DAI CU'ONG KE SINH TRUNG 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 -) 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.) 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 Chu trinh phat trien cua KST: a Chu trinh truc tiep: nguoi la ki chu 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 ki chu (Toenia solium, T saginata); 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) Duung lay nhiem: a Duong tieu hoa: trung, bao nang, b Qua da: au trung, c Duong ho hap, giao hop, thai, truyen mau Nguon nhiem: dat, nuoc, thuc pham, tu nhiem, nguoi, thu, Chan doan benh: a Chan doan lam sang: b Chan doan KST c Xet nghiem truc tiep: i Tim KST 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 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) TB chat: a Ngoai sinh chat: dam dac, dan hoi (di chuyen, tieu hoa, bai tiet, ho hap va bao ve) 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 (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 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 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 dieu, pMa lung - hinh qua le, co song chay doc suot loi, nua truoc bung than cung, roi (4 roi than lom; nhan lon, moi huong ve pMa truoc va nhan co nhan the a roi ve pMa duoi) tao giua; roi (6 roi a mang luun song truoc, roi ngan a 1/3 chieu dai than; sau); song than, CD1 nhan to (de thay 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 - phat trien tot a 35-37oC bao nang va ki khi, pH 5.5 - bao nang: vach day, - pH acid (3.8 - 4.4): hinh bau duc, chiet khong song duoc quang, co suc de khang cao, truang co nhan nhan, nhan chua nhan the a giua nhan hay lech ben - Hat nhiem sac xep xung quanh, pMa mang nhan E histolytica E coli - the hoat dong: chan gia - song hoi sinh, dai; nhan lech ben, khong xam hinh cau; giua nhan co 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 ngoai nhan the kha to, khong the chuyen nam lech bao nang ngoai - tien bao nang: co khong - bao nang rat bao chua glycogen, co chiet quang, co the bat mau vo boc chua 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 nhan - bao nang G/d lay nhiem - bao nang - G/d phat tan - bao nang (1, 2, nhan) va the hoat MT dong - den ruot non: vo bao nang mat di - amip - amip: a ruot gia Noi song chinh - giao hop, me truyen sang - 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 + 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 VK Shingella: sot cao 5/ ton thuong hinh tan nam + gan: 1/ dau pMa duoi suon phai 2/ gan viem, rat dau 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, 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 tieu - tieu chay phan co chat nhon, mau va mui hoi Benh hoc (trieu chung) Chan doan 1/ Lam sang: xac dinh ruot - coi the hoat dong khong co hong cau) hay ngoai ruot 2/ Xet nghiem: - ruot: xem phan sau di tieu (coi hong cau) - Ngoai ruot: pp huyet + 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 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 + giot trang nuoc muoi sinh l^ hay dung 4/ Ki thuat vien nhong ta trang 90o, nhuom bang Giemsa 5/ Mien dich men ELISA hay Hematoxylin 2/ Nuoi cay: MT dac va long khong TB; mo; phoi ga 1/ 5-nitroimidazol: Metronidazol,1/ Dieu tri toan than: Tinidazol 2/ Furazolindon - Metronidazol (can (Furoxone): dung cho tre em 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 the: giai doan phat trien: 1/ The hoat dong (the tang truang 1/ Sinh san vo tmh (su liet sinh): xay a ngudi, gom pha: + Pha tien (ngoai) hong cau mo gan: thoa trung - the phan liet ngoai hdng cau - manh trung nhanh): hinh luoi liem/ hinh trai chuoi, dau nhon; dau tron, ngoai hdng cau chua nhan - Chu ki ngoai hong cau cung dien voi chu ki hong cau - sinh san bang cat liet theo - P vivax va P ovale: the ngu ton tai gan chieu doc, bi HCl da + Pha hong cau 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 a ngudi, sau xay 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 duoi 450C va HCl cua - Pha ngoai hong cau: 10-12 - Pha ngoai hong - Pha ngoai dich vi - The tu duong non: hinh chiec nhan, cau: 1521 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 gan - Ki sinh trung: day, tao tu ss huu tmh, khong bi anh huang bai HCl cua dich vi; - Hong cau bi nhiem khong phinh to, nam ton tai - chua bao tu nang co dom - The tu duong non gan h nhat - moi bao tu nang: thoa Maurer & gia: giong P nam trung > Gom the thuc phat - The tu duong gia: khong co 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 o nau vang dam, nam rai rac phinh to, co hat nhan, hat meo KCVV): gom chu trinh liet - The phan liet: nhon 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, dau - Giao bao duc: TB gia: nhieu hat sinh huu tmh - The phan tan MT: cun (nhu dieu xi ga), TB chat mau tim chat mau tim, 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: TB - The phan liet- an thit song - muoi chmh, truyen me truyen cho(hinh trai chua nang - thoa trung (phat trien manh a gan) - trung nang (g/d bao tu nang) - hong cau tre, te bao luoi - 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 bon, 1/ Benh Toxoplasma mac phai: each 48 gin tai phat) each 48 gin tai phat) cach tai phat + nhiem sau sinh (5-25t) Van de killing thuoc1/ S (Sensibility): nhay cam: sach KST ngay; khong tai phat tuan tiep theo 2/ R (Resistance): khang thuoc - RI: khang muon: sach KST ngay; tai phat 28 sau - RII: khang som: giam the vo tmh nhung khong sach KST tuan dau - RIII: khang han: the vo tmh khong giam hoac tang tuan dau - Thoi ki tiem an: gom chu ki ngoai hong cau, h nhat hay chu ki noi hong cau - Thoi ki tien trien: ret keo dai 1-2h, lanh toan than, than nhiet tang len 390C; sau nong sot keo dai, da nong, than nhiet len 40-410C; sau do mo hoi 2-4h, nhiet giam nhanh - the lach ton thuongmach, gan: giam albumin, prothrombin 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 - Sot ret the nao: than nhiet tang, tim dap nhanh va yeu, da nhot nhat; me sang, lu lan 2/ Sot ret the tieu huyet sac to: than nhiet tang, dau lung du doi, oi mat, nuoc tieu mau 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, xuong, dich nao 1/ Quan sat duoi KHV (nhuom Giemsa/ nhuom Schiff) 2/ PP tiem benh pham cho thu 3/ PP huyet 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 mau) quang gian tiep 4/ PP huyet hoc nghiem ELISA 1/ Diet the phan liet 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 TH khang thuoc (khong dung cho phu nu co thai, tre em duoi tuoi) 2/ Diet giao bao (the huu t^nh): - Amino 8-quinolein; Artemisinin hay Artesunat (tre em < tuoi: dihydroartemisininpiperaquin) - Sot ret ac t^nh: dung Artesunat tiem tinh mach - CV8: diet the ngu (phu nu co thai tren thang) - Phu nu co thai duoi thang: Quinin + clindamycin 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) 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 giai doan truang (song 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 giai doan au trung (song phu tang): i Cysticercus: au trung san day lon va san day bo 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 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 sua/ hong hon duc/ hong M sinh hay dau co moi quanh gan doc ben nhat; - khong nhat song tu mi eng than - dau co co - dau thuon - dang M sinh: - due: duoi cong, - mieng co moi bao cap nho, duoi chi gom gai giao hop ngan, - thuc quan co u mieng moc phinh to cai trinh san, bang phinh hinh cu phinh ra, pMa - duc: duoi thuc quan dai, Hinh the va chuc - cai: duoi thang, hanh cong ve bung cong, co tu cung co 4-5 nang hinh non - duc: duoi ph^a than ma co gai trung (hinh ve) - trung: co vo day, co cong, - suon lung - cai: duoi - dang tu do: lop albumin xu xi, gai , chia rang hinh lu&i thang, + duc: duoi cong, gai - cai: duoi vang nau nhanh, dao bau giao hop = + cai: thang, nhon - trung ko thu tinh: hinh moi -suon lung chia - trung: bau duoi nhon - trung: hinh bau thuon, dai, co hat nhanh nhanh, duc, duc, hoi det chiet quang ko deu che moi nhanh che 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: 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 MT - 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 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 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 cao, chan an - nhieu: dai; - it: buon non, an ko dem, dai dam, co giat 3/ - thieu mau va roi loan tuan thieu mau - 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 - nhieu: dau bung, non nhat, mi mat bi phu, mat - bach cau toan 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 phan 1/ tim trung - dua tren lam sang va 2/ Can lam sang: dung 2/ cay phan phan 2/ PP phong 1/ tim au trung phan cong thuc mau PP Graham, lay bang keo 3/ PP huyet hoc phu hoa xet nghiem (pb 2/ G/d truung thanh: au trung giun moc) - tim trung phan 2/ PP Baernann 3/ Hut dich ta trang 4/ tim khang the huyet ng benh - 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/ ca: nhuc moi, sut can, cau 1/ gan: xuat hien nang- Nang nhieu lo giong to ong gat to dan, so ko dau 2/ 2/ mo duai da: not nho di phoi: khac mau, ho dong, khong dau 3/ mat: lien tuc, co the tao ap roi loan thi giac 4/ ca xe phoi tim: nhip tim dap nhanh, 3/ nao: tang ap luc kho tho, ngat xiu 5/ nao: so, gay dong kinh 4/ nhuc dau, chong mat, cau than: suy nhuoc chuc kinh, dong kinh, liet nang 1/ Tim trung phan 1/ Tim nang au trung qua sinh 1/ Co buau lanh dang tien - PP mien dich hoc 2/ Tim trung can nuac tieu (S.haematobium) 3/ thiet, X quang 2/ PP mien trien Tim trung mo sinh thiet truc trang 4/ PP dich ELISA 2/ Chup hinh gan bang pp huyet 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/ (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) Nganh phu tho bang mang: lap Giap xac (tom, cua) Nganh phu tho bang kh quin: a Lap Nhen, Bo Ve mat (Acarina) i Cai ghe ii Ve iii Mat b Lap trung i Bien doi hinh thai hoan toan: Bo canh (Diptera): Ruoi, muoi Bo khong canh (bo Bo chet - Siphonaptera): a Chi co long to: i Pulex irritans (song a nguai): long to truac mat va long to sau dau ii Xenopsylla cheopis (song a chuot): 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 luac a nguc truac ii Ctenocephalides canis (song a cho): co luac: a nguc truac, a gan mieng ii Bien doi hinh thai khong hoan toan: Bo khong canh (Anoploura) a Chay (Pediculus humanus) b Ran (Phthirus inguinalis) Ve Mat (mo) Bo 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 - co lo tha a giua hay sau than - cap chan: cap truac - au trung: hinh - co chuy gom: nam han ve truac than; + khau a pMa bung + cau a ph^a lung + tuc xuc hinh chuy bau duc, cap cap sau nam dang sau chan - au trung: cap chan; chuy a mut dau; ban chan hut tho so than bo phan mieng - bo phan mieng nho va co rang - duc: 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 mang lung bung, khong lo ngoai dia hut, cap chan thu 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 mat, chi co cau hinh kep + chan chuy hinh 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 chan - nhong - trung - au trung cap chan - nhong 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: - benh sot phat ban bui - co nhung dudng ham dac huyet): Dermacentor gay nen Ornithodorus truyen xoan hoang au trung Benh hoc (trieu trung bieu bi, not khuan Borrelia duttoni - benh sot noi mun (sot not): Trombicula akamushi chung) nho li ti Rhipicephalus gay nen truyen Rickettsia - benh te liet 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 canh (Diptera) Ten va Ten khoa hoc - canh truac a the mang, canh sau thay the bang lac - gom bo phu dua vao so dot cua rau: Hinh the va chuc + Bo phu rau ngan (Brachycera): rau duai dot; than map; canh rong; mat kep, rat na nang, thuong dmh lien a duc + Bo nang phu rau dai (Nematocera): rau tren 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 voi chich - moi duai va moi tren: uon cong voi - nguc den, co rach - ham tren va ham duai: xuyen thung da vang, bung mau > Muoi cai de trung can dk: nong (25-30oC), am uat va hut mau vang - Muoi thmh mau den, xanh bien, - duc: 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: 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 a 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 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: - benh giun chi Ma loa: giong ruoi Bancroft: Culex Aedes aegypti truyen Lai: Mansonia Chrysops quinquefasciatus Benh hoc (trieu virus Dengue - benh ngu Phi - benh viem nao Nhat chung) chau: giong Ban B 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 nau, map be khong co canh; cap bung, phan chia ro ret vai bung, khong phan chia ro ngang chan, cap cuoi dai va bung ret - dau: nho, thut vao khoe nhat, giup nhay xa - song tren dau va song - dau: tuong doi ngan va lom o nguc truac - bung 10 dot minh nam lom cua nguc - mat to, 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 ben trung ban, lan hon - nguc giua: co cap - au trung: hinh sau, - trung: hinh bau duc, co canh rat nho, hinh bau co sung dau nap, dinh cuc vao long/ duc - sinh co gai chitin co hinh - duc: 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 quang xung - benh dich hach: VK Yersinia nho, rat ngua quanh, rat ngua pestis = Pasteurella pestis gay 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 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: Benh nam ngoai bien Benh nam a da Benh nam duai da Benh nam noi tang Benh nam ca hoi Benh doc to nam - Dua vao phuong thuc sinh san huu tmh: lap Bang trung, sgi ta nam thong suot: Nam tao (Phycomycetes) Bang tui, sgi nam co ngan: Nam tui (Ascomycetes) Bang dam, sgi nam co ngan: Nam dam (Basidiomycetes) Khong co bo phan sinh san huu tmh: Nam khuyet (Adelomycetes) 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) Nam da (Dermatophytes): nam ua keratin thuoc hg Gymnoasceceae, chi: Trichophyton, Microsporum va Epidermophyton Nam luong hinh: dang hinh the: dang nam sgi va dang nam men a Sporothrix schenckii b Penicillium marneffei c Histoplasma capsulatum 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 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: Bao tu dmh lan: vach ngan nam ngang hay vach ngan dang muriform Bao tu d^nh nho: ii San xuat the binh: Phialophora, Phaeoacremonium iii Bao tu dmh nho hgp 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 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 tru choi/ bao tu dam - sinh san bang Dac diem va chuc - khong len men, dong choi a cuc tren nang hoa inositol day rong - san xuat ure, phan - sinh san da choi ung vai xanh khong xay diazonium B - 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 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 - 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 + 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 Benh hoc (trieu chung) 26 1/ mieng - hau: 1/ The phoi nguyen phat: 1/ benh lang ben: 1/ Benh & da nhan: - viem cac bo - ho, dau nguc, sot nhe, - dom da bi doi mau, - hac lao: thuong ton hinh vong lan rong, phan o mieng, xuat khac dom co mau, nhat mau hon/ nau bo hoi go cao co vay, mun rop, o giua hien cac dom trang met moi, sut can nhat co mau lot mang trang 2/ He TK trung uong: 2/ viem tang tiet ba: - vay rong: T concentricum moc o mem de troc, dau - nhuc dau, sot, k^ch - mang do, dong vay, diem roi lan dan ca than tru mat va dau; hong 2/ Thuc thmh mang nao, roi ngua 3/gau: da khong viem nhung troc vay tao nhieu quan va ruot: loan thi giac - bong vay da dau, vong tron dong tam - loet mang nhay co/3/ Da: ngua 4/ viem nang2/ Nam ben: (chu yeu & nam): ko co mang gia - not nhu, ko dau long: - noi mun, ban do, bo bong vay, rat ngua; - tieu chay, phan co - buou, ung loet, ban - rat ngua nhat la luc - - thuong ton doi xung ben ben, lan mau xuat huyet mo hoi/ tam; xuong dui: E.floccosum gay - soi bung, ngua hau3/ Xuong: mun nuoc, mun mu - mang o ben ko doi xung, lan xuong mon, hau mon dau - viem xuong, viem o nang long mong: T rubrum va T dai tien 3/ Am khop, co the khong 5/ nhiem trung mau: mentagrophytes ho - am dao: trieu chung - sot, tang bach cau, 3/ Nam chan: ke chan troc vay nhe, chay nuoc va - ngua, rat bong, giam tieu cau ngua, noi mun nuoc o long ban chan: T sung am ho, - kho tho, nhip tim mentagrophytes gay 4/ Nam mong: dang huyet trang duc cham, ngu lim, xanh - tu bo mong, ria mong, mong day va nhu sua, khong co t^m, nhip tho cong: T rubrum mui hoi, nhieu nhanh/ lach to - tu mat tren mong: T mentagrophytes mang trang 5/ Nam toc: 4/ da va niem mac: - kieu noi phat (bao tu nam than - mun khong co toc): bo ro ret, mang ban toc gay rung ngang muc vay da, ban do, bong vay chay nuoc da mung mu - kieu ngoaiphat (bao tu nam bao quanh 5/ Nam mong va viem quanh toc): toc gay rung cach da dau vai mm, mong: da dau viem - mong tro nen duc, - favus: T.schoenleinii: toc rung, dong 6/ mo sau: - benh Candida mau: + gia tang co dinh cua Candida spp + thay doi trnh nguyen ven cua niem mac + suy giam mien dich tai cho - benh Candida lan toa (a ngudi ung thu mau) Chan doan Dieu tri 1/ Lam sang: cac benh a da va - Tim vi nam 1/ quan sat bang mat 2/ cao vay1/ Xet nghiem truc tiep - lay vay phet KOH 10niem mac 2/ Xet nghiem: ddm, dich rua phe da, dung dd KOH 20%/ 20%, quan sat KHV 2/ Cay (MT Sabouraud co mang trang mieng, quan, phe nang/ dich dung bang keo dinh cloramphenicol va cycloheximid) - quan sat bot mong, huyet trang, nao da, coi KHV 3/ cay mau va mau,^ a/ Coi kinh hien vi 1/ Nhuom muc tau - xem 2/ Ly dinh danh nam (trong nudc muoi sinh l^) tam - Cay vao MT Sabouraud b/ Ly trich 3/ PP huyet - cloramphenicol - xem KHV 3/ PP huyet thanh: dung thu nghiem Latex - Uong: itraconazol1/ Phoi: 1/ Boi: selenium sulfid; 1/ Benh da nhan, nam ben, nam chan: boi va fluconazol - Amphotericin B ketoconazol; miconazol 2/ - dd BSI (acid benzoic, acid salicylic, - Ngam/ Boi: - Fluconazol 2/ Nao: Uong: Itraconazol hay iod) nystatin, - Amphotericin fluconazol - dan xuat imidazol: miconazol, clotrimazol, B+flucytosin 3/ Nhiem trung huyet: tiem tinh clotrimazol, ketoconazol amphotericin B - Fluconazol mach amphotericin B - Uong: Griseofulvin/ Terbinafin/ Itraconazol/ Fluconazol 2/ Choc dau, nam moc: uong nhu tren Ten va Ten Sporothrix schenckii (song khoa hoc hoai sinh) 27 Nam lu&ng hinh Penicillium marneffei Histoplasma capsulatum Nam moc gay benh (song ngoai sinh) Fusarium spp Zygomycetes Aspergillus spp (A fumigatus) dang sgi: trang- gay benh man tinh - hat men nho - ko mau, co vach - phat trien o- ua nhiet, phat trien o ban, tran/ nhan; cac TB, dai ngan, phan MT khong t0 > 370C bao tu hinh giot thuc bao, bach nhanh chua nuac, dang chuy cau dan nhan to - nhieu bao tu cycloheximi Dac diem va - dang nam men: - bao tu dmh nho: tren cuong d chuc nang trang vang kem; hinh tron/ giot bao tu dai, - bao tu lan: TB hinh dieu nuac tren bao thang dung, hinh thoi xiga, sinh san dai ngan moc len tu TB - bao tu nho: bang choi - bao tu d^nh lan: goc bau duc to, vo co gai/ dau mang bao - hit - hit, tiep xuc true tiep bao - hit (khong lay truc tiep - hit Duung lay nhiem tu nguoi sang nguoi) - dang nam men - bao tu - bao tu The lay nhiem - bao tu - bao tu - bao tu The phat tan - bao tu dmh nho (dang -bao tu MT nam sgi) - song hoai sinh - dat, phan dai, phan chim bo Noi song chinh cau,^ 1/ The da — mach bach - sot, chan an, 1/ Xo nhiem phoi: 1/ cuong phoi di ung, viem1/ viem giac mac, nam1/ nhiem nam o xoang huyet (benh man tinh): - giam bach - dau nguc, khan xoang mui, cuon nam, da, nam mong 2/ mui 2/ viem phoi 3/ tu not - tim den, cau, giam co, met moi, sot hen suyen 2/ viem giac nguoi suy giam nhiem nam lan toa mem, mu set vang, lan tieu cau vua, dau bap thit, mac, noi nhan: bat dau mien dich: sot keo 4/ viem da 5/ viem theo mach bach huyet - sut can, tieu dau khap xuang la cuc nho hai go cao, dai, viem cac ca mang bung 6/ viem 2/ The da co dinh: chay, gan 2/ Benh phoi man tinh: trang xam, xung quanh quan so ca quan khac - vet loet u hat o lach to - ho khac dom co co vong rong xam - cay mau duang tinh Benh hoc vi tri tiep xuc - viem hach mau, kho tho, nhat - dau nhuc mat, (trieu (mat); not ve bach huyet sot, suy ho hap 3/ vet loet, de boc chung) tinh mung mu - da: xuat Dang lan toa: tung mang, loet ap xe xung quanh hien cac - noi hach toan 3/ viem ong tai ngoai 4/ 3/ The lan toa: mun nuac than, gan lach to, viem ca tim va mang - cuc u nho, cung, co ron o ton thuang tim (o van DM ti loet trung tam xuang, tuy, he chu, van la) 4/ The nguyen phat & TK, tim, mat, phoi (do hit bao tu): noi than hach - 28 5/ sot keo dai: 38oC 5-7 3/ ho, kho tho, ho mau, dau nguc 4/ xoang, gan, he TK trung uong: co van de 5/ chup X quang: co not hay ap xe Chan doan 1/ Quan sat true tiep: hat 1/ Lam sinh thiet mau,1/ Lam sang: X quang giong1/ Quan sat truc tiep dom 1/ Lam sang 2/ Chup X1/ Xet nghiem truc tiep: men dai hinh dieu xiga, da - nhuom PAS nhu lao 2/ Phan ung noi2/ Cay, ly trich tu dom/ cay quang 3/ Ly trich, dom, dich mui, dich the nhieu canh hay May Grunwald bi vai Histoplasmin (+) mau am t^nh vai cac sinh thiet mo rua phe nang, mo 2/ 2/ Cay (MT Sabouraud; - Giemsa 2/ Cay 3/ Xet nghiem: VK gay benh 3/ Trac Cay thach BHI hay thach MT Sabouraud - coi - coi vet loet, nghiem da vai khang mau) - coi KHV 3/ Gay KHV nhuom hay vi nguyen 4/ PP huyet nhiem tren thu: TB men 3/ Mien dich khuyet tan phau (giong cot hoc 5/ Thu bat mau Gram (+), dai 2) nghiem tim khang the/ nhu dieu xi ga - Cay MT khang nguyen Sabouraud 6/ Phan ung PCR 1/ The da: 1/ Amphotericin B (+ 1/ Amphotericin B: tiem nho1/ Benh di ung: nhe 1/ Amphotericin B 2/ 1/ Cap tinh: - dd KI bao hoa flucytosin) giot vao tinh mach 2/ - Prednison Natamycin: viem Amphotericin B + - Itraconazol 2/ Itraconazol hay Itraconazol 2/ Benh cuon nam o’ phoi, giac mac phau thuat 2/ Man - Fluconazol 2/ ketoconazol viem noi nhan, o da: tinh: Phoi: Amphotericin B 3/ - KI bao hoa - Itraconazol: nhe Hoai tu phoi cap: - Ketoconazol Dieu tri - Amphotericin - Amphotericin B - Itraconazol B: nang 3/ + phau thuat cat 4/ Xuang - khap: bo mo 4/ Viem Fluconazol nhu phoi xoang mui: - phau thuat cat bo - Itraconazol Ten va Ten khoa hoc Nam soi mau (Dematiaceous _ fungi) 29 Dac diem va chuc nang Duung lay nhiem The lay nhiem The phat tan MT Noi song chmh Benh hoc (trieu chung) cho mau toi tu oliu, nau den den sac to dihydroynaphthalen melanin o TB 1/ Benh o da va mong: chi anh huong phan mo sung hoa, mong sam mau, viem quanh mong 2/ Viem giac mac, co the gay mu, gap nhieu o nam gioi 3/ Viem xoang mui di ung, man tinh hay cuon nam mui xoang Chan doan 1/ Quan sat truc tiep: nhuom voi KOH 10-20% hay Giemsa, Schiff, 2/ Cay (MT Sabouraud), thach mau 3/ Chup X quang 1/ Viem giac mac: 2/ Viem xoang mui di ung: - dd natamycin 5% - phau thuat + nho nudc muoi sinh l^ - Amphotericin B 0.1-1% 3/ Viem xoang mui man tmh: - Azol: Miconazol, Ketoconazol, - phau thuat + chat khang nam 4/ Cuon nam mui Itraconazol, Fluconazol xoang: - Corticosteroid + chat khang nam - giai phau, khong can thuoc khang nam Dieu tri Doc to Afatoxin - Nam moc gay benh A.flavus, A.parasiticus, A.nomius Aflatoxin B1, B2, G1 va G2 Aflatoxin B1: doc tinh cao nhat Afatoxin M1 va M2: sua bo Noi song chmh Benh hoc - hat dau phong, hat bap, ke, 1/ Benh cap: ho dao - Viem gan cap tinh: an bap: vang da, sot nhe, suy - hat ngu coc, gao, rau, trai cay nhuoc, chan an, tieu chay, thoai hoa chat beo o gan - ruou vang, bia, sua - Benh Kwashiorkor, hoi chung Reye’s: 2/ Benh man tmh: - Ung thu gan: aflatoxin B1, dot bien gen p53, chuyen G T o vi tri cua codon 249 - lua mach, hat ca phe - gay doc than va gan Ochratoxi - A.ochraceus, Penicillium n verrucosum A o thu (heo, chuot) Trichothecen - Fusarium Ochratoxin spp., Trichothecium, Trichoderma, Stachybotrys, - 30 gay benh giam bach cau (ATA): teo xuong, mat bach cau hat, viem hong hoai tu, xuat huyet non mua, tieu chay, dau bung dom xuat huyet o da, xoang mieng, phinh hach bach huyet Fumonisin - 31 Fusarium moniliforme, F proliferatum uc che N-acyltransferase - bap va thuc pham chua bap - ung thu thuc quan o nguoi ung thu gan o chuot cong, phu phoi o lon, benh nao o ngua 28 [...]... 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:... - 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... 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... 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... 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... (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%),... 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,... 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 -... 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... clotrimazol, ketoconazol amphotericin B - Fluconazol mach amphotericin B - Uong: Griseofulvin/ Terbinafin/ Itraconazol/ Fluconazol 2/ Choc dau, nam moc: uong nhu tren Ten va Ten Sporothrix schenckii (song khoa hoc hoai sinh) 27 Nam lu&ng hinh Penicillium marneffei Histoplasma capsulatum Nam moc gay benh (song ngoai sinh) Fusarium spp Zygomycetes Aspergillus spp (A fumigatus) dang sgi: trang- gay benh man