Parasitology Practice Questions

Q: River blindness is caused by?

Onchocerca volvulus. ***Onchocerca volvulus*** - **River blindness**, or **onchocerciasis**, is caused by the parasitic nematode *Onchocerca volvulus*. - This parasite is transmitted by the bite of infected **blackflies** (genus *Simulium*), which breed in fast-flowing rivers. *Loa loa* - *Loa loa* causes **Loiasis**, also known as African eye worm disease. - While it can manifest as an eye worm and cause itching and swelling, it does not typically lead to permanent blindness or the widespread skin lesions associated with river blindness. *Ascaris* - *Ascaris lumbricoides* causes **ascariasis**, an intestinal infection. - Symptoms are primarily gastrointestinal, such as abdominal pain, malnutrition, and, in severe cases, intestinal obstruction; it does not affect the eyes or cause blindness. *B. malayi* - *Brugia malayi* is one of the causes of **lymphatic filariasis**, also known as **elephantiasis**. - This disease primarily affects the lymphatic system, causing severe swelling in the limbs and genitals, but it does not cause blindness.

Q: A young sexually active female presents with intense pruritus and watery discharge. What is the most likely causative organism?

Trichomonas vaginalis. ***Trichomonas vaginalis*** - **Trichomoniasis** presents with **intense vulvovaginal pruritus** and **profuse discharge** that can range from watery to **frothy, yellow-green** in appearance, often with a **strawberry cervix**. - It is a **sexually transmitted infection (STI)** caused by a **flagellated protozoan** with vaginal **pH >4.5** and is treated with **metronidazole**. *Chlamydia trachomatis* - Often causes **asymptomatic infections** or **mucopurulent cervical discharge** with **dysuria** and **post-coital bleeding**, but typically **no intense pruritus**. - It is a **bacterial STI** that primarily causes **cervicitis** and **pelvic inflammatory disease**, not the characteristic intense itching described. *Candida albicans* - Causes **severe vulvovaginal pruritus** but with a **thick, white, curd-like discharge** rather than watery discharge, and is **not sexually transmitted**. - Known as **vulvovaginal candidiasis** or yeast infection, caused by fungal overgrowth, often precipitated by **antibiotics** or **immunosuppression**. *Gardnerella vaginalis* - Associated with **bacterial vaginosis**, presenting with **thin, grayish-white discharge** and **fishy odor** (especially after intercourse), but **minimal pruritus**. - Caused by **vaginal flora imbalance** with loss of **lactobacilli** and overgrowth of anaerobic bacteria, not primarily an STI.

Q: Amoebic liver abscess can be diagnosed by demonstrating-

Trophozoites in the pus. ***Trophozoites in the pus*** - **Amoebic liver abscesses** are caused by the invasive **trophozoite stage** of *Entamoeba histolytica*. - Demonstrating **trophozoites** in the characteristic **'anchovy paste' pus** aspirated from the abscess cavity is diagnostic. *Cysts in the pus* - **Cysts** are the **infective stage** of *Entamoeba histolytica* and are typically found in the **feces**, not in an abscess. - Cysts are responsible for transmission and survival outside the host, but they do not cause invasive disease. *Cysts in the liver* - The disease in the liver is caused by **trophozoites**, which invade the intestinal wall and then spread to the liver. - **Cysts** are never found within the liver parenchyma or abscesses. *Trophozoites in the feces* - While **trophozoites** can be found in the feces during acute amoebic dysentery, their presence alone does not confirm a liver abscess. - Furthermore, **trophozoites** are fragile and often difficult to detect in stool samples, especially once the stool has cooled.

Q: Cutaneous larva migrans is due to ?

Ancylostoma braziliense. ***Ancylostoma braziliense*** - **Cutaneous larva migrans** is primarily caused by the larvae of **dog and cat hookworms**, especially *Ancylostoma braziliense*. - Humans become **accidental hosts** when these larvae penetrate the skin but cannot complete their life cycle, leading to **serpiginous tracks**. *W. bancrofti* - This parasite, **Wuchereria bancrofti**, is a filarial nematode that causes **lymphatic filariasis** (elephantiasis). - Its effects are characterized by **lymphedema** and **hydrocele**, not migrating skin lesions. *B. Malayi* - **Brugia malayi** is another filarial nematode responsible for **lymphatic filariasis** in humans, similar to *W. bancrofti*. - It primarily causes **swelling of the limbs** and scrotum, not cutaneous larva migrans. *D. medinensis* - **Dracunculus medinensis** is the parasite that causes **dracunculiasis**, also known as **Guinea worm disease**. - This infection is characterized by a **painful blister** and subsequent emergence of the adult worm, which is distinct from creeping eruptions.

Q: Which of the following statements about malaria transmission is correct?

Individuals harboring gametocytes can transmit malaria.. ***Individuals harboring gametocytes can transmit malaria.*** - **Gametocytes** are the sexual stage of the malaria parasite that circulate in the human bloodstream and are infectious to mosquitos. - When an *Anopheles* mosquito feeds on an infected human, it ingests these gametocytes, allowing the parasite's life cycle to continue in the mosquito vector, leading to transmission. *P. vivax always completely fills the infected RBC with schizonts.* - While *P. vivax* does infect **reticulocytes** (young RBCs) and can enlarge them, the **schizonts** typically occupy a significant portion but not always completely fill the host cell. - The infected RBCs are often enlarged to about 1.5 to 2 times their normal size and contain numerous **Schüffner's dots**. *Malaria can only be transmitted through blood transfusions.* - The primary mode of malaria transmission is through the bite of an **infected female *Anopheles* mosquito**. - While **blood transfusions** can transmit malaria, it is a less common and secondary route compared to vector-borne transmission. *All stages of P. falciparum are commonly seen in peripheral blood smears.* - In *P. falciparum* infections, only the **ring forms** and **gametocytes** are commonly observed in the peripheral blood smear. - The more mature asexual stages (trophozoites and schizonts) typically sequester in the capillaries of internal organs, where they are not readily visible in peripheral circulation.

Q: Cylindrical helminths are -

Roundworms. ***Roundworms*** - **Roundworms**, also known as **nematodes**, are characterized by their **cylindrical body shape**. - Their unsegmented, tapered bodies distinguish them from flatworms like tapeworms and flukes. *Tapeworms* - **Tapeworms**, or **cestodes**, have **flat, ribbon-like bodies** segmented into proglottids. - They are not cylindrical but rather dorsoventrally flattened. *Flukes* - **Flukes**, or **trematodes**, have **flat, leaf-shaped bodies**, which are not cylindrical. - Their morphology includes suckers for attachment and they are not segmented. *Hookworms* - **Hookworms** are a type of **roundworm** (nematode), which means they are cylindrical. However, "Roundworms" is a broader and more accurate classification for the general term "cylindrical helminths." - While hookworms are indeed cylindrical, the option "Roundworms" encompasses all such cylindrical helminths, making it a more general and appropriate answer.

Q: What does the hookworm primarily feed on?

Blood from intestinal mucosa. ***Blood from intestinal mucosa*** - Hookworms attach to the **intestinal wall** and ingest host blood, leading to blood loss and potential **anemia**. - They produce **anticoagulants** to facilitate continuous feeding from the mucosal capillaries. *Plasma proteins* - While plasma contains proteins, hookworms primarily feed directly on **whole blood**, not just isolated plasma proteins. - Feeding mainly on plasma proteins would not explain the significant **iron-deficiency anemia** associated with hookworm infection. *Lymphatic fluid* - Hookworms reside in the **small intestine** and do not typically feed on lymphatic fluid. - Other parasites, like **filarial worms**, are known to inhabit and obstruct the lymphatic system. *Interstitial fluid* - Interstitial fluid is found in the spaces between cells; hookworms feed from the **vascular supply** within the intestinal mucosa. - Feeding on interstitial fluid would not cause the characteristic **blood loss** seen in hookworm infections.

Q: What is the infective form of Trypanosoma brucei?

Trypomastigote. ***Trypomastigote*** - The **trypomastigote** is the infective form of *Trypanosoma brucei* transmitted to humans by the **tsetse fly** bite. - In the human host, trypomastigotes multiply in the **blood and lymphatic system**, eventually invading the central nervous system. *Amastigote form* - The **amastigote** form is characteristic of *Trypanosoma cruzi* and *Leishmania* species, not *Trypanosoma brucei*. - **Amastigotes** are found intracellularly and lack a flagellum, responsible for replication within host cells for these other parasites. *Egg stage* - *Trypanosoma brucei* is a **protozoan parasite** and does not have an **egg stage** in its life cycle. - Egg stages are typical for helminths, such as **tapeworms** or **flukes**. *No infective form* - This statement is incorrect; **all parasitic organisms** must have an infective stage to be transmitted to their hosts. - The **trypomastigote** is specifically adapted for transmission and survival in the human host and vector.

Q: Which Schistosoma species is primarily associated with eggs being discharged in urine?

S. haematobium. ***S. haematobium*** - *S. haematobium* specifically targets the **urinary bladder plexus**, leading to the discharge of eggs in the **urine**. - Infection with *S. haematobium* is the primary cause of **urinary schistosomiasis** and is associated with complications like **hematuria** and bladder cancer. *S. japonicum (intestinal)* - *S. japonicum* primarily infects the **mesenteric veins of the small intestine** and discharges its eggs in **feces**, not urine. - This species is known for causing severe **intestinal and hepatic schistosomiasis** due to the large number of eggs produced. *S. mansoni (intestinal)* - *S. mansoni* also primarily infects the **mesenteric veins, mainly of the large intestine**, and its eggs are excreted in **feces**. - It is a common cause of **intestinal schistosomiasis**, leading to symptoms such as abdominal pain, diarrhea, and hepatosplenomegaly. *S. mekongi* - *S. mekongi* is another **intestinal schistosome**, closely related to *S. japonicum*, and its eggs are discharged in **feces**. - This species is found in specific regions of Southeast Asia and causes similar symptoms to other intestinal schistosomes.

Q: Trophozoites in stool are characteristically seen in which of the following conditions?

**Note:** This question has significant issues. Trophozoites in stool are characteristically seen in **protozoal infections** such as *Entamoeba histolytica* (amoebiasis), *Giardia lamblia*, or *Balantidium coli* [1][2] - none of which are listed as options. ***None of the given options is medically accurate*** for characteristic trophozoites in stool. However, if forced to choose from these options: *Ascariasis* - **Ascariasis** is caused by the nematode *Ascaris lumbricoides* - Diagnosis is by identifying **ova (eggs)** in stool, not trophozoites - Trophozoites are protozoal forms, not associated with helminthic infections [2] *Strongyloidiasis* - Caused by *Strongyloides stercoralis* (nematode) - Typically diagnosed by finding **rhabditiform or filariform larvae** in stool - Not characterized by trophozoites in routine stool examination *Eosinophilic gastroenteritis* - Inflammatory condition with **eosinophilic infiltration** of GI tract - Not a parasitic infection - No trophozoites present - diagnosis is by endoscopic biopsy showing eosinophils *Allergic colitis* - Inflammatory condition related to **food allergies** (common in infants) - Presents with blood and mucus in stool with eosinophilia - Not an infectious process - no trophozoites present **Clinical Pearl:** Trophozoites (motile feeding stage of protozoa) in stool are diagnostic of **acute intestinal protozoal infections** like amoebiasis or giardiasis, where they must be identified in fresh, warm stool samples as they rapidly deteriorate [1][2]. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Alimentary System Disease, pp. 364-365. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Gastrointestinal Tract, pp. 801-802.

Question 1

River blindness is caused by?

Accepted Answer

Onchocerca volvulus

Answer

Loa loa

Answer

Ascaris

Answer

B. malayi

Question 2

A young sexually active female presents with intense pruritus and watery discharge. What is the most likely causative organism?

Accepted Answer

Trichomonas vaginalis

Answer

Chlamydia trachomatis

Answer

Candida albicans

Answer

Gardnerella vaginalis

Question 3

Amoebic liver abscess can be diagnosed by demonstrating-

Accepted Answer

Trophozoites in the pus

Answer

Trophozoites in the feces

Answer

Cysts in the pus

Answer

Cysts in the liver

Question 4

Cutaneous larva migrans is due to ?

Accepted Answer

Ancylostoma braziliense

Answer

W.bancrofti

Answer

B. Malayi

Answer

D. medinensis

Question 5

Which of the following statements about malaria transmission is correct?

Accepted Answer

Individuals harboring gametocytes can transmit malaria.

Answer

P. vivax always completely fills the infected RBC with schizonts.

Answer

Malaria can only be transmitted through blood transfusions.

Answer

All stages of P. falciparum are commonly seen in peripheral blood smears.

Question 6

Cylindrical helminths are -

Accepted Answer

Roundworms

Answer

Tapeworms

Answer

Flukes

Answer

Hookworms

Question 7

What does the hookworm primarily feed on?

Accepted Answer

Blood from intestinal mucosa

Answer

Plasma proteins

Answer

Lymphatic fluid

Answer

Interstitial fluid

Question 8

What is the infective form of Trypanosoma brucei?

Accepted Answer

Trypomastigote

Answer

Amastigote form

Answer

Egg stage

Answer

No infective form

Question 9

Which Schistosoma species is primarily associated with eggs being discharged in urine?

Accepted Answer

S. haematobium

Answer

S. japonicum

Answer

S. mansoni

Answer

S. mekongi

Question 10

Trophozoites in stool are characteristically seen in which of the following conditions?

Answer

Ascariasis

Answer

Strongyloidiasis

Answer

Allergic colitis

Answer

Eosinophilic gastroenteritis

Parasitology — MCQs

Parasitology — MCQs

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