Helminths

Question 1

Nematodes are what type of worm?

Answer 1

Round worm (filarial and non-segmented)

Question 2

Cestodes are

Answer 2

Tapeworms (flat worms) - segmented

Question 3

Trematodes are

Answer 3

Flukes (flat worms) - non-segmented

Question 4

2 types of flat worms

Answer 4

Flukes (trematodes) and Cestodes

Question 5

Segments in tapeworms are called

Answer 5

Proglottids

Question 6

Clonorctis sinesis is a flatworm that causes

Answer 6

cholangiocarcinoma

Question 7

Ascaris - causes

Answer 7

obstruction of small bowel

biliary colic

Question 8

Flukes and tapeworms - lifecycle

Answer 8

Often dont have a sexually maturing stage they are hermaphrodites

Question 9

Ascaris - life cycle

Answer 9

Direct life cycle

- fecal-oral

Question 10

Ascaris and Filaria - mechanism of harming hosts

Answer 10

Mechanical obstruction -

• ascaris: biliary colic
• Filaria: Lymphatics

Question 11

Which worm do you see macrocytic Vitamin B 12 deficiency?

Answer 11

Tapeworms -

Question 12

Which worm do you often find out-competes the host for Iron?

Answer 12

Hookworm - lodges in bowel and removed blood from capillary

Question 13

Fasciola liver fluke can cause

Answer 13

Cytotoxicity - to liver cells

Question 14

Blood flukes like Schistosoma can cause

Answer 14

Granulomatous inflammation

Question 15

schisotosoma species can cause malignant

Answer 15

Bladder cancer - metaplasia - squamous cell cancer

Question 16

Which cell-mediated response is needed for clearance of intestinal worms?

Answer 16

Th2 response

Question 17

Which cells are also important to fight worms coated with IgE

Answer 17

Eosinophils - degranulate onto IGE coated worms

Question 18

Macrophages fight worms by

Answer 18

ROS intermediated after phagocytosing filaria

Question 19

Nitric oxide produced in response to

Answer 19

IFN gamma and TNF-a

Question 20

IgE dependent mast-cell reactions localize the

Answer 20

Eosinophils to parasites

Question 21

Eosinophils adhere to the worm via which receptors

Answer 21

Fc (binds IgE) and C3 receptor - destroy skin

Question 22

What are the 2 hallmarks of an immune response to worm infections

Answer 22

IgE and Eosinophilia

Question 23

How do you detect shistosomiasis

Answer 23

Urine- blood

Question 24

2 worms you detect radiologically

Answer 24

Hyatid cyst
Cysticercosis
BOTH CESTODES

Question 25

Serology most common to diagnose

Answer 25

infections

Question 26

Which worm causes Hyatid cysts

Answer 26

Echinococcus Tapeworm

Question 27

In Echinococcus tapeworm life cycle who is the definitive host

Answer 27

The dog - adult worm in the gut of dog - sheep and goat are intermediate - we usually act as intermediate host!

Question 28

How do we often treat helminths

Answer 28

anti-parasitics Pumpkin seeds for tapeworms Abx and Antifungals DONT work

Question 29

Hydatid cycsts often managed

Answer 29

Surgically - lung, brain

Question 30

Case: 20 yr old, 3 seizures,

Answer 30

Neurocysticercosis - tapeworm Taenia solium

Question 31

In Taenia solium what is the intermediate host

Answer 31

The pig - greatest seizure disorder | - high prevalence in latin america, asia, india

Question 32

Larva of taenia solium has a predilection for

Answer 32

brain and striated muscle

Question 33

Larva of taenia solium matures in

Answer 33

pig -

Question 34

Taeniasis

Answer 34

Eating raw pig infected with T solium

Question 35

Cystocercosis

Answer 35

When we eat fecal matter from another human - infected with T solium

Question 36

If you eat pig - you do NOT

Answer 36

get cystocercosis

Question 37

Natural history of Parenchymal NeurocS - when are you asymptomatic - first few years

Answer 37

When heads of worm - scolex - are in brain evading immune system

Question 38

Natural history of Parenchymal NeurocS - when do you have seizures

Answer 38

Inflammation - host immune response to the DYING parasite

Question 39

Natural history of Parenchymal NeurocS - when do you punctate calcified scar

Answer 39

dead cystocersis - symptom resolution

Question 40

How do you treat cysticercosis

Answer 40

Anti-parasitic - albenazole, praziquantel

Question 41

If you have cystocercosis in ventricles you need to

Answer 41

Remove endoscopically

Question 42

CASE: 46 yr old goes to montego bay, intense pruritis of plantar foot

Answer 42

Cutaneous Larva migrans - CLM | very COMMON IN JAMAICA

Question 43

In the cat or dog the CLM has a

Answer 43

Direct life cycle - | but in humans it is Indirect via skin penetration

Question 44

How do you diagnose CLM

Answer 44

anti-parasitics

Question 45

25 yr old, proximal wrist swelling, orbital swelling, 3 weeks in central cameroon, very high eosinophilia

Answer 45

Loiasis - a type of filariasis - nematode!! - round worm

Question 46

Loa Loa life cycle - what is the host - eye worm!

Answer 46

vector-borne - deer fly - injects larval stage - need male and female - microfalaria circular in blood, FLY is definitive host

Question 47

Elephantiasis filariasis causes

Answer 47

Moquito borne Lympathic obstruction

Question 48

Filarial dance sign

Answer 48

Ultrasound

Question 49

Serology for filariasis

Answer 49

Cross react with other organisms, NOT specific but very sensitive

Question 50

What is the one case where you can treat with antimicrobials

Answer 50

Doxycycline for Loa loa | and can use anti parasitics