Parasite Cases

Question 1

Acute: pt comes in with epigastric pain and a hematoma of the liver
Chronic: pt comes in with what looks like gall bladder disease and right upper quadrant pain

Answer 1

Fasciola hepatica

Question 2

Pt is from China (or any Eastern country) and has chronic liver disease (or gall bladder or bile duct cancer). Used to eat a lot of fish when they lived in China.

Answer 2

Clonorchis sinensis

Question 3

Pt came back from vacation in China where they swam in fresh water. The returned with a rash and a fever, but ignored it and are now presenting with blood in urine and a reproductive disorder (or chronic diarrhea, malnutrition and portal hypertension).

Bug is dioecious and sexually dimorphic.

Answer 3

Schistosoma or bilharzia

Question 4

Pt ate sketchy pork and is now having seizures and other neurologic symptoms.

Answer 4

Taenia solium

Question 5

Pt are sketchy beef and is now having seizures and other neurologic symptoms.

Answer 5

Taenia saginata

Question 6

Pt presents with anemia, abdominal pain, nausea, vommiing and diarrhea.

Egg is lumpy and golden surrounded by a clear shell.

Answer 6

Ancylostoma (Hookworms)

Question 7

Pt presents with abdominal pain, diarrhea, malaise, intestinal blockage and respiratory symptoms.

Egg is spherical and lumpy and mostly light brown with dark brown banding.

Answer 7

Ascaris lumbricoides

Question 8

Pt presents with diarrhea and rectal prolapse.

Egg is deep golden brown and oval with two nubs on each pole.

Answer 8

Trichuris trichiura

Question 9

Pt is 5 year old child complaining of an itchy butthole. Parents noticed something crawling around kid’s ass when they checked at night so they put scotch tape on his butt and brought that in to check under the microscope.

Eggs are mostly clear with dark edges and a pointy oval shape.

Answer 9

Enterobius vermicularis (pinworms)

Question 10

Pt lives in Africa and presents with elephantiasis.

Answer 10

Wuchereria bancrofti

Question 11

Pt remembers being bitten by a blackly and how has a disabling itch and decreased visual acuity.

Answer 11

Oncocerca volvulus (River Blindness)

Question 12

Pt has AIDS and comes in complaining about a new cough.

Answer 12

Aspergillus

Question 13

Pt is a rose gardener and has a hard nodule on their hand that goes up their arm like a string of pearls.

Answer 13

Sporotrichosis: Sporothrix

Question 14

Pt lives in Mojave desert and comes in complaining of mild flu-like symptoms.

Bug has barrel shaped hyphae.

Answer 14

Coccidiomycosis: Coccidiodes immitis

Question 15

Pt lives in Eastern USA and works for a local bat reserve. Loves birds too. Had a dry cough and pneumonia but let it go. Comes in presenting with CNS issues, meningitis and chronic lung issues.

Answer 15

Histoplasmosis: Histoplasma capsulatum

Question 16

Pt has AIDS and comes in with meningitis.

Bug found in soil and pigeon droppings.

Answer 16

Cryptococcus

Question 17

Pt recently came back from a developing country and presents with amoebic dysentery and liver and brain abcesses.

Answer 17

Entamoeba histolytica

Question 18

Pt is a camper who drank water from a stream and now has watery, greasy, foul-smelling stool.

Bug has tear drop shape.

Answer 18

Giardia lamblia

Question 19

Pt works on a cattle ranch and presents with diarrhea and large fluid loss.

Bug has small oocysts that stain with an acid fast stain.

Answer 19

Cryptosporidium

Question 20

Pt has HIV and presents with chronic watery diarrhea.

Bug has small oocysts that stain with an acid fast stain.

Answer 20

Cyclospora

Question 21

Pt is female and presents with itching, burning during urination, foul greenish discharge and history of miscarriage.

Bug has round body with free flagella, single nucleus and one stiff rod sticking out.

Answer 21

Trichomonas vaginalis

Question 22

1. Pt has acute febrile illness. Cycles of fever (paroxysm) that break and then peak again.
2. Pt presents with seizures, coma and multi organ system failure.
   In both pt recently came back from the amazon where he remembers getting bitten by an Anopheles mosquito.

Answer 22

Plasmodium falciparum
First case - uncomplicated malaria
Second case - completed malaria

Question 23

Pt is a recent immigrant from Colombia, remembers being bitten by a reijuviid bug and presents with cardiomyopathy and digestive megasyndromes.

Answer 23

Chagas Disease (Trypanosomiasis)

Question 24

Pt lives in Sub-Saharan Africa, remembers being bitten by a Glossina or Tootsie fly and presents with encephalitis.

Answer 24

African Sleeping Sickness (Trypanosomiasis)

Question 25

Pt remembers being bitten by a sanely phlebotomies and presents with fever, weight loss, splenomegaly and anemia.

Answer 25

Visceral Leishmaniasis

Question 26

Pt remembers being bitten by a sanely phlebotomies and presents with a small red papule on their skin and ulcers with raised hardened borders, but not painful.

Answer 26

Cutaneous Leishmaniasis

Leishmania Tropica, leishmania major

Question 27

Pt remembers being bitten by a sanely phlebotomies and presents with portions of ear missing. Reports having a small red papule and ulcers but ignored those.

Answer 27

Mucocutaneous Leishmaniasis

Leishmania brasiliensis

Question 28

Pt is a new mother who remembers having the flu during her first trimester and her child now has hydrocephalus and seizures. She has a cat and continued caring for it like normal while she was pregnant.

Answer 28

Toxoplasma gondii

Question 29

Pt is a contact lens wearer who presents with photophobia, decreased visual acuity, pain and redness.

Answer 29

Acanthamoeba