Chpt 2. Protozoans 11-26 Flashcards
1
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Question and Options
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Answer and Explanation
2
Q
What is the causative organism of malaria? a) Trypanosoma b) Plasmodium c) Leishmania d) Entamoeba
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Answer: b) Plasmodium Explanation: Malaria is caused by protozoa of the genus Plasmodium. There are several species, including Plasmodium falciparum, which is the most virulent.
3
Q
What type of malaria is caused by Plasmodium falciparum? a) Benign tertian malaria b) Quartan malaria c) Malignant tertian malaria d) Ovale malaria
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Answer: c) Malignant tertian malaria Explanation: Plasmodium falciparum causes malignant tertian malaria, which is severe and often life-threatening compared to other forms of malaria.
4
Q
Which mosquito is responsible for transmitting malaria? a) Aedes b) Culex c) Anopheles d) Mansonia
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Answer: c) Anopheles Explanation: Malaria is transmitted by the bite of an infected female Anopheles mosquito.
5
Q
What is the periodicity of fever in Plasmodium vivax malaria? a) Every 24 hours b) Every 48 hours c) Every 72 hours d) Every 96 hours
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Answer: b) Every 48 hours Explanation: In P. vivax infections, fever recurs every 48 hours, giving it the name tertian malaria.
6
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In which organ do Plasmodium species first develop after infection? a) Heart b) Brain c) Liver d) Spleen
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Answer: c) Liver Explanation: Plasmodium sporozoites first infect the liver cells, where they undergo the exoerythrocytic schizogony phase before entering the bloodstream.
7
Q
What type of malaria is characterized by relapses years after the initial infection? a) Plasmodium falciparum b) Plasmodium vivax c) Plasmodium malariae d) Plasmodium ovale
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Answer: b) Plasmodium vivax Explanation: Plasmodium vivax can cause relapses due to the presence of dormant liver forms called hypnozoites, which can activate years after the initial infection.
8
Q
What cellular structure in Plasmodium falciparum malaria causes sequestration of infected red blood cells? a) Schuffner’s dots b) Maurer’s clefts c) Chromatoid bodies d) Trophozoites
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Answer: b) Maurer’s clefts Explanation: P. falciparum-infected red blood cells develop Maurer’s clefts, which contribute to their sequestration in small blood vessels, leading to severe complications.
9
Q
What is the most common complication of Plasmodium falciparum infection? a) Hemorrhage b) Hepatomegaly c) Cerebral malaria d) Nephritis
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Answer: c) Cerebral malaria Explanation: P. falciparum often causes cerebral malaria due to the sequestration of infected red blood cells in the brain capillaries, leading to severe neurological symptoms.
10
Q
What is the primary mode of malaria transmission? a) Blood transfusion b) Mosquito bite c) Contaminated water d) Contact with an infected person
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Answer: b) Mosquito bite Explanation: Malaria is primarily transmitted through the bite of an infected female Anopheles mosquito, which injects sporozoites into the bloodstream.
11
Q
Which type of malaria is known for its 72-hour fever cycle? a) Plasmodium vivax b) Plasmodium malariae c) Plasmodium falciparum d) Plasmodium ovale
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Answer: b) Plasmodium malariae Explanation: P. malariae causes quartan malaria, where fever paroxysms occur every 72 hours.
12
Q
Which of the following species causes the rarest form of malaria? a) Plasmodium falciparum b) Plasmodium vivax c) Plasmodium malariae d) Plasmodium ovale
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Answer: d) Plasmodium ovale Explanation: P. ovale is the rarest human malaria parasite, mostly confined to the tropics.
13
Q
In Plasmodium falciparum infection, which age group of erythrocytes is invaded by merozoites? a) Only mature erythrocytes b) Only reticulocytes c) Erythrocytes of any age d) Only aging erythrocytes
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Answer: c) Erythrocytes of any age Explanation: In P. falciparum malaria, merozoites can invade erythrocytes of any age, contributing to higher levels of parasitemia.
14
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How long does the sexual stage of Plasmodium falciparum take to develop? a) 5 days b) 7 days c) 10 days d) 15 days
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Answer: c) 10 days Explanation: In P. falciparum infection, the sexual stages (gametocytes) require about 10 days to develop.
15
Q
What is a key feature distinguishing Plasmodium vivax merozoites from Plasmodium falciparum? a) They invade all erythrocytes b) They invade only mature erythrocytes c) They invade only young erythrocytes (reticulocytes) d) They invade endothelial cells
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Answer: c) They invade only young erythrocytes (reticulocytes) Explanation: P. vivax merozoites can only invade young erythrocytes (reticulocytes), unlike P. falciparum, which can invade erythrocytes of any age.
16
Q
What immune system component is responsible for the phagocytosis of infected erythrocytes in malaria? a) Neutrophils b) Macrophages c) T-cells d) B-cells
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Answer: b) Macrophages Explanation: Infected erythrocytes in malaria are phagocytosed by macrophages, particularly in the spleen.
17
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Question
A
Answer & Explanation
18
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What immune system component is responsible for the phagocytosis of infected erythrocytes in malaria?\na) Neutrophils\nb) Macrophages\nc) T-cells\nd) B-cells
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Answer: b) Macrophages\nExplanation: Infected erythrocytes in malaria are phagocytosed by macrophages, particularly in the spleen.
19
Q
Which of the following is NOT a feature of Plasmodium falciparum malaria?\na) High parasitemia\nb) Relapses after treatment\nc) Cerebral complications\nd) Sequestration of red blood cells
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Answer: b) Relapses after treatment\nExplanation: Relapses are not characteristic of P. falciparum malaria, but recrudescence may occur due to incomplete elimination of the parasite.
20
Q
What is the primary pathological effect of malaria infection?\na) Inflammation\nb) Hyperglycemia\nc) Anemia\nd) Dehydration
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Answer: c) Anemia\nExplanation: Malaria primarily causes anemia due to the destruction of red blood cells, both parasitized and non-parasitized.
21
Q
How is Plasmodium vivax naturally resistant in many African populations?\na) Due to absence of Duffy antigen\nb) Due to sickle cell trait\nc) Due to high antibody levels\nd) Due to rapid erythropoiesis
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Answer: a) Due to absence of Duffy antigen\nExplanation: Many African populations are resistant to P. vivax because their red blood cells lack the Duffy antigen, which the parasite requires to enter the cells.
22
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Which Plasmodium species can cause infection after a blood transfusion decades after initial infection?\na) Plasmodium falciparum\nb) Plasmodium vivax\nc) Plasmodium malariae\nd) Plasmodium ovale
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Answer: c) Plasmodium malariae\nExplanation: P. malariae can persist in the blood for decades and is a common cause of transfusion-related malaria.
23
Q
What is the primary host organ affected during the exoerythrocytic phase of Plasmodium infection?\na) Heart\nb) Liver\nc) Lungs\nd) Kidneys
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Answer: b) Liver\nExplanation: The exoerythrocytic phase of malaria occurs in the liver, where the parasite undergoes development before entering the bloodstream.
24
Q
Which of the following Plasmodium species is primarily responsible for tertian malaria?\na) Plasmodium falciparum\nb) Plasmodium vivax\nc) Plasmodium ovale\nd) Plasmodium malariae
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Answer: b) Plasmodium vivax\nExplanation: Plasmodium vivax causes benign tertian malaria, characterized by fever paroxysms every 48 hours, a periodicity referred to as tertian.
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How long can recrudescence occur in Plasmodium malariae infection?\na) 3 months\nb) 1 year\nc) 10 years\nd) 53 years
Answer: d) 53 years\nExplanation: Recrudescence of Plasmodium malariae can occur up to 53 years after the initial infection due to the parasite's long persistence in the bloodstream.
26
Which malaria-causing species is least common?\na) Plasmodium falciparum\nb) Plasmodium vivax\nc) Plasmodium ovale\nd) Plasmodium malariae
Answer: c) Plasmodium ovale\nExplanation: Plasmodium ovale is the rarest of the four human malaria parasites, primarily confined to tropical regions.
27
What is the primary manifestation of malaria on red blood cells?\na) Enlargement of the erythrocytes\nb) Destruction of parasitized and non-parasitized erythrocytes\nc) Formation of Schuffner’s dots\nd) Binding to lymphocytes
Answer: b) Destruction of parasitized and non-parasitized erythrocytes\nExplanation: Malaria causes the destruction of erythrocytes, which can lead to anemia and other severe complications.
28
In severe falciparum malaria, what may happen to parasitized erythrocytes?\na) They may adhere to endothelial cells\nb) They may shrink and disappear\nc) They may mutate into another species\nd) They may become resistant to treatment
Answer: a) They may adhere to endothelial cells\nExplanation: In Plasmodium falciparum infection, parasitized erythrocytes tend to adhere to the capillary endothelium, leading to the clogging of blood vessels.
29
Which organ primarily phagocytoses malaria-infected erythrocytes?\na) Liver\nb) Spleen\nc) Brain\nd) Kidney
Answer: b) Spleen\nExplanation: The spleen is responsible for phagocytosing parasitized erythrocytes, leading to its enlargement (splenomegaly) in malaria patients.
30
Which malaria species exhibits a relapsing pattern up to 8 years after infection?\na) Plasmodium vivax\nb) Plasmodium falciparum\nc) Plasmodium malariae\nd) Plasmodium ovale
Answer: a) Plasmodium vivax\nExplanation: Plasmodium vivax can cause relapses up to 8 years after the initial infection due to the presence of dormant hypnozoites in the liver.
31
What is the term used for the periodic recurrence of malaria symptoms?\na) Incubation\nb) Relapse\nc) Paroxysm\nd) Sporulation
Answer: c) Paroxysm\nExplanation: Paroxysm refers to the periodic recurrence of fever and other symptoms in malaria, often timed with the release of merozoites into the bloodstream.
32
What is the characteristic shape of a mature schizont of Plasmodium ovale?\na) Oval or spherical\nb) Irregular and amoeboid\nc) Ring-like\nd) Star-shaped
Answer: a) Oval or spherical\nExplanation: The mature schizont of Plasmodium ovale typically has an oval or spherical shape, producing 4 to 16 merozoites.
33
In Plasmodium falciparum infection, what occurs when parasitized erythrocytes form 'rosettes'?\na) They invade the liver\nb) They bind to uninfected red cells\nc) They undergo apoptosis\nd) They replicate uncontrollably
Answer: b) They bind to uninfected red cells\nExplanation: In Plasmodium falciparum malaria, infected erythrocytes can bind to uninfected red cells, forming rosettes, which can obstruct blood vessels.
34
Which malaria species has a characteristic stippling called Schuffner’s dots?\na) Plasmodium falciparum\nb) Plasmodium malariae\nc) Plasmodium vivax\nd) Plasmodium ovale
Answer: c) Plasmodium vivax\nExplanation: Plasmodium vivax trophozoites are associated with Schuffner’s dots, which are distinct stipplings seen in infected erythrocytes.
35
What is the most dangerous form of malaria?\na) Plasmodium vivax malaria\nb) Plasmodium ovale malaria\nc) Plasmodium malariae malaria\nd) Plasmodium falciparum malaria
Answer: d) Plasmodium falciparum malaria\nExplanation: Plasmodium falciparum malaria is the most virulent and potentially fatal, responsible for severe complications such as cerebral malaria.
36
Which malaria species is most common in tropical Africa?\na) Plasmodium vivax\nb) Plasmodium falciparum\nc) Plasmodium ovale\nd) Plasmodium malariae
Answer: b) Plasmodium falciparum\nExplanation: Plasmodium falciparum is the most common malaria species in tropical Africa and is responsible for the highest mortality rates.
37
What is the primary site of exoerythrocytic schizogony in malaria?\na) Bone marrow\nb) Lymph nodes\nc) Liver\nd) Spleen
Answer: c) Liver\nExplanation: Exoerythrocytic schizogony occurs in the liver, where sporozoites mature into schizonts before releasing merozoites into the bloodstream.
38
Which malaria-causing species invades only young erythrocytes (reticulocytes)?\na) Plasmodium falciparum\nb) Plasmodium malariae\nc) Plasmodium vivax\nd) Plasmodium ovale
Answer: c) Plasmodium vivax\nExplanation: Plasmodium vivax merozoites can only invade young red blood cells (reticulocytes), limiting its parasitemia levels compared to other species.
39
What is a significant feature of blackwater fever associated with Plasmodium falciparum?\na) Vomiting\nb) Anaemia\nc) Hemoglobinuria\nd) Cerebral impairment
Answer: c) Hemoglobinuria\nExplanation: Blackwater fever is characterized by hemoglobinuria (presence of hemoglobin in urine), a complication of severe Plasmodium falciparum malaria.
40
What symptom is more prominent in Plasmodium falciparum infection compared to other malaria species?\na) Lymph node swelling\nb) Severe headache\nc) Increased parasitemia\nd) Rapid heart rate
"Answer: c) Increased parasitemia\nExplanation: Plasmodium falciparum causes higher
41
Question
Answer & Explanation
42
How long does it take for gametocytes of Plasmodium vivax to appear in peripheral blood?\na) 5 days\nb) 4 days\nc) 10 days\nd) Almost immediately
Answer: d) Almost immediately\nExplanation: In Plasmodium vivax infection, gametocytes may appear in peripheral blood almost at the same time as trophozoites.
43
Which form of malaria may remain dormant in the liver as hypnozoites?\na) Plasmodium falciparum\nb) Plasmodium malariae\nc) Plasmodium vivax\nd) Plasmodium ovale
Answer: c) Plasmodium vivax\nExplanation: Plasmodium vivax and Plasmodium ovale can form hypnozoites that remain dormant in the liver, leading to relapses.
44
What is the appearance of the spleen during acute malaria?\na) Small and firm\nb) Enlarged and congested\nc) Soft and pale\nd) Normal-sized but fibrous
Answer: b) Enlarged and congested\nExplanation: In acute malaria, the spleen becomes enlarged and congested due to the phagocytosis of parasitized red blood cells.
45
Which symptom is typically NOT associated with malaria?\na) Splenomegaly\nb) Diarrhea\nc) Fever\nd) Anaemia
Answer: b) Diarrhea\nExplanation: Diarrhea is not a common symptom of malaria; fever, splenomegaly, and anemia are more characteristic.
46
How long is the usual intrinsic incubation period for Plasmodium vivax?\na) 7-9 days\nb) 10-17 days\nc) 20-30 days\nd) 1-3 months
Answer: b) 10-17 days\nExplanation: The intrinsic incubation period for Plasmodium vivax, the time between the bite of an infected mosquito and the appearance of clinical symptoms, is typically 10-17 days.
47
Which of the following is the most common complication of severe malaria caused by Plasmodium falciparum?\na) Hepatitis\nb) Acute renal failure\nc) Cerebral malaria\nd) Pneumonia
Answer: c) Cerebral malaria\nExplanation: Cerebral malaria is the most serious complication of Plasmodium falciparum infection, leading to impaired consciousness, seizures, and potentially death.
48
Which organ does Plasmodium falciparum primarily affect during cerebral malaria?\na) Liver\nb) Kidneys\nc) Brain\nd) Spleen
Answer: c) Brain\nExplanation: Cerebral malaria is a severe manifestation of Plasmodium falciparum infection where parasitized red blood cells clog brain capillaries, causing neurological symptoms.
49
Which of the following drugs is most effective for treating the liver stage (hypnozoites) of Plasmodium vivax?\na) Chloroquine\nb) Primaquine\nc) Mefloquine\nd) Quinine
Answer: b) Primaquine\nExplanation: Primaquine is effective against the dormant liver stages (hypnozoites) of Plasmodium vivax and Plasmodium ovale, preventing relapse.
50
What stage of Plasmodium falciparum is responsible for causing the characteristic fever paroxysms in malaria?\na) Sporozoites\nb) Gametocytes\nc) Trophozoites\nd) Merozoites
Answer: d) Merozoites\nExplanation: Merozoites are released from infected red blood cells during schizogony, triggering the immune response that causes fever paroxysms.
51
What type of anemia is typically associated with severe malaria?\na) Aplastic anemia\nb) Hemolytic anemia\nc) Iron deficiency anemia\nd) Megaloblastic anemia
Answer: b) Hemolytic anemia\nExplanation: Hemolytic anemia is common in malaria due to the destruction of parasitized and non-parasitized red blood cells.
52
What is the method of choice for diagnosing malaria in a clinical setting?\na) Rapid antigen test\nb) Blood culture\nc) Peripheral blood smear\nd) Serology
Answer: c) Peripheral blood smear\nExplanation: A peripheral blood smear remains the gold standard for malaria diagnosis, allowing direct visualization of the parasite in red blood cells.
53
What vector transmits malaria?\na) Aedes mosquitoes\nb) Anopheles mosquitoes\nc) Culex mosquitoes\nd) Ticks
Answer: b) Anopheles mosquitoes\nExplanation: Malaria is transmitted by female Anopheles mosquitoes, which inject Plasmodium sporozoites into the bloodstream during feeding.
54
Which population is at the highest risk for severe complications from malaria?\na) Healthy adults\nb) Pregnant women\nc) Young males\nd) Adolescents
Answer: b) Pregnant women\nExplanation: Pregnant women are at higher risk for severe complications from malaria due to decreased immunity, and infection can affect both mother and fetus.
55
Question
Answer & Explanation
56
In quartan malaria (P. malariae), how frequently do the attacks occur?\na) Every 24 hours\nb) Every 48 hours\nc) Every 72 hours\nd) Every 96 hours
Answer: c) Every 72 hours\nExplanation: In quartan malaria, caused by P. malariae, the attacks occur every 72 hours if only a single brood of parasites is present.
57
What is a common complication of any type of malaria?\na) Anaemia\nb) Pulmonary oedema\nc) Hypoglycemia\nd) Blackwater fever
Answer: a) Anaemia\nExplanation: Anaemia is a frequent complication of all types of malaria due to the destruction of red blood cells by the parasite.
58
Which type of malaria is associated with splenic rupture?\na) P. falciparum\nb) P. malariae\nc) P. vivax\nd) P. ovale
Answer: c) P. vivax\nExplanation: Splenic rupture is a complication seen in P. vivax malaria (benign tertian), but it is rare.
59
Nephrosis, characterized by large amounts of albumin in the urine, is commonly associated with which type of malaria?\na) P. falciparum\nb) P. malariae\nc) P. vivax\nd) P. ovale
Answer: b) P. malariae\nExplanation: Chronic P. malariae infection is often linked to nephrosis, leading to proteinuria (albumin in the urine).
60
What symptom is more pronounced in P. falciparum malaria compared to other types of malaria?\na) Prostration\nb) Fever paroxysms\nc) Sweating\nd) Joint pain
Answer: a) Prostration\nExplanation: Prostration and a greater tendency to delirium are more pronounced in P. falciparum malaria.
61
What is the most common serious complication of P. falciparum malaria?\na) Cerebral malaria\nb) Pulmonary oedema\nc) Renal failure\nd) Algid malaria
Answer: a) Cerebral malaria\nExplanation: Cerebral malaria is a severe complication of P. falciparum infection, marked by coma, hyperpyrexia, and convulsions.
62
Which of the following is a fatal complication of severe falciparum malaria often associated with over-administration of intravenous fluids?\na) Hypoglycemia\nb) Pulmonary oedema\nc) Blackwater fever\nd) Anaemia
Answer: b) Pulmonary oedema\nExplanation: Pulmonary oedema, often caused by excessive IV fluids, is a grave complication of severe P. falciparum malaria.
63
What phase of the Plasmodium life cycle occurs in the mosquito?\na) Erythrocytic cycle\nb) Pre-erythrocytic cycle\nc) Sporozoite phase\nd) Extrinsic cycle
Answer: d) Extrinsic cycle\nExplanation: The extrinsic cycle takes place in the mosquito, where gametocytes develop into gametes, fertilize, and eventually form sporozoites.
64
What stage of the Plasmodium life cycle infects liver cells in humans?\na) Gametocytes\nb) Sporozoites\nc) Merozoites\nd) Ookinete
Answer: b) Sporozoites\nExplanation: Sporozoites are injected into humans by mosquitoes and travel to the liver to infect hepatocytes.
65
What condition is characterized by the lysis of red blood cells and the presence of free haemoglobin in the blood and urine?\na) Cerebral malaria\nb) Pulmonary oedema\nc) Blackwater fever\nd) Algid malaria
Answer: c) Blackwater fever\nExplanation: Blackwater fever is associated with P. falciparum malaria and results in massive erythrocyte destruction and dark-colored urine due to haemoglobinuria.
66
Which of the following symptoms is common in algid malaria?\na) High blood pressure\nb) Cold, clammy skin\nc) Intense sweating\nd) Elevated glucose levels
Answer: b) Cold, clammy skin\nExplanation: Algid malaria is marked by circulatory collapse, cold skin, and low blood pressure due to shock.
67
What is the main cause of death in blackwater fever?\na) Renal failure\nb) Cerebral hemorrhage\nc) Heart failure\nd) Pulmonary oedema
Answer: a) Renal failure\nExplanation: Renal failure due to impaired glomerular filtration and tubular resorption is often the cause of death in blackwater fever.
68
Hypoglycemia in falciparum malaria is caused by which of the following?\na) Increased insulin production\nb) Reduced concentration of blood glucose\nc) Decreased liver function\nd) Hypermetabolism of the parasite
Answer: b) Reduced concentration of blood glucose\nExplanation: Hypoglycemia, or reduced blood glucose levels, is common in falciparum malaria due to the parasite’s metabolic demands.
69
Why is the clinical diagnosis of malaria considered unreliable?\na) It requires advanced equipment\nb) Malaria symptoms are non-specific\nc) It is too expensive\nd) It only detects severe cases
Answer: b) Malaria symptoms are non-specific\nExplanation: The clinical diagnosis of malaria is unreliable due to the overlap of symptoms with other febrile illnesses.
70
What is the 'gold standard' for malaria diagnosis?\na) Rapid diagnostic test\nb) Microscopy\nc) PCR test\nd) Serology
Answer: b) Microscopy\nExplanation: Microscopy remains the gold standard for malaria diagnosis, allowing for the identification and quantification of malaria parasites.
71
Which diagnostic test detects Histidine-rich protein II (HRP-II)?\na) Microscopy\nb) PCR\nc) RDT for P. falciparum\nd) Blood smear
Answer: c) RDT for P. falciparum\nExplanation: Rapid diagnostic tests for P. falciparum detect HRP-II, a protein produced by the trophozoites of the parasite.
72
Which antigen is detected by rapid diagnostic tests (RDTs) for all species of Plasmodium?\na) Aldolase\nb) HRP-II\nc) pLDH\nd) Gametocyte antigen
Answer: a) Aldolase\nExplanation: Aldolase is targeted by RDTs that detect a 'pan-malarial' antigen common to all Plasmodium species.
73
What is a key disadvantage of microscopy for malaria diagnosis?\na) It is too specific\nb) It requires trained personnel\nc) It takes only 15 minutes\nd) It cannot identify species
Answer: b) It requires trained personnel\nExplanation: Microscopy is labor-intensive, time-consuming, and depends on well-trained technicians and good equipment.
74
What advantage do RDTs have over microscopy in malaria diagnosis?\na) Faster results\nb) Higher specificity\nc) Requires less blood\nd) Can detect parasites at any stage
Answer: a) Faster results\nExplanation: RDTs are faster, providing results in about 15 minutes, whereas microscopy can take at least an hour.
75
Which malaria-causing parasite is most likely to result in severe complications?\na) P. vivax\nb) P. falciparum\nc) P. malariae\nd) P. ovale
Answer: b) P. falciparum\nExplanation: P. falciparum is responsible for the majority of severe and fatal malaria cases, especially due to complications like cerebral malaria.
76
Which type of malaria is more likely to present with gastrointestinal symptoms and headache?\na) P. vivax\nb) P. malariae\nc) P. falciparum\nd) P. ovale
Answer: c) P. falciparum\nExplanation: P. falciparum malaria often presents with gastrointestinal symptoms like nausea and vomiting, as well as headaches, which can become severe.
77
In the human host, which cells are initially infected by Plasmodium sporozoites?\na) Red blood cells\nb) White blood cells\nc) Liver cells\nd) Spleen cells
Answer: c) Liver cells\nExplanation: After being injected by the mosquito, sporozoites travel to and infect liver cells, where they mature into merozoites.
78
What stage of Plasmodium is released from ruptured red blood cells to infect other red cells?\na) Gametocytes\nb) Ookinetes\nc) Sporozoites\nd) Merozoites
Answer: d) Merozoites\nExplanation: Merozoites are released when infected red blood cells rupture and then invade new red blood cells to continue the infection cycle.
79
Which type of malaria is associated with nephrotic syndrome in chronic cases?\na) P. vivax\nb) P. falciparum\nc) P. malariae\nd) P. ovale
Answer: c) P. malariae\nExplanation: Chronic infection with P. malariae is commonly linked to nephrotic syndrome, characterized by heavy proteinuria (nephrosis).
80
What is the estimated duration of a typical paroxysm in tertian malaria (P. vivax)?\na) 6 hours\nb) 8 hours\nc) 10 hours\nd) 12 hours
Answer: c) 10 hours\nExplanation: In P. vivax malaria, the paroxysm (cycle of fever, chills, and sweating) typically lasts around 10 hours.
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"What type of malaria is characterized by continuous or remittent fever, as opposed to intermittent fever?\na) P. vivax\nb) P. malariae\nc) P. falciparum\nd) P. o
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Question and Options
Answer and Explanation
83
In quartan malaria (P. malariae), how frequently do the attacks occur? a) Every 24 hours b) Every 48 hours c) Every 72 hours d) Every 96 hours
Answer: c) Every 72 hours; Explanation: In quartan malaria, caused by P. malariae, the attacks occur every 72 hours if only a single brood of parasites is present.
84
What is a common complication of any type of malaria? a) Anaemia b) Pulmonary oedema c) Hypoglycemia d) Blackwater fever
Answer: a) Anaemia; Explanation: Anaemia is a frequent complication of all types of malaria due to the destruction of red blood cells by the parasite.
85
Which type of malaria is associated with splenic rupture? a) P. falciparum b) P. malariae c) P. vivax d) P. ovale
The correct answer is a) P. falciparum.
Why:
Plasmodium falciparum is the most dangerous species of the malaria parasite, and it is strongly associated with severe complications, including splenic rupture. This occurs because:
P. falciparum causes high levels of parasitemia (high numbers of parasites in the blood), which can lead to the enlargement and rupture of the spleen. The spleen becomes congested due to the accumulation of infected red blood cells, making it more prone to rupture, especially in severe cases of malaria.
The rupture of the spleen is a potentially life-threatening condition that requires immediate medical attention.
While P. vivax, P. ovale, and P. malariae can also cause splenomegaly (enlarged spleen), splenic rupture is more commonly associated with P. falciparum due to its more severe and acute impact on the body.
86
Nephrosis, characterized by large amounts of albumin in the urine, is commonly associated with which type of malaria? a) P. falciparum b) P. malariae c) P. vivax d) P. ovale
Answer: b) P. malariae; Explanation: Chronic P. malariae infection is often linked to nephrosis, leading to proteinuria (albumin in the urine).
87
What symptom is more pronounced in P. falciparum malaria compared to other types of malaria? a) Prostration b) Fever paroxysms c) Sweating d) Joint pain
Answer: a) Prostration; Explanation: Prostration and a greater tendency to delirium are more pronounced in P. falciparum malaria.
88
What is the most common serious complication of P. falciparum malaria? a) Cerebral malaria b) Pulmonary oedema c) Renal failure d) Algid malaria
Answer: a) Cerebral malaria; Explanation: Cerebral malaria is a severe complication of P. falciparum infection, marked by coma, hyperpyrexia, and convulsions.
89
Which of the following is a fatal complication of severe falciparum malaria often associated with over-administration of intravenous fluids? a) Hypoglycemia b) Pulmonary oedema c) Blackwater fever d) Anaemia
Answer: b) Pulmonary oedema; Explanation: Pulmonary oedema, often caused by excessive IV fluids, is a grave complication of severe P. falciparum malaria.
90
What phase of the Plasmodium life cycle occurs in the mosquito? a) Erythrocytic cycle b) Pre-erythrocytic cycle c) Sporozoite phase d) Extrinsic cycle
Answer: d) Extrinsic cycle; Explanation: The extrinsic cycle takes place in the mosquito, where gametocytes develop into gametes, fertilize, and eventually form sporozoites.
91
What stage of the Plasmodium life cycle infects liver cells in humans? a) Gametocytes b) Sporozoites c) Merozoites d) Ookinete
Answer: b) Sporozoites; Explanation: Sporozoites are injected into humans by mosquitoes and travel to the liver to infect hepatocytes.
92
What condition is characterized by the lysis of red blood cells and the presence of free haemoglobin in the blood and urine? a) Cerebral malaria b) Pulmonary oedema c) Blackwater fever d) Algid malaria
Answer: c) Blackwater fever; Explanation: Blackwater fever is associated with P. falciparum malaria and results in massive erythrocyte destruction and dark-colored urine due to haemoglobinuria.
93
Which of the following symptoms is common in algid malaria? a) High blood pressure b) Cold, clammy skin c) Intense sweating d) Elevated glucose levels
Answer: b) Cold, clammy skin; Explanation: Algid malaria is marked by circulatory collapse, cold skin, and low blood pressure due to shock.
94
What is the main cause of death in blackwater fever? a) Renal failure b) Cerebral hemorrhage c) Heart failure d) Pulmonary oedema
Answer: a) Renal failure; Explanation: Renal failure due to impaired glomerular filtration and tubular resorption is often the cause of death in blackwater fever.
95
Hypoglycemia in falciparum malaria is caused by which of the following? a) Increased insulin production b) Reduced concentration of blood glucose c) Decreased liver function d) Hypermetabolism of the parasite
Answer: b) Reduced concentration of blood glucose; Explanation: Hypoglycemia, or reduced blood glucose levels, is common in falciparum malaria due to the parasite’s metabolic demands.
96
Why is the clinical diagnosis of malaria considered unreliable? a) It requires advanced equipment b) Malaria symptoms are non-specific c) It is too expensive d) It only detects severe cases
Answer: b) Malaria symptoms are non-specific; Explanation: The clinical diagnosis of malaria is unreliable due to the overlap of symptoms with other febrile illnesses.
97
What is the "gold standard" for malaria diagnosis? a) Rapid diagnostic test b) Microscopy c) PCR test d) Serology
Answer: b) Microscopy; Explanation: Microscopy remains the gold standard for malaria diagnosis, allowing for the identification and quantification of malaria parasites.
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Which diagnostic test detects Histidine-rich protein II (HRP-II)? a) Microscopy b) PCR c) RDT for P. falciparum d) Blood smear
Answer: c) RDT for P. falciparum; Explanation: Rapid diagnostic tests for P. falciparum detect HRP-II, a protein produced by the trophozoites of the parasite.
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Which antigen is detected by rapid diagnostic tests (RDTs) for all species of Plasmodium? a) Aldolase b) HRP-II c) pLDH d) Gametocyte antigen
Answer: a) Aldolase; Explanation: Aldolase is targeted by RDTs that detect a "pan-malarial" antigen common to all Plasmodium species.
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What is a key disadvantage of microscopy for malaria diagnosis? a) It is too specific b) It requires trained personnel c) It takes only 15 minutes d) It cannot identify species
Answer: b) It requires trained personnel; Explanation: Microscopy is labor-intensive, time-consuming, and depends on well-trained technicians and good equipment.
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What advantage do RDTs have over microscopy in malaria diagnosis? a) Faster results b) Higher specificity c) Requires less blood d) Can detect parasites at any stage
Answer: a) Faster results; Explanation: RDTs are faster, providing results in about 15 minutes, whereas microscopy can take at least an hour.
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Which malaria-causing parasite is most likely to result in severe complications? a) P. vivax b) P. falciparum c) P. malariae d) P. ovale
Answer: b) P. falciparum; Explanation: P. falciparum is responsible for the majority of severe and fatal malaria cases, especially due to complications like cerebral malaria.
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Which type of malaria is more likely to present with gastrointestinal symptoms and headache? a) P. vivax b) P. malariae c) P. falciparum d) P. ovale
Answer: c) P. falciparum; Explanation: P. falciparum malaria often presents with gastrointestinal symptoms like nausea and vomiting, as well as headaches, which can become severe.
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In the human host, which cells are initially infected by Plasmodium sporozoites? a) Red blood cells b) White blood cells c) Liver cells d) Spleen cells
Answer: c) Liver cells; Explanation: After being injected by the mosquito, sporozoites travel to and infect liver cells, where they mature into merozoites.
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What stage of Plasmodium is released from ruptured red blood cells to infect other red cells? a) Gametocytes b) Ookinetes c) Sporozoites d) Merozoites
Answer: d) Merozoites; Explanation: Merozoites are released when infected red blood cells rupture and then invade new red blood cells to continue the infection cycle.
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Which type of malaria is associated with nephrotic syndrome in chronic cases? a) P. vivax b) P. falciparum c) P. malariae d) P. ovale
Answer: c) P. malariae; Explanation: Chronic infection with P. malariae is commonly linked to nephrotic syndrome, characterized by heavy proteinuria (nephrosis).
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What is the estimated duration of a typical paroxysm in tertian malaria (P. vivax)? a) 6 hours b) 8 hours c) 10 hours d) 12 hours
Answer: c) 10 hours; Explanation: In P. vivax malaria, the paroxysm (cycle of fever, chills, and sweating) typically lasts around 10 hours.
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What type of malaria is characterized by continuous or remittent fever, as opposed to intermittent fever? a) P. vivax b) P. malariae c) P. falciparum d) P. ovale
Answer: c) P. falciparum; Explanation: P. falciparum malaria is often associated with continuous or remittent fever rather than the classic intermittent fever seen in other forms.
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What diagnostic method is considered the most reliable for determining parasitemia levels in malaria? a) PCR b) Serology c) RDT d) Microscopy
"Answer: d)
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Question and Options
Answer and Explanation
111
Which of the following is NOT an individual control measure for malaria prevention? a) Chemoprophylaxis b) Use of insect repellents c) Use of larvicides d) Use of insecticide-impregnated nets and clothing
Answer: c Explanation: Individual control measures include chemoprophylaxis, insect repellents, and insecticide-impregnated nets/clothing. Larvicides are used for vector control, which is a communal measure.
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Why is malaria more severe in pregnant women compared to non-pregnant women? a) Increased susceptibility to mosquito bites b) Higher risk of transmission through placental blood c) Higher malaria-associated mortality d) Lack of immunity due to pregnancy
Answer: c Explanation: Malaria is more severe in pregnant women due to higher mortality rates, and it can cause complications such as abortion, stillbirth, and premature delivery.
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What is the significance of residual indoor spraying in malaria control? a) It prevents mosquitoes from laying eggs b) It selectively kills vectors that rest indoors c) It eliminates all mosquitoes within the community d) It creates a barrier against mosquito bites
Answer: b Explanation: Residual indoor spraying kills vectors that rest indoors, reducing transmission. However, its effectiveness can be limited by factors such as exophily and insufficient coverage.
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Which of the following correctly defines 'Anthropophily'? a) Preference for biting indoors b) Preference for resting outdoors c) Preference for human blood d) Preference for animal blood
Answer: c Explanation: Anthropophily refers to a mosquito’s preference for human blood, which is critical in understanding vector control strategies.
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In Toxoplasma gondii, which stage is responsible for initiating the enteroepithelial cycle in cats? a) Tachyzoites b) Bradyzoites c) Sporozoites d) Merozoites
Answer: c Explanation: Sporozoites enter the epithelial cells in the small intestine of cats and initiate the enteroepithelial cycle.
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Which of the following is TRUE about the asexual reproduction of Toxoplasma gondii? a) It occurs only in cats b) It occurs through a process known as schizogony c) It is known as endodyogeny d) It only happens in the blood
Answer: c Explanation: Asexual reproduction in Toxoplasma gondii occurs via endodyogeny, where two daughter cells form inside a mother cell.
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How can humans acquire Toxoplasma gondii infection? a) Inhalation of spores b) Direct ingestion of oocysts from cat feces c) Bite of infected mosquitoes d) Transfusion of infected blood
Answer: b Explanation: Humans can acquire toxoplasmosis by ingesting oocysts from cat feces or bradyzoites from undercooked meat.
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What is the primary target organ in cases of congenital toxoplasmosis? a) Liver b) Brain c) Lungs d) Kidneys
Answer: b Explanation: In congenital toxoplasmosis, the brain is often the primary target, leading to potential malformations such as hydrocephaly and mental retardation.
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Which antimalarial drug is NOT commonly used for prophylaxis? a) Chloroquine b) Proguanil c) Artemether-lumefantrine d) Doxycycline
Answer: c Explanation: Artemether-lumefantrine is typically used for treatment, not prophylaxis. Drugs like chloroquine, proguanil, and doxycycline are used for malaria prophylaxis.
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Which of the following is a symptom of chronic toxoplasmosis? a) Painful, swollen lymph nodes b) Rupture of cysts in the brain c) Acute encephalitis d) Fever and muscle pain
Answer: b Explanation: Chronic toxoplasmosis involves the formation of tissue cysts, and if they rupture in the brain, it can cause chronic encephalitis.
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Question and Options
Answer and Explanation
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11. What is the role of endophily in vector control? a) It encourages vectors to bite indoors b) It allows vectors to rest indoors, making them vulnerable to insecticide c) It ensures vectors avoid indoor spraying d) It allows vectors to breed in water bodies indoors
Answer: b Explanation: Endophily refers to vectors resting indoors, where they can be targeted by indoor residual spraying.
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12. What is the term used for vectors that prefer animal blood? a) Anthropophily b) Zoophily c) Endophily d) Exophily
Answer: b Explanation: Zoophily refers to vectors that prefer animal blood, which affects vector control strategies.
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13. Which stage of Toxoplasma gondii is responsible for rapid multiplication during the acute phase? a) Tachyzoites b) Bradyzoites c) Sporozoites d) Oocysts
Answer: a Explanation: Tachyzoites multiply rapidly during the acute phase of toxoplasmosis, spreading through the host’s body.
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14. In what condition does toxoplasmosis become subacute? a) When immunity develops too rapidly b) When tachyzoites are cleared quickly c) When immunity develops slowly d) When bradyzoites form early in infection
Answer: c Explanation: Subacute toxoplasmosis occurs when immunity develops slowly, allowing tachyzoites to continue destroying cells.
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15. Which symptom is commonly associated with acute toxoplasmosis in humans? a) Blindness b) Paralysis c) Swollen lymph nodes d) Myocarditis
Answer: c Explanation: Swollen lymph nodes, often in the cervical region, are a common symptom of acute toxoplasmosis.
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16. What is the primary consequence of repeated retinal infection in chronic toxoplasmosis? a) Myocarditis b) Blindness c) Pneumonia d) Paralysis
Answer: b Explanation: Repeated retinal infections in chronic toxoplasmosis can lead to blindness due to damage and rupture of cysts.
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17. Which factor does NOT contribute to the severity of toxoplasmosis? a) Age of the host b) Virulence of Toxoplasma strain c) Vector control strategies d) Natural susceptibility of the host
Answer: c Explanation: Vector control strategies are not relevant to the severity of toxoplasmosis, which is influenced by host factors and the parasite’s virulence.
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18. What is the recommended control measure for malaria in urban areas with few breeding sites? a) Residual indoor spraying b) Larval control c) Use of chemoprophylaxis d) Zoophilic vector control
Answer: b Explanation: Larval control is recommended in densely populated areas with limited breeding sites, such as urban environments.
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19. Which of the following is true about congenital toxoplasmosis? a) It is always symptomatic b) It can result in severe malformations c) It is not transmitted transplacentally d) It primarily affects the lungs
Answer: b Explanation: Congenital toxoplasmosis can result in severe malformations, such as hydrocephaly and microcephaly, although it is often asymptomatic.
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20. What is the most common mode of human infection with Toxoplasma gondii? a) Contact with infected mosquitoes b) Ingestion of undercooked meat c) Direct inhalation of bradyzoites d) Skin penetration of sporozoites
Answer: b Explanation: Humans most commonly acquire toxoplasmosis by ingesting undercooked meat containing bradyzoites.
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21. Which antimalarial drug is commonly used in areas where chloroquine resistance is present? a) Chloroquine b) Proguanil c) Doxycycline d) Quinine
Answer: c Explanation: Doxycycline is commonly used in areas with chloroquine-resistant strains of malaria, offering an alternative for prophylaxis and treatment.
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22. Which control measure directly targets mosquito larvae? a) Indoor residual spraying b) Use of insect repellents c) Larvicides d) Bed nets
Answer: c Explanation: Larvicides target mosquito larvae in breeding sites, helping reduce the population before they mature into adults.
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23. How do rapid diagnostic tests (RDTs) for malaria work? a) They detect antibodies produced by the host b) They detect circulating antigens of the parasite c) They measure the number of infected red blood cells d) They detect the parasite’s DNA directly
Answer: b Explanation: RDTs detect circulating antigens of the parasite, making them effective even when parasites are sequestered in deeper tissues and undetectable by microscopy.
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24. Which of the following vectors is responsible for malaria transmission? a) Anopheles mosquitoes b) Aedes mosquitoes c) Culex mosquitoes d) Sandflies
Answer: a Explanation: Anopheles mosquitoes are the vectors responsible for transmitting the malaria parasite (Plasmodium spp.).
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25. Which of the following is a classical larvicide? a) DDT b) Paris green c) Pyrethroids d) Permethrin
Answer: b Explanation: Paris green is a classical larvicide used to control mosquito larvae in breeding sites, such as stagnant water.
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26. What is the principal site of multiplication for Toxoplasma gondii in humans? a) Lymph nodes b) Intestinal epithelial cells c) Red blood cells d) Liver and lungs
Answer: d Explanation: The liver and lungs are the primary sites of multiplication for Toxoplasma gondii during the acute phase of infection.
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27. Which of the following best describes endophagy? a) The tendency of mosquitoes to bite indoors b) The tendency of mosquitoes to rest outdoors c) The tendency of mosquitoes to bite animals d) The tendency of mosquitoes to rest indoors
Answer: a Explanation: Endophagy refers to mosquitoes’ tendency to bite indoors, which is a critical factor in determining the effectiveness of indoor vector control methods.
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28. Which of the following is associated with subacute toxoplasmosis? a) Rapid tachyzoite proliferation b) Development of extensive lesions in vital organs c) Formation of cysts in the retina d) Asymptomatic infection
Answer: b Explanation: In subacute toxoplasmosis, tachyzoites continue to destroy cells, leading to the development of extensive lesions in organs like the lungs, heart, and brain.
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29. Which type of mosquito is most likely to rest outdoors after feeding? a) Endophilic mosquitoes b) Exophilic mosquitoes c) Zoophilic mosquitoes d) Anthropophilic mosquitoes
Answer: b Explanation: Exophilic mosquitoes prefer to rest outdoors after feeding, which can make them harder to target with indoor residual spraying.
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30. What is the primary source of infection for humans in cases of toxoplasmosis? a) Infected water sources b) Direct contact with cat urine c) Consumption of undercooked meat or exposure to cat feces d) Airborne transmission from infected individuals
Answer: c Explanation: Humans primarily acquire toxoplasmosis by consuming undercooked meat containing tissue cysts or by ingesting oocysts from contaminated cat feces.
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31. What occurs during the enteroepithelial cycle of Toxoplasma gondii in cats? a) Formation of bradyzoites b) Sexual reproduction c) Development of tachyzoites d) Asexual reproduction by endodyogeny
Answer: b Explanation: The enteroepithelial cycle in cats involves sexual reproduction, with the formation of gametocytes and the release of oocysts in the cat’s feces.
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32. Which of the following best describes 'Exophily'? a) The tendency of mosquitoes to feed indoors b) The tendency of mosquitoes to rest outdoors c) The preference of mosquitoes for animal blood d) The preference of mosquitoes for human blood
Answer: b Explanation: Exophily refers to the tendency of mosquitoes to rest outdoors after feeding, making them less susceptible to indoor residual spraying.
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33. How do bradyzoites contribute to chronic toxoplasmosis? a) They are rapidly dividing forms in acute infections b) They form cysts in muscles and the brain c) They stimulate immediate immune responses d) They cause severe symptoms of acute disease
Answer: b Explanation: Bradyzoites are the slow-dividing form of Toxoplasma gondii, and they accumulate in tissue cysts in muscles and the brain during chronic infection.
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34. What is the primary method of diagnosing toxoplasmosis in immunocompromised patients? a) Detection of antibodies b) Detection of circulating antigens c) Detection of tachyzoites in the blood d) Detection of bradyzoites in muscle biopsies
Answer: a Explanation: In immunocompromised patients, toxoplasmosis is commonly diagnosed through the detection of antibodies against Toxoplasma gondii, indicating prior exposure or active infection.
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35. Which of the following drugs is NOT effective against Toxoplasma gondii? a) Sulfadoxine-pyrimethamine b) Doxycycline c) Atovaquone d) Spiramycin
Answer: b Explanation: Doxycycline is primarily used for malaria prophylaxis, while drugs like sulfadoxine-pyrimethamine, atovaquone, and spiramycin are used for treating toxoplasmosis.
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36. What is the primary pathological site in acute toxoplasmosis in cats? a) Central nervous system b) Lungs c) Intestinal epithelium d) Liver
Answer: c Explanation: In cats, acute toxoplasmosis primarily affects the intestinal epithelium, where the parasite undergoes its enteroepithelial cycle.
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"37. What are the characteristics of congenital toxoplasmosis? a) It is always symptomatic b) It frequently results in stillbirths and severe
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Question and Options
Answer and Explanation
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37. What are the characteristics of congenital toxoplasmosis? a) It is always symptomatic b) It frequently results in stillbirths and severe malformations c) It is easily treated with standard antimalarials d) It does not affect the newborn's vision
Answer: b Explanation: Congenital toxoplasmosis can lead to stillbirths and severe malformations, though many cases are asymptomatic at birth.
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38. Which of the following factors can exacerbate the severity of toxoplasmosis in immunocompromised individuals? a) Active immune response b) High levels of bradyzoites c) Co-infection with other pathogens d) Strong genetic resistance
Answer: c Explanation: Co-infection with other pathogens can exacerbate the severity of toxoplasmosis in immunocompromised individuals, leading to more severe clinical outcomes.
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39. What is a common treatment option for severe cases of toxoplasmosis in immunocompromised patients? a) Quinine b) Spiramycin c) Clindamycin d) Metronidazole
Answer: c Explanation: Clindamycin is commonly used in severe cases of toxoplasmosis, especially in immunocompromised patients, in combination with other treatments.
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40. Which insecticide is commonly used for indoor residual spraying (IRS) in malaria vector control? a) DDT b) Pyrethroids c) Organophosphates d) Carbamates
Answer: b Explanation: Pyrethroids are commonly used for indoor residual spraying in malaria vector control due to their effectiveness and relatively low toxicity.
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41. What is the role of bed nets in malaria prevention? a) They repel mosquitoes b) They provide a physical barrier to prevent bites c) They kill mosquitoes on contact d) They enhance indoor residual spraying
Answer: b Explanation: Bed nets provide a physical barrier to prevent mosquito bites, particularly when treated with insecticides, increasing their efficacy.
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42. Which of the following best describes the term 'zoophilic'? a) Preferentially feeding on human blood b) Preferentially resting indoors c) Preferentially feeding on animal blood d) Preferring to breed indoors
Answer: c Explanation: Zoophilic refers to vectors, such as some mosquito species, that preferentially feed on animal blood rather than human blood.
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43. What is a significant risk factor for the transmission of congenital toxoplasmosis? a) High consumption of fish b) Inadequate cooking of pork c) High exposure to outdoor cats d) Ingesting unpasteurized dairy products
Answer: c Explanation: High exposure to outdoor cats increases the risk of congenital toxoplasmosis due to potential ingestion of oocysts shed in cat feces.
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44. How does Toxoplasma gondii evade the host's immune response? a) By rapidly multiplying in the blood b) By forming cysts in tissues c) By causing immediate symptoms d) By stimulating high levels of antibodies
Answer: b Explanation: Toxoplasma gondii evades the host’s immune response by forming cysts in tissues, where it can remain dormant and undetected.
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45. Which type of malaria is characterized by severe anemia? a) Plasmodium falciparum b) Plasmodium vivax c) Plasmodium malariae d) Plasmodium ovale
Answer: a Explanation: Plasmodium falciparum is associated with severe anemia due to the high rate of red blood cell destruction and sequestration.
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46. Which of the following is a method of vector control that uses biological agents? a) Indoor residual spraying b) Larviciding c) Use of insect growth regulators d) Release of genetically modified mosquitoes
Answer: d Explanation: The release of genetically modified mosquitoes is a biological vector control method aimed at reducing the population of disease-carrying mosquitoes.
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47. What is the primary vector for chikungunya? a) Anopheles mosquitoes b) Culex mosquitoes c) Aedes mosquitoes d) Tabanidae flies
Answer: c Explanation: Aedes mosquitoes, particularly Aedes aegypti and Aedes albopictus, are the primary vectors for chikungunya virus transmission.
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48. Which symptoms are typically associated with acute chikungunya infection? a) Fever and rash b) Nausea and vomiting c) Diarrhea and abdominal pain d) Severe respiratory distress
Answer: a Explanation: Acute chikungunya infection typically presents with fever and rash, along with severe joint pain.
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49. What is the main goal of malaria elimination programs? a) To reduce the incidence of malaria b) To eradicate all malaria cases globally c) To control vector populations d) To eliminate Plasmodium from human hosts
Answer: a Explanation: The main goal of malaria elimination programs is to reduce the incidence of malaria to zero in a specific region.
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50. Which of the following factors contributes to the re-emergence of malaria in previously controlled areas? a) Increased use of bed nets b) Drug resistance c) Enhanced surveillance systems d) Improved sanitation
Answer: b Explanation: Drug resistance in malaria parasites can contribute to the re-emergence of malaria in areas where it was previously controlled.
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51. What is the primary function of insect repellents in malaria prevention? a) Killing adult mosquitoes b) Deterring mosquitoes from biting c) Preventing larvae from developing d) Enhancing indoor spraying effectiveness
Answer: b Explanation: Insect repellents work by deterring mosquitoes from biting, thus reducing the risk of malaria transmission.
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52. Which disease is primarily transmitted through the Aedes aegypti mosquito? a) Malaria b) Yellow fever c) Schistosomiasis d) Leptospirosis
Answer: b Explanation: Yellow fever is primarily transmitted through the bite of infected Aedes aegypti mosquitoes.
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53. How does the immune response to Toxoplasma gondii differ in immunocompetent versus immunocompromised individuals? a) Immunocompetent individuals show stronger responses b) There is no difference in response c) Immunocompromised individuals show stronger responses d) Both groups respond similarly
Answer: a Explanation: Immunocompetent individuals typically mount a stronger immune response to Toxoplasma gondii than immunocompromised individuals, who may experience severe disease.
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54. Which antimalarial drug is used as a first-line treatment for uncomplicated malaria? a) Quinine b) Chloroquine c) Doxycycline d) Artemisinin
Answer: b Explanation: Chloroquine is commonly used as a first-line treatment for uncomplicated malaria caused by Plasmodium vivax and Plasmodium ovale.
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55. Which of the following is a primary symptom of severe malaria? a) Fatigue b) Anemia c) Neurological impairment d) All of the above
Answer: d Explanation: All of the above symptoms can occur in severe malaria, highlighting the serious nature of the disease.
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56. Which type of immunity is primarily involved in combating Toxoplasma gondii infections? a) Humoral immunity b) Innate immunity c) Cell-mediated immunity d) Passive immunity
Answer: c Explanation: Cell-mediated immunity plays a crucial role in combating Toxoplasma gondii infections by activating T cells to control tachyzoite proliferation.
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57. What is the mode of action for artemisinin-based combination therapies (ACTs)? a) They inhibit DNA synthesis b) They disrupt protein synthesis c) They kill parasites by generating reactive oxygen species d) They block glycolysis in parasites
Answer: c Explanation: Artemisinin-based combination therapies (ACTs) kill parasites by generating reactive oxygen species, leading to parasite death.
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58. Which intervention is most effective in reducing malaria transmission in high-risk areas? a) Only using insecticide-treated nets b) Community-wide insecticide spraying c) Providing treatment for malaria d) Integrating multiple strategies, including education and vector control
Answer: d Explanation: Integrating multiple strategies, including education, vector control, and treatment, is most effective in reducing malaria transmission in high-risk areas.
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59. What is the significance of diagnosing malaria promptly? a) It allows for immediate treatment b) It prevents outbreaks c) It helps monitor drug resistance d) All of the above
Answer: d Explanation: Prompt diagnosis of malaria is significant as it allows for immediate treatment, helps prevent outbreaks, and aids in monitoring drug resistance.
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60. Which of the following strategies can be implemented for effective vector control in urban areas? a) Use of larvicides b) Environmental management c) Community engagement d) All of the above
Answer: d Explanation: Effective vector control in urban areas can be achieved through a combination of strategies, including larvicides, environmental management, and community engagement.
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Question
Answer and Explanation
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1. Which of the following is the most suitable medium for culturing Toxoplasma gondii?\na) Guinea pigs\nb) Mice\nc) Hamsters\nd) Rabbits
Answer: b\nExplanation: Mice are the most suitable medium for culturing Toxoplasma gondii as they do not suffer from toxoplasmosis and provide a conducive environment for the parasite.
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2. The most widely used serological test for detecting antibodies to Toxoplasma gondii is:\na) Direct agglutination test\nb) Fluorescent antibody test\nc) Sabin-Feldman dye test\nd) Complement fixation test
Answer: c\nExplanation: The Sabin-Feldman dye test is a highly sensitive and widely used serological test for detecting antibodies to Toxoplasma gondii.
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3. Which of the following is NOT commonly used for diagnosing toxoplasmosis?\na) PCR for T. gondii DNA\nb) Urine analysis\nc) Serological tests\nd) Microscopic examination of tissue samples
Answer: b\nExplanation: Urine analysis is not used for diagnosing toxoplasmosis, while serology, PCR, and tissue examination are standard diagnostic methods.
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4. The most effective combination of drugs for treating toxoplasmosis in humans is:\na) Penicillin and sulfonamides\nb) Pyrimethamine and sulfonamides\nc) Metronidazole and pyrimethamine\nd) Quinine and metronidazole
Answer: b\nExplanation: The combination of pyrimethamine and sulfonamides is considered the most effective treatment for toxoplasmosis in humans and animals.
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5. Which of the following vectors is responsible for transmitting Leishmania parasites?\na) Aedes mosquitoes\nb) Phlebotomine sandflies\nc) Culex mosquitoes\nd) Tsetse flies
Answer: b\nExplanation: Phlebotomine sandflies are the only known vectors responsible for transmitting Leishmania parasites.
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6. Cutaneous leishmaniasis typically presents as:\na) Enlarged spleen and liver\nb) Ulcers or nodules on the skin\nc) Destruction of nasal mucosa\nd) Fever and anemia
Answer: b\nExplanation: Cutaneous leishmaniasis generally presents with ulcers or nodules on the skin due to the infection of dermal macrophages by Leishmania parasites.
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7. In which form of leishmaniasis do destructive ulcerations of the mucosa occur?\na) Cutaneous leishmaniasis\nb) Visceral leishmaniasis\nc) Muco-cutaneous leishmaniasis\nd) Post-kala-azar dermal leishmaniasis
Answer: c\nExplanation: Muco-cutaneous leishmaniasis is characterized by progressively destructive ulcerations of the mucosa, particularly affecting the nose and mouth.
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8. Which of the following is NOT a clinical form of leishmaniasis?\na) Cutaneous leishmaniasis\nb) Muco-cutaneous leishmaniasis\nc) Visceral leishmaniasis\nd) Dermal leishmaniasis
Answer: d\nExplanation: Dermal leishmaniasis is not a recognized clinical form. The main forms are cutaneous, muco-cutaneous, visceral, and post-kala-azar dermal leishmaniasis.
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9. Visceral leishmaniasis is also known as:\na) Kala-azar\nb) Espundia\nc) Dermal leishmaniasis\nd) Splenomegaly fever
Answer: a\nExplanation: Visceral leishmaniasis is also known as kala-azar, and it is characterized by long-duration fever, splenomegaly, and anemia.
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10. Post-kala-azar dermal leishmaniasis is frequently observed after treatment in:\na) Brazil\nb) Sudan\nc) India\nd) Spain
Answer: b\nExplanation: Post-kala-azar dermal leishmaniasis is a complication often observed after treatment for visceral leishmaniasis, especially in Sudan.
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11. Leishmania donovani primarily affects which system in the human body?\na) Cardiovascular system\nb) Respiratory system\nc) Reticuloendothelial system\nd) Digestive system
Answer: c\nExplanation: Leishmania donovani primarily affects the reticuloendothelial system, particularly the spleen, liver, and bone marrow.
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12. What is a key difference between zoonotic and anthroponotic visceral leishmaniasis?\na) Zoonotic involves only humans as reservoirs\nb) Anthroponotic involves animals as reservoirs\nc) Zoonotic is transmitted from animals to humans\nd) Anthroponotic occurs in non-feline animals
Answer: c\nExplanation: Zoonotic visceral leishmaniasis is transmitted from animals (mainly dogs) to humans, while anthroponotic visceral leishmaniasis is transmitted between humans via sandflies.
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13. Which of the following is a common vector of visceral leishmaniasis in East Africa?\na) Phlebotomus argentipes\nb) Phlebotomus martini\nc) Phlebotomus chinensis\nd) Lutzomyia longipalpis
Answer: b\nExplanation: Phlebotomus martini is a common vector of visceral leishmaniasis in East Africa.
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14. The life cycle of Leishmania donovani involves which two main forms?\na) Tachyzoites and bradyzoites\nb) Promastigotes and amastigotes\nc) Sporozoites and merozoites\nd) Oocysts and trophozoites
Answer: b\nExplanation: Leishmania donovani has two main forms: the promastigote form, found in the sandfly, and the amastigote form, which is intracellular in the human host.
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15. Which organ is most commonly enlarged in visceral leishmaniasis?\na) Lungs\nb) Kidneys\nc) Spleen\nd) Heart
Answer: c\nExplanation: Visceral leishmaniasis commonly results in the enlargement of the spleen (splenomegaly) due to the infection of macrophages within the reticuloendothelial system.
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16. Which of the following species causes zoonotic visceral leishmaniasis in the Mediterranean region?\na) Leishmania donovani\nb) Leishmania infantum\nc) Leishmania braziliensis\nd) Leishmania tropica
Answer: b\nExplanation: Leishmania infantum is responsible for zoonotic visceral leishmaniasis in the Mediterranean region, where dogs act as the primary reservoir.
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17. The transmission of Leishmania parasites to humans occurs through:\na) Contaminated water\nb) Infected blood transfusions\nc) Sandfly bites\nd) Direct contact with infected animals
Answer: c\nExplanation: Leishmania parasites are transmitted to humans through the bites of infected phlebotomine sandflies.
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18. Which species of sandfly is the main vector of kala-azar in India?\na) Phlebotomus pernicious\nb) Phlebotomus papatasi\nc) Phlebotomus argentipes\nd) Phlebotomus chinensis
Answer: c\nExplanation: Phlebotomus argentipes is the main vector responsible for transmitting visceral leishmaniasis (kala-azar) in India.
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19. Which diagnostic method is considered the gold standard for diagnosing visceral leishmaniasis?\na) PCR for Leishmania DNA\nb) Serology\nc) Blood smear examination\nd) Bone marrow biopsy
Answer: d\nExplanation: Bone marrow biopsy is considered the gold standard for diagnosing visceral leishmaniasis because it allows direct visualization of amastigotes in the reticuloendothelial system.
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20. Which condition is a common complication of visceral leishmaniasis?\na) Leukopenia\nb) Hyperthyroidism\nc) Meningitis\nd) Hepatitis
Answer: a\nExplanation: Leukopenia, or a reduction in white blood cell count, is a common complication of visceral leishmaniasis.
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21. Leishmania braziliensis is primarily associated with which form of leishmaniasis?\na) Visceral leishmaniasis\nb) Muco-cutaneous leishmaniasis\nc) Post-kala-azar dermal leishmaniasis\nd) Cutaneous leishmaniasis
Answer: b\nExplanation: Leishmania braziliensis is the primary species responsible for causing muco-cutaneous leishmaniasis, which involves destructive ulcerations of the mucosa.
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22. Post-kala-azar dermal leishmaniasis commonly presents with:\na) Enlarged liver and spleen\nb) Macular, maculo-papular, or nodular rash\nc) Fever and weight loss\nd) Severe anemia and jaundice
Answer: b\nExplanation: Post-kala-azar dermal leishmaniasis is characterized by a rash, which can be macular, maculo-papular, or nodular in nature. It often occurs as a complication after treatment for visceral leishmaniasis.
197
23. Which of the following is NOT a typical symptom of visceral leishmaniasis (kala-azar)?\na) Splenomegaly\nb) Fever\nc) Lymphadenopathy\nd) Lung collapse
"Answer: d\nExplanation: Lung collapse is not a symptom of visceral leish
198
Question and Options
Answer and Explanation
199
58. The most common clinical feature of visceral leishmaniasis is: \na) Fever \nb) Weight gain \nc) Skin rash \nd) Cough
Answer: a \nExplanation: The most common clinical feature of visceral leishmaniasis is fever, often accompanied by weight loss, anemia, and splenomegaly.
200
59. Which type of immune response is primarily involved in combating leishmaniasis? \na) Humoral immunity \nb) Cell-mediated immunity \nc) Innate immunity \nd) Passive immunity
Answer: b \nExplanation: Cell-mediated immunity is crucial for controlling Leishmania infections, particularly through the action of T cells and macrophages.
201
60. The drug of choice for treating visceral leishmaniasis is: \na) Amphotericin B \nb) Metronidazole \nc) Acyclovir \nd) Doxycycline
Answer: a \nExplanation: Amphotericin B is considered the drug of choice for treating visceral leishmaniasis due to its efficacy against Leishmania parasites.
202
61. Which laboratory technique is used to visualize Leishmania amastigotes in tissue samples? \na) PCR \nb) Blood smear \nc) Culture \nd) Histopathology
Answer: d \nExplanation: Histopathology allows for the visualization of Leishmania amastigotes within tissue samples, confirming the diagnosis.
203
62. Leishmania parasites primarily enter the human host through: \na) Ingestion \nb) Skin abrasions \nc) Inhalation \nd) Sandfly bites
Answer: d \nExplanation: Leishmania parasites enter the human host primarily through bites from infected phlebotomine sandflies.
204
63. Which demographic is most at risk for visceral leishmaniasis? \na) Healthy adults \nb) Children and immunocompromised individuals \nc) Elderly individuals \nd) Pregnant women
Answer: b \nExplanation: Children and immunocompromised individuals are at higher risk for developing visceral leishmaniasis due to weaker immune responses.
205
64. The presence of Leishmania amastigotes is typically confirmed in which of the following tests? \na) Serology \nb) Blood culture \nc) Bone marrow aspirate \nd) Liver biopsy
Answer: c \nExplanation: The presence of Leishmania amastigotes is typically confirmed through a bone marrow aspirate, where the parasites can be visualized.
206
65. Which of the following factors increases susceptibility to visceral leishmaniasis? \na) Good nutrition \nb) HIV infection \nc) Regular exercise \nd) Vaccination
Answer: b \nExplanation: HIV infection significantly increases susceptibility to visceral leishmaniasis by compromising the immune system.
207
66. The clinical features of cutaneous leishmaniasis typically include: \na) Fever and weight loss \nb) Skin ulcers and lesions \nc) Joint pain \nd) Abdominal pain
Answer: b \nExplanation: Cutaneous leishmaniasis typically presents with skin ulcers and lesions at the site of infection.
208
67. Which form of leishmaniasis can cause fatal complications if untreated? \na) Cutaneous leishmaniasis \nb) Muco-cutaneous leishmaniasis \nc) Visceral leishmaniasis \nd) Post-kala-azar dermal leishmaniasis
Answer: c \nExplanation: Visceral leishmaniasis can cause fatal complications if left untreated due to its systemic effects.
209
68. The major reservoir host for cutaneous leishmaniasis is: \na) Cats \nb) Dogs \nc) Rodents \nd) Humans
Answer: c \nExplanation: Rodents are major reservoir hosts for cutaneous leishmaniasis, facilitating transmission through sandflies.
210
69. Which of the following is a characteristic of visceral leishmaniasis in children? \na) Severe anemia \nb) High fever \nc) Skin lesions \nd) Joint swelling
Answer: a \nExplanation: Severe anemia is a characteristic feature of visceral leishmaniasis in children due to bone marrow involvement.
211
70. In endemic regions, the most effective control measure against leishmaniasis is: \na) Vaccination \nb) Vector control \nc) Antibiotic treatment \nd) Education and awareness
Answer: b \nExplanation: Vector control is the most effective measure to reduce transmission of leishmaniasis in endemic regions.
212
Question and Options
Answer and Explanation
213
40. The characteristic fever in kala-azar is: \na) Low-grade and persistent \nb) High-grade with daily fluctuations \nc) Intermittent with evening spikes \nd) Continuous without fluctuation
Answer: c \nExplanation: The characteristic fever in kala-azar is intermittent with evening spikes, often accompanied by malaise and weight loss.
214
41. Which factor plays a crucial role in the increasing incidence of visceral leishmaniasis? \na) High vaccination rates \nb) Environmental degradation \nc) HIV co-infection \nd) Frequent sandfly eradication programs
Answer: c \nExplanation: HIV co-infection is a crucial factor contributing to the increasing incidence of visceral leishmaniasis.
215
42. Which organ is commonly affected in visceral leishmaniasis, leading to anemia and leukopenia? \na) Kidneys \nb) Lungs \nc) Bone marrow \nd) Heart
Answer: c \nExplanation: The bone marrow is infiltrated by Leishmania parasites, leading to suppression of red and white blood cell production, which causes anemia and leukopenia.
216
43. Which is NOT a vector for transmitting visceral leishmaniasis? \na) Phlebotomus argentipes \nb) Lutzomyia longipalpis \nc) Phlebotomus martini \nd) Anopheles mosquito
Answer: d \nExplanation: Anopheles mosquitoes are vectors for malaria, not leishmaniasis. Sandflies like Phlebotomus and Lutzomyia are responsible for transmitting leishmaniasis.
217
44. The pathogenesis of visceral leishmaniasis primarily involves: \na) Destruction of liver cells \nb) Invasion of red blood cells \nc) Parasite multiplication in macrophages \nd) Attack on the nervous system
Answer: c \nExplanation: The pathogenesis of visceral leishmaniasis involves Leishmania parasites multiplying inside macrophages, leading to widespread infection of the reticuloendothelial system.
218
45. Kala-azar (visceral leishmaniasis) is also known as: \na) Black sickness \nb) African sleeping sickness \nc) Espundia \nd) River blindness
Answer: a \nExplanation: Kala-azar is also called black sickness due to the darkening of the skin seen in advanced cases of the disease.
219
46. The definitive diagnosis of leishmaniasis involves: \na) Clinical symptoms only \nb) Identification of parasites in tissue samples \nc) Serology alone \nd) Ultrasound of the spleen
Answer: b \nExplanation: Definitive diagnosis of leishmaniasis is made by identifying Leishmania parasites in tissue samples such as bone marrow, spleen, or lymph nodes.
220
47. What is the most effective treatment combination for leishmaniasis? \na) Pyrimethamine and sulphonamides \nb) Chloroquine and doxycycline \nc) Amphotericin B and pentavalent antimonials \nd) Metronidazole and clindamycin
Answer: a \nExplanation: The combination of pyrimethamine and sulphonamides is effective for treating both human and animal leishmaniasis cases.
221
48. Which form of leishmaniasis is typically fatal if left untreated? \na) Cutaneous leishmaniasis \nb) Muco-cutaneous leishmaniasis \nc) Visceral leishmaniasis \nd) Post-kala-azar dermal leishmaniasis
Answer: c \nExplanation: Visceral leishmaniasis (kala-azar) is fatal if left untreated, due to its systemic effects on vital organs like the spleen, liver, and bone marrow.
222
49. Which test is most widely used for the detection of antibodies to Toxoplasma gondii? \na) Complement fixation test \nb) Direct agglutination test \nc) Sabin-Feldman dye test \nd) Hemagglutination test
Answer: c \nExplanation: The Sabin-Feldman dye test is the most widely used and sensitive serological test for detecting antibodies to Toxoplasma gondii.
223
50. Which of the following is NOT a serological test for diagnosing Toxoplasma gondii infection? \na) Complement fixation test \nb) Direct agglutination test \nc) Hemagglutination test \nd) Gram stain test
Answer: d \nExplanation: The Gram stain test is used to identify bacterial infections, not Toxoplasma gondii, which is a protozoan parasite. The other options are specific serological tests for toxoplasmosis.
224
Question and Options
Answer and Explanation
225
Which of the following stages of Plasmodium is injected into humans by mosquitoes? a) Gametocytes b) Sporozoites c) Merozoites d) Ookinetes
Answer: b) Sporozoites; Explanation: Sporozoites are the infectious form of Plasmodium injected into the human bloodstream by the female Anopheles mosquito during a blood meal.
226
What happens to Plasmodium merozoites after they leave the liver? a) They become gametocytes b) They invade red blood cells (RBCs) c) They transform into sporozoites d) They remain in the bloodstream
Answer: b) They invade red blood cells (RBCs); Explanation: After the liver stage, merozoites are released into the bloodstream, where they invade RBCs and continue their asexual multiplication cycle.
227
Which of the following is a symptom of Blackwater fever? a) Dark-red or black urine b) Hypoglycemia c) Jaundice d) All of the above
Answer: d) All of the above; Explanation: Blackwater fever is characterized by dark urine, jaundice, and sometimes hypoglycemia due to massive destruction of RBCs.
228
Algid malaria is associated with which of the following? a) High blood pressure b) Cold, clammy skin c) Increased urine output d) Increased blood glucose levels
Answer: b) Cold, clammy skin; Explanation: Algid malaria results in circulatory collapse, leading to cold and clammy skin and low blood pressure.
229
Which malaria parasite species is most commonly associated with severe malaria and cerebral malaria? a) Plasmodium ovale b) Plasmodium vivax c) Plasmodium falciparum d) Plasmodium malariae
Answer: c) Plasmodium falciparum; Explanation: P. falciparum is known for causing severe and cerebral malaria, which can be life-threatening.
230
The gold standard for diagnosing malaria is through which of the following methods? a) Clinical diagnosis b) Rapid Diagnostic Tests (RDTs) c) Microscopy d) PCR testing
Answer: c) Microscopy; Explanation: Microscopy, specifically light microscopy, remains the gold standard for detecting and identifying malaria parasites.
231
One major advantage of Rapid Diagnostic Tests (RDTs) over microscopy is that they: a) Are more sensitive b) Do not require electricity c) Can distinguish between Plasmodium species d) Provide permanent records
Answer: b) Do not require electricity; Explanation: RDTs are more practical in field settings because they don't require electricity, unlike microscopy.
232
What characteristic is unique to the detection of Histidine-rich protein II (HRP-II) in Rapid Diagnostic Tests (RDTs)? a) It is present in all Plasmodium species b) It is only produced by P. falciparum c) It distinguishes between P. vivax and P. ovale d) It detects mature gametocytes
Answer: b) It is only produced by P. falciparum; Explanation: HRP-II is produced by trophozoites and young gametocytes of P. falciparum, making it specific to this species.
233
Which of the following is a preventive measure for malaria? a) Use of chloroquine b) Administering doxycycline c) Insecticide-treated nets d) All of the above
Answer: d) All of the above; Explanation: Malaria prevention involves the use of drugs like chloroquine, doxycycline, and protective measures such as insecticide-treated nets.
234
What is the main reason for renal failure in Blackwater fever? a) Overproduction of urine b) Haemoglobin buildup in the kidneys c) Dehydration d) Excessive glucose in the blood
Answer: b) Haemoglobin buildup in the kidneys; Explanation: In Blackwater fever, the massive breakdown of erythrocytes releases free haemoglobin, which accumulates in the kidneys, leading to renal failure.
235
In algid malaria, the circulatory collapse results in which of the following? a) Increased cardiac output b) Low blood pressure c) Fever without chills d) High peripheral blood flow
Answer: b) Low blood pressure; Explanation: Algid malaria involves circulatory collapse, which causes low blood pressure and cold, clammy skin.
236
What is a major cause of the development of drug resistance in malaria? a) Overuse of RDTs b) Overdiagnosis and overtreatment c) Poor nutrition d) Use of untreated bed nets
Answer: b) Overdiagnosis and overtreatment; Explanation: Overdiagnosis and overtreatment increase drug pressure on malaria parasites, facilitating the development of drug resistance.
237
Which Plasmodium stage is involved in the erythrocytic cycle? a) Gametocytes b) Merozoites c) Sporozoites d) Ookinetes
Answer: b) Merozoites; Explanation: Merozoites are involved in the erythrocytic cycle, where they invade RBCs and multiply.
238
The rapid development of shock in malaria is referred to as: a) Cerebral malaria b) Algid malaria c) Blackwater fever d) Mild malaria
Answer: b) Algid malaria; Explanation: Algid malaria is a severe form characterized by circulatory collapse and rapid development of shock.
239
Which diagnostic method for malaria provides a permanent record of the results? a) RDT b) Clinical diagnosis c) Light microscopy d) PCR
Answer: c) Light microscopy; Explanation: Light microscopy provides a permanent slide record that can be reviewed and archived.
240
The symptoms of severe malaria most often overlap with other febrile illnesses. What does this imply for diagnosis? a) It makes clinical diagnosis unreliable b) It makes microscopy unnecessary c) It simplifies the diagnosis process d) It leads to underdiagnosis
Answer: a) It makes clinical diagnosis unreliable; Explanation: The symptoms of malaria are non-specific, making clinical diagnosis unreliable without confirmation from lab-based methods.
241
Why is malaria more severe in pregnant women? a) Due to a weakened immune system b) High parasite load c) Poor nutrition d) Lack of prenatal care
Answer: a) Due to a weakened immune system; Explanation: Pregnant women have a reduced immune response, making them more susceptible to severe forms of malaria.
242
What is the consequence of reduced glucose concentration in severe malaria cases? a) Anaemia b) Hyperglycemia c) Hypoglycemia d) None of the above
Answer: c) Hypoglycemia; Explanation: Hypoglycemia is a common symptom in severe malaria, particularly with P. falciparum infection, due to the parasite's metabolic activity.
243
What is the primary goal of malaria prophylaxis? a) To increase the immune response b) To prevent the disease before exposure c) To kill the vector d) To provide temporary immunity
Answer: b) To prevent the disease before exposure; Explanation: Malaria prophylaxis involves the use of drugs and other measures to prevent infection before exposure to malaria.
244
What is the main vector control strategy against malaria? a) Residual insecticide spraying b) Mass vaccination c) Treatment with quinine d) Use of antipyretics
Answer: a) Residual insecticide spraying; Explanation: Vector control through residual insecticide spraying remains one of the most effective strategies against malaria transmission.
245
Endophily refers to the mosquito's tendency to: a) Rest outdoors b) Bite outdoors c) Rest indoors d) Bite indoors
Answer: c) Rest indoors; Explanation: Endophily is the tendency of mosquitoes to rest indoors after feeding.
246
What does the term 'zoophily' indicate in relation to mosquito feeding habits? a) Preference for human blood b) Preference for animal blood c) Feeding in dark environments d) Feeding during daytime
Answer: b) Preference for animal blood; Explanation: Zoophily indicates the preference of mosquitoes to feed on animals rather than humans.
247
What are the feeding and resting habits of vectors in relation to human habitation, and how do they influence malaria control?
Answer: The feeding and resting habits of malaria vectors, particularly mosquitoes, are categorized by their preferences for human or animal blood and their tendencies to rest or bite indoors or outdoors. These characteristics influence control strategies: Anthropophily: Refers to the vector's preference for human blood, which makes them more dangerous for human populations. Zoophily: Indicates a preference for animal blood, which may divert mosquitoes from humans, reducing transmission risks. Endophagy: Refers to vectors that bite indoors, making indoor residual spraying (IRS) more effective. Exophagy: Indicates outdoor biting, making indoor interventions less effective. Endophily: Refers to vectors that rest indoors, again favoring IRS as a control method. Exophily: Refers to vectors that rest outdoors, reducing the efficacy of indoor spraying. Explanation: These behaviors guide the use of insecticides and the design of protective measures like bed nets and repellents, targeting mosquito behavior patterns to maximize the success of malaria control efforts. Understanding the feeding and resting habits allows for more strategic interventions in both endemic and epidemic regions.
248
Explain how rapid diagnostic tests (RDTs) detect malaria and the advantages they offer over microscopy.
"Answer: Rapid diagnostic tests (RDTs) detect malaria by using immunochromatographic methods to identify antigens from malaria parasites in lysed blood. The tests employ monoclonal antibodies that target parasite antigens such as histidine-rich protein II (HRP-II) from Plasmodium falciparum or parasite lactate dehydrogenase (pLDH) from all Plasmodium species. They can detect the presence of malaria in about 15 minutes. Advantages of RDTs: Simpler and faster to perform than microscopy. Do not require electricity,
249
Explain how rapid diagnostic tests (RDTs) detect malaria and the advantages they offer over microscopy.
Answer: Rapid diagnostic tests (RDTs) detect malaria by using immunochromatographic methods to identify antigens from malaria parasites in lysed blood. The tests employ monoclonal antibodies that target parasite antigens such as histidine-rich protein II (HRP-II) from Plasmodium falciparum or parasite lactate dehydrogenase (pLDH) from all Plasmodium species. They can detect the presence of malaria in about 15 minutes. Advantages of RDTs: Simpler and faster to perform than microscopy. Do not require electricity, special equipment, or expert technicians. Can detect infections even when parasites are sequestered in deep vascular compartments, which may be missed by microscopy. They are also useful in remote or resource-limited settings, improving access to malaria diagnosis and treatment.
250
Discuss the lifecycle of Plasmodium and the significance of each stage in malaria transmission.
Answer: The lifecycle of Plasmodium consists of two main phases: the asexual phase in humans and the sexual phase in mosquitoes. Key stages include: 1. Sporozoites: Injected by mosquitoes, they travel to the liver where they mature into schizonts. 2. Schizonts: Undergo asexual replication, producing merozoites that are released into the bloodstream. 3. Merozoites: Infect red blood cells, leading to the clinical symptoms of malaria. 4. Gametocytes: Formed in RBCs and are taken up by mosquitoes during a blood meal. 5. In the mosquito: Gametocytes develop into gametes, fertilization occurs, and sporozoites form in the salivary glands, ready to infect another human. Each stage is crucial for the continuation of malaria transmission, highlighting the importance of targeting both the human and vector populations in control strategies.
251
Identify the major challenges in malaria elimination efforts and potential strategies to overcome them.
Answer: Major challenges in malaria elimination include: 1. Drug resistance: Resistance to antimalarial drugs such as artemisinin poses a significant threat. Strategies: Continuous monitoring and development of new drugs. 2. Insecticide resistance: Mosquitoes developing resistance to insecticides can undermine vector control efforts. Strategies: Rotating insecticides, using combination treatments, and developing new vector control tools. 3. Environmental factors: Climate change and urbanization affect mosquito habitats and transmission dynamics. Strategies: Integrated vector management that considers environmental changes. 4. Access to healthcare: In many regions, access to diagnosis and treatment remains a challenge. Strategies: Strengthening health systems, increasing community health worker training, and improving logistics for drug delivery. Addressing these challenges requires a multifaceted approach involving research, policy, and community engagement.
252
Explain the concept of herd immunity in the context of malaria prevention.
Answer: Herd immunity refers to the indirect protection from infectious diseases that occurs when a significant portion of a population becomes immune to the disease, either through vaccination or previous infections. In the context of malaria, achieving herd immunity can reduce transmission rates, protecting individuals who are not immune, such as young children and pregnant women. Strategies to enhance herd immunity include widespread use of malaria vaccines, effective treatment to reduce parasite reservoirs, and vector control measures that decrease overall malaria transmission within the community.
253
What role do environmental factors play in malaria transmission, and how can they be managed?
Answer: Environmental factors, such as climate, topography, and human activities, significantly influence malaria transmission. Factors include: 1. Climate: Temperature and rainfall affect mosquito breeding and survival. Warmer temperatures can lead to increased mosquito populations. 2. Land use: Deforestation and agricultural practices can create new breeding sites. Management strategies: Implementing sustainable land use practices and maintaining wetlands. 3. Urbanization: Increases the risk of malaria in some regions due to increased human-mosquito interactions. Strategies: Urban planning that considers vector control measures and public health infrastructure. Effective management of these factors is crucial for malaria prevention efforts.
254
Discuss the importance of community engagement in malaria control programs.
Answer: Community engagement is vital for the success of malaria control programs. Benefits include: 1. Increased awareness: Educating the community about malaria transmission and prevention fosters personal responsibility. 2. Improved treatment-seeking behavior: Engaged communities are more likely to seek timely diagnosis and treatment. 3. Participation in control efforts: Community involvement in vector control activities (e.g., clearing breeding sites) enhances program effectiveness. 4. Trust in healthcare systems: Community engagement builds trust, encouraging cooperation with health initiatives. Strategies to enhance community engagement include training local health workers, conducting outreach programs, and utilizing community leaders to disseminate information.
255
Explain the significance of monitoring and evaluation in malaria control initiatives.
Answer: Monitoring and evaluation (M&E) are essential components of malaria control initiatives for several reasons: 1. Assessing effectiveness: M&E helps determine the impact of interventions, guiding resource allocation. 2. Identifying challenges: Regular evaluations can uncover barriers to implementation, allowing for timely adjustments. 3. Data-driven decision making: M&E provides data to inform policy changes and improve program strategies. 4. Accountability: M&E fosters transparency and accountability among stakeholders. To enhance M&E, it is crucial to develop robust data collection systems, train personnel, and establish clear indicators for success.
256
What are the implications of malaria for maternal and child health?
Answer: Malaria significantly impacts maternal and child health in several ways: 1. Increased maternal morbidity and mortality: Pregnant women are at higher risk for severe malaria, leading to complications such as anemia and low birth weight. 2. Neonatal health: Infants born to mothers with malaria have an increased risk of low birth weight and mortality. 3. Delayed healthcare: Malaria in pregnancy can result in delays in seeking care, increasing the risk of adverse outcomes. Strategies to mitigate these impacts include integrating malaria prevention (e.g., insecticide-treated nets) into maternal health programs and ensuring prompt treatment for pregnant women.
257
Describe the role of international partnerships in combating malaria.
Answer: International partnerships play a critical role in combating malaria by: 1. Coordinating efforts: Collaborative programs ensure that resources are used efficiently and interventions are harmonized across regions. 2. Funding and resource mobilization: International organizations provide funding, technical assistance, and resources to support malaria control efforts. 3. Research and innovation: Partnerships facilitate research on new treatments, vaccines, and vector control methods, accelerating progress against malaria. 4. Sharing best practices: Countries can learn from each other's successes and challenges, improving local strategies. Successful partnerships involve governments, NGOs, and international organizations working together towards common goals.
258
Explain the concept of herd immunity in the context of malaria prevention.
Answer: Herd immunity refers to the indirect protection from infectious diseases that occurs when a significant portion of a population becomes immune to the disease, either through vaccination or previous infections. In the context of malaria, achieving herd immunity can reduce transmission rates, protecting individuals who are not immune, such as young children and pregnant women. Strategies to enhance herd immunity include widespread use of malaria vaccines, effective treatment to reduce parasite reservoirs, and vector control measures that decrease overall malaria transmission within the community.
259
What role do environmental factors play in malaria transmission, and how can they be managed?
Answer: Environmental factors, such as climate, topography, and human activities, significantly influence malaria transmission. Factors include: 1. Climate: Temperature and rainfall affect mosquito breeding and survival. Warmer temperatures can lead to increased mosquito populations. 2. Land use: Deforestation and agricultural practices can create new breeding sites. Management strategies: Implementing sustainable land use practices and maintaining wetlands. 3. Urbanization: Increases the risk of malaria in some regions due to increased human-mosquito interactions. Strategies: Urban planning that considers vector control measures and public health infrastructure. Effective management of these factors is crucial for malaria prevention efforts.
260
Discuss the importance of community engagement in malaria control programs.
Answer: Community engagement is vital for the success of malaria control programs. Benefits include: 1. Increased awareness: Educating the community about malaria transmission and prevention fosters personal responsibility. 2. Improved treatment-seeking behavior: Engaged communities are more likely to seek timely diagnosis and treatment. 3. Participation in control efforts: Community involvement in vector control activities (e.g., clearing breeding sites) enhances program effectiveness. 4. Trust in healthcare systems: Community engagement builds trust, encouraging cooperation with health initiatives. Strategies to enhance community engagement include training local health workers, conducting outreach programs, and utilizing community leaders to disseminate information.
261
Explain the significance of monitoring and evaluation in malaria control initiatives.
Answer: Monitoring and evaluation (M&E) are essential components of malaria control initiatives for several reasons: 1. Assessing effectiveness: M&E helps determine the impact of interventions, guiding resource allocation. 2. Identifying challenges: Regular evaluations can uncover barriers to implementation, allowing for timely adjustments. 3. Data-driven decision making: M&E provides data to inform policy changes and improve program strategies. 4. Accountability: M&E fosters transparency and accountability among stakeholders. To enhance M&E, it is crucial to develop robust data collection systems, train personnel, and establish clear indicators for success.
262
What are the implications of malaria for maternal and child health?
Answer: Malaria significantly impacts maternal and child health in several ways: 1. Increased maternal morbidity and mortality: Pregnant women are at higher risk for severe malaria, leading to complications such as anemia and low birth weight. 2. Neonatal health: Infants born to mothers with malaria have an increased risk of low birth weight and mortality. 3. Delayed healthcare: Malaria in pregnancy can result in delays in seeking care, increasing the risk of adverse outcomes. Strategies to mitigate these impacts include integrating malaria prevention (e.g., insecticide-treated nets) into maternal health programs and ensuring prompt treatment for pregnant women.
263
Describe the role of international partnerships in combating malaria.
Answer: International partnerships play a critical role in combating malaria by: 1. Coordinating efforts: Collaborative programs ensure that resources are used efficiently and interventions are harmonized across regions. 2. Funding and resource mobilization: International organizations provide funding, technical assistance, and resources to support malaria control efforts. 3. Research and innovation: Partnerships facilitate research on new treatments, vaccines, and vector control methods, accelerating progress against malaria. 4. Sharing best practices: Countries can learn from each other's successes and challenges, improving local strategies. Successful partnerships involve governments, NGOs, and international organizations working together towards common goals.
264
Discuss the potential impact of climate change on malaria transmission patterns.
Answer: Climate change can significantly affect malaria transmission patterns through several mechanisms: 1. Altered mosquito habitats: Changes in temperature and rainfall can expand or reduce suitable breeding sites for mosquitoes. 2. Increased vector survival: Warmer temperatures may enhance the lifespan of mosquitoes, leading to prolonged transmission seasons. 3. Geographic shifts: Malaria transmission may spread to new areas that were previously unsuitable due to climate conditions. 4. Impact on human populations: Vulnerable populations may face increased exposure to malaria as climatic conditions change. Strategies to address these impacts include climate adaptation measures and strengthening health systems to respond to evolving malaria risks.
265
How does the economic burden of malaria affect affected countries?
Answer: The economic burden of malaria can have profound effects on affected countries through various channels: 1. Healthcare costs: Malaria treatment and prevention place a significant financial strain on healthcare systems. 2. Lost productivity: Illness and premature death due to malaria can lead to reduced workforce productivity, impacting economic growth. 3. Tourism and investment: High malaria prevalence can deter tourism and foreign investment, further hindering economic development. 4. Education: Malaria can lead to absenteeism in schools, affecting children's education and future opportunities. Addressing the economic burden requires investment in effective malaria control measures and healthcare infrastructure.
266
Explain the role of vaccines in malaria prevention.
Answer: Vaccines play a crucial role in malaria prevention by: 1. Providing immunity: Vaccines stimulate the immune system to recognize and combat malaria parasites, reducing the risk of infection. 2. Reducing transmission: Widespread vaccination can lower the overall number of infections in a community, contributing to herd immunity. 3. Complementing other strategies: Vaccination works alongside other preventive measures, such as insecticide-treated nets and antimalarial drugs. Current vaccine candidates, like RTS,S/AS01, aim to protect vulnerable populations, particularly children. Ongoing research is essential for developing more effective malaria vaccines.
267
Identify the significance of integrated vector management in malaria control.
Answer: Integrated vector management (IVM) is significant in malaria control for several reasons: 1. Comprehensive approach: IVM combines multiple strategies (e.g., biological control, environmental management, chemical control) for effective vector control. 2. Sustainability: By addressing environmental factors and promoting community involvement, IVM aims for long-term solutions to vector control. 3. Reducing resistance: Integrating different control methods can help delay the development of resistance to insecticides. 4. Tailored interventions: IVM allows for context-specific strategies that consider local ecological and epidemiological factors, improving the effectiveness of malaria control efforts.
268
Discuss the importance of community health workers in malaria control programs.
Answer: Community health workers (CHWs) are vital to malaria control programs due to their unique roles: 1. Local knowledge: CHWs understand community dynamics and can tailor interventions to meet local needs. 2. Outreach and education: They educate community members about malaria prevention and treatment, increasing awareness and compliance. 3. Early detection and treatment: CHWs can provide rapid diagnostic tests and initiate treatment, improving access to care. 4. Bridging gaps: They connect communities with formal healthcare systems, ensuring that vulnerable populations receive necessary services. Training and supporting CHWs enhance the overall effectiveness of malaria control strategies.
269
Explain the concept of focal malaria transmission and its implications for control strategies.
Answer: Focal malaria transmission refers to localized outbreaks of malaria that occur in specific geographic areas, often due to unique environmental or social conditions. Implications for control strategies include: 1. Targeted interventions: Focal transmission requires focused efforts, such as enhanced surveillance and tailored control measures. 2. Resource allocation: Understanding focal transmission helps allocate resources efficiently, prioritizing high-risk areas. 3. Monitoring and evaluation: Ongoing monitoring is essential to detect and respond to outbreaks rapidly. 4. Community engagement: Engaging local populations in understanding and addressing transmission dynamics is crucial for effective control. Strategies must be adaptable to local contexts to mitigate risks.
270
Discuss the role of public awareness campaigns in malaria prevention.
Answer: Public awareness campaigns play a critical role in malaria prevention by: 1. Educating communities: Raising awareness about malaria transmission, symptoms, and prevention measures fosters informed behaviors. 2. Promoting health-seeking behavior: Campaigns encourage individuals to seek timely diagnosis and treatment, reducing morbidity and mortality. 3. Enhancing community participation: Engaging communities in campaigns fosters ownership of malaria prevention efforts, promoting compliance with control measures. 4. Reducing stigma: Campaigns can help reduce stigma associated with malaria and increase acceptance of treatment and preventive measures. Effective campaigns utilize various communication channels to reach diverse audiences.
271
Explain the role of technology in malaria diagnosis and treatment.
Answer: Technology plays a transformative role in malaria diagnosis and treatment by: 1. Enhancing diagnostic capabilities: Innovations such as molecular diagnostics and RDTs improve the accuracy and speed of malaria detection. 2. Mobile health solutions: Mobile applications can support data collection, health education, and treatment reminders, increasing access to care. 3. Telemedicine: Remote consultations facilitate access to expert care, especially in remote areas with limited healthcare resources. 4. Data analytics: Technology enables the analysis of malaria transmission patterns, guiding targeted interventions and resource allocation. Embracing technological advancements can significantly improve malaria control efforts.
272
Question and Options
Answer and Explanation
273
What is the primary indication for larval control? a) Rural areas b) Densely populated areas c) Coastal regions d) Forested areas
Answer: b) Densely populated areas Explanation: Larval control measures are most effective in densely populated areas with limited breeding places, such as urban regions and irrigated arid areas.
274
Which of the following is a classical larvicide? a) Chlorine b) Paris green c) DDT d) Malathion
Answer: b) Paris green Explanation: Paris green is a classical larvicide used for controlling mosquito larvae, along with other substances like larvicidal oils and polystyrene beads.
275
Who first discovered Toxoplasma gondii? a) Louis Pasteur b) Nicolle and Manceaux c) Robert Koch d) Joseph Lister
Answer: b) Nicolle and Manceaux Explanation: Toxoplasma gondii was first discovered in 1908 by Nicolle and Manceaux in a desert rodent.
276
What type of parasite is Toxoplasma gondii? a) Bacterium b) Virus c) Obligate intracellular protozoan d) Fungi
Answer: c) Obligate intracellular protozoan Explanation: Toxoplasma gondii is classified as an obligate intracellular protozoan parasite, requiring a host cell to reproduce.
277
In which species can Toxoplasma gondii be found? a) Only in felines b) Only in rodents c) Many species, including humans d) Only in primates
Answer: c) Many species, including humans Explanation: Toxoplasma gondii is found in a wide range of species, including carnivores, rodents, pigs, herbivores, primates, and birds.
278
What is the first site of infection in cases of acute toxoplasmosis? a) Brain b) Liver c) Intestine d) Skin
Answer: c) Intestine Explanation: In most cases of acute toxoplasmosis, the intestine is the first site of infection where Toxoplasma gondii enters.
279
What are tachyzoites? a) Dormant forms of Toxoplasma b) Rapidly dividing cells in acute infection c) Infective cysts d) Adult parasites
Answer: b) Rapidly dividing cells in acute infection Explanation: Tachyzoites are the rapidly dividing forms of Toxoplasma gondii during acute infections.
280
Which symptoms are common in acute toxoplasmosis? a) Fever and headache b) Skin rash c) Abdominal cramps d) Nausea
Answer: a) Fever and headache Explanation: Common symptoms of acute toxoplasmosis include fever, headache, swollen lymph glands, and muscle pain.
281
How is congenital toxoplasmosis transmitted? a) Through contaminated food b) Direct contact with infected animals c) Transplacental route from mother to fetus d) Airborne transmission
Answer: c) Transplacental route from mother to fetus Explanation: Congenital toxoplasmosis occurs when the parasite invades the fetus through the placenta after acute maternal infection.
282
Which of the following is NOT a factor influencing the pathology of toxoplasmosis? a) Age of the host b) Virulence of the strain c) Host's natural habitat d) Acquired immunity of the host
Answer: c) Host's natural habitat Explanation: The natural habitat of the host does not directly influence the pathology of toxoplasmosis; instead, factors like age, strain virulence, and immunity are significant.
283
What can chronic toxoplasmosis lead to in the brain? a) Tumors b) Nodules of cells c) Atrophy of neurons d) Increased synaptic connections
Answer: b) Nodules of cells Explanation: In chronic toxoplasmosis, the formation of cysts can lead to the development of nodules in the brain.
284
Which serological test is most widely used for diagnosing Toxoplasma gondii? a) Complement fixation test b) Dye test (Sabin-Feldman) c) Hemagglutination test d) Direct agglutination test
Answer: b) Dye test (Sabin-Feldman) Explanation: The Sabin-Feldman dye test is a sensitive serological test widely used to detect antibodies against Toxoplasma gondii.
285
Which of the following statements about Toxoplasma gondii is FALSE? a) It is a cosmopolitan parasite. b) It only infects cats. c) It can be transmitted congenitally. d) It can remain dormant in tissues.
Answer: b) It only infects cats Explanation: Toxoplasma gondii infects a wide range of hosts, not just cats.
286
What is the main method of treatment for Toxoplasmosis? a) Antibiotics b) Combination of pyrimethamine and sulfonamides c) Antiviral drugs d) Surgery
Answer: b) Combination of pyrimethamine and sulfonamides Explanation: The most effective treatment for Toxoplasmosis in both humans and animals is a combination of pyrimethamine and sulfonamides.
287
What is leishmaniasis primarily caused by? a) Bacteria b) Viruses c) Leishmania parasites d) Fungi
Answer: c) Leishmania parasites Explanation: Leishmaniasis is caused by several species of the Leishmania parasites, which are protozoans belonging to the Trypanosomidae family.
288
What type of organism transmits leishmaniasis? a) Ticks b) Mosquitoes c) Phlebotomine sandflies d) Fleas
Answer: c) Phlebotomine sandflies Explanation: Phlebotomine sandflies are the known vectors responsible for transmitting leishmaniasis.
289
Which form of leishmaniasis is characterized by skin ulcers? a) Visceral leishmaniasis b) Mucocutaneous leishmaniasis c) Cutaneous leishmaniasis d) Post-Kala-azar dermal leishmaniasis
Answer: c) Cutaneous leishmaniasis Explanation: Cutaneous leishmaniasis is characterized by the formation of skin ulcers at the site of the sandfly bite.
290
What is a common symptom of visceral leishmaniasis? a) Skin lesions b) Fever and weight loss c) Nausea d) Diarrhea
Answer: b) Fever and weight loss Explanation: Visceral leishmaniasis, also known as kala-azar, commonly presents with fever, weight loss, and splenomegaly.
291
Which of the following diseases can be caused by congenital toxoplasmosis? a) Hydrocephalus b) Malaria c) Typhoid d) Meningitis
Answer: a) Hydrocephalus Explanation: Congenital toxoplasmosis can lead to malformations such as hydrocephalus, microcephaly, and chorioretinitis.
292
What kind of lesions are associated with subacute toxoplasmosis? a) Mild rashes b) Extensive lesions in multiple organs c) Benign tumors d) Ulcers
Answer: b) Extensive lesions in multiple organs Explanation: Subacute toxoplasmosis can cause extensive lesions, particularly in the lungs, heart, liver, brain, and eyes.
293
Which tissue is primarily affected by Toxoplasma gondii during acute infection? a) Muscle b) Nervous tissue c) Intestinal epithelium d) Skin
Answer: c) Intestinal epithelium Explanation: The intestinal epithelium is primarily affected during the initial acute infection stage of Toxoplasma gondii.
294
Which of the following is NOT a method for diagnosing Toxoplasmosis? a) Serology b) Tissue biopsy c) Blood culture d) Imaging studies
Answer: d) Imaging studies Explanation: While imaging studies can help assess damage, they are not a direct diagnostic method for Toxoplasmosis; serology and tissue biopsy are more relevant.
295
Question and Options
Answer and Explanation
296
What effect do cyst walls have on bradyzoites? a) They protect them from host defenses b) They facilitate their rapid multiplication c) They enhance their toxicity d) They allow them to disperse in the environment
Answer: a) They protect them from host defenses. Explanation: The cyst walls provide protection for bradyzoites from the host's immune system, allowing them to survive in a dormant state within the host's tissues.
297
Which form of leishmaniasis is known for causing lesions in the mucous membranes? a) Cutaneous leishmaniasis b) Visceral leishmaniasis c) Mucocutaneous leishmaniasis d) Zoonotic leishmaniasis
Answer: c) Mucocutaneous leishmaniasis. Explanation: Mucocutaneous leishmaniasis is characterized by lesions affecting the mucous membranes, particularly of the nose and mouth.
298
What is the primary diagnostic method for leishmaniasis? a) Blood culture b) Serological tests c) Tissue biopsy and microscopic examination d) PCR (Polymerase Chain Reaction)
Answer: c) Tissue biopsy and microscopic examination. Explanation: Tissue biopsy and microscopic examination of the affected tissues are the primary methods for diagnosing leishmaniasis, allowing for the identification of Leishmania amastigotes.
299
Explain the life cycle of Toxoplasma gondii.
Answer: The life cycle of Toxoplasma gondii involves both definitive and intermediate hosts. The definitive host is typically a cat, where the parasite undergoes sexual reproduction, resulting in the shedding of oocysts in the feces. These oocysts can contaminate food and water, leading to infection in various intermediate hosts, including humans, rodents, and livestock. Inside the intermediate host, the oocysts develop into tachyzoites, which multiply rapidly and can infect various tissues. Eventually, some tachyzoites differentiate into bradyzoites, forming cysts that can remain dormant for long periods.
300
Describe the common symptoms associated with acute toxoplasmosis.
Answer: Common symptoms of acute toxoplasmosis can include fever, muscle aches, fatigue, swollen lymph nodes, and headaches. Some individuals may experience flu-like symptoms, and in more severe cases, ocular symptoms such as blurred vision or eye pain can occur if the parasite infects the eyes. Immunocompromised individuals may experience more severe manifestations.
301
What are the potential complications of congenital toxoplasmosis?
Answer: Congenital toxoplasmosis can lead to several serious complications, including hydrocephalus (accumulation of fluid in the brain), microcephaly (abnormally small head), chorioretinitis (inflammation of the retina), and intracranial calcifications. Other potential issues may include developmental delays and other neurological impairments.
302
Explain the mechanism of action of pyrimethamine and sulfonamides in treating toxoplasmosis.
Answer: Pyrimethamine is an antiprotozoal agent that inhibits dihydrofolate reductase, an enzyme critical for folate metabolism in protozoa. This inhibition disrupts DNA synthesis, preventing the growth and reproduction of the Toxoplasma gondii parasite. Sulfonamides complement this action by inhibiting the synthesis of folic acid, which is necessary for nucleic acid synthesis. The combination of these drugs leads to a synergistic effect, enhancing the treatment's efficacy against Toxoplasmosis.
303
Discuss the role of phlebotomine sandflies in the transmission of leishmaniasis.
Answer: Phlebotomine sandflies are the primary vectors responsible for the transmission of Leishmania parasites to humans. When a female sandfly bites an infected host, it ingests the Leishmania promastigotes, which can then develop into infectious forms within the sandfly's gut. Upon biting another host, the sandfly injects these parasites through its saliva, leading to infection. The transmission cycle is heavily influenced by the ecological conditions that support sandfly populations, such as temperature, humidity, and availability of breeding sites.
304
Identify the different clinical forms of leishmaniasis and their characteristics.
Answer: Leishmaniasis presents in three primary clinical forms: Cutaneous leishmaniasis: Characterized by skin ulcers at the bite site, which can be painless or painful. Lesions may take months to heal and can lead to scarring. Visceral leishmaniasis (kala-azar): A severe form affecting internal organs, causing symptoms like prolonged fever, weight loss, splenomegaly, and anemia. It can be fatal if left untreated. Mucocutaneous leishmaniasis: Involves lesions in the mucous membranes of the nose and mouth, leading to significant disfigurement and secondary infections.
305
Explain the significance of serological tests in the diagnosis of Toxoplasma gondii infection.
Answer: Serological tests play a critical role in diagnosing Toxoplasma gondii infections by detecting specific antibodies (IgM and IgG) produced by the host in response to infection. The presence of IgM indicates recent infection, while IgG signifies past exposure. These tests help distinguish acute from chronic infections, assess the risk of congenital transmission in pregnant women, and guide treatment decisions. Additionally, they are essential for screening immunocompromised patients at risk for reactivation of latent infections.
306
What factors influence the pathology and clinical outcomes of leishmaniasis?
Answer: Several factors influence the pathology and clinical outcomes of leishmaniasis, including the species of Leishmania involved, the host's immune response, the route of transmission, and the presence of co-infections. The virulence of the specific Leishmania strain can affect the severity of symptoms. Host factors, such as genetic predisposition and nutritional status, also play crucial roles. The overall health of the host's immune system significantly determines the clinical outcome, with immunocompromised individuals being more susceptible to severe forms of the disease.
307
Discuss the impact of environmental factors on the transmission of leishmaniasis.
Answer: Environmental factors significantly affect the transmission dynamics of leishmaniasis. Changes in land use, such as deforestation and urbanization, can alter the habitats of sandflies and their rodent hosts, potentially increasing human exposure to infected sandflies. Climatic conditions like temperature and humidity also play a critical role in the lifecycle of the sandfly vector, with warmer and more humid environments favoring their proliferation. Additionally, seasonal variations can influence the incidence of leishmaniasis outbreaks, particularly in regions where vectors are more active during specific months.
308
Explain the treatment options for leishmaniasis.
Answer: Treatment options for leishmaniasis vary based on the clinical form of the disease and the patient's condition. Common treatment regimens include: Pentavalent antimonials (e.g., sodium stibogluconate): These are the first-line treatment for most forms of leishmaniasis, effective in both cutaneous and visceral cases. Amphotericin B: Used for severe visceral leishmaniasis, especially in cases where first-line treatments fail. Miltefosine: An oral drug that can be used for both cutaneous and visceral leishmaniasis, particularly in pregnant women. Paromomycin: An alternative treatment option for cutaneous leishmaniasis, particularly in patients who cannot tolerate antimonials. Local treatments: Such as cryotherapy or topical agents, may be effective for cutaneous leishmaniasis in specific cases. Treatment choice depends on the geographical location, local guidelines, and the individual patient's health status.
309
What preventive measures can be taken to avoid Toxoplasma gondii infection?
Answer: Preventive measures to avoid Toxoplasma gondii infection include: Cooking meat thoroughly: Ensuring that meat is cooked to safe internal temperatures can kill the parasite. Avoiding raw or undercooked meat: Particularly pork and lamb, which are common sources of Toxoplasma. Practicing good hygiene: Washing hands thoroughly after handling raw meat, soil, or cat litter can reduce the risk of infection. Avoiding contact with cat feces: Pregnant women should take precautions to avoid handling cat litter, as oocysts are shed in the feces of infected cats. Washing fruits and vegetables: Cleaning produce properly can eliminate any potential contamination.
310
How does the immune response differ between acute and chronic toxoplasmosis?
Answer: In acute toxoplasmosis, the immune response is characterized by a rapid activation of the innate immune system, leading to the production of pro-inflammatory cytokines and the recruitment of immune cells to the site of infection. This response helps to control the initial tachyzoite proliferation. In chronic toxoplasmosis, the immune system transitions to a more regulated response, often involving the production of IgG antibodies and the formation of tissue cysts containing bradyzoites. The immune system's ability to contain the infection without completely eradicating the parasite leads to a balance where the host remains asymptomatic while the parasite persists.
311
What are the challenges in controlling leishmaniasis in endemic areas?
"Answer: Controlling leishmaniasis in endemic areas faces several challenges, including: Vector control: The difficulty of effectively controlling sandfly populations due to their breeding sites often being in inaccessible or environmentally sensitive areas. Lack of resources: Limited financial and healthcare resources in many endemic regions hinder the implementation of effective control programs and access to treatment. Cultural practices: Local customs and practices, such as housing conditions or animal husbandry, may facilitate transmission and complicate prevention efforts. Environmental changes: Factors such as deforestation, urbanization, and climate change can alter the habitats of both sandflies and reservoir hosts, impacting transmission dynamics. Asymptomatic cases: Many individuals with cutaneous leishmaniasis remain asymptomatic, complicating surveillance and control
