26 Questions
What is the typical size range of an adult Paragonimus westermani?
7-12 mm by 4-6 mm by 3.5-5 mm
What is the primary mode of transmission of Paragonimus westermani?
Ingesting raw or cooked crabs harboring metacercariae
Which diagnostic technique is highly sensitive for Paragonimus westermani diagnosis?
Sputum concentration with 3% sodium hydroxide
What is the drug of choice for treating Paragonimus westermani infections?
Praziquantel
What is the characteristic feature of the egg of Paragonimus westermani?
Ovoid in shape, yellowish brown in color
What is the intermediate host of Paragonimus westermani?
Antemelania asperata
What is the primary imaging technique used for diagnosing pulmonary paragonimiasis?
Radiography
Which species of parasite is associated with cerebral paragonimiasis?
Paragonimus westermani
What is the shape of the embryonated eggs of Schistosoma japonicum?
Ovoid, round or pear-shaped
What is the main advantage of the Kato-Katz technique in diagnosing Schistosomiasis?
It is suitable for quantification of eggs
What is the primary Snail host of Schistosoma japonicum?
Oncomelania hupensis quadrasi
What is the drug of choice for treating Schistosomiasis?
Praziquantel
What is the characteristic feature of the male Schistosoma japonicum?
Gynecophoric canal
What is the purpose of the Merthiolate-Iodine-Formalin Concentration Technique (MIFC) in diagnosing Schistosomiasis?
Detection of moderate and heavy infections
What is the limitation of the Rectal Snips and Imprints technique in diagnosing Schistosomiasis?
Inability to distinguish between untreated and treated infections
What is the primary mode of transmission of Schistosomiasis?
Contact with contaminated water
What is the characteristic feature of the female Schistosoma japonicum?
Single pyramidal ovary located in the midline
What is the purpose of the Circumoval Precipitin Test (COPT) in diagnosing Schistosomiasis?
Demonstration of precipitates on the surface of schistosome eggs
What is the typical length of Toxoplasma gondii?
4-8 um
What is the primary diagnostic method for toxoplasmosis?
Antibody detection
What is the purpose of testing for IgM antibodies in toxoplasmosis?
To determine the time of infection
What is the drug of choice for treating toxoplasmosis?
Pyrimenthamine
What is the mode of transmission of Fasciola spp?
Ingestion of contaminated water
What is the stage of the life cycle of Fasciola spp. that is excreted by the infected definitive host?
Unembryonated eggs
What is the characteristic of the anterior end of Toxoplasma gondii?
Tapered
What is the purpose of the Enzyme Immunoassay (EIA) in diagnosing toxoplasmosis?
To detect IgM antibodies
Study Notes
Paragonimus westermani (Paragonimiasis)
- Adult worms: flattened, lance-shaped, 10-25 mm long, 3-5 mm wide, with oral and ventral suckers (acetabulum) that are relatively small
- Diagnosis: cholangiography reveals fluke within the mucosa of the bile duct; immunodiagnosis using ELISA, PCR, and EIA
- Drug of choice: Praziquantel, Albendazole, or Praziquantel-Albendazole
- Cyst and Trophozoite: not mentioned
- Prevention and Control: not mentioned
Life Cycle
- Mode of Transmission: ingesting raw or cooked crabs harboring metacercariae
- Infective Stage: metacercariae
- Intermediate Hosts:
- First: Antemelania asperata, Antemelania dactylus
- Second: Sundathelphusa philippina
- Diagnosis:
- Egg: ovoid, yellowish-brown, 80-120 um by 45-70 um, with prominent operculum and thickened abopercular end
- Best sensitivity for microscopy diagnosis: sputum concentration with 3% sodium hydroxide with repeated sputum examination up to 3 times on different days
Adult Worm
- Reddish-brown in color, resembling a coffee bean
- 7-12 mm long, 4-6 mm wide, 3.5-5 mm thick, with a round anterior and tapering posteriorly
Immunodiagnosis
- Complement Fixation (CF) Test: high sensitivity for diagnosis and assessment of cure post-therapy
- EIA
- Immunoblot
Imaging
- Radiography: for diagnosis of pulmonary paragonimiasis, showing lung parenchyma lesions that are infiltrative, nodular, or cavitating
- CT Scan
- MRI: for cerebral paragonimiasis, showing conglomerated, multiple, ring-enhancing lesions with surrounding edema on the brain, with a "grape-cluster" appearance
Schistosoma spp. (Toxoplasmosis)
- Species: Schistosoma spp.
- Disease: Toxoplasmosis
- Life Cycle: not mentioned
- Mode of Transmission: not mentioned
- Diagnostic Stage & Infective Stage: not mentioned
- Guidelines: not mentioned
- Diagnosis:
- Antibody detection: primary diagnostic method to determine toxoplasmosis
- Immunofluorescence Assay (IFA)
- Enzyme Immunoassay (EIA)
- IgG antibody: indicates infection at some time
- IgM antibody: determines time of infection
- Drug of Choice: Pyrimethamine and Sulfadiazine
Fasciola spp. (Fascioliasis)
- Species: Fasciola hepatica, F. gigantica
- Disease: Fascioliasis
- Life Cycle: not mentioned
- Mode of Transmission: unembryonated eggs excreted by infected definitive host, eggs hatch in water, and cercariae penetrate the skin of the definitive host
- Diagnostic Stage & Infective Stage: not mentioned
- Guidelines: Snail control, focal approach, area-wide control, and control of breeding
- Diagnosis:
- Eggs: large, rounded, pale yellow, 70-100 um long, 55-64 um wide
- Adult: large sucker capping the anterior end, ventral sucker, and gonophore
- Male: shorter, 12-20 mm long, with gynecophoric canal
- Female: longer, 15-26 mm long, with single pyramidal ovary located in the midline
- Stool Examination:
- Kato-Katz Technique: suitable for quantification of eggs
- Merthiolate-Iodine-Formalin Concentration Technique (MIFC): sufficient sensitivity for moderate and heavy infections
- Rectal Snips & Imprints: require specialized equipment and personnel
- Immunodiagnostic Tests:
- Intradermal Test: highly sensitive but non-specific
- Indirect Hemagglutination: highly sensitive
- Circumoval Precipitin Test (COPT): demonstration of the formation of bleb-like or septate precipitates attached to the egg surface
- ELISA: using soluble antigens on adult worms and eggs
- Drug of Choice: Praziquantel, with mass chemotherapy in areas of prevalence
This quiz is about the characteristics and diagnosis of Clonorchis sinensis, a parasitic flatworm. It covers the physical description of the adult fluke and diagnostic methods such as cholangiography and immunodiagnosis.
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