Liver Flukes: Clonorchis sinensis

Question 1

Common name of Chlonorchis sinensis

Answer 1

• Chinese Liver Fluke

Question 2

1st IH of C. sinensis

Answer 2

• Bulinus spp.
• Parafossarulus manchouricus
• Parafossarulus anomalospiralis
• Parafossarulus stratulus
• Alocinma longicornis
• Thiara granifera
• Melanoides tuberculatus
• Semisulcospira

Question 3

For the 1st IH, what are the species under Parafossarulus? There are 3.

Answer 3

1. P. manchouricus
2. P. anomalospiralis
3. P. stratulus

Question 4

For the 1st IH, what are the species under Bulinus? There is only 1.

Answer 4

• B. striatulus

Question 5

For the 1st IH, what are the species under Alocinma? There is only 1

Answer 5

• A. longicornis

Question 6

For the 1st IH, what are the species under Thiara? There is only 1

Answer 6

• T. granifera

Question 7

For the 1st IH, what are the species under Melanoides ? There is only 1

Answer 7

• M. tuberculatus

Question 8

2nd IH of Clonorchis sinensis. There are 2.

Answer 8

1. Freshwater fish (Cyprinidae)
2. Freshwater shrimp (but not all the time)

Question 9

Final host/Definitive Host of C. sinensis.

Answer 9

Human

Question 10

Habitat of the adult C. sinensis in Man.

Answer 10

• Bile ducts
• Bile passages
• Gallbladder

Question 11

Diagnostic Stage of C. sinensis

Answer 11

Recovery of eggs/ovaries in stool
embryonated eggs

Question 12

Drug of choice for C. sinensis

Answer 12

Praziquantel

Question 13

Alternative Drug of choice for C. sinensis

Answer 13

Albandazole

Question 14

What is the appearance of the oral sucker of C. sinensis and where is it located?

Answer 14

• Located on the anterior which is tapering

Question 15

Which sucker is bigger than the other C. sinensis

Answer 15

Oral > Ventral

Question 16

What is the appearance of C. sinensis’s testis?
A. Branched
B. Unbranched
C. Highly Branched
D. Coiled

Answer 16

C. Highly branched

Question 17

What is the arrangement of C. sinensis Testis?
A. In tandem
B. Simple
C. Oblique

Answer 17

A. In tandem

Question 18

What trematode is highly associated with cancer/malignancy?

Answer 18

Clonorchis sinensis

Question 19

What trematode can also be attributed to the ff. diseases?
- cholangiocarinoma
- gallbladder carcinoma
- liver carcinoma`

Answer 19

Chlonorchis sinensis

Question 20

Why does cancer/malignacy happens to a human when infected with C. sinensis?

Answer 20

The presence of the parasite in the liver, the liver adjusts. They are secreting substances which triggers inflammation or tissue damage in liver/gallbladder.

Question 21

When the egg of C. sinensis is laid, is it embryonated or unembryonated?

Answer 21

Embryonated

Question 22

The abopercular end of C. sinensis has what distinct appearnce?

Answer 22

• Has small tail or comma-like projection

Question 23

What is the appearance of C. sinensis embryonated egg? In terms of its shape, color, operculum, and shoulders.
(same with Opisthorchis)

Answer 23

• Shape: Ovoid
• Color: Yellowish brown
• Operculum: Convex
• Shoulders: Thickened rim
  + well-developed miracidium that has assymetrical feature inside the eggs

Question 24

In C. sinensis eggs are stained using what stain?

Answer 24

Potassium permanganate

Question 25

Adult c. sinensis are stained with what stain?

Answer 25

India Ink

Question 26

Diagnosis of C. sinensis

Answer 26

1. Detection of egg in stool (DFS, FECT, Kato-Katz) 2. Liver biopsy 3. **Cholangiography** -> CT Scan, X-ray 4. ELISA 5. EIA (Enzyme immunoassay, RTPCR), 6. Coproovosccopy 7. PCR

Question 27

What trematode is associated in these pathology? - Clonorchiasis - Cholangiocarcinoma

Answer 27

Clonorchis sinensis

Question 28

T/F: Clonorchis egg is leaf-like structure

Answer 28

True

Question 29

It is the most important Liverpool Fuke of man a. Clonorchis b. Opisthorchis

Answer 29

a. Clonorchis

Question 30

Reservoir hosts of C. sinensis

Answer 30

- Cats - Dogs - Pigs - Other mammals

Question 31

C. sinensis Life Cycle not yet

Question 32

Clonorchis sinensis: Adult Morphology - mas manipis yung upper part, mas makapal/rounded yung lower part

Answer 32

- Flat - transparent - attenuated anteriorly - rounded posteriorly

Question 33

Clonorchis sinensis: Adult Morphology - Ovaries: _______ - Testes: ______ - Intestinal Ceca: ______ - Looks like ______ - Oral Sucker is ______ (size)

Answer 33

- Ovaries: Lobed - Testes: Deeply branched, in tandem - Intestinal Ceca: Simple; Not branching - Looks like Spatula - Oral Sucker is very large

Question 34

C. sinensis/Opisthorchis eggs - Yes/No: Presence of abopercular protrude

Answer 34

Yes

Question 35

C. sinensis/Opisthorchis eggs Immature/Mature when passed?

Answer 35

Mature when passed

Question 36

Clonorchis and Opisthorchis: Eggs In the opposite side of operculum, there is a hook-like structure called ________ ________.

Answer 36

abopercular protruberance

Question 37

Clonorchis and Opisthorchis: Disease Manifestations What happens in Acute infection?

Answer 37

- Fever and chills - fatigue - weakness - weight loss - liver enlargement - eosinophilia

Question 38

Clonorchis and Opisthorchis: Disease Manifestations What happens in Chronic infection?

Answer 38

- Periductal fibrosis - Cirrhosis and portal hypertension - Perforation of gallbladder - Chronically infected persons may develop - Cholangiocarcinoma (Bile duct Carcinoma)

Question 39

Clonorchis and Opisthorchis: Diagnosis For Stool

Answer 39

1. FECT, KATO-KATZ, STOLL’S DILUTION 2. Duodenal Aspirates, Entero-test

Question 40

Clonorchis and Opisthorchis: Diagnosis For Serology

Answer 40

1. ELISA (Detect secretory antigens)

Question 41

Clonorchis and Opisthorchis: Diagnosis For Molecular

Answer 41

1. PCR

Question 42

Pathology of *C. sinensis*

Answer 42

● Bile duct obstruction ● Cholangio carcinoma ● Liver carcinoma ● Gallbladder carcinoma