rd

OSPE Revision Year

3
MBBS, PMC
• A 6 years old child is suffering from high grade
fever, chills, respiratory distress and pain in left
chest when he coughs.

• His sputum was thick rusty colored. There was

dullness in the left lateral posterior chest
suggesting consolidation of the lung.

• Sputum culture on blood agar showed alpha

hemolysis.
• Identify the given organism?
• Streptococcus pneumonae

• Name two reagents used in gram staining?

• Crystal violet, grams iodine, safranin (any 2)

• What type of hemolysis it shows?

• Alpha haemolysis

• Name two diseases caused by this organism?

• Pneumonia, meningitis, otitis media, sinusitis (any 2)
• You are shown a culture plate generally used for
urine culture in microbiology laboratories. Carefully
observe the given photograph below and answer
the given questions.
• Identify the given medium in photograph?

• CLED agar

• CLED is abbreviation of?

• Cystein lactose electrolyte deficient medium.

• Name four organisms which can grow on this

medium?

• E. coli, Klebsiella pneumonae, proteus species,

Enterococcus faecalis, staphylococcus aureus,
Streptococci. (any 4)
• A 21 years old male
patients was suffering
from high grade fever
with vomiting and
abdominal discomfort
since last 10 days. His
blood sample was taken
and a test was performed
which is shown in the
picture below. Carefully
examine the picture and
answer the questions.
• Name this test? 1
• Widal test

• Define titer? 1
• The maximum dilution of serum in which agglutination
occurs is known is titer.

• What is the titer of “O” and “H” antigen in the given

report? 1
• Titer H antigen is 1:320 and O antigen is 1:160

• Name two alternative tests?1

• Blood culture, Typhidot test
• You are shown gram stained smear of vaginal swab
from a lady with excessive vaginal discharge.
Carefully examine the photograph and accomplish
your task by answering the given questions.
• Write down your findings in this photograph?
• Yeast showing pseudo- hyphae

• Identify the given organism?

• Candida albicans.

• Name 2 diseases caused by this organism?

• Thrush, vaginitis, esophagitis, mucocutaneous
candidiasis, endocarditis (any 2).

• What type of infection it is?

• It is opportunistic infection.
• A parasite whose
vector is tsetse fly
and is spread
through the skin to
the blood and then
to lymph nodes and
brain is shown in
the photograph
below (pointing
arrow).
• Identify the organism?
• Trypanosoma bruci ________Trypomastigote

• What is the disease caused by this organism?

• Sleeping sickness disease

• Name 2 other species of this organism?

• Trypanosoma gambiense, trypanosoma rhodience

• Write down two methods for its lab. diagnosis?

• Wet blood film, thick and thin blood smear, ELISA for
IgM antibody, Spinal fluid elevated proteins
• A nutrient
medium
commonly
used in
microbiology
laboratory in
shown in the
• Identify the medium?
• TSI agar
• Name three sugars present in this medium?
• Glucose, lactose and sucrose

• Name pH indicator used in this medium? 1

• Phenol Red

• What is the reason of black color in 3rd tube?

• H2S production
• You are shown a medium in the photograph below.
Observe the picture carefully and answer the given
question.
• Identify the medium?
• LJ Medium (Lowenstein Jensen Medium)

• What makes the color of the medium green? 1

• Malachite green

• Name two organisms which can grow on this medium?

• Mycobacterium tuberculosis, Mycobacterium bovis,
Mycobacterium avium(any2).

• Growth of the organism will be observed after how

much time?
• 03-04 week
• An instrument which is
commonly used in
medical laboratories
and hospitals is shown
in the photograph
below.
• Identify the instrument?
• Autoclave

• What is principal involved in its use?

• Steam at 121 C, under high pressure of 15lbs/square
inch for 15-20 minutes.

• Write one of its limitations?

• Plastic ware, sharp instruments may become dull.

• Name two other methods used for sterilization? 1

• Radiations, Chemicals
• An apparatus that is commonly used in medical
laboratories is shown in the photograph below.
•
• Name the apparatus shown in photograph?
• Hot Air Oven (01 Mark).

• Write down its use in Medical laboratory?

• It is used for sterilization of lab instruments which can
withstand high temperatures of dry heat e.g. glassware.
(01 Mark)

• How its temperature is controlled in this apparatus?

• Thermostat. (01Marak).

• What is the nature of heat generated by this apparatus?

Dry heat. (01Marak).
• An instrument hat is commonly used in
Microbiology laboratories is shown in the
photograph below. Carefully examine the
photograph and answer the given questions
correctly.
• Name the instrument shown in the photograph?
• Wire loop or inoculating loop.

• Write down its 02 uses in Microbiology laboratory?

• Inoculation of specimen on culture media, transferring
colony from one medium to another medium, making
smear (any two).
• Before isolating colonies with it, what should be done to
it?
• It should be sterilized on flame.
• What kind of material should be used ideally to form the
tip of loop?
• Platinum
• An apparatus that is commonly used in Microbiology
laboratories is shown in the photograph below.
Carefully examine the photograph and answer the
given questions correctly.
• Name the apparatus shown in above photograph?
• Anaerobic jar (Gas Pack anaerobic jar).
• Write down principle of its use?
• Anaerobic jar creates an artificial anaerobic
environment by using chemical gas pack. It
generates hydrogen gas which with oxygen in air
and generates water. Also generates CO2.

• Name 4 anaerobic bacteria?

• Bacteroides, clostridium tetani, clostridium
botulinum, clostridium difficile, fusobacterium,
prevotella, propionibacterium,
pepetosteptococcus, actinomyces, (any 2).
• A culture medium that is commonly used in
microbiology laboratory for bacterial culture is shown
in the photograph below. Carefully examine the
photograph and answer the given questions correctly.
• Identify the medium shown in the above photograph?
• Mac Conkey’s agar (un inoculated).
• What type of medium it is?
• It is selective (for enteric bacteria) and differential
media (differentiates lactose fermenters from non-
lactose fermenters.
• What is the color of colonies of lactose fermenters on
this medium?
• Pink colour.
• What is a differential medium?
• A differential medium differentiates between two
different bacteria based on their colony colour
differences on the medium or changes in colour around
the colonies.
• A culture
medium
that is
commonly
used in
microbiolog
y laboratory
is shown in
the
photograph.
• Identify the medium shown in the above photograph?
• Chocolate agar (un inoculated).
• Name 02 pathogenic bacteria which can be isolated
/identified using this medium?
• Neisseria gonorrhoea, Neisseria meningitidis, H.
influenzae (any 2).
• Does it contain chocolate?
• No.
• Which samples are inoculated on this medium for growth
of bacteria?
• Samples from urethral discharge, Cerebrospinal fluid
(CSF), Sputum (any 02).
• Chocolate
agar medium
in petri
dishes is
shown below
in
photograph.
Examine the
photograph
and answer
the given
questions
correctly.
•
• Why bacteria are cultured on media?
• Bacteria are cultured for their; identification, isolation,
studying their properties, preparing vaccine, antigens
toxins and test antibiotic sensitivity (any 4).
• Name 4 types of culture media?
• 1. Basic media, 2. Selective media, 3. Differential
media, 4. Enriched media, 5. Special media (any 4).
• How chocolate agar culture medium is prepared?
• Chocolate agar is non- selective enriched growth
medium that is prepared by heating the blood agar
slowly to 80C which lyses RBCs and inactivates the
inhibitors.
• You are
shown blood
culture
bottle that is
commonly
used for
blood
culture in
microbiology
laboratory.
• Why blood culture is done?
• Blood culture is done to detect any infection in the
blood of a suspected patient of septicaemia and treat it
appropriately.
• Name 4 major clinical indications for blood culture?
• Known or suspected sepsis, meningitis, osteomyelitis,
arthritis, endocarditis, peritonitis, pneumonia and
suspected typhoid fever or pyrexia of unknown cause.
• In case of typhoid fever, when blood culture is most likely
positive?
• In first week its positive in 90% of cases, in second week
75% and in third week it is positive in 60% of cases.
• You are shown a
bacterial culture
medium that is
used in
microbiology
laboratory.
Examine the
photograph and
answer the given
questions
correctly.
• Identify this medium?
• Robertson’s cooked meat medium (Broth).
• What is its composition?
• Peptic digest of animal tissue, dextrose, sodium
chloride, yeast extract, Vitamin K, iron filling, hemin
water in a specific ration.
• Which bacteria can be cultured using this medium?
• It is used to differentiate between clostridium
perfringens (turns the colour of meat pieces red) and
clostridium tetani (turns the colour black due to
proteolysis).
• You are
shown a
device that
is used in
serological
testing in
clinical
laboratory.
Examine the
photograph
and answer
the given
questions.
• Identify the given device?

• Elisa Microtiter plate.

• Name the serological technique in which it is used?

• Enzyme linked immunosorbent assay (ELISA).

• Write four clinical applications of this technique?

• To detect antigens/antibodies against hep. B virus,

antibodies against hep. C virus, HIV, Hep. A virus,
Cytomegalovirus.
• A 26 years old welding worker presents to surgical OPD with
massive cellulitis on the back of his leg after a nail injury. On
examination he was febrile with swelling and redness on his leg. A
swab was taken from the site of nail injury and sent to the clinical
laboratory. The bacterial growth showed golden colonies on blood
agar. Gram stained smear of the culture is shown.
• Name the organisms visible in the above slide?
• Staphylococcus aureus (Gram positive cocci in clusters).
• What is Gram Staining?
• Gram staining is a staining technique that differentiates
bacteria into two major groups bases on the structure of
cell wall. Gram positive (Blue or purple colour) and gram
negative (pink or red colour). It helps in identification of
bacteria based on their morphology.
• Name one test that differentiates staphylococci from
streptococci?
• Catalase test.
• Name four enzymes of staphylococcus aureus?
• Coagulase, fibrinolysin, hyaluronidase, proteases,
nucleases, and lipases. (any 4)
• A 26 years old university student came to clinic with
complaints of sore throat. Physician after his medical
examination sent a throat swab sample to clinical
laboratory for culture. After culture on blood agar the
smear was gram stained that is shown.
• Identify the organism with pointed arrow?
• Streptococci (Gram positive cocci in chains)
• Name single test that can differentiate between
streptococci and staphylococci?
• Catalase test
• Name the test that can differentiate between group A
and group B streptococci?
• Bacitracin test.
• What is beta haemolysis, give one example?
• Beta haemolysis is complete haemolysis caused by
streptococci on blood agar plate. examples are group A
streptococci (streptococcus pyogenes), Group B
streptococci (streptococcus agalactiae). (any 1)
• Shown below is a
picture of the test
that is used to
differentiate
between two groups
of gram positive
cocci bacteria.
Carefully examine
the photograph,
correlate your
knowledge about the
test and answer the
questions?
• Name the test?
• Bacitracin test.
• Which group of bacteria is sensitive to this test?
• Group A streptococci (Streptococcus pyogenes) are
sensitive to the test (bacitracin).
• Which group is resistant to this test?
• Group B streptococci (streptococcus agalactiae) are
resistant to the test (bacitracin).
• What is alpha haemolysis, give one example?
• Alpha haemolysis is incomplete haemolysis caused by
streptococci on blood agar plate. examples are
streptococcus pneumoniae, viridans group of
streptococci. (any 1)
• Shown below is the
picture of a test that
is used for
identification of
gram positive cocci
bacterium that
causes pneumoniae
and meningitis.
• Name the test?
• Optochin test.
• Which bacteria is sensitive to this test?
• Streptococcus pneumoniae are sensitive to this test
(Optochin).
• Which bacteria is resistant to this test?
• Viridans group of streptococci are resistant to this test
(Optochin).
• What is quelling reaction?
• When a specific antiserum is applied against an
antigenic type of streptococcus pneumoniae its capsule
swells up which helps in identification. This is called
quelling reaction.
• A 22 years old
sexually active
male came to
clinic with
complaints of
fever, pain and
white color
urethral
discharge. A swab
sample of
urethral discharge
was sent to
microbiology
laboratory.
• Name the microorganism shown with pointed arrow?
• Neisseria gonorrhoea.
• Name two diseases caused by this organism?
• Pelvic inflammatory disease, conjunctivitis (ophthalmia
neonatorum), disseminated infection, cervicitis,
urethritis (any 2).
• Write down two properties of polysaccharide capsule of
this organism?
• Enhances virulence by its antiphagocytic action, Is the
antigen that defines the serologic groups, Is the antigen
detected in the spinal fluid of patients with meningitis,
the antigen in the vaccine. (any 2).
• Name the media that is used for culturing this
bacterium?
• Chocolate agar.
• Shown below
is a picture of
gram positive
rod bacteria.
Carefully
examine the
photograph,
correlate your
knowledge
and answer
the questions?
• Identify the micro-organism pointed with arrow?

• Bacillus anthracis.

• Name two diseases caused by this organism?

• Cutaneous and pulmonary anthrax.

• What is composition of capsule of this organism?

• It is composed of D-glutamate.

• Does vaccine available for this organism?

• Yes.
• Shown below is a
picture of gram
positive rod
bacteria that is
anaerobic, spore
forming and
enters wound
through
contaminated
soil. Carefully
examine the
photograph,
correlate your
knowledge and
answer the
questions?
• Identify the micro-organism pointed with arrow?
• Clostridium perfringens.
• Name two diseases caused by this organism?
• Gas gangrene (myonecrosis, necrotizing fasciitis),
food poisoning.
• Does this organism exist as normal flora?
• Yes (colon)
• Name toxin produced by this bacterium which
destroys cell membranes?
• Alpha toxin (lecithinase)
• Shown below is a picture of gram positive rod (club
shaped) bacteria. Carefully examine the
photograph, correlate your knowledge and answer
the questions?
• Identify the micro-organism shown above?
• Corynebacterium diphtheriae.
• Name one disease caused by this organism?
• Diphtheria, tonsillitis (pseudo membrane),
lymphadenopathy
• Name two disease complications caused by this organism?
• Airway obstruction, myocarditis (arrhythmias) nerve
weakness or paralysis (any 2).
• What is Schick’s test?
• The immune status of a person can be assessed by Schick's
test. The test is performed by intradermal injection of 0.1
mL of purified standardized toxin. If the patient has no
antitoxin, the toxin will cause inflammation at the site 4–7
days later. If no inflammation occurs, antitoxin is present,
and the patient is immune.
• Shown below is
microscopic
view of gram
stained
bacteria.
Carefully
examine the
photograph,
correlate your
knowledge and
answer the
questions?
• Identify the micro-organism shown above?
• Gram negative bacilli.
• Name 4 organisms which show this type of morphology?
• E. coli, klebsiella pneumoniae, salmonella typhi,
proteus mirabilis, pseudomonas aeruginosa. (any 4).
• How can we generally differentiate between these
organisms?
• Colony morphology on culture media, staining
morphology, biochemical tests.
• What type of infection is usually caused by these
microorganisms?
• Urinary tract infections (UTIs).
• A 17 years old boy
develops watery
diarrhea after
eating fish from
Clifton beach. He is
dehydrated and has
cold skin. His stool
sample was sent to
laboratory to
determine the
cause of his
condition. After
inoculation the
organism isolated,
is shown in gram
stained picture.
• Identify the micro-organism shown above?
• Curve or comma shaped gram-negative bacilli (vibrio
cholera)
• Which part of the body is infected by this organism?
• Small intestine.
• Why this organism needs high infectious dose?
• Because it is sensitive to stomach acid.
• Name the toxin that causes cholera?
• Choleragen.
• A gram stained smear of CSF showing coco-bacillary
gram-negative rods (H. influenzae) is shown below.
Carefully examine the photograph, correlate your
knowledge and answer the questions?
• Name most pathogenic serotype of H. influenzae?

• H. influenzae serotype b (Hib).

• Name two diseases caused by H. influenzae?

• Meningitis and sepsis.

• What is the biochemical nature of the capsule of this

organism?

• Polysaccharide capsule.

• What is base of serotyping in capsular organisms?

• Serotyping is based on the antigenicity of capsule.

• A gram-
negative rod
bacterium
that shows
typical
pattern of
growth on
media, its
culture is
shown on
blood agar
plate.
• Name the organism with this typical pattern of
growth?
• Proteus species.
• What is this typical pattern of growth is called?
• Swarming effect (swarming growth pattern).
• Is vaccine available for this organism?
• No.
• What method is generally used to detect
organism’s motility under microscope?
• Hanging drop method.
• A gram-
negative rod
bacterium
that shows
typical
pattern of
growth on
media, its
culture is
shown on
agar.
• Name the organism that shows this growth
pattern?
• Pseudomonas aeruginosa.
• Name 2 pigments produced by this organism?
• Pyocyanin, pyoverdine.
• Name 2 infections caused by this organism?
• UTIs, pneumonia, skin infections, burn wound
infections. (any 2).
• How it smells on nutrient agar?
• It has fruity aroma on nutrient agar.
• This photograph shows acid fast bacilli pinkish-red
in color with bluish background.
• Name four acid fast bacteria?
• Mycobacterium tuberculosis, mycobacterium leprae,
M. kansasii, M. bovis, M. avium, nocardia asteroids
(any 4).
• Why these organisms are called acid fast?
• Because they resist decolorization by acid alcohol
• Name 2 methods of acid fast staining?
• ZN staining (Hot method) and Kinyon Method (cold
method), fluorescent methods (with fluorescent
stain). (any 2).
• Name the medium on which M. tuberculosis can be
cultured?
• Lowenstein Jensen (LJ) medium.
• This photograph shows dark field microscopic view
of the organism.
• Identify the organism?
• Spirochetes.
• Name two pathogenic types of this organism?
• Treponema pallidum, Leptospira species, Borelia
burgdorferi. (any 2).
• Name 2 diseases caused by this organism?
• Syphilis, Leptospirosis, Lyme disease, (any 2).
• Write 2 characteristics of this organism?
• Anaerobic, free living.
• Carefully examine the photograph, correlate your
knowledge and answer the questions?
• Identify the organism pointed with long arrow?
• Inclusion body of chlamydia trachomatis.
• What is the route of transmission of this organism?
• Sexual and through birth canal.
• Name 2 intracellular bacteria?
• Chlamydia and rickettsia.
• What is Reiter’s syndrome?
• Reiter's syndrome is an autoimmune disease caused
by antibodies formed against C. trachomatis cross-
reacting with antigens on the cells of the urethra,
joints, and uveal tract.
• A throat infection swab from a patient was cultured
on blood agar. The colonies of organism obtained
on agar plate are shown in the picture below.
• Identify and describe the gross features of above
isolated colonies?
• Colonies are wide zone of beta haemolysis.
Streptococcus pyogenes colonies.
• How much, temperature, atmospheric conditions and
time required for its culture?
• Incubation for 18-24 hrs, 37C, aerobically.
• Why there is clear zone around the colonies?
• Beta haemolysis of RBCs due to streptolysins O and S
(enzymes).
• Write names of 2 bacteria which produce this type of
colonies?
• Streptococcus pyogenes, streptococcus agalactiae,
streptococcus fecalis.
• A 40 years old homeless male, a known case of
AIDS for 5 years came to the hospital with
complaints of dizziness, vertigo along with cough
and fever. CSF sample through lumber puncture
was taken and stained with India ink stain. The
microscopic findings are presented in the picture
below.
• Name the fungus causing this condition?
• Cryptococcus neoformans.
• What is the route of transmission of this fungus?
• Inhalation.
• How many morphological forms of this fungus exist?
• Only yeast form.
• Give 02 methods for its lab diagnosis?
• India ink staining, gram staining, culture, serological
tests (both antigen and antibodies), latex
agglutination test for capsular antigen (any 02).
• A 52 years old male patient came to pulmonology
clinic with the complaints of asthma like symptoms,
cough and fever. On auscultation physician finds
consolidation in right lung. Chest x-ray shows a
round opaque area in the lung. A full course of
antibiotics didn’t resolve the issue. A biopsy
specimen shows following microscopic picture.
• Give your diagnosis?
• Aspergillus fumigatus (fungus ball in lungs).
• What is the route of transmission of this fungus?
• Airborne conidia (from decaying vegetation).
• How many morphological forms of this fungus exist?
• Only mold form.
• Give 02 methods for its lab diagnosis?
• Biopsy specimen staining, KOH skin preparations,
high titre of galactomannan antigen in serum, culture
shows radiating conidia, PCR for genetic analysis. (any
02).
• A bird farmer came to the clinic with the complaints of
generalized weakness, pain in left hypochondrium and
fever. His biopsy specimen shows yeasts inside
macrophages. You are provided microscopic picture of
specimen.
• Give your diagnosis?
• Histoplasma capsulatum (yeast within macrophages)
• What is the route of transmission of this fungus?
• Inhalation of spores.
• How many morphological forms of this fungus exist?
• Dimorphic fungus (mold in soil and yeast in tissue)
• Give 02 methods for its lab diagnosis?
• Tissue and bone marrow biopsy, culture on sabourauds
agar, histoplasma antigen by radioimmunoassay,
histoplasma RNA and DNA probes, serological tests,
(any 02).
• A selective culture medium that is most commonly
used for skin scapings and high vaginal swab
inoculation in microbiology laboratory is shown in
the picture below.
• Name the medium?

• Sabouraud agar (sabouraud dextrose agar)

• Give its composition?

• Mycological peptone (enzymatic digest of casein

and animal tissue), dextrose, agar, pH 5.6 at 25C.

• What is the color of yeast colonies on this medium?

• Yeasts will grow creamy to white color colonies.

• An 11 years old boy who live in village and works
for an animal farm presents to a dermatologist will
the lesion on his scalp shown in the picture below.
• Name the condition?

• Tinea capitis (fungal infection of scalp).

• Name three genera of dermatophytes?

• Epidermophyton, trichophyton, Microsporum

• How will you diagnose it in microbiology laboratory?

• Scalp scraping microscopic examination with KOH

preparation, Culture of sample for fungal isolation,
PCR technique.
• A 15 years old child was brought to OPD. He had
complaints of headache, high grade fever every third
day with chills and sweating. His blood was examined
under microscope and showed a banana shaped
parasite.
• Identify the parasite?

• Gametocyte of plasmodium falciparum.

• Write two methods for its diagnosis?

• Preparation of blood smear (thin and thick smear),

Rapid Diagnostic test (using kit), PCR technique tor
identification of genetic material.

• What is the complication caused by this parasite? 1

• Cerebral malaria, Kidney failure (black water fever).

• A 22 years old girl was brought to OPD. She had
complaints of headache, high grade fever every third
day with chills and sweating. Her blood sample
revealed the given picture under microscope.
• Identify the organism (pointed with arrow head)?

• Blood cell containing ring shaped trophozoites.

• What specie most likely shows this type of parasitemia?

• This is high level parasitemia which is shown by

plasmodium falciparum.

• Name four other species of this parasite?

• Four other species are, Plasmodium vivax, Plasmodium

ovale, Plasmodium malariae, Plasmodium knowlesi.
• A parasite that has transplacental transmission. It can
result in abortion, still birth, chorioretinitis and is one
of the leading cause of blindness in children. Its
infection can be life threatening in severely
immunocompromised individuals especially AIDS
patients.
• Identify the organism (pointed with arrow)?
• Toxoplasma gonidia (Tachyzoite in cardiac muscles).
• What is the definite host of this organism?
• Domestic cat.
• What is the intermediate host?
• Humans and other mammals.
• Name two methods for its laboratory diagnosis?
• Immunofluorescence assay for IgM antibody (acute
and congenital infections). Giemsa-staining (crescent-
shaped trophozoites during acute infections). Mice
inoculation, cell culture (any 02).
• A 60 years old male has sudden onset of fever, non-
productive cough, dyspnoea, and tachypnoea. Chest x-
ray shows a diffuse interstitial pneumonia with "ground
glass" infiltrates bilaterally. If not treated it can lead to
death of the patient. Lung cyst biopsy was taken and
observed under microscope.
• Identify the pathogen (pointed with arrow)?
• Pneumocystis carni (Pneumocystis jerovici)
• How it is transmitted?
• Inhalation.
• Name the disease caused by this organism in humans?
• Pneumonia.
• Give 2 reasons why it is fungus not a parasite?
• (I) An analysis of rRNA sequences indicates that it is
fungus related to yeasts such as Saccharomyces
cerevisiae.
• (II) Analysis of mitochondrial DNA supports the idea
that it is a fungus.
• A parasite that is primarily found in central and south
America but is prevalent in other parts of the world
spreads via blood through a vector. Cardiac muscle is
most commonly affected but also causes megacolon and
megaesophagus. Hepatosplenomegaly and
lymphadenopathy with fever is also common.
• Identify the pathogen (pointed with arrow)?
• Trypanosoma cruzi (Amastigotes).
• Name the bug that transmits this parasite?
• Reduviid bug.
• Name the disease caused by this parasite?
• Chagas disease (American trypanosomiasis).
• Give 2 laboratory diagnostic tests?
• (I) Trypomastigotes in thin and thick blood film
• (II) Tissue biopsy will reveal amastigotes
• (III) Xenodiagnosis
• (IV) Indirect fluorescent antibody test
• (V) Complement fixation test (any 02).
• A parasite that is primarily found in Africa, India, some
parts of china and America. In Pakistan, you come across
cases of the parasite in desert areas like Cholistan, Thar
and Thall regions. A high prevalence of this parasite is
reported among Afghan refugees. A few cases have been
reported in people of mountainous areas. You are
provided bone marrow biopsy slide of lesion caused by
this parasite.
• Identify the parasite (pointed with arrow)?
• L. donovani.
• Name the vector of this parasite?
• Sand fly.
• Name the disease caused by this parasite?
• Cutaneous leishmaniasis.
• Write 02 diagnostic tests?
• (I) Bone marrow, spleen and lymph node biopsy shows
amastigotes
• (II) Culture
• (III)Indirect immunofluorescence test
• (IV) High concentration of IgG antibody.
• A parasite that is injected to human body via the bite of
an insect vector and lesion begins as red papule at the
bite site, later metastatic lesions are formed at
mucocutaneous junctions especially nose and mouth. A
lesion caused by this parasite on the dorsum of hand of a
patient is shown in given photograph.
• Name the vector of this parasite?
• Sand fly.
• What is your provisional diagnosis?
• Cutaneous leishmaniasis.
• Name four species of leishmania?
• (I) L. tropica
• (II) L. maxicana
• (III) L. braziliensis
• (IV) L. donovani
• A 24 years old university student ate pork from a market
in Kula lumpur about 11 weeks ago, he suddenly
developed diarrhea and anorexia with flatulence in
abdomen. He was examined by a physician and stool
sample was sent to the laboratory for diagnosis.
Microbiologist observed the parasitic tapeworm
contains gravid proglottids with 5-10 primary uterine
branches under microscope.
• Identify the parasite causing this condition?

• Taenia solium.

• Name definite host of this parasite?

• Humans.

• What is point with arrows 1 and 2?

• 1. Circle of hooklets, 2. One of the four suckers.

• A 54 years old female went as a tourist to Singapore and
ate fresh salad from a small market. She came back to
her country after 2 weeks. A few weeks later she started
to feel nausea and vertigo. Later she started experiencing
seizures attack. Due to lack of facilities her CT scan or
MRI couldn’t be done. Autopsy of the brain after death
showed the following picture.
• Name the causative parasite?

• Taenia solium.

• What is pointed with long arrow?

• Larva of Taenia solium.

• What is pointed with short arrow?

• Wall of cysticercus (sac) that is surrounding larva.

• Name the drug of choice for treatment?

• Praziquantel.
• Life cycle of parasitic tapeworms is shown in the
diagram.
• Name the parasites?
• Taenia solium and Taenia saginata.
• For which parasite pig is the intermediate host?
• Taenia solium.
• Name the infective stage for humans?
• Cysticercus.
• What is the length of parasite whose intermediate
host is cattle?
• 5-7 meters may reach upto 25 m.
• A cow was slaughtered and a cyst in thigh contained a
large parasite that causes infection in human as well.
The following specimen of the parasite was preserved.
•
• Name the parasites?

• Gross specimen of Taenia saginata.

• What is the intermediate host of this parasite?

• Cattle.

• Name the disease caused by this parasite in humans?

• Taeniasis.

• What is the length of this parasite?

• 5-7 meters may reach upto 25 m. (01 Mark).

• 5 friends planed a trip to River Ravi for fishing last
summer. They made smoked fish BBQ and ate it. After 4
weeks 2 of them developed abdominal discomfort with
some diarrheal stools. They felt weakness with no other
significant symptom. They went to clinic and were
examined by physician. A stool and blood samples were
sent to the laboratory. The following eggs were observed
in stool along with anemia.
• Identify the egg of parasite?
• Egg of Diphyllobothrium latum.
• What is the definitive host of this parasite?
• Humans.
• What type of anemia is caused by this parasite in
humans?
• B12 deficiency or megaloblastic anaemia.
• What is the length of this parasite?
• It can be up to13 meters.
• A medical student who was living in a hostel along
with 3 other students in a single room presents to a
physician with the complaints of itching in the
groin, armpit and behind the knee joint. He also
complains that itching worsens at night and 2 of his
other roommates are also experiencing the same
symptoms. Physician examined and found scaly
lesions in these areas. A skin scraping sample was
taken and sent to the laboratory for diagnosis. The
following photograph is obtained by microscopy.
• Identify the parasite?
• Sarcoptes scabiei.
• How it is transmitted?
• Direct contact, fomites (any one)
• In which layer of the skin it is located?
• Stratum corneum
• How will you diagnose this parasite in lab.?
• Microscopic examination of skin scrapings.
• A 7 years old boy came to the pediatrician with the
complaints of perianal itching. On examination the
pediatrician finds pruritis. He advised the test for
him. Microbiologist observes following eggs under
microscope.
• Identify the eggs of parasite?

• Enterobius vermicularis—Eggs

• How many hosts are involved in its life cycle?

• Confined to humans only

• What type of nematode it is?

• Intestinal nematode

• Name the test for its lab. diagnosis?

• Scotch tape test.

• You are shown the eggs of an intestinal nematode
in the photograph.
• Identify the eggs of parasite?

• Trichuris trichiura

• Describe the shape of the egg?

• Elongated, lemon shaped, two plugs on ends

• What is common complication caused by this

parasite in children?

• Rectal prolapse
• A 14 years old boy came to the OPD with complaints of
abdominal pain and discomfort. He is also
malnourished. After examining, physician advised him
stool examination. His stool sample revealed the egg
shown in the photograph.
• Identify the egg of parasite?

• Ascaris lumbricoides egg

• What is route of transmission?

• Oro-fecal route

• Describe the shape of the ovum?

• Egg is oval with an irregular surface

• Write down one complication caused by the parasite?

• Intestinal obstruction, pneumonia (any one)

• A 14 years old boy came to the OPD with complaints of
abdominal pain, flatulence, discomfort and intestinal
obstruction. Worms are coming out of his nose and
mouth.
• Name this parasite?
• Ascaris lumbricoides
• What type of parasite it is?
• It is intestinal nematode, with pointed ends
• What is route of transmission?
• Faecal-oral
• Write down one complication?
• Intestinal obstruction, pneumonia, malnutrition (any
one)
• Shown in the given photograph is the head of an
intestinal parasite which attaches to the abdominal wall
and leads to severe blood loss followed by anemia.
• Name the parasite?

• Ancylostoma duodenale

• What body parts are indicated with arrows?

• Teeth

• What is route of transmission?

• Penetrates through skin of feet or legs

• Write down one complication?

• Anemia due to severe blood loss (any one)

• Humans are dead end host of this parasite. They are
acquired by eating undercooked pork or meat which
contain larvae of the parasite. Shown in the
photograph are larvae of the parasite in skeletal
muscles.
• Name the parasite causing this condition?
• Trichinella spiralis
• What is the disease caused by this parasite?
• Trichinosis
• What is route of transmission?
• Consumption of undercooked pork or meat
• Write down one complication?
• Encystation in brain and cardiac muscles, cardiac
arrhythmias which can lead to death (any one)
• A parasite that is transmitted to human via an arthropod
vector and causes severe lymphatic obstruction. It is a
tissue nematode. Shown in the photograph are larvae of
the parasite in blood.
• Name the parasite causing this condition?
• Wuchereria bancrofti
• What is vector for parasite?
• Female anopheles and Culex mosquito
• What is the disease caused by this parasite?
• Filariasis
• How you will diagnose it?
• Thick blood smears taken from the patient at night
reveal the microfilariae.
• A parasite that is transmitted to human via skin through
fresh water and is a tissue nematode. Eggs of two
species of this parasite is shown in the photograph.
• Identify the egg in picture 1 and 2?
• Eggs of 1; shishtosoma mansoni,2; shistosoma
haematobium
• Which tissue is infected by 1 and 2?
• S. mansoni;1, affects the gastrointestinal tract and 2 S.
haematobium affects urinary tract.
• How will you diagnose the infection caused by these
parasites in lab?
• Diagnosis depends on finding the characteristic ova in
the feces or urine.
• The large lateral spine of S. mansoni and the
rudimentary spine of S. japonicum are typical, as is the
large terminal spine of S. haematobium.
• A 70 years old male patient was admitted to the
hospital with the complaints of pain in upper right
quadrant. Abdominal CT Scan revealed a liver
abscess. Antibiotics failed to resolve the abscess.
Abscess was aspirated with anchovy paste like pus.
Microscopic examination after staining with PAS
stain showed the picture given below.
• Name the parasite causing this condition?

• Entamoeba histolytica

• What is route of transmission of this parasite?

• Fecal-oral and anal-oral (homosexual male) route

• Name 2 diseases caused by this parasite?

• Amoebic dysentery, liver abscess

• Name the motile form of the parasite?

• Trophozoite
• A 26years old male patient came to OPD with the
complaints of abdominal discomfort, pain,
flatulence and blood mucous containing diarrhea.
He was examined by physician and a sample of his
diarrheal stool was sent to microbiology laboratory
for diagnosis. Microscopic examination showed the
picture given below.
• Identify the structure pointed with long arrow?
• Trophozoite of Entamoeba histolytica
• How many trophozoites are formed from 1 cyst of this
parasite?
• Eight
• Name the ulcer caused by this parasite in muscularis
mucosa of intestine?
• Flask shaped ulcers
• Name the non- motile form of the parasite?
• Cyst.
• A 34 years old male patient came to OPD with the
complaints of anorexia, nausea, abdominal discomfort,
flatulence and abdominal cramps persisting about 8
weeks. He has foul smelling non-bloody watery diarrhea.
He was examined by the physician and a sample of his
diarrheal stool was sent to microbiology laboratory for
diagnosis. Microscopic examination showed the picture
given below.
• Name the object pointed with arrow?
• Trophozoite of Giardia lamblia
• How many pair of flagella the trophozoite of this
parasite has?
• Four pair
• Name the disease caused by this parasite?
• Giardiasis
• How many trophozoites are formed from 1 cyst of the
parasite?
• Two
• A 27 years old sexually active women came to
gynecology clinic with the complaints of greenish, foul
smelling vaginal discharge. She also symptoms of
itching and burning sensation with pruritis. After
examination a sample was sent to microbiology
laboratory for diagnosis. Microscopic examination
showed the picture given below.
• Name the object pointed with arrows?

• Trichomonas vaginalis—Trophozoite

• What is the rout of transmission of this parasite?

• Sexual contact

• Name the disease caused by this parasite?

• Trichomoniasis

• How many forms of this parasite exist?

• Only trophozoite form