Parasitology Samplex

A 10 year old girl from Samar was brought to Manila with an enlarging abdomen. Examination showed hepatosplenomegaly and Kato thick smear is positive for eggs with a lateral knob. You are probably dealing with infection with:
a. Taenia saginata
b. Paragonimus westermani
c. Schistosoma japonicum
d. Taenia solium

c. Schistosoma japonicum

A patient complains of seeing flesh-colored rectangular proglottids from his stools. He has been having signs of pallor and a history of swimming in a lake. What drug should you give him?
a. none of the other choices
b. mebendazole
c. ketoconazole
d. diethycarbamazine

a. None of the other choices

A tapeworm with exactly 3 proglottids were found inside the intestines of a child. Which of the following is your diagnosis?
a. Echinococcosis
b. Diphyllobothriasis
c. Hymenolepiasis
d. Cysticercosis

a. Echinococcosis

A very rich son of a general is suspected of chronic liver fluke infection. What diagnostic modality would you recommend to confirm infection?
a. ELISA
b. stool microscopy
c. string test
d. abdominal CT scan

b. Stool microscopy

A visiting friend from Thailand complains of abdominal discomfort. You just read your Liver Flukes lecture given to you due to the recent suspension of classes, so you would be primarily suspecting which parasite?
a. Opisthorchis
b. Chlonorchis
c. Fasciola
d. D latum

a. Opisthorchis

All of the following statements are TRUE about cestodes EXCEPT:
a. They are provided with separate sexes
b. They are flatworms
c. They do not have a digestive system
d. adult worms are always in the small intestines

a. They are provided with separate sexes

All of the following warm-blooded vertebrates can be used as reservoir hosts of S. japonicum EXCEPT
a. lizards and birds
b. carabaos and pigs
c. dogs and rats
d. cows and goats

a. lizards and birds

Chlonorchis and Opisthorchis infections are associated with signs and symptoms related to pathology in which organ/tissue/location?
a. biliary tract
b. small intestines
c. large intestines
d. liver parenchyma

a. Biliary tract

Circumoval precipitin test for schistosomiasis is an example of
a. Serological test
b. Stool examination
c. Imaging technique
d. Histopathologic procedure

a. Serological test

Current challenges in the control of lung fluke infections in the Philippines include the following EXCEPT:
a. low coverage of mass drug administration
b. lack of capacity for surveillance and control at the local health unit level
c. access to the drug of choice
d. lack of a well-defined program for surveillance and control

c. access to the drug of choice

Drug of choice in most cestode and trematode infections is:
a. praziquantel
b. pyrantel
c. albendazole
d. mebendazole

a. Praziquantel

Due to the relative invasiveness of the parasite, you would suspect which clinical sign in Fascioliasis patients not found in other liver fluke infections?
a. Hepatomegaly
b. urticaria
c. diarrhea
d. abdominal pain

a. Hepatomegaly

During an episode of House, the girl with the long fish tapeworm in her body was suffering from dementia which can be attributed to:
a. pernicious anemia
b. iron deficiency anemia
c. iron deficiency syndrome
d. RBC ingestion by the parasite

a. Pernicious anemia

During stool microscopy, you see an operculated egg with prominent "shoulders" jutting from the sides of the operculum. Which parasite would be your primary suspect?
a. Clonorchis sinensis
b. Fasciola hepatica
c. Taenia solium
d. D. latum

a. Clonorchis sinensis

Experts advocate integrated parasite control involving the following parasitic infections EXCEPT:
a. lymphatic filariasis and neurocysticercosis
b. soil-transmitted helminthiasis and schistosomiasis
c. soil-transmitted helminthiasis and lymphatic filariasis
d. schistosomiasis and lymphatic filariasis

a. lymphatic filariasis and neurocysticercosis

For surveillance and monitoring of schistosomiasis and STH Infections in the community, the best diagnostic procedure is:
a. Kato Katz method
b. Modified Kato thick method
c. Formalin ether concentration technique
d. Direct fecal smear

a. Kato-Katz method

Granuloma formation in the lungs and liver is caused by:
a. Schistosoma japonicum
b. Taenia solium
c. Paragonimus westermani
d. Haplorchis taichui

a. Schistosoma japonicum

Head, neck and proglottids are main body parts of:
a. Cestode
b. Trematode
c. Nematode

a. Cestode

Heavy infection with echinostomes may result in one of the following conditions
a. intestinal obstruction
b. microcytic anemia
c. megaloblastic anemia
d. cerebral complications

b. microcytic anemia

Heterophyidiasis usually concomitant with which of the following conditions?
a. capillariasis
b. fascioliasis
c. echinostomiasis
d. clonorchiasis

c. Echinostomiasis

How can a patient present with Fasciola eggs in his stools without being actively infected by the parasite?
a. ingestion of infected liver
b. this is not possible; if you exhibit eggs in your stools, you are infected
c. ingestion of contaminated snails
d. eating uncooked watercress

a. ingestion of infected liver

How can you tell if a parasite egg is from D. latum instead of from Fasciola?
a. they have an abopercular knob
b. they are macroscopic
c. they have an open operculum
d. they are embryonated when they are released from the adult

a. they have an abopercular knob

Human cysticercosis has been found in the following organs EXCEPT:
a. inside long bones
b. brain
c. muscles
d. eyes

a. inside long bones

Humans acquire cysticercosis through:
a. ingestion of Taenia solium eggs
b. ingestion of Taenia saginata eggs
c. ingestion of infected pork
d. ingestion of infected beef

a. ingestion of Taenia solium eggs

In schistosomiasis, the major pathology and disease manifestations can be attributed to:
a. host granulomatous reaction to eggs deposited in the liver and other organs
b. host reaction to the allergenic substances released by the adult worms
c. both the adult worms' and the eggs' production of toxic metabolites
d. intestinal obstruction with resulting abdominal enlargement

a. host granulomatous reaction to eggs deposited in the liver and other organs

In Sorsogon, how often is co-infection with acid fast bacilli with paragonimiasis?
a. 30% of patients with paragonimiasis also had positive AFB smear
b. 60% of patients with paragonimiasis also had positive AFB smear
c. 30% of patients with positive AFB smear also had paragonimiasis
d. 60% of patients with positive AFB smear also had paragonimiasis

c. 30% of patients with positive AFB smear also had paragonimiasis

In the biology of Taenia solium, man may serve as:
a. definitive and intermediate host
b. definitive and paratenic host
c. paratenic host and intermediate host
d. intermediate and transport host

a. definitive and intermediate host

Introduction of animals that eat snails will help in the prevention and control of which of the following parasites?
a. Chlonorchis
b. Diphyllobothrium
c. Taenia solium
d. Hymenolepis

a. Chlonorchis

Involvement of the central nervous system due to cysticercosis can be suspected with the following manifestations EXCEPT:
a. Loeffler's syndrome
b. Behavioral changes
c. Seizures
d. Blurring of the vision

a. Loeffler’s syndrome

Known paragonimiasis endemic provinces in the Philippines include:
a. Sorsogon and Bohol
b. Davao Oriental and Leyte
c. Basilan and Cebu
d. Zamboanga del Norte and Bataan

b. Davao Oriental and Leyte

Lung flukes may invade any of the following organs EXCEPT:
a. heart
b. brain
c. spinal cord
d. peritoneal organs

a. heart

Man can acquire hymenolepiasis through ingestion of another stage in the life cycle of H. nana aside from eggs.
a. TRUE
b. FALSE
c. IRRELEVANT QUESTION

a. TRUE

Metacercariae of lung flukes may be found in:
a. Sundathelphusa sp.
b. Antemelania sp.
c. Oncomelania sp.
d. Brotia sp.

a. Sundathelphusa sp.

Neurocysticercosis is caused by:
a. Taenia solium
b. Schistosoma japonicum
c. Paragonimus westermani
d. Haplorchis taichui

a. Taenia solium

Newly described schistosomiasis endemic areas in the recent years include the following EXCEPT:
a. Camiguin
b. Surigao del Sur
c. Cagayan
d. Negros Occidental

a. Camiguin

One of the following characteristics is a diagnostic feature of the adult echinostomes:
a. collarette of spines
b. bilateral genital pores
c. location of the vitellaria
d. dendritic testes

a. collarette of spines

One of the following paired items is NOT CORRECT:
a. Taenia solium and beef
b. Heterophyid flukes and fish
c. Fasciolopsis buski and water caltrop
d. Taenia asiatica and pork

a. Taenia solium and beef

Oral and ventral suckers are exhibited by:
Trematode
Cestode
Nematode

Trematode

Parasitic infection which produce signs and symptoms very similar to cardiac beri-beri is:
Heterophyidiasis
Taeniasis
Echinostomiasis
Fascioliasis

a. Heterophyidiasis

Pathology in lung fluke infection includes the following EXCEPT:
Portal hypertension
Tubercle-like abscesses
Granuloma formation
Destruction of blood vessels

a. Portal hypertension

Peptic ulcer-like disease is a common manifestation of:
Heterophyidiasis
Fascioliasis
Schistosomiasis
Paragonimiasis

a. Heterophyidiasis

Planktons play a role in the life cycle of Diphyllobothrium latum, acting as:
1st intermediate host
2nd intermediate host
3rd intermediate host
Definitive host

a. 1st intermediate host

Pseudophyllidean tapeworms do not undergo apolysis due to the presence of one of the following structures:
Uterine pore
Genital pore
Sucking grooves
Sucking disc

a. Uterine pore

Sparganum is a general term used to define which stage of a cestodes' life cycle?
Plerocercoid larva
Coracidia
Embryonated egg
Procercoid larva

a. Plerocercoid larva

Specific identification of the following parasites may not be possible through the examination of the egg stage EXCEPT:
Paragonimus westermani and Echinostoma ilocanum
Taenia solium and Taenia saginata
Fasciola gigantica and Fasciolopsis buski
Haplorchis taichui and Heterophyes heterophyes

a. Paragonimus westermani and Echinostoma ilocanum

Specimens that can be examined for demonstration of Paragonimus ova include the following EXCEPT:
Urine
Pleural effusion fluid
Stool
Sputum

a. Urine

Taenia solium can be differentiated from Taenia saginata through the examination of the following EXCEPT:
Eggs
Scolex
Mature segments
Gravid segments

a. Eggs

Taeniasis can be diagnosed through the following laboratory techniques EXCEPT:
Stool culture
Stool concentration
Examination of segments
Peri-anal swab

a. Stool culture

Taeniasis saginata is possibly absent among the following groups of people:
Muslims
Buddhists
Christians
Jehovah's Witnesses

b. Buddhists

Target groups for combined control of schistosomiasis and STH infections in endemic communities include the following EXCEPT:
a. Soldiers
b. School age children
c. Women of child bearing age
d. Farmers

a. Soldiers

The encysted larva of Taenia asiatica is usually found in which organs?
a. liver
b. muscles
c. eyes
d. subcutaneous tissue

a. Liver

The current gold standard in diagnosis of paragonimiasis is:
a. sputum examination
b. serologic test
c. antigen detection
d. stool examination

a. Sputum examination

The Cysticercus viscerotropica is the encysted larva of which of the following parasites?
a. Taenia asiatica
b. Taenia solium
c. Taenia taeniaformis
d. Taenia saginata

a. Taenia asiatica

The development of liver flukes inside the intermediate host can be listed as:
a. miracidia --> sporocyst --> radiae --> cercariae
b. cercariae --> sporocyst --> radiae --> miracidia
c. miracidia --> cercariae --> sporocyst --> radiae
d. none of the other choices

a. miracidia → sporocyst → rediae → cercariae

The drug of choice for fascioliasis is:
a. Triclabendazole
b. Mebendazole
c. Albendazole
d. Metronidazole

a. Triclabendazole

The drug of choice for neurocysticercosis is:
a. Albendazole
b. Triclabendazole
c. Mebendazole
d. Metronidazole

a. Albendazole

The drug of choice for paragonimiasis is:
a. Praziquantel
b. Metronidazole
c. Albendazole
d. Mebendazole

a. Praziquantel

The drug of choice for pulmonary paragonimiasis is:
a. Praziquantel
b. Mebendazole
c. Albendazole
d. Metronidazole

a. Praziquantel

The encysted larvae of pseudophyllideans found in the first intermediate host is:
a. procercoid
b. sparganum
c. cysticercoid
d. plerocercoid

a. Procercoid

The following are the characteristics of lung fluke ova EXCEPT:
a. easily found on concentrated stool examination
b. flattened operculum
c. thickened abopercular end
d. best seen in sputum

a. Easily found on concentrated stool examination

The following are true statements about the lung fluke EXCEPT:
a. cercariae are infective to humans
b. it is a hermaphrodite
c. mollusks are first intermediate hosts
d. crustaceans are second intermediate hosts

a. Cercariae are infective to humans

The following laboratory techniques may be used to diagnose schistosomiasis EXCEPT:
a. Sputum concentration technique
b. Rectal biopsy
c. Circum-oval precipitin test
d. Kato-Katz stool examination

a. Sputum concentration technique

The golden apple snails carry the metacercariae of one of the following parasites:
a. Echinostoma malayanum
b. Heterophyes heterophyes
c. Fasciolopsis buski
d. Metagonimus yokogawai

a. Echinostoma malayanum

The intermediate host for Fasciola hepatica is:
a. snail
b. fishes
c. sheep
d. none of the other choices

a. snail

The maturity of cyclophyllidean eggs is indicated by the presence of:
a. hexacanth embryo
b. coracidium
c. miracidium
d. procercoid

a. hexacanth embryo

The miracidium of the following trematode eggs can be appreciated in a stool examination EXCEPT:
a. Schistosoma japonicum
b. Fasciolopsis buski
c. Heterophyes heterophyes
d. Opisthorchis viverrini

a. Schistosoma japonicum

The most common reservoir hosts of Fasciolopsis buski is:
a. pigs
b. rodents
c. birds
d. cows

a. pigs

The natural habitat of Paragonimus is the:
a. lung
b. crab
c. fresh water stream
d. blood

a. lung

The number of lateral branches from the main uterus of a gravid segment is about the same for the following tapeworms:
a. Taenia asiatica and Taenia solium
b. Taenia saginata and Taenia asiatica
c. Taenia solium and Taenia saginata
d. Hymenolepis nana and Hymenolepis diminuta

b. Taenia saginata and Taenia asiatica

The parameter of a successful tapeworm treatment is:
a. recovery of scolex
b. recovery of segments
c. absence of eggs in stool
d. absence of patient's complaints

a. recovery of scolex

The recommended serological test in the detection of antibodies against cysticercosis due to its high sensitivity and high specificity is:
a. Electro-immuno Transfer Blot
b. Circum-oval Precipitin Test
c. Indirect Hemagglutination
d. Latex flocculation test

a. Electro-immuno Transfer Blot (EITB)

The scolex of which parasite resembles two leaves with grooves?
a. Diphyllobothrium
b. Taenia
c. Hymenolepis
d. Echinococcus

a. Diphyllobothrium

The snail intermediate host of S. japonicum in the Philippines is:
a. Oncomelania hupensis quadrasi
b. Oncomelania hupensis hupensis
c. Oncomelania hupensis lindoensis
d. Biomphalaria glabrata

a. Oncomelania hupensis quadrasi

The trematode larva that leaves the snail intermediate host is called:
a. cercaria
b. sporocyst
c. redia
d. metacercaria

a. cercaria

To prevent fish tapeworm infection, you would advise fish farmers to:
a. freeze fishes at -20 degC
b. cook all hog feeds
c. build their comfort rooms near the fish pens
d. marinade fresh fish in vinegar and chili for at least 12 hours before serving

a. freeze fishes at -20°C

Treatment with praziquantel can achieve all of the following EXCEPT:
a. Prevent reinfection
b. Reduce morbidity
c. Destroy the eggs
d. Kill the adult worms

a. Prevent reinfection

Trematodes are attached to their organ of predilection through a structure, an organelle called:
a. ventral sucker
b. scolex
c. bothria
d. penetration glands

a. ventral sucker

Upon ultrasound of the liver, you notice multiple cysts present. Which parasite would you suspect?
a. Echinococcus
b. Fasciola
c. Chlonorchis
d. Hymenolepis

a. Echinococcus

What is the infective stage of Fasciola gigantica?
a. metacercaria
b. miracidia
c. embryonated egg
d. unembryonated egg

a. metacercaria

What is the most sensitive diagnostic procedure for schistosomiasis that can differentiate between past and current infection?
a. Rectal biopsy/imprint
b. Antibody detection
c. Stool concentration technique
d. Ultrasound

a. Rectal biopsy/imprint

When are antibody tests such as ELISA NOT useful as a diagnostic tool for Fascioliasis?
a. to monitor response to pharmacologic treatment
b. to rule out possible infection in the liver
c. during the chronic phase of infection
d. to rule out false positives

a. to monitor response to pharmacologic treatment

Where is the natural habitat of the cestode which is associated with vitamin B12 deficiency?
a. small intestines
b. liver
c. biliary tract
d. large intestines

a. small intestines

Which of the following administrative regions is not known to be endemic for paragonimiasis?
a. Western Visayas
b. Western Mindanao
c. Eastern Visayas
d. Southern Mindanao

a. Western Visayas

Which of the following are described as Asian schistosomes?
a. S. japonicum and S. mekongi
b. Schistosoma mansoni and S. japonicum
c. S. intercalatum and S. mekongi
d. S. haematobium and S. mansoni

a. S. japonicum and S. mekongi

Which of the following cestodes/trematodes are more commonly found in Asia?
a. F. gigantica and Opisthorchis
b. F. hepatica and Chlonorchis
c. Opisthorchis and D latum
d. D latum and F. hepatica

a. F. gigantica and Opisthorchis

Which of the following characteristics can be used to identify Opisthorchis from Fasciola infection?
a. presence of embryonated egg inside adult fluke
b. presence of operculated eggs seen during stool microscopy
c. usage of snails as 2nd intermediate host
d. none of the other choices

d. none of the other choices

Which of the following has eggs with a lateral spine?
a. Schistosoma mansoni
b. Schistosoma hematobium
c. Schistosoma japonicum
d. Schistosoma mekongi

a. Schistosoma mansoni

Which of the following has the greatest number of known reservoir hosts:
a. Schistosoma japonicum
b. Schistosoma hematobium
c. Schistosoma mekongi
d. Schistosoma mansoni

a. Schistosoma japonicum

Which of the following is associated with carcinoma of the urinary bladder:
a. Schistosoma hematobium
b. Schistosoma mansoni
c. Schistosoma japonicum
d. Schistosoma mekongi

a. Schistosoma hematobium

Which of the following paired items is INCORRECT?
a. Hymenolepis diminuta and hydatid cyst
b. Taenia solium and Cysticercus cellulosae
c. Dipylidium caninum and cysticercoid
d. Diphyllobothrium and procercoid

a. Hymenolepis diminuta and hydatid cyst

Which of the following pairings is WRONG?
a. F. hepatica: abopercular knob
b. F. gigantica: Galba truncata
c. Opisthorchis viverrini: cholangiocarcinoma
d. Opisthorchis felineus: former Soviet Union

a. F. hepatica: abopercular knob

Which of the following pairings is WRONG?
a. rat tapeworm: H. nana
b. south east asian liver fluke: Opisthorchis
c. cow tapeworm: T. saginatta
d. broad tapeworm: D. latum

a. rat tapeworm: H. nana

Which of the following pairings regarding H. nana is CORRECT?
a. intermediate host: man
b. intermediate host: fleas
c. definitive host: beetles
d. accidental host: rats

b. intermediate host: fleas

Which of the following provinces in the Philippines are known to be endemic for schistosomiasis?
a. Davao, Agusan del Sur, Leyte and Samar
b. Rizal, Leyte, Sorsogon and Davao
c. Palawan, Cebu, Marinduque and Sorsogon
d. Samar, Leyte, Boracay and Cebu

a. Davao, Agusan del Sur, Leyte and Samar

Which of the following statements is erroneous about the schistosome life cycle?
a. The metacercaria stage is seen in the first intermediate host.
b. The eggs are embryonated when deposited in the environment.
c. The miracidium has to find a suitable intermediate host within 24 to 48 hours.
d. The infective stage is the cercaria.

a. The metacercaria stage is seen in the first intermediate host.

Which of the following statements regarding albendazole is TRUE as echinococcosis treatment?
a. albendazole is used to prevent recurrence after treatment
b. albendazole is not used for echinococcus treatment
c. albendazole is used as the most reliable cure for echinococcosis
d. albendazole is used to avoid allergic reactions during surgery

a. albendazole is used to prevent recurrence after treatment

Which stage of development emanates from the first intermediate host of Paragonimus?
a. cercaria
b. miracidium
c. metacercaria
d. cysticercus

a. cercaria

You are trying to monitor the epidemiology of fish tapeworms in a certain area. You might want to use freshwater fishes to monitor for which stage of the parasite's life cycle?
a. plerocercoid larva
b. procercoid larva
c. eggs
d. tachyzoites

a. plerocercoid larva

You note the presence of a 2 cm-long flat adult worm with a tapered anterior end and prominent "shoulders" from a liver sample. Which of the following drugs would you use for treatment?
a. Triclabendazole
b. Cotrimoxazole
c. Metronidazole
d. Praziquantel

a. Triclabendazole

Hepatic echinococcal cyst describe as unilocular cystic lesion with uniform anechoic content without pathognomonic signs is classified by WHO as

Type CL
Type CE3
Type CE2
Type CE1

Type CL