Cestodes (tapeworms) US Medical PG Practice Questions and MCQs
Practice US Medical PG questions for Cestodes (tapeworms). These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Cestodes (tapeworms) US Medical PG Question 1: A 22-year-old man presents with abdominal cramps and diarrhea over the last few weeks. He notes that several of his bowel movements have a small amount of blood. Past medical history is significant for an intermittent cough that has been persistent since returning from Mexico last month. The patient takes no current medications. On physical examination, there is diffuse tenderness to palpation. Which of the following medications is indicated for this patient’s condition?
- A. Pyrantel
- B. Praziquantel
- C. Albendazole
- D. Mebendazole
- E. Ivermectin (Correct Answer)
Cestodes (tapeworms) Explanation: ***Ivermectin***
- This patient's symptoms (abdominal cramps, bloody diarrhea, persistent cough, recent travel to Mexico) are highly suggestive of **Strongyloidiasis**. **Ivermectin** is the drug of choice for this parasitic infection.
- Strongyloidiasis larvae can cause a **transient cough** as they migrate through the lungs, and adult worms in the intestines lead to gastrointestinal symptoms like **diarrhea** and abdominal pain.
*Pyrantel*
- **Pyrantel** is primarily effective against **pinworms**, **roundworms**, and **hookworms**, but not Strongyloides.
- It works by neuromuscular blockade, causing paralysis and expulsion of the worms.
*Praziquantel*
- **Praziquantel** is the drug of choice for treating **tapeworm** infections (e.g., Taenia species) and **schistosomiasis**.
- It acts by increasing the permeability of the worm's cells to calcium, leading to paralysis and death.
*Albendazole*
- **Albendazole** is a broad-spectrum anthelmintic effective against many intestinal nematodes, including **hookworm**, **roundworm**, and **whipworm**, and some tissue nematodes.
- While it has some activity against Strongyloides, **Ivermectin is generally preferred** due to higher efficacy and fewer side effects in many cases of strongyloidiasis.
*Mebendazole*
- **Mebendazole** is effective against various intestinal worms such as **pinworms**, **roundworms**, and **hookworms**.
- Its mechanism of action involves inhibiting microtubule synthesis, thereby impairing glucose uptake by the worms.
Cestodes (tapeworms) US Medical PG Question 2: A 34-year-old man presents with dysphagia. The patient says that he has pain on swallowing which gradually onset 2 weeks ago and has not improved. He denies any change in diet but does say that he recently returned from a prolonged work trip to the Caribbean. No significant past medical history or current medications. On physical examination, the patient looks pale. His tongue is swollen and has a beefy, red appearance. Angular stomatitis is present. Laboratory findings are significant for macrocytic, megaloblastic anemia, decreased serum folate, increased serum homocysteine, and normal methylmalonic acid levels. Which of the following conditions most likely caused this patient’s symptoms?
- A. Diphyllobothrium latum infection
- B. Autoimmune destruction of parietal cells
- C. Tropical sprue (Correct Answer)
- D. Poor diet
- E. Celiac disease
Cestodes (tapeworms) Explanation: ***Tropical sprue***
- The combination of **dysphagia**, **glossitis** (beefy, red, swollen tongue, angular stomatitis), **macrocytic megaloblastic anemia**, **decreased serum folate**, and a history of travel to the **Caribbean** strongly suggests tropical sprue.
- **Normal methylmalonic acid** levels rule out B12 deficiency, leaving folate deficiency as the primary cause of macrocytic anemia, consistent with tropical sprue's malabsorption.
*Diphyllobothrium latum infection*
- This infection causes **vitamin B12 deficiency** due to the parasite absorbing B12, leading to **macrocytic megaloblastic anemia**.
- However, B12 deficiency would present with **elevated methylmalonic acid** (MMA) levels, which are normal in this patient.
*Autoimmune destruction of parietal cells*
- This condition (pernicious anemia) leads to a **lack of intrinsic factor**, causing **vitamin B12 malabsorption** and subsequent B12 deficiency.
- Like *Diphyllobothrium latum* infection, it would also present with **elevated methylmalonic acid** levels.
*Poor diet*
- While a severely poor diet can lead to nutritional deficiencies, the patient denies any change in diet, and the specific constellation of symptoms (especially a history of travel to the Caribbean and **normal MMA**) points more directly to a malabsorption syndrome like tropical sprue.
- While a poor diet could cause folate deficiency, it wouldn't explain the rapid onset of severe symptoms or the specific malabsorptive context without further history.
*Celiac disease*
- Celiac disease typically causes **malabsorption** leading to iron deficiency anemia (microcytic) or, less commonly, folate deficiency (macrocytic).
- However, celiac disease is an immune reaction to **gluten** and is not specifically associated with travel to the Caribbean or the classic oral findings described.
Cestodes (tapeworms) US Medical PG Question 3: An 11-year-old boy is brought to the pediatrician by his mother for vomiting. The patient has been vomiting for the past week, and his symptoms have not been improving. His symptoms are worse in the morning and tend to improve throughout the day. The patient also complains of occasional headaches and had diarrhea several days ago. The patient eats a balanced diet and does not drink soda or juice. The patient's brothers both had diarrhea recently that resolved spontaneously. His temperature is 99.5°F (37.5°C), blood pressure is 80/45 mmHg, pulse is 90/min, respirations are 16/min, and oxygen saturation is 98% on room air. On physical exam, the patient appears to be in no acute distress. Cardiopulmonary exam reveals a minor flow murmur. Neurological exam reveals cranial nerves II-XII as grossly intact with mild narrowing of the patient's visual fields. The patient's gait is stable, and he is able to jump up and down. Which of the following is the most likely direct cause of this patient's presentation?
- A. Remnant of Rathke's pouch (Correct Answer)
- B. Intracerebellar mass
- C. Gram-positive enterotoxin
- D. Gram-negative microaerophilic bacteria
- E. Non-enveloped, (+) ssRNA virus
Cestodes (tapeworms) Explanation: ***Remnant of Rathke's pouch***
- The patient's symptoms, including **morning vomiting**, **headaches**, and **visual field narrowing**, are highly suggestive of **increased intracranial pressure** from a **craniopharyngioma**.
- **Craniopharyngiomas** are benign tumors derived from remnants of **Rathke's pouch** and are the most common supratentorial tumors in children.
- These suprasellar masses compress the **optic chiasm**, causing **bitemporal hemianopsia** (visual field defects).
*Intracerebellar mass*
- While an intracerebellar mass could cause **increased intracranial pressure** and vomiting, the specific **visual field narrowing** points toward a suprasellar lesion affecting the optic chiasm, not a cerebellar location.
- Cerebellar masses typically cause **ataxia**, **nystagmus**, and coordination problems, which are not present in this patient.
*Gram-positive enterotoxin*
- A **gram-positive enterotoxin** (e.g., *S. aureus*, *B. cereus*) would cause acute onset, severe gastrointestinal symptoms with vomiting and diarrhea, but would not explain the **neurological symptoms** like headaches and visual field deficits.
- The patient's prolonged symptoms (one week of vomiting) and neurological findings do not align with acute food poisoning.
*Gram-negative microaerophilic bacteria*
- **Gram-negative microaerophilic bacteria** like *Helicobacter pylori* or *Campylobacter* can cause gastritis or gastroenteritis, but do not explain the **neurological signs** of increased intracranial pressure or visual field defects.
- The patient's chronic vomiting with neurological signs indicates intracranial pathology rather than gastrointestinal infection.
*Non-enveloped, (+) ssRNA virus*
- A **non-enveloped, (+) ssRNA virus** (e.g., norovirus, enterovirus) would cause acute, self-limiting gastroenteritis with vomiting and diarrhea.
- It would not explain the **progressive neurological symptoms** and the prolonged duration of vomiting, which suggests a structural intracranial lesion rather than viral gastroenteritis.
Cestodes (tapeworms) US Medical PG Question 4: A 9-year-old girl is admitted to the hospital with a one-day history of acute abdominal pain and vomiting. She also has a two-day history of fever, headache, and neck pain. Her immunizations are up-to-date. She is confused and oriented only to place and person. Her temperature is 39.7°C (103.5°F), pulse is 148/min, blood pressure is 90/50 mm Hg, and respiratory rate is 28/min. Cervical range of motion is limited by pain. The remainder of the neurologic examination shows no abnormalities. Laboratory studies show:
Hemoglobin 10.9 g/dL
Leukocyte count 44,000/mm3
Serum
pH 7.33
Na+ 130 mEq/L
Cl- 108 mEq/L
K+ 6.1 mEq/L
HCO3- 20 mEq/L
Urea nitrogen 34 mg/dL
Glucose 180 mg/dL
Creatinine 2.4 mg/dL
Urine ketones negative
A CT scan of the head shows enhancement of the arachnoid and pia mater. Cerebrospinal fluid analysis shows a leukocyte count of 3,400/μL (90% neutrophils), a glucose concentration of 50 mg/dL, protein concentration of 81 mg/dL, and no erythrocytes. Gram stain of the CSF shows gram-negative diplococci. This patient is at increased risk for which of the following complications?
- A. Vesicular skin eruptions
- B. Adrenal hemorrhage (Correct Answer)
- C. Pancreatitis
- D. Temporal lobe inflammation
- E. Deep neck abscess
Cestodes (tapeworms) Explanation: **Adrenal hemorrhage**
- The clinical picture of **fever, acute abdominal pain, confusion, hypotension, and a high WBC count (44,000/mm³)**, along with **Gram-negative diplococci in CSF**, indicates **meningococcal meningitis with sepsis**. This rapidly progressive infection by *Neisseria meningitidis* can lead to **Waterhouse-Friderichsen syndrome**, characterized by **adrenal hemorrhage** and profound shock.
- The **elevated potassium (6.1 mEq/L)** and **hyponatremia (130 mEq/L)** are consistent with **adrenal insufficiency** resulting from adrenal hemorrhage.
*Vesicular skin eruptions*
- **Vesicular skin eruptions** are characteristic of viral infections such as **herpes simplex virus (HSV)** or **varicella-zoster virus**, which would present differently (e.g., HSV encephalitis often causes temporal lobe involvement).
- While various infections can cause skin rashes, this specific presentation with extensive meningeal inflammation and septic shock points away from typical vesicular eruptions.
*Pancreatitis*
- **Pancreatitis** is characterized by severe epigastric pain radiating to the back, often with nausea and vomiting, and elevated lipase/amylase. While **abdominal pain** is present, other symptoms like **neck stiffness, confusion, and CSF findings of bacterial meningitis** are not typical for pancreatitis.
- There is no specific evidence, such as imaging findings or elevated pancreatic enzymes, to suggest pancreatitis in this case.
*Temporal lobe inflammation*
- **Temporal lobe inflammation** is a hallmark of **HSV encephalitis**, which often presents with seizures, bizarre behavior, and specific MRI findings in the temporal lobes. While a CT scan showed arachnoid and pia mater enhancement, this indicates **meningeal inflammation**, not specifically temporal lobe parenchymal inflammation (encephalitis).
- The presence of **Gram-negative diplococci in the CSF** strongly indicates bacterial meningitis, not viral encephalitis, making temporal lobe inflammation less likely.
*Deep neck abscess*
- A **deep neck abscess** would typically cause localized neck pain, swelling, dysphagia, and stridor, potentially with fever, but would not explain the widespread CNS symptoms (confusion, meningeal signs, CSF findings) or systemic signs of shock and coagulopathy seen here.
- While the patient has neck pain, it is due to **meningismus**, not a localized abscess, and there is no mention of local swelling or airway compromise.
Cestodes (tapeworms) US Medical PG Question 5: A 45-year-old man presents to the emergency department with abdominal distension. The patient states he has had gradually worsening abdominal distension with undulating pain, nausea, and vomiting for the past several months. The patient does not see a physician typically and has no known past medical history. He works as a farmer and interacts with livestock and also breeds dogs. His temperature is 98.7°F (37.1°C), blood pressure is 159/90 mmHg, pulse is 88/min, respirations are 15/min, and oxygen saturation is 99% on room air. Physical exam is notable for mild abdominal distension and discomfort to palpation of the upper abdominal quadrants. Laboratory values are ordered and are notable for a mild eosinophilia. A CT scan of the abdomen demonstrates multiple small eggshell calcifications within the right lobe of the liver. Which of the following is the most likely etiology of this patient's symptoms?
- A. Echinococcus granulosus (Correct Answer)
- B. Enterobius vermicularis
- C. Necator americanus
- D. Taenia solium
- E. Taenia saginata
Cestodes (tapeworms) Explanation: ***Echinococcus granulosus***
- The patient's history of working with **livestock** and dogs, combined with **abdominal pain**, **eosinophilia**, and characteristic **eggshell calcifications** in the liver on CT, is highly suggestive of **hydatid disease** caused by *Echinococcus granulosus*.
- This parasite's larval stage forms **hydatid cysts** primarily affecting the liver and lungs, which can grow slowly and cause symptoms as they expand.
*Enterobius vermicularis*
- This parasite causes **pinworm infection**, primarily manifesting as **perianal itching**, especially at night.
- It does not typically cause abdominal distension, liver cysts, or eosinophilia to this extent, and is diagnosed via the **scotch tape test**.
*Necator americanus*
- This is a type of **hookworm** that primarily causes **iron deficiency anemia** due to chronic blood loss in the GI tract.
- Symptoms include fatigue, weakness, and pallor, but not liver cysts with eggshell calcifications or significant abdominal distension as described.
*Taenia solium*
- **Pork tapeworm** infection can cause **cysticercosis** if humans ingest the eggs, leading to cysts in muscles, subcutaneous tissue, and the brain (neurocysticercosis).
- While it can cause cysts, the classic "eggshell calcifications" in the liver are not typical for *Taenia solium* infection, and the symptoms described fit *Echinococcus* better.
*Taenia saginata*
- This is the **beef tapeworm**, which causes relatively mild symptoms in humans, often limited to mild abdominal discomfort or passage of proglottids in stool.
- It does not cause tissue cysts like those seen in cysticercosis from *T. solium* or hydatid cysts from *Echinococcus*.
Cestodes (tapeworms) US Medical PG Question 6: A 28-year-old male presents to his primary care physician with complaints of intermittent abdominal pain and alternating bouts of constipation and diarrhea. His medical chart is not significant for any past medical problems or prior surgeries. He is not prescribed any current medications. Which of the following questions would be the most useful next question in eliciting further history from this patient?
- A. "Does the diarrhea typically precede the constipation, or vice-versa?"
- B. "Is the diarrhea foul-smelling?"
- C. "Please rate your abdominal pain on a scale of 1-10, with 10 being the worst pain of your life"
- D. "Are the symptoms worse in the morning or at night?"
- E. "Can you tell me more about the symptoms you have been experiencing?" (Correct Answer)
Cestodes (tapeworms) Explanation: ***Can you tell me more about the symptoms you have been experiencing?***
- This **open-ended question** encourages the patient to provide a **comprehensive narrative** of their symptoms, including details about onset, frequency, duration, alleviating/aggravating factors, and associated symptoms, which is crucial for diagnosis.
- In a patient presenting with vague, intermittent symptoms like alternating constipation and diarrhea, allowing them to elaborate freely can reveal important clues that might not be captured by more targeted questions.
*Does the diarrhea typically precede the constipation, or vice-versa?*
- While knowing the sequence of symptoms can be helpful in understanding the **pattern of bowel dysfunction**, it is a very specific question that might overlook other important aspects of the patient's experience.
- It prematurely narrows the focus without first obtaining a broad understanding of the patient's overall symptomatic picture.
*Is the diarrhea foul-smelling?*
- Foul-smelling diarrhea can indicate **malabsorption** or **bacterial overgrowth**, which are important to consider in some gastrointestinal conditions.
- However, this is a **specific symptom inquiry** that should follow a more general exploration of the patient's symptoms, as it may not be relevant if other crucial details are missed.
*Please rate your abdominal pain on a scale of 1-10, with 10 being the worst pain of your life*
- Quantifying pain intensity is useful for assessing the **severity of discomfort** and monitoring changes over time.
- However, for a patient with intermittent rather than acute, severe pain, understanding the **character, location, and triggers** of the pain is often more diagnostically valuable than just a numerical rating initially.
*Are the symptoms worse in the morning or at night?*
- Diurnal variation can be relevant in certain conditions, such as inflammatory bowel diseases where nocturnal symptoms might be more concerning, or functional disorders whose symptoms might be stress-related.
- This is another **specific question** that should come after gathering a more complete initial picture of the patient's symptoms to ensure no key information is overlooked.
Cestodes (tapeworms) US Medical PG Question 7: A 42-year-old man presents with unremitting diarrhea that has lasted for 2 weeks. He describes his bowel movements as watery, non-bloody, foul-smelling, and greasy. He also has cramping abdominal pain associated with the diarrhea. He says that his symptoms started right after he returned from a father-son camping trip to the mountains. His son has similar symptoms. His vital signs include: pulse 78/min, respiratory rate 15/min, temperature 37.2°C (99.0°F), and blood pressure 120/70 mm Hg. A stool sample is obtained and microscopic analysis is significant for the findings shown in the image below. Which of the following pathogens is most likely responsible for this patient’s condition?
- A. Giardia lamblia (Correct Answer)
- B. Yersinia enterocolitica
- C. Bacillus cereus
- D. Clostridium difficile
- E. Campylobacter jejuni
Cestodes (tapeworms) Explanation: ***Giardia lamblia***
- The patient's symptoms of **watery, non-bloody, foul-smelling, greasy stools** (steatorrhea) with abdominal cramping after a camping trip are classic for giardiasis. The image shows a **trophozoite of Giardia lamblia**, characterized by its pear shape, multiple flagella, and two nuclei, often described as having an "old man's face" appearance.
- The **epidemiological context** (camping trip, son with similar symptoms) suggests exposure to contaminated water, a common source of *Giardia* infection.
*Yersinia enterocolitica*
- This pathogen typically causes **bloody diarrhea**, fever, and sometimes abdominal pain that can mimic appendicitis (*pseudoappendicitis*), which are not present in this case.
- It's mainly associated with consuming **undercooked pork** or contaminated milk products, not typically recreational water exposure.
*Bacillus cereus*
- This bacterium causes **food poisoning** with either an emetic form (vomiting) due to preformed toxins in **fried rice** or a diarrheal form (watery diarrhea) associated with meat and vegetable dishes.
- The incubation periods are usually short (1-6 hours for emetic, 6-15 hours for diarrheal), which does not fit the 2-week duration described.
*Clostridium difficile*
- *C. difficile* infection is characterized by **watery diarrhea** and **abdominal cramps**, often following **antibiotic use** or in healthcare settings, which are not mentioned here.
- While it can cause severe diarrhea, the stool is usually not described as greasy, and the image does not show *C. difficile* organisms or their toxins.
*Campylobacter jejuni*
- This bacterium is a common cause of **bacterial gastroenteritis**, typically presenting with **bloody diarrhea**, fever, and abdominal pain.
- It is often acquired from contaminated **poultry** or unpasteurized milk, and is associated with complications like **Guillain-Barré syndrome**, none of which are suggested by the clinical picture or image.
Cestodes (tapeworms) US Medical PG Question 8: A 45-year-old man with a history of poorly controlled human immunodeficiency virus (HIV) infection presents to the emergency room complaining of clumsiness and weakness. He reports a 3-month history of worsening balance, asymmetric muscle weakness, and speech difficulties. He recently returned from a trip to Guatemala to visit his family. He has been poorly compliant with his anti-retroviral therapy and his most recent CD4 count was 195. His history is also notable for rheumatoid arthritis and hepatitis C. His temperature is 99°F (37.2°C), blood pressure is 140/90 mmHg, pulse is 95/min, and respirations are 18/min. On exam, he has 4/5 strength in his right upper extremity, 5/5 strength in his left upper extremity, 5/5 strength in his right lower extremity, and 3/5 strength in his left lower extremity. His speech is disjointed with intermittent long pauses between words. Vision is 20/100 in the left eye and 20/40 in his right eye; previously, his eyesight was 20/30 bilaterally. This patient most likely has a condition caused by which of the following types of pathogens?
- A. Arenavirus
- B. Bunyavirus
- C. Herpesvirus
- D. Polyomavirus (Correct Answer)
- E. Picornavirus
Cestodes (tapeworms) Explanation: ***Polyomavirus***
- The patient's **poorly controlled HIV**, **low CD4 count (195)**, and progressive neurological symptoms (clumsiness, weakness, speech difficulties, vision changes) are highly suggestive of **Progressive Multifocal Leukoencephalopathy (PML)**.
- PML is caused by the **JC virus**, which is a type of **polyomavirus**, typically reactivating in immunocompromised individuals.
*Arenavirus*
- Arenaviruses (e.g., Lassa fever virus) are known to cause **hemorrhagic fevers** and can lead to neurological complications, but the clinical presentation described (progressive focal neurological deficits in an HIV patient) is not typical for an arenavirus infection.
- While some arenaviruses cause **meningoencephalitis**, the progressive, demyelinating-like course seen in this patient points away from arenavirus.
*Bunyavirus*
- Bunyaviruses (e.g., Hantavirus, La Crosse encephalitis virus) can cause **encephalitis**, fever, and myalgia, but they don't typically present with the specific constellation of **progressive white matter lesions** and focal neurological signs characteristic of PML in an HIV patient.
- Hantaviruses are more associated with **hemorrhagic fever with renal syndrome** or **hantavirus cardiopulmonary syndrome**.
*Herpesvirus*
- While herpesviruses (e.g., HSV, CMV, VZV) can cause severe neurological disease in HIV patients (e.g., **CMV encephalitis**, **HSV encephalitis**, **VZV vasculopathy**), the described progressive multifocal deficits, especially with rapid worsening, in an HIV patient with a low CD4 count strongly favor PML.
- Herpesviral encephalitides often present with more acute onset, fever, and seizures, or specific radiographic patterns not directly matching PML.
*Picornavirus*
- Picornaviruses, such as enteroviruses, can cause **aseptic meningitis** or **encephalitis**, particularly in immunocompromised individuals.
- However, the progressive, multifocal neurological deficits, particularly affecting **white matter**, are not characteristic of picornavirus infections, which tend to cause more diffuse or acute inflammatory processes.
Cestodes (tapeworms) US Medical PG Question 9: A 42-year-old woman comes to the physician because of episodic abdominal pain and fullness for 1 month. She works as an assistant at an animal shelter and helps to feed and bathe the animals. Physical examination shows hepatomegaly. Abdominal ultrasound shows a 4-cm calcified cyst with several daughter cysts in the liver. She undergoes CT-guided percutaneous aspiration under general anesthesia. Several minutes into the procedure, one liver cyst spills, and the patient's oxygen saturation decreases from 95% to 64%. Her pulse is 136/min, and blood pressure is 86/58 mm Hg. Which of the following is the most likely causal organism of this patient's condition?
- A. Clonorchis sinensis
- B. Trichinella spiralis
- C. Echinococcus granulosus (Correct Answer)
- D. Strongyloides stercoralis
- E. Schistosoma mansoni
Cestodes (tapeworms) Explanation: ***Echinococcus granulosus***
- The presentation of a **calcified liver cyst** with **daughter cysts** in a patient with animal exposure (**animal shelter worker**) is highly suggestive of **hydatid disease** caused by *Echinococcus granulosus*.
- The **anaphylactic-like reaction** (decreased oxygen saturation, hypotension, tachycardia) upon cyst spillage during aspiration is a classic and dangerous complication, indicating a severe allergic response to the **hydatid fluid**.
*Clonorchis sinensis*
- This parasite causes **cholangitis** and **cholangiocarcinoma**, and typically presents with symptoms related to biliary obstruction, rather than large calcified cysts with daughter cysts.
- It is acquired by eating **undercooked freshwater fish** and is endemic in East Asia, which doesn't align with the patient's exposure history or cyst morphology.
*Trichinella spiralis*
- This parasite is acquired by consuming **undercooked pork** and causes **trichinosis**, characterized by muscle pain, periorbital edema, and eosinophilia, and does not typically form liver cysts.
- Liver involvement with *Trichinella* is rare and does not manifest as calcified cysts with daughter cysts.
*Strongyloides stercoralis*
- This nematode causes **strongyloidiasis**, often manifesting as gastrointestinal symptoms, skin rash (**larva currens**), and pulmonary symptoms in cases of autoinfection.
- It does not form macroscopic liver cysts, and liver involvement is generally non-cystic.
*Schistosoma mansoni*
- Causes **schistosomiasis**, which can lead to **hepatic fibrosis** (**pipestem fibrosis**) and **portal hypertension**, but does not typically cause large, calcified hydatid-like cysts with daughter cysts.
- Infection is acquired through contact with **freshwater contaminated with snails** carrying the parasitic larvae.
Cestodes (tapeworms) US Medical PG Question 10: A 28-year-old female in the 2nd trimester of pregnancy is diagnosed with primary Toxoplasma gondii infection. Her physician fears that the fetus may be infected in utero. Which of the following are associated with T. gondii infection in neonates?
- A. Hutchinson’s teeth, saddle nose, short maxilla
- B. Deafness, seizures, petechial rash
- C. Hydrocephalus, chorioretinitis, intracranial calcifications (Correct Answer)
- D. Patent ductus arteriosus, cataracts, deafness
- E. Temporal encephalitis, vesicular lesions
Cestodes (tapeworms) Explanation: ***Hydrocephalus, chorioretinitis, intracranial calcifications***
- These are the classic triad of symptoms (known as the **Sabin triad**) often associated with **congenital toxoplasmosis**.
- **Hydrocephalus** results from obstruction of cerebrospinal fluid flow, **chorioretinitis** can lead to vision loss, and **intracranial calcifications** are a hallmark of the infection's impact on the brain.
*Hutchinson’s teeth, saddle nose, short maxilla*
- These are characteristic features of **congenital syphilis**, not *Toxoplasma gondii* infection.
- **Hutchinson's triad** includes Hutchinson's teeth, interstitial keratitis, and sensorineural hearing loss in congenital syphilis.
*Deafness, seizures, petechial rash*
- While seizures can occur with severe congenital infections, this combination is more suggestive of **cytomegalovirus (CMV)** infection or **rubella**, which can cause petechial rash (blueberry muffin baby) and profound sensorineural deafness.
- *Toxoplasma gondii* does not typically cause a petechial rash as a primary symptom.
*Patent ductus arteriosus, cataracts, deafness*
- This constellation of symptoms is highly characteristic of **congenital rubella syndrome**.
- **Cardiac defects** (like patent ductus arteriosus), **ocular abnormalities** (cataracts), and **sensorineural deafness** are classical signs of rubella.
*Temporal encephalitis, vesicular lesions*
- **Temporal encephalitis** with vesicular lesions, particularly in a neonatal context, is a classic presentation of **congenital herpes simplex virus (HSV) infection**.
- *Toxoplasma gondii* can cause encephalitis, but not typically with vesicular lesions or a primary predilection for the temporal lobe in this specific clinical presentation.
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