LE1 (Diagnostic Techniques and Treatment)

Question 1

Diagnostic Technique: Trichomonas vaginalis

Answer 1

Golden Standard: Culture (Diamond’s Modified Medium, Amies Gel Medium, InPouch TV) and Nucleic Acid Amplification Test (APTIMA Trichomonas vaginalis Assay)

Papanicolau Smear, Saline preparation/wet mount microscopy, Rapid Antigen Test (OSOM Trichomonas Rapid Test)

Question 2

Treatment: Trichomonas vaginalis

Answer 2

(MT): Metronidazole & Tinidazole

Question 3

Diagnostic Technique: Leishmania spp.

Answer 3

Lesion & Tissue Scrapings, Aspirates or Biopsy, Blood Smear (Giemsa and Hemotoxylin & Eosin (H&E) Stain)

Isoenzyme Analysis, Serology, and Molecular Diagnosis (PCR of rRNA ITS2)

Question 4

Treatment: Leishmania spp.

Answer 4

(SSAP) Sodium stibogluconate & n-methyl-glucamine, Amphotericin B, and Pentamidine

Question 5

Diagnostic Technique: Plasmodium spp.

Answer 5

Golden Standard: Microscopy (Morphologic Analysis): Thick and Thin Blood Smear (Giemsa, Wright, Wright-Giemsa Stain)

Question 6

Treatment: Plasmodium spp.

Answer 6

(PD-BSD-GD-HAD-SD) Prophylactic Drugs, Blood Schizonticidal Drugs, Gametocytocidal Drugs, Hypnozoitocidal/Antirelapse Drugs, Sporonticidal Drugs

Atovaquone

Question 7

Diagnostic Technique: Giardia duodenalis

Answer 7

Golden Standard: Direct Fluorescent Antibody (DFA) Assay

Stool Sample, Duodeno-jejunal aspiration, Trichome Stain (cysts), EIA, Rapid Immunochromatographic Cartridge Assay

Question 8

Treatment: Giardia duodenalis

Answer 8

(M) - Metronidazole

Question 9

Diagnostic Technique: Naegleria Fowleri

Answer 9

CSF Smears Direct Visualization (H&E Stain, Periodic Acid-Schiff (PAS), Trichome, Giemsa, Wright-Giemsa Stain)

Tissue (Brain Biopsy or Autopsy Specimens), Immunohistochemical Staining (Indirect Immunofluorescent (IIF) Staining & Immune Alkaline Phosphatase Staining (IHC), PCR

Question 10

Treatment: Naegleria Fowleri

Answer 10

(NAmCo) - Amphotericin B and Clotrimazole

Question 11

Diagnostic Technique: Entamoeba histolytica/dispar

Answer 11

Stool Sample, Trichome Stain, EIA, Rapid Immunochromatographic Cartridge Assay

Question 12

Treatment: Entamoba histolytica/dispar

Answer 12

(MD): Metronidazole & Diloxanide Furoate

Question 13

Diagnostic Technique: Trypanosoma brucei gambiense/rhodesiense

Answer 13

Blood Smears (Thick & Thin Smear, Giemsa Stained) | Antibody Detection

Molecular Detection | Concentration Techniques (Blood and Spinal Fluid) | Serial Examinations

Question 14

Treatment: Trypanosoma brucei gambiense/rhodesiense

Answer 14

(1SP2MN3E) - First Stage = Intravenous suramin sodium for both spp., Intramuscular pentamidine for Gambian form | CNS Stage = Intravenous Melarsoprol, if inefficient, use Nitrofurazone | Hemolymphatic Stage = Eflornithine (Effective against T.b. gambiense)

Benznidazole

Question 15

Diagnostic Technique: Sarcocystis spp.

Answer 15

Oocysts viewed under UV Microscopy | Negative Staining Technique according to Heine | PCR of 18s rRNA | H&E Stain | PAS

Intestinal (Caused by S. hominis and S. suihominis) observation of oocysts or sporocysts in stool (Cow or Pig (IH)) | Muscular (Sarcocysts in tissue specimens, non-human sarcocystosis)

Question 16

Treatment: Sarcocystis spp.

Answer 16

(MAlC): Muscle Biopsy, Albendazole, Corticosteroids

Question 17

Diagnostic Technique: Babesia spp.

Answer 17

Golden Standard: PCR

Giemsa Stained Peripheral Blood Smear, ELISA, Immunochromatographic Test (ICT), Immunofluorescent Assay Test

Question 18

Treatment: Babesia spp.

Answer 18

(CQAAAV) - Clindamycin + Quinine, Azithromycin + Atovaquone, Antipyretics, Vasopressors

Question 19

Diagnostic Technique: Toxoplasma gondii

Answer 19

Tissue Examination (Giemsa, H&E Stain)

Serodiagnostic Methods | PCR | Isolation of Parasites from Blood or other Body Fluids (Using Intraperitoneal Inoculation into Mice or Tissue Culture)

Question 20

Treatment: Toxoplasma gondii

Answer 20

(PuSa): Pyrimethamine, Sulfadiazine

Question 21

Diagnostic Technique: Cryptosporidium spp.

Answer 21

EIA and Rapid Immunochromatographic Cartridge Assay (should NOT be concentrated)

Differential Interference Contrast (DIC) | Modified Acid-Fast Stain DFA | Safranin Stain

Question 22

Treatment: Cryptosporidium spp.

Answer 22

(Crypto NA): Nitazoxanide, Azithromycin

Question 23

Diagnostic Technique: Fasciola spp.

Answer 23

Egg Identification, Adult Worm Recovery, Immunodiagnosis (ELISA & Western Blots), Radiological Examinations (Sonography & CT Scans)

Question 24

Treatment: Fasciola spp.

Answer 24

Triclabendazole, Bithionol

Question 25

Diagnostic Technique: Clonorchis sinensis

Answer 25

Cholangiography, ELISA, Western Blots, PCR, EIA

Question 26

Treatment: Clonorchis sinensis

Answer 26

Praziquantel, Albendazole, Praziquantel-albendazole

Question 27

Diagnostic Technique: Paragonimus westermani

Answer 27

Complement Fixation (CF) Test, EIA, Immunoblot, Radiography, CT Scan, MRI

Question 28

Treatment: Paragonimus westermani

Answer 28

Praziquantel, Triclabendazole, Bithionol

Question 29

Diagnostic Technique: Schistosoma spp.

Answer 29

Kato-Katz Technique, ELISA

Merthiolate-iodine-formalin concentration (MIFC), Rectal snips, and imprints, intradermal test, indirect hemagglutination, Circumoval precipitin test (COPT)

Question 30

Treatment: Schistosoma spp.

Answer 30

Praziquantel

Question 31

Diagnostic Technique: Taenia spp.

Answer 31

CAT Scan, MRI, FECT, Perianal Swabs

Question 32

Treatment: Taenia spp.

Answer 32

T. saginata = Praziquantel, Niclosamide

T. solium = Praziquantel, Albendazole, Corticosteroids

Question 33

Prevention and Control: Amebiasis

Answer 33

• Provide for sanitary disposal of human feces
• Safe drinking water & food

Question 34

Treatment: Amebiasis

Answer 34

Azithromycin

Question 35

Diagnosis of Cryptosporidiosis

Answer 35

• stool examination
• indirect fluorescent antibody
• enzyme immunoassay

Question 36

Clinical manifestations of Cryptosporidiosis

Answer 36

• diarrhea lasting for 2-3 weeks
• abdominal pain
• intestinal villi become blunted