Parasitology — MCQs

Parasitology Indian Medical PG Practice Questions and MCQs

Question 901: A 4 year old child presents with acute watery diarrhea and abdominal cramps. Stool microscopy reveals trophozoites with falling leaf motility. What is the etiological agent?

A. Giardia lamblia (Correct Answer)
B. Trichomonas tenax
C. Balantidium coli
D. Entamoeba histolytica

Explanation: **Giardia lamblia** - The presence of **trophozoites** with characteristic **falling leaf motility** in stool microscopy is pathognomonic for **Giardia lamblia** infection. - **Giardiasis** commonly causes **acute watery diarrhea** and **abdominal cramps** in children, often acquired through contaminated water or food. *Entamoeba histolytica* - **Entamoeba histolytica** causes **amoebic dysentery**, characterized by bloody diarrhea, unlike the watery diarrhea described. - Its trophozoites exhibit **directional motility** with pseudopods and may contain ingested red blood cells, not falling leaf motility. *Trichomonas tenax* - **Trichomonas tenax** is found in the **oral cavity** and is not associated with intestinal infections or diarrhea. - Its typical habitat and clinical presentation are entirely different from the symptoms described. *Balantidium coli* - **Balantidium coli** is a large, ciliated protozoan whose trophozoites have a **distinctive kidney-shaped macronucleus** and rotary motility with cilia. - It causes **balantidiasis**, which can range from asymptomatic to dysentery, but its trophozoite morphology and motility are distinct from falling leaf.

Question 902: Which of the following statements about Helminths is false?

A. Alimentary canal is complete in Nematodes
B. Nematodes have separate sexes
C. Body cavity is present in trematodes (Correct Answer)
D. Alimentary canal is present but incomplete in trematodes

Explanation: ***Body cavity is present in trematodes*** - Trematodes are **flatworms** (Platyhelminthes), which are **acoelomate**, meaning they lack a true body cavity or coelom. - Their internal organs are embedded in a **parenchymal tissue** rather than being suspended within a fluid-filled cavity. *Alimentary canal is complete in Nematodes* - **Nematodes** (roundworms) possess a **complete alimentary canal**, with a distinct mouth, intestine, and anus. - This allows for **unidirectional flow of food** and waste through their digestive system. *Nematodes have separate sexes* - **Nematodes** are generally **dioecious**, meaning they have separate male and female individuals. - This sexual dimorphism is a characteristic feature for most species within this phylum. *Alimentary canal is Present but incomplete* - The statement refers to the digestive system of **Platyhelminthes** (flatworms) like trematodes and cestodes, where the alimentary canal is present but **incomplete** (lacking an anus). - This means they have a **single opening** that serves as both mouth and anus for digestion.

Question 903: Cutaneous larva migrans is due to ?

A. W.bancrofti
B. B. Malayi
C. D. medinensis
D. Ancylostoma braziliense (Correct Answer)

Explanation: ***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.

Question 904: Which Schistosoma species is primarily associated with eggs being discharged in urine?

A. S. haematobium (Correct Answer)
B. S. japonicum
C. S. mansoni
D. S. mekongi

Explanation: ***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.

Question 905: What does the hookworm primarily feed on?

A. Plasma proteins
B. Lymphatic fluid
C. Interstitial fluid
D. Blood from intestinal mucosa (Correct Answer)

Explanation: ***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.

Question 906: Which of the following statements about malaria transmission is correct?

A. Individuals harboring gametocytes can transmit malaria. (Correct Answer)
B. P. vivax always completely fills the infected RBC with schizonts.
C. Malaria can only be transmitted through blood transfusions.
D. All stages of P. falciparum are commonly seen in peripheral blood smears.

Explanation: ***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.

Question 907: Persons with heterozygous sickle cell trait are protected from infection by:

A. Pneumococcus
B. P. falciparum (Correct Answer)
C. P. vivax
D. Salmonella

Explanation: ***P. falciparum*** - Individuals with heterozygous sickle cell trait have a **protective effect** against severe malaria caused by *P. falciparum* due to altered red blood cell morphology [1][2]. - The sickle hemoglobin (HbAS) provides a **selective advantage**, reducing the severity of malaria infections and the parasitic load [2][3]. *P. vivax* - Sickle cell trait does not confer significant protection against *P. vivax*, which primarily infects non-sickled red blood cells [2]. - The infection still occurs in individuals with the trait because it specifically affects the reticulocyte count, which is less impacted by sickling. *Salmonella* - While sickle cell disease is linked with increased susceptibility to **Salmonella infections**, the sickle cell trait itself does not provide protection against it [2]. - The trait does not influence immunity or susceptibility to bacterial pathogens like *Salmonella*. *Pneumococcus* - Individuals with sickle cell trait still have a normal risk of **invasive pneumococcal disease**, similar to those without the trait [2]. - Protection against *Pneumococcus* primarily relates to vaccination status and not to hemoglobinopathies. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Infectious Diseases, pp. 398-400. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 598-599. [3] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 50-51.

Question 908: Which organism can be isolated from stool & sputum?

A. Fasciola
B. P. carinii
C. Clonorchis
D. Paragonimus (Correct Answer)

Explanation: ***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 909: The Hanging Drop method is primarily used for studying which of the following microorganisms?

A. Trichomonas vaginalis (Correct Answer)
B. Plasmodium falciparum
C. Toxoplasma gondii
D. Cryptosporidium parvum

Explanation: ***Trichomonas vaginalis*** - The **hanging drop method** is excellent for observing the **motility** of this parasite, which is crucial for its identification due to its characteristic jerky, tumbling movement. - This method helps differentiate it from other non-motile organisms in vaginal fluid samples. *Plasmodium falciparum* - This parasite is primarily identified through examination of **blood smears** (thick and thin films) for its characteristic **intraerythrocytic stages** (rings, trophozoites, schizonts, gametocytes). - It is an **intracellular parasite** and does not exhibit free motility in a hanging drop preparation. *Toxoplasma gondii* - Diagnosis typically involves **serological tests** for antibodies or **PCR** for detecting parasitic DNA, as well as histological examination of tissue biopsies. - While it can move, it's an **obligate intracellular parasite** and is not primarily identified by its motility in a simple hanging drop preparation from clinical samples. *Cryptosporidium parvum* - This parasite is diagnosed by detecting its **oocysts in stool samples** using specialized staining techniques like **acid-fast stain** or immunofluorescence assays. - The oocysts are non-motile and are not identified using the hanging drop method.

Question 910: What is the correct sequence of the sexual cycle in malaria?

A. Sporozoites to gametocytes
B. Gametocytes to gametes
C. Gametocytes to sporozoites (Correct Answer)
D. Gametes to zygote

Explanation: ***Gametocytes to sporozoites*** - The sexual cycle begins when a mosquito ingests **gametocytes** during a blood meal. - These gametocytes develop into **gametes**, which fuse to form a **zygote**. The zygote matures into an **oocyst** and then releases **sporozoites**, which migrate to the mosquito's salivary glands, ready to infect a new human host. *Gametocytes to gametes* - This is an initial step within the sexual cycle where gametocytes differentiate into **male and female gametes**, respectively. - However, it's not the complete *sequence* of the sexual cycle, as it omits subsequent crucial stages like fertilization and sporozoite formation. *Sporozoites to gametocytes* - **Sporozoites** are injected into a human host and initiate the asexual cycle by infecting liver cells, then red blood cells. - **Gametocytes** are formed later during the asexual cycle in the human host, ready to be picked up by another mosquito; this sequence describes part of the human infection, not the sexual cycle in the mosquito. *Gametes to zygote* - This step represents **fertilization**, where male and female gametes fuse, forming a **zygote** in the mosquito gut. - While essential, it is only one part of the overall sexual cycle and doesn't encompass the full transformation from gametocytes to infective sporozoites.

Practice by Chapter

Classification of Parasites

Practice Questions

Intestinal Protozoa

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Blood and Tissue Protozoa

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Malaria Parasites

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Leishmaniasis

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Intestinal Helminths: Nematodes

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Tissue Nematodes

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Trematodes

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Cestodes

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Ectoparasites

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Antiparasitic Drugs

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Laboratory Diagnosis of Parasitic Infections

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