Id 4Y1: Parasites Ii

Front 1

What is the most important trematode infection

Back 1

Schistosomiasis: “The Snail did it.”

Front 2

Schistosomiasis

Disease due to inflammatory responses to _____________

Back 2

parasite eggs

Front 3

Schistosomiasis

Primarily affects which continents?

Back 3

Sub saharan Africa

Eastern South America

Front 4

Schistosomiasis Life Cycle:

1a. S._______, S. ________ = in feces
1b. S. __________ = in urine

released into ____ _____ supply--> 2. Eggs hatch releasing ______ --> 3. ________ penetrate _____ tissue
--> 4. Sporocysts in ____ (successive generations)
--> 5. _________ released by ____ into water and free-swimming
--> 6. Penetrate skin (human contact)
--> 7. _______ lose _____ during penetration and become __________
-->8. Travel via _________
--> 9. Migrate to _____________ and mature into adults
--> 10. Paired adult worms migrate to: 10a. _____________ while laying eggs that circulate to the ______ and shed in ______ (for organisms 1a)
10b. for organisms in 1b: travel to ________________

Back 4

1a. S.mansoni, S. japonicum = in feces
1b. S. Haematobium = in urine

released into fresh water supply --> 2. Eggs hatch releasing miracida --> 3. Miracidia penetrate snail tissue
--> 4. Sporocysts in snail (successive generations)
--> 5. Cecariae released by snail into water and free-swimming
--> 6. Penetrate skin (human contact)
--> 7. Cercariae lose tails during penetration and become schistosomulae
-->8. Travel via circulation
--> 9. Migrate to portal blood in liver and mature into adults
--> 10. Paired adult worms migrate to: 10a. mesenteric venules of bowel rectum laying eggs that circulate to the liver and shed in stools (for organisms 1a)
to: 10b venous blexus of bladder

Front 5

Schistosomiasis

Invasive stage called?
Adult schistosomes in ______

Back 5

Cercaria (invasive stage)

copula

Front 6

S. Mansoni pathogenesis

_________ around eggs and periportal fibrosis lead to ________ _____________

Back 6

Granulomas around eggs and periportal fibrosis lead to portal hypertension

Front 7

Brazilian children with schistosomiasis

Kids often die from __________

Back 7

Often die from upper GI bleeding from esophogeal varices

Front 8

Schistosomiasis:

May present in colon with:
____ induced intestinal _______

Back 8

egg induced intestinal polyps

Front 9

Schistosomiasis - Control Strategies

Control of Vector: (2)

Targetting Host: (2)

Targetting Parasite: (1)

Back 9

Vector
- Molluscicides (but this will kill everything in water, not just parasite)
- Biological Approaches

Host
- Sanitation
- Vaccination (mostly experimental)

Parasite
- Chemotherapy (to kill parasite)

Front 10

Host Biology and Defense

Nematodes have ___________ that makes them resistant to immune attack

Chemical weapons - enzymes that can _________ _________

Back 10

surface coat (cuticle)

cleave antibodies

Front 11

Host Armamentarium

Humoral Immunity (Ab, especially ___; C')

Cells (_______, Macs, Neutrophils)

Chemical weapons (__, ______, _______)

Back 11

IgE - especially - highly elevated with worm infections in tissues

Eosinophils are hallmark of worm infection

Chemical weapons (NO, Major Basic Protein, Oxidants)

Front 12

Eosinophil:

bilobed granulocyte increased in _____ and _______ infections.

Secondary granules contain ___________.

Back 12

Eosinophil:
bilobed granulocyte increased in allergy and helminth infections.

Secondary granules contain toxic major basic protein.

Front 13

_________ (agent) damages the parasite surface to reveal internal antigens for immune attack

this agent covers what organisms?

Back 13

Praziquantel damages the parasite surface to reveal internal antigens for immune attack

broad spectrum anti-helminthic agent coverign cestodes and trematodes alike.

Front 14

Schistosoma hematobium:

Tropism around ?

Back 14

Tropism around bvs around urinary tract, kidney, bladder,

Front 15

Schistosoma hematobium:

Can cause?

Back 15

Kidney related problems (since it infects veins surrounding bladder)
- Ureteral strictures
- Hydronephrosis

Front 16

Tapeworm proglottids and scolexes

Back 16

Suckers and hooks to attach to intestines

Front 17

A 3 year old Mexican child presents with new onset epilepsy 

MRI shows a cystic lesion with surrounding edema

Diagnosis?

Back 17

Cerebral cysticercosis aka Neurocysticercosis

Front 18

Tapeworm life cycle:

1. _____ or gravid ________ in feces and passed into environment

2. Embryonated _____ and or gravid __________ ingested by _____ and humans

3. Humans can also acquire the infection by ingesting ______ from infected animal host.

4. __________ hatch, penetrate intestinal wall, and circulate to __________ in pigs or humans

5. Oncospheres develop into __________ in muscles --> cause __________ (may develop in any organ, being more common in __________ tissues as well as in the _____ and _____.

6. _____ attaches to intestine

7. Mature to adults in small intestine --> passed in _____ and into environment --> repeat

Back 18

1. Eggs or gravid proglottids in feces and passed into environment

2. Embryonated eggs and or gravid proglottids ingested by pigs and humans

3. Humans can also acquire the infection by ingesting raw or undercooked meat from infected animal host.

4. Oncospheres hatch, penetrate intestinal wall, and circulate to musculature in pigs or humans

5. Oncospheres develop into cysticerci in muscles --> Cysticercosis (may develop in any organ, being more common in subcutaneous tissues as well as in the brain and eyes.

6. Scolex attaches to intestine

7. Mature to adults in small intestine --> passed in feces and into environment --> repeat

Front 19

65 year old Bosnian woman with vague abdominal pain and an abdominal mass

Gross Path shows:
Complex echinococcal cyst in omentum

Microscopically:
Protoscolices (larval tapeworms)

Diagnosis?

Back 19

Echinococcus Ganulosis

(Hydatid Disease, an Extra-intestinal Tapeworm infection)

Front 20

Little tapeworm, only a few cm long, still contained in eggs, animals will eat that, and cysts will form in ______, if this organ then ingested by dog/human, infection spreads

Back 20

Little tapeworm, only a few cm long, still contained in eggs, animals will eat that, and cysts will form in liver, if liver then ingested by dog/human, infection spreads

Front 21

Echinococcus granulosis

Zoonosis: _______ and _________ (esp. ______)

Presenting Findings:
Incidental ____ or local _____ (4 sites affected)

Dx: (2)

Management:
Medical (___________),
Surgery, PAIR

Complications: (2)

Back 21

Zoonosis: Dogs and domestic animals (esp. sheep)

Presenting Findings:
Incidental mass or local pain (liver, kidney, bone, brain)

Dx: Microscopy or Serology

Management:
Medical (Albendazole),
Surgery, PAIR

Complications: dissemination, allergy

Front 22

Diphyllobothrium latum (___ Tapeworm)

Ingestion of _______

Tapeworm can be __ meters long!

Mild __________ discomfort

________ (vitamin ____ deficiency

Rx: __________

Back 22

Diphyllobothrium latum (Fish Tapeworm)

Ingestion of raw fish

Tapeworm can be 10 meters long!

Mild abdominal discomfort

Anemia (vitamin B-12 deficiency

Rx: Niclosamide