Trắc nghiệm ký sinh trùng

Noi sinh chat: long, chua nhieu hat, chua nhan sinh san, khong bao tieu hoa, the bat mau Nhan the: phan bao, phan biet cac loai Sarcomastigophora trung roi va trung chan gia amip Sarcod

DAI CU'ONG KE SINH TRUNG

1 Cac hien tuffng k sinh:

a Cong sinh (+ va +)

b Hoi sinh (+ va 0): Entamoeba coli, Escherichia coli

c Hoai sinh:

i Ngoai hoai sinh: Aspergillus, giun luon

ii Noi ngoai sinh: Candida spp

d Ki sinh (+ va -)

2 Cac loai KST:

a KST bat buoc:

i Ngoai KST:

- song o da/ xoang thien nhien: cai ghe, nam da

- song ben ngoai, truyen benh: muoi, bo chet

ii Noi KST: song o cac co quan sau

b KST lac chu: giun moc cho (gay benh au trung di dong o da

nguoi), giun dua cho - meo

c KST lac cho: giun dua Ascaris lumbricoides

d KST co hoi: tu noi ngoai sinh ^gay benh (Candida albicans)

e KST ngau nhien: tu ngoai hoai sinh ^ gay benh (Aspergillus

spp.)

3 Tinh dac hieu ki sinh:

a Dac hieu ve ki chu/ KST lac chu:

i Hep: Ascaris lumbricoides

ii Rong: Toxoplasma gondii

b Dac hieu ve noi ki sinh/ KST lac cho:

i Hep: Ascaris lumbricoides, Enterobius vermicularis

ii Rong: Toxoplasma gondii, Giardia

4 Chu trinh phat trien cua KST:

a Chu trinh truc tiep: nguoi la ki chu duy nhat: (Ascaris

lumbricoides, E vermicularis, E histolytica)

i Chu trinh truc tiep ngan: trung roi, amip, giun kim

ii Chu trinh truc tiep dai: giun dua, giun moc, giun toc, giun luon

b Chu trinh gian tiep: can 2 ki chu (Toenia solium, T

saginata); 3 ki chu,

- San dai heo (o nguoi KCVV)-Dot san, trung-nang san (heo KCTG)

- San la nho o gan (nguoi KCVV) - trung, au trung long - bao tu nang;redia (oc KCTG I) - au trung duoi - nang trung (ca KCTG II)

5 Duung lay nhiem:

a Duong tieu hoa: trung, bao nang,

b Qua da: au trung,

c Duong ho hap, giao hop, nhau thai, truyen mau

6 Nguon nhiem: dat, nuoc, thuc pham, tu nhiem, nguoi, thu,.

7 Chan doan benh:

a Chan doan lam sang:

b Chan doan KST

c Xet nghiem truc tiep:

i Tim KST trong phan:

- Don bao (amip, trung roi duong ruot), giun, san

- Doi voi TH suy giam mien dich: tim Cryptosporidium spp., Microsporidia, giun luon

ii Tim KST trong mau: Don bao (Plasmodium spp., Trypanosoma spp.), Au trung giun chi

iii Nuoc tieu: Trichomonas vaginalis, au trung giun chi, nam men, trung S haematobium

iv Dam: trung san la phoi, Aspergillus, Cryptococcus neoformans

v Dich ta trang: trung va au trung giun luon, trung giun moc, Giardia lamblia, vi nam,

d Xet nghiem gian tiep = Mien dich chan doan:

i Tang bach cau toan tinh (giun san, au trung di dong)

ii Tang bach cau da nhan (sot ret, amip o gan)iii Giam bach cau da nhan ( sot ret man tinh)

iv Tang bach cau don nhan (benh Toxoplasma)

- Phan ung ngung ket hong cau: tim khang the amip, san mang, san la gan, buou san, vi nam

- Mien dich huynh quang

- Mien dich dien di

- Mien dich men ELISA: tim khang the don bao, vi nam Candid

> r

DON BAO (1 te bao)

a Ngoai sinh chat: dam dac, dan hoi (di chuyen, tieu hoa, bai tiet, ho hap va bao ve)

b Noi sinh chat: long, chua nhieu hat, chua nhan (sinh san), khong bao tieu hoa, the bat mau Nhan the: phan bao, phan biet cac loai

Sarcomastigophora (trung roi

va trung chan gia amip) Sarcodina (trung chan gia) - Entamoeba- Endolimax, Iodamoeba, Acanthamoeba - li amip

Mastigophora(trung roi) Ki sinh o duong tieu hoava duong sinh duc - Giardia- Trichomonas

- Dientamoeba, Chilomatix

- viem ruot

- viem nieu - sinh duc

Ki sinh trong mau - Trypanosoma

- Leishmania - benh ngu, benh chagas- viem nao; nhiem trung da, niem mac

Entamoeba (trung chan gia)

a Ki sinh o ruot gia: E histolytica, E dispar, E hartmani va E coli

b Ki sinh o mieng: E gingivalis

Giardia lamblia (trung roi)

Trichomonas vaginalis (trung roi), Trichomonas intestinalis(trung roi)

Plasmodium spp (ki sinh trung sot ret)

1

- 1 nhan, nhan chua nhan the a giua nhan hay lech 1 ben

- Hat nhiem sac xep xung quanh, pMa trong mang nhan

- Co khong bao tieu hoa, khong co the Golgi va ti the.

- The hoat dong chua den 40 loai ribonucleoprotein

- the hoat dong: hinh con dieu, pMa lung loi, nua truoc bung lom; 2 nhan lon, moi nhan co 1 nhan the a giua; 8 roi (6 roi a truoc, 2 roi ngan a sau); 1 song than, CD lac lu

- sinh san bang cach nhan doi

- the hoat dong vao ruot ket

chuyen thanh bao nang

- bao nang: vach day, hinh bau duc, chiet quang, co suc de

khang cao, truang thanh co 4 nhan

- tre em de bi nhiem hon nguoi lon

- chi co the hoat dong.

- hinh qua le, co 1 song than cung, 5 roi (4 roi huong ve pMa

truoc va 1 roi ve pMa duoi) tao thanh mang luun song 1/3 chieu dai than;

1 nhan to (de thay khi nhuom voi

- the hoat dong ra ngoai khong the

chuyen thanh bao nang.

- tien bao nang: co khong bao chua glycogen, co the bat mau

- bao nang khong bj tieu diet &

nong do clorid tay trung nutfc.

- song hoi sinh, khong xam nhap mo cua M chu

- the hoat dong: chan gia ngan; nhan nam giua hay gan giua; nhan the kha to,nam lech ra ngoai

- bao nang rat chiet

quang, co vo boc chua 8 nhan.

Chu trinh phat

trien

the hoat dong tien bao nang

-bao nang - hau -bao nang - the hoat dong hau bao nang

Duung lay

nhiem - duong tieu hoa.- qua da (tay ban) - duong tieu hoa.- qua da (tay ban) - duong tieu hoa - giao hop, me truyen sang con - duong tieu hoa

G/d phat tan ra

MT - bao nang (1, 2, 4 nhan) va the hoat dong - bao nang, the hoat dong

Noi song chinh

- den ruot non: vo bao nang mat di

- 8 amip con

- amip: a ruot gia

- ban dau: manh trang roi xuong ruot ket

- ruot gia va sinh san manh a MT kiem

- Nu: am ho, am dao, co tu cung

(khons lav sang tu cans)

- Nam: tuyen tien liet, tui tinh, nieu dao

- ruot gia

Noi song phu - gan, phoi, nao, da

Benh hoc (trieu

3/ buot mot hau mon

4/ than nhiet gan binh thu’d’ng > li do VK Shingella: sot cao 5/ ton thuong hinh tan nam.

+ 6 gan:

1/ dau pMa duoi suon phai

2/ gan viem, rat dau khi go ngon tay vao, lach ko to, ko vang da; sot cao

- tieu chay, phan long, set/ dac,

co mui hoi

- giam can, dau bung, day hoi

- gay viem nhe

- Nu: am dao bi viem, do rat, ngua ngay, huyet trang, co mu

- co the gay vo sinh

- Nam: viem ong tieu, co giot mutrang vao buoi sang, tieu kho va dau khi tieu

- tieu chay

- phan co chatnhon, mau vamui hoi

Chan doan

1/ Lam sang: xac dinh trong ruot hay ngoai ruot

2/ Xet nghiem:

- 6 ruot: xem phan ngay sau khi di

tieu (coi hong cau)

- Ngoai ruot: pp huyet thanh + sieu

am + chup cat lop

- coi the hoat dong

(khong co hong cau) 1/ phan dac: tim bao nang 2/ phan long: tim bao nang va the

hoat dong 3/ xem dich ta trang

4/ Ki thuat vien nhong ta trang5/ Mien dich men ELISA

1/ xem truc tiep chat nhon am dao, nhieu dao

2/ xet nghiem: chat nhon + 1 giotnuoc muoi sinh l^ hay dung con

90o, nhuom bang Giemsa hay Hematoxylin

2/ Nuoi cay: MT dac va long khong TB; trong mo; trong phoi

ga con

- kham dai trang

thai 6/ TH kliang thuoc:

- Metronidazol va Albendazol

- Nitazoxanide

- Quinacrine va Metronidazol

1/ Dieu tri toan than:

- Metronidazol (can trong cho phu nu co thai)

- Tinidazol (thay the)

2/ Dieu tri tai cho:

- Thuoc dat am dao, vien nen phu

khoa: Gynoplix, Flagyl 3/ TH khang thuoc:

- Nimorazole (Naxogyn)

- Nitazoxanide / Hamycin

Ten va Ten khoa

Hinh the va chuc

nang

(hinh ve)

- 2 giai doan phat trien:

1/ Sinh san vo tmh (su liet sinh): xay ra a ngudi, gom 2 pha:

+ Pha tien (ngoai) hong cau trong mo gan: thoa trung - the phan liet ngoai hdng cau - manh trung

ngoai hdng cau

- Chu ki ngoai hong cau cung dien ra voi chu ki hong cau

- 6 P vivax va P ovale: the ngu ton tai trong gan

+ Pha hong cau trong mau: manh trung - the tu duang (sac to mau den hemozoin) - the phan liet - the

hoa hdng - manh trung noi hdng cau

2/ Sinh san huu tmh (bao tu sinh): giai doan dau xay ra a ngudi, sau do xay ra a muoi Anopheles cai

(giao tu duc+cai - trung - di noon - noon nang - thoa trung)

- ton tai a 3 the:

1/ The hoat dong (the tang truang

nhanh): hinh luoi liem/ hinh trai chuoi, 1 dau nhon; dau kia tron, chua

1 nhan

- sinh san bang cat liet theo chieu doc,

bi HCl trong da day huy nhanh 2/ The nang: hinh tron/ hinh bau duc, chua

rat nhieu thoa trung, khong bi anh huang bai nhiet do duoi 450C va HCl cua dich vi

- Pha ngoai hong cau: 10-12 ngay

- The tu duong non: hinh chiec nhan, nhan do,

TB chat xanh duong, khong bao ko mau

- Hong cau bi nhiem khong phinh to, co dom Maurer.

- The tu duong gia: khong co trong mau ngoai bien; hat sac to to, mau nau vang dam, nam rai

- Giao bao cai: hinh luoi liem (hinh trai chuoi),

TB chat mau xanh duong

- Mau ngoai bien: chi co the nhan & giao bao

- Pha ngoai hong cau: 1521 ngay

- Ki sinh trung co the ton tai trong gan 2 nam

- The tu duong non & gia:

giong P falciparum

- Hong cau bi nhiem phinh

to, co hat Schiifner mau nau nho

- Giao bao duc: 1 TB chat mau tim, 1 nhan to, dai

- Giao bao cai: 1 TB chat mau tim lot/ xanh duong ,

1 nhan dam dac, nam a 1 ben

- Pha ngoai hong cau:

3-6 tuan

- Ki sinh trung: ton tai trong gan h nhat 3 nam

- The tu duong non:

hinh nhan, 1 hat sac to

- The tu duong gia:

nhieu hat sac to, mau nau den

- The phan liet hinh hoa hong

Noi song chmh - khong ton tai o’ gan- hong cau gia va tre - hong cau tre, te bao luoi - hong cau gia, co khuynh huong teo lai - trong mau

Benh hoc (trieu

chung) - benh sot hang ngay/ benh sot cach nhat nang(each 48 gin tai phat) - benh sot cach nhat nhe(each 48 gin tai phat) - benh sot ngay bon,cach 3 ngay tai phat 1/ Benh Toxoplasma mac phai:+ nhiem sau khi sinh (5-25t)

Van de killing

thuoc 1/ S (Sensibility): nhay cam: sach KST trong 7 ngay; khong tai phat trong 3 tuan tiep theo. 2/ R (Resistance): khang thuoc

- RI: khang muon: sach KST trong 7 ngay; tai phat trong 28 ngay sau do.

- RII: khang som: giam the vo tmh nhung khong sach KST trong tuan dau.

- RIII: khang han: the vo tmh khong giam hoac tang trong tuan dau.

- Thoi ki tiem an: gom 2 chu ki ngoai hong cau, h nhat 1 hay 2 chu ki noi hong cau.

- Thoi ki tien trien: con ret keo dai 1-2h, lanh toan than, than nhiet tang len 390C; sau do nong sot keo dai, da nong, than nhiet len 40-410C; sau do do mo hoi 2-4h, nhiet do giam nhanh

- lach to, ton thuong gan: giam albumin, cholesterol, prothrombin trong mau

+ nuot trung nang+ an thit song chua nanga/ The hach: sot, noi hach, met moi(tu khoi, ko can dieu tri)

b/ The nang (hiem gap) gom:

- dang phat ban, viem mang nao,

- dang ton thuong day mat

2/ Benh Toxoplasma bam sinh (do

me truyen sang thai nhi) 1/ Sot ret the ac tmh: nghen mach, tao huyet khoi, thieu mau cuc bo

- P vivax, P malariae, P ovale: chi nhiem hong cau gia hay tre

- P falciparum: co the nhiem ca 2

- Sot ret the nao: than nhiet tang, tim dap nhanh va yeu, da nhot nhat; me sang, lu lan

- Benh pham: mau, mu, tuy xuong, dich nao tuy

1/ Quan sat duoi KHV (nhuom Giemsa/ nhuom Schiff)

huyet thanh hoc:

- thu nghiem mau Sabin-Feldman

- thu nghiem ngung ket hong cau

- thu nghiem khang the huynh quang gian tiep

- thu nghiem ELISA

- thu nghiem co dinh bo the

Chan doan

1/ Lam sang: (pb voi thuffng han, cum)

- sot co chu ki, giai doan ret-nong-toat mo hoi

- lach to, o vung sot ret 2/ Xet nghiem:

- Xet nghiem mau: PP lam mau mong hay PP giot mau day 3/ PP mien dich huynh quang (tim trong mau)

4/ PP huyet thanh hoc

Dieu tri

1/ Diet the phan liet trong mau (the vo tmh):

- Quinin: hap thu nhanh, thai tru nhanh

- Artemisinin (Quinghaosu): dung cho P falciparum, tac dung cham

- Amino 4-quinolein: Cloroquin, Amodiaquin: hap thu nhanh, thai tru cham

- Amino-ancol: Mefloquin, Halofantrin: hap thu cham, thai tru cham

- Thuoc khang acid folinic, khang acid folic: tac dung cham, de bi de khang

> Sulfadoxin + Pyrimethamin (Fansidar): nguoi lon (khong dung cho phu nu co thai)

> Fansidar + Mefloquin: tre em

> Quinin + tetracyclin/doxycyclin/clindamycin: dung trong TH khang thuoc (khong dung cho phu nu

co thai, tre em duoi 8 tuoi)

2/ Diet giao bao (the huu t^nh):

- Amino 8-quinolein; Artemisinin hay Artesunat (tre em < 3 tuoi: dihydroartemisinin-piperaquin)

- Sot ret ac t^nh: dung Artesunat tiem tinh mach

- CV8: diet the ngu (phu nu co thai tren 3 thang)

- Phu nu co thai duoi 3 thang: Quinin + clindamycin

a Nhom ki sinh o’ ruot:

i Giun dua (Ascaris lumbricoides)

ii Giun kim (Enterobius vermicularis)iii Giun moc (Ancylostoma duodenale va Necator americanus)

iv Giun toc (Trichuris trichiura)

v Giun luan (Strongyloides stercoralis)

b Nhom ki sinh ff ruot va to chuc: Giun xoan (Trichinella spiralis)

c Nhom ki sinh ff mau va cac to chuc:

i Ki sinh a he bach huyet: Giun chi Bancroft (Wuchereria Bancrofti); Giun chi Ma lai (Brugia malayi)

ii K sinh duai da: Onchocerca volvulus, Loa loa

d Nhom ki sinh lac chu gay hoi chung Larva migrans:

i Au trung di chuyen a da: Ancylostoma caninum (ki sinh a cho), Ancylostoma brasiliense (ki sinh a cho va meo)

ii Au trung di chuyen a noi tang: Toxocara canis (ki sinh a cho), Toxocara cati (ki sinh a meo)

Lup san la (Trematoda): than hinh la, dep, khong co vo cung

a San la (Flukes)

b San la gan lan (Fasciola hepatica), San la gan nho (Clonorchis sinensis)

c San la ruot (Fasciolopsis buski)

d San la phoi (Paragonimus westermani)

San mang (Schistosoma): S haematobium, S mansoni, S japonicum, S

mekongi Lop san day (Cestoda): nhieu dot dep, hinh day bang, khong co vo

cung

a Ki sinh a nguoi trong giai doan truang thanh (song trong ruot):

i San day lon (Toenia solium)

ii San day bo (Toenia saginata)iii San day ca (Diphyllobothrium latum)

iv San day cho (Dipylidium caninum)

v San day lun (Hymenolepis nana)

b Ki sinh a nguoi trong giai doan au trung (song trong phu tang):

i Cysticercus: au trung san day lon va san day bo

ii Hydatid: au trung san day Echinococcus granulosus

iii Sparganum: au trung g/d 2 cua san day Spirometra erinacei

2

3

4

Ten va Ten khoa

Hinh the va chuc

- con cai: duoi thang, hinh non

- trung: co vo day, co lop albumin xu xi, vang nau

- trung ko thu tinh: hinh thuon, dai, co hat chiet quang ko deu dan

- nhiem giun duc: khong co trung

- mau trang, dau hoi phinh,

co 2 gan doc 2 ben than

- con cai: duoi thang, nhon

- trung: hinh bau duc, hoi det 1 pMa, vo day

- con cai de trung o hau mon vao ban dem

- mau trang sua/

hong nhat;

- dau co bao mieng phinh ra, cong ve ph^a than

- suon lung chia 2

nhanh, moi nhanh che 3.

- duc: duoi xoe ra

hinh chuong, 2 gai

giao hop dai

- cai: duoi cun

- trung: bau duc, vomong

- ngan hon

- khong co 2 cap

moc pMa bung

ma co 2 rang hinh lu&i dao

-suon lung chia 2nhanh,

moi nhanh che 2.

- trung dai va thon hon

- mau trang duc/

co nut chat nhay

- rat nho, song M sinh hay song tu do

- dang M sinh: chi gom con cai trinh san, thuc quan dai, tu cung co 4-5 trung

- dang tu do:

+ duc: duoi cong, 2 gai giao hop = nhau + cai: duoi nhon

Chu trinh phat

trien

- phat trien truc tiep dai: 2 tuan

- trung chua phoi bao - trung co phoi - au trung - giun dua

- phat trien truc tiep ngan,

- trung chua phoi bao - trung co phoi

- au trung - giun toc

- truc tiep: au trung

thuc quan hinh ong

- gian tiep: au trung

thuc quan co u phinh

Duung lay nhiem - duong tieu hoa, ho hap - duong tieu hoa, tu nhiem - qua da - duong tieu hoa - qua da, tu nhiem The lay nhiem - trung co phoi - trung co phoi - au trung thuc quan hinh ong - trung co phoi - au trung thuc quan hinh ongThe phat tan ra

MT - trung chua phoi bao - trung co phoi - trung chua phoi bao - trung chua phoi bao - au trung thuc quan co uphinh

Noi song chmh

- ruot non

- au trung: phan cuoi ruot non

- truong thanh: manh trang

gia - ruot non (chi gom con cai trinh san)

Noi song phu (lac

cho) - gan, phoi, ruot thua, ong tuy, mieng, mui - hau mon - phoi, ruot non - ruot non, ruot thua - tim, phoi, ta trang, gan,cac hach

Benh hoc (trieu

chung)

1/ Giai doan au trung:

- gay hoi chung Loeffler:

+ ho khan, dau nguc, sot nhe +bach cau toan tmh tang cao (20-40%)

1/ roi loan u ruot:

- ngua hau mon (ban dem)

- dau bung, buon non, tieu chay

2/ roi loan than kinh (u tre em): mat ngu, khoc

dem, dai dam, co giat 3/

roi loan ctf quan sinh due nu: viem am ho, am

dao

1/ G/d mo (song u cac cu quan):

- ho khan khong dom, khan tieng,phat am kho

2/ G/d u ruot:

- roi loan tieu hoa: viem ta trang, dauvung thuong vi; doi con cao, chan an

- thieu mau va roi loan tuan hoan:

bach cau toan tmh tang nhanh, da kho va tai nhat, mi mat bi phu, mat sung hup, kho tho, mach nhanh, u tai, chong mat

- roi loan than kinh: nhuc dau, dequen, suy sup than kinh

- giong nhu kiet li

- dau bung, di tieu nhieu lan, phan it

- nhieu: thieu mau nhuoc sac

1/ Da: da san do, ngua,

nhung vung au trung di qua noi may day, ngua ngay

2/ Phoi:

- ho khan, keo dai;

- con suyen, tai phat nhieu lan/ ngay

- bach cau toan tmh tangcao

1/ Giai doan au trung:

- dua tren lam sang va cong thuc mau

2/ G/d truung thanh:

- tim trung trong phan

1/ Lam sang: ngua hau mon

2/ Can lam sang: dung

PP Graham, lay bang keo

trong

1/ tim trung trong phan2/ cay phan

3/ PP huyet thanh hoc

1/ tim trung trong phan 2/ PP phong phu hoa 1/ tim au trung trong phan, xet nghiem ngay

(pb au trung giun moc)

2/ PP Baernann 3/ Hut

dich ta trang 4/ tim khang the trong huyet thanh ng benh

Dieu tri

1/ Pamoat pyrantel (than trong cho tre < 2t)

2/ Mebendazol (Vermox, Fugacar): ko dung cho tre duoi

2 tuoi3/ Albendazol (Zentel)4/ Flubendazol (Fluvermal)

> tat ca chi giet duoc giun

truong thanh, ko giet duuc trung/ au trung (lap lai dieu tri

2-3 tuan)

1/ Pamoat pyrantel 2/

Mebendazol (Vermox)3/ Albendazol (Zentel) 4/

Flubendazol (Fluvermal)

> dieu tri tap the

1/ Pamoat pyrantel 2/ Mebendazol (Vermox, Fugacar) 3/ Albendazol (Zentel)

4/ Flubendazol (Fluvermal)5/ Bephenium hydroxynaphtoat (Alcopar)

1/ Mebendazol(Vermox,Fugacar)2/ Albendazol (Zentel)3/ Flubendazol (Fluvermal)

1/ Thiabendazol (Mintezol)

2/ Albendazol (Zentel)3/ Ivermectin

(Stromectol)

Ten va Ten khoa hoc Giun xoan Trichinella spiralis Giun chi Au trung di chuyen & da Au trung di chuyen & noi tang

Hinh the va chuc

nang

(hinh ve)

- mau trang due

- due: duoi hai cong, ko co gai giao hop, co 2 the phu

hinh non de giao hop

- cai: de phoi

- au trung chi chet khi dun soi khoang 30 phut

- giong soi chi mem, mau trang duc

- duc: 2 gai giao hop dai, khong deu

- cai: dai han duc, de phoi, boc boi 1 bao

Giun chi Bancroft

Wuchereria Bancrofti Giun chi Ma lai Brugia malayi

- duc + cai: vo ngoai lang, song cuon vao nhau

- phoi: duoi nhon, than uon

eo deu dan; hat nhiem sac thekhong di den mut duoi

- phoi: bao ngan han, rat an mau;

than uon eo ko deu dan; hat nhiem sac di den gan mut duoi;

duoi co cho phinh nho

Chu trinh phat trien - phoi - ken chua au trung

- au trung - giun xoan - phoi xuat hien trong mau ngoai bien vao ban dem

vao mach mau - duong tieu hoa

- muoi Culex va Anopheles - muoi Anopheles va Mansonia

The lay nhiem - phoi chua au trung - phoi chua au trung - au trung co thuc quanhinh ong - au trung

The phat tan ra MT

Noi song chmh - ruot non - giun truong thanh: song o mo- giun cai: song o he bach huyet hay o mo - duoi da

Noi song phu (lac cho) - ca, mau - he tuan hoan- chi M sinh o nguoi - co the ki sinh o ngoai nguoi (khi, cho meo) - gan, phoi, mat, nao

Benh hoc (trieu chung)

3 giai doan:

1/ G/d viem ruot:

- tieu chay nhieu, dau bung,

nhuc dau, buon non, sot cao lien tuc (chi co & giun xoan)

2/ G/d toan phat:

- phu o mat, m^ mat, co

- di ung: da ngua ngay, noi man, co not do

- viem cuc bo

- tac nghen mach bach huyet

- gay xa cung, phi dai mo 1/

Thoi ki nung: ko ro ret 2/

ThOi ki kh&i phat:

- moi met chi, dau o nach, hang, bui, tinh hoan

- sot nhe (38.50C), noi ban, ngua, dau khop xuang

- chu yeu gay phu voi & chan - da co vet san do, ngua

ngay, mong nuoc, noi man

- Au trung A caninum vao mat tao u hat

- sot nhe, keo dai,bieng an, sut can, roiloan tieu hoa

- ho khac ra dom,bach cau toan tmhtang, kho tho

- da noi do, may day, ngua

- gan to cung, khong dau

3/ G/d au trung thanh

ken: dau a ca, khap xuang,

nhai kho, tha kho, sot giam,

di ung giam

3/ Thui ki toan phat:

- viem hach bach huyet 4/

Thai ki man tmh (di chung):

tac mach bach huyet, gay hien tuung phu voi a bo

phan sinh duc, vu, tay chan

- xet nghiem gian tiep: phanung khang nguyen khang the; mien dich dien di;

ngung ket hong cau

- Tim phoi trong nuac tieu

- Phan ung huyet thanh hoc(mien dich dien di, mien dich men, mien dich huynh quang)

1/ Lam sang 2/ Dua vao dich te co tiep xuc vai dat o nhiem phan cho, meo

1/ bach cau toan tmh tang rat cao 2/ y-globulin tang cao3/ Lam sinh thiet tim

au trung a mo 4/ PP huyet thanh hoc: miendich dien di, mien dich huynh quang,

mien dich men ELISA (dac hieu han

ca)

Dieu tri

1/ Thiabendazol (Mintezol)2/ Albendazol (Zentel)3/ Mebendazol (Vermox)

1/ Diethylcarbamazin (Notezine, Hetrazan) 2/ Ivermectin (Stromectol) + Albendazol 1/ Thiabendazol (Mintezol)

2/ Albendazol (Zentel)3/ Flubendazol

(Fluvermal)4/ Ivermectin

1/ Thiabendazol (Mintezol)2/ Albendazol (Zentel)3/ Mebendazol (Vermox)

Ten va Ten khoa hoc San la Flukes San la gan lon Fasciola hepatica Clonorchis sinensisSan la gan nho San la ruot (to nhat)Fasciolopsis buski San la phoi Paragonimus

westermani

Hinh the va chuc

nang - than dep, hinh chiec la, co dia hut, khong phan doan, chong co ong tieu hoa hoan chinh, khong co hau mon.- lo sinh due a truac dia hut bung - lo sinh duc a sau.

- co 2 dia hut: dia hut mieng

va dia hut bung

- khong co ca quan ho hap

va tuan hoan

- thudng luang tinh

- noan phong: nai trung duactao thanh

- tu cung: nai chua trung

- trung: hinh bau duc, conap, vo day mau nau

- than mau do nhat

- ong tieu hoa khong phan nhanh

- 2 tinh hoan phan nhanh

it, nam tren duoi

- trung: hinh bau duc, hai phinh a giua, co nap, co 1 gai nho doi dien nap

- trung co phoi luc mai sinh

- than day, mau nau/ xam

- khong co the hinh non

- TB noan phong chiet quang nhieu han

- than map, mau nau/ do, mat bung dep, mat lung loi

- tinh hoan it phan nhanh

- buong trung to, chia thuy

- trung: hinh bau duc, nau sam; co nap bang, h loi

- trong nang trung: co 2 san

va 1 dich mu do

Chu trinh phat trien

- trung - au trung - bao tu nang - redia - nang trung

- san la truang thanh

- vao ta trang: nang trung thanh san non

Duong lay nhiem - dudng tieu hoa

The lay nhiem - nang trung

Noi song chmh - ong dan mat, ruot, phoi - ong dan mat cua gia sue va cua ngudi - ong dan mat - ruot non - phe quan (phoi)

Au trung duoi bien

thanh nang trung - thuc vat thuy sinh - ca ho Cyprinidae - thuc vat thuy sinh - cua/ tep

Ki chu trung gian - oc Limnea - oc Bithynia- ca ho Cyprinidae - oc Planorbis - oc Melania

Benh hoc (trieu chung)

1/ ThUi ki xam nhap (o’

gan): gan to, cung, so thay

dau

- sot bat thuong, noi man, dau bung, bieng an, buon non; bach cau toan tinh

tang nhanh 2/ ThUi ki toan phat (u ong dan mat): tao bon + tieu chay,

vang da, gay, thieu mau;

bach cau toan tinh giam (con 5-10%)

1/ G/d khui phat:

- roi loan da day, chan an, buon non, tieu chay + tao bon

- bach cau toan tinh tang 2/

G/d toan phat:

- thieu mau, gay, phu ne chi duoi, co truong

- gan to ro ret, so dau

- tac ong mat, vang da

- bach cau toan tinh tang

- nhieu: tac ruot, phu ne

- ho co dom lan mau, dom mau gi sat

Chan doan

1/ Thui ki xam nhap:

- Tim trung trong phan

- Phan ung huyet thanh 2/

Thui ki toan phat:

- xet nghiem phan/ dich ta trang de tim trung

- trung It: PP phong phu hoa

- tim trung trong phan hay trong dich ta trang - xet nghiem phan de tim trung 1/ xet nghiem dom tim trung khong nhuom 2/ xet

nghiem phan tim trung3/ Phan ung huyet thanh hoc (dung cho tre em)4/ Sieu am, CT scan

Dieu tri 1/ 2-dehydro emetin 2/ Bithionol (Bitin, Actamer)

3/ Triclabendazol (Fasinex)

1/ Bithionol (Bitin) 2/

Cloxyl 3/ Praziquantel (Biltricide) 1/ Niclosamid (Tredemine, Yomesan) 2/

Praziquantel (Biltricide)3/ Hat cau, sac uong

1/ Niclofolan (Bilevon) 2/ Bithionol (Bitin, Actamer)3/ Praziquantel (Biltricide)

ung thu gan

Ten va Ten khoa hoc San day Inn Toenia solium San day bo Toenia saginata Diphyllobothrium latumSan day ca (dai nhat) San day cho Dipylidium caninum San day lun Hymenolepis nana

Hinh the va chuc nang- chung: deu co dau, co va dot