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Questions and Answers
Which type of eggs is associated with Paragonimus and Fasciolopsis?
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?
In terms of habitat, where do Schistosomes reside?
- Liver
- Mesenteric vein (correct)
- Bile passage
- Lungs
What is the mode of transmission for Schistosomes?
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?
Which of the following is an infective stage for most Trematodes except Schistosomes?
What is the morphology of Trematodes, excluding Schistosomes?
What is the morphology of Trematodes, excluding Schistosomes?
Which of the following is not a general feature of Trematodes?
Which of the following is not a general feature of Trematodes?
Which species of fluke inhabits the portal blood stream of vertebrates?
Which species of fluke inhabits the portal blood stream of vertebrates?
What is the class of the phylum Platyhelminthes that includes flukes?
What is the class of the phylum Platyhelminthes that includes flukes?
Which of the following flukes inhabits the lungs of vertebrates?
Which of the following flukes inhabits the lungs of vertebrates?
What is the name of the species of fluke that inhabits the small intestines of vertebrates?
What is the name of the species of fluke that inhabits the small intestines of vertebrates?
Which of the following is NOT a species of liver fluke?
Which of the following is NOT a species of liver fluke?
What is the drug of choice for the treatment of lung flukes?
What is the drug of choice for the treatment of lung flukes?
Which drug can be used as an additional treatment for lung fluke infection involving cerebral symptoms?
Which drug can be used as an additional treatment for lung fluke infection involving cerebral symptoms?
Which drug is considered an alternative to praziquantel for lung fluke treatment?
Which drug is considered an alternative to praziquantel for lung fluke treatment?
What is the mechanism of action of triclabendazole in affecting lung flukes?
What is the mechanism of action of triclabendazole in affecting lung flukes?
In the diagnosis of paragonimiasis, which diagnostic tool is considered the most basic and readily available?
In the diagnosis of paragonimiasis, which diagnostic tool is considered the most basic and readily available?
How does human infection with P. westermani occur?
How does human infection with P. westermani occur?
Where do the miracidia hatch and seek the first intermediate host?
Where do the miracidia hatch and seek the first intermediate host?
What is the infective stage for the mammalian host in the life cycle of P. westermani?
What is the infective stage for the mammalian host in the life cycle of P. westermani?
How does P. westermani enter the human lungs during the infection process?
How does P. westermani enter the human lungs during the infection process?
Where does the parasite encyst as a metacercaria in the crustacean host?
Where does the parasite encyst as a metacercaria in the crustacean host?
What prevents the completion of the life cycle of P. westermani when the worms reach the brain or striated muscles?
What prevents the completion of the life cycle of P. westermani when the worms reach the brain or striated muscles?
What is the size of the Adult Heterophyid Fluke?
What is the size of the Adult Heterophyid Fluke?
Where is the genital sucker located in the Adult Heterophyid Fluke?
Where is the genital sucker located in the Adult Heterophyid Fluke?
Which suckers does the Adult Heterophyid Fluke possess?
Which suckers does the Adult Heterophyid Fluke possess?
Where are the vitellaria located in the Adult Heterophyid Fluke?
Where are the vitellaria located in the Adult Heterophyid Fluke?
Which method is used for stool analysis to detect the presence of eggs?
Which method is used for stool analysis to detect the presence of eggs?
Why is PCR considered a useful diagnostic tool for low-intensity heterophyid infections?
Why is PCR considered a useful diagnostic tool for low-intensity heterophyid infections?
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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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