Parasitic Diseases of the lungs

Question 1

Parasites known to affect the lungs

Answer 1

Ascaris, Hookworm, Strogyloides, schistosoma

Question 2

Helminth that cause pulmonary hypertension

Answer 2

Schistosoma or Oriental blood fluke

Question 3

Causative agent of TPE

Answer 3

Wuchereria bancrofti

Question 4

Visceral larva migrans

Answer 4

toxocara

Question 5

Also nown as simple pulmonary eosinophilia, characterzied by transient pulmonary infiltrates associated with peripheral eosinophilia

Answer 5

Loeffler’s syndrome

Question 6

Pathogenesis of Loeffler’s sydnrome

Answer 6

hypersensitivty response to an ingested or inhaled antigen

Question 7

Toxic eosinophilic products

Answer 7

major basic protein
Eosinophil cationic protein
Eosinophil derived neurotoxin

Question 8

Paralysis of cilia, causing cough and difficulty in breathing

Answer 8

Ciliastasis

Question 9

Results in asthma like symptoms, can be misdiagnosed as bronchial asthaama and pneumonia

Answer 9

Loeffler’s syndrome

-release of PAF and leukotrienes contributing to bronchospasm

Question 10

Embolization of microfilariae or eggs which degenerate and expose antigens to the local immune system can lead to?

Answer 10

Grranuloma formation

Question 11

Most common roundworm parasitism in the philippines

Answer 11

Ascariasis (Ascaris lumbricoides)

Question 12

Life cycle of ascaris lumbricoides

Answer 12

Lumen of small intestine -> Unfertizied egg -> fertile eggs -> ingested -> larvae -> intestinal mucosa -> portal -> systemic -> lungs -> bronchial tree to the throat and are swallowed.

Question 13

Sputum findings of Ascariasis

Answer 13

eosinophils, charcot leyden crystals, sometimes larvae

Question 14

Causative sp. of hookworming infction

Answer 14

Necator americanus, ancylostoma duodenale

Question 15

___ and _____ are observed during the lung migration phase of hookworms

Answer 15

Transient pulmonary infiltrates and eosinophilia

Question 16

Large number of larvae causing nausea, vomiting dyspnea and high eosinophilia.

Answer 16

Wakuna disease

Question 17

type of anemia caused by hookworm

Answer 17

microcytic hypochromic anemia

Question 18

Volume of blood/day consumed by hookworms

Answer 18

30 to 150 uL/day

Question 19

Transmission of Strongyloides stercoralis

Answer 19

skin penetration

Question 20

Acute phase of Strongyloidiasis

Answer 20

Diarrhea

Question 21

Chronic phase of strongyloidiasis

Answer 21

Dormant infection

Question 22

Large numbers of recently larvae burrow through the intestine and migrate to the lungs

Answer 22

Hyperinfection syndrome

Question 23

Most common cause of schistosomiasis in the philippines

Answer 23

Schistosoma japonicum (hardest to control)

Question 24

Most common complication of schistosomiasis

Answer 24

pulmonary hypertension

*Fibrous State

Question 25

Chronic pulmonary Manidestation schistosomiasis

Answer 25

Chronic cough and dyspnea Production of thick, blood tinged sputum or frank hemoptysis Patchy infiltrates, coin lesions

Question 26

Abnormal looking mucosa of the rectum is sampled and analyze under microscope

Answer 26

Rectal imprint

Question 27

COPT

Answer 27

circumoval precipitin test

Question 28

Associated with immune hyperresponsiveness to Wuchereria bancrofti and brugia malayi

Answer 28

Lymphatic filariasis and tropical pulmonary eosinophilia

Question 29

SIgns of LF

Answer 29

filariasis, lymphedema, hydrocoele

Question 30

Acquried through ingestion of inadequately cooked or pickled crustacean

Answer 30

Paragonimus

Question 31

Foodborne trematode

Answer 31

Paragonimus westermani

Question 32

Characterstics of P. westermani

Answer 32

Plump val, reddish brown fluke 7.5 -20mm long, 4-6 mm wide and 3-5 mm thick Hermaphroditic With two suckers (oral and ventral)

Question 33

Life cycle of P westermanii

Answer 33

Embtyonated eggs _> miracidia ->snail -> sporocysts - > rediae -> cercariae -> human infection -> metacercariae excyst in the duodenum -> lungs

Question 34

Juvenile worms can elaborate hydrolytic enzymes like _____ which are important in invasion biology

Answer 34

cysteine proteases

Question 35

Pathology of Paragonimiasis

Answer 35

Generalized fibrosis Cystic dilatation Persistent pneumonia cyst formatin

Question 36

Destroys the protective covering of the cyst so that the immune system can appropriately eliminate the invading parasite

Answer 36

Praziquantel

Question 37

Egg depositin starts -___ weeks ater infection (paragonimus)

Answer 37

5-6

Question 38

Sputum of pt with paragonimiasis

Answer 38

rusty, with the color of clotted blod

Question 39

Extrapulmonary paragonimiasis

Answer 39

Cerebral, abdominal (Spleen and liver), subcutaneous and miscellaneous forms

Question 40

Concentration technique for light paragonimiasis infection

Answer 40

3% NaOH

Question 41

Paragonimiasis wasfirst described by?

Answer 41

Musgrave

Question 42

First intermediate host of P. westermani

Answer 42

Antemelania asperata | Antemelania dactylus

Question 43

2nd intermediate hosts of P. westermani

Answer 43

Sundathelpusa philippina | Varuna literata

Question 44

Reservoir host of P. westermanii

Answer 44

Cats, dogs, rats

Question 45

Paratenic host of P. westermanii

Answer 45

Pig

Question 46

Treatment for P. westermanii

Answer 46

Praziquantel (25 mg/kg 3x daily (203 days)

Question 47

Follow up to treated patients.

Answer 47

Repeat sputum exam after 90 days after treatment.

Question 48

Triclabendazole

Answer 48

First line drug This now the recommended drug of choice by WHO 10mg/kg for two doses in a single day 10 mg/kg single dose, high cure rates, better tolerated and better