Opisthorchiida (opisthorchis, clonorchis, metagonimus, heterophyes)

Question 1

Opisthorchis spp

Answer 1

• Opistorchis felineus
• Opistorchis viviernii
• Opisthorchis guayaquilensis
• Opistorchis tenuicollis
• Opisthorchis simulans
• Opisthorchis geminus

Question 2

Opisthorchis felinus aka..

Answer 2

Cat liver flukes

Question 3

geography of Opisthorchis felinus

Answer 3

central & eastern europe

Question 4

IH, FH, location, and geography of Opisthorchis simulans &
Opisthorchis geminus

Answer 4

• 1st IH: Freshwater snail
• 2nd IH: Freshwater fish
• FH: goat & sheep.
• Location: bile ducts
• Geography: India & Pakistan.

Question 5

IH, FH, location, and geography of Opisthorchis tenuicollis

Answer 5

• 1st IH: Freshwater snail
• 2nd IH: Freshwater fish
• FH: cattle & buffaloes.
• Location: bile ducts
• Geography: India & Pakistan.

Question 6

IH of Opistorhis spp & Clonorchis siensis

Answer 6

• 1st IH: Freshwater snail
• 2nd IH: Freshwater fish

Question 7

FH of Opistorhis spp & Clonorchis siensis

Answer 7

Fish eating mammals

• man, dog, cat, pig

Question 8

location of Opistorhis spp & Clonorchis siensis

Answer 8

Liver, bile duct, pancreatic duct

Question 9

morphology of Opistorhis spp & Clonorchis siensis

Answer 9

• 7-12 mm
• Oval adults
• Ovary and uterus anterior to testes
• Vitelline pores are large and anterior to gonadal region.
• Suckers are weak developed.
• O. fellineus has testes caudal part and are oval
• C. sinesis is like F. hepatica

Question 10

LC of Opistorhis spp & Clonorchis siensis

Answer 10

1. Embryonated eggs are shed from host faeces.
2. In freshwater, the IH1 (freshwater snails) ingests the eggs. The miracidium develop to mother
   sporocyst -rediae -1000+ cercariae released in the water after 1-2 months after infection of the snail.
3. In IH2 (freshwater fish), the cercariae penetrates the tissue of the fish and encysts to become fully infective metacercaria under the fish’s skin or in muscle.
4. FH eats raw fish -metacercaria excyst in the intestine - mature in bile duct.
   Reservoir hosts of C. sinensis and O. viverrini: human, pigs, rodents

Question 11

egg morphology of of Opistorhis spp & Clonorchis siensis

Answer 11

• Size: Small
• Shape: oval - asymmetrical
• External structure: 2 shells with operculum, shoulder, knob
• Internal structure: embryonated - miracidium
• Color: yellow

Question 12

pathogenesis of Opistorhis spp & Clonorchis siensis

Answer 12

• Cholangitis, cholecystitis, bile stasis

Question 13

CS of of Opistorhis spp & Clonorchis siensis

Answer 13

Jaundice, anemia, diarrhea, ascites, fever, nausea, hepatomegaly (& painful), splenomegaly

Question 14

DX of Opistorhis spp & Clonorchis siensis

Answer 14

• Sedimentation method
• Serology: ELISA

Question 15

TX of Opistorhis spp & Clonorchis siensis

Answer 15

Praziquantel

Question 16

Control of Opistorhis spp & Clonorchis siensis

Answer 16

• Don’t eat undercooked/raw fish
• Protect water resources

Question 17

clonorchis siensis geography

Answer 17

east asia & india

Question 18

Juvenile stages of Opistorhis spp & Clonorchis siensis in dogs & cats

Answer 18

liver parenchyma migration = Hepatitis

Question 19

Adult fluke of Opistorhis spp & Clonorchis siensis in dogs & cats cause

Answer 19

Cholangitis, pericholangitis

Question 20

pathogenesis of Opistorhis spp & Clonorchis siensis in dogs & cats

Answer 20

pancreas damage, slimming, latent flow

Question 21

clinical manifestation of Opistorhis spp & Clonorchis siensis in dogs & cats

Answer 21

in moderate infection

Question 22

geography of metagonimus yokogawaii

Answer 22

• europe

Question 23

IH of metagonimus yokogawaii

Answer 23

• 1st IH: water snail - Semiliscospira
• 2nd IH: sweet fish - cyprinid fish

Question 24

FH of metagonimus yokogawaii

Answer 24

Fish-eating mammals

• dogs, cats, humans, rats, pigs

Question 25

location of metagonimus yokogawaii

Answer 25

SI

Question 26

morphology of metagonimus yokogawaii

Answer 26

* 1 – 1.5 mm * scaly surface * small ventral sucker, situated laterally from the midline (sexual opening is close by).

Question 27

LC of metagonimus yokogawaii

Answer 27

* PP & IP: 1-2 weeks 1. Embryonated eggs with fully developed miracidium passed in feces of FH 2. Snail ingest eggs and miracidium emerge from eggs and penetrate the snail’s intestine. Inside the snail it develops into sporocyst --> redia --> cercaria. 3. Cercaria is released from the snail and penetrates the skin of freshwater/ brackish water fish and encyst as metacercaria in the tissue of the fish. 4. FH becomes infected by ingestion of undercooked fish containing MC

Question 28

Pathology of metagonimus yokogawaii

Answer 28

**inflammation, ulceration & necrosis of SI** * Flukes invade the intervillous space of SI * Mechanical and toxic effects lead to catarrhal inflammation * Invasion of crypts of Lieberkühn * Erosion of enterocytes * Deformation of intestinal villi * Edema, vascular dilation, & inflammatory infiltration * Digestive disorders * Eggs (rarely) enter lymph or veins, causing ectopic lesions in heart or CNS

Question 29

DX of metagonimus yokogawaii

Answer 29

* Microscopy – eggs in feces

Question 30

TX of metagonimus yokogawaii

Answer 30

Praziquantel

Question 31

CS of metagonimus yokogawaii

Answer 31

* Abdominal pain, diarrhea * Zoonotic character

Question 32

Geography of Heterophyes heterophyes

Answer 32

asia, balkan, israel

Question 33

IH of Heterophyes heterophyes

Answer 33

* 1st IH: snail * 2nd IH: Fresh fish or frog

Question 34

FH of Heterophyes heterophyes

Answer 34

Fish-eating mammals and birds (man)

Question 35

location of Heterophyes heterophyes

Answer 35

SI

Question 36

Morphology of Heterophyes heterophyes

Answer 36

* 1 mm * Wider posterior than anterior, has tegument

Question 37

egg morphology of Heterophyes heterophyes

Answer 37

* **size:** small * **shape**: oval * **internal structure**: embryonated * **external structure:** 2 shells with operculum * **color:** brown

Question 38

LC of Heterophyes heterophyes

Answer 38

1. Embryonated eggs with fully developed miracidium passed in feces of FH 2. Snail ingest eggs and miracidium emerge from eggs and penetrate the snail’s intestine. Inside the snail it develops into sporocyst --> redia --> cercaria. 3. Cercaria is released from the snail and penetrates the skin of freshwater/ brackish water fish and encyst as metacercaria in the tissue of the fish. 4. FH becomes infected by ingestion of undercooked fish containing MC 5. Metacercaria excyst in the SI & matures to adult in SI. Fish eating mammals can also be infected

Question 39

Pathogenesis of Heterophyes heterophyes

Answer 39

Inflammation, ulceration, necrosis in SI * mild inflammatory reaction * In heavy infections – intestinal pain and mucosa diarrhea. * heart can be affected with tissue reaction in the valves and myocardium that cause heart failure * Eggs can also get into the brain or spinal cord and cause neurological disorders and sometimes fatalities.

Question 40

CS of Heterophyes heterophyes

Answer 40

* Diarrhea and colicky abdominal pain. * Migration of the eggs to the heart, resulting in potentially fatal myocardial and valvular damage

Question 41

DX of Heterophyes heterophyes

Answer 41

coprological exam (eggs)

Question 42

TX of Heterophyes heterophyes

Answer 42

praziquantel

Question 43

Epidemiology of Heterophyes heterophyes

Answer 43

* Eating raw fish from contaminated water. * People poop in water, egg in water.