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Tropical Medicine > Trematodes > Flashcards

Trematodes Flashcards

1
Q

What are the liver flukes

A

Fasciola hepatica, fasciola gigantica, clonorchis sinensis, opistorchis

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2
Q

What are the lung flukes

A

Paragonimus

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3
Q

What are the blood flukes

A

Schistosoma

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4
Q

What is the intestinal fluke

A

Fasciolopsis Buski

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5
Q

What type of digestive system do flukes have

A

incomplete digestive system (mouth, pharynx, esophagus bifurcates, sucker, no anus)

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6
Q

All trematodes except schisto:
Eggs?
Larvae?
Life Cycle?
Transmission?

A

Eggs: Operculated
Larvae: five larval forms -miracidium, sporocyst, redia 1st gen, 2nd redia, cercaria, metacercaria
Life Cycle: 1st: freshwater snails or mollusc. 2nd aquatic plant, fish, or crab

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7
Q

All trematodes except schisto:
Eggs?
Larvae?
Life Cycle?
Transmission?

A

Eggs: Operculated
Larvae: five larval forms -miracidium, sporocyst, redia 1st gen, 2nd redia, cercaria, metacercaria
Life Cycle: 1st: freshwater snails or mollusc. 2nd aquatic plant, fish, or crab
Transmission: By eating host plants with metacercariae

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8
Q

Definitive host, int host of schistosoma

A

Def: Man; Int: Snail

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9
Q

Infective form of trematodes (except schisto)

A

metacercaria larva

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10
Q

infective form of schisto

A

cercaria larva

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11
Q

Fasciola life cycle

A

Unembryonated eggs in feces of humans/sheep/cows–>eggs become embryonated in water–>miracidia hatch from eggs, seek out snail intermediate hosts –>miracidia penetrate the snail (spococysts–>rediae–>cercariae)–>Free-swimming cercariae encyst on aquatic vegetation–>metacercariae on vegetation ingested by definitive host–>immature flukes excyst in duodenum, penetrate the intestinal wall, migrate through liver

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12
Q

Watercress

A

Fasciola hepatica

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13
Q
A

unembryonated egg 120-140um of fasciola
-operculum with bile stained shell, thin

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14
Q

Differences between fasciola hepatica and fasciolopsis buski adult worms

A
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15
Q

Paragonimus infective, diagnostic, intermediate hosts, definitive host

A

Infective stage: Metacercariae
Diagnostic: Unembryonated egg
Int Hosts: Snail, Crustacean
Definitive host: Human

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16
Q
A

paragonimus infective stage (metacercariae)

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17
Q
A

paragonimus unembryonated egg, asymmetrical oval, operculum

18
Q
A

S. Mansoni (large lateral spine)
S. Haematobium (large terminal spine)
S. Japonicum (rounded, small lateral spine)

19
Q

Schistosoma Life cycle

A

Eggs shed in stool or urine–>eggs hatch in water releasing mircidia in the water–>mircidia penetrate and develop over 1-2 weeks as 2 generations of sporocysts in snails –>Snails release cercariae and the cercariae can penetrate the skin causing swimmers itch –>schisto migrate to the blood in the liver and mate for life–>bladder or liver –>katayama fever–>eggs shed in stool

20
Q

Which Fluke causes periportal fibrosis

A

schistosoma mansoni

21
Q

Which fluke causes chronic salpingitis

A

schistosoma hematobium

22
Q

How do you diagnose schisto

A

direct smear (Kato); Urine (proteinuria + hematuria), serology (good for expats)

23
Q

Treatment of schisto

A

Prednisone for katayama fever Praziquantel (adulticidal) ; then repeat prazi in at least 4-6 weeks so the other worms mature into adults

24
Q

What are your co-infections with schisto

A

Malnutrition, Viral hepatitis, Salmonella, Bladder cancer

25
Q

Patient with lifelong freshwater exposure and eosinophilia and periportal fibrosis

A

Schistosomiasis
Schistosoma Mansoni
Treatment: PRednisone for katayama + praziquantel x 2 (kill all adult forms of the worm)

26
Q

41 year old male with 30 days of chills, fever at night, moderate sweating, abdominal pain in the epigsatrium, chronic alcoholic. Eosinophilia +
Organism?
Diagnosis?
Definitive host? Location? 1st Int Host? Infective stage?
Treatment?

A

Fasciola Hepatica
ELISA
Def: Sheep, cattle
1st int host: Snails
Worldwide (hepatica); Gigantica is more africa, asia, south america
Infective stage: Metacercariae in the 2nd host (watercress)
Treatment: Triclabendazole

27
Q

Which fluke can cause sclerosing cholangitis, biliary cirrhosis

A

Fasciola hepatica and Fasciola gigantica

28
Q

Patient with migrating larval flukes, reddish cutaneous tracks, subcutaneous nodules, pruritic, painful, inflamed , +eos

A

Cutaneous Fasciolasis

29
Q

How to diagnose f. hepatica and f gigantica

A

ELISA, Serology

30
Q

Treatment of fasciola

A

Triclabendazole 1-2 days
If you’re in the chronic stage, 500mg BID x 7 days

31
Q

Clonorchis and opistorchis epidemiology, definitive host, intermediate host?

A

Clonorchis Sinensis: Korea, China, Taiwan, Vitenam, Indo-China
Opistorchis Viverrini: Laos, Thailand
Opistorchis Felineous: Eastern Europe

Definitive hosts: cats, dogs, pigs, rats, fish eating mammals

1st int host; snails
Infectious stage: metacercariae
2nd int host: fresh water fish

32
Q

Clinical manifestations of clonorchis and opistorchis

A

induce fibrosis around bile ducts, small portal vessels; depends on how many flukes for severe illness; abdominal pain, diarrhea, abdominal distention, anorexia, indigestion, fullness, atigue, weight loss; can have enlarged gallbladder, ascites. Will see raised alk phosph

33
Q

clonorchis and opistorchis life cycle

A

eggs passed in feces, ingested by snail (miracidia–>sporocysts–>rediae–>Cercariae) free-swimming cercariae encyst in the skin or flesh of fresh water fish–>metacercariae in flesh of fresh water fish are ingested by humans–>cause excyst in duodenum–>adults in biliary tract

34
Q

patient with recurrent ascending cholangitis. What is the organism? What is the treatment?

A

Organism: clonorchis sinensis, opsitorchis viverrini/felineus
Treatment: praziquantel x2 days; albendazole x 7 days

35
Q

Giant intestinal fluke? Where is it found? Who is the definitive host? Intermediate host?

A

Fasciolopsis Buski, China/India/SE Asia, Pigs are def host, 1st int host snails

36
Q

Fasciolepsis clinical manifestations

A

anorexia, nausea, vomiting, foul smelling idarrhea, eosinophilia, malabsorption, hypoalbuminemia

37
Q

Patient with fever, eosinophilia, low B12, hypoalbuminemia, foul smelling diarrhea and undigested food, comes from india . Organism? Treatment?

A

Fasciolopsis Buski
Tx: Praziquantel 15-25mg/kg

38
Q

34year old male with 13m of cough, blood streaked sputum, chills nocturnal sweating, back pain, negative AFB. +Eos

A

Paragonimus Westermani

39
Q

where do you find paragonimus westermani?

A

Far east, China, Japan, Korea, Taiwan, Philippines

40
Q

Hosts of paragonimus

A

definitive: felines, canids, weasel, opposum
1st intermed host: snails
2nd int : crab crayfish hrimp
paratenic host: wild boards

41
Q

gelatinous brownish sputum, chronic fough, fishy odor, marked eosinophila. organism? treatment?

A

paragonimus westermani
tx: Praziquantel

Tropical Medicine (19 decks)

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