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‫‪Written Microbiology‬‬

‫‪1‬‬ ‫‪Written Questions‬‬ ‫‪2‬‬ ‫‪16‬‬

‫‪2‬‬ ‫‪Written Cases‬‬ ‫‪17‬‬ ‫‪18‬‬

‫‪Written Parasitology‬‬

‫‪1‬‬ ‫‪Para Summary‬‬ ‫‪19‬‬ ‫‪23‬‬

‫‪2‬‬ ‫‪Written Questions‬‬ ‫‪24‬‬ ‫‪38‬‬

‫‪3‬‬ ‫‪Written Cases‬‬ ‫‪39‬‬ ‫‪41‬‬

‫شكر خاص من أرسة مكتبة هارفارد لدكاترة سنرت انسباير و سنرت ابيكس عىل مجهودهم‪ ،‬متمنيني‬
‫لجميع الطلبة املزيد من النجاح والتفوق ‪...،‬‬
‫د‪ .‬أحمد جمعه‬
‫د‪ .‬زياد مهنا‬

‫مع حتيات أرسة مكتبة هارفارد‬

 Microbiology Written Questions

Questions on lecture 1 General Bacteriology

1) Compare between prokaryotic and eukaryotic organisms

List four differences between prokaryotic and eukaryotic organisms
Prokaryotes Eukaryotes
Mitochondria Absent Present
Mitosis Absent Present
Nuclear membrane Absent Present
Chromosomal number One copy (Haploid) Two copies (Diploid)
Histones No histones associated with DNA
Ribosome 70S 80S
Peptidoglycan Present Absent
Cell wall sterols Absent Present

2) Classify bacteria according to habitat

Parasitic (need host): Saprophytic (free living):
▪ bacterial flora (commensally) ▪ in soil, air and water
▪ pathogenic bacteria

3) List structures present in bacterial envelope ?

1) Cell wall.
2) Cytoplasmic membrane
3) Capsule or slime layer.

4) List the differences in special components in cell wall of gram +ve , -ve
Gram +ve Gram -ve
▪ Teichoic acid: ▪ Outer membrane (thick):
- Ribitol or glycerol. - Lipoprotein.
▪ Polysaccharides - Lipopolysaccharide:
Special
✓ Lipid A (the endotoxin).
component ✓ Polysaccharide (somatic Ag).
▪ Periplasmic space: contains hydrolytic
enzymes and penicillinase

5) What is the function of periplasmic space in gram -ve bacteria

▪ It is the space between cytoplasmic membrane and outer membrane
▪ contains hydrolytic enzymes and penicillinase

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 Microbiology Written Questions

6) What is the importance of bacterial cell wall

Enumerate three functions of bacterial cell wall
1. Antigenic character: in gram +ve , -ve ….
2. Cell wall is the target for the action of some Antibiotics
3. Preservation of the shape of the cell.
4. Cell wall is responsible for Gram staining reaction
5. Plays an essential role in cell division
6. Permeability of the cell , Non selectively permeable
7. Protective against high internal osmotic pressure
8. Toxicity

7) What are the antigenic characters of gram +ve , -ve bacterial cell wall
▪ In Gram positive: Teichoic acid.
▪ In Gram negative: somatic "O" antigen (Polysaccharide).

8) List the sites and function of lysozyme in resistance to bacteria

▪ Enzymes that attack cell walls:
▪ Peptidoglycan is hydrolyzed by lysozyme
▪ Found in tears, saliva & nasal secretions

9) What are the functions of bacterial cell membrane ?

1. Electron transport & oxidative phosphorylation:
- for energy production (ATP).
2. Chemotactic function:
- contain receptors of binding and repellents
3. Excretion of hydrolytic enzymes
4. Permeability &transport:
- Transport nutrients into and waste products out of the cell.
5. Biosynthetic function:
- Carries enzymes & molecules for biosynthesis of cell wall, DNA & memb. lipids

10) What is the difference between bacterial capsule, glycocalyx, slime layer
1. Capsule: condensed well-defined layer closely surround the cell.
2. Glycocalyx: polysaccharide- containing material lying outside the cell.
3. Slim layer: if glycoclyx is loosely surround the cell.

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 Microbiology Written Questions

11) What are the functions of bacterial capsule

▪ Virulence factor: as it protects bacterial cell from phagocytosis.
▪ Protects cell wall: against bacteriophage, complement & lysozymes
▪ Antigenic (K-antigen): used in serodiagnosis or vaccine preparation

12) Enumerate 4 types of arrangement of flagellae

a) Monotrichous: single polar flagellum.
b) Lophotrichous: multiple polar flagellae.
c) Amphitrichous: One flagellum in each pole of the cell.
d) Peritrichous: flagella distributed over the entire cell. e.g. E.coli.

13) Why motility is important function to bacteria ?

1. Movement to nutrients.
2. Movement to optimal oxygen concentration in aerobic bacteria.
3. Choosing site for colonization.
4. penetration through a viscid mucous secretion.

14) What are the differences between flagellae and pili

1. Occur in motile as well as non-motile strains but flagellae in motile organisms
2. More numerous "100-500" per cell.
3. Much shorter and thinner but flagellae is longer and thicker
4. more or less straight, flagellae are spiral.
5. Originate from cytoplasmic membrane Not originated from cytoplasm like flagellae.

15) List the different antigenic parts types in bacteria

1. Flagellae (H-antigens).
2. Capsule K-antigen
3. In gram negative bacteria Polysaccharide somatic Ag ( O Ag )

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 Microbiology Written Questions

Lecture 2

1) Define Bacterial endospores (give examples, function)

▪ Some bacteria are capable of forming resistant endospores under certain unfavorable in
vitro (outside the body) conditions as:
- starvation, desiccation, heat and chemical agents.
▪ Examples:
- The genus Clostridium ( anaerobic ) and genus Bacillus ( aerobic )
▪ Function:
- It is a resting cell, highly resistant to desiccation, heat and chemical agents.

2) What is the structure of bacterial endospore

Bacterial DNA Cell membrane Small amount of cytoplasm
Peptidoglycan thick keratin coat with + Ca Very little water

3) What is meant by germination of bacteria

▪ The spore has no metabolic activity and can remain dormant for many years.
▪ Upon exposure to water and appropriate nutrients: specific enzymes degrade the coat,
water and nutrients enter, and germination into a metabolizing, reproducing bacterial cell
occurs

4) What are the steps for bacterial sporulation ?

1. The nuclear material in the cell moves to one pole.
2. Cytoplasmic membrane:
- invaginates to form the forespore
- engulfs forespore within a second membrane.
3. Cortex formation by deposition of Dipicolinic acid and calcium.
4. Formation of spore coat.
5. Release of endospores.
6. Rest of bacterial cells undergoes autolysis.

5) Enumerate three basic elements for bacterial growth

Major Minor
▪ Carbon ▪ Sulphur Phosphorous
▪ Nitrogen ▪ Calcium K ,Mg

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 Microbiology Written Questions

6) What are the bacteria that need high concentration of Co2

▪ Neisseria & Brucella abortus stimulation of growth (capnophilic)
▪ Bacillus anthrax & Pasteurella formation of capsule
▪ Staphylococcus aureus enterotoxin production

7) What is meant by the following and give example

Capnophilic ▪ organisms require higher concentrations ▪ Neisseria & Brucella
of CO2 (5-10%) to be provided in the abortus
culture media
Obligatory ▪ can grow only in presence of free O2. ▪ T.B
aerobes
Facultative ▪ can grow well in presence or absence of ▪ Most pathogenic bacteria
anaerobes O2. ▪
Obligatory ▪ Grow in absence of O2 and cannot grow ▪ Clostridium
anaerobes in the presence of oxygen, due to lack of Group
peroxidase enzyme or catalase enzyme.
so in presence of O2, peroxides will be
formed which is toxic to the organism.
Microaerophilic ▪ grow best in presence of a minimal ▪ Propionibacterium acne
amount of O2. ▪
Autotrophic ▪ assimilate inorganic chemicals (CO2) as ▪ saprophytic bacteria.
the only source of carbon.
Heterotrophic ▪ Require organic sources of carbon ▪ Pathogenic bacteria

8) List examples of bacterial enzymes

Proteolytic enzymes ▪ act on protein
Saccharolytic enzymes ▪ act on CHO
Lipolytic enzymes ▪ act on lipids
Respiratory enzymes ▪ dehydrogenases and oxidases

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 Microbiology Written Questions

9) What are the characters of endopigment, exopigments and give examples

Endopigment Exopigment
▪ Remains bound to the body of ▪ Diffuses into the surrounding
Character the organism. medium.
▪ Not diffuse into the surrounding.
▪ ✓ Red pigment: ▪ ✓ Pseudomonas aeruginosa:
Example ✓ Serratia marcescens. ✓ pyocyanin → Blue pig.
▪ ✓ Golden yellow: ✓ fluorescens → Yellow
✓ Staphylococcus aureus.
Colony ▪ colored ▪ colored
Surrounding ▪ not colored ▪ colored
medium
Function ▪ respiration and antibacterial action

10) Compare between Exotoxin and Endotoxin

Exotoxin Endotoxin
1) Diffusibility ▪ Diffusible outside bacteria ▪ Non diffusible
2) Preparation ▪ Then filtrated through a ▪ Disintegration of the
bacterial filter. organism
3) Action ▪ On specific organ. ▪ On Interleukin 1
▪ Tumor necrosis factor
▪
4) Antigenicity & toxicity ▪ Highly ▪ Less
5) Gene code it ▪ On plasmid ▪ On chromosome
▪ transferred by
bacteriophage
6) Source ▪ G + ve mainly & G-ve ▪ G – ve
7) Structure ▪ Protein ▪ lipopolysaccarides
8) Specificity ▪ specific in action ▪ non specific
9) Effect of heat (60-80C) ▪ Thermolabile destroyed ▪ thermostable
10) Effect of 0.3% formaline ▪ Detoxicated giving toxoid ▪ Not detoxicated

11) What is net result of bacterial growth in fluid media

▪ uniform turbidity: facultative anaerobic bacteria
▪ surface pellicle aerobic bacteria
▪ sediment leaving relatively clear medium anaerobic bacteria

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 Microbiology Written Questions

12) What is the cause of varying duration of lag phase

1. type of organism: 1 hr in Ecoli , few days in TB
2. Type of media: more suitable → more shorter
3. Size of inoculum: bigger → shorter lag phase
4. Stage from which the bacteria is taken: if log phase → lag phase is shorter

13) What is the cause of appearance of bacterial death in stationary phase

1. Exhaustion of nutrients.
2. O2 Starvation.
3. Accumulation of toxic materials

14) Enumerate the phases of growth curve and their correlation clinically invivo
The lag phase ▪ Incubation period in vivo.
The logarithmic phase ( exponential) ▪ invasive period
The stationary phase ▪ symptoms and signs in vivo.
The decline phase ▪ convalescent period in vivo.

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 Microbiology Written Questions

Lecture 3 Virology

1) What are the general characters of viruses ( enumerate & mention )

1. They do not have membrane-bound nucleus = prokaryotes.
2. They are not cells, they do not have cell membrane = A-cellular.
3. They are obligate intracellular parasites (They do not have ribosomes) & contain one
kind of nucleic acid (RNA or DNA)
4. They are the smallest infectious agents (20 to 300 nm in diameter).

2) What is meant by Nucelocapsid and its function

▪ Def: The capsid with its enclosed nucleic acid
▪ Functions of the capsid are:
a) It protects the viral genome against inactivation by nuclease enzymes.
b) The arrangement of capsomers gives icosahedral, helical or complex symmetry.
c) Role in viral replication “attachment step”.
d) Participates in adsorption of virions to susceptible cells. It determines the antigenicity.
▪ Functions of nucleic acid:
- It is the infectious part of the virus (codes for viral structure and non-structural
proteins).

3) What is the structure of viral envelope, its function ?

▪ Structure: Lipid containing membrane that viruses acquire by budding through host cell
membrane.
- Lipoprotein, the lipid from the host cell membranes and protein is virus specific.
- Contains ‘glycoproteins’ which are spike-like projections on the surface of the virus,
which attach to the host cell receptors during infection (attachment).
▪ Function: Determines virus specificity and antigenicity.

4) Compare between non-enveloped , enveloped viruses in Penetration , release from host

cells
In nonenveloped viruses
Penetration ▪ Crossing the plasma membrane
directly or by receptor mediated
endocytosis
Release ▪ Rupture of the cell membrane and
release of the mature particles
In enveloped viruses
▪ by fusion of viral envelope with
cell membrane or with membrane
of endosome at the cell surface
▪ Budding through the outer cell
membrane

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 Microbiology Written Questions

5) Enumerate the steps essential for virus replication

1. Adsorption (Attachment)
2. Penetration
3. Uncoating
4. Viral gene expression
5. Viral nucleic acid synthesis (replication)
6. Assembly
7. Release

6) What are the methods of viral isolation

What is the indirect method for viral diagnosis
Discuss how to diagnose viral infection indirectly
a. Tissue cultures:
- Pieces of animal or human tissues are trypsinizied to get separate cells.
- Cells are grown in media contain amino acids, vitamins, calf serum and antibiotics.
- A monolayer or (sheet) of cells is formed on the flat side of the container (flask)
within few days. Viruses are inoculated on the monolayer.
b. Embryonated egg.
c. Animal inoculation.

7) Mention two drugs used to treat the following viruses

Herpes viruses Acyclovir, Ganciclovir
HIV Retroviruses Azidothymidine Squinavir and indinavir
Influenza A Zanamivir and oseltamivir Amantadine
HBV & HCV Ribavirin, Interferon -β

8) Mention types of interferon, origin , their role in viral replication .

▪ There are 3 types of interferons:
- Interferon-α (IFN-α).
- Interferon -β (IFN-β): treatment of HBV & HCV.
- Interferon-γ (IFN-γ):
▪ Origin:
- IFN-α and IFN-β are secreted by the infected cell and then bind to a common cell
surface receptor, known as the interferon receptor, on both the infected cell and
nearby cells.
- IFN-γ: which induced by activated T cells.
▪ Function: Interferon induces the synthesis of several host cell proteins e.g. RNA
dependent protein kinase (PKR) that contributes to the inhibition of viral replication.

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 Microbiology Written Questions

Lecture 4 Genetics questions

1) What are the most famous extrachromosomal elements

▪ Plasmids
▪ Transposons
▪ Bacteriophage (Virus infecting bacteria)

2) Define plasmid and classify it according to shape

▪ Def: Piece of DNA that exist separated from the chromosome, containing origin of
replication, so independently replicate from the chromosome
▪ Classification acc to shape:
Covalently closed circular (CCC) Semicircular Linear
Incidence Most common Transient form In some bacteria
▪ Double strand. ▪ One strand. ▪ Double strand.
▪ Completely closed circular ▪ Completely ▪ Unstable as it's
Description
forms as E.coli Closed & the attacked by
other is opened exonucleases

3) Classify plasmids according to (copy number, Compatibility of plasmids)

Copy number
▪ Stringent plasmids:
✓ 2 copies/cell E.g.: F-plasmid & phage
plasmid hybrid (P2)
▪ Low copy number plasmids:
✓ 10 - 15 copies/cell E.g.: pSC 101
▪ High copy number plasmids:
✓ up to 50 copies/cell E.g.: Col E plasmid
▪ Extremely high copy number plasmids:
✓ up to 100 - 200 copies/cell
Compatibility of plasmids
▪ Compatible plasmids:
✓ cell can maintain more than one plasmid
in the same cell
✓ If they carry different origins of
replication
▪ Incompatible plasmids:
✓ inability of two plasmids with the same
origin of replication to be maintained in
the same cell
✓ If they carry same origins of replication

4) Define: ((you must define general def of plasmid firstly))

▪ Stringent plasmids:
- 2 copies/cell E.g.: F-plasmid & phage plasmid hybrid (P2)
▪ Shuttle vector
- Can mobilized itself & another plasmid from cell to cell
- May be natural or artificial plasmid
5) Compare between natural and artificial plasmid

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 Microbiology Written Questions

Natural plasmid Artificial plasmid

▪ All discussed plasmids are
present naturally in bacterial
Def. & some yeast cells.
▪ F pili (during conjugation)
Example
▪ Naturally present plasmid but designed
artificially by adding some markers (genes).
▪ Most of artificial plasmids are used in gene
cloning & genetic engineering as vectors
▪ Antibiotic resistance markers
▪ DNA sequence to be target of restriction
endonuclease

6) Define plasmid and mention 2 beneficil uses for bacteria

▪ Def: as before
▪ Functions
1. Resistance: Antibiotic resistance ,, Heavy metal → metal reductase ,,UV → DNA
repair enzymes
2. Conjugation.
3. Production: Toxins, enzymes & bacteriocin
4. Biochemical Reactions: sugar fermentation.

7) How plasmid act as vector ?

▪ It can be used in Molecular biology (as a vector): Cloning vectors.
▪ Gene therapy: Plasmids used for insertion of therapeutic genes at pre-selected
chromosomal target sites.

8) Define transposons and mention the simplest structure

▪ Def: Extra-chromosomal small pieces of DNA that are capable of moving itself from one
location in DNA to another (Movable elements or Jumping genes)
▪ They can transpose into any DNA molecules Except themselves
- Insertion sequence is the simplest form
- Their ends have the same repeats either direct or inverted repeats (15 - 25bp)
- Encode only ptn needed for own transpositions

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 Microbiology Written Questions

9) Compare between composite Tn and non-composite Tn and give examples for its
functions
Composite Non-composite
▪ 2 IS at both ends ▪ No IS at their ends but encode for
▪ Central piece encode for: transposition protein.
✓ Antibiotic resistance ▪ Central piece encode for:
✓ Virulence factor ✓ Antibiotic resistance
✓ Virulence factor
✓ Catabolic enzymes
▪ Tn 5: ▪ Tn 3:
✓ for kanamycin resistance ✓ carry ampicillin resistance gene
▪ Tn 10: ▪ Tn 7:
✓ for tetracycline resistance ✓ carry streptomycin & trimethoprim
resistance gene

10) Enumerate types of gene transfer

▪ Vertical gene transfer: Transfer of genetic material from parental organism to progeny
Include Conjugation. Transduction Transformation
▪ Horizontal (lateral) gene transfer: organism transfers genetic material to another
organism that is not its offspring.

11) Define conjugation and what are the requirements for it to occur
▪ Definition:
- It is a form of gene transfer in which two cells come in direct contact and DNA is
transferred from one cell (donor) to the other (recipient).
▪ Requirements:
- Donor cell should contain F-plasmid, which encodes for F pili needed for conjugation.
- Donor plasmid should contain tra gene (conjugative type) to mobilize the plasmid.
- Conjugation most frequently occurs in Gram negative bacilli but Gram-positive
organisms can make conjugation.

12) How conjugation occur in gram positive bacteria

▪ Mediated by: signaling molecules called pheromones.

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 Microbiology Written Questions

13) List the steps of conjugation.

▪ Donor Gram negative bacilli containing F plasmid come in contact with other F- Gram
negative bacilli.
▪ The F pili of the donor cell (F +) attach to specific receptor on the recipient cell (F -).
▪ The F pili contract the recipient cell to be in close contact and then canalization occurs
through the F pili between the two cells.
▪ Once canal is formed, F plasmid start to mobilize one strand of its ds DNA to the
recipient cell.
▪ New ds DNA is formed from the single strand in both donor and recipient cells so the
recipient now contains F plasmid and changed to F+ cell which will act as a donor cell.

14) How to create high frequency of recombination cell

▪ If the F plasmid integrate into loci in the chromosome, this integrated F factor create H fr
▪ If this integrated plasmid is transferred to another cell by conjugation, it can transfer a
segment (locus) of chromosome during excision and can transfer this locus (gene or
genes) from the donor cell (Hfr) to a recipient chromosomal cell

15) Enumerate bacteriophage types and their role in gene transfer

▪ Virulent phage (Lytic cycle) → generalized transduction
▪ Temperate phage (lysogenic cycle) → specialized transduction

16) Define transformation and how to occur naturally or artificially

▪ Definition:
- It is a method of gene transfer in which direct uptake of DNA by recipient cell either
naturally or artificially in the laboratory. Methods:
- Natural transformation: rare occasion e.g., Streptococcus pneumoniae
- Laboratory induced competence: increasing the permeability of the cell envelopes by
adding calcium chloride solution and chilled on ice then heat-shocked
- Transformation by electroporation: by exposing a mixture of recipient cells and
plasmids to electrical field to form pores in the cell envelopes.

14
 Microbiology Written Questions

Lecture 5 Mycology

1) What are the differences between bacterial and fungal cell wall, cell membrane
Bacteria prokaryote
▪ rigid layer The Peptidoglycan is a
complex consists of:-
- Backbone of N-acetylglucosamine
Cell wall
alternating with N-acetyl muramic
acid.
▪ Side chains: (4 amino acids)
▪ composed of bi-phospholipids & proteins
Cytoplasmic ▪ prokaryotes have no sterols in
membrane cytoplasmic membrane except for
Mycoplasma
Fungi eukaryote
▪ rigid cell wall made of chitin
(a polymer of N-acetyl
glucosamine), glucans,
mannans & complex
polysaccharide
▪ encloses the cytoplasm,
vacuoles, endoplasmic
reticulum, and mitochondria.
It contains ergosterol.

2) Compare between yeast and yeast like fungi and give examples
Yeasts Yeast like (pseudohyphae)
round to oval unicellular fungi round to oval multi-cellular fungi
reproduce by budding or fission reproduce by budding
progenitor then detached from mother cell progenitor remain attached to mother cell
giving a chain of elongated yeast cell
e.g. (Cryptococcus neoformans). e.g. (Candida).

3) Enumerate methods of formation of fungal spores sexually and asexually

▪ Fungi reproduce by the formation of spores either asexual or sexual
I) Asexual spores:
a. Sporangiospore
b. Conidiospore:
✓ Arthroconidia (Arthrospores)
✓ Blastoconidia (Blastospores)
✓ Phialoconidia
✓ Chlamydoconidia (Chlamydospores)
II) Sexual spores
- Basidiospores - Ascospores - Zygospores - Oospores

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 Microbiology Written Questions

4) What are Harmful effect of fungi ‫سؤال كبير‬

1. Hypersensitivity reactions due to environmental exposure to fungal spores.
2. Infection result from invasion of tissue and organs.
3. Toxicosis ‫سؤال صغير منه‬
- There are two types of fungal toxicosis:
a. Mycotoxicosis: result from accidental consumption of food products contaminated
by toxin producing fungi e.g
Ergot alkaloids toxicosis Aflatoxicosis
b. Mycetismus: ingestion of fungi containing preformed toxin e.g: Mushroom
poisoning

5) Give short account on mycetoma

▪ it is subcutaneous mycosis Infection involving the dermis, subcutaneous tissue, muscle
and fascia.
▪ Caused by Madurell, Exophiala.
▪ Chronic subcutaneous infection
▪ progress slowly and burrows into deeper tissue
▪ producing abscess which bursts with formation of chronic sinuses discharging fluid
containing granules.
6) Define opportunistic fungi and give examples
▪ caused by saprophytic fungi affecting immunocompromised individuals.
- e.g. Candidiasis, Aspergillosis, and Cryptococcosis

7) Enumerate different clinical types of dermatophytosis and their sites

Tinea capitis scalp & hair.
Tinea barbae beard hair.
Tinea ungium the nails
Tinea pedis between toes
Tinea corporis non-hairy smooth skin.
Tinea cruris groin, moist areas.

8) Mention the mechanism of action of the following drugs

Caspofungin: - inhibit 1,3- β glucan synthetase enzyme → Inhibit cell wall synthesis.
- bind firmly to ergosterol in the fungal cell membrane forming pores →
Polyenes:
disrupt membrane function → cell death
- interact with microtubules → disrupt mitotic spindle function → inhibit
Griseofulvin:
growth→ inhibit nuclear division

16
 Microbiology Written Cases

Clinical Cases

A23-year old man presents to the emergency department complaining of bloody diarrhea,
abdominal pain , and fever. Laboratory tests of blood and stool show an oxidase-negative,
motile, Gram-negative bacillus that grows as rose-pink colonies on Mac Conkey agar.
Treatment with penicillin injections failed to clear the case.

➢ Which part of bacterial structures responsible for this failure? Plasmid

53-years old male farmer has a 4.5 cm circular skin lesion of black eschar surrounded by
vesicles and edema. The Gram stain from the colonies grown on blood agar shows Gram
positive spore forming bacilli in chains.

➢ What is the organism most likely causing this condition? Bacillus anthracis
➢ What are the steps of spore formation? As before

A-10-month-old female, started getting sick with a mild cough, running nose and fever 3
days ago, then progressively worsened. She is now coughing frequently and has vomited
after coughing. Her pulmonary examination shows her to be in moderate respiratory
distress. Laboratory diagnosis for bacterial and fungal infections were excluded by
negative culture results

➢ What is the likely infectious cause of her respiratory illness?

➢ What are methods of laboratory diagnosis of the case?

▪ Lower respiratory tract infection can be caused by viruses, bacteria and fungi. Viruses are
thought to cause up to 80% in infants and children. The condition can be hard to diagnose
because it may start out with similar symptoms as the common cold. Diagnosis of
bacterial and fungal infection can be done by sample culture using culture media. Viruses
are obligate intracellular parasite and can be isolated by using cell culture or embryonated
egg. Other rapid methods as EIA to detect viral antigen or electron microscope to detect
viral particle in the sample

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 Microbiology Written Cases

A 49-year-old Pennsylvania woman who had not traveled within the prior five months
visited a clinic with symptoms of a urinary tract infection. Urine culture revealed Gram
negative bacteria that was resistant to all antibiotics. It also appears to be spreading this
resistance to others of its kind.

➢ How could you explain resistance of the bacteria to antibiotics?

➢ Describe the mechanism that most likely accounts for gene transfer.
▪ The bacteria had first been infected with a plasmid, which carry genes that confers
resistance to all antibiotics.
▪ Resistant Gene transfer to other bacteria by conjugation

A 40-year-old woman came to the dermatology clinic complaining of discolored and rough
fingernails. She does not complain of pain or any other bodily symptoms. By examination:
the nail plates are thickened, opaque yellow” cloudy appearance”, and separate from the
nail bed, no periungual inflammation. She denied previous infection around nails. The
patient mentioned that her mother suffered from a similar condition.

➢ What is the most likely case diagnosis?

▪ Fungal infection of the nail
➢ What is the type of mycosis according to the site of infection?
▪ Cutaneous mycosis

18
 L1 : Introduction
Parasite def : Organism lives in or on another organism (host) & gains Types of hosts : Enumerate?? & Define?
nutrients & protection at other's expense. 1) Definitive hostHost in which parasite reaches sexual maturity (Adult).
Types of parasites : Enumerate?? & Define? Or where parasite multiplies sexually.
1) Obligatory Can’t complete its life-cycle without invading 2) Intermediate Contain immature (larval) stage of parasite
parasites suitable host. host Or where parasite multiplies asexually. “Amplifier host”
2) Facultative Can either live freely (in soil or water) or as 3) Reservoir host Animal harbors parasite & acts as continuous source of
parasites parasites in hosts in unfavorable conditions. human infection.
3) Ectoparasite Lives on the outside of host. 4) Paratenic Harbors parasite in arrested state of development but parasite
4) Endoparasite Lives within body of host. “Transport” remain alive & viable, ready to infect suitable host.
5) Temporary Visit its host from time to time for feeding then 5) Dead-end host From which infectious agents not transmitted to other hosts.
parasites leave. & infection chain ends at that host.
6) Accidental Free living organisms enter human body by 6) Vector host Arthropod transmits parasite from host to another.
parasites mistake. E.g. larvae of flies. E.g: Anopheles is vector of malaria.
7) Specific Affects only one host.
8) Coprozoic Parasite just pass through git without infecting host.
Zoonoses
(Spurious) E.g : Parasite eggs in animal liver .
Def : infectious diseases transmitted between animals & humans.
Types : Enumerate
Host-parasite interactions 2021
1) Anthropozoonosis Zoonosis of animals & transmissible to humans
Symbiosis : Relationship () 2 organisms live closely together.
2) Zooanthroponosis Parasitic infections of human transmissible to Animals
1) Parasitism Parasite benefits & host suffers from such association.
3) Anthroponosis Parasitic infections in man alone. As Enterobius worm
2) Both live together & commensal benefits without
Commensalism causing harm to host.
Classification :
3) Mutualism Both benefit from association to extent both can’t live 1) According to Source of infection
separate.
a. Feral or sylvatic Source of infection is wild animal
E.g: Flagellate in intestine of termite .
b. Domestic Source of infection is man's own domesticated animals.
4) Phoresis Phoront mechanically carried by host.
2) According to Method of transmission:
No physiological or biochemical dependenc.
a. Direct Infection directly transmitted from reservoir host to man.
E.g: Dientamoeba fragilis on Enterobius egg).
b. Metazoonosis Infection transmitted from reservoir host to man via
arthropod.
c. Saprozoonosis Infection is transmitted Via soil & water.

Dr/ Raven 19
 L2 : Medical helminthology
1) Trematoda “Flukes” 2) Cestoda “Tapeworms” 3) Nematoda “Round worms”
1. Flat Except Schistosoma “Female is rounded” 1. Flat. & No body cavity. 1. Cylindrical, Rounded in cross section.
2. No body cavity & Unsegmented. 2. No digestive canal “GIT”. 2. Has body cavity , Unsegmented.
3. Organs of fixation : Enumerate? 3. Hermaphrodites : auto-copulation occur. 3. Separate sexes (Unisexual) :
a) Suckers : 4. Segmented into scolex, neck & strobila ✓ Females longer than males.
- Oral sucker : at anterior end around mouth. a) Scolex Carry organs of fixation : ✓ Female posterior end straight & Male
- Ventral sucker : in ventral surface “head” a. Suckers or grooves (bothria) posterior end > curved.
b) Cuticle with spines. List? b. Rostellum & Hooks. 4. Digestive system :
4. Digestive system : b) Neck Actively dividing form segments a) Mouth : teeth.
a) Mouth . c) Segments a. Immature b) Esophagus : takes different shapes.
b) Esophagus having muscular pharynx. “Proglottids b. Mature c) Intestine ends in anus
c) 2 intestinal caeca end blindly. or Strobila” c. Gravid : Uterus full of eggs.
“Except Schistosoma Intestine reunite”
5. Hermaphrodites except Schistosoma. Trematoda Cestoda Nematoda
Shape Flat except Flat Rounded IV. Clinical presentations:
III. Mode of transmission : Enumerate? Schistosomes - Nausea & Vomiting
1) Feco-oral “Auto-infection” Body NO Has body 1. Intestinal : - Diarrhea
2) Ingestion of contaminated food or drink cavity cavity List? 2020 - Abdominal pain
3) Ingestion of under cooked infected meat Segments NO Segmented NO - Loss of Appetite
4) Skin penetration by larva Suckers Present NO - Intestinal obstruction.
5) By an arthropod : e.g. mosquito bite. GIT Present NO Present 2. Hepatobiliary Right hypochondrium pain
Teeth NO Present Jaundice
V. Diagnosis : List? Sex Hermaphrodic Hermaphro- Separate a) Hemoptysis.
1. Microscopic examination to detect : except ditic sexes 3. Lung b) Dyspnea.
 Eggs, Segments, or larvae. Schistosomes c) Respiratory failure
- Intestinal or hepatobiliary helminthes : Stool Life cycle Eggs must Water or Water,Soil, d) Chest pain, Cough
- Pulmonary helminthes : Sputum, Or Stool. complete reach water. Soil arthropod 4. Blood flukes - Esophageal varices
2. In tissue helminthes : d in “Schistosoma” - Haematemesis
- Imaging : X-Ray, MRI - Melena
I.H Needs Snail As animals or Some need
- Serology : detect antibodies. 5. Lymphatics Elephantiasis
I.H. Fish arthropod

Dr/ Raven 20
 L3 : Protozoa
Def : unicellular organisms, 1-150u, occur singly or in colony. Biology of protozoa
1) Cytoplasm 2) Nucleus 1) Movement “Locomotion” may move by :
a. Ectoplasm b. Endoplasm Formed of : a) Pseudopodia : Entamoeba
Outer hyaline Inner granular a. Nuclear b) Flagella with or without undulating membrane
Responsible for : Responsible for : membrane.
c) Cilia : Balantidium
Ingestion & excretion Nutrition & b. Nucleoplasm.
Respiration, Protection. reproduction. c. Chromatin 2) Nutrition through :
Structures : Contains : 2F, 2C granules. a. Absorption of liquid food.
1) Organs of locomotion 1) Food vacuoles d. Karyosome b. Ingestion of solid material by pseudopodia or cytostome.
2) Organs for : 2) Foreign bodies (nucleolus) : 3) Excretion : performed by : “OCD”
- Food intake : Cytostome 3) Contractile vacuoles - DNA body Osmotic pressure, Contractile vacuoles, Cytopyge, Diffusion
- Excretion : Cytopyge 4) Chromatoid bodies.
4) Reproduction : only in Trophozoite stage.
Classification “according to locomotion” :
A) Asexual reproduction
a. Sarcodina “Amoebae” :
▪ Move with pSeudopodia 1) Simple binary fission 2) Multiple (Schizogony , merogony or
1) Sarco- Sporogony)
▪ E. Histolytica
mastigophora Longitudinal or transverse, Nucleus > several divisions, followed by division
b. Mastigophora “Flagellates” :
Giardia lamblia into 2 organisms. of cytoplasm E.g. Plasmodium.
2. Ciliophora Move with Cilia, E.g. Balantidium coli. B) Sexual reproduction
Move with Apical Complex. 1. Gametogony or Syngamy 2. Conjugation
3. Apicomplexa
 Plasmodium
Fusion of 2 cells female (macrogamete) Fusion of nuclei from 2 organisms.
& male cell (microgamete) to form
General prevention & control strategy :
1. Case treatment zygote.
2. Health education E.g. Plasmodium. E.g. Blantidium coli.
3. Environmental sanitation
4. Pure water supply
5. Safe clean food
6. Sanitary disposal of feces
7. Insect control

Dr/ Raven 21
 L4 Summary
Mosquito Lice “Pediculus” Capitis Flies (Musca Fleas Ticks (Hard & Soft) A) Sarcoptes Scabiei B) Demodex House dust mites
& Corporis. domestica) “Scabies Disease” folliculorum
Medical importance
Only female A) Cause Pediculosis 1. Mechanical Transmits : A) Causes : ▪ Intracutaneous Tunnels Causes : Cause :
transmits (Vagabond’s disease): transmission 1) Plague 1) Dermatitis. ▪ Between fingers 1) Acne 1) Asthma.
diseases C/P : of : 2) Endemic 2) Tick paralysis ▪ Severe Itching at night - 2) Dermatitis 2) Allergic
1) Filariasis - Irritation. Viruses – typhus fever. by toxins in Saliva , Insomnia 3) Black heads Rhinitis
2) Dengue fever - Skin : thick, Bacterial – block neuromuscular ▪ Activated by warmth 4) Blepharitis. 3) Conjunctivitis
3) Human hyperpigmentation Parasites. Cause junctions ▪ Tortuous tunnels Dark in
Malaria 2. Accidental 3) Flea B) Transmits : color
4) Yellow fever B) Transmit: (body myiasis. Dermatitis - Lyme disease. ▪ Scratching  Secondary
louse) - Viral meningo- bacterial infection on top
1) Epidemic typhus. encephalitis fever. ▪ Crusted scabies.
2) Epi. relapsing - Texas cattle fever.
fever
3) Trench fever
Control
1. Physical : 1) Bathing. 1. Health 1. Sanitation. Treatment : 1. Application of : 1) Sulphur ointment 1) Exclusion of
Bed nets (27 2) Boil clothing education & 2. Boiling of By removal of tick : Pyrethrum - Benzyl 2) Benzyl benzoate dust
meshes/square 3) Application of : sanitation. cloths & 1) Anaesthetize with benzoate - Sulphur- 3) Oral Ivermectin. 2) Cleaning
inch) Permethrin lotion 1% 2. Fly nets. linings. Ether lanoline - Ivermectin beds &
2. Biological. - Benzyl alcohol - 3. Insecticides 3. insecticides. 2) Suffocate it with 2. Antihistaminic for furniture by
3. Chemical : Malathion. e.g. DDT & 4. Flea traps. Gasoline oil. itching. vacuum cleaner.
Repellants - ivermectin. Pyrethrum 3. Antibiotic for 2ry
Paris green Control : insecticides. infection.
4. All members of family
treated

Dr/ Raven 22
 L5 : Myiasis
Def : invasion of tissues of man or animals by larva of flies.
1) According to habitat (Site of invasion) 2) According to Habit (Biological habit of fly)
A) Internal Myiasis B. External myiasis 1) Specific 2) Semi-specific 3) Accidental
Intestinal Urogenital 1. Cutaenous 2. Ocular 3. Aural Invade only living Flies oviposit or - Fly eggs or larvae
1. Deposit 1.Enter via Wounds or - Larvae - Larvae tissues larviposit on dead deposit on food “cheese &
Mode of eggs or urinary or genital ulcers. attracted to attracted to tissues. vegetables”
infection larvae on orifices. discharge discharge 1) Hypoderma & Then accidentally ingested
food 2. lesions on from Eye or from Ears. Dermatobia Mode of Infection:  intestinal myiasis.
2. On anus orifices. Nose & brain. Invade skin > boil Attracted to
- Nausea 1. Obstruction of - Delayed 1. Ocular : - Crawling like swellings. discharge from - Eggs deposited around
Clinical - Vomiting urine flow + wound Severe eye sensation neglected wounds anus or urogenital orifice
Present- - Diarrhea dysuria healing pain – - Buzzing 2) Wohlfahrtia & > intestinal or urogenital
ation - Abdominal 2. Inflammation: - Boil like Lacrimation noise Oestrus larvae C/P : myiasis.
pain pus, mucus & lesion. - irritation. - Discharge invade eyes, nose Sepsis & Larvae
blood in urine. - Sever 2. Nasal : - Perforation & external ears. prevent healing. Example of such flies are :
Living & dead Larvae in urine. pruritis, Discharge – of drum. d. Piophila : in cheese
Diagnosis larvae in - Creeping Obstruction - Examples : e. Drosophila : in fruits
stools or eruption facial Edema Sarcophaga f. Fannia .
vomitus. - Epistaxis. Wohlfahrtia g. Musca.
Causes : - Musca - Fannia Dermatobia. Oestrus Wohlfahrtia Lucilia.
Larvae of - Lucilia - Musca Wohlfahrtia Hypoderma Lucilia
- Fannia Gastrophilus

Diagnosis 1) Finding larvae in lesion 2021 then Identify larvae by posterior respiratory spiracles.
2020 2) Breeding living larvae to adult stage
Treatment 1) Removal of larvae : excision or endoscopy.
2) Treatment of 2ry infection by Antibiotics
Control 1) Insecticides & nets.
2) Protection of food from flies.
3) Cleaning & covering wounds by gauze &dressing.

Dr/ Raven 23
 Parasitology Written Questions

Lecture 1

1) Define the following:

▪ Parasites which can’t complete its life-cycle without exploiting
Obligatory parasites:
a suitable host.
▪ Parasites which can either live freely (in soil or water) or as
Facultative parasites parasites in hosts when unfavorable environmental conditions
occur.
▪ these are free living organisms which enter the human body by
mistake
Accidental parasites:
▪ e.g. larvae of flies which are accidentally ingested and live in
the
Temporary parasites: ▪ visit its host from one time to another for feeding then leave.
Specific parasite: ▪ affects only one host species.
▪ a parasite species foreign to the host which has just passed
Coprozoic (Spurious)
through the alimentary canal without infecting the host.
parasites:
▪ (For example, parasite eggs in animal liver).
Ectoparasite: ▪ a parasite which lives on the outside of the host.
Endoparasite: ▪ a parasite which lives on the outside of the host.

2) What is the stage that this host contain?

▪ a host in which the parasite reaches its sexual maturity (adult
Definitive host
stage).
▪ a host in which the immature (larval not adult) stage of the
Amplifier host
parasite is found, or in which the parasite multiplies asexually.
▪ an animal that harbors the parasite and acts as continuous
Reservoir host
source of human infection.
▪ a host that harbors a parasite in an arrested state of
Paratenic host development but the parasite remains alive and viable, ready to
infect a subsequent suitable host.

3) What are classes or types of symbiosis relationship?

1- Parastisim
2- commensalism
3- mutalism
4- phoresis

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 Parasitology Written Questions

4) Classify zoonosis according to source of infection

▪ the source of infection is a wild animal with no close
relationship to man.
a. Feral or sylvatic zoonosis
▪ Humans become exposed to infection in the course of
hunting.
▪ the source of infection is man's own domesticated
b. Domestic zoonosis:
animals.

5) Classify zoonosis according to method of transmission

▪ infection is directly transmitted from the reservoir host
a. Direct zoonosis:
to man.
▪ infection is transmitted from the reservoir host to man
b. Metazoonosis:
via an arthropod.
▪ infection is transmitted via a non-animal developmental
c. Saprozoonosis:
site as the soil and water.

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 Parasitology Written Questions

Lecture 2
1) What are the general characters of trematodes (flukes)?
▪ Flattened dorsoventrally (leaf like) except Schistosoma
▪ Has no body cavity
Characters ▪ Unsegmented
▪ Bilaterally symmetrical
▪ Cuticle covered with spines (help in fixation)

2) What are the organ of fixation in trematodes?

▪ Oral sucker: at the anterior end surrounding the mouth.
▪ Ventral sucker: in the ventral surface
▪ Genital sucker sometimes
▪ spines suckers

3) Describe the alimentary canal of trematodes:

▪ Mouth at the anterior end
▪ Esophagus having a muscular pharynx
▪ Two intestinal caeca end blindly at the posterior end

4) What is the sex of trematodes?

▪ Each adult parasite contains both male and female sex organs) except Schistosoma
(unisexual).

5) What are the general characters of cestodes?

▪ Flattened dorsoventrally.
▪ Has no body cavity.
▪ Has no digestive canal.
▪ Segmented into scolex, neck and strobila.
▪ Cestodes are hermaphrodites:
- Each mature segment contains both male and female sex organs.
- Cross as well as auto-copulation takes place.

6) Who is responsible formation of strobila and describe its formation?

▪ Neck is the most importantbecause it contain active dividing cells .
▪ (Proglottids or segments) a chain of segments which is divided into:
- Immature segments in which the reproductive organs are not fully developed.
- Mature segments in which the reproductive organs are fully developed and
functioning.
- Gravid segments in which the uterus is full of eggs.
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 Parasitology Written Questions
7) What are the organs of fixation of cestodes?
▪ bothria suckers rostellum and hooks

8) Describe the alimentary canal of nematodes:

▪ Mouth that may have lips, papillae, a buccal cavity or provided with teeth.
▪ Esophagus which takes different shapes
▪ Intestine ends in the anus

9) What is the sex of nematodes?

▪ Separate sexes (unisexual) male is smaller and curved posterior end / female is longer
and straight posterior end

10) What is the difference between male and female nematodes?

▪ Females are longer than males
▪ Female posterior end: Straight
▪ Male posterior end: Curved.

11) Tabulate the differences between trematode, cestode, nematode according to habitat
and presence of snail:
Trematoda Cestode Nematode
Hosts snail Animal or fish arthropod
Snail NEED NOT NOT

12) Compare between trematode and cestode digestive system, sex:

Trematode Cestode
Digestive system Presen( incomplete)t NO
Sex Hermaphroditic Except Schistosomes Hermaphroditic

13) List the intermediate hosts in the following helminthes:

a) Trematodes Need snail
b) Cestodes … Animal or fish
c) Nematodes Most of soil parasites don’t need I.H
Some need arthropod

14) What are the hosts that must be present in

helminthes?
▪ Definitve host, intermediate host ( snails )
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 Parasitology Written Questions

15) List 4 methods of transmission in helminthes (enumerate , mention):

▪ Feco-oral
▪ Ingestion of contaminated food or drink
▪ By an arthropod → Ingestion of under cooked infected meat
▪ Skin penetration by larva

16) What is the complaint when patient presented with gastrointestinal helminthic infection ?
▪ Abdominal colic
▪ Diarrhea
▪ Vomiting,
▪ May be complicated by intestinal obstruction in heavy infection.

17) What is the complaint when patient presented with pulmonary helminthic infection ?
▪ Chest pain, cough, dyspnea (difficult breathing), hemoptysis (coughing of blood) or
respiratory failure.

18) What is the complaint when patient presented with hepatic helminthic infection?
▪ Right hypochondrium pain
▪ Jaundice.

19) List 4 complications to helminthic infection:

▪ Intestinal obstruction in heavy infection.
▪ Respiratory failure.
▪ Esophageal varices
▪ Elephantiasis

20) Mention three different diagnostic modalities in helminthic infection:

Clinical
▪ Microscopic examination to detect the adult, characteristic eggs,
segments or larvae.
▪ In intestinal or hepatobiliary helminths: stool or duodenal aspirate
Laboratory
help in diagnosis.
▪ Pulmonary helminths: sputum or stool examination
▪ Urinary helminths: urine examination
▪ Imaging: X-Ray, US, C.T or MRI on affected organs.
In tissue ▪ Serological tests: detect antibodies in serum
helminths ▪ Endoscopy e.g. sigmoidoscopy or cystoscopy.
▪ Histopathological diagnosis

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 Parasitology Written Questions

21) List 2 types of endoscope used to diagnose helminthic infection:

▪ Sigmoidoscopy or cystoscopy

22) Enumerate types of samples in case of helminthic infection:

▪ Microscopic examination to detect the adult, characteristic eggs, segments or larvae.
▪ In intestinal or hepatobiliary helminths: stool or duodenal aspirate help in diagnosis.
▪ Pulmonary helminths: sputum or stool examination
▪ Urinary helminths: urine examination

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 Parasitology Written Questions

Lecture 3

1) Define ectoplasm and mention its function:

▪ The outer hyaline layer that is responsible for ingestion of food, excretion, respiration,
protection and sensation.
▪ Some structures develop from ectoplasm as:
▪ Organs of locomotion: pseudopodia, flagella and cilia.
▪ Organs for food intake or excretion: cytostome and cytopyge.

2) Define endoplasm and mention its components:

▪ The inner granular part of cytoplasm that is responsible for nutrition and reproduction.
▪ The endoplasm contains number of structures as:
▪ food vacuoles, foreign bodies, contractile vacuoles and chromatoid bodies.

3) List the structural component of protozoal nucleus:

a) Nuclear membrane.
b) Nucleoplasm.
c) Chromatin granules.
d) Karyosome (nucleolus): It is a DNA containing body, situated centrally or peripherally
within the nucleus.

4) What are the organs of locomotion in protozoa:

▪ pseudopodia, flagella and cilia and apical complex

5) Illustrate methods of nutrition in protozoa:

▪ It is through:
a) Absorption of liquid food.
b) Ingestion of solid material through the ectoplasm by pseudopodia or the cytostome
and become surrounded by food vacuoles.

6) What is the function of digestive enzymes used by protozoa:

▪ assimilate the food and the undigested particles are extruded through the surface of the
body or through a specialized opening (cytopyge).
7) What are the organs of excretion in protozoa:
▪ It is performed by osmotic pressure, contractile vacuoles, diffusion or cytopyge.

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 Parasitology Written Questions

8) Protozoa have many secretions. List 5 of them:

▪ cyst wall, digestive enzymes, pigments, proteolytic enzymes, haemolysins, cytolysins,
toxic and antigenic substances

9) What is meant by the following and give example:

a) Schizogony followed by division of cytoplasm into small parts to produce large number
of small merozoites or sporozoites within the schizont, e.g. Plasmodium.
b) Gametogony It means fusion of two cells, one is female (macrogamete) and the other is
the male cell (microgamete), e.g. Plasmodium.

10) Compare between types of life cycle of protozoa according to host, multiplication ,
habitat:
1. Simple life cycle: 2. Complex life cycle:
Host ▪ Only one host ▪ a vertebrate and an invertebrate host
▪ asexually ▪ The sexual multiplication occurs in
Multiplication one host and the asexual
multiplication in another host.
▪ Intestinal and luminal ▪Most blood and tissue parasites
Habitat protozoa

11) Classify sarcomastigophora and give examples:

a) Sub-phylum Sarcodina (Amoebae): Parasitic Amoeba Entamoeba histolytica
b) Sub-phylum Mastigophora (Flagellates): Giardia intestinalis.

12) Mention alternative names of apicomplexa and give example:

▪ Called: Sporozoa or Coccidia.
▪ Move with Apical Complex.
▪ E.g.: Plasmodium.

13) Mention five preventive measures to eradicate protozoa:

1. Case treatment
2. Health education
3. Environmental sanitation
4. Pure water supply
5. Safe & clean food
6. Sanitary disposal of feces
7. Insect control

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 Parasitology Written Questions

Lecture 4

1) Compare between hexapoda and octapoda according to `body, wings, legs give
examples:
Hexapoda Octapoda
a) Head a) Cephalothorax
Body b) Thorax b) Abdomen
c) Abdomen c) OR one mass
Wings 2 pairs, 1 pair OR No wings. Absent
Legs 3 pairs 4 pairs

2) How arthropods act as disease agents?

1) Tissue invasion as :
- Larvae of flies (myiasis)
- Sarcoptes scabiei (Scabies) .
2) Inoculation of Poisons: Ticks, Scorpions & Spiders.
3) Entomophobia: Abnormal fear occurs when seeing an arthropod (Scorpion)
4) Dermatitis: by insect bite as lice, mosquitoes

3) What are the types of transmission in insects and give examples?

How insecta transmit diseases and act as vectors?
▪ Arthropods as vectors for transmission of diseases agents, by:
1. Mechanical transmission (Passive carrier)
- e.g. Typhoid fever by Musca fly.
2. Biological transmission (Part of its Life cycle)
- e.g. Plague by Fleas.

4) What are the types of metamorphosis and give examples

1. Complete metamorphosis
Mosquitoes, Flies, Fleas .
- Egg - Larva - Pupa - Adult
2. Incomplete metamorphosis
Lice
- Egg - Nymph – Adult
3. Gradual metamorphosis
Arachnida
- Egg - Larva - Nymph – Adult

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 Parasitology Written Questions

5) Mention different types of mosquitoes and its medical importance

Human malaria (Anopheles spp.)

Lymphatic filariasis (Culex spp.)
Yellow fever, dengue fever (Aedes aegypti)

6) What is the Value of insecticides and give examples

Chemical control for class insecta as mosquitoes and flies or fleas
example: in mosquitoes (Paris green as poison for larvae, DDT), repellants
(Citronella oil).
7) What is the medical importance of musca domestica
▪ Mechanical transmission of Viruses, Bacterial & Parasites disease (e.g.,protozoa cyst &
helminths eggs).
▪ Accidental myiasis.

8) Enumerate lice types infesting human

▪ Lice infesting man:
▪ Pediculus humanus capitis (head louse).
▪ Pediculus humanus corporis (body louse).
▪ Phthirus pubis (pubic louse): sexually transmitted parasite.

9) What are the disease transmitted by pediculus , and which species can transmit them
▪ Head Lice cause itching and dermatitis (NOT known to transmit pathogens).
▪ Pediculosis (vagabond’s disease) by all types:
- severe dermatitis, skin becomes thickened hyper-pigmented skin.
▪ Vector of diseases (body louse): as Epidemic typhus, Epidemic relapsing fever & Trench
fever.

10) How to prevent pediculosis and mention the oral drug can be used
▪ Oral ivermectin.
▪ Topical pediculicides (Permethrin lotion 1%, Benzyl alcohol).
▪ Heath education and good hygiene.
▪ Frequent bathing.
▪ Wet combing of hair.
▪ Washing cloths and bed lining in boiled water.

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 Parasitology Written Questions

11) Mention the general characters of fleas

▪ Small, bilaterally compressed.
▪ Brown in colour, with no wings.
▪ Mouth is adapted for piercing and sucking of blood.
▪ Complete metamorphosis (Egg —> Larva —> Pupa —> Adult).

12) What is the bacterial diseases transmitted by pulex irritans

▪ Plague: Acute severe infectious disease.

13) Mention two types of fleas and two diseases transmitted by them
1. Pulex irritans (Human flea).
2. Xenopsylla cheopis (Rat flea).
a) Plague: Acute severe infectious disease.
b) Endemic typhus fever.

14) Classify ticks

▪ Ixodidae (hard ticks)
▪ ArgaSidae (Soft ticks).

15) Enumerate three diseases transmitted by ticks .

1) Viral disease: Viral meningoencephalitis fever.
2) Bacterial diseases: Lyme disease.
3) Protozoal diseases: Texas cattle fever.

16) Give short account on tick paralysis and what are the species cause it.
▪ Produced by toxins in Saliva of tick.
▪ Occur when tick attach near to CNS “Head or spinal cord”
▪ Toxin block neuro-muscular junctions & some synapses of spinal cord.
▪ Paralysis :
- Start in legs then spread upward.
- Disappears after removal of tick.

17) How to treat tick bite ?

▪ By removal of tick - it is best to :
- Anaesthetize tick with Ether
- Suffocate it with Gasoline oil, Glycerin or Kerosene.

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 Parasitology Written Questions

18) What are the important members in mites family ?

A) Sarcoptes scabiei (Itch mite)
B) Demodex folliculorum.
C) House dust mites (HDMs).

19) Illustrate briefly habitat and life cycle of sarcopetes scabiei

▪ Skin: It lives in intracutaneous tunnels of thin skin between fingers, wrist, back of the
hands
▪ The head and neck are not affected.
▪ The female burrows tortuous tunnels in the skin epidermis and deposits eggs.
▪ The larvae and nymphs move freely over the skin and found in hair follicles.

20) Mention four clinical manifestations in patient with scabies

▪ The activity of mites usually occurs during night.
▪ It is activated by the warmth of the affected part.
▪ Mites produce tortuous tunnels, dark in colour due to the toxins secreted and their
excretions.
▪ Severe itching occurs.
▪ Scratching and secondary bacterial infection occur on top, resulting in vesicles and
pustules.
21) Mention different types of scabies ( classical , crusted )
a) Classical scabies: affect any part of skin, severe itching and scratching
b) Crusted scabies: A form of the infestation, called Crusted Scabies (Norwegian Scabies),
it is severe form can occur in immunosuppressed individuals; high numbers of mites are
present in keratotic lesions all over the body, highly infective.

22) How to diagnose a case of scabies

▪ Clinically:
- History of severe itching during night, its sites distribution in the skin, and by finding
the scratches, vesicles and pustules
▪ Laboratory:
- Skin scrapping of intracutaneous tunnels or lesions and then rapid microscopic
examination of the specimen by using Dermoscope.

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 Parasitology Written Questions

23) Scabicidal drugs ( mention two examples and how to apply )

a) Pyrethrum cream 5%
b) Benzyl benzoate (25%)
c) Sulphur- lanoline 5-10%
d) Ivermectin: Single Oral dose or recently as topical application.
▪ These creams & lotions applied to skin from neck downwards
▪ Washed off after 8-12 hours
▪ 2nd application a week later is recommended.

24) What are the important precautions in scabies case ?

1. Treatment of infested patients.
2. Avoid contact with infested patients.
3. Boiling of internal cloths & bed linen.
4. Personal hygiene as frequent Bathing.

25) Demodex is one mite family. Mention habitat and mode of infection
▪ Habitat: Hair follicles & sebaceous glands.
▪ Site : Face: Around nose, eyelids, mouth
1. Direct Contact with patient.
2. Using polluted towels

26) What are the clinical manifestation of hair follicle mite

1. Acne
2. Dermatitis
3. Black heads
4. Blepharitis

27) What is the habitat of house dust mite and clinical manifestations ?
▪ House dust mites contain dust allergens that produce allergic reactions in humans.
1) Bronchial Asthma.
2) Allergic Rhinitis
3) Conjunctivitis

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 Parasitology Written Questions

Lecture 5 myiasis

1) Define myiasis and classify according to habitat , give examples.

▪ It is the invasion of the tissues of man or animals by larvae of dipterous (have 2 wings)
flies.
A. Internal:
1. Intestinal
2. Urogenital
B. External:
1. Cutaenous
2. Ocular or Nasopharengeal
3. Aural

2) Classify myiasis according to habit

A. Specific
B. Semi-specific
C. Accidental

3) Intestinal myiasis ( mention mode of transmission , symptoms , example )

1. Flies deposit eggs or larvae on human food
2. On anus (Rural children) during sleep or defecation in open places.
a. Nausea
b. Vomiting
c. Diarrhea
d. Abdominal pain
a. Lucilia (green bottle fly) c. Musca
b. Fannia d. Calliphora.

4) Urogenital myiasis ( mention mode of transmission , symptoms , example)

1. Urinary or genital orifices.
2. Lesions on orifices during urination in open places.
3. Obstruction of urine flow with dysuria
4. Inflammation with pus, mucus & blood in urine.
a. Sarcophaga
b. Fannia “the latrine fly”
c. Musca
d. Calliphora

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 Parasitology Written Questions

5) What is the presentation of nasal myiasis and mention flies causing it.
▪ first complaint in ocular myiasis : Severe eye pain followed by lacrimation & irritation.
▪ Nasal myiasis presented with :
- Foul smelling discharge followed by nasal obstruction
- Facial edema
- Frontal headache & epistaxis.

6) What are the complaints of aural myaisis

▪ Larvae invade middle & inner ear.
▪ Invade Brain tissue in extreme cases.
▪ Crawling sensation & buzzing noise
▪ Foul smelling discharge

7) What is meant by and give example for the following

a) Specific myiasis ……
- This is the condition when larvae invade only living tissues (Obligatory tissue
parasite)
- e.g. Hypoderma and Dermatobia;
b) b- Semispecific myiasis:
- This group includes flies which habitually oviposit or larviposit on dead tissues of
man or animals or decaying organic matter (Facultative parasites). Examples of
such flies are: Calliphora, Lucilia, Chrysomia.Sarcophaga, Wohlfahrtia.
c) Accidental myiasis:
- When fly eggs or larvae are deposited on food material (e.g. cheese and vegetables)
and then they are accidentally ingested leading to intestinal myiasis.
- Example of such flies Piophila in cheese, Drosophila in fruits and Fannia (the latrine
fly).

8) How to diagnose a case of intestinal

myiasis
▪ Living & dead larvae in stools or
vomitusLarvae identified by its posterior
spiracles or through its breeding to
become adult

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 Parasitology Written Cases

Cases

Case 1

A50-year-old male farmer complained from fatigue, abdominal pain and passage of
bloody stool. Abdominal examination showed hepato-splenomegaly and stool microscopic
examination revealed eggs with lateral spine.

➢ What is the most likely parasitic diagnosis?

✓ Schistosoma mansoni

➢ Examine the life cycle then identify:

1. The definitive host. human
2. The reservoir host. Sheep or cattle
3. The intermediate host. Snail

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 Parasitology Written Cases

Case 2

A24 year old man presented to outpatient clinic with fever, crampy abdominal pain and
frequent bloody mucoid diarrhea. Stool examination revealed motile amoeboid
trophozoites.

➢ What is the most likely parasitic diagnosis?

✓ Entamoeba Histolytica

Case 3

A 12-year-old boy presented to outpatient clinic for delayed wound healing of his left toe.
He reported having an operation for ingrown toe nail, 3 months earlier. After that, he
ignored wound care due to pain while dressing the wound. At presentation, the lateral
edge of his left toe was hyperemic and swollen without purulent material. Worms like
structure were observed on the lesion’s necrotic tissues. The surgeon debrided the necrotic
tissues, removed the larvae, and an antibiotic was administered to treat a secondary
bacterial infection. The wound was kept clean and dry.

✓ Cutaneous myiasis

Case 4

A 11-year-old boy was presented to Ear, Nose and Throat (E.N.T.) specialist suffering
from earache, with foul-smelling discharge from his right ear, for 15 days. He was
diagnosed as right otitis media. He was prescribed several types of antibiotics with no
response. After one month, his mother observed some small worm-like structures coming
out of his infected ear, with purulent aural discharge.

1) Which insect(s) is(are) causing this patient's symptoms ?

✓ Lucilia – chrysomia – sarcophaga → Aural Myasis
2) How can you confirm the diagnosis ?
3) What is the specific treatment ?
4) Can you classify myiasis according to parasitism and according to the type of tissue
invaded ?

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 Parasitology Written Cases

Case 5

A 11-year-old child was presented to the Dermatologist suffering from sever itching in the
groin, lower abdomen, elbows and neck. The child said that itching was sever during
night. Clinical examination revealed multiple scratches, elevated red tracks in the skin
with small papular lesions in the affected areas. Skin specimens, of the affected areas .

5) Do you think that the patient's illness may be a result of parasitic infection ?
✓ Yes
6) Name the insect that may cause this patient's illness.
✓ Sarcopetes scabie
7) Name the disease caused by this insect.
✓ Scabies
8) How is this infection acquired ?
9) Describe the life cycle and pathogenicity of this insect.
10) How is the diagnosis of this infection made ?
11) How is this infection treated ?
12) What are the precautions to be followed during treatment of this infection ?
13) How can you prevent and control this disease ?

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