Trắc nghiệm ký sinh trùng

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,...

1

-

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 Candi


d


.

>

r

DON BAO (1 te bao)
1.
2.
TB

chat:

a.
Ngoai sinh chat: dam dac, dan hoi (di chuyen, tieu hoa, bai tiet, ho hap va bao ve)
1.
2.
3.
4.
5.
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)
Toxoplasma gondii
>- La dun bao ki khi (E.coli, E. hartmani: hoai sinh, khong gay benh)
J
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
Nganh
Nganh phu
Chi
Sarcodina (trung chan gia)
- Entamoeba
- li amip
Sarcomastigophora (trung roi va
Endolimax,
Iodamoeba,
trung chan gia amip)
Acanthamoeba
Mastigophora Ki sinh o duong tieu hoa va

- Giardia
(trung roi)
- Trichomonas
duong sinh duc
- Dientamoeba, Chilomatix
Ki sinh trong mau
- Trypanosoma
- Leishmania
Ciliophora (trung long)
- Balantidium coli
- benh li
Apicomplexa (trung bao tu)
Lop Coccidia
- Cryptosporidium
- Isospora
- Toxoplasma
-

Gay benh
viem ruot
viem nieu - sinh duc
benh ngu, benh chagas
viem nao; nhiem trung da,
niem mac
tieu chay
tieu chay
benh Toxoplasma


Lop Haematozoa (k^ sinh trong mau)

Trung chan gia Entamoeba

"N
Ten va Ten khoa
hoc

- Plasmodium
Trung roi Giardia lamblia

- benh sot ret
Trung roi (Trichomonas)
T. vaginalis
T. intestinalis
the hoat dong: hinh
- chi co the hoat dong. - mang luon song
con dieu, pMa lung
- hinh qua le, co 1 song
chay doc suot
loi, nua truoc bung
than cung, 5 roi (4 roi
than
lom; 2 nhan lon, moi
huong ve pMa truoc va
nhan co 1 nhan the a
1 roi ve pMa duoi) tao
giua; 8 roi (6 roi a
thanh mang luun song
truoc, 2 roi ngan a
1/3 chieu dai than;
sau); 1 song than, CD1 nhan to (de thay khi nhuom voi

lac lu
hematoxylin feric)
sinh san bang cach
- the hoat dong: di
nhan doi
chuyen kieu lac lu va
the hoat dong vao
xoay vong
ruot ket chuyen thanh
- phat trien tot a 35-37oC
bao nang.
va ki khi, pH 5.5 - 6
bao nang: vach day,
- pH acid (3.8 - 4.4):
hinh bau duc, chiet
khong song duoc
quang, co suc de
khang cao, truang
thanh co 4 nhan

1 nhan, nhan chua nhan the a giua nhan hay lech 1
ben.
- Hat nhiem sac xep xung quanh, pMa trong mang
nhan.
E. histolytica
E. coli
- the hoat dong: chan gia
- song hoi sinh,
dai; nhan lech 1 ben,
khong xam

hinh cau; giua nhan co 1
nhap mo cua M
Hinh the va chuc
nhan the nho, ro; co cac
chu.
nang (hinh
soi khong sac; co khong
- the hoat dong:
ve)
bao tieu hoa, co hong
chan gia ngan;
cau, the bat mau, khong
nhan nam giua
co ti the.
hay gan giua;
- the hoat dong ra ngoai
nhan the kha to,
khong the chuyen thanh
nam lech ra
bao nang.
ngoai
- tien bao nang: co khong
- bao nang rat
bao chua glycogen, co
chiet quang, co
the
bat
mau.
vo boc chua 8
the hoat dong - tien bao nang - bao

Chu trinh phat
nang - hau bao nang - the hoat
trien
dong hau bao nang
- duong tieu hoa.
- duong tieu hoa.- duong tieu hoa
Duung lay nhiem
- qua da (tay ban)
- qua da (tay ban)
- bao nang 8 nhan
- bao nang
G/d lay nhiem - bao nang
-

G/d phat tan ra - bao nang (1, 2, 4 nhan) va the hoat
MT
dong
- den ruot non: vo bao
nang mat di - 8 amip con
- amip: a ruot gia
Noi song chinh

- giao hop, me truyen sang con
- the hoat dong

- duong tieu hoa
- the hoat dong

- bao nang, the hoat dong
-

ban dau: manh- ruot
trang roi xuong
ruot ket.
ruot gia va sinh
san manh a MT
kiem

-

co quan sinh duc (nam- ruot gia
va nu)
Nu: am ho, am dao, co
tu cung (khons lav
sang tu cans)
Nam: tuyen tien liet, tui
tinh, nieu dao


Noi song phu

- gan, phoi, nao, da
- gay benh li amip.
+ 6 ruot:
1/ tieu chay (10-15 lan/ngay, phan It, co chat nhon, vet mau)
2/ dau bung that (muon di tieu gia tao)
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 mu trang vao buoi
sang, tieu kho va dau
khi tieu.

-

tieu
chay
phan co
chat
nhon,

mau va
mui hoi

Benh hoc (trieu
chung)

Chan doan

1/ Lam sang: xac dinh trong ruot - coi the hoat dong
khong co hong cau)
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

1/ Emetin (nhieu phan ung phu)
2/ 5-nitroimidazol (hap thu tot o ruot)
Dieu tri
- Metronidazol (Flagyl)
- Tinidazol
(ket hop nhom
- Secnidazol
metronidazol
- Ornidazol (ap xe gan)
vdi 1 thuoc
3/ Diet bao nang:

khong hap
- Furamide
thu & ruot de
- Iodoquinol (Yodoxin)
diet bao nang)
- Paromomycin (Humatin)

1/ phan dac: tim bao nang 2/ phan
1/ xem truc tiep chat nhon am dao,- kham dai trang
long: tim bao nang va the
nhieu dao.
hoat dong 3/ xem dich ta
2/ xet nghiem: chat nhon + 1 giot
trang.
nuoc muoi sinh l^ hay dung
4/ Ki thuat vien nhong ta trang
con 90o, nhuom bang Giemsa
5/ Mien dich men ELISA
hay Hematoxylin.
2/ Nuoi cay: MT dac va long
khong TB; trong mo; trong
phoi ga con.
1/ 5-nitroimidazol: Metronidazol,1/ Dieu tri toan than:
Tinidazol 2/ Furazolindon
- Metronidazol (can
(Furoxone): dung cho tre em
trong cho phu nu co
5/ Paromomycin (Humatin):
thai)
dung cho phu nu co thai 6/

- Tinidazol (thay the)
TH kliang thuoc:
2/ Dieu tri tai cho:
- Metronidazol va
- Thuoc dat am dao, vien
Albendazol
nen phu khoa:
- Nitazoxanide
Gynoplix, Flagyl 3/ TH
- Quinacrine va
khang thuoc:
Metronidazol
- Nimorazole (Naxogyn)
- Nitazoxanide /


Ten va Ten khoa hoc

Hinh the va chuc
nang
(hinh ve)

Dudng lay nhiem
The lay nhiem
Noi song chmh
Benh hoc (trieu
chung)

Ki sinh trung sot ret Plasmodium spp.

Trung bao tu Toxoplasma gondii
- ton tai a 3 the:
2 giai doan phat trien:
1/
The
hoat
dong (the tang truang
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 nhanh): hinh luoi liem/ hinh trai
chuoi, 1 dau nhon; dau kia tron,
ngoai hdng cau
chua 1 nhan.
- Chu ki ngoai hong cau cung dien ra voi chu ki hong cau
- sinh san bang cat liet theo
- 6 P. vivax va P. ovale: the ngu ton tai trong gan
chieu doc, bi HCl trong da
+ Pha hong cau trong mau: manh trung - the tu duang (sac to mau den hemozoin) - the phan liet - the
day huy nhanh 2/ The nang:
hoa hdng - manh trung noi hdng cau
hinh tron/ hinh bau duc,
2/ Sinh san huu tmh (bao tu sinh): giai doan dau xay ra a ngudi, sau do xay ra a muoi Anopheles cai
chua rat nhieu thoa trung,
(giao tu duc+cai - trung - di noon - noon nang - thoa trung)
khong bi anh huang bai nhiet
P. falciparum (doc nhat)
P. vivax
P. malariae
do duoi 450C va HCl cua
- Pha ngoai hong cau: 10-12 ngay
- Pha ngoai hong

- Pha ngoai
dich vi.
- The tu duong non: hinh chiec nhan,
cau: 1521 ngay
hong cau: 3-6
3/
The
trung
nang: hinh bau duc, vo
nhan do, TB chat xanh duong, khong
- Ki sinh trung co the
tuan
bao ko mau.
ton tai trong gan 2
- Ki sinh trung: day, tao ra tu ss huu tmh, khong bi
anh huang bai HCl cua dich vi;
- Hong cau bi nhiem khong phinh to,
nam.
ton tai trong
- chua 2 bao tu nang.
co dom
- The tu duong non
gan h nhat 3
- moi bao tu nang: 4 thoa
Maurer.
& gia: giong P.
nam
trung > Gom 2 the thuc phat
- The tu duong gia: khong co trong
falciparum

- The tu duong
trien:
mau ngoai bien; hat sac to to, mau
- Hong cau bi nhiem
non: hinh
1/
Chu
trinh
hoan chinh (xay ra o
nau vang dam, nam rai rac.
phinh to, co hat
nhan, 1 hat
meo KCVV): gom chu trinh liet
- The phan liet: nhon 1 dau, hinh qua le,
Schiifner mau nau
sac to.
hinh ngon nen.
nho
- The tu duong sinh vo tinh va chu trinh giao tu
- Giao bao duc: dai, map a giua, 2 dau
- Giao bao duc: 1 TB
gia: nhieu hat sinh huu tmh
- The phan tan ra MT:
cun (nhu dieu xi ga), TB chat mau tim
chat mau tim, 1
sac to, mau
trung nang khong chua
ca.
nhan to, dai
nau den

bao
tu nans
- Giao
bao mau,
cai: hinh
luoi liem
- Giao bao cai: 1 TB
- The phan liet- an thit song
- muoi chmh,
truyen
me truyen
cho(hinh
con trai
chua
nang
- thoa trung (phat trien manh a gan)
- trung nang (g/d bao tu nang)
- hong cau tre, te bao luoi
- trong mau
- hong cau gia, co
- khong ton tai o’ gan
- hong cau gia va tre
khuynh huong teo lai
- benh sot hang ngay/ benh sot cach nhat nang - benh sot cach nhat nhe
- benh sot ngay bon, 1/ Benh Toxoplasma mac phai:
each 48 gin tai phat)
each 48 gin tai phat)
cach 3 ngay tai phat + nhiem sau khi sinh (5-25t)

Van de killing thuoc1/ 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.
- the
lach
ton nghen
thuongmach,
gan: giam
albumin,
prothrombin
trong mau.
1/ Sot ret
acto,
tmh:
tao huyet
khoi,cholesterol,
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
2/ Sot ret the tieu ra huyet sac to: than nhiet tang, dau lung du doi, oi ra mat, nuoc tieu mau do

Chan doan

Dieu tri

+ nuot trung nang
+ an thit song chua nang
a/ 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)
- Benh
pham:
mau, mu, tuy
xuong, dich nao tuy.
1/ Quan sat duoi KHV (nhuom Giemsa/
nhuom Schiff)
2/ PP tiem benh pham cho thu 3/ PP
huyet thanh hoc:
- thu nghiem mau Sabin1/ Lam sang: (pb voi thuffng han, cum)
Feldman
- sot co chu ki, giai doan ret-nong-toat mo hoi
thu nghiem ngung ket hong
- lach to, o vung sot ret 2/ Xet nghiem:
cau
- Xet nghiem mau: PP lam mau mong hay PP giot mau day 3/ PP mien dich huynh quang (tim

thu nghiem khang the huynh
trong mau)
quang gian tiep
4/ PP huyet thanh hoc
nghiem ELISA
1/ Diet the phan liet trong mau (the vo tmh):
1/ TH mac thu
phai:
- Quinin: hap thu nhanh, thai tru nhanh
- Rovamycin + vitamin C.
- Artemisinin (Quinghaosu): dung cho P. falciparum, tac dung cham
2/ TH bam sinh/ suy giam mien dich:
- Amino 4-quinolein: Cloroquin, Amodiaquin: hap thu nhanh, thai tru cham
- Rovamycin + Fansidar +
- Amino-ancol: Mefloquin, Halofantrin: hap thu cham, thai tru cham
acid folinic + corticoid.
- Thuoc khang acid folinic, khang acid folic: tac dung cham, de bi de khang
- Phu nu co thai: chi
> Sulfadoxin + Pyrimethamin (Fansidar): nguoi lon (khong dung cho phu nu co thai)
Rovamycin
> 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: dihydroartemisininpiperaquin)
- 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

1.

GIUN SAN
Giun (Nematoda): than hinh ong, vo cung
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)
2.
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)
3.
4.
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.
8


1.

ii. Hydatid: au trung san day Echinococcus granulosus.
Giun dua
Giun kim
Giun toc Trichuris
Giun luun
Sparganum: au trung
Giun moc
Ascaris lumbricoides
Enterobius vermicularis
trichiura
Strongyloides
g/d 2 cua san day
Ancylostoma
Necator
duodenale
americanus
Spirometra
erinacei.Ten va
- mau trang due/ hong
- mau trang, dau

- mau trang
- ngan
- mau trang
- rat nho, song
nhat, co van ngang;
hoi phinh, co 2
sua/ hong
hon
duc/ hong
M sinh hay
dau co 3 moi quanh
gan doc 2 ben
nhat;
- khong
nhat
song tu do
mi eng
than.
- dau co
co
2
- dau thuon
- dang M sinh:
- con due: duoi cong, 2
- mieng co 3 moi
bao
cap
nho, duoi
chi gom con
gai giao hop ngan,

- thuc quan co u
mieng
moc
phinh to
cai trinh san,
bang nhau
phinh hinh cu
phinh ra,
pMa
- duc: duoi
thuc quan dai,
Hinh the va chuc
- con cai: duoi thang,
hanh.
cong ve
bung
cong, co
tu cung co 4-5
nang
hinh non
- con duc: duoi
ph^a than
ma co
gai
trung
(hinh ve)
- trung: co vo day, co
cong, 1
- suon lung
2

- cai: duoi
- dang tu do:
lop albumin xu xi, gai ,
chia 2 rang hinh lu&i
thang, + duc: duoi cong, 2 gai
- con cai: duoi
vang nau
nhanh,
dao
bau
giao hop = nhau + cai:
thang, nhon
- trung ko thu tinh: hinh
moi
-suon lung chia 2
- trung: bau duoi nhon
- trung: hinh bau
thuon, dai, co hat
nhanh
nhanh,
duc, do
duc, hoi det 1
chiet quang ko deu
che 3. moi nhanh che 2.
nau, vo
pMa,
vo
day
dan.
duc:

duoi
trung
cuc
- phat trien truc tiep
- phat trien truc - trung chua phoi bao - au trung thuc - trung chuaday,
phoi2 bao
- truc tiep: au
dai: 2 tuan
tiep ngan, tu
quan u phinh - au trung thuc quan - trung co phoi trung thuc
- trung chua phoi bao nhiem
hinh ong - giun moc
au trung - giun
quan hinh ong
Chu trinh phat trien
trung co phoi - au
- trung co phoi toc
- gian tiep: au
trung - giun dua
au trung
trung thuc
co u
- duong tieu hoa, ho hap
- duong-tieugiun
hoa,kim
tu
- qua da
- duong tieu hoa - qua da, tuquan
nhiem
nhiem

Duung lay nhiem
- trung co phoi
- trung co phoi
- au trung thuc quan hinh ong
- trung co phoi
- au trung thuc quan hinh
The lay nhiem
ong
- trung chua phoi bao
- trung co phoi
- trung chua phoi bao
- au trung thuc quan co u
- trung chua phoi bao phinh
The phat tan ra MT

9


1.

- ruot non
Noi song chmh
Noi song phu (lac
cho)

Benh hoc (trieu
chung)

Chan doan

10

- manh trang o ruot - ruot non (chi gom con
au trung: phan - ta trang
cai trinh san)
cuoi ruot non
gia
- truong thanh:
manh trang
hau
mon
- phoi, ruot non
- tim, phoi, ta trang, gan,
- gan, phoi, ruot thua, ong tuy,
mieng, mui
- ruot non, ruot thua
cac hach
1/ Giai doan au trung:
1/ roi loan u ruot:
1/ G/d mo (song u cac cu quan):
- giong nhu
1/ Da: da san do, ngua,
- gay
hoi
chung
- ngua hau mon
- ho khan khong dom, khan
kiet li
nhung vung au trung
Loeffler:

(ban dem)
tieng, phat am kho
- dau bung, di qua noi may day,
+ ho khan, dau nguc, sot nhe. +
- dau bung, buon 2/ G/d u ruot:
di tieu
ngua ngay
bach cau toan tmh tang cao
non, tieu chay
- roi loan tieu hoa: viem ta
nhieu lan,
2/ Phoi:
(20-40%)
2/ roi loan than kinh (u tre
trang, dau vung thuong vi;
phan it
- ho khan, keo
2/ G/d truung thanh:
em): mat ngu, khoc
doi con cao, chan an
- nhieu:
dai;
- it: buon non, an ko dem, dai dam, co giat 3/
- thieu mau va roi loan tuan
thieu mau
- con suyen, tai
tieu, dau bung, tieu roi loan ctf quan sinh
hoan: bach cau toan tmh
nhuoc sac
phat nhieu lan/

chay.
due nu: viem am ho, am dao
tang nhanh, da kho va tai
ngay
- nhieu: dau bung, non
nhat, mi mat bi phu, mat
- bach cau toan
ra giun, tac ruot, viem
sung hup, kho tho, mach
tmh tang cao
ruot thua, thung ruot,
nhanh, u tai, chong mat
3/ Ruot:
tac mat
- roi loan than kinh: nhuc
- viem ta trang,
dau, de quen, suy sup than
dau vung
thuong vi,
1/ Giai doan au trung:
1/ Lam sang: ngua hau mon1/ tim trungkinh.
trong phan
1/ tim trung trong
- dua tren lam sang va 2/ Can lam sang: dung
2/ cay phan
phan 2/ PP phong
1/ tim au trung trong phan
cong thuc mau
PP Graham, lay bang keo 3/ PP huyet thanh hoc
phu hoa

xet nghiem ngay (pb
2/ G/d truung thanh:
trong
au trung giun moc)
- tim trung trong phan
2/ PP Baernann 3/ Hut
dich ta trang 4/ tim
khang the trong huyet
thanh ng. benh
-


1.

1/ Pamoat pyrantel 2/ Mebendazol 1/ Mebendazol
1/ Thiabendazol
1/ Pamoat pyrantel (than trong 1/ Pamoat pyrantel 2/
Mebendazol (Vermox)
(Vermox, Fugacar) 3/ Albendazol (Vermox,
(Mintezol)
cho tre < 2t)
3/
Albendazol
(Zentel)
4/
(Zentel)
Fugacar)
2/
Albendazol
(Zentel)

2/ Mebendazol (Vermox,
Flubendazol (Fluvermal)
4/ Flubendazol (Fluvermal)
2/ Albendazol
3/ Ivermectin (Stromectol)
Fugacar): ko dung cho tre
>
dieu
tri
tap
the
5/
Bephenium
hydroxynaphtoat
(Zentel)
duoi 2 tuoi
(Alcopar)
3/ Flubendazol
Dieu tri
3/ Albendazol (Zentel)
(Fluvermal)
4/ Flubendazol (Fluvermal)
> tat ca chi giet duoc giun truong
thanh, ko giet duuc trung/
au trung (lap lai dieu tri 2-3
tuan)
Giun chi
Au trung di chuyen &Au trung di chuyen &
Giun xoan Trichinella
Ten va Ten khoa hoc

da
noi tang
spiralis
T.
canis
- mau trang due
A.
- giong soi chi mem, mau trang duc
- due: duoi hai
braziliense:
- duc: 2 gai giao hop dai, khong deu
cong, ko co gai
mi eng co 2 cap rang
- cai: dai han duc, de phoi, boc boi 1 bao
giao hop, co 2 the
hinh moc
Giun chi Bancroft
Giun chi Ma lai
phu hinh non de
- A. caninum:
Hinh the va chuc
Wuchereria Bancrofti
Brugia malayi
giao hop
mieng co 3
nang
- duc + cai: vo ngoai- phoi: bao ngan han, rat an mau;
- cai: de phoi
cap rang hinh
(hinh ve)

lang, song cuon vao than uon eo ko deu dan; hat
- au trung chi chet
moc
nhau
nhiem sac di den gan mut duoi;
khi dun soi
- phoi: duoi nhon,
duoi co cho phinh nho
khoang 30 phut
than uon eo deu
dan; hat nhiem sac
the khong
denngoai bien vao ban dem
Chu trinh phat trien
- phoi - ken chua au- phoi xuat hien
trong di
mau
trung
- au trung - giun
Duong lay nhiem
- duong tieuxoan
hoa
- qua ruoi, muoi
- qua da nhung khong - duong tieu hoa
- muoi Culex va Anopheles - muoi Anopheles va Mansonia
vao mach mau
- phoi chua au trung
- phoi chua au trung
- au trung co thuc quan - au trung
The lay nhiem

hinh ong
The phat tan ra MT
11


1.

- duoi da
giun truong thanh: song o mo
giun cai: song o he bach huyet hay o mo
- ca, mau
- co the ki sinh o ngoai nguoi (khi,
he tuan hoan
Noi song phu (lac cho)
chi M sinh o nguoi cho meo)
- chu yeu gay phu voi & chan
3 giai doan:
viem cuc bo
1/ G/d viem ruot:
tac nghen mach
- tieu chay nhieu,
bach huyet
dau bung, nhuc
- gay xa cung, phi dai
dau, buon non, sot
mo 1/ Thoi ki
Benh hoc (trieu chung)
cao lien tuc (chi
nung: ko ro ret 2/
co & giun xoan)

ThOi ki kh&i
2/ G/d toan phat:
phat:
- phu o mat, m^
- moi met chi, dau o
mat, co
nach, hang, bui,
- trung
di ung:
da ngua 3/ Thui ki toan
tinh hoan
3/ G/d au
thanh
phat:
Noi song chmh

- ruot non

-

ken: dau a ca, khap xuang, - viem hach bach huyet 4/ Thai
nhai kho, tha kho, sot
ki man tmh (di chung): tac
giam, di ung giam
mach bach huyet, gay hien
tuung phu voi a bo phan
sinh duc, vu, tay chan

12

- gan, phoi, mat, nao
da co vet san
- sot nhe, keo
do, ngua
dai, bieng
ngay, mong
an, sut can
nuoc, noi
roi loan tieu
man
hoa
Au trung A.
- ho khac ra
caninum vao
dom, bach
mat tao u hat
cau
toan
tmh
tang
kho tho
- da noi do,


1.

Chan doan

Dieu tri

Du phong
Ten va Ten khoa hoc
Hinh the va chuc
nang

13

1/ G/d khoi phat:
1/ Lam sang:
1/ Lam sang 2/ Dua vao1/ bach cau toan tmh
- tim trong phan 2/
- tang nhanh bach cau toan tmh, xuat hien di dang 2/
dich te co tiep xuc
tang rat cao 2/ yG/d toan phat:
Xet nghiem:
vai dat o nhiem phan globulin tang cao
- xet nghiem mau:
- PP tot nhat: lay mau ngoai bien ve dem
cho, meo
3/ Lam sinh thiet tim au
tim au trung, so
- it phoi: PP Harris
trung a mo 4/ PP
luong bach cau
- Tim phoi trong nuac tieu
huyet thanh hoc:
toan tmh tang
- Phan ung huyet thanh hoc
mien dich dien di,
nhanh

(mien dich dien di, mien dich men, mien dich huynh quang)
mien dich huynh
- xet nghiem gian
quang, mien dich
tiep: phan ung
men ELISA (dac
khang nguyen
hieu han ca)
khang the; mien
dich dien di;
ngung ket hong
cau (Mintezol) 1/ Diethylcarbamazin (Notezine, Hetrazan) 2/ Ivermectin
1/ Thiabendazol
1/ Thiabendazol
1/ Thiabendazol
2/ Albendazol (Zentel)
(Mintezol)
(Mintezol)
(Stromectol) + Albendazol
3/ Mebendazol (Vermox)
2/ Albendazol (Zentel) 2/ Albendazol (Zentel)
3/ Flubendazol
3/ Mebendazol
(Fluvermal)
(Vermox)
4/ Ivermectin
- uong Notezine
San la Flukes San la gan lon Fasciola San la gan nho Clonorchis San la ruot (to nhat)
hepatica
sinensis

Fasciolopsis buski San la phoi Paragonimus
westermani
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.


1.

- boc bai tieu bi
- co the hinh non a
- than mau do nhat
- than day, mau
- than map, mau
- lap ca:
ph^a dau.
- ong tieu hoa
nau/ xam
nau/ do, mat
+ ca vong a ngoai,
- than day, mau
khong phan
- khong co the
bung dep, mat
+ ca cheo a giua,
trang/ xam do
nhanh
hinh non &dau
lung loi
+ ca doc a trong > co gian

- manh trang, tinh
- 2 tinh hoan
- manh trang
- tinh hoan it
theo 3 chieu
hoan,
buong
phan nhanh it,
khong phan
phan nhanh
- co 2 dia hut: dia
trung phan nhanh
nam tren duoi
nhanh
- buong trung to,
hut mieng va dia
nhieu
- trung: hinh bau
- buong trung,
chia thuy
(hinh ve)
hut bung
- trung: hinh bau
duc, hai phinh a
tinh hoan phan
- trung: hinh bau
- khong co ca quan
duc, co nap, vo
giua, co nap, co 1
nhanh nhieu

duc, nau sam; co
ho hap va tuan
day mau nau
gai nho doi dien
- trung: hinh bau
nap bang, h loi
hoan
nap.
duc, mau nau
- trong nang trung:
- thudng luang tinh
- trung co phoi luc
sam, co nap, hai
co 2 san va 1
- noan phong: nai
mai sinh
phinh a giua
dich mu do
trung duac tao
- TB noan phong
thanh - au trung chiet quang - vao ta trang: nang trung
- trung
thanh san non
bao tu nang - redia
Chu trinh phat trien
- nang trung
- san la truang thanh
Duong lay nhiem
- dudng tieu hoa
The lay nhiem

- nang trung
The phat tan ra MT - trung co nap
- trung co phoi, co nap
- trung co nap
- ong dan mat, ruot, phoi
- ruot non
- phe quan (phoi)
- ong dan mat cua gia sue va- ong dan mat
Noi song chmh
cua ngudi
- gan
- duai da, xoang bung, gan,
Noi song phu (lac cho)
tinh hoan, nao
- thuc vat thuy sinh
- ca ho Cyprinidae
- thuc vat thuy sinh
- cua/ tep
Au trung duoi bien
thanh nang trung
- oc Limnea
- oc Planorbis
- oc Melania
- oc Bithynia
Ki chu trung gian
- ca ho Cyprinidae

14

1.

1/ ThUi ki xam nhap (o’ 1/ G/d khui phat:
1/ G/d khui phat:
- ho co dom lan mau, dom
gan): gan to, cung, so
- roi loan da day,
- nhieu: moi met, mau gi sat
thay dau
chan an, buon
xanh xao, suy
- sot bat thuong, noi man,
non, tieu chay +
nhuoc
dau bung, bieng an,
tao bon
2/ G/d toan phat:
buon non; bach cau toan
- bach cau toan
- dau bung vung
tinh tang nhanh 2/ ThUi
tinh tang 2/ G/d
ha vi, tieu chay,
Benh hoc (trieu chung)
ki toan phat (u ong dan
toan phat:
phan long ko co
mat): tao bon + tieu
- thieu mau, gay,
mau nhung

chay, vang da, gay, thieu
phu ne chi duoi,
nhay, vang nhat,
mau; bach cau toan tinh
co truong
rat hoi
giam (con 5-10%)
- gan to ro ret, so
- bung bi truong
dau
- bach cau toan
tac
ong
mat,
tinh
tang
1/ Thui ki xam nhap:
xet
nghiem
phan
de tim 1/ xet nghiem dom tim trung
- tim trung trong phan hay
- Tim trung trong
trung
khong nhuom 2/ xet
trong dich ta trang
phan
nghiem phan tim trung
- Phan ung huyet
3/ Phan ung huyet thanh hoc

thanh 2/ Thui ki
(dung cho tre em)
Chan doan
toan phat:
4/ Sieu am, CT scan
- xet nghiem phan/
dich ta trang de
tim trung.
- trung It: PP
1/ Bithionol (Bitin) 2/
1/ Niclosamid (Tredemine,
Cloxyl 3/ Praziquantel
1/ 2-dehydro emetin 2/
Yomesan) 2/
1/ Niclofolan (Bilevon) 2/
Dieu tri
(Biltricide)
Bithionol (Bitin,
Praziquantel
Bithionol (Bitin,
Actamer)
(Biltricide)
Actamer)
3/ Triclabendazol (Fasinex)
3/ Hat cau, sac uong
3/ Praziquantel (Biltricide)
- Opisthorchis viverrini
Du phong
nguy hiem hon, co the
gay ung thu gan

San day ca (dai San day cho Dipylidium San day lun Hymenolepis
San day bo Toenia
nhat)
Ten va Ten khoa hoc San day Inn Toenia solium
saginata
caninum
nana
Diphyllobothrium
Hinh the va chuc nang
- chung: deu co dau, co va dot
15


1.

(scan hinh /149)

Chu trinh phat trien

Dunng lay nhiem
The lay nhiem
The phat tan ra MT
Noi song chmh
Ki chu trung gian
Benh hoc (trieu chung)

-

1 ngudi chi chua
- dau: khong co

- dau: hinh bau
- dau: 4 dia hut
- dau: 1 chuy chi
1 con
chuy va moc; co
duc, khong co
hinh chen; chuy
co 1 hang moc
- dau: 4 dia hut
4 dia hut hinh
dia hut, khong co
co 3-4 hang moc
- lo sinh duc: ben
tron, 1 chuy
bau duc
moc; chi co 2
- dot gia: mang
trai
ngan; chan chuy
- dot gia: rung
ranh hut sau va
trung hinh hat
- trung: hinh bau
co 2 hang moc.
tung dot, rdi
dai
dua leo
duc, vo day,
- dot gia: khong tu
nhau, co kha

- dot gia: khong
- lo sinh duc: ca 2
trong suot, co
dong bo ra ngoai
nang bo ra ngoai
tach rdi khoi
ben
phoi 6 moc
- lo sinh duc: ben
- lo sinh duc: ben
than
- trung: hinh cau,
hong va xen ke
hong, xen ke
- lo sinh duc: nam
6 moc, ket dinh
tuong doi deu.
khong deu
giua dot
thanh tung dam
- trung:
- phoi
trung:
hinh
bau
- trung chua
phoi -hinh
nangcau,
au trung - -san trung: hinh bau - trung ko
- trung co - trung - nang au trung co - trung - nang au trung co

duoi - san
duoi - san
phoi 6 moc - au trung
procercoid - au trung
plerocercoid - san
- dudng tieu hoa
- truc tiep tu tieu hoa/ an
- an thuc an chua bo chet
banh mi nuong ko chm
- nang au trung
- nang au trung
- au trung plerocercoid
- nang au trung
- trung chua phoi 6 moc - trung chua phoi
- trung khong phoi
- trung chua phoi 6 moc - trung chua phoi 6 moc
- ruot non
- ruot
- ruot
- ruot non
- ruot non
- lon
- bo
- giap xac ho
- bo chet cho, meo
Cyclops
- ca
1/ roi loan tieu hoa: buon non, tieu chay + tao bon 2/ roi loan than kinh: nhuc dau, mat ngu, suy nhuoc TK 3/ roi loan giac quan: nhin
md, u tai
4/ roi loan tim mach: danh trong nguc, dau truoc ph^a tim, ngoai tam thu 5/ roi loan ho hap: ho co con, kho tho.

6/ roi loan o da: ngua ngay, noi me day.

Chan doan
Dieu tri

16

1/ xem phan bang mat: coi dot san; bang kmh hien vi: coi trung san 2/ PP Graham (giong tim trung giun kim)
1/ Niclosamid (Tredemine, Yomesan)
3/ Hat M do (b^ ngo): an song/ rang ch^n
1/ Niclosamid 2/
2/ Praziquantel
4/ Hat cau: sac nuoc uong
Praziquantel


1.

Sparganum
Cysticercus cellulosae (au
Hydatid
trung san day lorn)
San mang Schistosoma
(au trung san day nho)
Echinococcus
Echinococcus
- due: mau trang due, phan than truoc hinh - dau: 4 dia hut; chuy mang
granulosus
multilocularis
hang moc

tru, phan than con lai dep; 2 mep than cong
lai tao 1 ranh hinh mang, chua con cai
- trung: co 1 cua ben hong/ o mut duoi, khong
co nap
S.japonicu
S. haematobium
S.mansoni
m- doan
- doan
- doan
- dau: 1 chuy loi,- kmh thuoc nho hon
manh
manh
manh
2 hang moc, 3-4
Hinh the va chuc
trang
trang
trang
dot
nang
ngan hon
dai hon
dai hon
- au trung sau 5
^ than
'/2 than
/ than
tilling lorn hon
- duc: 4-5

- duc: 8- duc: 6san truung
tinh hoan
9 tinh
8 tinh
thanh ca tram
- trung: co
hoan
hoan
lan:
cua o mut
- trung:
- trung:
+ 1 vo boc ngoai, co van,
duoi, thai
co cua
co cua
day, trang duc, khong
theo nuac
ben
ben
co nhan + 1 mang sinh
tieu
hong,
hong,
mam mong gom nhieu
TB co nhan
- trung - au
ong - bao tuthai
nang - au trung cun,
Chu trinh phat

trung
trien
duoi cheJia hay nang trung
- qua da
- an uong
- an uong
- an
Du’d’ng lay nhiem
Cyclops
- au trung duoi
- trung co phoi
- trung
- trung co phoi 6 moc (phoi
- tu nhiem
co buou)
The lay nhiem
The phat tan ra - trung chua au trung long
MT
- gan (70%)
- gan
- tinh mach cua tinh
- ruot non cho,
- tinh mach cua - tinh mach cua - co, mo duoi da
mach lach, bang dam roi tinh
dong mach
meo
Noi song chmh
quang
mach mac treo phoi
trang duai

Ten va Ten khoa
hoc

17


1.

Noi song phu (lac
cho)

- mat, nao, tim, gan, phoi,
than

- oc Bullinus
Ki chu trung gian

Benh hoc (trieu
chung)

Chan doan

Dieu tri

18

- oc Planorbis - oc
Oncomelania

- phoi, nao

- phoi (15%), than, lach,...
- loai gam nham nho,
chuot dong

1/ 6 ca: nhuc moi, sut can, cau
1/ 6 gan: xuat hien 1 nang- Nang nhieu lo giong
to ong
gat
to dan, so ko dau 2/ 6
2/ 6 mo duai da: not nho di
phoi: khac ra mau, ho
dong, khong dau 3/ 6 mat: lien tuc, co the tao ap
roi loan thi giac 4/ 6 ca
xe phoi
tim: nhip tim dap nhanh, 3/ 6 nao: tang ap luc trong
kho tho, ngat xiu 5/ 6 nao: so, gay dong kinh 4/ 6
nhuc dau, chong mat, cau than: suy nhuoc chuc
kinh, dong kinh, liet
nang
1/ Tim trung trong phan
1/ Tim nang au trung qua sinh
1/ Co 1 buau lanh dang tien
- PP mien dich hoc
2/ Tim trung trong can nuac tieu (S.haematobium) 3/
thiet, X quang 2/ PP mien trien
Tim trung trong mo khi sinh thiet truc trang 4/ PP
dich ELISA
2/ Chup hinh gan bang pp
huyet thanh hoc
dong vi phong xa 3/

Chup X quang 4/ Phan
ung mien dich 5/ Ki
thuat sieu am: phat
hien nang san

-

-

nhe,
gay
dau,
ngu
a
vao
mat
gay
vie
m
loet
giac

1/ Niridazol (Ambilhar) - S.haematobium 2/
1/ Phau thuat 2/ Praziquantel1/ Mo lay nang 2/ Bam 1/ Giai phau loai bo - Rach va gap
Oxamniquin (Vansil) - S.mansoni 3/ Metrifonat
3/ Albendazol (Zentel)
formol 10% hay
nang 2/
ra
(Bilarcil) - S.haematobium 4/ Oltipraz - S.mansoni

cetrimid: diet dau san
Albendazol (KST
& S.haematobium 5/ Praziquantel (tat ca)
va mang sinh mam 3/
de khang vai
Albendazol
Praziquantel)


TIET TUC (Arthropoda)
1. Nganh phu tho bang mang: lap Giap xac (tom, cua)
2. Nganh phu tho bang kh quin:
a. Lap Nhen, Bo Ve mat (Acarina)
i. Cai ghe
ii. Ve
iii. Mat
b. Lap con trung
i. Bien doi hinh thai hoan toan:
1. Bo 2 canh (Diptera): Ruoi, muoi
2. Bo khong canh (bo Bo chet - Siphonaptera):
a. Chi co long to:
i. Pulex irritans (song a nguai): 1 long to truac mat va 1 long to sau dau
ii. Xenopsylla cheopis (song a chuot): 1 long to truac mat, nhieu long to sau dau; chan cac long to xep hinh chu V.
b. Chi co luac:
i. Ceratophyllus fasciatus = Nosophyllus fasciatus (song a chuot): chi co 1 luac a nguc truac
ii. Ctenocephalides canis (song a cho): co 2 luac: 1 a nguc truac, 1 a gan mieng
ii. Bien doi hinh thai khong hoan toan:
1. Bo khong canh (Anoploura)
a. Chay (Pediculus humanus)
b. Ran (Phthirus inguinalis)

Ve
Mat (mo)
Bo 4 canh nua
(Hemiptera): Rep Cai ghe (nho) Sarcoptes scabiei
(Cimex
Hinh
the va chuc
- than: hinh bau duc, mau
- than: phu day
nang
xam, vo boc ngoai co lan
long to, mau
song song nhau; tha qua
vang cam/ do, co
- than: hinh bau duc, khong co long/ long ngan
da
hinh so 8
- co lo tha a giua hay sau than
- 4 cap chan: 2 cap truac
- au trung: hinh
- co chuy gom:
nam han ve truac than; 2 + 1 ha khau a pMa bung + 2 cau a ph^a lung + 2 tuc xuc hinh chuy
bau duc, 3 cap
cap sau nam dang sau
chan
- au trung: 3 cap chan; 1 chuy a mut dau; ban chan hut tho so
than
bo phan mieng
- bo phan mieng nho ra va co rang
- duc: 2 cap chan sau mang

an, khong co
Ho Ixodidae
Ho Argasidae
rang

19


dia hut
- ve cung, chuy a mut dau, mai a
- ve mem, chuy nam duai
cai: cap chan thu 3 mang
lung
bung, khong lo ra ngoai
dia hut, cap chan thu 4 tan
- chan tan cung bang ban chan hut
- khong co mai tren lung
cung bang long to dai
- Chuy ngan, ranh boc hau mon a
- khong co ban chan hut
- dau gia rat ngan, ko co
ph^a sau hau mon:
+ Argas: than gay, dep, lang, co 1
mat, chi co 2 cau hinh kep
+ chan chuy hinh 6 goc: Rhipicephalus +
lan phan chia ro ret lung va
chan chuy hinh chu nhat: Dermacentor
bung
- Chuy dai, ranh hau mon nam
+ Ornithodorus: than map,

pMa truac hau mon: Ixodes
san sui, khong co lan phan
chia ro ret bung va lung
- trung - au trung 6 chan - nhong 8 - trung - au trung 3 cap chan - nhong 4 cap chan - ve
Chu trinh phat trien chan - cai ghe
Duong lay nhiem - qua da
- tren thu, ngudi
- noi da mong, co nep nhan,
Noi song chmh
khong co o mat
- ngua, thudng ve dem
- benh sot phat ban (sot dom xuat- benh sot hoi quy: do
- benh sot phat ban bui
- co nhung dudng ham dac
huyet): do Dermacentor gay nen Ornithodorus truyen xoan
hoang do au trung
Benh hoc (trieu
trung trong bieu bi, not
khuan Borrelia duttoni
- benh sot noi mun (sot not): do
Trombicula akamushi
chung)
nho li ti
Rhipicephalus gay nen
truyen Rickettsia
- benh te liet do ve (a tre em)
orientalis
Phong
ngua:
boi

Butyl
hexachlorid
1/ Thuoc mo co luu huynh 2/ dd
benzoat-benzyl (Ascabiol) 3/
Dieu tri
Lindan 1% tron bot hoat thach 4/
Pyrethrinoid (Spregal)
5/ Crotamiton (Eurax)
Bo 2 canh (Diptera)
Ten va Ten khoa hoc
- 2 canh truac a the mang, 2 canh sau thay the bang con lac
- gom 2 bo phu dua vao so dot cua rau:
Hinh the va chuc
+ Bo phu rau ngan (Brachycera): rau duai 3 dot; than map; canh rong; mat kep, rat na nang, thuong dmh lien nhau a con duc. + Bo
nang
phu rau dai (Nematocera): rau tren 3 dot; than manh khanh; canh dai, hep; mat It na nang
Ruoi (Bo phu rau ngan)
Muoi
-

20


1/ Giong ruoi chfch va hut
- co nhung vay nho
mau: ruoi trau
- duc: rau co long to dai va ram; hut nhua cay
(Tabanidae)
- cai: rau co long thua va ngan; hut mau
- co 1 voi chich

- moi duai va moi tren: uon cong thanh voi
- nguc den, co rach
- 2 ham tren va 2 ham duai: xuyen thung da
vang, bung mau > Muoi cai de trung can 3 dk: nong (25-30oC), am uat va hut mau
vang
- Muoi thmh mau den, xanh bien, do
- duc: 2 mat dmh
- Mau trang, vang: ^t loi cuon muoi
lien; hut dich cua
Phu ho Culicinae
hoa
Giong Culex
Phu ho Anophelinae (giong
Giong Aedes (muoi van/ Giong Mansonia
- cai: 2 mat cach xa; Anopheles - muoi don soc)
muoi dom)
hut mau suc vat
- dau xien, mau den
- dau song song, mau
- dau song song,
- gan giong
2/ Giong ruoi ko chfch:
toan than, canh co
nau nhat/ nau sam
nho, mau den nau,
Culex
- ruoi nha (Musca
dom den trang
- duc: xuc bien ham
co dom trang bac

- than vang
domestica)
- xuc bien ham dai «
dai hon voi
a chan
nau/ nau
- moi tren va thuong
voi
- cai: xuc bien ham dai
- bung muoi: co
- chan va
yet hau ngan
- duc: xuc bien ham
khoang 1/3 voi
bang ngang, mau
than co
- moi duai hinh voi
phinh ra a 2 dau giong
- au trung co ong tha
trang
dom, vay
mem
cai bay
dai va hep a dot ap
- duc: giong Culex
canh to,
- khong co ham tren
- cai: xuc bien ham
chot
- cai: giong Culex

co cho
hay ham duai; chi
suon
- duoi cun
- duoi nhon
dam cho
co
xuc
bien
ham
rieng
le, lang
co 2 quang) - nhong - muoi
- ong tha au trung
lot
- trung - au trung - - trung -- au trung:
trung (bo
gay,
nhong
Chu trinh phat trien
ruoi giun chi Loa
- benh
- benh giun chi
- benh sot xuat huyet: do
- benh giun chi Ma
loa: do giong ruoi
Bancroft: do Culex
Aedes aegypti truyen
Lai: do Mansonia
Chrysops

quinquefasciatus
Benh hoc (trieu
virus Dengue
- benh ngu Phi
- benh viem nao Nhat
chung)
chau: do giong
Ban B do Culex
ruoi Glossinia
tritaeniorhynchus
truyen
Bo
chet
Ten va Ten khoa
Chay
Ran
Rep
hoc
Pediculus humanus
Phthirus inguinalis
Cimex lectularius

21


-

dau nho so vai nguc,
- than dai, nguc hep hon
- than thun lai, nguc lan hon

- mau do nau, map be
khong co canh; 3 cap
bung, phan chia ro ret vai
bung, khong phan chia ro
ngang
chan, cap cuoi dai va
bung.
ret
- dau: nho, thut vao 1
khoe nhat, giup nhay xa
- song tren dau va song
- dau: tuong doi ngan va
lom o nguc truac
- bung 10 dot
trong minh
nam trong lom cua nguc
- 2 mat to, 2 rau lan
Hinh the va chuc
- duc: duong vat ve pMa
- song tren dau: mau xam,
- chan: co mong dai va khoe,
- nguc truac: lom o ph^a
nang
cuoi dot chot
chu yeu o toc
cong lai
duai, no ngang, venh o
- cai: co tui chua tinh
- song o than: mau trang
2 ben

trung
ban, lan hon
- nguc giua: co 1 cap
- au trung: hinh con sau,
- trung: hinh bau duc, co
canh rat nho, hinh bau
co 1 sung dau
nap, dinh 1 cuc vao long/
duc
- sinh
co gai
chitin co hinh
- duc: 1 gai giao hop
Noi k sinh
- ngoai ki
trung
- o dau toc
va onho
than1 chat nhua
- vung long bo phan sinh duc
- trung - au trung - rep
Chu trinh phat
- trung - au trung - nhong - bo chet
trien
- benh sot phat ban, sot hoi quy - khong truyen benh, chi xuat hien not- co mun co 1 quang do xung
- benh dich hach: do VK Yersinia
nho, rat ngua
quanh, rat ngua
pestis = Pasteurella pestis gay
ra

1/ The noi hach (thuong gap nhat):
chong mat, nong lanh, oi mua;
co hach o hang, nach, mu rat
hoi va nhieu VK 2/ Dich hach
Benh hoc (trieu
phoi: lan truyen nguoi qua
chung)
nguoi boi nuac bot; sot nang,
kho tho, tuc nguc, ho ra dom
mau; gan va lach to, phu phoi
cap
3/ Nhiem khuan huyet (dich hach
den): bi sot, oi mua, me man,
xuat huyet
1/ Pyrethrin + Butoxyd piperonil:
1/ Streptomycin 2/ Tetracyclin 3/
a/ Neopyramin (Lenpoucid) b/
Dieu tri
Sulfamid (Sulfadiazin,
Sumithrin (Parasidose) c/
Sulfadoxin)
Bioallethrin (Parapoux)

22


VI NAM HOC
- Dua vao benh hoc:
1. Benh nam ngoai bien
2. Benh nam a da

3. Benh nam duai da
4. Benh nam noi tang
5. Benh nam ca hoi
6. Benh doc to nam
- Dua vao phuong thuc sinh san huu tmh: 4 lap
1. Bang trung, sgi ta nam thong suot: Nam tao (Phycomycetes)
2. Bang tui, sgi nam co ngan: Nam tui (Ascomycetes)
3. Bang dam, sgi nam co ngan: Nam dam (Basidiomycetes)
4. Khong co bo phan sinh san huu tmh: Nam khuyet (Adelomycetes)

1. Nam men gay benh:
a. Candida spp. (vi nam da hinh)
b. Cryptococcus neoformans (nam men co nang)
c. Malassezia spp. (nam men ua chat beo)
2. Nam da (Dermatophytes): nam ua keratin thuoc hg Gymnoasceceae, 3 chi: Trichophyton, Microsporum va Epidermophyton.
3. Nam luong hinh: 2 dang hinh the: dang nam sgi va dang nam men
a. Sporothrix schenckii
b. Penicillium marneffei
c. Histoplasma capsulatum
4. Nam moc gay benh:
a. Hyalohyphomycetes: sgi nam khong mau, co vach ngan: Aspergillus spp., Fusarium spp.
b. Zygomycetes: sgi nam khong mau, khong vach ngan
c. Phaeohyphomycetes: sgi nam co mau
5. Nam sgi mau (Dematiaceous fungi)
a. Co dang nam men:
i. Nam men: Phaeoannellomyces, Phaeococcomyces, Aureobasidium, Hormonema.
ii. Giai doan dau giong nam men: Exophiala, Wangiella dermatiditis
23

b. Thuoc nam sgi:
i. Cuong bao tu dang ghep hinh sim:
1. Bao tu dmh lan: vach ngan nam ngang hay vach ngan dang muriform
2. Bao tu d^nh nho:
ii. San xuat the binh: Phialophora, Phaeoacremonium
iii. Bao tu dmh nho hgp thanh chuoi: Cladosporium, Cladophialophora.
Cryptococcus
Malassezia spp.
Cau truc sinh san
Candida spp. (Candida
neoformans
albicans)
phuc tap:
- nam men co nang (vo
- nam men ua chat
- co the tao thanh bao tu bao
boc bang
beo
day (chiet quang)
polysaccharid)
- mau kem, tran nhan
- hinh cau/ bau duc,
- hinh cau/ bau duc/
sinh san bang nay
tru
choi/ bao tu dam
- sinh san bang nay
Dac diem va chuc
- khong len men, dong
choi a 1 cuc tren

nang
hoa inositol
day rong
- san xuat ure, phan
- sinh san da choi
ung vai xanh
khong xay ra
diazonium B
- thanh phan
polysaccarid:
glucuroxylomanman
- ki chu de khang
nhd: dai bach
1/ ket dmh vao mo nhd
bao a phe nang; TB thuc bao,
tuang tac receptor TB T va B 1/ kha nang phat
ligand; luc VanderWalls,
trien a 37oC 2/ kha nang tai
luc tinh dien
tao nang polysaccarid day 3/
2/ vi nam luang hinh
Yeu to lien quan den
sinh tong hop melanin
3/ tinh ki nuac a be mat
doc luc
TB do su glycosyl hoa
mannoprotein
4/ bao tu choi than nuac
5/ cac enzym bao ve
chong lai khang the

- TB men hinh cau - bao tu
Chu trinh phat trien choi - dang soi nam gia
ngan va dai - soi nam

24

Nam da Dermatophytes
- 2 g/d sinh san: sinh san vo tinh va huu t^nh +
ten goi g/d ss huu tinh cua:
> Microsporum: Nannizzia
> Trichophyton: Arthroderma
- thuoc nam soi, co vach ngan, phan nhanh
- da so ss vo t^nh bang bao tu d^nh lan hay
bao tu d^nh nho
- Dac diem bao tu d^nh lan:
+ Microsporum: hinh thoi, vach day, nhan, co
gai min.
+ Trichophyton: vach mong, tran +
Epidermophyton: vach tran, hinh chuy, khong
co bao tu d^nh nho


Duong lay nhiem

-

The lay nhiem

nguon lay nhiem - dudng ho hap
ch^nh: nguon noi

sinh
DK can: suy giam
hang rao bao ve
cua k^ chu
tu vat dung bi
nhiem
- TB nam men mat nang

- song hoai sinh o co quan tieu- phoi
hoa
Noi song chinh
Noi song phu (lac - mi eng, am dao, nieu dao, da- da, he than kinh
cho)
va duoi mong
- phan bo cau
Ki chu trung gian

25

- song hoai sinh o da

- da, toc, mong