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Clinical Medicine Lecture - Professor Kramer > Infectious Disease - Helminth Infestations 1 > Flashcards

Infectious Disease - Helminth Infestations 1 Flashcards

(72 cards)

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1
Q

Hookworms infect __% of the world’s population

A

25%

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2
Q

Schistosomiasis affects ___million people worldwide, accounts for ___,___ deaths annually

A

200

100,000 deaths annually

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3
Q

Pinworm infections are more common in kids or adults?

A

kids

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4
Q

Nematoda types?

A

Trichinella
Hookworms
Pinworms

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5
Q

Cestodes type?

A

Tapeworm

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6
Q

Trematodes type?

A

Schistosomiasis

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7
Q

Severe infections may cause?

A

Anemia
Protein loss ( deficiency )
Malabsorption

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8
Q

Hookworm only host?

A

humans

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9
Q

Hookworm eggs are passed in the _____ and hatch in moist ____.

A

stool

soil

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10
Q

Hookworm larvae last for?

A

hr to weeks

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11
Q

Hookworm penetrate the ____ and migrate through the _____ to the _________ ___________ where they destroy ________? They are then carried by cilia to the _____?

A

penetrate the skin and migrate in the bloodstream to the pulmonary capillaries
destroy alveoli
carried by cilia to the mouth

*they get the blood stream and go to the lungs and cardio and then trachea and the GI tract - migration is incredible by hematogenous spread = pretty bad PNA from these guys **

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12
Q

Once swallowed hookworm larvae attach to the ______ muscle and suck blood.

A

small bowel

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13
Q

Hookworm light infection?

A

1,000 eggs/g feces

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14
Q

Hookworm moderate infection?

A

2,000 to 8,000 eggs/g feces

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15
Q

What are the two species of hookworm that commonly infect humans?

A

Ancylostoma duodenale and Necator americanus

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16
Q

How much of the worlds population is infected with hookworm?

A

25%

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17
Q

Location of hookworms?

A

Moist tropics and subtropics

Sporadic cases occur in the southeastern US

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18
Q

GI Hx?

A

Anorexia ( DECREASE APPITITE)

Diarrhea

vague pain

ulcer-like epigastric symptoms

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19
Q

Pulmonary stage Hx? earlier in infection process

A

Wheeze

Blood-tinged sputum

low-grade fever

Hx is progression of sxs

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20
Q

PE: Examination at night may reveal ?

A

may reveal worms in the anus or stool

*Dx stool or presentation in the ANUS**

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21
Q

PE: Pulmonary ?

A

wheeze

low-grade fever

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22
Q

Hookworm diagnostic study: diagnostic?

A

Stool O & P - – eggs or larva can be demonstrated

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23
Q

Hookworm labs to consider? And results?

A

Hemoccult - +

CBC - Hypochromic microcytic anemia and Eosinophilia

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24
Q

Treatment for hookworms?

A

Mebendazole in a single dose

Albendazole

pyrantel

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25
Who gets treated with worms ?
whole family
26
Pinworm organism?
Enterobius vermicularis
27
Pinworm only host?
human *Infection is easily passed through hands, food, drink, and fomites. Skin , pet dander, toys etc…**
28
Pinworm eggs are swallowed and hatch in the ________: larvae then pass into the _____ and mature in _-_ weeks?
duodenum cecum 3-4 weeks
29
Adult worms are loosely attached to the ______, primarily in the ____?
muscosa cecum
30
Pinworm gravid females pass through the anus to lay eggs on the __________?
perianal skin
31
Pinworm Hx?
Many patients are asymptomatic perianal pruritus - crawling sensation that is worse at night Insomnia weight loss Enuresis - involuntary urination irritability
32
Pinworm diagnostic Physical Exam? Examination at night ?
may reveal worms in the anus or in the stool Excoriations
33
Screening lab for pinworm?
Tape test
34
Diagnostic lab for pinworm?
O & P
35
Complication of pinworm?
secondary skin infections (i.e., impetigo - staph infections) Vulvovaginitis Diverticulitis - not really in kids Appendicitis - not really in kids Cystitis granulomatous reactions
36
Pinworm treatment?
Mebendazole
37
Pinworm prevention?
Hand washing after defecation and before meals must be stressed Linens should be washed thoroughly
38
Oral antihelminthic?
Albendazole, mebendazole, or pyrantel given in a single dose repeated 2 to 4 weeks later All members of the household should be treated concurrently *beds, linens and carpets cleaned throughly **
39
Schistosomiasis AKA?
Bilharzia, Snail Fever
40
Schistosomiasis parasite enter through the skin or music and migrate to the _______ to mature then they enter the __, __.
liver GI GU
41
Schistosomiasis Hx ( symptoms)?
Fever 2-8 weeks after exposure GI, GU
42
Schistosomiasis Hx - GI symptoms?
Abd pain | N/V
43
Schistosomiasis Hx - GU symptoms?
Dysuria | Hematuria
44
Schistosomiasis PE?
Nonspecific | Possible abd tenderness
45
Schistosomiasis diagnostic labs?
Ova and parasites - eggs can be identified , heavy infections Biopsy - rectum, colon, liver, or bladder ELISA- available from the CDC, 99% specific for all species, Schistosomal Ab - gotta wait 4-6 weeks
46
Schistosomiasis O&P heavy infection results?
> 400 eggs per gram of feces or | 10 mL of urine are indicative
47
Schistosomiasis treatment?
Oral praziquantel once may repeat in a couple weeks *kill worm in Gi tract, not 1 pill 1 time thing, disseminated cases more than just one time - more vigorouss treatment **
48
Tapeworm organism?
Taenia infection
49
Tapeworm comes from under cooked what?
beef , pork, fish
50
Tapeworm causes ______ in animal muscle?
cysts
51
Tapeworm develops gravid segments and ___________ released in feces.
Proglottids
52
Tapeworm Hx?
Often asymptomatic | Occasional abd pain
53
Tapeworm PE?
Possible abd tenderness | Nonspecific
54
Tapeworm dx lab?
O & P
55
Tapeworm: labs to consider? and result?
CBC - look for anemia, eosinophilia ( high count) B12 (Pernious anemia) *these guys block B12 uptake in the GI tract so they have pernicious anemia presentation**
56
Treatment for tapeworms?
Praziquantel (Biltricide) Oral once Repeat in one week *one time and then a couple weeks later **
57
Trichinosis (Trichinellosis) type of infection?
Nematode Trichinella infection
58
Nematode Trichinella infection | occurs when there is ingestion of ____ containing cysts of ___________ , especially pork
meat Trichinella * eventually becomes muscle cyst , “a lot of people do not know what it is cause it is so benign” **
59
Trichinosis larvae invade the _____ _____ mucosa, where they mature into adult worms
small bowel
60
After _ week female trichinosis worms release newborn ______ and they migrate through the blood to ________ ______.
1 week larvae striated muscle
61
Trichinosis Hx?
Myalgias Diarrhea Abdominal pain Constipation nausea or vomiting weakness
62
Trichinosis PE?
Periorbital and facial edema hemorrhages: Subconjunctival Retina nail beds (“splinter” hemorrhages) *very unique symptoms of the face and hands, edema of the lower lids = more advanced = conjunctival injection and retinal hemorrhages, splinters hemorrhages on the nail beds, periorbital edema **
63
Trichinosis Screening labs? and results?
CBC - eosinophilia Antibody titer trichinella - elevated usually does not occur until after the third week of infection confirms the diagnosis
64
Trichinosis diagnostic labs?
Muscle biopsy ( multiple muscles cysts and are asymmetric) - definitive diagnosis
65
Trichinosis labs to consider?
Creatinine kinase (ck) Lactate dehydrogenase (LDH)
66
Trichinosis complications?
myocarditis encephalitis
67
Trichinosis prognosis?
usually benign
68
Uncomplicated Trichinosis treatment?
No Tx Comfort measures
69
Complicated Trichinosis treatment?
Mebendazole
70
Trichinosis: treatment for myositis symptoms?
Oral Glucocorticoids - prednisone for 1 week
71
Prevention of Trichinosis?
Pork Larvae may be killed by cooking pork until it is no longer pink or by freezing it at –15°C for 3 weeks
72
Trichinosis complicated treatment?
Mebendazole OR albendazole are active against enteric stages of the parasite efficacy against encysted larvae has not been conclusively demonstrated

Clinical Medicine Lecture - Professor Kramer (28 decks)

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