Parasitology – Questions arranged by Topic Midterm to Final

From Prior Weeks:

Babesiosis Malaria African sleeping sickness

Intracellular Intracellular can cross BBB

Malaria / filariasis / babesiosis / African sleeping sickness are caused by single celled eukaryotes.

Closed fecal sanitation systems had directly led to the reduction of all of the following nematode
infections EXCEPT: Elephantiasis {Giardiasis / Ascariasis / Strongyloidiasis}

A 49-year-old male transplant patient being treated with steroids came to the hospital complaining of
abdominal pain and has lower respiratory symptoms suggesting pneumonia. He was febrile with a
temperature of 102°F. Other history includes that he was born in Panama and became a U.S. citizen at
age 25 after graduating from college in Texas. Laboratory results revealed positive blood cultures: E. coli
was identified. The white blood cell count (WBC) was 18,000/µL with 80% neutrophils, 5% bands, 5%
lymphs, and 10% monocytes. The fecal exam revealed the presence of numerous threadlike worms with
a short buccal capsule and a large genital primordium. This parasite is .

stronarides fffadium

Strongyloides stercoralis

A mother brought her 2-year-old child to the pediatrician to examine a severe rash in the child’s anal
region. She reported that the child was observed scratching the area repeatedly. The physician
performed a cellophane tape test and sent it to the laboratory for analysis. The laboratory scientist
 Parasitology – Questions arranged by Topic Midterm to Final

noted the parasitic form in the accompanying figure. The child was infected with
icearis
vermin
Enterobius vermicularis Iffy
A 60-year-old male has been taking Methotrexate to manage rheumatoid arthritis for a year. He recently
suffers bloody diarrhea, weight loss, abdominal pain, colitis, and rectal prolapse. If you find the following
microorganisms in patient’s loose stool sample, the patient most likely has______________ infection.

Trichuris trichiura
EÉ
Match the eggs with the adult worm producing it – whipworm (trichuriasis): who

Which of the following parasites must be swallowed twice by the human host, first as an egg and later as
a larva? - Ascaris lumbricoides

Which of the following is the largest intestinal roundworm?

lumbricoides
fgfwfffgnastpartfswallo
Ascan's
.ms
inanimat
Ascaris lumbricoides
c yard
 Parasitology – Questions arranged by Topic Midterm to Final

A patient complains of fever, pneumonitis, vomiting, and abdominal pain. If you find the following
microorganisms in patient’s loose stool sample, the patient suffers ________ infection. Ascaris
lumbricoides

rnodesiensetfwestafoisaffds.gs
brucei sleeping
Tsetsefly african
sleeping
bruceigambien
gambien
TeaniaSolium
swine
fries
Offer a
volvulus
bad
Which of the following relationships is mismatched? T. brucei rhodesiense and West African sleeping
sickness {CORRECTLY matched: Tsetse fly and African sleeping sickness / Teania solium and swine /
Black flies and Onchocera volvulus / T. brucei gambiense and Gambian sleeping sickness}

What specific challenge does Trypanosoma brucei present to the immune system? It frequently
changes its antigens, staying one step ahead of the host’s antibody response
Trypanosomabrucei changes antigens
Annie was outdoors and received multiple mosquito bites. Several months later, she developed
high fever, chill, sweating, anemia. She visited her primary care physician and blood sample was
taken. Based on the following blood smear, Annie was infected with ________
mosquito bites
plasmodiumfalciparum comesfrom
plasmodium malaria

annan
fit
Plasmodium falciparum
Acanthamoeba differs from Naegleria fowleri in that only Acanthamoeba… Enters
typically through broken skin or the conjunctva. {These are the other choices: is acquired by
swimming in contaminated water / is the cause of primary amebic meningoencephalitis / is a
free-living ameba of fresh waters / enters through the nasal mucosa.}
You may find _________ in the soil. Protozoan cysts / Bacteria endospores / Viruses {NOT:
adult liver flukes – they live in definitive host’s liver and NOT copepods – they live in water}
soil protozoancysts bacteriaendosporeviruses
Which of the following infection is caused by bacteria? Psittacosis {Eukaryotic infections:
Histoplasmosis / Cryptococcosis / Candidiasis / Schistosomiasis / Malaria}

Malaria Histoplasmosis cryptococcosis candidiasis schistosomiasis

EUKARYOTE
Psittacosis bacteria
 Parasitology – Questions arranged by Topic Midterm to Final

plasmodiumspp malaria

protozoan

helminth

trypanosoma
cruzi fish

virus
Zika
Zika cytomegalovirus
CMV baby
pregnant
pts
immunosuppressed
compromised
 Parasitology – Questions arranged by Topic Midterm to Final

do NOT
parasitichelminths
larvaeeggs Parasites: Helminths
adult havecysts
Parasitic helminths have the following characteristics, EXCEPT: They have developmental forms that
include cysts {true statements: they include tapeworms / they are multicellular animals / they include
roundworms / they have a definitive host where the adult form lives} helminths tapeworm multicellular
roundworms definitivehost
Which of the following is not an effective way to minimize human contact with parasitic helminths?
These are all effective ways {proper sewage disposal / avoiding human feces as fertilizer / freezing foods
/ thoroughly cooking foods}
twitter.mg tpfafhdd'head freerefood thoroughly
cookfood

GI
oundworms Tapeworm

infectiveform
Trichuris/Ascaris/Enterobius –eggs
round worms; nemotodes; GI issues; Eggs are infective form.
Trichuris / Ascaris – Associated with coinfection because eggs need to mature in soil for
months.

gfio
Ascaris – largest round worm. Requires Liver-Lung Migration Ascan's
Enterobius – immediately infective – Pinworms/Butt itch
requires n largest
largesttingling roundworm
enterobies but itch
Necator/ Ancylostoma / Strongyloides – larva are infective
Strongyloides – One host may have “3” infections: egg, larva, and adult
organ fluke hermaphrodite
Parasitology – Questions arranged by Topic Midterm to Final
blood fluke gynecophoral canal
segmented; tape worms; live in flesh of animals of
diphyllobothrium linesin FLESH animals
Taenia
Taenia / Diphyllobothrium – flat worm;
Schistosoma / Opisthorchis – unsegmented flatworm; snails

opisthorchis Schistosoma snails host sexually mature

The sexually mature life cycle stage of helminths occurs in the def
- Definitive host

atoned
Larvae and eggs are developmental forms of - helminths
eggs awae Tahoelopmental
All of the following are helminths EXCEPT - trypanosomes {roundworms / tapeworms /
pinworms / flukes}
trypanosome chagas
All of the following are correct about helminths EXCEPT - They generally make only a few eggs
per day {they are not all parasites, although some are / as parasites, their reproductive organs
are their most developed organs / their eggs and larvae are vulnerable to heat / tapeworms and
millionspinworms are two examples} helminthsmakeMORE thanafew eggsperday
Nematodes: Roundworms

nematode/roundworm

Intestinal Nematodes -
Infective in Egg Stage: Trichuris trichiura (whipworm), Ascaris lumbricoides (Ascariasis),
Enterobius Vermicularis (Pinworm)

Infective in Larval Stage: Necator americanus (New World hookworm), Ancyclostoma

duodenale (Old World hookworm), Strongyloides stercoralis (threadworm), Trichinella spiralis
(trichina worm)
pcystgqqrgg.es NS
infection
Consuming undercooked pork may increase the risk of __________ infection. Taenia solium AND
Trichinella spiralis

Which of the following are single celled eukaryotic microorganism? Giardia intestinalis
Candida albicans (yeast) {NOT: Schistosoma haematobium and
oral thrush opportunistic
fungus
Tissue Nematodes –
Humans are _________ host for tissue nematodes definitive subcutaneous LEE
Which of following may be found in subcutaneous tissue? Dracunculus medinensis / Loa Loa /
Onchocerca volvulus

Mosquitoes may transmit _____. Filariasis (elephantiasis) / Zika virus / Malaria / West Nile virus /
Dengue fever / Chikungunya

Mosquitoestransmit
elephantiasis Filariasis Zika malaria
denguefever chikungunya
Westwick
 Parasitology – Questions arranged by Topic Midterm to Final

bite mosquito

f
require bite
a ormanage
partite
Cyclops

YE ff.si ansan EEafaaer

Filariae: Tissue Nematodes Elephantiasis, Wuchereria bancrofti (Bancroft’s

filariasis), Brugia malayi (Malayan filiariasis)
Nocturnal periodicity occurs for elephantiasis transmission because… all of these {mosquitoes more
likely bite human at night / microfilaria are not inside human cells / there are eosinophils, antibodies,
and complement proteins in blood may attack microfilaria}

Lymphangitis (vessels)/ lymphadenitits (nodes)

Elephantiasis is a clinical symptom associated with: Wuchereria bancrofti

Elephantiasis includes all the following, EXCEPT: the parasitic helminth is transmitted by black fly
vectors {True statements: microfilariae are in the blood / larval infestation causes blockage of main
lymphatic channels / it is caused by filarial nematodes / severe edema occurs in the extremities and
scrotum}
ffectors
evrnafisenfabancrofti.nu taE1
 Parasitology – Questions arranged by Topic Midterm to Final

Nocturnal periodicity is observed during the life cycle of microorganism causing ____________.

Nocturnalperiodicity filariasis

filariasis

Jackie played outdoors and received multiple mosquito bites. Several days later, she had fever,
lymphangitis and lymphadenitis. She visited her primary care physician and blood sample was taken.
Based on the following blood smear, Annie was infected with ________

bancrotti
wocheria

Wuchereria bancrofti

You may find _______ in patient’s blood with tissue nematode infection.

tissuenematode microfilariae

Microfilaria

This is Elephatiasis
ERRTIMET
microfilariae
filariasis
Diethylcarbamazine (DEC) is one of medications for treating filariasis because it is effective to kill
__________ Microfilaria interfere
w metabolism
In order to prevent transmission of elephantiasis among human population, _________ DEC fortified
salt is used / Tetracycline is used for treatment / Ivermectin is used for treatment

You may find _______ inside human red blood cells and ____________ outside human red blood cells.

Tasmodium
Plasmodium merozoites, Wuchereria microfilariae

malaria
Wuchereria outsideRBCS
mosquito
 Parasitology – Questions arranged by Topic Midterm to Final

The following image shows patient with ______ via _______ bites. Elephantiasis, mosquito

elephantiasis mosquitovector
b c mosquitos like
elephants

Nocturnal periodicity occurs for elephantiasis transmission because… mosquitoes more likely bite
human at night / microfilaria are not inside human cells / there are eosinophils, antibodies, and
complement proteins in blood may attack microfilaria
M Onchocerca volvulus
Antibacterial antibiotic tetracycline/doxycyclin may be used to treat ____ . River blindness and
Elephantiasis (the antibiotics target bacteria in the adult worm)

elephantiasis
frivertindess
tetracycline
waffindness Loa Loa (Belly then Eyes)
River
Blindness
subcutaneous M volvulus
1
Which of the following infection involve Calabar swelling? Loa Loa / Onchocerca

10 eyeworm

An 18-year-old college student sought medical attention because she felt something moving in
the sclera of her right eye and observed a worm when she looked in the mirror. She had similar
symptoms 2 years ago but ignored it at that time because symptoms abated after about 2 h.
Currently, she presented with painless swelling at the base of her right thumb and the dorsum
of her right hand that lasted for a few days at a time and had waxed and waned over the past
year. No contacts or family members had similar symptoms. She was born and raised in a large
city in Nigeria but went to boarding school in a more rural area. She had traveled to the
southeast region of Nigeria on vacation with her family shortly before moving to the United
States 3 years ago to attend college. She had not returned to Nigeria since. Based on her
symptoms, this is a case of _____ infection? Onchocerca volvulus / Loa Loa
 Parasitology – Questions arranged by Topic Midterm to Final

This image shows _______ in blood smear.

Microfilaria
Based on the morphology of microfilaria, the patient had Loa loa infection. What is the vector
for transmission of the Loa loa parasite? deer fly (Chrysops Fly)
10910avectordegysotpff.fr

Loa loa exhibits diurnal periodicity. What is the optimum time for blood collection? 10:00 to
14:00
10am 2pm or1000 1400
Chiropractic doctors may help patients by identifying _______ stage of river blindness and Loa
silineenes
for L
loa infection. Both skin and eyes

Onchocerca volvulus (Belly)

Which of the following parasitic diseases can cause blindness: Onchocerca volvulus subcutaneous
Calabar
Which of the following infection involve Calabar swelling? Loa Loa / Onchocerca volvulus 10alod
River blindness is: A disease in which worms can invade the eyes rhodesiense I
East African T brucei
p
Which of the following relationships is mismatched? T. brucei rhodesiense
sÉgI
and West African sleeping
sickness {CORRECTLY matched: Tsetse fly and African sleeping sickness / Teania solium and swine /
Black flies and Onchocera volvulus / T. brucei gambiense and Gambian sleeping sickness}
I
West African
Antibacterial antibiotic tetracycline/doxycyclin may be used to treat ____ . River blindness and
Elephantiasis (the antibiotics target bacteria in the adult worm)

Black fly may transmit ________ infection River blindness

blackfly river blindmesshoa

to a onchocercavolvulus

simulium
 Parasitology – Questions arranged by Topic Midterm to Final

Onchocercomas is typically involved in ___ infection. Onchocerca volvulus

A 42-year-old Cameroonian woman with history of invasive ductal mammary carcinoma status
post right mastectomy presented with a 1-cm right peri-scapular lesion. Position emission
tomography scan showed a corresponding subcutaneous mildly fluorodeoxyglucose (FDG)-avid
(standardized uptake value = 3.8) lesion, suspicious for metastasis (Figure 1A). Histologic
examination of a skin biopsy revealed helminths consistent with Onchocerca volvulus. How did
this woman acquire this infection?
black fly (Simulium Fly)
III FDG-avid lesion in the right periscapular region
corresponding to a biopsied hypermetabolic soft tissue
nodule

The following method(s) may be used to prevent serious complications associated with river
blindness.

early diagnosis and treatment / black fly control

Ikinriverbineness
Chiropractic doctors may help patients by identifying _______ stage of river blindness and
prevent losing eyeslight. - Skin

ringhdness
109109
skin teyes
 Parasitology – Questions arranged by Topic Midterm to Final

Parasites and Immunity

Dracunculus medinensis (Guinea worm, Dracontiasis)
The nematode infection that is acquired by ingesting a Cyclops (water flea) is: Dracunculus medinensis
Diphyllo
Which parasite is carried by Cyclops, an arthropod commonly found in still water? Drancunculus fish
Broad
medinesis
Cyclops draconculus med
The portal of entry for Guinea worm infection is____ Consuming water with infected copepod

Which of the following is the largest tissuecopepod

roundworm? Cyclops guineaworminf
roundworm drawnw usmed
largestTISSUE

Dracunculus medinensis

Cyclops may transmit _____. Dracunculus medinensis

Cyclops spp. (Copepod) is _______ host for Guinea worm? Intermediate

CYCLOPS INTERMEDIATE hostforguineaworm

Copepod (Cyclops) may transmit _____ infection Dracunculus medinensis / Diphyllobothrium latum

Class Cestode (Tapeworm)

hermaphroditic tapeworm
 Parasitology – Questions arranged by Topic Midterm to Final

Match eggs with the adult worm producing it – tapeworm:

segment
proglottid animals
one have
will BOILEY
All of the following pertain to tapeworms, EXCEPT the …. One proglottid segment will have either
female or male reproductive organs {DO pertain to tapeworms: strobila is made up of proglottids /
cysticerci are young infective larvae ingested in undercooked meat / proglottids are reproductive
segments / scolex is the attachment organ.

Taenia / Cystocercosis / Taenia saginata / Taeniasis / Taenia solium

The larval forms of certain Taenia species, which typically infest muscles of mammalian intermediate
hosts are also called - cysticerci. store
Taenia species lanae form cys tiara
The larva stage of tapeworm infecting brains and develops after chronic infections is… cysticercosis
brain Taenia saginata
infects
Consumption of raw or undercooked beef is associated with
Undercooked the risk of __________
undercooked pork may increase beef
Consumingraw saginata
taeniainfection. Taenia solium AND
spiralis
Taenia solium trichinella
Trichinella spiralis
undercooked pork
A 31-year-old male who emigrated from Mexico 3 years prior to admission, was brought to the ER by his
family with a witnessed seizure. He had been previously healthy. Neurologic examination demonstrated
no focal findings. A CT scan of the head showed multiple small cystic and calcified lesions. CSF analysis
showed increased WBC's, with 5 % neutrophils, 89 % lymphocytes and 6 % monocytes. The CSF glucose
was 63 mg/dl and protein was 36 mg/dl.

What is the most likely diagnosis? Tania

solium re
Taniasolium

This patient has? Neurocysticercosis and

Taeniasis (Taeniasis first as adult worm in GI
tract. Larva migrate to nervous system to
create Neurocysticercosis).

neurocysticercosis
in
T.ge 9sis nervous system
 undercookedbeet
Parasitology – Questions arranged by Topic Midterm to Final Taenia say
shig dysenterae
Consuming undercooked beef may increase the risk of __________ infection. Taenia saginata (flatworm
in steak) / Shigella dysenterae (prokaryote likely in hamburger) / E. coli (prokaryote likely in hamburger)

The following image is __________. Infection with this form is called ________ Tape worm, taeniasis

ingeneral
tapeworm taeniasis

This is the life cycle of _________. Taenia saginata (from tapeworms of cows)

Dwarf Tapeworm (Hymenolepis nana)

A six-year-old boy living in Florida began complaining of a so-called tummy ache on his ride home from
his regular day care center. He began having diarrhea shortly after arriving home. He had not eaten his
lunch and said he was dizzy. The diarrhea continued intermittently for several hours, prompting his
mother to take him to the doctor. His pediatrician ordered a stool culture and an Ova & Parasite
examination. Results of the stool culture were negative for pathogenic bacteria, but several eggs were
recovered as shown:
 episnana
Parasitology – Questions arranged by Topic Midterm to Final hymeno
hookletsinegg
tapeworm
dwarf
This parasite is: Hymenolepis nana (hooklets in the egg)
8821 9
fff
Common nonhuman hosts for this parasite include: Mice
commonvector
Common transport hosts for this parasite include: Fleas and beetles

Infections may become more severe in human hosts by: Autoreinfection

magfffsaoe
autorein.fi

infectedrodentstransmit
flees and beetles

hymen nana rabiesYersiniapetis

francis
Infected rodents may transmit the following microbial infections: Hymenolepsis nana (sheep) / Tavensis
Francisella tularensis (rabbits) / Yersinia pestis (fleas) / Rabies (dogs)

Diphyllobothrium latum (broad fish tapeworm)

Which of the following tapeworm infections is associated with vitamin B12 deficiency and macrocytic
anemia:
anemiacopepoff skis
diphyllobothriumlatum this
causes

eating
undercooked fish crab
Diphyllobothrium latum

Copepod (Cyclops) may transmit _____ infection Dracunculus medinensis / Diphyllobothrium latum

Eating undercooked fish/crab may increase the risk of all following worm infections. Which one is
tapeworm? ALL of the FOLLOWING: Clonorchis sinensis / Opisthorchis sinensis; Paragonimus
westermani; Diphyllobothrium latum
infective
a copepod
“Egg -> coracidium n
-> procercoid -> pleurocercoid -> adult worm -> egg” is _____’s life cycle.
Diphyllobothrium latum
egg cora cold adult
proceroid pleurocer worm ftp.nobotfffmn
Besides intestine obstruction, malnutrition, and abdominal pain, patients with broad fish tape worm
infection may also suffer ______________. Vitamin B12 deficiency / Anemia / Psychosis

VitB12def anemia psychosis

 Parasitology – Questions arranged by Topic Midterm to Final

Transmission:
• Infection starts by eating raw
or undercooked freshwater
fish.
• Worm eggs in the feces of
infected human develop a
CORACIDIUM (a ciliated
hexacanth embryo in the
egg).
• Coracidium get to the fresh
water and be eaten by
copepod and fish.

PROCERCOID: A larval stage

in the body of freshwater
crustacean.
PLEUROCERCOID: A larval
stage after ingestion of
procercoid that forms an
immature scolex and is infective
if eaten by human.

Echinococcus granulosus (hydatid tapeworm / hydatid disease)

disea
tapeworm
The definitive host for Echinococcus granulosus is a: hydatid
carsgranulosis
zoonotic echo
soundslikerhino
animals canines

- Dog, Wolves (Canines)

definitive

HOST
INTERMEDIATE
HUMAN
Human are intermediate host for _________ Echinococcus granulosus

Hydatid disease may be prevented by_______ Picking up dog poops & Deworming dogs

Picking up dog’s poop could prevent transmission of _____ Hydatid disease / Toxocariasis / Hookworm
infection

pickingup dogpoop PREVENTS infection

hookworm
toxocariasis
hyatid
 Parasitology – Questions arranged by Topic Midterm to Final
trematodes
flukes organ fluke
alf Organ Flukes: Trematodes / Class Digeneac
Snails and water environment. Hermaphroditic fluke of GI and Lungs. Change shape to adapt to living
environment. Eggs out of humans to water.

Match the eggs with the adult worm producing it – liver/lung flukes:

The trematode/ fluke digestive system is characterized by all of the following EXCEPT: An anal
tapewormopening, through which soluble waste is released {Other choices: an oral cavity that opens in the
center of the oral sucker / a metabolically active body surface that can absorb nutrients / a metabolically
cestode active body surface that can release soluble waste product}

Which following parasites are hermaphrodite? Taenia saginata / Hymenolepis nana / Diphyllobothrium
latum / Fasciola hepatica / Faciolopsis buski

“Egg -> miracidium -> sporocyst -> rediae -> cercariae -> metacercaria -> adult worm -> egg” is
________________’s life cycle : organ flukes

During the general life cycle of hermaphroditic flukes, the larval stage leaving the snail intermediate host
is:- The cercaria

digenea – trematode/fluke; hermaphroditic; organ fluke

Snails may transmit _________ Faciolopsis buski / Fasciola hepatica / Clonorchis sinensis / Opisthorchis
sinensis / Paragonimus westermani

Snail is ____ host for _________ Intermediated (larva); flukes (both organ and blood)

Snails are intermediated hosts for ___. Blood Flukes and Organ Flukes

All flukes are hermaphroditic. False {only liver and organ flukes are hermaphroditic}
 Parasitology – Questions arranged by Topic Midterm to Final

Faciolopisis buski / Fasciola hepatica

Bob’s British cousin, Susan, came to the United States for an extended visit. She was happy to get away
from the family’s sheep farm. While shopping at a local farmer’s market, she bought English breakfast
tea and some watercress, so she could introduce her American cousin to her British favorite, watercress
sandwiches. Watercress grew wild on her farm and was a common ingredient on the menu. During the
visit, Susan developed a fever and abdominal pain. Bob took her to his family physician, who noted
hepatomegaly and urticaria around her waist. Her laboratory results revealed an elevated white blood
cell (WBC) count with 15% eosinophils noted on the differential. Chemistry results revealed increased
total and direct bilirubin and slight elevation in alanine transaminase (ALT – enzyme associated with
liver).
These results suggest: Some other eukaryotic parasitic disease

A fecal examination for parasites was ordered and the form shown was recovered in the
routine procedure. This egg resembles that of: Fasciola hepatica

Humans become infected with this parasite by ingesting metacercariae from

undercooked: a. Crayfish or crabs Water plants

The probable natural host for this parasite is: Sheep

Fasciola hepatica is a Liver fluke

The infective form in the Fasciola hepatica life cycle is the: Metacercaria
 Parasitology – Questions arranged by Topic Midterm to Final

Sheep liver rot disease is caused by: - Faciola hepatica

Human are _____ host for Fasciola hepatica and Faciolopsis buski. Definitive host AND Accidental host

Liver Flukes: Trematodes

Clonorchis sinensis or Opisthrochis sinensis
Eating undercooked fish/crab may increase the risk of all following worm infections. Which one is
tapeworm? ALL of the FOLLOWING: Clonorchis sinensis / Opisthorchis sinensis; Paragonimus
westermani; Diphyllobothrium latum

Paragonimus westermani (paragonimiasis) (Oriental Lung Fluke)

For which of the following is sputum useful in the diagnosis of parasitic infection: Paragonimus
westermani

This is a blood fluke

Eating undercooked fish/crab may increase the risk of all following worm infections. Which one is
tapeworm? ALL of the FOLLOWING: Clonorchis sinensis / Opisthorchis sinensis; Paragonimus
westermani; Diphyllobothrium latum

Which followings are eukaryotes that infect lung? Aspergillus fumigatus / Paragonimus
westermani / Blastomyces dermatitidis

A 17-year-old American foreign exchange student returned home to the United States after finishing his
school year in Japan. He complained to his mother that he had been coughing a lot and that his sputum
was reddish. His mother noted a fever and took him to the doctor. The physician ordered cultures for
routine bacteriology and tuberculosis. When the report indicated “normal flora” and no acid-fast
bacteria were noted, the doctor questioned the young man further and found out that he had enjoyed
eating unusual Japanese foods. His favorite was crayfish because they “tasted like shrimp” and were not
 Parasitology – Questions arranged by Topic Midterm to Final

“weird like sushi.” The physician then ordered a new examination of his sputum for eggs and parasites.
The laboratory found the parasite form shown in the accompanying figure

What is the most likely diagnosis? Paragonimus westermani

What is the most possible method of infection? Eating crayfish

Schistosomiasis (S. mansoni, S. japonicum, S. haematobium)/Blood Flukes

B C

Schistosomiasis mansoni trematodes, NOT hermaphroditic

Schistosomiasis involves… - All of the choices are correct {a blood fluke / cercariae which penetrate hair
follicles and pass to the blood and then the liver / snails which enable development of the parasite into
 Parasitology – Questions arranged by Topic Midterm to Final

cercaria / a life cycle stage which continues when eggs from humans enter water and develop into
miracidia}

Which following are multicellular eukaryotes? Molds and Blood Flukes

Which animals serve as intermediate hosts for human schistosomes? - Snails

Snails are intermediated hosts for ___. Blood Flukes and Organ Flukes

____________ of Schistoma mansoni exit infected snail. Cercariae

Male schistomsomas have a ventral groove called the __________________ in which females reside for
maturation. - Gynecophoral canal

The adult forms of ____________ and ____________ can be found paired in blood vessels in liver
sinuses - Schistosoma mansoni and Schistosoma japonicum

Egg -> miracidium -> sporocyst -> cercariae -> schistosomule -> adult worm -> egg” is _____’s life cycle
Schistoma mansoni
Schistosoma and Plasmodium species both require - two hosts to complete their life cycle and
reproduce.
A patient is experiencing liver cirrhosis and bloody diarrhea. If you find the
following microorganisms in patient’s loose stool sample, the patient
suffers _____ infection. The image shows __. - Schistosoma mansoni,
egg

Schistosomamansoni SPIKE
take Mason
Match eggs with the adult worm producing it – Schistosoma mansoni:

A 40-year-old female presents skin rash, fever, and pain during urination. Urinalysis
indicate the following microorganism in her urine. The patient most likely suffer
__________ infection.
- Schistosoma haematobium
 Parasitology – Questions arranged by Topic Midterm to Final
bladdercancer
Schistosoma
haematobium
Which of the following infection is associated with bladder cancer? Schistosoma haematobium

A 42-year-old female presents with cirrhosis of the liver with ascites and signs of portal hypertension.
The family had recently moved from Egypt. She vaguely remembers that she was treated for a parasitic
infection but cannot remember the name. Liver biopsy reveals the following slides. This is more likely a
__________________ infection. Parasitic worm infection {likely Schistosoma as this appears to be a
blood fluke in the blood around the liver, not in the liver tissue itself which would then be an organ
fluke}

Granulomatous reaction round egg Lodged in mesenteric vein

Same patient also has a stool sample done and it reveals the
following: Schistosoma mansoni

Microbilharzia variglandis (swimmer’s itch) / Blood Fluke

A 10-year-old girl swam in her farm pond and played with ducks nearby.
She had severe itch after swimming. The microorganism associated with
this infection most likely is______________.
Microbilharzia variglandis

Swimmer'sitch micro bilharzia

variglandis
vagina
Human is _______ host for Microbilharzia variglandis. Accidental host {because they die in
skin}

HUMAN accidental host for

microbilharziavariglandis
 Parasitology – Questions arranged by Topic Midterm to Final

Mycology / Fungi
The routes of entry for most fungi into the body are - Respiratory and cutaneous

Amphotericin B, nystatin, and the imidazoles are all - Antifungal drug

Which antifungal drug inhibits cell division of the fungus? - Griseofulvin

All fungi are heterotrophic and can break their substrates down by secreting enzymes. -true

What do zygospores, ascospores, and basidiospores have in common? - They are sexual spores

Fungi that grow as yeast at one temperature but will grow as mold at another temperature are called -
Dimorphic

A mold is observed to have asexual conidia, sexual spores within a sac, and septate hyphae. It is most
likely classified in the - Ascomycota

The terms used for the four general types of fungal infection include the following, EXCEPT -
Bloodborne {Types of fungal infections: cutaneous / systemic / superficial / subcutaneous}

The ability of a fungus to grow as a yeast or a mold depending on its environmental temperature is
called - Dimorphism

A mold is observed to have asexual conidia, sexual spores within a sac, and septate hyphae. It is most
likely classified in the - Ascomycota

The "sick building syndrome" (SBS) is due to growth of ______________ in humid building.
Stachybotrys chartarum

Fungal spores are common allergens that cause hypersensitivities. True

Thermal dimorphism is associated with opportunistic fungi and never seen in true fungal pathogens
- False

Chitin is a chemical component of the cell walls of - Fungi

Which following contains chitin cell wall? Molds

Praziquantel is ____ medication and amphotericin B is _________ medication

antihelminthic, (flatworms) / antifungal

You may find fungi in___________ All of the Above {Soil / Water / Human skin / Air}

Examples of fungi include ___________ All of the Above {Mushroom / Yeast / Mold / Lichen /
Mycorrhizae}

Which following are multicellular eukaryotes? Molds and Blood Flukes

Which following(s) lack mitotic spindle? Candida albican / Bacillus cereus / Monkeypox virus {NOT
human skin cells}
 Parasitology – Questions arranged by Topic Midterm to Final

Basidiospores are the type asexual spores produced by Basidiomycota. FALSE {Basidiomycota produce
sexual spores}

The following picture (to the left) is the reproductive structure

of__________: Basidiomycetes

Yeast divide by __________________ Budding

Thermal dimorphism is common for ______. True fungal pathogens

Which phase of a fungal life cycle is best adapted to growing in a host’s body? Yeast

Which phase of fungal life cycle is best adapted to growing in the soil? Conidial (mold)

Fungi may cause disease in human via ____ All of above {Toxin production / Fungal multiplication in
human tissues / Allergic reaction towards fungal spores}

The fusion two fungal nuclei as their mycelia come together is known as: Karyogamy {FYI
plasmogamy is cytoplasmic fusion}

Ascomycetes produce _______ as sexual spore. Ascospores

Which of the following may be target for antifungal medication? All of above {Chitin cell wall /
Ergosterol in cell membrane / Unique mitosis process in fungi}

True fungal infections are example of ____________diseases. Natural reservoirs are ____________
Endemic, soil

It is recommended to not consume this mushroom due to _______ Cytotoxins

Are Mycetoma, chromoblastomycosis and other deep mycoses Neglected Tropical Diseases? YES

Fungal spores are common allergens that cause hypersensitivities. - True

Which antifungal drug inhibits cell division of the fungus? - Griseofulvin

All the following are fungal allergies, except- thrush {teapicker's lung / bark stripper's disease /
farmer's lung}

The routes of entry for most fungi into the body are - Respiratory and cutaneous
 Parasitology – Questions arranged by Topic Midterm to Final

Which of the following may prevent fungal infection? Wear mask during windy season / Keep skin
clean and dry / Wear shoes

Fungi may cause diseases in __________ . All of above: { Skin / Respiratory system / Nervous system /
Urogenital system}

Systemic Mycoses – Histoplasma capsulatum / Histoplasmosis

Characteristics of Histoplasma capsulatum include - it grows in moist soil, rich in nitrogen from bird
and bat guano.

Which of the following infection is/are associated with exposures of soil with bird dropping?
Histoplasmosis / Cryptococcosis / Psittacosis {a bacterial pneumonia}

Which is incorrect about histoplasmosis? - Histoplasmosis never spreads to sites outside the
respiratory tract {true: Chronic cases have symptoms similar to tuberculosis / Respiratory infections
range from mild to severe / It is transmitted by inhalation of spores /The pathogen grows inside
macrophages}

Portal of entry for systemic mycosis is Inhalation of fungal spores

Soils enriched with birds/pigeon droppings are reservoir for____________ All of these
{Histoplasmosis / Psittacosis / Cryptococcosis / Salmonellosis}

The highest incidence of histoplasmosis in the United States occurs in the East and Midwest

Coccidiodes immitis
All of the following pertain to coccidioidomycosis , except - The pathogen grows best in soil
with bird and bat guano {Do pertain to: It is also called valley fever / it often has symptoms of fever,
chest pain, cough, headache, malaise / fungomas occur in the lungs of those infected / it is transmitted
by inhalation of arthrospores / it is also called valley fever}

All of the following pertain to coccidioidomycosis , except - It causes a superficial cutaneous

infection.

A 42-year-old male construction worker in southern Arizona developed a cold-like illness, experiencing a
chronic cough, chest pain, headaches, and general fatigue. When the symptoms did not abate after
several weeks, he visited his physician who ordered microscopic examination and culture of his sputum
specimen. Direct microscopic exam demonstrated the presence of large spherule structures full of
endospores. The specimen was cultured at both 25 degrees C and 37 degrees C. The plate incubated at
25 degrees C grew tan colonies with a fluffy white center. Examination of these colonies microscopically
showed branching septate hyphae. As the culture matured, the hyphae fragmented into arthrospores.
What is the most likely diagnosis? - Coccidioidomycosis

The primary reservoir for Coccidioides immitis is dry soil

 Parasitology – Questions arranged by Topic Midterm to Final

35-year-old male in Arizona presented with fever, cough, and skin rash (erythema nodosum). His
morning routine includes running for one hour prior to work. Immunodiffusion test of his blood using
proteins from Coccidioides immitis as antigen. He is patient 4 on the following image. This patient had
_________________ infection.

- Coccidioides immitis

A 62-year-old male presents to the emergency department with complaints of fever, headache and
altered mental status. The patient has a history of Type 2 Diabetes, hypertension, high cholesterol and
had been treated a month prior for pneumonia and persistent cough. The patient is a construction
worker in the Southern California area and spends the majority of the day outside. The patient was
started empirically on antituberculosis (TB) medicine due to symptoms and prior TB testing.

 Besides tuberculosis, which additional microbial infection patient might be co-infected

with? Fungal infection
 Spherules are observed from the patient’s lung sample. Arthroconidia were seen
microscopically in lactophenol cotton blue tease preps from the fungal culture in the
laboratory. the patient most likely suffers ___________

Coccidioides immitis
 Which medication is appropriate for treatment? Amphotericin B

Blastomyces dermatitidis
Blastomyces dermatitidis - Causes Gilchrist’s disease and Chicago’s disease

Alternative names for Blastomyces dermatitidis include Gilchrist's disease.

Which followings are eukaryotes that infect lung? Aspergillus fumigatus / Paragonimus
westermani / Blastomyces dermatitidis
 Parasitology – Questions arranged by Topic Midterm to Final

Subcutaneous Mycoses – Sporothrix Schenckii (Sporotrichosis / Rose Gardners Disease)

Which is incorrect about Sporothrix schenckii? It causes a superficial cutaneous infection {It is often
transmitted by soil-contaminated thorns / It lives in the soil / It causes nodules along regional lymphatic
channels / It is dimorphic}

Portal of entry for subcutaneous mycosis is Broken skin

Chromoblastomycosis
Chromoblastomycosis - Is caused by saprobes with dark-pigmented mycelia and spores

Maduromycosis/Mycetoma
Mycetoma is - A subcutaneous infection that looks like a tumor

Cutaneous Mycoses - Dermatophytoses / Trychophyton

Dermatophyte spores can survive for years on fomites. - True

Microsporum, Trichophyton, and Epidermophyton - have reservoirs that include humans, animals,
and soils.

Dermatophytoses are - All of the choices are correct {often time-consuming to eradicate
completely / also called tineas / fungal infections of the skin, hair, and nails / also called ringworm}

Ben, a 17-year-old wrestler, developed a lesion on his upper back. The lesion was relatively round and
consisted of a pink scaly rough center and raised edge. While it wasn’t painful, the itching was
bothersome to the young man. His coach advised him to see his doctor about the lesion. Upon visiting
his physician, a scraping of the affected area was collected and placed in a drop of KOH, then examined
under the microscope, revealing slender fungal hyphae. A culture was inoculated, which grew a
spreading flat fuzzy colony after 10 days of incubation at 30°C. Microscopic examination of the culture
demonstrated the presence of both macroconidia and microconidia. What is the most likely diagnosis?

Dermatophytosis

The primary portal of entry for fungal infections is? Respiratory Tract

Dermatophytic fungi attack the __ in the ___. keratin; skin, nails and hair

Superficial Mycoses –
Which is mismatched? - Tinea capitis -ringworm of the beard {Tinea unguium - ringworm of the
nails / Tinea pedis -ringworm of the foot / Tinea cruis -ringworm of the groin / Tinea corporis -ringworm
of the body / Tinea capitis – scalp}
 Parasitology – Questions arranged by Topic Midterm to Final

The common name of Tinea Pedis is - Athlete’s foot

Amphotericin B is an over-the-counter drug to treat athlete's foot. - False

Transmission of tineas include - All of the following {is an obligate parasite / causes serious
infection in the elderly, premature infants, and AIDS patients / has protozoan and fungal characteristics
/ lacks ergosterol in its plasma membrane}

Piedra / Trichosporon beigelii / Piedraia hortae

Which of the following cause black piedra? Piedraia hortae

Tinea nigra
Which of the following may cause Tinea nigra? Hortaea werneckii (Cladosporium werneckii)

Tinea versicolor / Malassezia furfur

Which is incorrect about tinea versicolor? - It is often transmitted by fomites.

Opportunistic Mycoses
Which of the following are likely to predispose patients to fungal infections?- All of the choices are
correct {Malnutrition / Cancer / AIDS / Tuberculosis}

Candida albicans / Candiasis / Thrush / C. vaginitis / balanitis

All of the following pertain to Candida albicans, except - it has a large capsule {it is an opportunistic
yeast / small numbers found in the mouth, intestines, genitalia, and skin / infections often arise from an
endogenous source / persistent moist skin influences infection}
 Parasitology – Questions arranged by Topic Midterm to Final

All of the following are dimorphic, true fungal pathogens except - Candida {True fungal
pathogens: Paracoccidioides / Blastomyces / Histoplasma / Coccidioides}

Candidiasis includes- All of these choices are correct {vulvovaginal infection / intertriginous infection
of skin sites / skin and nail infections / oral cavity and esophageal infections}

Oral thrush is caused by? Candida albicans

During a visit to her doctor, a woman pointed out a red rash that occurred just under her breasts. The
doctor collected a scraping of the affected area, suspended the scrapings in potassium hydroxide, and
then examined it microscopically. Upon viewing, she detected budding yeast cells and pseudohyphae.
What is the most likely diagnosis? - Yeast infection- candidiasis

Which of the following are single celled eukaryotic microorganism? Giardia intestinalis and Candida
albicans (yeast)

Cryptococcosis / C. neoformans / C. meningoencephalitis

Cryptococcosis can include - All of the choices are correct. {septicemia / pulmonary infection /
meningitis / bone infection}

Cryptococcus neoformans has the following characteristics, except - It is commonly found in

the human mouth, intestines, and genitalia {it usually enters body by inhalation / it primarily infects
patients with AIDS, cancer, and diabetes / it is an encapsulated yeast / it is commonly found in the
human mouth, intestines, and genitalia / it can be found in high numbers in soil containing pigeon
droppings}

Which following utilize capsule as one of virulent factors to invade human immune system? Bacillus
anthracis / Streptococcus pneumoniae / Klebsiella pneumoniae / Cryptococcus neoformans

Which following is capsulated eukaryotic microorganism? Cryptococcus neoformans

Soils enriched with birds/pigeon droppings are reservoir for____________ All of these
{Histoplasmosis / Psittacosis / Cryptococcosis / Salmonellosis}

Which of the following infection is/are associated with exposures of soil with bird dropping?
Histoplasmosis / Cryptococcosis / Psittacosis {a bacterial pneumonia}

If you discovered the following encapsulated budding yeast in spinal fluid, the
patient most likely suffers ___________ Cryptococcus neoformans
 Parasitology – Questions arranged by Topic Midterm to Final

Pneumocystis jirovecii / Pneumocystis pneumonia

This opportunist is the most frequent cause of life-threatening pneumonia in AIDS patients. -
Pneumocystis jirovecii

Serious mycoses treated with amphotericin B include all the following, except - Pneumocystis
pneumonia {coccidioidomycosis/zygomycosis / histoplasmosis / invasive aspergillosis}

Pneumocystis jirovecii - All are correct {is an obligate parasite / lacks ergosterol in its plasma
membrane / has protozoan and fungal characteristics / causes serious infection in the elderly,
premature infants, and AIDS patients.

Aspergillus
This organism commonly contaminates grains, corn, and peanuts and produces a potent mycotoxin
called aflatoxin: - Aspergillus flavus

Aspergillosis includes all the following, except -There are no effective drugs to treat the infection
{Includes: a pneumonia that disseminates to the brain / most cases are due to A. fumigatus / life-
threatening infections in AIDS, leukemia, and transplant patients / noninvasive infections of the eyelids,
sinuses, conjunctiva, and ear canals.

Decaying vegetation, such as piles of leaves and compost matter, allows growth and transmission of

- Aspergillus

Which followings are eukaryotes that infect lung? Aspergillus fumigatus / Paragonimus
westermani / Blastomyces dermatitidis

Aspergillosis is an example of ______ infection Opportunistic and Secondary

Mucormycosis
A patient with diabetes mellitus (type 2) recovered from COVID-19 infection. The patient was given oral
corticosteroids as part of management of COVID-19 infection. The patient is presenting with nasal
blockage, local pain and orbital swelling. Nasal endsoscopy showing pale mucosa with black necrotic
eschar.
 Parasitology – Questions arranged by Topic Midterm to Final

Samples were taken from blackish area of nasal cavity Smears were prepared with 10% KOH wet mount
and stained with Giemsa stain. Based on the images, the patient most likely suffers ______infection.

Pseudomonas aeruginosa / Abdidia spp. / Rhizomucor spp.

CT scan showing rhino-orbital mucosal thickening, edema and mass collection suggestive of infective
etiology

Based on this finding, the patient most likely have invasive Rhino-Orbital-Cerebral mucormycosis.

A 61-year-old female patient with poorly controlled diabetes mellitus (type 2) who was diagnosed with
moderate-severity COVID-19. She had fever, cough, rhinorrhoea, myalgia and breathlessness upon
exertion or at rest. The patient had received systemic corticosteroids and broad-spectrum antibiotics for

the management of severe COVID-19 pneumonia. Examination of the oral cavity revealed the presence
of black necrotic tissue involving the palate with pharyngeal extension consistent with an eschar.
Samples were taken from blackish area of oral cavity Smears were prepared with Calcofluor White
staining. Which additional infection the patient might have? Mucor spp. / Rhizopus spp.
Parasitology – Questions arranged by Topic Midterm to Final

Based on this Coronal CT scan of paranasal sinuses showing bilateral

right more than left-sided opacification of the maxillary sinuses with
poor aeration. Gadolinium-enhanced T1-weighted axial magnetic
resonance imaging demonstrates the presence of a heterogeneously
enhancing intra-orbital lesion with contiguous involvement of the right
cavernous sinus. Gadolinium-enhanced T1-weighted coronal magnetic
resonance imaging (MRI) of the brain demonstrates the presence of a
right-sided ring-enhancing lesion suggestive of a fungal abscess

invasive Rhino-Orbital-Cerebral mucormycosis.

Parasitology – Questions arranged by Topic Midterm to Final
Parasitology – Questions arranged by Topic Midterm to Final
Parasitology – Questions arranged by Topic Midterm to Final