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  1. Cestodes

    What are cestodes?
    They are tapeworms which live attached to the mucosa of the small intestine.

    *Absorb protein & carbs to reproduce

    • Scolex is organ of attachment
    • Proglottids is attached to scolex
    • Stobila is the chain of proglottids
  2. Diphyllobothrium latum - d. latum

    Life Cycle
    • Human eats under-cooked fish
    • scolex, proglottis, & adults harbor in small intestine.
    • human passes unembronated egg
    • embryonated eggs infect crustacean which
    • then infect fish.
  3. D. latum

    Who is the definitive host & intermediate host
    Definitive:humans, dogs, foxes, cats, seals, etc. that might eat fish

    Intermediate: copepod(crustacean), fish, pike or salmon are common
  4. D. latum

    Location & Disease
    Europe, Russia,Israel,US in heavy fish eating regions. ie. Great Lakes Region

    (larval infection), anemia (B12), obstruction, diarrhea, abd pain
  5. D. latum

    Eggs or proglottids in stool
  6. Cestode: Taenia species - 

    Life Cycle - same for saginata and solium
    • 1) Animal (Beef/Pork) eat infected vegetation
    • 2) Oncospheres hatch & invade intestinal wall then migrated to striated muscles. 
    • 3) Develop into cysticerci.
    • 4) Humans eat undercooked meat.
    • In 2 mos time, cysticerus mature to adult tapeworm.
    • 5) Adults attache to small intestine & produce proglottids.
    • 6) Proglottids leave via stool with eggs.

    *In Solium: if eggs ingested, oncosphere hatch and move to muscle of man instead of pig.
  7. T. saginata - Beef Tapeworm

    Worldwide - rare in US

    Disease: Taeniasis

    Few symptoms: discomfort, proglottids crawling out of anus
  8. T. saginata

    Worm Identification
    • Scolex: 4 Suckers, NO hooks
    • Proglottids: 15-20 lateral uterine branches

    Egg: 35-45um with Radial striations
  9. T. solium - Pork Tapeworm

    Worldwide - rare in US

    Disease: Taeniasis or cysticercosis

    cysticercosis must be surgically removed
  10. T. saginata 

    What is the intermediate host
    Cow - beef
  11. T. solium

    What is intermediate host
    Pig - pork
  12. T. solium

    Worm Identification
    • Scolex: 4 Suckers with a central crown of HOOKS. 
    • Proglottids: 7-13 uterine branches (usually 9)

    Egg: Identical to T. saginata
  13. T. saginata & T. solium

    Eggs are identical - treatment same for both. 

    • Count uterine branches
    • Solium has hooks too.
  14. Cestode: Hymenolepis nana - H. nana

    is also known as:
    dwarf tapeworm
  15. H. nana

    Location / clinical disease
    • Worldwide - common in children
    • Spread person to person via eggs

    • Autoinfection possible
    • hymenolepis - can by asymptomatic, symptoms may include headache dizziness, abd pain, diarrhea.
  16. H. nana

    Worm & Egg Identification
    • Worm: up to 40mm long
    • Scolex: 4 small suckers & short rostellum with hooks.

    Egg - Round to oval, thin wall 30-45um
  17. H. nana

    Recovery of characteristic eggs in stool.

    Adult rarely found
  18. Hymenolepis diminuta: H. diminuta:

    Rat Tapeworm

    Diagnosis & Worm & Egg Ident
    Recovery of eggs. adult rarely found

    Worm: adult 20-60cm long

    • Eggs are similar to those of H. nana
    • *little more round thought* (my thoughts.)
  19. Diipylidium caninum - Dog Tapeworm

    Location / disease / life cycle
    World wide

    • Dogs & cats are host.
    • Humans (usually young children) accidental host via eating fleas.

    indigestion, abd discomfort, eosinophilia
  20. D. caninum

    Recovery of egg packets or proglottids.

    • O&P may not be useful if proglottids are not seen. 
    • *Gravid segments are small, white, & motile & sometimes mistaken for pinworms.
  21. Echinococcus granulosis : E. granulosis

    Life Cycle
    • Adult worm in dogs intesting
    • Proglottids & eggs passed
    • Eggs ingested by intermediate host (man)
    • Hatch in duodenum, oncospheres penetrate intestine & moves into bloodstream
    • Various organs affected.
    • cysts contain protoscolices or hydatid sand
  22. E. granulosis

    • Echinococcosis,, hydatid cyst disease -
    • Cyst location determines severity
    • Liver 65%
    • lungs 20%
    • brain 1% or kidney 3% or peritoneal 7%
  23. E. granulosis

    Treatment & Diagnosis
    Dx. Abd mass, EITB, pathology (examination of cyst fluid)

    Treatment: Surgery, removal of cysts. 

    If rupture, anaphylactic reactions may occur!
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