helminths

Question 1

Helminthes are divided to

Answer 1

1. Nematodes (roundworms)
2. Cestodes (tapeworms)
3. Trematodes (flukes)

Question 2

Antihelmintihic therapy - drugs

Answer 2

1. Menbendazole
2. Pyrantel paomate
3. Ivermectin
4. Diethylacarbamazine
5. Praziquantel

Question 3

Nematodes (roundworms) bugs and divisions

Answer 3

intestinal:

• Enterobius vermcularis (pinworm)
• Ascaris Lumbricoides (giant roundworm)
• strongyloides stercoralis
• Ancylostomas duodenale (hookworm)
• Necator americans (hookworm)
• Trichinella spiralis
  tissue:
• ochocerca vovlulus
• loa loa
• wucheria bancrofti
• Toxocara canis

Question 4

Enterobius vermcularis is AKA / transmission / disease / treatment / diagnosis

Answer 4

pinworm / fecal oral / intestinal infection causing anal pruritus / bendazoles / seeing egg via the tape test

Question 5

Ascaris lumbricoides is AKA / transmission / disease / treatment / diagnosis

Answer 5

giant roundworm / fecal oral / intestinal infection with possible obstruction at ileocecal valve / bendazoles / egg visible in feces under microscope

Question 6

Strogyloides stercoralis - transmission / disease / treatment

Answer 6

• Larvae in soil penetrate the skin
• intestinal infection causing vomiting, diarrhea, epigastric pain (may feel like peptic ulcer)
• treatment: bendazoles or ivemectin

Question 7

Ancylostomas duodenale and Necator americans (hookworms) - transmission

Answer 7

larvae penetrate skin

Question 8

Ancylostomas duodenale and Necator americans (hookworms) - disease

Answer 8

intestinal infection causing microcytic anemia by sucking blood from intestinal walls
Cutaneous lavra migrans

Question 9

Cutaneous lavra migrans?

Answer 9

caused by Hookworms: pruritic, serpiginous rash from walking barefoot on contaminated beach

Question 10

Ancylostomas duodenale and Necator americans (hookworms) - treatment

Answer 10

bendazoles or pyrantel pamoate

Question 11

tissue nematodes (roundworms) - bugs

Answer 11

1. onchocerca vovlulus
2. loa loa
3. wurcheria bancrofti
4. toxocara canis

Question 12

onchocerca vovlulus - transmission and treatment

Answer 12

female blackfly bite

ivermectin

Question 13

onchocerca vovlulus disease

Answer 13

1. hyperpigmented skin
2. river blindness skin nobules
3. allergic reaction to microfilaria possible
4. loss of elastic fibers

Question 14

Wucheria bancrofti - transmission

Answer 14

female mosquito

Question 15

Wucheria bancrofti - disease and symptoms (and mechanism)

Answer 15

ELEPHANTIASIS: worms block lymphatic vessels –> edema (takes 9 months - 1 yr after bite to become symptomatic)

Question 16

Wucheria bancrofti - treatment

Answer 16

diethylcarbamazine

Question 17

loa loa - disease / transmission / treatment

Answer 17

swelling in skin, worm in conjunctiva

1. deer fly
2. horse fly
3. mango fly
   - diethylcarbamazine

Question 18

Toxocara canis - disease and mechanism

Answer 18

visceral lavra migrans: nematodes migrate to bood through intestinal wall causing inflammation and damage –> organs frequently affected include the heart (myocarditis) liver and CNS (seizure and coma)

Question 19

trichinella spiralis - transmission / treatment

Answer 19

fecal oral
undercooked meat (eps pork)
- Bendazole

Question 20

trichinella spiralis - disease (mechanism and symptoms)

Answer 20

intestinal infection: lavrae enter bloodstream and encyst in striated muscle -> inflammation of muscle
Trichinosis –> fever, vomiting, nausea, periorbital edema, myalgias

Question 21

Nematode routes of infection (and bugs) (generally)

Answer 21

1. ingested –> enterobius, ascaris, toxocara, trichinella
2. cutaneous –> strongyloide, ancylostoma, necator
3. Bites –> Loa Loa, onchocerca vovlulus, Wuchereria bancrofti

Question 22

Cestodes (tapeworms) - bugs

Answer 22

1. Taenia solium
2. Diphyllobothrium latum
3. Echinococcus granulosus

Question 23

Taenia solium - transmission

Answer 23

1. ingestion of larvae encysted in undercooked pork
2. ingestion of eggs contaminated with human feces
   - Central + south america, africa, asia

Question 24

Taenia solium - disease

Answer 24

if ingestion of eggs –> Cysticercosis, neurocysticercosis

if ingestion of larvae encysted in undercooked pork –> intestinal infection

Question 25

Taenia solium - treatment

Answer 25

praziquantel (for intestinal infection and cysticercosis) | albendazole (for neurocysticercosis)

Question 26

cysticercosis - mechanism and presentation

Answer 26

cysticerci in skeletal muscle, brain (neurocysticercosis), eye (blindness)

Question 27

neurocysticercosis - presentation and treatment

Answer 27

``` 1. seizures 2. focal neurological deficit hydrocephalus treatment: 1. seizure/ICH management 2. antiparasaitic: albendazole 3. corticosteroids ```

Question 28

Diphyllobothrium latum - transmission / treatment

Answer 28

ingestion of lavrae from raw freshwater fish | - praziquantel

Question 29

Echinococcus granulosus - transmission / host

Answer 29

ingestion of eggs from dog feces | Sheep are an intermediate host

Question 30

Echinococcus granulosus - treatment

Answer 30

albendazole percutaneous therapy (if more than 5 cm or septations) - if rupture: surgery

Question 31

Cestodes are divided to ... (and treatment)

Answer 31

1. Taenia solium --> praziquantel (for intestinal infection and cysticercosis), albendazole (for neurocysticercosis) 2. Diphyllobothrium latum --> prazuquantel 3. Echinococcus granulosus --> Albendazole, hydatid cysts injected with ethanol or hypertonic saline to kill daughter cysts before removal

Question 32

Trematodes (flukes) - bugs / AKA

Answer 32

Flukes: 1. Schistosoma 2. Clonorchis sinensis

Question 33

Schistosoma - transmission

Answer 33

snail are host | cercarieae penetrate skin of humans

Question 34

Schistosoma - bugs and treatment

Answer 34

1. S. mansoni 2. S. japonicum 3. S. haematobium praziquantel

Question 35

Schistosoma - disease

Answer 35

Liver and spleen enlargement (S. mansoni S. japonicum), fibrosis and inflammation, portal hypertension chronic infection with S. haematobium --> SCC of the bladder and pulmonary hypertension

Question 36

Clonorchis sinensis - transmission

Answer 36

undercooked fish

Question 37

Clonorchis sinensis - disease

Answer 37

Biliary tract inflammation --> pigmented gallstones | associated with cholangiocarcinoma

Question 38

Trematodes (flukes) - bugs and treatment

Answer 38

1. Schistosoma 2. Clonorchis sinensis PRAZIQUANTEL

Question 39

Parasites hints - Brain cysts and seizures

Answer 39

Taenia solium (neurocysticercosis)

Question 40

Parasites hints - Biliary tract disease

Answer 40

chlonarchis siensis

Question 41

Cutaneous Lavra migrans - epidemiology

Answer 41

1. Hookworm Lavrae (dog or cat) 2. Humans are incidental hosts 3. Barefoot contact with contaminated sand or soil

Question 42

cutaneous lavra migrans - clinical manifestation

Answer 42

1. 1ry lower extr 2. cutaneous (deeper is rare) 3. Erythematus, pruritic papule at site of entry 4. intensely pruritic migrating, serpiginous, reddish-brown tracks

Question 43

cutaneous lavra migrans - diagnosis / treatment

Answer 43

1. history of clinical findings 2. eosinophils usually are normal treatment: antihelmintic (eg. ivermectin)

Question 44

neurocysticercosis - diagnosis

Answer 44

CT/MRI - cysts: hypodense, enchancement/edema or Ca2+

Question 45

hydatid cyst - CT

Answer 45

egg shell calcification

Question 46

Mycobact avium - manifestations

Answer 46

nonspecific (fever, cough, abd pain, diarrhea, night sweats, weight loss) in the presence of splenomegaly and an elevated alkaline phosphate level