* NLE * NCLEX * CGFNS * HAAD * PROMETRICS * DHA * MIDWIFERY * LET * RAD TECH * CRIMINOLOGY * DENTISTRY * PHARMACY *

TERMINOLOGIES

* _______________- a study of parasites, organisms that live on and obtain their nutrients from
another organism
* _______________- the process of inoculating an infective agent
* _______________- establishment of the infective agent in the host; presence of an endoparasite
in the host
* _______________- establishment of the infective agent in the host; presence of ectoparasite in
the host
* _______________- the period between acquisition of the parasite and the demonstration of
infection
* _______________- the period between acquisition of the parasite and the evidence of symptom *
_______________- results when an infected individual becomes his own direct source of infection
* _______________- results when an already infected individual is further infected with the same
species leading to massive infection with the parasite
* _______________- results when an already infected individual is concurrently further infected
with another species of parasite
* _______________- parasite that wander from its usual site of infection into a location that it does
not ordinarily live in to
* _______________- the use of antihelminthic drugs in an individual
* _______________- effect of drug against an infective agent in ideal experimental conditions *
_______________- measure of the effect of a drug against an infective agent in a particular host *
_______________- the number of previously positive subjects found to be negative on examination
of a specimen at a set time after deworming
* _______________- permanent reduction to zero of the worldwide incidence of infection caused
by a specific agent, as a result of deliberate efforts; once achieved, continued measures are no
longer needed
* _______________- a reduction to zero of the incidence of a specified disease in a defined
geographic area as a result of deliberate efforts; continued intervention or surveillance measure
are still required

CLASSIFICATION OF PARASITES
A. According to habitat of the parasite
* ____________- parasite living outside he host
* ____________- parasite living inside the host
B. According to mode of living
* ____________- parasite that remains in the host for its entire life
* ____________- parasite that remains in the host for a short period of time
* ____________- parasite that establishes itself to a host where it does not ordinarily live *
____________- a free-living organism that passes through the digestive tract of the host
without infecting the host itself
C. According to mode of development
* ____________- capable of existing independently of a host
* ____________-cannot survive outside of a host; cannot complete its developmental cycle
without its host

CLASSIFICATION OF HOST
* _________________- host which harbors the larval/asexual stage of the parasite development
occurs
PREPARED BY
Frany A. Bumanglag, RMT, MSMT
* _________________- host on which the parasite adult sexual phase of parasite development
occurs
* _________________- one in which the parasite does not develop further to later stages, but
parasite is kept alive and is capable of infecting another susceptible host
* _________________- animal host other than definitive host that can allow continuation of the life
cycle and become additional sources of human infection
* _________________- hosts that harbors a particular pathogen without manifesting any signs and
symptoms

PARASITE-HOST RELATIONSHIP
* _________________- living together; the association of two living organisms, each of a different
species
* _________________- association of two different species of organisms that is beneficial to one
and neutral to the other
* _________________- association of two different species of organisms that is beneficial to both *
_________________- association of two different species of organisms that is beneficial to one at the
other’s expense
* _________________- parasite that has demonstrated the ability to cause disease

_________________- are responsible for transmitting the parasite from one host to another *
_________________- transmits the parasite after the completion of its development in the host;
necessary for the completion of life cycle
* _________________- transports the parasite; no development of the parasitic life
cycle

PARASITIC MODE OF TRANSMISSION

⮚ Ingestion of contaminated food or water
⮚ Skin penetration
⮚ Inhalation
⮚ Sexual or venereal route
⮚ Congenital transmission

LABORATORY DIAGNOSIS
A. Specimen collection and processing
* Specimen types
‐ Stool vi. Rectal swab or duodenal specimen ‐ Tissue biopsies vii. Skin snips
‐ Urine viii. CSF
‐ Sputum ix. Genital discharge
‐ Blood x. Corneal scrapings
* Special considerations for STOOL sample
‐ Should not be stored at room temperature longer than a couple of hours
‐ Free of antimicrobial agents or substances that inhibit parasitic growth
‐ At least ___________ of fecal sample in _______________________
‐ It should be free of urine contamination
‐ Liquid stools will show ____________
‐ Formed stools will show ____________
* Stool preservatives
‐ 5 or 10% Formalin

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
‐ _______________ to preserve stool specimen
 ____________________________________________
‐ Advantages- easy to prepare, preserve spx for several years, long shelf
life
‐ Disadvantage- DOES NOT PRESERVE PARASITE MORPHOLOGY
for permanent smears

‐ Polyvinyl alcohol (PVA)

‐ _________________ preservative for preparing
____________________________
‐ Disadvantages- use of SCHAUDINN SOL’N; toxic

‐ Sodium acetate formalin (SAF)

‐ __________________ preservative used for both
_________________________ like PVA

‐ Schaudinn’s fluid
‐ Modified PVA
‐ substituted with ________________________________
‐ Used for ____________________________

‐ Merthiolate-iodine-formalin
‐ For _____________________________________ but
____________________________

* Permanent stains
‐ Wheatley,s trichrome stain
‐ MOST WIDELY USED permanent stain
‐ Iron hematoxylin stain
‐ Time-consuming
‐ Excellent intestinal protozoa morphology
‐ Modified acid-fast stain
‐ Useful for the demonstration of the oocyst of _______________,
_______________ and ______________
‐ Modified trichrome stain
‐ Using a 10-fold increase concentration of ______________________
‐ Fluorescent staining
‐ Using optical whitening agents such as __________________ and
______________
B. Laboratory techniques

STOOL EXAMINATION
* ___________________
‐ One of the most easily performed and commonly used for routine examinations
‐ Uses a drop of _____________ or a drop of _______________________
‐ ____________________________________ may be used
‐ Use of straight Lugol’s iodine or Gram’s iodine causes clumping of material
‐ Iodine enhances the visibility of __________ structures of protozoal cysts and in
detecting _________________

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
‐ Iodine causes the loss of trophozoite motility, cyst refractility and difficulty in
recognizing chromatoid bodies
‐ Has low sensitivity because small portion of the fecal sample is used
Materials and reagents
‐ Wooden applicator sticks
 ‐ Pens or markers
‐ Microscope slide
‐ Isotonic saline solution and iodine
* ____________________
‐ Uses a measured amount of stool that has been sieved through a wire mesh and
pressed under cellophane paper soaked in ___________________________
solution
‐ Uniform amount of stool is examined for egg counting
‐ Used for assessing the intensity of infection in schistosomiasis and soil
transmitted helminthes
‐ Can only be done in fresh formed stool and NOT on liquid and preserved stool
samples
Materials and reagent
‐ Wooden applicator sticks
‐ Stainless steel, nylon or plastic screen
‐ Cardboard template
‐ Spatula and microscope slides
‐ Hydrophilic cellophane
‐ Flat bottom jar with lid
‐ Forceps
‐ Glycerol-malachite green
‐ Newspaper
* ______________________
‐ Similar to Kato-Katz
‐ No measurement of amount of stool used is required
‐ 50-60mg of stool is placed in slide and covered with cellophane soaked with
glycerin-malachite green
‐ Are performed to enhance detection of smaller amounts of parasites that may not
be detected in the direct mount

CONCENTRATION TECHNIQUES
* _________________________________
‐ MOST WIDELY USED due to simplicity and its suitability in most laboratory
situations
‐ Based on ______________
‐ Efficient in recovering most protozoan cysts and helminth eggs and larvae
‐ Less distortion of protozoal cysts than in Zinc sulfate floatation.
‐ Used widely due to simplicity and its suitability in most laboratory situations ‐
Steps
▪ Approximately ________of stool is suspended in 5-10% formalin.
▪ Suspension is filtered through gauze into a ______ centrifuge tube (either
0.85% NaCl or 5-10% formalin is added to fill the tube almost
completely)
▪ Centrifuge at ___________________ (after centrifugation, supernatant is
discarded)

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
▪ Wash step (repeated until supernatant is clear)
▪ After the last wash step, resuspend in about _______________
▪ A _______________________ is added, shake tube for atleast 30
seconds
▪ Centrifuge again, _____________ should be obtained
▪ Top three layers are poured off
▪ Sediment is resuspended in formalin and used for wet mounts
* __________________________________
 ‐ Fresh stool is processed using zinc sulfate with a specific gravity of ________ and
formalinized stool is processed with a solution of specific gravity of _______ ‐
Parasitic elements are recovered from the surface film of solution following
centrifugation
‐ Provides a cleaner preparation than is provided by formalin ethyl acetate
concentration technique
‐ Steps
▪ Approximately ________of stool is suspended in 5-10% formalin.
▪ Suspension is filtered through gauze into a ______ centrifuge tube
▪ Centrifuge at ___________________ (after centrifugation, supernatant is
discarded)
▪ Wash step (repeated until supernatant is clear)
▪ After the last wash step, resuspend in about ______________________
▪ Recentrifuge for _____________________
▪ Two layers will result- a small amount of the sediment and a layer of
zinc sulfate
▪ The liquid is examined for parasites
* ________________________________
‐ This procedure is similar to the zinc sulfate procedure, except __________ is
used in place in zinc
‐ The sucrose solution has a specific gravity of _____________

EXAMINATION OF BLOOD
‐ For the diagnosis of blood-borne pathogen such as Plasmodium, Babesia,
Trypanosoma, Leishmania and Filarial worms
‐ Thick and thin blood films
‐ Concentration techniques for blood specimen include
▪ Knott’s concentration technique
▪ Buffy coat smears
Wright’s stain
‐ Fixative and stain in one sol’n
‐ Yields satisfactory result
Giemsa’s stain
‐ Separate fixative and stain
‐ PREFFERED stain

Collection and handling

• Collected from – fingertip or earlobe (gives best morphology for parasite)
• Causes of unsatisfactory result
• Improper collection and smear preparation
• Capillary blood contaminated with alcohol
• Milked blood from fingertip

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
• Anti-coagulants
• Anti-coagulant of CHOICE – EDTA

CEREBROSPINAL FLUID and other STERILE FLUIDS

• Collected for diagnosis of
• _____________________
• _________________________
• Examined promptly
• Wet preparation to characterize morphologic forms of
• __________________
• _________________________
 • ____________________ of Trypanosoma spp.

EXAMINATION OF TISSUE BIOPSIES AND DISCHARGE

‐ Vaginal, urethral and prostatic discharge/secretions
‐ Sputum samples
‐ Muscle biopsies
‐ Skin biopsies
* Additional techniques
‐ Cellulose tape technique
‐ Novy-McNeal-Nicole medium
‐ Stool culture using Robinson’s and Inoki medium
‐ Proteose-peptone, yeast extract, glucose, cysteine medium
‐ Boekc’s and Drbohlav’s media
‐ Nelson and jones media
‐ Harada-Mori paper strip culture
‐ Baermann funnel technique
‐ Sabin-Feldman dye test

NEMATODES
(ROUNDWORMS)

* Ascaris lumbricoides * Enterobius vermicularis * Trichuris trichiura * Filarial

worms * Hookworms * Trichinella * Strongyloides stercoralis * Capillaria
philippinensis

CLASSIFICATION
A. Intestinal nematodes
a. Ascaris lumbricoides
b. Enterobius vermicularis
c. Trichuris trichiura
d. Strongyloides stercoralis
e. Necator maericanus
f. Ancylostoma duodenale
B. Intestinal- tissue nematodes
a. Trichinella spiralis
b. Dracunculus medinensis
C. Presence of chemoreceptors
a. Aphasmids

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
b. Phasmids

GENERAL CHARACTERISTICS
* Adult nematode is elongated, cylindrical worm, primarily bilaterally symmetrical, non-segmented *
Anterior end may be equipped with __________, ___________, __________________ * Adult
worms have complete digestive tract, having both oral and anal openings * Alimentary tract is simple
tube extending from mouth to anus. Theres is NO circulatory system * Adult worms are
non-hermaphroditic
* Males are generally smaller with curved posterior ends
* Provided with chemoreceptor
‐ Cephalic chemoreceptor
‐ Caudal chemoreceptor
* Life cycle- ___________˃____________˃ ____________
* _______________- lays egg in unsegmented stage
* _______________- lays egg in segmented stage
 * _______________- larval stage only
* Adults of intestinal nematodes may be found in the large and small intestine ‐
Large intestine
‐ Small intestine
‐ Extra-intestinal nematodes

Ascaris lumbricoides
* Romans _______________
* GIANT INTESTINAL ROUNDWORM
* Adult- white cream or pinkish yellow when fresh
‐ head is provided with 3 lips and a triangular buccal cavity
* Egg- fertile (3 layers) or infertile (2 layers)
* Causes ascariasis resulting in intestinal tissue destruction and bowel obstruction *
Worms can migrate to the lungs causing pulmonary disorders, and to other body sites *
Mode of transmission- ________________
* Infective stage- _________________
* Diagnostic stage- _________________

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
Trichuris trichiura
* WHIP WORM
* Diseases- trichuriasis, whip worm infection, trichocephaliasis, _____________________ *
Adult- flesh colored or pinkish gray worms, slender or attenuated in the anterior ‐ Anterior
‐ Posterior
* Egg- _______________________
* Mode of transmission- ______________________
* Infective stage- _______________________
* Diagnostic stage- ______________________
Hookworms
* Necator americanus (American hookworm, American murderer, New world hookworm) *
Ancylostoma duodenale (Old world hookworm)
* Ancylostoma braziliense (Cat hookworm)
* Ancylostoma caninum (Dog hookworm)
* Disease- Iron deficiency anemia
‐ Ground itch
‐ Creeping eruptions/ CLM
* Egg- ovoidal, thin-shelled and colorless
* Mode of transmission- __________________________

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
* Infective stage- _____________________________ *
Diagnostic stage- ________________________
 Strongyloides stercolaris * THREADWORM
* Disease- cochin- china diarrhea, strongylidiasis *
Honey-combed appearance of the intestinal mucosa *
Mode of transmission- ______________________ *
Infective stage- ________________________ *
Diagnostic stage- _______________________

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
Hookworm vs Strongyloides stercoralis
Rhabditiform larva (1st stage) Hookworm Strongyloides stercoralis

Buccal cavity

Genital primordium

Filariform larva (2nd stage)

sheath

tail

Enterobius vermicularis
* PIN WORM, SEAT WORM, SOCIAL WORM, SOCIETY WORM
* Disease- oxyuriasis, enterobiasis, pruritus ani
* Adult - has cephalic alae and prominent esophageal bulb
‐ Small, whitish or brownish in color
* Egg- elongated, flattened on one side, D-shaped
* Mode of transmission- ________________________
* Infective stage- ________________________
* Diagnostic stage- _________________________
Capillaria philippinensis
* PUDOC WORM
* Disease- capillariasis or mystery disease
* Adult- delicate tiny worms
‐ Male- chitinized spicule/ spicule sheath
‐ Female- usually have eggs in utero
* Egg- bipolar mucus plugs, striated and smaller than T. trichiura egg
‐ Guitar, peanut shaped, segmented
* Mode of transmission- _______________________
* Infective stage- ________________________
* Diagnostic stage- ______________________

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
* Intermediate host- ______________________ Trichinella spiralis

* MUSCLE WORM, TRICHINA WORM

* Disease- trichinosis, trichinellosis, myalgia *
Adult in intestine; larvae in muscles
* Mode of transmission- _________________________ *
Infective stage- ___________________________ *
 Diagnostic stage- ___________________________

PREPARED BY
Frany A. Bumanglag, RMT, MSMT

Filarial worms
* Mode of transmission- ______________________________
* Infective stage- _____________________________
* Diagnostic stage- _____________________
* Definitive host- ___________________
* Intermediate host- _________________
FILARI HABITAT VECTOR SPECIMEN MICROFILARIA PERIODICITY
AL
 WORM

Wuchereria Lymphatics Aedes, Blood Sheathed, Nocturnal

bancrofti anopheles nuclei absent
in tail

Brugia malayi Lymphatics Mansonia sp. Blood Sheathed, tail Subperiodic

with 2 separate nocturnal
nuclei

Loa loa Subcutaneo Chrysops Blood Sheathed, Diurnal

us tissue sp. nuclei
Tabanid continuous up
Mango fly to the tip of
the tail

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
Onchocerca Subcutaneo Simulium Skin snips Unsheathed, Nonperiodic
volvulus us tissue sp. Black or skin nuclei absent in
fly shavings tail

Mansonella Body cavities Culicoides Blood Unsheathed, Nonperiodic

ozzardi sp. nuclei absent in
tail

Mansonella Body cavities Culicoides Blood Unsheathed, Nonperiodic

perstans sp. nuclei up to the
tip of the tail
Other nematodes
Angiostrongylus cantonensis
* RAT LUNG WORM
* Disease- eosinophilic meningoencephalitis
* Intermideate host- ________________

PREPARED BY
Frany A. Bumanglag, RMT, MSMT

Dracunculus medinensis
* GUINEA WORM, FIERY SERPENT OF THE ISRAELITES
* Disease- dracontiasis, dracunculosis
* Adult worm inhabits the cutaneous and subcutaneous tissue
* Mode of transmission- ______________________
* Infective stage- _______________________
* Diagnostic stage- ____________________
PREPARED BY
Frany A. Bumanglag, RMT, MSMT
CESTODES
(TAPEWORMS)

* Taenia solium * Dipylidium caninum

* Taenia saginata * Echinococcus granulosus
* Hymenolepis nana * Diphyllobothrium latum
* Hymenolepis diminuta

MORPHOLOGY
* _____________- is the anterior portion of the body containing suckers and sometimes hooklets
responsible for attachment to the host. The ‘’crown’’ of the scolex is called __________ *
_____________- make up the major portion of the tapeworm; they contain male and female
reproductive structures
* _____________- located directly behind the scolex and is the site of new proglottid production *
_____________- is the entire length of the tapeworm except for the scolex and neck

GENERAL CHARACTERISTICS
* Adults are white and yellowish in color; flat and ribbon-like in appearance
* Subclass of helminthes compromising true tapeworms
* Have three life cycle stages
* Have several intermediate hosts
* Diagnosis- examination of stool samples for the presence of eggs or proglottids * Transmission of
infective eggs occur with contaminated food and water. Contamination can come from the feces of
cows, pigs, fish and humans
* Lack alimentary system
* The head carries suckers and some with hooks

FALSE TAPEWORM vs TRUE TAPEWORM

Pseudophyllidean Cyclophyllidean
 Scolex No suckers, spoon-shaped with Quadrate, with 4 cuplike
slit-like sucking grooves or bothria suckers (rostellum armed or
unarmed hooklets)

Strobila Anapolytic Apolytic

Ova Ovoid, operculated, immature Spherical, non-operculated,

when laid, ciliated embryonated, mature when
laid, not ciliated

Larval stages Coracidium˃ Procercoid˃ Plerocercoid Cysticercus

Cysticercoid
Hydatid

Intermediate host 2 intermediate host 1 intermediate host only

Adult worm Fish tapeworm Beef tapeworm

Pork tapeworm
Dwarf tapeworm
Rat tapeworm
Double-pored dog tapeworm

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
Diphyllobothrium latum
* BROAD OR FISH TAPEWORM
* Disease- Vitamin B12 deficiency
* Spalute scolex/ spoon-shaped/ almond shaped with sucking organ called ___________ *
Eggs are operculated
* Mode of transmission- _______________
* Infective stage- _________________
* Diagnostic stage- _________________
* Intermediate hosts- _________________
* Definitive hosts- _________________

Taenia sp.
 * Mode of transmission- _____________________
* Diagnostic stage- __________________
Taenia saginata Taenia solium

Common name

Intermediate host

Definitive host

Scolex

Uterus

Vagina

Length Up to 25 meters Up to 7 meters

Number of proglottids 1000-2000 Below 1000

Gravid proglottid

Eggs Spherical and striated Similar to T.saginata

containing an
embro/oncosphere with 6

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
hooklets

Larva

Infective stage

Pathogenesis

Mode of infection Ingestion of undercooked Ingestion of undercooked

(measly beef) containing (measly pork) containing
cysticercus bovis cysticercus cellulosae,
autoinfection and egg in
contaminated vegetable,
food and water.

Diagnosis

Treatment Albendazole, anti-epileptics

in neurocysticercosis

Taenia asiatica
* 3rd specie of Taenia, also known as TAIWAN TAENIA

Additional information
* Cysticercosis
 * Irritated by ___________
* Uterine branches can be demonstrated using ___________

Hymenolepis nana
* DWARF TAPEWORM

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
* Mode of transmission- ___________________
* Infective stage- ________________________
‐ Direct ______________
‐ Indirect _____________
* Diagnostic stage- ______________________
* Intermediate host- ____________________

Hymenolepis diminuta
* RAT TAPEWORM
* Mode of transmission- _______________________
* Infective stage- ______________________
* Diagnostic stage- _______________________
* Intermediate host- ______________________
H. nana vs H. diminuta
Hymenolepis nana Hymenolepis diminuta

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
Common name

Scolex

Eggs

Infective stage

Intermediate host The only human tapeworm INSECTS

that does not require I.H to
complete its natural life
cycle, however insects may
act as an
intermediate host in
SOME CASES

Definitive host Man Norway rats

Dipylidium caninum
* DOG TAPEWORM, DOUPLE PORED TAPEWORM
* Proglottids- pumpkin seed/ melon seed/ rice grains shaped
‐ Double set of reproductive organs and genital pore on each side of the lateral margin *
Mode of transmission- _____________________
* Infective stage- ______________________
* Diagnostic stage- __________________
* Intermediate host- ___________________________________________________
Echinococcus granulosus
* DOG TAPEWORM

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
* Hydatid worm producing hydatid disease
* Scolex- pyriform with 4 suckers and prominent rostellum, short neck and strobili *
Definitive host- ___________________________
* Intermediate host- __________________
* Mode of transmission- _________________________
* Infective stage- _____________________
* Diagnostic stage- ______________________

TREMATODES
(FLUKES)

* Schistosoma sp. * Heterophyid flukes

 * Paragonimus wetermani * Fasciola spp
* Fasciolopsis buski * Clonorchis sinensis
* Echinostoma ilocanum * Opistorchis spp.

GENERAL CHARACTERISTICS
* Leaf-like and hermaphroditic, except ____________________
* Eggs are operculated, except ______________________
* Infective stage is METACERCARIA, except __________________
* Mode of transmission is through INGESTION except ________________
* 1st INTERMEDIATE HOST is always _________
* Requires 2 INTERMDIATE HOST except __________________
* Generally has 2 suckers- Oral and ventral sucker

CLASSIFICATION BASED ON HABITAT

* LIVER- ___________________________________________________________

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
* INTESTINES- ______________________________________________________ *
LUNGS- _____________________________
* PORTAL VEINS/ BLOOD- ___________________________

CLASSIFICATION BASED ON EGGS/ OVA

* Operculated- ___________________________________
* Embryonated ova- ____________________
* Immature ova- ____________________

LIFE CYCLE OF TREMATODES

1. Eggs
2. Larval stage- miracidium ˃ sporocyst ˃ redia ˃ cercaria ˃ metacercaria
3. Adult

LIVER FLUKES
Fasciola hepatica
* SHEEP LIVER FLUKE, TEMPERATE LIVER FLUKE
* Disease- fascioliasis, _____________________
* Prominent CEPHALIC CONE, small OS and VS
* Mode of transmission- _______________________
* Infective stage- ____________________
* Diagnostic stage- _____________________
* Intermediate host
‐ 1st intermediate host- SNAIL (Lymnae philippinensis, Lymnea swinhoe, Lymnae
truncatula)
nd
‐ 2 intermediate host- AQUATIC VEGETATION (Ipomea obscura/ KANGKONG,
Nasturtium officinale/ WATER CRESS)
Fasciola gigantica
* GIANT LIVER FLUKE, TROPICAL LIVER FLUKE

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
* Disease- HALZOUN/ Pharyngeal fascioliasis
* Larger, more lanceolate, less developed CEPHALIC CONE
* Ova- _________________
* Mode of transmission- __________________
* Infective stage- _____________________
* Diagnostic stage- _____________________
* Intermediate host
‐ 1st intermediate host- SNAIL
‐ 2nd intermediate host- AQUATIC VEGETATION

Clonorchis sinensis
* CHINESE LIVER FLUKE, ORIENTAL LIVER FLUKE, DISTOME OF CHINA *
Disease- associated in formation of gall stones
* Ventral sucker is smaller than oral sucker
* Ova- _______________________
* Mode of transmission- ______________________
* Infective stage- _________________
* Diagnostic stage- ___________________
* Intermediate host
‐ 1st intermediate host- SNAIL (Parafossarulus, Bulimus, Alocinma, Thiara, Melanoides) ‐
2nd intermediate host- FISH (Ctenopharyngodon idellus, Caridina nilotica gracilipes)
Opistorchis felineus
* CAT LIVER FLUKE

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
* Lancet shaped, Oral sucker is smaller than ventral sucker
* Two OBLIQUELY arranged testes
* Mode of transmission- __________________________
* Infective stage- ____________________
* Diagnostic stage- ________________________
* Intermediate host
‐ 1st intermediate host- SNAIL (Bithynia leachi)
‐ 2nd intermediate host- FISH (Idus melanotus, Tinca tinca, Cyprinus carpio, Barbus
barbus)
INTESTINAL FLUKE
Fasciolopsis buski
* GIANT INTESTINAL FLUKE, LARGE INTESTINAL FLUKE
* No cephalic cone
* Ova- ___________________________
* Mode of transmission- ____________________
* Infective stage- _______________________
* Diagnostic stage- _______________________
* Intermediate host
‐ 1st intermediate host- SNAIL (Segmentina or Hippeutis)
‐ 2nd intermediate host- AQUATIC VEGETATION (WATER CALTROP/ Trapa bicornis,
WATER CHESTNUT/ Eliocharis tuberosa, WATER MORNING GLORY/ Ipomea
obscura, LOTUS/Nymphaea lotus)

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
Echinostoma ilocanum
* GARRISON’S FLUKE
* Oral sucker with spines
* Testes is BILOBED/ TANDEM formation
* Mode of transmission- ______________________
* Infective stage- _____________________
* Diagnostic stage- ____________________
* Intermediate host
‐ 1st intermediate host- SNAIL (Gyraulus convexlusculus or Hippeutis umbilicalis) ‐ 2nd
intermediate host- SNAIL (KUHOL/ Pila luzonica, SUSONG PAMPANG/ Vivipara
angularis)

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
Heterophydiae
Heterophyes heterophyes
* VON SIEBOLD’S FLUKE
* Smallest fluke of man
* 3rd sucker- GONOTYLE
* Mode of transmission- _____________________
* Intermediate host
 ‐ 1st intermediate host- SNAIL (Pironela conica)
‐ 2nd intermediate host- FISH (Mugil, Acanthogobius)

Metagonimus yokogawai
* SMALL INTESTINAL FLUKE
* Mode of transmission- ____________________
* Intermediate host
‐ 1st intermediate host- SNAIL (Thiara and Hua)
‐ 2nd intermediate host- FISH (Salmo, Richarsonlum, Odontoburis)

Haplorchis taichui
* Mode of transmission- ____________________
* Intermediate host
‐ 1st intermediate host- SNAIL (Thiara riquetti)
‐ 2nd intermediate host- FISH (BANGUS/ Chanos chanos)

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
LUNG FLUKE
Paragonimus westermani
* ORIENTAL LUNG FLUKE
* Disease- pulmonary distosomiasis
* Ova- operculated, thickened abopercular end
* Mode of transmission- ___________________
* Infective stage- ____________________
* Diagnostic stage- _____________________
* Intermediate host
‐ 1st intermediate host- SNAIL (Antemalania asperata, Antemalania dactylus) ‐
2nd intermediate host- CRAB (Sundathelpusa philippina)
PORTAL VEIN/ BLOOD FLUKE
* Schistosoma spp.
* Generally are _________
* Males are shorter, stouter with gynecophoral canal
* Ova- ________________, fully embryonated
* Mode of transmission- _________________
* Infective stage- ____________________

Schistosoma mansoni
* INTESTINAL SCHISTOSOME
* Schistosomiasis mansoni
* Egg- __________________
* Habitat of adult- inferior mesenteric veins of lower colon
* Intermediate host- Biomphalaria snail

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
Schistosoma haematobium
* URINARY SCHISTOSOME
* Bilharziasis/ Urinary schistosomiasis
* Egg- ______________________
* Habitat of adult- veins of the urinary bladder
* Intermediate host- Bulinus snail

Schistosoma japonicum
* ORIENTAL BLOOD FLUKE
* Katayama’s disease, Intestinal/ Hepatic schistosomiasis
* Egg-____________________
* Habitat of adult- superior mesenteric veins adjacent to small intestines
* Intermediate host- Oncomelania snail

Schistosoma mekongi- resemble S. japonicum but smaller, causes milder disease and has different
intermediate host
Schistosoma intercalatum- adults in mesenteric vein; eggs resemble S. haematobium, except that spine is
slightly bent; eggs are acid fast

PROTOZOANS
* Sporozoans * Flagellates
* Ciliates * Amoeba

SPOROZOANS
* Plasmodium spp.
* Babesia

Plasmodium
* Includes- P. vivax, P. falciparum, P. malariae, P. ovale
* 2 life cycle
1. ___________ - sexual phase that occurs within the intestinal tract of mosquito
2. ___________ - asexual phase that occurs in the human host
* Causative agent for MALARIA
* P. falciparum and P. vivax is responsible for over 90% of all cases of human malaria *
Vector transmitted, by mosquitoes of the __________________

PREPARED BY
Frany A. Bumanglag, RMT, MSMT

Parasite life cycle includes

 * Asexual cycle in humans a.k.a _______________
‐ Pre- erythrocytic or exoerythrocytic schizogony
‐ Erythrocytic schizogony
‐ Gametogony
* Sexual cycle in mosquito a.k.a ________________
* Stages in the development of Plasmodium in humans include
‐ Ring stage
‐ Trophozoite
‐ Schizont
‐ Gametocyte
* Infective stage to mosquitoes- ___________________
* Infective stage to humans- _____________________

The malarial paroxysm

* ______________- starts with sudden inappropriate feeling of coldness and apprehension;
characterized by mild shivering and sometimes violent teeth chattering and shaking of the whole
body, with intense peripheral vasoconstriction; lasts for approximately 15 to 60 minutes
* ______________- patient becomes hot and manifests with headache, palpitations, tachypnea,
epigastric discomfort; temperature may reach a peak of 40 to 41°C; lasts for about 2 to 6 hours *
______________- involves defervescence or diaphoresis, and patients manifest profuse sweating

Plasmodium species
Specie and disease Length of erythrocytic Type of RBC infected
(asexual) cycle

P. falciparum

P. vivax

P. malariae

P. ovale

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
Malarial relapse
* Occurs in infections with ________________ and ________________
* Relapse is renewed asexual parasitemia following a period in which the blood contains no
detectable parasites
* Reactivation of ____________ forms of the parasite in the liver

Pathologic processes
* Hemolytic anemia * Cerebral malaria
* Tropical splenomegaly syndrome * Acute respiratory distress/ Pulmonary edema * Liver
destruction * Acute renal failure

NOTES TO REMEMBER
1. Mosquito is the definitive host in Plasmodium infection
2. P. falciparum malaria causes the most severe malarial infection
3. Banana or crescent shaped gametocytes are found in P. falciparum infection 4. Applique
forms and double chromatin forms are typical of P. falciparum infection 5. Only ring forms and
gametocytes are found in the peripheral blood in cases of P. falciparum infection
6. __________________ are found in P. vivax infection
7. RBCs are _____________ in P. vivax infection
8. ______________ are found in P. malariae infection
 9. ____________________ are typical of P. ovale infection

Laboratory diagnosis
* Definitive diagnosis- _________________________
‐ _________________- screening
‐ _________________- serves to identify the species of the parasite
* Immunochromatographic assays
‐ Optimal Assay and Diamed optimal IT
▪ detects for ___________ present in viable malarial parasites
‐ MalaQuick Standby Malaria Test, ParaHIT f Test and Paracheck Pf test ▪
detects for ___________ P. falciparum

Treatment
* Anti-malarial drugs are protective or prophylactic, curative or therapeutic and preventive *
CHLOROQUINE

Babesia microti
* Babesiosis
* Vector- Ixodes scapularis
‐ Same vector with a bacterial infection caused by ___________________ *
Life cylcle
‐ Similar to Malaria, except that Babesia life cycle DO NOT HAVE
____________________
‐ Infective stage to humans- _________________
‐ Infective stage to ticks- ___________________
* Diagnosis
‐ Giemsa- stained blood film with a characteristic of ____________________ ‐
Immunofluorescent assay
‐ Intraperitoneal inoculation of gold hamster with blood

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
FLAGELLATES
* Hemoflagellates * Intestinal flagellate
‐ Leishmania spp. ‐ Giardia lamblia
‐ Trypanosoma spp. ‐ Dientamoeba fragilis
* Other flagellates
‐ Chilomastix mesnili ‐Trichomonas hominis
‐ Trichomonas vaginalis ‐Trichomonas tenax

Leishmania spp.
Specie Disease Vectors (sandfly)

Leishmania braziliensis

Leishmania tropica

Leishmania mexicana

Leishmanial donovani

Trypanosoma spp.
Specie Disease Vector Clinical sign
 Trypanosoma
brucei gambiense

Trypanosoma
brucei
rhodesiense

Trypanosoma cruzi

Giardia lamblia
* Also known as Giardia intestinalis, Giardia duodenalis, Lamblia duodenalis or Lamblia
intestinalis
* Causes ____________________________________________
* Patients with IgA deficiency are more susceptible
* Patient have excessive flatus with an odor of ____________________________ *
Route of transmission- _________________
* Inhabits the _______________
* Cysts are ovoid, with four nuclei and median body
* Trophozoites are characteristically described as ___________________; bilaterally symmetrical;
pyriform or teardrop shaped; possess 4 pairs of flagella and 2 sucking disks; trophozoites exhibit
____________________
‐ Divided by- ________________
‐ Specimen- stool, duodenal aspirates
* Trophozoites can be demonstrated using _________________

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
Dientamoeba fragilis
* Originally described as an __________, now classified as ____________
* Characteristics
‐ Rosette-shaped nuclei
‐ No peripheral chromatin, karyosome with 4-6 discrete granules
‐ No cyst stage
* Inhabits the ___________________________
* Transmission ____________________________

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
Chilomastix mesnili
* Trophozoite form contains _____________, flagella, cytostome
* Cyst form is ______________ with a nipple at one end, and cytostome

Trichomonas hominis
* Trophozoite- pear shaped with 4 anterior and 1 posterior flagella, axostyle and undulating
membrane

Trichomonas vaginalis
* Can only survive in the pH of vaginal secretion
 * A sexually transmitted disease
* In females, associated with trichomonad vaginitis, characterized by yellow green, frothy, foul
smelling discharge and ____________ cervix
Characteristic T. hominis T. tenax T. vaginalis

Habitat Intestines Oral cavity Genitals

Size Medium Smallest Largest

Nucleus Ovoid Round Ovoid

Undulating membrane As long as the costa Two-thirds of the costa Less than half of
the costa

Inclusion bodies None None Siderophil

Granules

Specimen for diagnosis Stool Oral scrappings Urine, vaginal

discharge, prostatic
secretions

CILLIATES
Balantidium coli
* Largest protozoan infecting man
* The only ciliate capable of infecting humans
* Route of transmission- ______________
* Can cause ulcer formation in the intestines, leading to bloody diarrhea
* Structure
‐ Has __________ through which the ciliate acquires food
‐ Has __________ through which the ciliate excretes its wastes
‐ Possess a kidney bean shaped _______________ and a round _____________ *
Found in association with pigs throughout the tropics

AMOEBA
* Entamoeba histolytica * Entamoeba coli *Entamoeba hartmanni * Entamoeba dispar * Entamoeba
polecki * Entamoeba gingivalis * Endolimax nana * Iodamoeba butschlii * Blastocystis hominis *
Acanthamoeba * Naegleria

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
Steps in identifying amoebae
✔ Identify the stage
‐ Cysts are round or oval, non- motile, refractile, thick walled
‐ Trophozoites have irregular shape, motile and usually with one nucleus
✔ Identify the genus
‐ Entamoeba are true amoeba since they contain peripheral chromatin and chromatoid
bodies
‐ Peripheral chromatin are visible nuclear membrane present in cyst and trophozoite forms ‐
Chromatoid bodies are found in cysts, not in trophozoites
 ‐ Endolimax and Iodamoeba do not contain peripheral chromatin and chromatoid bodies
✔ Identify the specie

Entamoeba histolytica
* PATHOGENIC AMOEBA
* Associated with amoebic dysentery, amoebic liver abcess, colonic perforation (flask-shaped
ulcers), and amoebic meningoencephalitis
* Mode of transmission- ____________________
* Primary site or habitat- __________________
* Drug of choice- __________________
* Stages
✔ Trophozoites
‐ Unidirectional, progressive motility via pseudopodia
‐ Regular, even chromatin pattern
‐ Centrally located karyosome in the nucleus
‐ With some ingested RBCs
✔ Cysts
‐ Mature cyst is quadrinucleated
‐ Clean cytoplasm
‐ Cigar-shaped chromatoidal bars

COMMENSAL AMOEBAE
Entamoeba coli
* Trophozoite- sluggish motility
‐ Thick, irregular peripheral chromatin pattern
‐ Large eccentric nucleus
‐ More granular and vacuolated endoplasm
‐ Cytoplasm with bacteria and debris but no RBCs
* Cysts- mature cyst has 8 nucleus, larger in size
‐ Granular and junky cytoplasm
‐ Chromatoidal bars are splinter-ends

Entamoeba hartmanni- differentiated from Entamoeba histolytica on the basis of __________

‐ E. hartmanni is _________ than Entamoeba histolytica
‐ Does not ingest RBCs, sluggish movements
‐ Chromatoidal bars with tapered ends or thin and bar-like

Entamoeba dispar- non-pathogenic species

‐ Similar to Entamoeba histolytica, cannot be differentiated using light microscopy ‐
Differentiated by ______________________

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
Entamoeba polecki- parasite of the pigs and monkey
‐ Similar to E. histolytica except that the cyst form is _____________

Entamoeba gingivalis- no cyst stage; found in the mouth (in gums and teeth surfaces)

Endolimax nana- small, quadrinucleated

‐ No peripheral chromatin, has large distinct karyosome

Iodamoeba butschlii- characterized by large glycogen vacuole, stained well with iodine
‐ No peripheral chromatin

Blastocystis hominis- has four morphological forms- ______________, _________________,

______________, ________________________
 ‐ __________________ that pushes the cytoplasm and the nuclei to the periphery of
the cell
‐ Associated with intestinal disorders

FREE-LIVING PATHOGENIC (OPPORTUNISTIC) AMOEBA

* Free-living amoeba that can inhabit the CNS

Acanthamoeba
* Causative agent of ______________, acquired from using contaminated cleaning solution for
contact lens
* Can also cause ______________________________
* Trophozoites- single, large nucleus with centrally located nucleolus with small spiny filaments
known as acanthopodia
* Cyst- bouble walled, outer wrinkled wall and inner polygonally-shaped wall

Naegleria
* Pathogenic species is Naegleria fowleri
* Has three forms- ____________, _____________, _________________
* Causative agent of __________________________
* Causes purulent spinal fluid, with motile amoeba
* Route of transmission- _________________
* Most commonly acquired while diving and swimming during hot weather in brackish or fresh
water
* Can survive at high temperatures and hyperchlorinated water
* ___________________________ inhibits growth of N. fowleri
* Trophozoites- blunt, lobose pseudopodia with directional motility

COCCIDIANS
* Crytosporidium parvum and Cryptosporidium hominis
* Cyclospora cayetanensis
* Isospora beli
* Toxoplasma gondii

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
Cryptosporidium sp.
* Include – C. hominis which infects _____________
‐ C. parvum which infects ________________
* _____________are the infective stage to humans
* Mode of transmission- _______________leads to self-limiting diarrhea in immunocompetent
host but severe chronic diarrhea in immunocompromised ones
* Attacks the ________________ of the intestinal epithelium
* Oocysts can be demonstrated using AFB staining; oocysts are _________
* Sheather’s sugar floatation technique

Cyclospora cayetanensis
* Was originally classified as a cyanobacterium-like body
* Causes diarrhea
* Oocysts are uninfective when released, requires external environment
* Oocysts are ___________________
* Oocysts contain- ________________, each containing _________________

Isopora beli
 * Oocysts characteristically contains ___________, each having ____________ *
Infect the _____________, enter the intestinal cells to perform schizogony
* Has stage that requires external environment; therefore the oocysts are not readily infective when
released
* Can cause diarrhea

Toxoplasma gondii
* An intracellular parasite
* Definitive host- _________
* Transmitted by- ____________________________________
* Asexual and extraintestinal stages- ______________________
* Oocysts contain ________________ each containing ________________
* Tachyzoites are found in the initial and acute stages of infection
* Tachyzoites can be transferred transplacentally and by granulocyte transfusion and organ
transplant
* Fast multiplying tachyzoites give rise to slow multiplying bradyzoites that form cysts *
Multiply by ______________
* Trophozoites are cresent shaped with pointed anterior and rounded posterior ends

Microsporidia
* Obligate intracellular parasite
* Includes- Encephalitozoon, trachipleistophora, Nosema, Brachiola, Vittaforma, Enterocytozoon *
Transmitted via ingestion and inhalation of spores
* Can infect cornea, biliary tract, muscle- can lead to disseminated infection

PREPARED BY
Frany A. Bumanglag, RMT, MSMT
ARTHROPODS

* ____________- bilaterally symmetrical invertebrate animals with segmented bodies, jointed

appendages and hard outer coverings or exoskeletons
* Ways by which arthropods affect humans
‐ Envenomization ‐ Entomophobia and delusory parasitoses
‐ Ingestant and inhalant allergens ‐ Ectoparasitism
‐ Myiasis ‐ Food, water and household pets * Pest vs Vector
‐ An arthropod becomes a ________ when it causes annoyance or nuisance, or when it
causes harm to man and properties
‐ An arthropod become a _________ when it becomes infected and capable of transmitting a
pathogen that causes infection or disease
* Types of vector according to infectivity
‐ ____________- vector that acquired the parasite from an infected human or animal ‐
____________- vector that supports the growth of the stage of a parasite that is infective to
humans
* Factors affecting the vector abundance and pathogen transmission
‐ Temperature ‐Relative humidity ‐Rainfall
* Characteristics of an efficient and competent vector
‐ Susceptible to infection
‐ Bites human indiscriminately
‐ Can maintain the transmission of pathogens from one host to another
 ‐ High longevity and high fecundity
‐ Host specific
‐ Short generation time
‐ High infectivity
‐ Widely distributed
‐ Physiological and behavioral resistance to chemical
* Most common arthropods
✔ Parasitic lice
▪ Pediculus humanus var. capitis- ________________
▪ Pediculus humanus var. humanus- ________________
▪ Phthirus pubis- _____________
‐ Associated with pediculosis, crabs
‐ Serves as vector for rickettsial infections and relapsing fever
✔ Fleas
‐ Xenophsylla cheopis- _______________
✔ Cockroach
‐ Three most common cockroaches include
▪ Blatella germanica, Blatta orientalis, Periplaneta Americana
‐ Ascaris and Trichuris, as well as Salmonella, Proteus, Escherichia and Citrobacter were
found in cockroaches
✔ Ticks
‐ Hard ticks ‐Soft ticks
✔ Mites
‐ ______________- produces scabei, the only species that produces human disease
✔ Fly

PREPARED BY
Frany A. Bumanglag, RMT, MSMT