Intestinal Nematodes

Question 1

What is pinworm?

Answer 1

Enterobius Vermicularis

Question 2

How is pinworm transmitted ?

Answer 2

Fecal Oral transmission

Question 3

Where doe pinworm live in the human body?

Answer 3

The cecum as does whipworm

Question 4

What are sx of pinworm infestation? What is the prepatent period?

Answer 4

Anal itch, Appendicitis, Salpingitis, Sterile Pyuria, Cervical Granuloma. The PP period is 3 to 4 weeks.

Question 5

What is the treatment of Pinworm?

Answer 5

Mebendazole/Albendazole; repeat in 2 weeks

Question 6

What is roundworm?

Answer 6

Ascaris Lumbricoides

Question 7

How is round worm transmitted?

Answer 7

Fecal Oral

Question 8

Where does round worm live?

Answer 8

The small intestine

Question 9

What are sx of roundworm infestation? What is the prepatent period?

Answer 9

Malnutrition,Vitamin A deficiency, growth lag, intestinal obstruction, volvulous, intussusception, intestinal infarction, Biliary obstruction and inflammation, Pancreatitis, Pneumonitis (Loeffler’s Syndrome). The PP period is 2 months. The life cycle involves passage from the SI to the blood to the liver and then to the heart and lung, The larva is swallowed and matures.

Question 10

What is whipworm?

Answer 10

Trichuris Trichura.

Question 11

Where does whipworm live in the human body?

Answer 11

The cecum.

Question 12

How is whipworm transmitted?

Answer 12

Fecal Oral route

Question 13

What are the sx of whipworm?

Answer 13

Colitis- mimics inflammatory bowel disease.
Dysentery
Rectal Prolapse

Question 14

What is hookworm?

Answer 14

Two species:Necator Americanus, Ancylostoma Doudenale

Question 15

Where does it live?

Answer 15

The small Intestine

Question 16

What is its life cycle?

Answer 16

Larvae penetrate the bare skin of feet or buttocks and enter the circulation. Upon arrival in the lung, they crawl up the Trachea and are swallowed. They then migrate to the Small intestine.

Question 17

What are sx of hookworm infestation?

Answer 17

Malnutrition, Kwashiorkor, Iron deficiency and Anemia,,. Lacona-pharyngeal irritation. The prepatent period is months to 1 year

Question 18

What is thread worm?

Answer 18

Strongyloides Stercolaris.

Question 19

Where does it live?

Answer 19

The duodenum and jejunum. The female lives in the lamina propria of the jejunum. It can mimic TB due toits effects on the Lung.

Question 20

What are the sx of this worm infestation?

Answer 20

Abdominal pain, Larva Currrens, Pulmonary infiltrates, Pneumonia, Gram Negative Meningitis, Intestinal Perforation, Can disseminate due to cancer and immunosuppressives such as steroids.

Question 21

What is the treatment of Strongyloides?

Answer 21

Ivermectin 200ug/kg for 1 to 3 days, Hyperinfection may occur and this requires albendazole and a steroid taper.

Question 22

What is the presentation of Paracapillaria Phillipensis?

Answer 22

Watery Diarrhea, like Sprue.

Question 23

What do the eggs resemble?

Answer 23

Those of Tricihuris Trichura

Question 24

What is the life cycle of this parasite?

Answer 24

Eggs are passed by humans,which are then ingested by freshwater fish. Internal autoinfection. also occurs.
Cysts of rodents and pigs are ingested and dissolve in the stomach. They transform into adults in the small intestine and become migrating larvae.

Question 25

What is the treatment for P. Phillipenisis?

Answer 25

Albendazole.for 10 days

Question 26

Where is Trichostrongylus eggs found?

Answer 26

Imbedded in intestinal mucosa of herbivores and humans

Question 27

In what part of the world does infection occur?

Answer 27

The Middle eats and central asia

Question 28

What worm does Trichostrongylus resemble?

Answer 28

Hookworm but larger.

Question 29

What is the treatment for this parasite?

Answer 29

ALbendazole 400 mg x 1 dose.

Question 30

What infestation is associated with Toxocara canis?

Answer 30

Hookworm infestation

Question 31

How is this worm transmitted to humans?

Answer 31

Transplacentally, thru breast feeding, orally thru PICA, exposure to other children and sandboxes

Question 32

What is the life cycle of Toxocara Canis?

Answer 32

After ingestion, larva goes to small intestine. It then enters the blood stream and passes to liver and then to lung.

Question 33

What are the clinical presentations of this infestation?

Answer 33

Neural, ocular and visceral Larva Migrans, Seizures, Learning Disability and Behavioral Problems, Urticaria, Prurigo, Myositis and Asthma. Ocular Larva Migrans can resemble a retinoblastoma-RX laser)

Question 34

What diseases resemble Toxocara Canis infection?

Answer 34

Balyascaris and Ancylostoma Caninum both of which causem cutaneous and visceral larva migrans

Question 35

What organisms cause visceral larva migrans?

Answer 35

Toxocara canis and cati-VLM Ancylostoma Bayliascaris-( Racoon Feces)- VLM, OLM, CLM, Brain Sx Capillaria Hepatica-( Rodents and Pigs)-VLM Gnathostoma Spinigerum- (undercooked fish, snakes and birds)- VLM, OLM, CLM Aniskasis Angiostrongylous Cantonensis(undercooked snails, slugs, shrimp, fish). can lead to eosinophilic meningitis

Question 36

What nematodes complete their life cycle in humans?

Answer 36

``` Trichnella Spiralis (pigs and bears) Capillaria Phillipenisis ( Rodents and Pigs) ```

Question 37

What organisms are arrested at the larval stage?

Answer 37

Anikasis

Question 38

What are the sx of Trichnella?

Answer 38

Abdominal Pain, nausea and vomiting followed in a week by edema, fever, rash and eosinophilia. Migration can involve the heart and cns.

Question 39

What is the treatment of Trichnosis?

Answer 39

Albendazole/Mebendazole, add steroids if there is heart and cns involvement.

Question 40

What is Aniskasis?

Answer 40

It is caused by larvae found in cod.It is usually a disease if marine mammals. 95% of cases in Japan.

Question 41

What are the sx of Anikasis?

Answer 41

Abdominal Pain, N, V, coughing up worms. Bowel perforation, allergic sx including anaphylaxis and urticaria

Question 42

What is the treatment for Aniskasiasis?

Answer 42

Albendazole 10 mg /kg + Steroids for 5 days, DEC 3mg/kg/day for in three divided doses for 21 days or Mebendazole 100 mg bid for 5 days