Immunology Exam Ii - Parasites - Helminths

Front 1

1. What species are Trematodes?

2. What species are Cestodes?

3. What species are Nematodes?

Back 1

1. Flukes - Schistosoma

2. Tapeworms - Taenia and Echinococcus

3. Roundworms - WANTED Loa Loa
3a. Wuchereria bancrofti
3b. Ascaris Lumbricoides
3c. Necator Americanus
3d. Trichuris trichiura
3e. Enterobius vermicularus
3f. Drancunculus medinensis
3g. Loa loa

Front 2

1. What species is pictured here and what category of helminth is this?
2. Describe the morphology.
3. Where are they found geographically?
4. Where are they found in the body?

Back 2

1. Schistosome - Trematode - Blood Fluke
2. Cylindrical bodies with 2 muscular suckers (1 oral, 1 attachment)
3. Africa - 2nd most prevalent tropical disease in the world
4. Found in blood vessels - OBLIGATE INTRAVASCULAR

Front 3

1. What is pictured here, what species is it, what form is it?
2. What is the function of this form of the helminth?
3. From what does this mature and in what intermediate host?
4. What symptom does it cause in humans?

Back 3

1. Trematode - Schistosoma - Blood Fluke - Cercariae Larva
2. Swims and penetrates the skin of the human host
3. Matures from a Sporocyst in the Snail (intermediate host)
4. Swimmer's itch

Front 4

1. What species is this, what form is it in?
2. Describe the morphology
3. Where do these particular ones infect?
4. What happens if this gets trapped in tissues during migration?

Back 4

1. Trematode - Schistosome - Blood Fluke - Schistosoma Haematobium Egg
2. S. Haematobium Eggs have terminal spines
3. Venous Plexus - Urinary Bladder and Ureters
4. Granulomatous reaction - T-cells, Macs, Eosinophils

Front 5

1. What species is this, what form is it in?
2. Describe the morphology
3. Where do these particular ones infect?
4. What happens if this gets trapped in tissues during migration?

Back 5

1. Trematode - Schistosome - Blood Fluke - Schistosoma Japonicum and Mansoni Egg
2. S. japonicum and S. mansoni eggs have lateral spines
3a. S. japonicum - Infects Superior Mesenteric Vein
3b. S. mansoni - Infects Inferior Mesenteric Vein
4. Granulomatous reaction - T-cells, Macs, Eosinophils

Front 6

1. What happens if a Schistosome Egg gets trapped in tissues during migration and what is the morphology?

2a. What disease from Schistosomes causes fever, hives, weight loss, cough, and headache?

2b. What causes the disease in 2a?

Back 6

1. Granulomatous reaction - T-cells, Macs, Eosinophils - Eosinophilia, Microascess

2a. Katayama Fever

2b. Initial Schistosomulae larva release

Front 7

Describe the life cycle and pathogenesis of the Schistosomes

Back 7

1. Eggs hatch into MIRACIDIA (larvae) in water
2. Eggs penetrate Intermediate Hosts (Snails)
3. Become SPOROCYTST in the snails
4. Mature into CERCARIAE (larvae)

5. Leave the snail and swim into a human via skin --> Swimmer's Itch dermatitis (allergy)

6. Cercariae lose their tail and become SCHISTOSOMULAE
7. Schistosomulae migrate thru tissues to Veins

8. Mature into ADULTS in the veins (JMH) --> Rarely pathologic (Coat themselves with Host Self substances)

9. Females deposit eggs in small venules

10. Eggs dig into the intestinal lumen, bladder, uterus using Tissue Destruction Enzymes

11. Eggs are eliminated via feces or urine

Front 8

1. What are complications of heavy worm burden with Schistosomes?

2. What is the non-heavy worm burden possibility?

3. What are the diagnostic techniques for Schistosomes?

4. How is this treated?

Back 8

1a. Cercarial Dermatitis (Swimmer's Itch) at entry point

1b. GI - Portal Hypertension, Fibrosis, Risk of Hep B and C, Dysentery, Ascites

1c. UTI - S. Haematobium ONLY - Renal Failure (Pyelonephritis), Glomerular Nephritis, Dysuria, Urinary Frequency, Terminal Hematuria

2. Asymptomatic Carrier

3a. Microscopy of stool or urine for Eggs
3b. Tissues biopsy of rectal (ALL) or bladder (S. haematobium ONLY)

4. Prizaquantel - causes contraction of parasite --> Poop it out

Front 9

1. What species is pictured here and what category of helminth is this?
2. Describe the morphology.

Back 9

1. Cestode - Tapeworms - Taenia Solium/Saginata

2a. Flat and Ribbion-like

2b. 4 muscular, cup-shaped suckers and a crown of hooklets on the Scolex

2c. Strobila body (chain of proglottids)

Front 10

1. What species is pictured here and what category of helminth is this?
2. Describe the morphology.
3. Where in the world is this found?
4. What is the reservoir?

Back 10

1. Cestode - Tapeworms - Taenia Solium/Saginata

2. Flat and Ribbion-like with 4 muscular, cup-shaped suckers and a crown of hooklets on the Scolex and a Strobila body (chain of proglottids)

3. Mexico, Central America, South America, Adia, Africa, India

4. Reservoir = PIGS!!! and Cattle (not usually infecting humans)

Front 11

1. What is pictured and what genus and species is this from?

2. Describe the pathogenesis of this in pigs.

3. Describe the pathogenesis of this in humans.

Back 11

1. Proglottid from Taenia Solium (Cestodes - Tapeworms)

2a. Pig ingests EMBRYONATED EGG or PROGLOTTID
2b. ONCOSPHERE hatches and penetrates intestinal wall
2c. Goes into circulation
2d. Becomes CYSTICERCUS in muscle

3a. Humans eat UNDERCOOKED PIG MEAT
3b. Incubation --> 2 months --> ADULT WORM
3c. Adults produce PROGLOTTIDS
3d. Proglottid becomes GRAVID and detaches
3e. Proglottid migrates to anus or passes in stool
3f. Eggs are eaten (fecal-oral) and ONCOSPHERES --> Intestinal wall --> Blood --> Tissues
3g. LARVAE die --> Release Antigen --> Inflammatory Rxn --> Fever and Eosinophilia

Front 12

1. What species is pictured here and what category of helminth is this?

2. What are the symptoms of Taeniasis?

3. What are the symptoms of Cysticercosis?

4. What are the possible complications?

Back 12

1. Taenia Solium Cysticercus (Cestode - Tapeworm) in skeletal muscle of a pig

2. Asymptomatic or Mild nausea, low apetite, constipation or diarrhea, dizziness weakness --> 50% have eosinophilia

3. Cysticercosis - Extraintestinal Encysted Larvae --> Neurocysticercosis (gets into the CNS 60-90% of time)

4. Complications - Appendicitis, Obstruction of Panc and/or Bile Ducts

Front 13

1. What is Taenia Solium/Saginata?

2. How is Taenia Solium/Saginata diagnosed?

3. How is it treated?

Back 13

1. Cestode - Flat, Ribbon-like Roundworm with a Strobila of Proglottids, 4 suckers and a hooklet crown on the scolex

2a. Check stool for Ova and Parasites (NEVER SEE ADULTS)
2b. Imaging for Neurocysticercosis (pictured)
2c. Serology with Anti-cysticeral Antibodies

3. Preziquantel - contracts the parasite so it will detach and you can poop it out

Front 14

1. What organism is pictured here and what it it's classification among helminths?
2. Describe its morphology.
3. Where is this found mostly?

Back 14

1. Nematodes - Roundworms - Enterobius Vermicularis (PINWORM)
2. Small, Cylindrical, Unsegmented, White worm
3. Found worldwide and Most common helminthic infection in North America

Front 15

1. What organism is pictured here and what it it's classification among helminths?
2. Describe its morphology.
3. Describe the pathogenesis of this.

Back 15

1. Nematode - Roundworm - Enterobius Vermicularis (PINWORM)
2. Small, Cylindrical, White, Unsegmented worm

3a. Ingestion of Embryonated Eggs (fecal-oral)
3b. Hatch in the Small Intestine
3c. Mature in Large Intestine
3d. Fertilization of female by male
3e. Eggs Laid in Perianal Folds AT NIGHT --> Anal Itching
3f. Eggs become infectious w/in 6-8 hours

Front 16

1. What organism is pictured here and what it it's classification among helminths?
2. Describe its morphology.
3. What are the clinical symptoms of this organism?

Back 16

1. Enterobius Vermicularis Eggs (PINWORM) - Nematodes - Roundworms
2. Small, White, Cylindrical, Unsegmented worms

3a. Most are asymptomatic
3b. Anal Itching (Pruritis) Nocturnally or Early AM
3c. Ab/Pelvic Pain, Restless, Irritable, VAGINAL ITCHING
3d. Reinfection is common

Front 17

1. What is pictured here?
2. How is this diagnosed?
3. What is the treatment for it?

Back 17

1. Enterobius Vermicularis - Pinworm - Laying an Egg in perianal folds
2. Scotch tape test and Microscopy
3. Mebendazole

Front 18

1. What organism is pictured here and what it it's classification among helminths?
2. Describe its morphology.
3. Where is it prevalent?
4. What about this organism causes clinical symptoms?

Back 18

1. Cestode - Roundworm - Ascaris Lumbricoides

2. Largest of the Intestestinal Nematodes

3. Found where there is Poor Sanitation - MOST COMMON HELMINTHIC INFECTION IN THE WORLD

4. Symptoms caused by movement of the worm

Front 19

1. What organism is pictured here and what it it's classification among helminths?
2. Describe its morphology.
3. Describe the pathogenesis of this organism.

Back 19

1 Ascaris Lumbricoides - Nematode - Roundworm - in the intestine

2. Largest of all Intestinal Nematodes

3a. Eggs located in feces (fecal-oral)
3b. 2-cell stage
3c. Advanced cleavage stage
3d. Eggs in external environment
3e. Develop in 10-14 days
3f. Ingestion by Humans
3g. Egg releases LARVAL WORM in Duodenum
3h. Worm --> duodenal wall --> Blood --> Liver, Heart --> Pulmonary Circulation (Loeffler's Syndrome - Pulmonary Eosinophilia
3i. LARVAE break free in Alveoli
3j. Coughed up and swallowed
3k. Fertilization of female in Small Intestine
3l. Egg production --> Shows up in feces 60-75 days after initial infection --> Repeat cycle

Front 20

1. What organism is pictured here and what it it's classification among helminths?
2. Describe its morphology.
3. What are the symptoms of Ascariasis?

Back 20

1. Ascaris Lumbricoides - Nematode - Roundworm
2. Largest intestinal nematode
3a. Asymptomatic if egg innocculum is low
3b. GI issues --> Malnutrition --> Iron Def Anemia
3c. Growth/Cognition impairment
3d. NON-PRODUCTIVE COUGH, wheezing, Dyspnea
3e. Biliary and intestinal Obstruction (PICTURED) can become gangrenous

Front 21

1. What organism is pictured here and what it it's classification among helminths?
2. Describe its morphology.
3. How do you test for this?
4. Why can you not analyze stool for this during the Larval Phase?
5. What is the treatment?

Back 21

1. Ascaris Lumbricoides - Nematode - Roundworm

2. Largest of Intestinal Nematodes

3a. CBC for Eosinophilia --> Loeffler's Pulm. Eosinophilia
3b. CXR for infiltrates
3c. Larvae in sputum of pulmonary migration phase
3d. Eggs in stool in Adult Phase
3e. Abdominal Radiography

4. NO EGGS IN THE STOOL DURING LARVAL PHASE

5. Removal of Gangrenous clogged organs (PICTURED)

Front 22

1. What organism is pictured here and what it it's classification among helminths?
2. Where is it located geographically?
3. How is it transmitted?

Back 22

1. Nematode - Roundworm - Trichuris Trichiura - WHIPWORM
2. Worldwide
3. Fecal-oral

Front 23

1. What organism is pictured here and what it it's classification among helminths?
2. What are the clinical symptoms of this infection?
3. Who is disease most common in?
4. How is this diagnosed and what is the treatment?

Back 23

1. Egg of Trichuris Trichiura - WHIPWORM - Nematode, Roundworm

2a. Most are Asymptomatic
2b. Rectal Prolapse, Dysentery, Developmental Deficits

3. Children

4. Fecal Smears - Mebendazole

Front 24

1. What organism is pictured here and what it it's classification among helminths?
2. Describe its transmission and pathogenesis.
3.

Back 24

1. Nematode, Roundworm - Necator Americanus - HOOKWORM

2a. Penetrates the skin
2b. Migrates through Venous Circulation --> Lungs
2c. Coughed up and swallowed
2d. ADULTS in the Small Intestine
2e. Remains in Small Intestine for years

Front 25

1. What organism is pictured here and what it it's classification among helminths?
2. What are the symptoms that this causes?
3. How is this diagnosed?
4. How is it treated?

Back 25

1. Necator Americanus - HOOKWORM - Nematode, Roundworm

2. Intestinal Blood Loss - Iron Deficiency Anemia

3. Find Eggs (PICTURED) in the feces

4. Mebendazole

Front 26

1. What organism causes this and what it it's classification among helminths?
2. Where is it located geographically?
3. How it is transmitted?
4. What causes the above symptomology?

Back 26

1. Wuchereria Bancrofti - Nematode, Roundworm

2. Tropical Areas, Africa, Asia, Latin America

3. Vector - Mosquito injects LARVAE

4. Adults block lymphatic vessels --> Lymphedema

Front 27

1. What organism causes this and what it it's classification among helminths?
2. What clinical symptoms does it cause?
3. How is this diagnosed?

Back 27

1. Wuchereria Bancrofti - Nematode, Roundworm

2. Elephantitis, Hydrocele, Lymphadenitis

3. Nocturnal Collection of Blood Demonstrates Larvae

Front 28

1. What organism causes this and what it it's classification among helminths?
2. Where is this located geographically?
3. How is it transmitted?

Back 28

1. Loa Loa - Nematode, Roundworm

2. Western and Central Africa

3a. Infected fly bites you and injects the LARVAE
3d. Larva becomes ADULT and migrates to subconjunctiva (PICTURED)

Front 29

1. What organism causes this and what it it's classification among helminths?
2. How is this diagnosed?
3. How is it treated?

Back 29

1. Loa Loa - Nematode, Roundworm

2a. Person returns from endemic area with local swellings.
2b. Visualization of adult worm beneath conjunctiva

3. Surgical Removal (Pictured)

Front 30

1. What is pictured above?
2. What is the transmission and pathogenesis?
3. How do they become visible?
4. How is it diagnosed and treated?

Back 30

1. Dracunculus Medinensis - Nematode, Roundworm

2a. Drink water containing COPEPODS
2b. Copepods release LARVAE
2c. Larvae --> Small intestine and Develop into ADULTS
2d. 1 year to mature
2e. Adults migrate to body surface and cause ULCERATIONS AND ERUPTIONS

3. Become visible thru ulceration

4. Diagnosed thru worm eruption - Treated with a stick