MEDICAL PARASITOLOGY 

   
SY 2020-2021 
2ND SEMESTER 
MEDINA & ALBANO | LECTURE & LABORATORY 

OUTLINE

I. General Characteristics
II. Intestinal Cestodes
III. Intestinal - Extraintestinal Cestodes
IV. Review Questions

I. GENERAL CHARACTERISTICS

● Belongs to Phylum ​Platyhelminthes

● Commonly known as ​Tapeworms
● Cestodes are a subclass of helminths comprising ​true tapeworms
● Multicellular animals characterized by a flat, bilaterally symmetric body, and acoelomate (no body cavity)
● Internal organs embedded in tissue called ​parenchyma
● Hermaphroditic​ (having both female and male reproductive organs)
● Complex and Indirect Life Cycles: 3 stages (egg, larval stages, and the adult worm)
● Morphology:
○ Scolex
- anterior attachment organ
- contains cup-shaped suckers and sometimes hooklets
- “crown” of scolex is called the ​rostellum
○ Neck
- region immediately posterior to scolex
- site of new proglottid production
○ Tegument
- external surface
- highly absorptive with digestive functions
○ Proglottids
- Body segments that make up the major portion of the tapeworm
- Chain of proglottids is called ​strobila
- contain male and female reproductive structures
a. Immature
➢ new segments
➢ not fully developed structures
b. Mature
➢ larger
➢ Found near the middle of the chain
➢ May contain either one or two sets of both male and female
reproductive organs
c. Gravid
➢ Terminal portion
➢ Usually filled eggs enclosed in the uterus
➢ May be discharged with eggs in stool

QUIZON 1
 MEDICAL PARASITOLOGY

II. INTESTINAL CESTODES

Hymenolepis nana Taenia solium Taenia saginata Diphyllobothrium latum

CN Dwarf tapeworm Pork tapeworm Beef tapeworm Broadfish tapeworm

IH Human Pig or Humans Cow/ Cattle 1ST: ​Copepod

2ND:​ Freshwater fish

DH House mouse, Human Human Human, Fish-eating mammals

HAB Small intestine

MOT Fecal-oral route Ingestion of egg or larvae in Ingestion of larvae in raw or Ingestion of pickled or
raw or uncooked pork insufficiently cooked beef insufficiently cooked fish
Autoreinfection (common)

IS Embryonated egg Cysticercus cellulosae Cysticercus bovis Plerocercoid larva (Spargana)

DS Embryonated egg Eggs, Gravid proglottid Eggs, Gravid proglottid Gravid proglottids, egg packets

DX Eggs in stool sample Eggs in feces Eggs in feces Eggs in feces

Radiographic computed Radiographic computed

tomography (CT), ELISA, tomography (CT), ELISA,
Indirect hemagglutination Indirect hemagglutination

DZ Taeniasis : Pork Tapeworm Taeniasis: Beef tapeworm Diphyllobothriasis

Hymenolepiasis Infection Infection Dibothriocephalus anemia
Fish tapeworm infection
Cysticercosis Broadfish tapeworm infection

PATH Light INF: ​Asymptomatic Light INF: ​Asymptomatic Light INF: ​Asymptomatic Light INF: ​Asymptomatic

Heavy INF: ​intestinal Taeniasis:​ nonspecific Taeniasis:​ abdominal pain, Diphyllobothriasis, Fish
enteritis, abdominal pain, abdominal pain,​ ​diarrhea, diarrhea, slight weight loss, tapeworm infection, Broadfish
diarrhea, anorexia slight weight loss, vomiting dizziness, vomiting and tapeworm infection:​ digestive
and nausea nausea discomfort, overall weakness,
vitamin B12 deficiency
Neurocysticercosis:
epilepsy, headache,
papilledema, and vomiting

TX/PR Niclosamide Taeniasis:​ Praziquantel or Praziquantel Niclosamide

Praziquantel Niclosamide Niclosamide Praziquantel
Paromomycin
Cysticercosis:
Proper hygiene Albendazole or surgery Proper hygiene Proper hygiene
Sanitation practices Thorough cooking of beef Sanitation practices
Eradicate rats and mice Proper hygiene Thorough cooking of fish
Avoid eating raw or Freezing of fish (48 hrs at -10C)
insufficiently cooked pork

Hymenolepis diminuta Dipylidium caninum

CN Rat tapeworm Flea tapeworm, Cucumber tapeworm

IH Flea or Beetle Dog flea

DH Rat Dogs or cats

MOT Ingestion of rat flea containing cysticercoid Ingestion of dog flea containing cysticercoid

IS Cysticercoid Cysticercoid

HAB Small intestine of rat, Humans (rare) Small intestine of dogs, Humans (rarel)

QUIZON 2
 MEDICAL PARASITOLOGY

III. INTESTINAL - EXTRAINTESTINAL CESTODES

Echinococcus granulosus

CN Dog tapeworm or Hydatid tapeworm

IH Human (accidental), Sheep, Goats, Swine or none

DH Dogs and other canines

HAB Liver or Lungs

MOT Ingestion of embryonated eggs

IS Embryonated egg

DS Hydatid cyst

DX Presence of solices, brood capsules, hydatid sand

Indirect hemagglutination
ELISA
Ancillary tests: X-ray, Ultrasound scan, CT detection of cyst

DZ Echinococcosis
Hydatid cyst
Hydatid disease
Hydatidosis

PATH Echinococcosis, Hydatid Cyst, Hydatid Disease, Hydatidosis: ​varied discomfort, rupture of cyst, anaphylactic shock,
eosinophilia, allergic reactions, or even death

E. granulosus lung infection:​ chest pain, coughing, shortness of breath,

E. granulosus liver infection: ​Asymptomatic to obstructive jaundice or portal hypertension

TX/PR Mebendazole
Albendazole
Praziquantel
Surgical removal of the hydatid cyst

Proper personal hygiene

Prevent dogs from eating carcass of sheep, cattle, and hogs

Legend:
CN​ (Common Name)
IH ​(Intermediate host)
DH​ (Definitive Host)
HAB​ (Habitat)
MOT​ (Mode of Transmission)
IS​ (Infective stage)
DS​ (Diagnostic stage)
DX​ (Lab Diagnosis)
DZ ​(Disease)
PATH ​(Pathology)
TX/PR​ (Treatment and Prevention)

QUIZON 3
 MEDICAL PARASITOLOGY

IV. REVIEW QUESTIONS

1. The best direct diagnosis of ​Echinococcus 9. Mature eggs of an adult tapeworm accumulate in
granulosus infection in humans is made by the:
identification of a. Mature proglottid
a. Adult worms in the intestine b. Strobila
b. Adult worms in tissues c. Scolex
c. Eggs in feces d. Gravid proglottid
d. Hydatid cysts in tissues
10. A type of tapeworm larva with large bladder,
2. This parasitic infection may result in vitamin B12 producing daughter cysts, brood capsules, and
deficiency, and individuals with pernicious anemia numerous scolices is:
are predisposed to more severe symptoms a. Cysticercus
a. Diphyllobothrium latum b. Hydatid cyst
b. Echinococcus granulosus c. Plerocercoid
c. Hymenolepis diminuta d. None of the above
d. Taenia saginata
11. Eggs from which tapeworm, when passed, are
3. Which stage of ​Taenia saginata is usually immediately infective to humans?
infective for humans? a. Diphyllobothrium latum
a. Cysticercus larva b. Dipylidium caninum
b. Embryonated egg c. Hymenolepis nana
c. Filariform larva d. Echinococcus granulosus
d. Rhabditiform larva
12. In the ​Diphyllobothrium latum life cycle, the
4. Hydatid cysts in humans are due to ingestion of infective stage for humans is:
tapeworm stage normally found in canines. This a. Cysticercus
stage is the b. Cysticercoid
a. Cercaria c. Procercoid
b. Cercocystis d. Plerocercoid
c. Cysticercus
d. Embryonated egg 13. The human condition resulting from the ingestion
of the immature larval form of ​D. latum​ is called
5. A patient from the Great Lakes area presents with a. Cysticercosis
vague abdominal symptoms and a macrocytic b. Hydatid disease
anemia. Which Cestoda would be the probable c. Racemose
cause? d. Sparganosis
a. Diphyllobothrium latum
b. Echinococcus granulosus 14. The number of uterine branches in the mature
c. Taenia saginata proglottid of ​Taenia saginata​ is:
d. Hymenolepis nana a. Less than 14
b. More than 14
6. The eggs of which two species are infective to
humans if ingested, resulting in larval stages and 15. The number of uterine branches in the mature
pathology in the host’s tissues? proglottid of ​Taenia solium ​is:
a. Taenia solium and T. saginata a. More than 14
b. Hymenolepis diminuta and Dipylidium b. Less than 14
caninum
c. Echinococcus granulosus and Taenia 16. The tapeworm scolex without cup-shaped suckers
solium is:
d. Hymenolepis nana and Taenia saginata a. Hymenolepis nana
b. Taenia saginata
7. The causative agent of cysticercosis is c. Taenia solium
a. Taenia solium d. Diphyllobothrium latum
b. Taenia saginata
c. Echinococcus granulosus 17. Which among the parts of a tapeworm aids in
d. Dipylidium caninum attachment to intestinal mucosa
a. Strobila
8. The examination of human feces is no help in the b. Integument
detection of: c. Scolex
a. Hymenolepis nana d. Proglottids
b. Taenia saginata
c. Echinococcus granulosus 18. What are fleshy extensions of select tapeworm
d. Dipylidium caninum scolices
a. Scolex

QUIZON 4
 MEDICAL PARASITOLOGY

b. Strobila c. Presence of hooklets and number of

c. Rostellum uterine branches in proglottid
d. Proglottids d. Egg morphology and presence of suckers
on scolex
19. What type of tissue constitutes the new segment
production in the strobila called
a. Parenchyma 23. Which is the preferred drug for treating intestinal
b. Muscle infection by Taenia species
c. Germinal a. Penicillin
d. Connective b. Praziquantel
c. Niclosamide
20. The embryo seen in certain cestode eggs bearing
d. Pentamidine
six tiny hooklets
a. Coracidium
b. Oncosphere 24. The characteristic of the life cycle of ​Hymenolepis
c. Cysticercus nana that differentiates it from the other cestodes
d. Plerocercoid is which of the following
a. Lack of an intermediate host
21. A persistent cough, localized pain, and liver and
b. Infective larval stage
lung involvement are associated with an infection
c. Need for external environment
with which of the following cestodes?
a. Diphyllobothrium latum d. Larval passage through the lungs
b. Echinococcus granulosus
c. Both A and B 25. A small bladder-like structure consisting little or
d. None of the above no fluid in which the scolex is enclosed
a. Coracidium
22. Which of the following are key distinguishing
b. Cysticercoid
factors in differentiating an infection between
c. Cysticercus
Taenia saginata​ and ​Taenia solium d. Plerocercoid
a. Egg morphology and number of uterine
branches in proglottid
b. Presence of hooklets on scolex and egg
morphology

26. Long, flat, segmented, ribbon-like a. Nematodes

27. Incomplete digestive tract b. Cestodes
28. Separate sexes c. Both
29. Simple body plan, pseudocoelomate
30. Acoelomate body
31. Males usually use special copulatory spines
32. Bilaterally symmetrical body
33. Presence of suckers, often with hooks
34. Tapered, cylindrical body
35. Endoparasites

Matching Type:​ Select the correct intermediate host (s) for each parasite

36. ​Taenia solium a. Fish

37. ​Hymenolepis nana b. Copepod
38. ​Hymenolepis diminuta c. Cow
39. ​Diphyllobothrium latum d. Human
40. ​Echinococcus granulosus e. Pig
41. ​Taenia saginata f. Snail
42. ​Dipylidium caninum g. Flea or beetle
h. Dog flea
i. Sheep
j. None

QUIZON 5
 MEDICAL PARASITOLOGY

Matching Type:​ Select one correct match for each parasite

43. ​Taenia solium a. Macrocytic anemia and vitamin B12 deficiency

44. ​Hymenolepis nana b. Plerocercoid subcutaneously
45. ​Diphyllobothrium latum c. Proglottid has 15 to 30 lateral uterine branches
46. ​Echinococcus granulosus d. Neurological symptoms if in brain
47. ​Dipylidium caninum e. Autoreinfection is common
48. Sparganosis f. Proglottid has 7 to 10 lateral uterine branches
49. Cysticercosis g. Human accidentally ingests infected flea
50. ​Taenia saginata h. Cysts found in liver, lungs, or other organs

QUIZON 6