Helminths

Question 1

What is the difference between Helminths and Protozoa

Answer 1

Helminths: DO NOT multiply in the host; DO cause eosinophilia
Protozoa: MULTIPLY in the host! ONLY Cystoisosopora causes eosinophilia

Question 2

Which filaria most commonly causes hydrocele

Answer 2

Wucheria Bancrofti

Question 3

Big differences between brugia malayi and wucheria

Answer 3

Brugia: Cold filarial abscess and elephantiasis is usually the LOWER legs

Question 4

Tropical Pulmonary Eosinophilia

Answer 4

Wucheria Bancrofti: Mostly males, paroxysmal nocturnal asthma, massive peripheral eoiphilia

Question 5

DEC

Answer 5

Diethylcarbamazine : has aggressive macrofilaricidal (adult) regimen; single dose is microfilaricidal (microfil in the blood)

Question 6

Ivermectin

Answer 6

Only Microfilaricidal, NOT macrofilaricidal

Question 7

Albendazole

Answer 7

Single dose is micro and macrofilaricidal

Question 8

infective stages of filaria:

Answer 8

L3, Hosts are generally flies or mosquitos; the MICROfilariae are released in humans (usually blood)

Question 9

Vector of onchocerca volvulus

Answer 9

similium flies

Question 10

punctate keratitis and snowflake opacities

Answer 10

Onocherca volvulus

Question 11

What is Sowda

Answer 11

Hyper reactive onchodermatitis: Localized hyperimmune reaction to microfilariae

Question 12

Treatment of onchocerva volvulus monoinfection

Answer 12

Ivermectin, Doxycycline, Ivermectin ; then ivermectin repeated q3-6 months

Question 13

Anytime >2500 microfilaria/mL loa loa

Answer 13

ALWAYS consider apharesis first.

Question 14

Dual Loa and Oncho infection

Answer 14

treat oncho FIRST with ivermectin, wait 6-12 months, then LOA with DEC., BUt if >2500 Loa, caution because ivermectin can facilitate loa entry into the CNS with severe encephalopathy and even death

Question 15

dual LF and Loa OR Oncho infection

Answer 15

First treat oncho with ivermectin, wait ONE month then DEC for lymphatic filariasis// If loa + LF, need to know how much Loa Loa there is. If <2500, DEC x 3 doses; if >2500, apharesis first OR ivermectin first then DEC.

Question 16

What can cause tubo-ovarian localization

Answer 16

enterobius vermicularis

Question 17

rectal prolapse and appendicitis

Answer 17

trichuris trichuria

Question 18

largest, obstructive helminth

Answer 18

ascaris lumbricoides

Question 19

anemia in helminths

Answer 19

hook worm, the adult worms ingest the blood

Question 20

Treatment of ascaris

Answer 20

albendazole

Question 21

Hookworm treatmetn

Answer 21

albendazole, 3 days

Question 22

trichuris tx

Answer 22

mebendazole

Question 23

helminths that PENETRATE the skin

Answer 23

ancylostoma duodenale, necator americanus, strongyloides stercoralis (ONLY ONE that causes larva currens)

Question 24

periorbital edema after eating bear, boar, horse meat

Answer 24

trichinella spiralis

Question 25

perianal pruritis in children worldwide

Answer 25

Enterobius vermicularis

Question 26

Vulvovaginitis

Answer 26

enterobius vermicularis

Question 27

D shape

Answer 27

Enerobius vermicularis

Question 28

Which helminths cause eosinophilia

Answer 28

trichuris trichiura, strongyloides stercoralis , ancylostoma duodenale/necator americanus , ascaris lumbricoides

Question 29

rectal prolapse, appendicitis

Answer 29

trichuris

Question 30

what causes visceral larva migrans

Answer 30

toxocara canis or cati

Question 31

clinical manifestations of toxocariasis; Tx?

Answer 31

asymptomatic usually with eosinophilia-abdominal pain, respiratory symptoms, hepatomegaly; can have ocular manifestations uveitis and retinitis// Steroids for ocular disease, DEC and albendazole

Question 32

Visceral larva migrans caused by racoon

Answer 32

baylisascaris procyonis

Question 33

clinical manifestations of baylisascaris

Answer 33

migration of larvae into tissues mostly CNS resulting in eosinophilic meningoencephalitis

Question 34

A gorgas course graduate goes to a sushi bar and then 4 hours later has horrible abdominal pain

Answer 34

anisakis larva in the gastric mucosa

Question 35

A business executive has an insidious onset of an intractable bitemporal headache. 6th nerve palsy. CSF shows 235 WBC and 55% eosinophils . Was at a dinner in seafood market in Bangkok

Answer 35

Agniostrongyliasis (eosinophilic meningitis): caused by angiostrongyliasis (rat lungworm)

Question 36

eosinophilic meningitis, SE asia

Answer 36

angiostrongylus cantonensis, tx with steroids

Question 37

Subcutaneous migratory swellings, creeping eruption; can hace cerebtal bleeding and conjunctival edema

Answer 37

Gnathostoma spinigerum (gnathstomiasis)

Question 38

An open lung resection of a solitary pulmonary nodule from a 35year old non-smoker from NY, a worm is discovered in the necrotic tissue that is removed ; coin lesion

Answer 38

Dirofilariasis : dirofilaria immitis

Question 39

42year old hunter who has never left the US complains of migratory transient swellings on his face for several months. feels like a worm is under his skin

Answer 39

Dirofilariasis tenuis

Question 40

profuse watery diarrhea with massive malabsorption, abdominal pain, eosinophilia, from philipines and thailand ; raw fish

Answer 40

capillaria philippinesis

Question 41

ingestion of water containging infected copepods with a painful lister on your leg. if you go into freshwater, it releases

Answer 41

dracunculus medinensis -guine worm

Question 42

5 causes of destructive facial lesions

Answer 42

Balamuthia Mucormycosis Rhinosclera TB Burkitts lymhoma Leish Paracocci

Question 43

Swimming, chronic nasal lesion, brain leions

Answer 43

Balamuthia Mandrillaris Treatment: Amph B/Miltefosine/albendazole/flucanazole

Question 44

7 warning signs of dengue

Answer 44

abdominal pain persistent vomiting thrombocytopenia with high hct hepatomegaly >2cm mucosal bleeding edema lethargy

Question 45

failed leish and TB treatment for 6 months

Answer 45

chromoblastomycosis tx: itraconazole Pathology: copper bodies