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WorksheetsClinical Parasitology
Total questions: 77
Worksheet time: 58mins
What is the motile, feeding, and reproducing stage of protozoa called?
Oocyst
Cyst
Trophozoite
Ova
Which amoeba genera have chromatoidal bodies in the cyst stage?
Dientamoeba and Entamoeba
Endolimax and Dientamoeba
Iodamoeba and Entamoeba
Endolimax and Iodamoeba
Amoebiasis is primarily caused by which organism?
Endolimax nana
Entamoeba coli
Iodamoeba butschlii
Entamoeba histolytica
Extraintestinal amoebiasis most commonly involves which organ?
Lungs
Brain
Kidneys
Liver
Which statement characterizes true amoebae?
Peripheral chromatin on the nuclear body
None of the statements are correct
Chromatin bodies in the trophozoite
Include pathogenic and nonpathogenic species
Which organism is a true amoeba?
Endolimax nana
Entamoeba hartmanni
Iodamoeba butschlii
Dientamoeba fragilis
In the human GI tract, which stage is nonmotile, nonfeeding, and infective for most amoebae?
Precyst
Trophozoite
Cyst
Metacyst
Trophozoites of Entamoeba histolytica typically show which nuclear feature?
Progressive motility with hyaline pseudopods
All listed characteristics
Fine even peripheral chromatin
Small delicate nuclear chromatin
Which pathogenic trophozoite is most likely to ingest host red blood cells?
Entamoeba coli
Entamoeba histolytica
Entamoeba hartmanni
Endolimax nana
A key differentiator between Entamoeba histolytica and Entamoeba hartmanni is which feature?
Presence of peripheral chromatin
Presence of chromatoidal bodies
Only a cyst stage present
Overall organism size
A cyst that possesses a single nucleus and a glycogen vacuole stained with iodine is
Entamoeba nana
Iodamoeba butschlii
Dientamoeba fragilis
Escherichia coli
Some amoebae have spiny, hyaline extensions called
Acanthopods
Cribriform plates
Limax form
Pseudopods
Naegleria has which characteristic?
Found in mucous membranes
Trophozoite can assume limax form
None of the above
Trophozoite can become amoeba flagellate
Intestinal flagellates are usually which shape in the trophozoite stage?
Round
Crescent shaped
Oval
Pear shaped
Which of the following is pathognomonic of Giardia lamblia and the stage found in?
Ventral sucking disc — trophozoite
Cytosome — cyst
Undulating membrane — trophozoite
Spiral groove — trophozoite
Infection with Dientamoeba fragilis can show which symptom?
Nausea
Body malaise
Asymptomatic
All of the above
None of the above
Which flagellates can be pathogens of the small intestine?
Entamoeba
Trichomonas
Giardia
None of the above
All of the above
Amoebae inhabiting the CNS enter the body through the
Eyes
Nasal mucosa
Mouth
Ears
In which specimens are Acanthamoeba and Naegleria usually found?
All of the above
Brain tissue
CSF
Blood
All of the following are false regarding atrial flagellates basic structure, except which set? I. Flagellum II. Kinetoplast III. Blepharoplast IV. Pseudopodia V. Cytostome VI. Axial rod VII. Undulating membrane VIII. Costa IX. Parabasal body
IX, VI, III, V, II, VII, I, and VIII
III, VIII, IX, VII, IV, V, I, VI, and II
I, IX, V, IV, VI, II, III, and VIII
VIII, III, IX, IV, I, VII, II, and VI
What does Dientamoeba fragilis share with Trichomonas vaginalis?
Both are ciliate protozoa
Both can appear as urine contaminants
Neither has a cyst form
All of the above
Which intestinal flagellate trophozoite has a sucking disc, two nuclei, eight flagella, and an axostyle?
Giardia intestinalis
Lamblia duodenalis
Lamblia intestinalis
All of the above
None of the above
Red and white blood cells in stool specimens are characteristic of which condition?
None of the above
Giardiasis
Dysentery
Steatorrhea
A pear-shaped flagellate with jerky motility identified in urine is most consistent with which organism?
Chilomastix mesnili
Trichomonas hominis
Giardia duodenalis
Trichomonas vaginalis
Eighty percent of Dientamoeba fragilis trophozoites possess how many nuclei?
Two nuclei
Three nuclei
No nucleus
One nucleus
Which single finding best explains right upper quadrant pain with a mildly vascular hypoechoic hepatic mass on ultrasound?
Hepatic hemangioma
Pyogenic liver abscess
Focal nodular hyperplasia
Simple hepatic cyst
Considering the CT findings of large hypodense hepatic lesions with central fluid density, which complication should be prioritized for monitoring?
Portal vein thrombosis
Septic dissemination
Spontaneous hepatic rupture
Adrenal crisis
Which social history element most increases risk for parasitic hepatic infection in this patient?
Occupational exposure denied
No prior diarrheal illness
No sick contacts reported
Recent immigration from Venezuela
Which single test result most strongly supports an inflammatory process in this case?
Total bilirubin 0.3 mg/dL
Erythrocyte sedimentation rate 107 mm
C-reactive protein 9.70 mg/dL
Alanine transaminase 131 U/L
CT images show multiple hypoenhancing hepatic lesions with sizes 79×82 mm, 78×55 mm, and 24×30 mm, plus a left adrenal nodule 11×9.1 mm. Serology is ELISA-positive for antigen of a certain protozoan parasite and negative for Echinococcus. What is the most likely diagnosis?
Hepatic hemangiomas with necrosis
Hydatid cyst disease of the liver
Pyogenic multiloculated liver abscess
Amoebic liver abscess due to E. histolytica
Metastatic colorectal liver lesions
Which is the most concerning immediate complication of an untreated amoebic liver abscess in this patient with large right-lobe lesions?
Massive hemobilia from cystic artery erosion
Hepatic encephalopathy due to ammonia rise
Portal vein thrombosis with cavernous transformation
Autoimmune cholangitis from immune complex deposition
Rupture into the peritoneal cavity causing peritonitis
Match the virulence factors of Entamoeba histolytica: I. Cysteine proteinase II. Ventral sucking disc A. Cytopathic B. Cytoadherence C. Pores forming. Choose the correct pairing.
I and A
II and C
I and C
I and B
II and A
Which is the treatment of choice for invasive amoebiasis presenting with liver abscess?
Doxycycline for intracellular bacteria
Tinidazole for tissue infection
Omeprazole for acid suppression
Albendazole for tissue nematodes
Paromomycin as monotherapy
After initial tissue-active therapy for amoebic liver abscess, which luminal agent is recommended to eradicate intestinal colonization?
Albendazole for ten days
Metronidazole lifelong suppression
Nitazoxanide single dose
Tinidazole for four weeks
Paromomycin for seven to ten days
Which stool concentration technique is recommended for identifying Entamoeba cysts in preserved samples?
Kato-Katz thick smear technique
Merthiolate-iodine-formalin concentration (MIFC)
Direct saline wet mount only
Cellophane tape test method
Formalin-ether concentration technique (FECT)
All listed amoebae are commensal in humans except which pathogen?
Entamoeba histolytica is pathogenic
Entamoeba coli is commensal
Dientamoeba fragilis is commensal
Entamoeba dispar is commensal
Endolimax nana is commensal
Which defensive layer of the Entamoeba cyst resists high pH?
Cystein proteinase
Lectin protein coat
None of the above
Hyaline cystic wall
Which morphologic form of Entamoeba histolytica is found in soft stool?
Schizont stage
Cyst stage
Ova stage
Trophozoite stage
A 61-year-old with colicky abdominal pain and watery diarrhea shows a pear-shaped protozoan with ventral sucking disc in stool. What is the causative agent of this disease?
Entamoeba histolytica
Dientamoeba fragilis
Giardia lamblia
Entamoeba dispar
Escherichia coli
What is the most likely diagnosis for the patient described, considering small intestinal wall thickening and response to metronidazole?
Amoebiasis
Trichomoniasis
Giardiasis
None of the above
This protozoan typically inhabits which part of the gastrointestinal tract?
B and C
Upper ileum
Jejunum
Duodenum
Lower ileum
The large ventral sucking disc is the ________ of this protozoan.
Pathogenic determinant
All of the above
Pathognomonic feature
Virulence factor
Which non-invasive laboratory procedure can obtain duodenal content to aid identification of this protozoan?
C and D
Enterotube test
String test
Fine needle aspirate biopsy
Direct fecal smear
Which clinical feature best explains the patient’s relief of pain after defecation in this infection?
Appendiceal obstruction
Hepatic abscess formation
Small-bowel gas and distension
Colonic ulceration with bleeding
Which laboratory finding supports malabsorption in this case of giardiasis?
High C-reactive protein level
Elevated serum amylase level
High eosinophil count
Low total protein and albumin
Which feature on wet mount best distinguishes Giardia trophozoites?
Cyst with four nuclei observed
Leukocytes surrounding trophozoites
Prominent ventral sucking disc visible
Single nucleus with central karyosome
What is the diagnostic stage of this protozoan detected on microscopy?
Ova only
Cyst and/or ova
Trophozoite and/or ova
Cyst only
Trophozoite and/or cyst
‘Passage of greasy, frothy stool’ is most often associated with chronic infection. Which option lists this description?
Diarrhea
Steatorrhea
Traveller’s diarrhea
Fat globules
A, B and C
Which odor is often associated with acute infection by this protozoan?
Rotten meat
None of the above
Rotten vegetable
Rotten egg
Rotten fish
Which drug is NOT a second-line therapy for this protozoan?
Furazolidone
Vancomycin
Quinacrine
Tinidazole
Paromomycin
How does this protozoan multiply?
Mitosis
Binary fission
Binary longitudinal fission
All of the above
None of the above
A 35-year-old male has urethral discharge and dysuria after multiple sexual partners and inconsistent condom use. Urethral swab shows trophozoites, and symptoms resolve after a single 2 g dose of oral metronidazole within a week. What is the most likely diagnosis?
Chlamydia
Gonorrhea
Giardiasis
Syphilis
Trichomoniasis
In the male reproductive system, which site does this protozoan commonly inhabit?
Glans penis
Prostate gland
Bulbourethral gland
Seminal vesicles
Vas deferens
A female patient presents with red, punctate lesions of the cervix in the same infection. What term is used for this finding?
Edematous cervix
None of the above
Strawberry cervix
Inflamed cervix
Cervical erosion
Which douche type uses 10% vinegar to clean the female reproductive tract and eradicate infection?
Basic douche
Acidic douche
Neutral douche
Saturated douche
Hypertonic douche
Which prevention strategy is best known to control this protozoan infection?
Abstinence
Using condom
4Cs
Case finding
Choice and number of sexual partners
A 30-year-old woman who kept her contact lenses in tap water developed severe retinitis. Culture of the water and vitreous fluid would most likely reveal which organism?
Naegleria spp.
Entamoeba spp.
Balantidium spp.
Acanthamoeba spp.
Charcot–Leyden crystals in stool are thought to be formed from the breakdown products of which cells?
Lymphocytes
Neutrophils
Monocytes
Eosinophils
Which vector transmits a parasite only after the parasite completes development within the host?
Phoretic vector
Biologic vector
Mechanical vector
Paratenic host
Which option only transports parasites without development occurring?
Phoretic vector
Biologic vector
Definitive host
Paratenic host
What term refers to the number of individuals estimated to be infected with a particular parasite?
Worm burden
Prevalence
Incidence
Cumulative prevalence
What term refers to the number of new cases of infection in a given period?
Cumulative prevalence
Epidemiology
Incidence
Worm burden
Which term is the number of worms per infected person?
Worm burden
Epidemiology
Morbidity
Cumulative prevalence
Which metric is the percent fall in egg counts after deworming?
Cure rate
Deworming
Egg reduction rate
Epidemiology
Which metric is the percent of previously positive subjects who become egg-negative?
Cure rate (%)
Epidemiology
Egg reduction rate
Deworming
Which approach is deworming at the individual level?
Targeted treatment
Universal treatment
Selective treatment
Global treatment
Which approach is treatment at the group level?
Selective treatment
Targeted treatment
Global treatment
Universal treatment
What is the proportion of the target population reached by an intervention called?
Effectiveness
Efficacy
Efficiency
Coverage
Measure of the effect of a drug against an infective agent.
Efficiency
Efficacy
Coverage
Effectiveness
A health education strategy that aims to encourage people to adapt and maintain healthy life practices.
Information-education-communication
Environmental management
Environmental sanitation
Sanitation
Planning, organization, performance, and monitoring of activities for the modification and/or manipulation of environmental factors.
Information-education-communication
Environmental management
Sanitation
Environmental sanitation
Interventions to reduce environmental health risks.
Sanitation
Environmental management
Environmental sanitation
Information-education-communication
Permanent reduction to zero of the incidence of infection caused by a specific agent, as a result of deliberate efforts.
Eradication
Elimination
All of the above
Reduction
Reduction to zero of the incidence of a specified disease in a defined geographic area as a result of deliberate efforts.
Reduction
All of the above
Elimination
Eradication
Locomotor apparatus of atrial flagellates.
Cilia
Flagella
Pseudopodium
All of the above
“Old-man with eyeglasses”.
Giardia lamblia
Giardia intestinalis
All of the above
Giardia duodenalis
Lamblia intestinalis
Ectoparasite.
Neither A nor B
both A and B
Infestation
Infection
