🔴Trematodes are flat helminths (flatworms). One of the most important trematodes is Schistosomiasis.
There are three main species of Schistosoma:
*Schistosoma mansoni: causes intestinal schistosomiasis and may involve the liver, leading to hepatic fibrosis.
*Schistosoma japonicum: causes intestinal schistosomiasis and is common in Japan . It may also affect the liver and cause fibrosis.
*Schistosoma haematobium: affects the urinary bladder and may lead to squamous cell carcinoma of the bladder.

الدكتور عنده حاجات يضيف فيها وينبه عليها ف الmcq وحاط ف كُل شيت ليه سلايد ينبه ع هذا الشئ ف ضروري تشوفوا ملاحظاته❗❗.

ملاحظات جزئية الnematode🐛✅:

Pharma| Cholinergic💊المحاضرة الأولى


🔴Acetylcholine is synthesized in the nerve endings of preganglionic neurons.

🔴Botulinum toxin (Botox) is the toxin used in cosmetic injections. When it is injected into the face or other areas for cosmetic purposes, it blocks the release of acetylcholine at the neuromuscular junction. This prevents muscle contraction, causing temporary muscle relaxation. As a result, facial wrinkles become less visible and the skin appears smoother. Its effect is temporary and usually lasts for a limited period.
In short:
Botulinum toxin blocks the release of acetylcholine, leading to temporary muscle relaxation.❗MCQ❗❗.

🔴receptors➡️✨أنواعهم قالت الدكتورة مروا عليهم نجيب فيهم✨

🔴M2➡️present mainly in cardiac muscle.❗mcq❗.


🔴the M1, M3 and M5 receptors are excitatory,M2 and M4 receptors are inhibitory.❗MCQ❗..

Pharma| Cholinergic 💊المحاضرة الثانية

🔴Muscarinic agonists➡️ cause vasodilation, not vasoconstriction, in blood vessels.❗MCQ❗..

Pharma| Cholinergic 💊المحاضرة التالثة

🔴Alzheimer's disease is associated with low levels of acetylcholine in the brain.

🔴Myasthenia gravis is associated with impaired acetylcholine action at the neuromuscular junction due to destruction of acetylcholine receptors.

🔴Parkinson's disease is associated with an imbalance between dopamine and acetylcholine, caused mainly by dopamine deficiency in the basal ganglia.

🔴Musscarinic Antagonists(Parasympatholytics)➡️treatment of Parkinson's disease➡️benztropine_Orphenadrine_benzhexol.

🔴Malignant Hyperthermia➡️mcq

Cholinergic➡️قالت الدكتورة تقريبياً 15 السؤال ف الفاينل

ملاحظات الدكتورة ف ال cholinergic✅.

طريقة اسئلة كوز الExamination من دفعة سابقة ⤴️:

Patho| cell tissue repair

🔴In the skin, the stem cells are called basal cells.
In the lung, the stem cells that regenerate the alveoli are called alveolar stem cells
They can differentiate into:
Type I pneumocytes
Type II pneumocytes

🔴Collagen type I is mainly found in bone.

🔴Collagen type II is mainly found in cartilage.

🔴Collagen type III is mainly found in reticular fibers.

🔴Collagen type IV is mainly found in the basement membran

🔴Day 1: neutrophils migrate toward fibrin clot,basal cells undergo mitosis➡️❗❗MCQ❗❗.

🔴Day 2➡️ epithelial cells from edges migrate proliferate along dermis depositing basement membrane result in thin epidermal layer.❗MCQ❗.

🔴Day 3➡️neutrophils replaced by macrophages with granulation tissue formation. Epithelial proliferation yield thick epidermal layer.

🔴The most common Factor cause delay repair is Infections.

🔴In normal healing by scar formation, the scar is usually flat.
This is the normal outcome of wound healing.
However, if collagen deposition continues excessively and does not stop properly during repair, it leads to a raised scar.


🔴There are two types of raised scars:

1_Hypertrophic scar➡️It does not extend beyond the borders of the injury.

2-Keloid➡️It grows outside the borders of the wound.


🔴Fat embolism (from the bone marrow)➡️❗❗MCQ❗❗..

قالت الدكتورة اي حاجة ف شيتها مدايرة عليها علامة الstar هذه* معناها هي الmost common

زي مثلاً أهني ،لو جابت The most common Factor cause delay repair is Infections❗❗.
حتى لو حطت الباقي ف الخيارات ،تعتبر الinfection هي الmost common.

ملاحظات شيت الcell tissue repair✅.

Para|المحاضرة الأولى في Trematode

🔴miracidium survives for only 24 hours; after that, it dies. During this time, it must find and penetrate a suitable snail host to continue its life cycle.


🔴Schistosomiasis
Schistosoma mansoni and Schistosoma japonicum inhabit the venous plexuses of the intestinal blood vessels, particularly around the superior and inferior mesenteric veins.
In other words, their habitat is the mesenteric venous plexus surrounding the intestine.
ملاحظة :قال كلمة intestine بروحها متسدش❗..


🔴has two possible pathways, and one of them is considered dangerous.
🔴One pathway is through the portal vein to the liver(not retrograde)
However, the adult male and female worms migrate in the opposite direction (retrograde) to the venous plexuses around the intestine.

🔴In Schistosomiasis, the main cause of pathology is the eggs, not the adult worms.
When the eggs are carried back to the liver, this becomes dangerous because they trigger granuloma formation and chronic inflammation.
The inflammatory infiltrate mainly consists of plasma cells, ostyocyte, and lymphocytes.

🔴Schistosomiasis, the eggs inside the granuloma are not easily destroyed. As a result, the chronic granulomatous inflammation gradually leads to fibrosis.
Therefore, one of the main complications of intestinal schistosomiasis is liver fibrosis.

🔴The characteristic feature of fibrosis in intestinal schistosomiasis is Symmers’ pipe-stem fibrosis.

🔴Swimmer’s itch (dermatitis) and fever are common features.
When fever is associated with generalized lymphadenopathy, it suggests infection with Schistosoma japonicum rather than Schistosoma mansoni.
This acute presentation is called Katayama fever.

🔴It is transmitted in less than 0.1% of cases through the buccal route, not the fecal–oral route.

🔴Urinary schistosomiasis is caused by Schistosoma haematobium.
Its habitat is the blood vessels around the urinary bladder, especially the vesical venous plexus, and it may also involve the vessels around the ureters and kidneys.
قال الدكتور لو قلت urinary bladder or kidney or ureter ح تاخد صفرر❗لأن لازم تقول vessels around the ureters and kidneys.

🔴Urinary schistosomiasis, caused by Schistosoma haematobium, has two possible pathways.
Eggs may be excreted in the urine, or they may remain in the urinary tract, especially in the bladder, and also involve the ureters and kidneys. The urinary bladder is the most commonly affected site.
The trapped eggs trigger granuloma formation, and instead of leading to fibrosis, they can predispose to squamous cell carcinoma of the bladder.
Note: The most common type of bladder cancer is transitional (urothelial) carcinoma, except in schistosomiasis, where squamous cell carcinoma is more common.

🔴Egg morphology helps in identifying the type of schistosomiasis:
If the egg has a lateral spine, it indicates Schistosoma mansoni.
If the egg has a small lateral spine (or knob-like spine), it suggests Schistosoma japonicum.
If the spine is terminal (at the posterior end)perpheral, it indicates Schistosoma haematobium, which is associated with urinary schistosomiasis.

🔴Complications include hematemesis (vomiting blood), which may occur due to esophageal varices.
It can also lead to ascites in the peritoneal cavity and splenomegaly.

ملاحظات جزئية الTrematod يلي أعطاها د.العجيلي✅.

Para| Trematod المحاضرة الثانية

🔴In trematodes, the infective stage is usually the metacercaria, except in Schistosoma.
In most trematodes, the infective stage for humans is the metacercaria.
In Schistosoma, the infective stage is the fork-tailed cercaria.

🔴Life cycle➡️قالت الدكتورة تجيب منها ف الاسئلة

🔴In flatworm infections, eggs usually do not appear in the stool until about 3–4 months after infection.
This creates a problem in the early stage of infection, because if a stool analysis is performed too soon, no eggs will be found. As a result, the diagnosis may be missed or incorrectly excluded.
There is also a problem in the late stage of infection. Eggs may not be detected in the stool because obstruction can prevent them from passing into the intestine.

🔴Clinical presentation ➡️تجيب فيها ف ال❗❗MCQ❗❗.

🔴The patient presents with pain and jaundice due to obstruction.
If medical treatment does not resolve the problem, an endoscopic procedure can be performed. The endoscope is passed through the duodenum to the ampulla, and the obstructing worm is removed.❗❗MCQ❗❗.

🔴Praziquantel, which is active against most trematodes (flukes), typically is not active against Fasciola parasites, and therefore, it is not recommended for fascioliasis.

🔴In Echinococcus granulosus infection (hydatid disease), prevention of hydatid cysts is more important than treating humans as a source of transmission.
Humans are accidental intermediate hosts and do not pass eggs in the stool.(Treatment of human not important).. Therefore, humans do not contribute to the transmission cycle. For this reason, prevention should focus on breaking the life cycle between dogs and livestock rather than treating humans as a source of infection.➡️قالت الدكتورة جابتها قبل ف ال❗mcq❗

Para| Trematod المحاضرة التالثة

🔴The difference between a vector and an intermediate host؟
قالت الدكتورة مفيش فرق بينهم غير لأن حشرة ف سميناهاvector

🔴Prevention and control➡️مهم جداً وركزت عليها الدكتورة

🔴The patient presents with abdominal pain, diarrhea, and may develop seizures.
If the patient gives a history of eating salted fish, the first test to request is CBC.
This is because the eggs may migrate to ectopic sites, and eosinophilia is commonly present.➡️❗❗MCQ❗❗..