Parasitology Practice Questions

Q: Maximum density of microfilariae in blood is reported to be between -

11 pm to 2 am. ***11 pm to 2 am*** - This period aligns with the **nocturnal periodicity** of *Wuchereria bancrofti* and *Brugia malayi* microfilariae, which are the most common causes of filariasis. - The microfilariae migrate to the **peripheral circulation** during these hours, making it the optimal time for blood smear collection for diagnosis. *9 pm to 11 pm* - While still within the active period for microfilarial migration, the **peak density** is generally observed slightly later. - Blood drawn during this time might show microfilariae, but in lower concentrations compared to the peak. *8 pm to 10 pm* - This timing is generally a little too early to consistently capture the **highest microfilarial load** in nocturnal periodic infections. - The microfilariae are still in the process of migrating from deeper tissues to the peripheral blood. *2 am to 5 am* - By this time, the microfilarial density in the peripheral blood of **nocturnal periodic species** usually starts to decline. - While some microfilariae may still be present, the count would likely be lower than during the earlier peak hours.

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 of the following amoebae does not have a neuropathogenic effect?

Dientamoeba. ***Dientamoeba*** - *Dientamoeba fragilis* is an intestinal flagellate (often mistakenly classified as an amoeba) that causes **gastrointestinal symptoms** like diarrhea and abdominal pain. - It has **no known neuropathogenic effects** and does not invade the central nervous system. *Naegleria* - *Naegleria fowleri* is a highly virulent amoeba that causes **primary amoebic meningoencephalitis (PAM)**, a rapidly fatal infection of the central nervous system. - It typically invades the brain after **nasal insufflation** of contaminated water. *Acanthamoeba* - *Acanthamoeba* species can cause **granulomatous amoebic encephalitis (GAE)**, a subacute to chronic central nervous system infection, particularly in immunocompromised individuals. - They are also known to cause **amoebic keratitis**, a severe eye infection. *Balamuthia* - *Balamuthia mandrillaris* causes **granulomatous amoebic encephalitis (GAE)**, similar to *Acanthamoeba*, but often in both immunocompetent and immunocompromised individuals. - It can also lead to **skin lesions** and has a tropism for the brain, causing severe neurological damage.

Q: Which of the following is the only ovoviviparous parasite among the options provided?

Strongyloides. ***Strongyloides*** - *Strongyloides stercoralis* stands out as the only **ovoviviparous** parasite among the options, meaning that its eggs hatch while still inside the uterus of the female worm. - The female worm lays **larvated eggs** that quickly hatch into **rhabditiform larvae** in the intestine or intestinal wall, which are then passed in the feces. *Ascaris* - *Ascaris lumbricoides* is **oviparous**, laying **unembryonated eggs** that are passed in the feces and require a period of maturation in the soil to become infective. - The eggs are robust and can survive for long periods in the environment before they are ingested. *Enterobius* - *Enterobius vermicularis* (pinworm) is also **oviparous**, with the female worm migrating to the perianal region to lay **embryonated eggs** on the skin. - These eggs are immediately infective to humans upon ingestion. *Ancylostome* - Ancylostomes (hookworms) are **oviparous** and lay **thin-shelled eggs** that are passed in the feces and hatch into rhabditiform larvae in the soil. - These larvae then develop into infective **filariform larvae** that penetrate the skin.

Q: In malaria, pre-erythrocytic schizogony occurs in -

Liver. ***Liver*** - After being introduced by a mosquito bite, **Plasmodium sporozoites** rapidly travel to the liver - In the liver, they invade **hepatocytes** and undergo asexual reproduction, known as **pre-erythrocytic (or hepatic) schizogony**, forming merozoites - This is the exo-erythrocytic cycle that occurs before red blood cell invasion *Lung* - The lungs are not a primary site for **Plasmodium** development or asexual reproduction in the human host - While some parasite components or host immune responses might involve the lungs in severe malaria, it is not where pre-erythrocytic schizogony occurs *Spleen* - The **spleen** is primarily involved in clearing infected red blood cells and acts as a site for immune responses to malaria, but not for initial schizogony - It plays a significant role in the **erythrocytic stage** of malaria by filtering and destroying parasitized red blood cells *Kidney* - The **kidneys** are not involved in the life cycle of the **Plasmodium parasite** during pre-erythrocytic schizogony - While malaria can cause **renal complications** (such as acute kidney injury in severe cases), this is a pathological effect, not a site of parasite development

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.

Q: Child having perianal pruritus with the following eggs is due to -

E. vermicularis. ***E. vermicularis*** - **Enterobius vermicularis**, or **pinworm**, is a common cause of **perianal pruritus** in children, particularly at night, due to the female worms migrating to the perianal region to lay eggs. - The characteristic eggs are **oval, flattened on one side**, and are typically identified via the **scotch tape test** around the anus. *Ascaris* - **Ascaris lumbricoides** causes **ascariasis**, which usually presents with **gastrointestinal symptoms** or **pulmonary symptoms** during larval migration, not typically perianal pruritus. - Their eggs are characteristically **mammillated** (roughened outer layer) and typically found in **feces**, not perianal region. *Ancylostoma duodenale* - **Ancylostoma duodenale** causes **hookworm infection**, leading to **iron deficiency anemia** due to blood loss in the intestines. - Hookworm eggs are characteristically **oval, thin-shelled**, and contain a developing **larva**, found in feces. *S. stercoralis* - **Strongyloides stercoralis** causes **strongyloidiasis**, which can present with skin manifestations (larva currens), gastrointestinal issues, or pulmonary symptoms. - It is unique because it causes **auto-infection** and primarily diagnostic stages are **rhabditiform larvae** in stool, not eggs, although eggs are rarely seen in stool.

Q: Most common site for hydatid cyst

Liver. ***Liver*** - The **liver** is the most common site for hydatid cysts, accounting for approximately **60-70%** of cases [1]. - It often leads to **biliary obstruction** and liver dysfunction, highlighting its impact on the organ. *Kidney* - Hydatid cysts in the **kidney** are rare and account for a small percentage of cases (around **2-5%**). - Symptoms are often nonspecific, including **flank pain** or hematuria, which are not primary concerns. *Brain* - While the **brain** can be affected, it is not a common site; CNS involvement occurs in only **1-2%** of hydatid disease cases. - Symptoms are related to increased intracranial pressure or focal neurological deficits, not typical for hydatid cysts. *Lung* - The **lung** is another site for hydatid cysts but accounts for about **10-20%** of cases. - Presentation may include **cough** and chest pain, making it less common compared to liver involvement.

Q: Cercariae are the infective form of which of the following parasites?

Schistosoma hematobium. ***Schistosoma hematobium*** - **Cercariae** are the motile, free-swimming larval stage of **Schistosoma** species, including *S. hematobium* - They **actively penetrate human skin** to initiate infection, making cercariae the infective form for humans *Paragonimus westermani* - The infective form for humans is **metacercariae**, which are ingested by consuming insufficiently cooked **crabs or crayfish** - Cercariae develop into metacercariae in secondary intermediate hosts (crustaceans) *Fasciola hepatica* - Humans are infected by ingesting **metacercariae** present on aquatic vegetation, such as **watercress** - Cercariae encyst on plants to form metacercariae, not directly infective *Taenia solium* - The infective forms are **cysticerci** in undercooked pork (for adult tapeworm) or **embryonated eggs** (causing cysticercosis) - This cestode has a different life cycle and does **not** involve cercariae

Q: Which organism can be isolated from stool & sputum?

Paragonimus. ***Paragonimus*** - *Paragonimus* species, particularly *P. westermani* (the **lung fluke**), are known to infest the lungs, leading to symptoms like **cough** and **sputum production**, where their eggs can be found. - While residing in the lungs, eggs can be swallowed, passed through the gastrointestinal tract, and subsequently found in **stool samples**. *Fasciola* - *Fasciola hepatica* (the **sheep liver fluke**) primarily infects the **liver and biliary ducts**. - Its eggs are typically found in **stool samples** but not in sputum, as it does not infest the respiratory tract. *Clonorchis* - *Clonorchis sinensis* (the **Chinese liver fluke**) also primarily inhabits the **bile ducts** of the liver. - Similar to *Fasciola*, its eggs are excreted in **feces** and are not found in sputum. *P. carinii* - *Pneumocystis jirovecii* (formerly *Pneumocystis carinii*) is a **fungus** that causes **pneumonia** (PCP) in immunocompromised individuals. - It is exclusively found in the **lungs** and identified in respiratory specimens like sputum or bronchoalveolar lavage, not in stool.

Question 1

Maximum density of microfilariae in blood is reported to be between -

Accepted Answer

11 pm to 2 am

Answer

9 pm to 11 pm

Answer

8 pm to 10 pm

Answer

2 am to 5 am

Question 2

What is the infective form of Trypanosoma brucei?

Accepted Answer

Trypomastigote

Answer

Amastigote form

Answer

Egg stage

Answer

No infective form

Question 3

Which of the following amoebae does not have a neuropathogenic effect?

Accepted Answer

Dientamoeba

Answer

Naegleria

Answer

Acanthamoeba

Answer

Balamuthia

Question 4

Which of the following is the only ovoviviparous parasite among the options provided?

Accepted Answer

Strongyloides

Answer

Ascaris

Answer

Enterobius

Answer

Ancylostoma

Question 5

In malaria, pre-erythrocytic schizogony occurs in -

Accepted Answer

Liver

Answer

Lung

Answer

Spleen

Answer

Kidney

Question 6

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

Answer

Ascariasis

Answer

Strongyloidiasis

Answer

Allergic colitis

Answer

Eosinophilic gastroenteritis

Question 7

Child having perianal pruritus with the following eggs is due to -

Accepted Answer

E. vermicularis

Answer

Ascaris

Answer

Ancylostoma duodenale

Answer

S. stercoralis

Question 8

Most common site for hydatid cyst

Accepted Answer

Liver

Answer

Lung

Answer

Brain

Answer

Kidney

Question 9

Cercariae are the infective form of which of the following parasites?

Accepted Answer

Schistosoma hematobium

Answer

Paragonimus westermani

Answer

Fasciola hepatica

Answer

Taenia solium

Question 10

Which organism can be isolated from stool & sputum?

Accepted Answer

Paragonimus

Answer

Fasciola

Answer

P. carinii

Answer

Clonorchis

Parasitology — MCQs

Parasitology — MCQs

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