Parasitology: Intestinal & Lung Flukes Topic Outline Quiz

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Questions and Answers

Which type of eggs is associated with Paragonimus and Fasciolopsis?

  • Mature eggs
  • Opistulated eggs
  • Immature eggs (correct)
  • Imperfect eggs

In terms of habitat, where do Schistosomes reside?

  • Liver
  • Mesenteric vein (correct)
  • Bile passage
  • Lungs

What is the mode of transmission for Schistosomes?

  • Respiration
  • Sexual contact
  • Ingestion
  • Skin penetration (correct)

Which of the following is an infective stage for most Trematodes except Schistosomes?

<p>Metacercaria (C)</p> Signup and view all the answers

What is the morphology of Trematodes, excluding Schistosomes?

<p>Flat and leaf-like (B)</p> Signup and view all the answers

Which of the following is not a general feature of Trematodes?

<p>Having separate sexes (D)</p> Signup and view all the answers

Which species of fluke inhabits the portal blood stream of vertebrates?

<p>Schistosoma japonicum (D)</p> Signup and view all the answers

What is the class of the phylum Platyhelminthes that includes flukes?

<p>Trematoda (A)</p> Signup and view all the answers

Which of the following flukes inhabits the lungs of vertebrates?

<p>Paragonimus westermani (C)</p> Signup and view all the answers

What is the name of the species of fluke that inhabits the small intestines of vertebrates?

<p>Fasciolopsis buski (A)</p> Signup and view all the answers

Which of the following is NOT a species of liver fluke?

<p>Echinostoma ilocanum (A)</p> Signup and view all the answers

What is the drug of choice for the treatment of lung flukes?

<p>Praziquantel (B)</p> Signup and view all the answers

Which drug can be used as an additional treatment for lung fluke infection involving cerebral symptoms?

<p>Corticosteroids (A)</p> Signup and view all the answers

Which drug is considered an alternative to praziquantel for lung fluke treatment?

<p>Bithionol (D)</p> Signup and view all the answers

What is the mechanism of action of triclabendazole in affecting lung flukes?

<p>Damaging the nuclear membrane of the parasite (A)</p> Signup and view all the answers

In the diagnosis of paragonimiasis, which diagnostic tool is considered the most basic and readily available?

<p>Acid fast stain (D)</p> Signup and view all the answers

How does human infection with P. westermani occur?

<p>By eating undercooked or pickled crab or crayfish (D)</p> Signup and view all the answers

Where do the miracidia hatch and seek the first intermediate host?

<p>A snail (B)</p> Signup and view all the answers

What is the infective stage for the mammalian host in the life cycle of P. westermani?

<p>Metacercariae (A)</p> Signup and view all the answers

How does P. westermani enter the human lungs during the infection process?

<p>Through the intestinal wall (D)</p> Signup and view all the answers

Where does the parasite encyst as a metacercaria in the crustacean host?

<p>Gills (C)</p> Signup and view all the answers

What prevents the completion of the life cycle of P. westermani when the worms reach the brain or striated muscles?

<p>Eggs getting trapped in these structures (C)</p> Signup and view all the answers

What is the size of the Adult Heterophyid Fluke?

<p>2 mm in length (B)</p> Signup and view all the answers

Where is the genital sucker located in the Adult Heterophyid Fluke?

<p>At the left posterior border of the ventral sucker (B)</p> Signup and view all the answers

Which suckers does the Adult Heterophyid Fluke possess?

<p>Oral, Genital, Acetabulum (A)</p> Signup and view all the answers

Where are the vitellaria located in the Adult Heterophyid Fluke?

<p>At the lateral sides, occupying the lower thirds of the body (A)</p> Signup and view all the answers

Which method is used for stool analysis to detect the presence of eggs?

<p>Kato-Katz method (A)</p> Signup and view all the answers

Why is PCR considered a useful diagnostic tool for low-intensity heterophyid infections?

<p>Because it has higher sensitivity, particularly for low-intensity infections (B)</p> Signup and view all the answers

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Study Notes

Diagnosis of Heterophyid Fluke

  • Clinical history: Peptic Ulcer Disease manifestation with bowel disturbance and history of eating raw fish
  • Adult Heterophyid Fluke: elongated, oval, or pyriform, measuring 2 mm in length
  • Tegument: fine scale-like spines
  • Genital sucker: located at the left posterior border of the ventral sucker, also known as gonotyl
  • Three suckers: oral sucker, genital sucker, and acetabulum (ventral sucker at the posterior border)
  • Esophagus: present
  • Ovary: one, globular, and slightly lobed, located in the submedian, pre- or post-testicular area
  • Testes: two, variously arranged, located in the posterior end of the body
  • Hermaphrodite: yes
  • Vitellaria: located at the lateral sides, occupying the lower thirds of the body

Detection and Diagnosis of Heterophyid Fluke

  • Kato-Katz method (Stool analysis): detects the presence of eggs
  • Definitive diagnosis: has higher sensitivity compared to formalin-ether/ethyl acetate concentration technique
  • Difficult to distinguish between Clonorchis and Opistorchis eggs
  • Heterophyid eggs: referred to as Opisthorchid-like eggs where the liver fluke is endemic
  • PCR: may be useful as a sensitive diagnostic tool, particularly for low-intensity heterophyid infections

Trematodes (Flukes)

  • Phylum: Platyhelminthes
  • Class: Trematoda
  • Infection: 4 types
    • Blood Flukes: Schistosomes
    • Liver Flukes: Fasciola, Clonorchis, Opistorchis
    • Lung Flukes: Paragonimus worms
    • Intestinal Flukes: Fasciolopsis, Echinostoma, Heterophyids

Characteristics of Trematodes (except Schistosomes)

  • Flat, leaf-like body
  • Hermaphrodite
  • Egg: Operculated
  • Habitat: Lungs, Liver, bile passage, intestine
  • Mode of transmission (MOT): Ingestion
  • Infective stage: Metacercaria
  • Two intermediate hosts: Snail and Fish, Crab, Snail, or Plant/Vegetation

Characteristics of Schistosomes (Blood Flukes)

  • Elongated and Cylindrical body
  • Separate sexes
  • Egg: Non-operculated
  • Habitat: Mesenteric vein
  • Mode of transmission (MOT): Skin penetration
  • Infective stage: Cercaria
  • Intermediate host: Snail (only one)

Intestinal Flukes

  • Species: Heterophyid Flukes, Echinostomid Flukes, Fasciolid Fluke
  • Second Intermediate Hosts:
    • Snail: Echinostoma ilocanum, Artyfechinostoma malayanum
    • Water plant: Fasciola hepatica, Fasciola gigantica, Fasciolopsis buski
    • Freshwater fish: Clonorchis sinensis, Opistorchis felinus, Heterophyes
    • Crab: Paragonimus westermani

Treatment Strategies

  • Praziquantel: Drug of choice, 25 mg/kg of BW x 3 times a day, for 2-3 days
  • Corticosteroids: used as an additional drug for cerebral involvement
  • Bithionol: alternative drug, 15-25 mg/kg BID on alternate days for 10-15 days
  • Triclabendazole: damages the nuclear membrane of the parasite

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