Parasites ( + Protozoa)

Question 1

Hiker comes in complaining of excess flatulence, bloating, and greasy foul-smelling diarrhea. Stool O&P shows a trophozoite with two anterior sucker pads and multiple flagella. Diagnosis?

Answer 1

Giardia lamblia

Question 2

Patient comes in with RUQ pain. Biopsy shows liver abscesses with a consistency of anchovy paste. There are also flask-shaped ulcerations in the intestines presenting as bloody diarrhea. Stool O&P shows trophozoites containing endocytosed RBC. Diagnosis?

Answer 2

Entamoeba histolytica –> causes Amebiasis (if just liver) and/or called Intestinal Amebiasis (if stomach probs)

Question 3

45 year old HIV+ patient presents with severe, unrelenting watery diarrhea. Labs show unicellular, partially acid-fast staining oocyst organisms. Diagnosis?

Answer 3

Cryptosporidium

-#1 cause of severe watery diarrhea in AIDS pt’s

Question 4

45 year old HIV+ patient presents with encephalitis and CT shows ring enhancing lesions in the brain. The Pt admits to taking care of multiple cats and cleans out their litter boxes regularly. He also does not always cook his meat all the way through. Diagnosis:

Answer 4

Toxoplasma gondii

Question 5

What is the triad of symptoms for congenital Toxoplasmosis?

Answer 5

Intracranial brain calcifications + hydrocephalus + chorioretinitis

Question 6

African dude was bit by a Tsetse fly and has since had recurrent fevers, cervical and axillary lymphadenopathy, and has progressed to coma. Diagnosis?

Answer 6

Trypanosoma brucei –> causes African Sleeping Sickness

Question 7

A backpacker that goes swimming in freshwater lakes presents with nuccal rigidity, fevers, and altered mental status. Lumbar puncture of CSF shows amoebas. Diagnosis?

Answer 7

Naegleria fowleri –> causes Meningo-encephalitis

Question 8

Patient was bitten by the Reduviid bug (the kissing bug). Later in life she has megacolon, dilated esophagus, and dilated cardiomyopathy. Diagnosis?

Answer 8

Trypanosoma cruzi –> causes Chaga’s disease

Question 9

Patient presents with jaundice due to hemolytic anemia, hemoglobinuria, and other blood related symptoms. He was hiking in NC and was bit by a Ixodes tick (deer tick). A blood smear shows tetrads of trophozoites in a Maltese Cross appearance. Diagnosis?

Answer 9

Babesia

Question 10

Patient in Africa has fever, headache, anemia, and splenomegaly. He was bit by an Anopheles mosquito. Blood smear and Giemsa stain show parasites inside RBCs. His fever is cyclic in a pattern of 72 hours, with fever presenting on day 1 and day 4 (fever every three days). What is he infected with?

Answer 10

Plasmodium malariae

Question 11

Patient in Africa has fever, headache, anemia, and splenomegaly. He was bit by an Anopheles mosquito. Blood smear and Giemsa stain show parasites inside RBCs. His fever is cyclic in a pattern of 48 hours with fever on days 1, 3, and 5 (fever every other day). What is he infected with?

Answer 11

Plasmodium vivax and/or Plasmodium ovale

Question 12

Patient in Africa has fever, headache, anemia, and splenomegaly. He is exhibiting neurologic symptoms and confusion. He was bit by an Anopheles mosquito. Blood smear shows banana-shaped bodies and Giemsa stain show parasites inside RBCs. His fever is relentless with no particular pattern or regularity. What is he infected with?

Answer 12

Plasmodium falciparum

Question 13

Patient was bit by a sandfly and now has disfiguring ulcers covering the skin. Blood smear shows Amastigotes. Diagnosis?

Answer 13

Leshmania braziliensis –> causes Cutaneous Leshmaniasis

Question 14

Mediterranian/African/Middle Eastern patient presents with hyperpigmented skin spots, fever, pancytopenia, and hepatosplenomegaly. This is called Kala-azar colloquially. Diagnosis?

Answer 14

Leishmania donovani –> “Black fever”

Question 15

Female presents with inflamed cervix called “strawberry cervix” and has a burning, itchy malodorous yellow-green discharge. Wet mount shows motile trophozoites. Diagnosis?

Answer 15

Trichomonas vaginalis

Question 16

Jakob-Creutzfeldt disease & Prions - subacute encephalitis and dementia and death

Answer 16

Blah

Question 17

Parasite worm infectious will cause what bodily reactions for lab values?

Answer 17

Eosinophilia (high serum eosinophil count) and Iron defiency anemia

Question 18

This causes Pinworm and is diagnosed with the ____ test.

Answer 18

Enterobius vermicularis

-Scotch tape test

Question 19

This causes hookworm, found in the Southern US and is typically gotten due to _____

Answer 19

Ancyclostoma duodenale AND/OR Necator americanus

-Gotten by walking barefoot

Question 20

This helminthe can undergo its entire lifecycle within the human body (through autoinfection)

Answer 20

Strongyloides

Question 21

This parasite is gotten from eating undercooked meat (esp. pork or bear) and deposits cysts in striated muscle, causing fever, vomiting, periorbital edema, and severe myalgias + eosinophilia

Answer 21

Trchinella spiralis

Question 22

This helminthe is known for causing intestinal blockages especially at the iliocecal valve

Answer 22

Ascaris lumbricoides (BLOCKS YOUR LUMBAR / ASS)

Question 23

This parasite conditions has a long worm emerge from a painful ulcer in the skin (Rod of Asclepius)

Answer 23

Dracunculus medinesis

Question 24

Chick in Africa by river gets bit by a black fly and gets scattered pruritic papules with hypo and hyperpigmentation. These can float in eye and cause blindness. Diagnosis?

Answer 24

Onchocerca volvulus

Question 25

This causes Elephantiasis

Answer 25

Wuchereria bancrofti
(Lara croft can take down elephants)

Question 26

This is transmitted from a deer fly bite in Africa. Causes subcutaneous swellings called Calabar Swellings and worms can be seen migrating across the eye in the conjuctiva.

Answer 26

Loa Loa worm (African Eye Worm)

Question 27

Taeniasis is another name for Tapeworm, which leads to GI problems. T. solium has visible ____ on proglottid heads. The Taenia genus can also cause ______ in which cysts will show up on body or in brain, giving a characteristic _____ appearance of the brain on CT.

Answer 27

1. Hooks on proglottid heads
2. Neurocysticercosis
3. Swiss cheese

Question 28

This can be caused from eating undercooked fish and causes megaloblastic anemia due to Vitamin B12 (Cobalamin) deficiency

Answer 28

Diphyllobothrium latum

Question 29

These are a risk for swimmers & cause swimmers itch, which can clog portal blood flow if they go systemic. Snails are an intermediate

Answer 29

Schistosoma (a type of trematode/fluke)

Question 30

This Fluke causes biliary tract fibrosis, pigmented gallstones, and can progress to cholangiocarcinoma. Its from eating undercooked fish

Answer 30

Clonorchis sinesis