Remedial (UMMP, Stage 2)

​Dr. Amirah Amir

​Remedial Class

(Parasitology)

UMMP, Stage 2

Multiple Select

This is a vector borne disease.

• Toxoplasmosis

• Malaria

• Giardiasis

• Cysticercosis

• Visceral leishmaniasis

Multiple Choice

Why are other stages of this Plasmodium species not seen in peripheral blood smear?

• They cannot develop in human blood

• They are sequestered in the microvasculature

• The heat from the skin drives them away

• They are eaten up by macrophages

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• ​Mature forms change the surface properties of infected RBC, causing them to stick to blood vessels (cytoadherence) → sequestration. This leads to obstruction of the microcirculation and results in dysfunction of multiple organs, typically the brain in cerebral malaria.

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• ​ As a result of this cytoadherence, the only asexual Plasmodium falciparum parasites found in peripheral blood smears are young (ring) stage parasites because their host RBCs do not yet have knobs and therefore do not cytoadhere to the microvascular endothelium.

Multiple Choice

Which of the following is the vector for malaria?

• Sandfly

• Tsetse fly

• Anopheles mosquito

• Reduviid bug

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• ​Only female mosquito feed on blood (to produce eggs)

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• ​Sandfly - Leishmania spp.

• ​Tsetse fly - Trypanosoma brucei (African trypanosomiasis/ African sleeping sickness)

• ​Reduviid bug - Trypanosoma cruzi (American trypanosomiasis/ Chagas' disease)

Multiple Select

Which of the following malaria species can cause relapse?

• Plasmodium falciparum

• Plasmodium vivax

• Plasmodium knowlesi

• Plasmodium malariae

• Plasmodium ovale

Multiple Select

This parasite can affect the central nervous system.

• Toxoplasma gondii

• Cryptosporidium parvum

• Trichomonas vaginalis

• Sarcoptes scabiei

• Taenia solium

Multiple Choice

Cerebral malaria is a complication caused by this infection.

• Plasmodium vivax

• Plasmodium malariae

• Plasmodium falciparum

• Plasmodium ovale

Multiple Choice

How do you acquire cysticercosis?

• Ingestion of uncooked beef containing tapeworm larva

• Ingestion of uncooked pork containing tapeworm larva

• Ingesting food/water contaminated with Taenia saginata eggs

• Ingesting food/water contaminated with Taenia solium eggs

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​Any organ or tissue may be involved, the most common being subcutaneous tissues, brain and eye.

Multiple Choice

Granulomatous amoebic encephalitis (GAE) usually affects immunocompromised patients

• True

• False

Multiple Select

This is a risk factor for acquiring amoebic keratitis.

• wearing contact lenses longer than you are supposed to

• cleaning contact lenses with homemade saline solutions

• touching contact lenses without first washing your hands

• cleaning contact lenses with regular water

Multiple Choice

This is a risk factor for primary amebic meningoencephalitis (PAM).

• Diving into hot spring

• Wearing contact lenses

• Swimming underwater in the sea

• Playing in the sand

Multiple Select

Disseminated strongyloidiasis

• is usually fatal if not treated

• is a common complication in immunocompetent patient

• is diagnosed by detecting the ova in stool

• is caused by the spread of filariform larvae in various organs

• ​Rule out the presence of strongyloidiasis before starting steroids or other immunosuppressive therapy.

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• ​Otherwise, patients can develop disseminated strongyloidiasis or hyperinfection syndrome. These conditions are potentially fatal.

Multiple Select

How do humans acquire toxoplasmosis?

• Drinking water contaminated with oocysts

• Bite of an infective sandfly

• Skin penetration by L3 larvae

• Eating medium-rare steak containing cyst

Multiple Select

Cryptosporidiosis in patients with AIDS

• presents with profuse chronic diarrhoea

• is treated with metronidazole

• improves with anti-retroviral therapy by increasing the host’s immune status

• is diagnosed via serology

Multiple Choice

Trichomonas vaginalis infection (trichomoniasis)

• is diagnosed via microscopic examination of the stool

• is treated with metronidazole

• does not cause symptoms in males

• is transmitted via faecal-oral route

​In males, it may produce urethral discharge and dysuria. Some may develop:

• Urethritis

• Epididymitis

• Prostatitis

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​In females, it may produce:

• Severe itching in the genital area 

• Foul smelling yellowish green frothy discharge

• Dysuria

• Dyspareunia

• Colpitis macularis or “strawberry cervix”

Multiple Select

Choose the correct statement regarding Entamoeba histolytica.

• It is the most common intestinal parasite seen in male homosexual communities throughout the world

• Its infection is acquired through ingestion of trophozoites

• Its infection is treated with metronidazole

• Amoebic liver abscess is a complication of its infection

Multiple Select

This is a clinical manifestation of giardiasis.

• Diarrhoea

• Steatorrhea

• Dysentery

• Dyspareunia

Multiple Choice

This infection is diagnosed via microscopic examination of stool

• Trichominiasis

• Toxoplasmosis

• Trichiuriasis

• Granulomatous amoebic encephalitis

• Visceral leishmaniasis

Microscopic examination of vaginal/urethral secretion​ to look for trophozoites

Serology

Microscopic examination of stool to look for eggs (barrel shaped, bipolar plugs)

Microscopic examination of CSF/brain tissues to look for cyst/trophozoites

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​Culture

Microscopic examination of blood/bone marrow aspirate/spleen imprint to look for amastigotes (LD bodies)