Parasites

Question 1

Presentation of naegleria fowleri

Answer 1

rapidly progressive, fatal meningoencephalitis

Question 2

transmission of naegleria fowleri

Answer 2

swimming in freshwater lakes, enters via cribiform plate

Question 3

diagnosis and treatment of naegleria fowleri

Answer 3

amoebas in CSF

amphotericin B (only few suriviors)

Question 4

presentation of trypanosoma brucei

Answer 4

african sleeping sickness

• lymphadenopathy
• recurrent fevers
• somnolence
• coma

Question 5

transmission of trypanosoma brucei

Answer 5

Tsetse fly

Question 6

diagnosis and treatment of trypanosoma brucei

Answer 6

trypanomastigote in blood smear

suramin (parasitaemia) and melarsoprol (CNS penetration)

Question 7

treament of malaria

• 1st line
• … if resistant?
• if life-threatening
• for P vivax/ovale​​

Answer 7

• chloroquine
• mefloquine or atovaquone/proguanil
• IV quinidine or artesunate (test G6DP deficiency)
• primaquine (for hypnozotie stage & test G6PD deficiency)

Question 8

presentation of babesia

Answer 8

babesosis - fever and haemolytic anaemia

Question 9

treatment of babesia

Answer 9

atovaquone + azithromycin

Question 10

presentation of trypanosoma cruzi

Answer 10

Chagas disease

dilated cardiomyopathy, megacolon/oegophagus, South American travel

unilateral periorbital swelling (acute phase)

Question 11

transmission of trypanosoma cruzi

Answer 11

kissing bug bite in South America

Reduviid bug

Question 12

diagnosis and treatment of trypanosoma cruzi

Answer 12

trypomastigote on blood smear

benznidazole or nifurtimox

Question 13

presentation of leishmania donovani

Answer 13

visceral leishmaniasis (kala-azar): fevers, HM, pancytopenia

cutaneous leishmaniasis: skin ulcers

Question 14

transmission of leishmania donovani

Answer 14

Sandfly

Question 15

diagnosis and treatment of leishmania donovani

Answer 15

macrophages containing amastigotes

amphotericin B, sodium stibogluconate

Question 16

what causes anal pruritis, diagnosed on tape test

Answer 16

enterobius vermicularis (pinworm)

Question 17

treatment for pinworm

Answer 17

pyrantel pamoate or bendazoles

Question 18

ileocecal valve obstruction, biliary obstruction, perforation

migrates from nose to mouth

knobbly/oval eggs seen in faeces under microscope

Answer 18

ascaris lumbricoides (giant roundworm)

Question 19

treatment of ascaris lumbricoides

Answer 19

bendazoles

Question 20

causes vomiting, diarrhoea, epigastric pain

larvae in the soil penetrate the skin

rhabditiform larvae on microscopy

Answer 20

strongyloides stercoralis

Question 21

treatment of strongyloides stercoralis

Answer 21

ivermectin or bendazoles

Question 22

cutaneous larva migrans - pruritic, serpiginous rash after contaminated beach

progress to microcytic anaemia

Answer 22

ancylostoma duodenale, Necator americanus

(hookworms)

Question 23

treatment for hookworms (ancylostoma duodenale, necator americanus)

Answer 23

bendazoles or pyrantel pamoate

Question 24

cysts on muscle fibres, leads to muscle inflammation

fever, vomiting, nausea, periorbital oedema

transmitted through undercooked meat

Answer 24

trichinella spiralis

Question 25

treatment of *trichinella spiralis*

Answer 25

bendazoles

Question 26

rectal prolapse in children

Answer 26

*trichuris trichuria* (whipworm)

Question 27

myocarditis, visual impairment and blindness, seizures and coma migrates through intestinal wall into blood stream then disseminates

Answer 27

visceral larva migrans - *toxocara canis*

Question 28

treatment of *toxocara canis*

Answer 28

bendazoles

Question 29

elephantitis 9mo - 1yr after innoculation transmission through female mosquito

Answer 29

*wushereria bancrofti*

Question 30

treament of elephantitis

Answer 30

diethylcarbamazine

Question 31

treatment of *taenia solium*

Answer 31

praziquantel

Question 32

vitamin b12 deficiency

Answer 32

*diphyllobothrium latum*

Question 33

treatment of *diphyllobothrium latum*

Answer 33

praziquantel

Question 34

hydatid cysts in liver from ingestion of eggs in food contaminated with dog faeces

Answer 34

*echinococcus granulosus*

Question 35

treatment of *echinococcus granulosus*

Answer 35

albendazole

Question 36

HSM, fibrosis, portal hypertension acutely chronic - SCC bladder and pulmonary HTN

Answer 36

*schistosoma mansoni* chronic - *schistosoma haematobium*

Question 37

treatment of *schistosoma*

Answer 37

praziquantel

Question 38

biliary tract inflammation, cholangiocarcinoma in the long term what kind of gall stone do you get?

Answer 38

*clonorchis sinensis* pigment gall stone