CAGAYAN STATE UNIVERSITY

COLLEGE OF MEDICINE & SURGERY

DEPARTMENT OF MICROBIOLOGY & PARASITOLOGY
PARASITOLOGY LECTURE
MIDTERM EXAMINATION
MARCH 7, 2014

NAME: ___________________________________________________ SCORE: _______/100

Surname First Name MI

INSTRUCTION: Choose the BEST answer from the given statements/clinical cases by writing CAPITAL
LETTERS on the space provided BEFORE the number. NO ERASURES.

1. Which of the following statements does not correctly describe the morphological characteristic of
Pinworm?
a. Its eggs has an inner triple albuminous covering
b. The rhabditiform larvae has an esophageal bulb but no cuticular expansion
c. Female worm is rarely seen because they die after copulation
d. Male worm has a curved tail with a single spicule
e. None of the above

2. Which of the following correctly describe Ascaris lumbricoides?

a. Holomyarian type of somatic muscle arrangement.
b. Female worm has a ventrally curved posterior end with 2 spicules
c. Male worm has double, long tortous tubule
d. Adult worms has a terminal mouth with 3 lips and sensory papillae.
e. None of the above.

3. Andres Pasiwat, a 7 year old pupil at Cataggamman Central School, is frequently observed of
scratching his perianal area by his teacher usually during the last period of class. Mr. Pascua, his
teacher subsequently referred him to the school clinic. Diagnostic tests were requested and found out
that he suffers oxyuriasis. Dr. Astudillo then prescribed Mebendazole (125mg/5ml; Weight 22 kg) to the
patient at this dosage.
a. 5 ml 2x a day for 2-4 weeks
b. 3.52 ml 2x a day for 2-4 weeks
c. 4.4 ml 2x a day for 1 week
d. 3.52 ml 2x a day as Single Dose
e. None of the above

4. The most frequent complaint in Acariasis?

a. Intestinal Volvulus
b. Intussusception
c. Lung infiltration
d. Asthmatic attacks
e. None of the above

5. In oxyuriasis, what stage of larvae hatch in the small intestine?

a. Unembryonated egg
b. Embryonated Egg
c. Fertilized Egg
d. 3L
e. None of the above

6. Mr. Salud, 24 year old law student came up to consult Dr. Shuhuki with complaints of intermittent blood
streaked diarrhea accompanied by abdominal pain & tenderness, Nasusea and vomiting, anemia and
weight loss. Direct Fecal Smear was requested which revealed eggs with a “Japanese Lantern
Appearance”. What yould his physician prescribe?
a. Mebendazole 250 mg 3 x a day for 7 days
b. Albendazole 500 mg 3x a day for 5 days
c. Mebendazole 500mg once a day x 3 days
d. Pyrantel pamoate 500mg OD for 7 days
e. None of the above

7. Which of the following statements does correctly describe the morphological characteristic of
Whipworm?
a. Female worm has a coiled posterior with a single spicule
b. Male worm has a bluntly rounded posterior end.
c. Egg is yellowish inner and transparent outer shell
d. Eggs are less susceptible to dessication than the large intestinal roundworm
e. None of the above
 # 8-9
8. Sonny Pascua, 24 year old medical student came up at the ER with a chief complaint on intermittent
abdominal pain and diarrhea. Physical Examination of the abdomen revealed hypoactive bowel sounds,
6 borborygmus which is consistent with small intestinal obstruction. Abdominal X ray plates revealed
air filled spaces along the intestinal walls. What is your diagnosis based on the clinical presentation of
the patient?
a. Capillariasis
b. Trichuriasis
c. Ascarriasis
d. Enterobiasis
e. None of the above

9. What is the drug of choice of the above case? Weight is 76 kg

a. Pyrantel pamoate 100 mg x 7 days
b. Metronidazole 500mg 3x a day x 7 days
c. Mebendazole 500 mg x 3 days
d. Albendazole 400mg as single dose
e. None of the above

10. Which of the following does NOT correctly describe the morphology of Strongyloides stercoralis?
a. Female worm has a muscular double bulb esophagus
b. Male worm has a ventrally curved tail
c. Rhabditiform larvae has an elongated esophagus with a pyriform posterior bulb
d. Filariform larvae has a long buccal cavity with 4 indistict lips
e. None of the above

11. Autoinfection is most possible with?

a. Ascaris lumbricoides
b. Trichuris trichiura
c. Capillaria philippinensis
d. Angiostrongylus cantonensis
e. None of the above

12. Ms. Grace Picardo, 23 years old female from Malate Manila came up to Consult Dr. Sales, a
Gastroenterologist, because of edema, emaciation, loss of appetite, anemia and lobar pneumonia.
Fecalysis was requested which revealed an egg with a clear thin shell. What is the drug of choice
based on the history presented?
a. Menendazole
b. Albendazole
c. Pyrantel pamoate
d. Ivermectin
e. None of the above

#13-19
13. Mansu, a 34 year old Medical student from Africa, who is fun of eating undercooked pork, came up to
consult Dr. Daniel because of diarrhea accompanied by severe myalgia and periorbital edema. Muscle
biopsy was requested which revealed an encysted larvae. What is the most common isolate based on
the patient’s Geographica location?
a. Trichinella spiralis spp nelsoni
b. Trichinella spiralis spp nativa
c. Trichinella spiralis spp spiralis
d. Trichinella spiralis spp bayawak
e. None of the above

14. If found in the Arctic Region, What is the most common species?
a. Trichinella spiralis spp nelsoni
b. Trichinella spiralis spp nativa
c. Trichinella spiralis spp spiralis
d. Trichinella spiralis spp bayawak
e. None of the above

15. Female adult worm of the isolate has:

a. Single ovary located in the anterior part of the body.
b. Has an oviduct, seminal receptacle
c. Lifespan is 1 year
d. Has the ability to produce 2000 larvae/year
e. None of the above

16. The dead end host is?

a. pigs
b. snail
c. rats
 d. bayawak
e. none of the above

17. Biochemistry results were requsted which revealed?

a. elevated CPK MB
b. elevated CPK MD
c. elevated CPK BB
d. elevated AST/SGOT
e. none of the above

18. The following muscles are the most commonly used sites for biopsy to diagnose the infection except?
a. Gastrocnemius
b. Triceps
c. Gluteus
d. Deltoid
e. None of the above

19. What is the best treatment of the above condition?

a. Albendazole
b. Ivermectin
c. Metronidazole
d. Pyrantel pamoate
e. None of the above

20. Which of the following does not correctly describe capillariasis?

a. Causative agent is Pudoc Worm
b. Abdominal pain, acute diarrhea and gurgling stomach
c. 1st recorded in Northern luzon
d. Natural hosts are the migratory fish eating birds
e. None of the above

#21-24
21. Diosanna, 8 year old female from Pengue Ruyu, Tuguegarao City, sought consult to Dr. Buenavidez
with a chief complaint of massive edema of lower extremities. History reveals that the patient is fun of
eating “Kilawen” or fresh fish. Fecalysis was requested which revealed striated shells with polar plugs.
What is the causative agent based on the history presented?
a. Ascaris lumbricoides
b. Trichuris trichiura
c. Enterobius vermicularis
d. Hypseleotris bipartita
e. None of the above

22. Biopsy of the GIT wall would most likely reveal the following, except?
a. flattened villi
b. dilated mucosal glands
c. lamina propria infiltrated with plasma cells
d. denuded villi
e. none of the above

23. Which of the following does NOT correctly describe the adult worms ofe parasite?
a. male worm has a spined sheath
b. anus is subterminal in location
c. female worm has a vulva located at the junction of anterior and middle 1/3
d. Esophagus contains rows of secretory cells called stichocytes
e. None of the above

24. Management of the patient condition includes the following, except?

a. electrolyte replacement
b. high protein diet
c. albendazole as 800 md OD x 10 days
d. all of the above
e. none of the above

25. All of the following pertains to Whipworm eggs, except?

a. Lemon-shaped
b. With plug-like translucent polar prominences
c. Yellowish outer and transparent inner shell.
d. Fertilized eggs: Segmented at oviposition and embryonic development takes place outside
the host when eggs are deposited in clayish soil.
e. None of the above

26. With regards to management of Trichiuriasis, which of the following statement is correct?
 a. Albendazole is not contraindicated in pregnant mothers
b. Mebendazole can be given in early pregnancy
c. Adverse effects of azole drugs are transient gastrointestinal discomfort and headache
d. Egg rates, cure rates, reinfection rates and egg counts are not necessary because the infection
could be diagnose clinically
e. None of the above

27. Epidemiologic Findings of Enterobiasis include the following, except?

a. The only intestinal nematode infxn that cannot be controlled thru sanitary disposal of human feces.
b. Eggs contaminate underwears and beddings.
c. Higher prevalence in females than males.
d. Migration occurs during daytime, more migration in the evening.
e. None of the above

28. Complications due to adult worm migration of Enterobius vermicularis, except?

a. Appendicitis
b. Vaginitis
c. Endometritis
d. Salphingitis
e. None of the above

29. General Anatomic Structure of threadworms, except?

a. Colorless, semi-transparent with a finely striated cuticle.
b. Slender tapering posterior end & a short conical pointed tail.
c. Short buccal cavity with 4 indistinct lips.
d. Long, slender esophagus extends the anterior 4th of the body.
e. None of the above

30. All of the following correctly describes the Rhabditiform larvae of hookworms, except?
a. Elongate esophagus with a pyriform posterior bulb.
b. Lack the midbulbar swelling.
c. Differs from the hookworm in being slightly smaller and less attenuated posteriorly.
d. Shorter buccal capsule and a large genital primodium
e. None of the above

31. Following a trip from Gonzaga, Cagayan, Mario Solis, 35 years old male presents with hematuria. Which of the
following specifically associated with Schistosoma haematobium infection?
a. Adenocarcinoma of the bladder d. Transitional Cell Carcinoma of the bladder
b. Adenocarcinoma of the renal pelvis e. None of the above
c. Squamous cell carcinoma of the bladder

32. Kuting, a 6 year old child is brought to Dr. Sigfrid Simangan, a pediatrician because of perianal itching. Physical
examination reveals scaly skin in the perianal region. A scotch-tape test reveals oval eggs that are flattened
along one side. The microorganism most likely responsible for the child’s symptoms is?
a. Ancylostoma duodenale d. Ancylostoma braziliense
b. Ascaris lumbricoides e. None of the above
c. Necator americanus

33. Mayyang, a cattle rancher’s wife develops abdominal pain, diarrhea, fever, periorbital edema, eosinophilia and
myalgia. She recalls going to the local cattle fair and having pork sausages. Which of the following techniques
would be most helpful for the diagnosis of this patient?
a. Gastric biopsy d. Muscle biopsy
b. Stool for ova e. None of the above
c. Stool for protozoan parasites

34. Cristina Dugyutin, 40 year old patient from Zambales presented with malaise, fever and rigors, followed by right
upper quadrant pain, vomiting and itching. Infestation with which of the following parasites is most strongly
suggested by the patient’s presentation?
a. Clonorchis sinensis d. Taenia saginata
b. Plasmodium ovale e. None of the above
c. Taenia solium

35. Rommel Adducul, 35 years old fisherman from Camiguin Island presented with chronic diarrhea and fatigue. A
complete blood count and differential reveals a megaloblastic anmemia with hypersegmentation of neutrophils.
Which of the following microorganisms is most likely cause of this patient’s problems?
a. Clonorchis sinensis d. Diphylobothrium latum
b. Metagonimus yokogawai e. None of the above
c. Loa loa

36. Luningning, 31 years old from Tuguegarao City is brought to the emergency room after suffering a seizure at
home. CT Scan of the head reveals multiple punctate calcifications, and two enhancing cystic lesions with
surrounding edema. What is the most likely diagnosis?
 a. Amoebiasis d. Neurocysticercosis
b. CMV infection e. None of the above
c. Echinococcosis

37. Atom Arollo, 31 year old news correspondent on his return from Zamboanga complains of tiredness, sore muscles
and spiking fevers. The man subsequently develops disabling illness complicated by severe anemia, pulmonary
edema, renal failure and shock. Which of the following organisms is the most likely pathogen?
a. Babesia microti d. Wuchereria bancrofti
b. Plasmodium vivax e. None of the above
c. Loa loa

38. Cholo Pascual, 14 years old from Aparri Cagayan presented with shortness of breath and palpitations. ECG
shows alterations in heart rhythm and 2D Echo reveals biventricular dilatation with massive cardiac enlargement.
An endomyocardial biopsy shows diffuse interstitial fibrosis, myocyte necrosis, chronic inflammation & the
presence of intracellular protozoan parasites. The most likely diagnosis is?
a. Chagas Disease d. Lyme Disease
b. Coxsackie B Myocarditis e. None of the above
c. Sleeping sickness

39. Norwin Abesamis, a 30 years old electrical engineer from Calayan, Cagayan was bitten by tse tse fly. He
developed a chancre at the site followed by generalized lymphadenopathy progressing to lethargy, apathy and
mental depression. Examination of the lymph node revealed curved motile organisms with free flagellum. The
most likely agent is?
a. Trypanosoma cruzi
b. Leishmania donovani
c. Toxoplasma gondii
d. Plasmadium falciparum
e. None of the above

40. Treatment of CNS manifestations of african sleeping sickness involves administration of which of the following
agents?
a. Melarsoprol d. Doxycycline
b. Suramin e. None of the above
c. Pentamidine

41. Morcon, a 29 year old male who has recently returned from Manila presents with severe, acute, right upper
quadrant abdominal pain. He has had several months of bloody diarrhea. CT scan of the liver demonstrates
abscesses. Which of the following organisms is the most likely cause?
a. Balantidium coli d. Loa loa
b. Giardia lamblia e. None of the above
c. Enterobius vermicularis

42. Martin, a psychotic med tech student has a history of multisubstance abuse present with persistent bloody
diarrhea. Stools are sent for ova and parasites, revealing numerous, granular, spherical, thin walled tetranucleate
cysts measuring 10-20um in dm. The most likely pathogen is?
a. Cryptosporidium parvum d. Giardia lamblia
b. Dientamoeba fragilis e. None of the above
c. Entamoeba histolytica

43. Following a camping trip, Kuya Obet presented with foul smelling, greasy stools devoid of blood or mucus. His
history is remarkable for drinking water from a stream infested with beavers. Microscopic examination of his stool
revealed stingray-shaped, flagellated trophozoites. The most likely agent is?
a. Trichomonas d. Cryptococcus
b. Leishmania e. None of the above
c. Entamoeba

44. Nancy Mali Bug, a 24 years old AIDS patient develops chronic abdominal pain, low grade fever, diarrhea and
malabsorption. Oocysts with 1 immature large and central sporozoite are demonstrated in the stool. Which of the
following organisms is most likely to be the cause of patient;s diarrhea?
a. Diphylobothrium latum d. Isopora belli
b. Entamoeba histolytica e. None of the above
c. Cryptosporidium parvum

45. Maria Pasang Awa, a sexually active 28 year old medical student presented with frothy greenish-yellow foul-
smelling vaginal discharge. A pap smear demonstrated protozoan parasites. These organisms are likely to be?
a. Cryptosporidium parvum
b. Entamoeba histolytica
c. Giardia lamblia
d. Endolimax nana
e. None of the above
 f. Cryptosporidium parvum
g. Entamoeba histolytica
h. Giardia lamblia
i. Endolimax nana
None of the above