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Platyhelminthes Flashcards

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1
Q

Tapeworm found in fish

A

Diphyllobothrium latum

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1
Q

Pathology of Echinococcosis

A

Hydatid cysts in liver (50-70%) and lungs (20-30%) but also spleen, kidney, bone and CNS

Latent periods up to 20 years

Disease onset when hydatid cysts cause pain or rupture

Cyst rupture can seed new sites by release of protoscolices

Anaphylaxis associated with rupture can be fatal

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2
Q

Transmission of Taenia solium

A

Intestinal (adult) - Ingest raw pork, Lung (larva) - Ingest free eggs

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2
Q

Location of Echinococcus granulosus

A

Liver, lungs, etc.

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2
Q

Location of Echinococcus granulosus

A

Tissues mainly lungs and liver, but also spleen, kidneys, heart, bone, and CNS

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2
Q

Describe the life cycle of* Echinococcus granulosus*

A

Basic cestode lifestyle; humans as intermediate host only

Requires intimate contact with dogs

Humans are a dead end host

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3
Q

Immunity of Diphyllobothrium latum

A

No clincally relevant immunity…reinfection is possible

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3
Q

Location of Schistosoma haematobium

A

Bladder

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3
Q

Katayama syndrome is associated with which pathogen?

A

Schistosomiasis. intense fever with onset of oviposition

14-84 days (middle onset/1-2 months)

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4
Q

What is a scolex?

A

The anterior end of adult tapeworms, used to attach to the gut wall of definitive hosts

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4
Q

Which of the Schistosoma species lay the most eggs per day?

A

Schistosoma japonicum = 1000 eggs/day

(Schistosoma mansoni and Schistosoma haematobium = 100 eggs/day)

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5
Q

Describe transmission of Trematoda

A

Transmission can be invasive or ingestive

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6
Q

Transmission of Diphyllobothrium latum

A

Undercooked fish containing plerocercoid

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6
Q

Describe the chronic onset (5-15 years) of Schistosomiasis pathology from S. haematobium

A

Eggs lodge in tissues in the bladder

Egg secretions lead to eosinic inflammatory response and granulomas

Extensive fibrosis of bladder leads to mucosal thickening & ulceration which leads to l_oss of bladder function_

Bladder cancer

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7
Q

Describe the body of a tapeworm (Cestoda)

A

Flattened, segmented bodies

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8
Q

Prevention of Echinococcosis

A

De-worm dogs, proper disposal of livestock internal organs

Good hygiene

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9
Q

Name the 4 species in Cestoda that we need to know

A
  • Taenia saginata*
  • Taenia solium*
  • Diphyllobothrium latum*
  • Echinococcus granulosus*
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10
Q

What is taeniasis and how is it acquired?

A

Tapeworm in the intestine from eating undercooked pork, ingesting cysticerci (larva)

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10
Q

Describe the chronic onset (5-15 years) of Schistosomiasis pathology from S. mansoni and S. japonicum

A

Eggs lodge in tissues in the intestine and liver

Egg secretions lead to eosinic inflammatory response and granulomas

Severe liver disease leading to periportal (liver) fibrosis which can lead to portal hypertension / hepatosplenomegally / megaesophogus which can lead to rupture of gastric or esophageal varices

Liver and colon cancer

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11
Q

Epidemiology of Diphylobothrium latum

A

Found globally in temperate zones where fish is a major part of the diet

Was brought to the New World by European immigrants

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12
Q

Treament of Schistosomiasis

A

Praziquantel in single or multiple dose

Potentiates active immune system killing of adult worms

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13
Q

Location of Schistosoma mansoni

A

Intestine (eggs migrate to descending colon)

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14
Q

Describe Trematoda (fluke) digestion

A

Simple digestive system, a single opening serves as mouth and anus

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15
Q

What is plerocercoid larva?

A

last larval form found in the second intermediate host of many Cestoda with aquatic life cycles (Diphyllobothrium latum)

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15
Immunity against Schistosomiasis
Adults masked by absorption of host serum proteins Immunity primarily involved in pathology Evidence for immunity to reinvasion in endemic areas, immune killing of schistosomula Intensive effort under way for a vaccine
16
Greek translation of Platyhelminthes
platy = flat, helminth = worms
18
What are proglottids?
Segments of the tapeworm bodies
20
Location of *Diphyllobothrium latum*
Intestinal
20
What is cysticercosis and how is it acquired?
Larva in muscle, eyes, brain from eating tapeworm eggs
20
What is a procercoid larva?
an elongate larval stage of some tapeworms (*Diphyllobothrium latum*) that usually develops in the *body of a freshwater copepod*
21
Intermediate hosts of *Diphyllobothrium latum*?
copepod that infects fish
22
What is the immunity against *Taenia solium*?
Humoral response to adult worms thus reinfection is possible
23
Tapeworm found in pork
*Taenia solium*
24
Diagnosis of *Diphyllobothrium latum*
Same as beef and pork tapeworm Easily discriminated from *Taenia* ssp by egg and proglottid Pernacious anemia, raw fish diet in endemic areas indicatve
25
Which *Schistosome* eggs are isolated from urine?
*S. haematobium*
26
Pathology of *Diphyllobothrium latum*
Like beef tapeworm Adults absorb 80-100% of dietary B12 B12 deficiency, anemia, occasionally neurological symptoms
27
Describe the early onset (0-2 weeks) of Schistosomiasis pathology
Most people have no symptoms when first infected Rash from invading cercaria, many exposures leads to hypersensitivity Rash subsides: fever, headache, nausea as the schistosomula migrate
29
Class for flukes
Trematoda
31
Describe the body of a fluke (Trematoda)
Broad, flattened body
32
Describe alveolar echinococcosis
Caused by *Echinococcus multiocularis* Humans are usually exposed when hunters feed internal organs to domestic dogs Wild animal cycles: wild canines and game animals in wilderness of North America, Europe, Asia
33
Tapeworm found in beef
*Taenia saginata*
34
How can *Taenia solium* presence be diagnosed?
**Self:** active proglottids **Clinical:** * observation of proglottids or eggs in stool (proglottid morphology discriminates from *T. saginata & D. latum*) * contrast studies show ribbon-like strucutre from intestine * Cysticercosis by X-ray, calcified dead larva * CAT/MRI, viable cysticerci
35
Diagnosis of Schistosomiasis
Observation of eggs in feces or urine most common Serology now available
36
Transmission of *Taenia saginata*
Ingest raw beef
37
Definitive host of* Echinococcus granulosus*
Wild & domestic canines
38
Treatment of Echinococcosis
Percutaneous drainage with instillation of hypertonic saline or alcohol Surgical removal, avoiding rupture If inoperable, treat with albendazole (28 day), low cure rate
39
What are the intermediate hosts of *Taenia solium*?
Pigs (or humans)
40
Transmission of Schistosomiasis
Invasive, aquitic free-living cercaria penetrate skin
41
Which *Schistosome* eggs are isolated from the stool?
*S. mansoni* and *S. japonicum*
43
Transmission of *Echinococcus granulosus*
Ingest free eggs
44
*Schistosoma mansoni* adult worms travel in which veins?
Inferior mesenteric veins
45
Class for tapeworms
Cestoda
47
Location of *Taenia solium*
Intestinal (adult), Any tissue, i.e. lungs (larva/cysticerci)
48
Definitive Host of *Schistosoma* organisms
Humans
50
Describe Cestoda (tapeworm) digestion
No internal digestive system, nutrients are absorbed across the cuticle
52
Describe the maturation process of Cestoda (tapeworms)
Segments (proglottids) mature from anterior to posterior, specialized for hermaphroditic reproduction
53
What are the definitive hosts of *Taenia solium*?
Humans
54
How did *Echinococcus* arise in the US?
It is not endemic in the US, but immigration and transportation increases have caused a rise throughout North America
54
Intermediate host of* Echinococcus granulosus*
Wild & domestic ungulates (hoofed animals) Humans
55
How can eggs of *Schistosoma* organisms incite chronic inflammation?
The eggs canf low into the portal vein tributaries and become trapped in the terminal portal venules, where they incite chronic inflammation
56
Describe the pathology of Cysticercosis
1) Muscle may cause lumps but usually no symptoms 2) Brain cause neurocysticercosis - symptoms depend upon where and how many cysticerci there are
57
Definitive host of *Diphyllobothrium latum*
Humans
58
Name the 3 species in Trematoda that we need to know
* Schistosoma mansoni* * Schistosoma japonicum* * Schistosoma haematobium*
59
Prevention of Schistosomiasis
Reduce source (treat infected individuals) Dispose of waste properly Control of intermediate hosts: molluscicides environmentally damaging Avoid contact with infested water: difficult in rural areas
61
Name the two classes of Platyhelminthes
Cestoda (tapeworms), Trematoda (flukes)
62
Location of *Taenia saginata*
Intestinal
63
Treatment of *Taenia solium*
Praziquantel, niclosamide, or albendazole, *single dose* effective for adult worms but prolonged treatment of cysticerci Dexamethasone used to _reduce inflammation_ during treatment, especially true in the CNS, treatment can induce seizures
65
Immunity against Echinococcosis
Circulating antibodies to hydatid cyst antigens Pathology more than protection
67
Diagnosis of Echinococcosis
Residence in endemic area, animal husbandry/hunting CAT scan/ultrasound Often presents as slow growing tumor Serology is used for confirmation
68
Transmission of *Schistosoma spp.*
Cercaria penetrate skin
69
Location of *Schistosoma japonicum*
Intestine (eggs migrate to small intestine)
70
What is Hydatid Disease?
from* Echinococcus granulosus* hydatid cysts in liver, lungs, etc.
71
Intermediate host of *Schistosoma* organisms
Snails
72
*Schistosoma japonicum* adult worms travel in which veins?
Superior mesenteric veins
73
Transmission of *Echinococcus granulosus*
Ingestion of eggs from dogs
75
Describe the pastoral cycle of Hydatid disease
Domestic grazing livestock (sheet) are in contact with dogs. The dogs must eat internal organs.
76
Location of *Schistosoma spp.*
Veins to gut/bladder
77
Describe the symptoms of Cystericercosis (neurocysticercosis)
Confusion, difficult with balance, brain swelling, excess fluid around the brain (hydrocephalus), seizures, headaches, and mortality
78
Describe the middle onset (1-2 months) of Schistosomiasis pathology
Symptoms mostly from _immune response to eggs_ Katayama syndrome (intense fever) Intestinal schistosomiasis causes _abdominal pain, diarrhea, blood in stool_ Urogenital schistosomiasis is _haematuria_ (blood in urine)
80
What are coracidia?
larvae of *Diphyllobothrium latum* that hatch and get eaten by freshwater crustaceans such as copepod
81
Epidemiology of Schistosomiasis
240 million infected globally public or agricultural water supply contaminated with _human waste_ Presence of appropriate _snail intermediate hosts_ Peak infection rate in _second decade_: children playing in water Pathology proportional to worm burden
82
*Schistosoma haematobium* adult worms travel in which veins?
Venous plexus (bladder)
83
Describe the symptoms/pathology of Taeniasis
Often asymptomatic or causes abdominal discomfort, occasionally nausea, vomiting, diarrhea, weight loss, & obstruction
84
Treatment of *Diphyllobothrium latum*
As in Taenia ssp, praziquantel or niclosamide, *single dose* Vitamin B12 supplement when deficiency is evident

Immunology (9 decks)

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