Micro Test 3: Trematodes

  1. Location of Trematodes Adults in Human Hosts:
    Fasciolopsis buski
    Metagonimus yokogawai
    Heterophyes heterophyes
  2. Location of Trematodes Adults in Human Hosts:
    Fasciola hepatica
    Clonorschis sinensis
    Dicrocoelium dendriticum
    Liver Flukes
  3. Location of Trematodes Adults in Human Hosts:
    Paragonimus westermani
    Lung flukes
  4. Location of Trematodes Adults in Human Hosts:
    Schistosoma haematobium
    S. j aponicum
    S. mansoni
    Blood flukes
  5. How are circulatory Schistosoma spp. acquired?
    Cercariae directly penetrate the skin of humans
  6. How are all trematodes/flukes acquired (except circulatory)?
    Eating metacercariae
  7. Trematode Adults:
    Dorsoventrally flattened (except schistosomes which are round)
    Hermaphroditic (except schistosomes)
    Self-fertilizing (except schistosomes)
    Two suckers
    Blind cecae (intestinal sacs)
    • Trematode Eggs:
    • Pass in feces/secretions of definitive hosts
    • Thick walled
    • Oval to round
    • Operculate or capped
    • +/_ embryonated (hatch or develop in water, miracidium often swims free)
  8. What type of cecae do flukes have?
  9. Fasciolopsis buski
    Giant Intestinal Fluke
  10. Diarrhea, toxemia from parasite metabolites, peripheral eosinophilia (rare in protozoa).
    • Fasciolopsis buski
    • Praziquantel (Biltricide)
  11. Diagnostic stage of Fasciolopsis buski?
  12. Heterophyes heterophyes transmission?
    Ingestion of encysted metacercariae in raw, pickled, or poorly cooked fish
  13. Metacercariae excyst attaches to mucosa of small intestine (btw villi) and mature into adults
    Heterophyes heterophyes
  14. Diagnosis of Heterophyes heterophyes?
    • Demonstrate characteristic eggs in stool
    • Praziquantel
  15. Protozoa w/ ventral sucker on side, spread by metacercariae in fish muscle (fish raised w/ feces).
    • Metagonimus yokogawai
    • Praziquantel
  16. Transmission of Fasciola hepatica?
    Ingestion of encysted metacercariae on raw, aquatic vegetation (water cress salad)
  17. Where is Fasciola hepatica most prevalent?
    Bolivia and Peru (Andes)
  18. Which adult fluke is large and fleshy with branched testes?
    Fasciola hepatica
  19. Sheep Liver Fluke
    Fasciola hepatica
  20. Peruvian sheep herder w/ liver damage (RUQ pain, biliary colic, jaundice)
    Fasciola hepatica
  21. Eating raw sheep liver with flukes causes a tickle in the throat and flukes/eggs in stool
    Halzoun; Fasciola hepatica
  22. Which fluke can NOT be treated w/ Praziquantel?
    What do you use to treat it?
    • Fasciola hepatica
    • Triclabendazole, Nitazoxanide
  23. Clonorchis sinensis
    Chinese liver fluke
  24. Chinese man eats raw fish, which came from a farm using human feces as fertilizer.  Protozoa found in his gall bladder.
    Clorochis sinensis (Chinese Liver Fluke)
  25. Metacercariae exist in small intestin and migrate up to bile duct to develop to adults.  Adults are lancet shaped w/ branched testes.
    Clonorchis sinensis
  26. Clonorchis sinensis (Chinese Liver Fluke)
    Praziquantel (Biltricide)
  27. Reddish-brown, lancet-shaped flukes that penetrate the duodenal wall into the peritoneal cavity and migrate to lungs
    Paragonimus westermani
  28. Which fluke gives you rust-colored sputum and hemoptysis?
    Paragonimus westermani
  29. Adult worms of Paragonimus westermani are located?
    Cystic spaces in the lungs
  30. Paragonimus westermani tx?
    Praziquantel (Biltricide)
  31. Schistosome Life Cycle
    • Eggs (S. mansoni, S. japonicum, and S. haernatobium) hatch releasing miracidia
    • Miracidial penetrate snail tissue
    • Sporocytes produced in snails
    • Cercariae released by snail into water and free-swimming
    • Penetrate skin
    • Cercariae lose tails during penetration and become schistosomutae
    • Circulation
    • Migrate to portal blood in liver and mature into adults
    • Paired adult worms migrate to  mesenteric venules of bowle/rectum (lay eggs that shed in stool) and venous plexus of bladder
  32. Diagnostic stage of Schistosome life cycle
    Eggs in feces (S. mansoni, S. japonicum) or in urine (S. haemotobium)
  33. Infective stage of Schistosome
    Cercariae released by snail into water penetrates the skin
  34. Forms of schistosome eggs shed in feces
    S. mansoni, S. japonicum
  35. Forms of Schistosome egg released in urine?
    S. haematobium
  36. Name the 3 species of Shistosoma (blood flukes) and where they are found.
    • S. masoni- colonic mesenteric veins
    • S. japonicum- small intestinal mesenteric veins
    • S. haematobium- vesicle, prostatic and urinary plexus
  37. Which flukes have diecious (separate sexes/not hermaphroditic) adults?
  38. Which Schistosome gives abdominal pain, hepatosplenomegaly, granuloma formation, dysentery, anemia, + serology
    Schistosoma mansoni
  39. Which fluke can give you pipestem fibrosis or portal hypertension?
    Schistosoma mansoni
  40. Schistoma mansoni
    Praziquantel (Biltricide)
  41. Which blood fluke give eosinophhia Yangtze River Fever, brain edema, urticaria, etc?
    Schistosoma japonicum (Oriental blood fluke)
  42. Which blood fluke causes pipestem fibrosis, cor pulmonale, heart failure, hepatomegaly, portal cirrhosis, etc?
    Schistosoma japonicum
  43. Diagnosis and tx of Schistosoma japonicum?
    • Eggs in stool
    • Praziquantel
    • Repair of damaged organs is not possible
  44. Which fluke gives HEMATURIA?
    Schistoma haematobium
  45. Secondary calcification and bladder fibrosis is a result of?
    Scistosoma haematobium
  46. Diagnosis of Schistosoma haematobium?
    • Eggs in urine or bladder wall(eggs have a terminal spine)
    • Praziquantel
  47. Swimmer's itch is caused by?
    Penetration of humans by bird schistosomes, adults do NOT mature in abnormal host

    • 1st Exposure results in mild prickling of skin/macules
    • 2nd Exposure results in erythema, vesicle formation
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Micro Test 3: Trematodes