Roundworm Inf of GI Flashcards
(59 cards)
1
Q
foul smelling, greasy floating stools/diarrhea=
A
giardia
2
Q
bloody mucous containing diarrhea=
A
entamoeba
3
Q
profuse water diarrhea=
A
cyclospora (anyone), isospora (mostly in immunodef), or cryptosporidium (anyone)
4
Q
profuse water diarrhea w/ raspberry seeds?
A
cyclospora
5
Q
which parasite fluoresces under UV light?
A
cyclospora oocysts
6
Q
acid fast stain modified would show?
A
isospora and crptosporidium
7
Q
nematodes
A
=roundworms
Non-segmented bodies
Separate sexes
Complete digestive system
8
Q
Cestodes
A
=tapeworms
Segmented bodies
Hermaphroditic
Absorb nutrients
9
Q
Trematodes
A
=flukes
Non-segmented (leaf)
Hermaphroditic
Primitive gut
10
Q
enterobius vermicularis eggs look like?
A
-flat on one side
11
Q
trichuris trichiura eggs look like?
A
-oval shaped with two “plugs” on the end
12
Q
ascaris lumbricoides fertile eggs look like?
A
-lumpy bumpy shell
13
Q
ascaris lumbricoides infertile eggs look like?
A
-lumpy bumpy shell
14
Q
hookworm eggs look like?
A
boring looking - round-ovalish eggs
15
Q
Nematodes-transmission/common areas
A
- Usually do not cause fatal infections, do contribute to malnutrition and a diminished work capacity.
- Most common in areas with poor sanitation, (FECAL ORAL TRANSMISSION) particularly in developing countries of the tropics
- Children are most likely to develop symptomatic infection.
- Most common in South Eastern US
16
Q
Nematodes - lifecycle
A
-The life cycle consists of egg, multiple larval, and adult stages.
-Separate sexes, and the female is usually larger than the male.
-Need to be infected by 2 or more to be shedding eggs
-Adult worms do not replicate in the man.
-Identified by the characteristic morphology of their eggs.
-Some GI nematodes pass through other tissues (lungs, skin) during development.
eosinophilia
17
Q
Anytime a helminth infection that leaves the gut patient will have??
A
ELEVATED EOSINOPHILIA LEVEL
Normal is like 1% but it would just to like 15%
18
Q
Geohelminths acquired through
A
- nematode infection acquired through contact with infected soil
- Larvae or eggs require a period of time to develop in warm moist soil
19
Q
Geohelminths - two groups:
A
- Ascaris and Trichuris: ingestion of infectious eggs
- Strongyloides and hookworms: penetration of the skin by infectious larvae found in soil
20
Q
Pinworm-Enterobius vermicularis - some details and lifecycle
A
- pinworm
- MOST COMMON HELMINTHIC INFECTION IN US
- lifecycle: eggs laid on butthole and easily airborne and transfered, move into small intestines, larval dev, large intestines into mucosa where they mate, females lay the eggs on butthole area.
- reinfection is common
21
Q
Pinworm-Enterobius vermicularis transmission?
A
- Transmission is fecal-oral
- Ingestion of eggs
- Reinfection is common as is transmission within families.
22
Q
Can animal pinworms infect humans?
A
NO
23
Q
Pinworm-Enterobius vermicularis symptoms and diagnosis:
A
- Most infections are asymptomatic.
- If Symptomatic infection: Perianal itching; Secondary bacterial infection; Appendicitis (?)
-Diagnosis: identification of eggs (adult worms) in perianal region.–> Flat-sided eggs on scotch – tape prep
24
Q
Pinworm-Enterobius vermicularis - control/prevention:
A
- Treatment is with several anti-helminthic compounds (mebendazole, pyrantel pamoate). -Usually a single dose, repeated again two weeks later.
- Treat all household members*
- Good hygiene and housekeeping.
25
eggs of Pinworm look like?
flat on one side
26
Whipworm-Trichuris trichiura- egg shape
oval shaped with two plugs on each end
27
Whipworm-Trichuris trichiura-life cycle:
- infected indiv shedding eggs in feces
- eggs need to be in environment to mature - warm moist soil
- eggs eaten later and infect idiv
- mom and pop make more babies and female lays eggs on outside
28
Whipworm-Trichuris trichiura where in the US is it mostly found?
Mostly tropical, but can be found in south-eastern United States.
29
Whipworm - transmission
- Fecal-oral ; contaminated soil.
| - Warm, moist soil promotes development of eggs
30
Whipworm-Trichuris trichiura - symptoms?
-90 % of infections are asymptomatic.
-IF Symptomatic infections:
Heavy worm burden (>200 adult worms)**
Bloody, mucus containing diarrhea
Frequent stools
Rectal prolapse in children - constantly straining
May contribute to growth retardation and anemia in children.
31
Whipworm diagnosis and control/prevention
- Diagnosis=look for eggs - oval shape with plugs on ends
| - Control/Prevention=Proper sanitation and personal hygiene.
32
Ascariasis-Ascaris lumbricoides - worm details and eggs type?
- LARGEST nematode that infects man - thick as a pencil and about foot long
- bumpy egg on outside
33
Ascaris lumbricoides lifecycle:
- eggs in feces
- eggs need to mature in environment
- break open in intestines
- larvae will pass through mucosal wall
- travel through lvier and make their way to lungs (GET PULMONARY EOSINOPHILIA) and up to throat = tickle in back
- host clears throat and swallows them = then the larvae bcome mom and pops back in the intestines
34
Ascaris lumbricoides patients will have what in their sputum?
larvae and eosinophils!
35
Ascaris lumbricoides most common where in US?
South East
36
Ascaris lumbricoides - transmission:
- Fecal-oral; soil contaminated with human feces.
| - Eggs need to develop in soil before they are infective
37
only reservoir for A. lumbricoides? cross species?
HUMANS
| ascaris from other animals do not affect us
38
largest of intestinal roundworms?
Ascariasis-Ascaris lumbricoides
39
Ascariasis-Ascaris lumbricoides symptoms?
- Most infections are asymptomatic.
| - Symptomatic disease: Range from abdominal discomfort to death (rare)
40
Ascariasis-Ascaris lumbricoides- intestinal disease:
- Physical presence of adult worms in small intestine
- Abdominal pain, indigestion, loss of appetite, vomiting, diarrhea
- Heavy infections can cause a physical obstruction.
- In children-nutritional deficiency, growth retardation.
41
Ascariasis-Ascaris lumbricoides - pulmonary disease
- A combination of the physical presence of larvae and the immune response to them.
- Mild cough, pneumonitis (inflammation of alveoli).
- Parasite antigens are highly allergenic
- Repeated exposure =asmatic attack
- Eosinophilia is common
42
Ascariasis-Ascaris lumbricoide - Diagnosis and Control/Prevention:
- Diagnosis-eggs in stool; larvae or eosinophils in sputum
| - Control / Prevention-Sanitation and Hygiene
43
Hookworm- Necator americanus & Ancylostoma duodenale
- eggs in feces
- mature in soil for weeks
- hatch in soil!
- NEED SKIN CONTACT
- Make their way into circulation
- lungs --> stomach and intestines
- eggs produced
44
Necator americanus & Ancylostoma duodenale location in US/ some detials
- South East US - mostly Necator americanus
| - major cause of anemia in children and prego
45
Necator americanus & Ancylostoma duodenale transmission
-larvae from fecal contaminated soil penetrate intact skin.
46
Necator americanus & Ancylostoma duodenale - reservoires for hookworms?
No aminal reservoir for HUMAN hook worms
| -cat and dog hookworms cause Cutaneous larval migrans in humans
47
Cutaneous larval migrans is what and caused by?
is hookworm disease transfered from cat or dog to human --> not usual GI infection
48
Iron-deficiency anemia
- hookworm disease
- due to blood loss from hookworm feeding. If infection is severe enough this can result in fatigue, exertional dyspnea, koilonychias (brittle, spoon shaped nails), pale sclera, and heart murmurs.
49
Other issues associated with hookworms?
- irondeficiency anemia - due to blood loss from hookworm feeding
- Children with severe infection can become protein malnourished due to blood loss.
- Penetration of the skin - moderate dermatitis (“ground itch”).
- Pneumonia and eosinophilia may accompany larval passage through the lungs.
50
Which hookworm is more pathogenic?
Ancylostoma consumes more blood than Necator; therefore it is usually considered more pathogenic.
51
Hookworm - diagnosis
-presence of eggs in stool
| Distinguishing between Necator and Ancylostoma requires and examination of adult worms or larvae.
52
Hookworm - Prevention / Control -
- Sanitation
| - Wear Shoes
53
Strongyloidiasis-Strongyloides stercoralis lifecycle
-infected indiv with adult worms + producing eggs
-eggs hatch in intestine = immature larvae
-LARVAE PASS IN STOOL
-Larvae go into soil and develop into adults
-replicate/mate in soil (CAN SURVIVE IN SOIL)
-then penetrate skin of indiv who step on them!
-into circulation--->lungs-->trachea--> swallowed===> new cycle of GI infection with adults
OR
HYPERINFECTION:
-some larvae just repenetrate from the intestines and get into the circulation again
54
smallest nematode infection in humans?
Strongyloides stercoralis
55
ONLY faculative parasite and what this means?
Strongyloides stercoralis - it can REPLICATE OUTSIDE OF THE HOST --> doesnt need host for survival
56
Strongyloidiasis-Strongyloides stercoralis location in US
- appalachia
| - Eastern US
57
Strongyloidiasis-Strongyloides stercoralis - transmission:
- penetration of skin by infectious larvae
- ***Infectious form larvae can develop in the intestine, penetrate the intestine, enter the bloodstream, and re-initiate infection (auto-infection).***
58
Strongyloidiasis-Strongyloides stercoralis - symptoms?
-Low worm burdens: little symptomology
non-specific symptoms including, epigastric pain and tenderness, bloating, and heartburn.
-Pulmonary stage of infection may provoke pulmonary inflammation (eosinophilia).
-Abrogation of immune defenses can result in hyperinfection.
-increased numbers of filariform larvae leave the intestine resulting in a worsening of intestinal (diarrhea) as well as pulmonary symptoms.
-hyperinfection can develop into disseminated infection, resulting in the migration of larvae not only to the lungs and GI tract, but also the CNS, peritoneum, liver and kidney.
-Disseminated strongyloidiasis is most frequently observed in individuals undergoing immunosuppressive therapy (glucocorticoides).
59
Strongyloidiasis-Strongyloides stercoralis - diagnosis and COntrol/Prevention
- Diagnosis- detection of larvae in stool.
| - Control / Prevention: Sanitation and Hygiene; Wear shoes
