worm gives birth to L1 larvae called microfilariae
103
How many microfilariae can a filarial worm lay
50,000 per day
104
sample for diagnosis for filarial infection
blood or lymphatic fluid
105
Drug of choice for filarial infection
If the patient is presenting tropical pulmonary eosinophilia and it could be caused by a filarial worm
Diethylcabamazine
106
Caused by Larva which is found at lymphatic and
| circulatory system
Tropical pulmonary eosinophilia
107
TRUE OR FALSE
Lymphatic filariasis is the second leading cause or permanent and long term disability, affecting both physical and psychological aspect of the patient
TRUE
108
What are the two most common causes of the lymphatic filariasis (etiologic agent)
Wuchereria bancrofti
| Brugia malayi
109
TRUE OR FALSE
The adult females of B. malayi and W. bancrofti are distinguishable
FALSE
| The adult females of B. malayi and W. bancrofti are indistinguishable
110
Hydrocele / chylocele is a common chronic manifestation of
Bancroftian filariasis
111
Trichinella spiralis female is viviparous and lives for ___ and can lay ___ larvae in its lifetime
30 days
1,500 larvae
112
superfamily of Capillaria philippinensis is
Trichinelloidea
to which trichuris and trichinella belong
113
superfamily of Trichinella spiralis is
Trichinelloidea
