MS.

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PARASITOLOGY

1. The following are typical stool collection a. Presence of bacteria in the cytoplasm
protocols: b. Unusually large size
1. Consists of three specimens c. Shape
2. Thumb sized d. Lack of defined internal structures
3. 6-10 grams
4. Collected prior to therapy May appear at first glance to be protozoan
a. 1, 2 cysts, particularly those of E. hartmanni
b. 1, 3 and E. nana
c. 1, 2, 4
d. 1, 2, 3, 4
5. In the direct examination of stool using
• Clean, watertight container with a tight- Lugol’s or D’Antoni iodine, protozoan
fitting lid
trophozoites will stain _________?
• Acceptable amount is 2 to 5 g
a. Brown
• Size of a walnut or thumb-sized
b. Black
• Stool samples from patients whose
c. Blue
therapy includes barium, bismuth, or
mineral oil should be collected prior to d. None of the above
therapy or not until 5 to 7 days after the
completion of therapy 6. An MLS finds an E. coli cyst on a wet mount
of a fresh stool specimen. Which of the
following should be done?
2. All but one can be used as a preservative for a. Request a second specimen
permanent stain: b. Look for additional E. coli cysts
a. SAF c. Examine the remaining area of the wet
b. 10% Formalin preparation
c. PVA d. Generate a final report
d. Single-vial system
Identifying multiple parasites in fecal
specimens is common, so a full examination of
Preservativ Concentratio Permanen Antige each slide is necessary.
e n t Stain n Tests
10% + − +
formalin 7. With a fecal specimen, which one of the
SAF + +* +
following is the most dependable
PVA ± + ** − procedure for the accurate, specific
Modified ± + ** ±
diagnosis of an intestinal amebic infection?
PVA (zinc) A. Direct saline wet mount
Single-vial + + ** ± B. Direct iodine wet mount
system
C. Permanently stained smear
* = Iron Hematoxylin only
D. Formalin-ethyl acetate sedimentation
** = Trichrome and Iron Hematoxylin technique

Formalin may be routinely used for direct examinations

and concentration procedures, but not for permanent The permanently stained smear is
smears. (Zeibig, 2012) especially recommended for the
identification of trophozoites,
for confirmation of species, and for
3. Elements of plant origin which resemble
keeping a permanent record of the
some parasites include:
organisms found.
1. Plant Cells/Fibers
2. Pollen grains Species identification of amebic
3. Starch granules trophozoites can rarely
4. Vegetable spirals be made from a single feature; permanent
stains enable one to observe the
a. 1, 2 cytoplasm and cytoplasmic inclusion
b. 1, 3 inclusions and the nuclear morphologic
c. 1, 3, 4 features of many cells.
d. 1, 2, 3, 4
Iron hematoxylin and trichrome are
4. The major feature that distinguishes starch commonly used stains.
cells from protozoan cysts is which of the
following?

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8. Specific gravity used in Zinc Sulfate Flotation
method
a. 1.13
b. 1.16
c. 1.18
d. 1.12
9. Oocyst of Cryptosporidium appears _____ in
Modified Acid Fast Stain
a. Blue
b. Pink
c. Green
d. Black
10. Best used for the recovery of coccidian
oocyts:
a. Zinc Sulfate Flotation
b. Sheather’s Sugar Flotation
c. Modified trichrome stain
d. Kato-katz
Boiled sugar solution preserved with phenol is
used in this method. This technique is
considered the best for the recovery of
coccidian oocysts, mainly Cryptosporidium,
Cyclospora, and Cystoisospora.
11. What are the requirements for collection of
an appropriate specimen for the optimal
detection of Trichomonas vaginalis?
a. Examine the collected specimen while it
is still fresh, when the organisms are still
motile.
b. First use a large swab to remove
secretions present, and then use a
second swab to collect the specimen.
c. Cleanse the site carefully before any
collection is done.
d. Culture at the bedside is preferred, using
chocolate agar and sheep blood agar
Motile trophozoites of T. vaginalis can be
identified microscopically in fresh urine
specimens and fresh genital secretions.
Specimens that are not examined immediately
may contain organisms; however, their
morphology generally has changed, becoming
“rounded up” and resembling a white blood
cell or a transitional epithelial cell
12. Collection of fecal samples for identification
of intestinal parasites should be done:
a. After radiologic studies using barium
sulfate have been completed
b. Before radiologic studies using barium
sulfate have been done
c. In the morning, before the patient has
bathed, defecated, or urinated
d. Before the onset of an acute phase of the
intestinal disease
Collection of stool samples for parasites
should always be done before radiologic
studies involving barium sulfate; the use of
barium will affect the sample for at least a
week.
13. Polyvinyl alcohol used in the preparation of
permanently stained smear of fecal material:
a. Concentrates egg
b. Dissolves artifact
c. Serves as an adhesive
d. Enhance stain penetration
Polyvinyl alcohol (PVA) is comprised of a
plastic powder that acts as an
adhesive for the stool specimen when
preparing slides for staining. PVA is most often
combined with Schaudinn solution, which
usually contains zinc sulfate, copper sulfate, or
mercuric chloride as a base
14. A method to culture Acanthamoeba sp. From
corneal ulcer scrapings is to inoculate:
a. McCoy cells
b. Novy, MacNeal and Nicolle (NNN)
medium
c. An agar plate overlaid with Escherichia
coli
d. Regan-Lowe medium
Currently, the most sensitive method for the
recovery of Acanthamoeba spp. from clinical
specimens is the non-nutrient agar culture
seeded with E. coli. The amoebae feed on the
bacteria; both trophozoites and cysts can be
recovered from the agar surface.
15. A formed stool is received in the laboratory
at 10:30 pm for ova and parasite exam. The
night shift technologist is certain that the
workload will prevent examination of the
specimen until 7 am when the next shift
arrives. The technologist should:
a. request that a new specimen be
collected after 7 am
b. hold the specimen at room temperature
c. examine a direct prep for trophozoites
and freeze the remaining specimen
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d. preserve the specimen in formalin until
it can be examined
Formalin has been used for many years as an
all-purpose fixative for the recovery of
protozoa and helminths
For detection of stippling, the smears should
be prepared within 1 hour after the specimen
is drawn.
Garcia L. S. & Bruckner D. A. (2020). Diagnostic medical parasitology.
Elsevier.

20. Which of the following are the characteristic

16. A liquid stool specimen is collected at 10:00
of Entamoeba histolytica?
pm and brought to the lab for culture and
1. Progressive, directional movement
ova and parasite examination. It is
2. Nonprogressive, nondirectional
refrigerated until 10:10 AM the next day,
movement
when the physician requests that the
3. Eccentrically located karyosome
technologist look for amoebic trophozoites.
4. Centrally located karyosome
The best course of action would be to:
5. Evenly distributed peripheral
a. Request a fresh specimen
chromatin
b. Perform concentration on the original
a. 1,3
specimen
b. 1,3,5
c. Perform a trichrome stain on the original
c. 1,4,5
specimen
d. 2,3,5
d. Perform a saline wet mount on the
e. 2,4
original specimen
E. histolytica E.coli
Refrigerated specimens are suitable for
Progressive, finger- Nonprogressive,
antigen testing only (CDC, 2016)
like pseudopodia blunt pseudopods
Centrally located Eccentrically located
17. Which one of these parasites should be karyosome karyosome
quantitated in the parasitology report? Fine and evenly Unevenly distributed
a. Giardia intestinalis distributed chromatin peripheral chromatin
b. Entamoeba coli
c. Trichomonas vaginalis
d. Blastocystis hominis 21. Which of the following organs of the body is
most often involved in extraintestinal
Situations in which quantitation is
important are as follows:
amebiasis
a. Lungs
a. Blastocystis hominis b. Kidneys
b. helminth eggs (Trichuris trichiura) c. Pancreas
c. Clonorchis sinensis
d. Liver
d. Schistosoma spp.
e. Plasmodium Occasionally, the parasite may spread to other
f. Babesia spp. organs (extraintestinal amebiasis), most
commonly the liver. (CDC, 2019)

18. The following are characteristic of Endolimax

nana EXCEPT: 22. Which of the following is true regarding E.
a. Blot-like karyosome hartmanni?
b. Cross-eyed cyst a. The organism is found worldwide.
c. Small race of E. histolytica b. It is generally considered a pathogen and
d. Smallest amoeba treatment is indicated.
c. It is an extraintestinal ameba.
Entamoeba hartmanni was at one time d. The life cycle requires one morphologic
designated as “small race” E. histolytica form, the trophozoite

Extraintestinal species:
19. To detect stippling, prepare films from 1. E. gingivalis
venipuncture within 2. N. fowleri
a. 1-2 minutes 3. Acanthamoeba
b. 30 minutes to 1 hour after being drawn Although some questions exist regarding the
c. 2 hours after being drawn pathogenicity (the ability to produces
d. 5-10 minutes infectious disease) of E. hartmanni, it is
generally considered a nonpathogen and
treatment is usually not indicated.

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a. CSF
b. Blood
23. A main difference between the trophozoites
c. Urine
of E. hartmanni and E. histolytica is which of
d. Stool
the following?
a. Trophozoites of E. hartmanni are smaller Microscopic examination of cerebrospinal
in size. fluid (CSF) is the method of choice for the
b. Presence of pseudopods recovery of Acanthamoeba
c. Trophozoites of E. hartmanni do not
contain ingested red blood cells. As with N. fowleri, the specimen of choice for
d. Nuclear structure and peripheral diagnosing Acanthamoeba spp. trophozoites
and cysts is CSF (Zeibig, 2012)
chromatin

Size accounts for the major difference

27. Which of the following parasite associated
between the trophozoites and cysts of
Entamoeba hartmanni and Entamoeba with AIDS
histolytica a. Cryptosporidium
b. Schistosoma
c. Babesia
24. E. histolytica infection is traditionally d. Plasmodium spp.
diagnosed by finding which of the following?
a. Adult and egg forms of the parasite in a • AIDS overall – Candida albicans
suspected stool sample • AIDS pneumonia - P. jirovecii
b. Trophozoites and/or cysts in a suspected • AIDS TB – M. avium-intracellulare complex
stool sample • AIDS Meningitis – Cryptococcus
c. Larvae in a suspected CSF sample neoformans
d. Adult form of the parasite in suspected • AIDS Dementia -Toxoplasma gondii
tissue samples • AIDS Diarrhea – Cryptosporidium parvum
• AIDS Cancer – HHV 8 Kaposi Sarcoma
With one exception, there are two
morphologic forms in the amebic life cycle—
trophozoites, the form that feeds, multiplies, 28. Which of the following is a true amoeba?
and possesses pseudopods, and cysts, the a. Endolimax nana
nonfeeding stage (Zeibig,2012) b. E. hartmanni
c. D. fragilis
Trophozoite Cyst d. I. butschlii
Feeds, multiplies Nonfeeding True amoeba has the presence of :
Delicate and fragile Thick protective cell • Peripheral chromatin
wall • Chromatoidal bar in cyst
Easily destroyed, not Cell wall allows cysts
usually transmitted to to remain viable for a
humans long period of time 29. The nucleus of this parasite is often describe
Destroyed by iodine Stains with iodine as resembling basket of flowers in shape
a. Entamoeba gingivalis
b. Entamoeba polecki
25. Which of the following prevention measures
c. Iodamoeba butschlii
can control the spread of E. histolytica?
d. Entamoeba polecki
a. Drinking tap water
b. Using human feces as fertilizer Unlike the other intestinal ameba, the
c. Boiling water or treat with iodine crystals nucleus. I. bütschlii does not undergo typical
d. Practicing unsafe sex division. The nucleus of the I. bütschlii cyst is
often described as resembling a basket of
Several steps may be taken to prevent E. flowers in shape
histolytica infections. Uncontaminated water
is essential; this may be accomplished by
boiling or treating with iodine crystals. It is 30. Cysts of Iodamoeba bütschlii typically have:
interesting to note that the infective a. Chromatoidal bars with rounded ends
(quadrinucleated) cyst is resistant to routine b. A heavily vacuolated cytoplasm
chlorination (Zeibig,2012) c. A large glycogen vacuole
d. Many ingested bacteria and yeast cells
26. In which specimen are Acanthamoeba and
Naegleria usually found?

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The cyst of I. bütschlii is characterized by a
large glycogen vacuole that is seen on the wet
smear (stains brown with iodine) and on the
permanent stained smear (vacuole will appear
clear). Occasionally, the vacuole will be so
large that the organism will collapse on itself.
31. A cyst of Entamoeba polecki contains ____
nucleus
a. One
b. Two
c. Three
d. Four
32. The following are not true regarding Giardia
lamblia EXCEPT:
a. Sensitive to routine chlorination
b. Has a total of 4 flagellas
c. Unsymmetrical protozoan
d. Shed in the stool in showers
G. lamblia is a bilaterally symmetrical parasite
that has 4 pairs of flagella. Its cysts are
resistant to routine chlorination.
It is important to note that Giardia is often
shed in the stool in showers, meaning that
many organisms may be passed and recovered
on one day’s sample and the following day’s
sample may reveal no parasites at all.
33. This amoeba is difficult to find in stool
because of its ability to blend in with the
background material of the sample
a. Acanthamoeba
b. Dientamoeba fragilis
c. Giardia lamblia
d. Trichomonas spp.
34. Human can be infected by Babesia through
a. Blood transfusion
b. Bite of sandfly
c. Ingestion of pork
d. None of the above
35. All of the following are true regarding P.
malariae EXCEPT:
a. Symptom periodicity: 72 hours
b. Infects old RBC
c. Presence of Ziemann’s dots
d. Infects young RBC
Manila Zoo = Malariae – Ziemann’s dots
Orange Juice = Ovale – James’ dots
Vilma Santos = Vivax – Schuffner’s Dots
Ferdinand Marcos = Falciparum – Maurer’s
dots
P. malariae = Infects old RBC = Matanda
P. vivax and ovale = Infects young RBC = VOTA
P. falciparum = Infects all RBC
36. Which species of Plasmodium is
characterized by the presence of Schuffner's
dots in the infected erythrocytes?
a. Plasmodium falciparum
b. Plasmodium knowlesi
c. Plasmodium malariae
d. Plasmodium ovale
The RBCs tend to be enlarged (young RBCs),
Schüffner’s dots (also known as James
stippling) are present from the beginning of
the cycle, the developing rings are less
ameboid than those of P. vivax, and the
mature schizont contains an average of eight
merozoites.
37. A Giemsa-stained thick blood film showed
many ring forms with no older stages, and a
number of a rings had double chromatin
dots. These findings are characteristic of
a. Plasmodium falciparum
b. Plasmodium vivax
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c. Plasmodium malariae
d. Plasmodium ovale
41. Which of the following is the vector for
P. falciparum infections tend to produce a Babesia?
large number of rings that frequently have a. Fleas
double chromatin, which is only occasionally b. Lice
found in other species. P. falciparum differs c. Ticks
from other plasmodia of humans in that only d. Mosquitoes
early trophozoites (ring forms) and
gametocytes are found in peripheral blood
42. Which organism is predominantly
except in severe cases. Sex differentiation of
responsible for visceral larva migrans
the gametes, when present, is difficult
a. A. braziliensis
b. O. volvulus
38. Early ring stages of the fifth human malaria, c. Toxocara canis
Plasmodium knowlesi, resemble those of: d. Trypanosoma brucei
a. Plasmodium malariae
b. Plasmodium ovale Animal ascaris
c. Plasmodium falciparum
TOXOCARA CANIS = VISCERAL LARVA
d. Plasmodium vivax
MIGRANS
TOXOCARA CATI = OCULAR LARVA MIGRANS
39. Babesia is an organism that has been
implicated in disease from both
splenectomized and nonsplenectomized
patients. Morphologically, the parasites
resemble:
a. Plasmodium falciparum rings
b. Leishmania donovani amastigotes
c. Trypanosoma cruzi trypomastigotes
d. Plasmodium vivax developing rings

43. This type of trophozoite is usually found in

The trophozoites of Babesia can mimic P.
a. P. falciparum
falciparum rings. The ring forms of Babesia
tend to be very pleomorphic and range in b. P. malariae
size, even within a single RBC. c. P. vivax
d. P. ovale
The diagnostic tetrads, the Maltese Cross,
though not seen in every specimen or 44. Cryptosporidium has the following
species, may be present characteristics:
I. Stains red with acid fast stain
II. Zoonotic transfer to humans
III. Spread by fecal-oral route

a. I, III
b. II
c. I, II
d. I, II, III

Zoonotic and anthroponotic transmission of C.

40. Individuals who lack the Duffy antigen on the
surface of their red blood cells are protected
against which species of Plasmodium
a. P. falciparum
b. P. vivax
c. P. malariae
d. P. ovale
The Duffy antigen is the receptor for
Plasmodium vivax (as well as Plasmodium
knowlesi); therefore loss of the receptor
affords some protection against infection.
parvum and anthroponotic transmission of C.
hominis occur through exposure to infected
animals or exposure to water contaminated by
feces of infected animals (CDC, 2023)
45. Potential problems using EDTA anticoagulant
and holding the blood too long prior to
preparation of thick and thin blood films
include:
a. Changes in parasite morphology, loss of
organisms within several hours, and poor
staining

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b. Loss of Schüffner’s dots, poor adherence of

the blood to the glass slide, and parasites 49. The specimen of choice for L. tropica
beginning the vector cycle within the tube of complex:
blood A. CSF
c. Neither A nor B B. Fluid underneath the ulcer bed
d. All of these option C. Blood
D. Tissue biopsy
There are many changes that occur if blood is
held longer than 1–2 hours prior to thick and The laboratory diagnosis of L. tropica consists
thin blood film preparation. These include of microscopic examination of Giemsa-stained
changes in parasite morphology, loss of slides of aspiration of fluid underneath the
parasites, poor staining, poor adherence of ulcer bed for the typical amastigotes
the blood to the slide, and the parasites
beginning that portion of the life cycle that
normally occurs within the vector. These 50. Vector of the West African Sleeping Sickness
changes are merely one reason that the a. Glossina palpalis
ordering, specimen collection, processing, b. Glossina morsitans
examination, and reporting for thick/thin c. Triatomid bug
blood films are considered STAT procedures. d. Glossina pallidipes

Parasite Vector
46. Causative agent of Black fever T.b. East African G. morsitans
a. Plasmodium falciparum rhodesiense sleeping G. pallidipes
b. Plasmodium malariae sickness
c. Leishmania donovani T.b. West African G.
d. Leishmania tropica gambiense sleeping tachinoides
sickness G. palpalis
47. Causative agent of Black water fever
a. Plasmodium falciparum
b. Plasmodium malariae
c. Leishmania donovani
d. Leishmania tropica

• Black Eschar = Cutaneous anthrax / B.

anthracis
• Black Fever = Leishmania donovani
• Black Water Fever = Plasmodium
falciparum 51. Which parasitic egg is being demonstrated
• Black rat = harbors Parastrongylus by the picture?
costaricensis a. Strongyloides stercoralis
• Black fly (Simulium spp.) = transmits O. b. Hookworms
volvulus c. Taenia
• Black dot ringworm = T. tonsurans d. Ascaris lumbricoides
• Black Piedra = Piedraia hortae

48. The best time to collect blood for

Plasmodium parasites is:
a. Between paroxysms
b. During paroxysms
c. Morning
d. Evening

The greatest number of parasites is present in

the blood in between characteristic bouts of
fever and chills resulting from the release of
merozoites and toxic waste products from
infected RBCs, known as paroxysms. Thus, this
is the optimal time to collect peripheral blood
samples to determine the presence of
Plasmodium spp. parasites 52. The image below is of a suspected parasite
seen on direct examination of material taken

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from a corneal scraping in an ophthalmology sanitation and personal hygiene practices, are
clinic. The most likely critical measures for breaking the life cycle of
identification of the parasite in this specimen A. lumbricoides (Zeibig, 2012)
is which of the following?
a. Acanthamoeba sp.
56. The specimen of choice for the recovery of
b. Enterobius sp.
Ascaris lumbricoides eggs is which of the
c. Paragonimus sp.
following?
d. Naegleria sp.
a. Stool
Morphologically, Acanthamoeba spp. b. Gallbladder biopsy
appear as a wrinkled, double-walled cyst c. Urine
and are known to cause corneal keratitis d. Sputum

53. Infective stage of Hookworms

a. Egg
b. Rhabditiform
c. Filariform
d. Adult

Hookworm S. stercoralis
Infective Filariform
Stage
Diagnostic Egg Rhabditiform
Stage

54. Trichina worm is acquired via which of the

following? 57. What parasitologic technique is being
A. Swimming in contaminated water demonstrated by the picture?
B. Consuming contaminated water a. Baermann Funnel Technique
C. Ingestion of contaminated food b. Harada-Mori
D. Inhalation of contaminated air droplets c. Knott’s Technique
d. Kato-katz
Infection is initiated after consuming
undercooked contaminated meat,
primarily striated muscle 58. This diagnostic stage of Strongyloides
stercoralis is best seen in stool using fecal
concentration techniques:
55. Which of the following are appropriate a. Eggs
Ascaris lumbricoides prevention and control b. Rhabditiform larvae
c. Filariform larvae
d. Adult worms

59. Elephantiasis is a complication associated

with which of the following?
a. Cysticercosis
b. Guinea worm
c. Hydatid cyst disease
d. Filariae

Elephantiasis - Enlargement of skin and

subcutaneous tissue

strategies? Calabar swellings - transient swelling of

a. Proper water treatment subcutaneous tissues
b. Appropriate food handling
c. Use of insect repellent
d. Proper sanitation practices
60. Characteristics of the rhabditiform larvae of
The avoidance of using human feces as Strongyloides stercoralis include a:
fertilizer, as well as exercising proper

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A. Short buccal capsule and large genital
primordium
B. Long buccal capsule and pointed tail
C. Short buccal capsule and small genital
primordium
D. Small genital primordium and notch in tail
Hookworm Threadworm
Buccal Long Short
Cavity
Genital Small Large
primordium
Tail Pointed Notched
Sheath Sheathed Unsheathed
61. Ground itch occurs in infections
hookworms at the
a. Site of larval penetration of the skin
b. During larval migration
c. Allergic reaction
d. A and C
Patients who are repeatedly infected may
develop intense allergic itching at the site of
hookworm penetration, a condition known as
ground itch (Zeibig, 2012)
62. Migration of larva through the skin can
sometimes produce allergic reactions called
larva migrans; this is associated with
A. Strongyloides stercoralis
B. Dracunculus medinensis
C. Onchocerca volvulus
D. Loa loa
63. Decontamination of drinking water, fruits,
and vegetables before consumption is
necessary in countries w/o well-developed
public sanitation. Which of the following
diseases would probably be least affected by
the kind of precaution?
a. Amebiasis
b. Ascariasis
c. Filariasis
d. Giardiasis
Microfilariae: Bite of an infected arthropod
Amebiasis: Ingestion of cyst
Ascariasis: Ingestion of ova
Giardiasis: Ingestion of contaminated water
64. A stool specimen for ova and parasite
examination contained numerous
rhabditiform larvae. Which factor(s) aid in
the identification of larvae?
a. Larva tail nuclei and presence of sheath
b. Length of the buccal cavity and
appearance of the genital primordium
c. Presence of hydatid cysts
MS. A, RMT
d. Prominent kinetoplast in trypomastigote
65. Human feces is not a recommended
specimen in the detection of:
a. Strongyloides stercoralis
b. Entamoeba histolytica
c. Echinococcus granulosus
d. Ancylostoma duodenale
Definitive host: Dog
Accidental host: Human
66. Organism that can be easily identified to the
species level from the ova in fecal specimens
include:
of a. Metagonimus yokogawai, Heterophyes
heterophyes
b. Taenia solium, Taenia saginata
c. Necator americanus, Ancylostoma
duodenale
d. Paragonimus westermani, Hymenolepis
nana
67. Examination of sputum may be necessary to
diagnose infection with:
a. Paragonimus spp.
b. Trichinella spiralis
c. Wuchereria bancrofti
d. Fasciola hepatica
P. westermani adult worms are found in the
lung, and eggs may be coughed up in the
sputum. Consequently, both sputum and stool
(if the sputum containing the eggs is
swallowed) are the recommended specimens
for examination for the eggs
68. Removal and gradual retraction of the adult
gravid female worm is recommended in
infections with:
a. Ancylostoma braziliense
b. Dracunculus medinensis
c. Trichinella spiralis
d. Toxocara cati
Because there are no specific
dracunculiasis medicines available,
successful treatment typically consists of
total worm removal.
69. Which of the following is the best technique
for identifying Dientamoeba fragilis in stool?
a. Formalin concentrate
b. Trichrome-stained smear
c. Modified acid-fast–stained smear
d. Giemsa stain
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Because there is no known cyst form, the best
technique to recover and identify D. fragilis
trophozoites would be the trichrome-stained
smear
Organisms seen in direct wet mounts may
appear as refractile, round forms; the nuclear
structure cannot be seen without examination
of the permanent stained smear.
70. Plasmodium vivax and Plasmodium ovale are
similar because they:
a. Exhibit Schüffner’s dots and have a true
relapse in the life cycle
b. Have no malarial pigment and multiple
rings
c. Have true stippling, do not have a
relapse stage, and infect old red cells
d. Have a 72-hour periodicity cycle in the
RBCs
A dormant schizogony may occur in P. vivax
and P. ovale organisms, which remain
quiescent in the liver. These resting stages
have been termed hypnozoites and lead to a
true relapse, often within 1 year or up to more
than 5 years later
71. The following infection may resemble acute
appendicitis:
a. Parastrongylus costaricensis
b. Gnathostoma sp.
c. Toxocara cati
d. Parastrongylus caninum
The clinical manifestations of abdominal
angiostrongyliasis (A. costaricensis
infection) arise from the parasite’s
invasion of the gastrointestinal wall, and
may mimic those of other conditions, such
as appendicitis, Crohn’s disease, or
Meckel’s diverticulum
72. A 60-year-old Brazilian patient with cardiac
irregularities and congestive heart failure
suddenly dies. Examination of the
myocardium revealed numerous
amastigotes, an indication that the
cause of death was most likely:
a. Leishmaniasis with Leishmania
donovani
b. Leishmaniasis with Leishmania
braziliense
c. Trypanosomiasis with Trypanosoma
brucei gambiense
d. Trypanosomiasis with Trypanosoma
cruzi
T. cruzi, the cause of Chagas disease, has two
forms within the human: the trypomastigote
in the blood and the amastigote in the striated
muscle (usually cardiac muscle and intestinal
tract muscle).
73. Eye infections with Acanthamoeba spp. have
most commonly been traced to:
a. Use of soft contact lenses
b. Use of hard contact lenses
c. Use of contaminated lens care solutions
d. Failure to remove lenses while
swimming
e. Dust in the eyes
The majority of eye infections with
Acanthamoeba spp. have resulted from the
use of contaminated eye care solutions,
primarily the use of homemade saline.
It is recommended that all solutions be
discarded at the expiration date. Continued
use may increase the risk of environmental
contamination of the fluids.
74. Which specimen is the least likely to provide
recovery of Trichomonas vaginalis?
a. Urethral discharge
b. Male urine
c. Female urine
d. Stool
T. vaginalis is site specific. The organisms are
found in the urogenital tract; thus, the
intestinal tract is not the normal site for these
organisms
75. One of the following protozoan organisms
has been implicated in waterborne and
foodborne outbreaks within the United
States. The suspect organism is:
A. Pentatrichomonas hominis
B. Dientamoeba fragilis
C. Giardia lamblia
D. Balantidium coli
For a number of years, G. lamblia has been
implicated in both waterborne and
foodborne outbreaks from the ingestion
of infective cysts within contaminated
water and food
Similar question in Bailey’s
76. Enterobius vermicularis infection is
diagnosed by:
a. Identification of eggs in a concentrated
stool specimen
b. Wet prep and iodine stain of a fresh
stool specimen
c. The Baermann funnel method
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d. Cellophane tape and microscopic slide
preparation
The specimen of choice for the recovery of
E. vermicularis is a cellophane tape
preparation collected from the perianal
region of the person
suspected of infection.
77. Fluke eggs are equipped with a lid at the top
of the shell called a/an:
a. Egress
b. Operculum
c. Nodule
d. Button
78. A stool specimen was collected at 8 pm from
a patient. Following collection the specimen
was not submitted to the laboratory until 11
pm. The laboratory technologist found
larvae with a long buccal cavity and a small,
reduced genital primordium in the fecal
sample. The larvae are most likely:
a. Ancylostoma duodenale
b. Strongyloides stercoralis
c. Trichuris trichiura
d. Unable to determine
79. Ova recovered from the stool are routinely
used to diagnose infections caused by all of
the following except?
a. Necator americanus
b. Ascaris lubricoides
c. Trichinella spiralis
d. Strongyloides stercoralis
Examination of the affected skeletal
muscle is the method of choice for
recovery of the encysted larvae
80. Which of the following parasites have
migration through the lungs as part of their
lifecycle?
a. Necator americanus, Ancylostoma
duodenale, Strongyloides stercoralis
b. Giardia lamblia, Wuchereria bancrofti,
Brugia malayi
c. Enterobius vermicularis, Trichuris
trichiura, Trichinella spiralis
d. Toxocara canis, Toxoplasma gondii,
Blastocystis hominis
81. Which of the following intestinal nematodes
is transmitted through the ingestion of
infective eggs?
a. Trichostrongylus spp.
b. Ascaris lumbricoides
c. Capllaria philippinensis
d. Strongyloides fuelleborni
The eggs of A. lumbricoides require a
warm humid environment in order for the
embryonated ovum to mature and
become infective. Transmission is through
the fecal-oral route, usually through the
ingestion of eggs on contaminated
material.
82. The intestinal nematode considered capable
of vertical transmission and the potential
cause for congenital infections is:
a. Ascaris lumbricoides
b. Enterobius vermicularis
c. Trichuris trichiura
d. Ancylostoma duodenale
May be associated with vertical
transmission and congenital infections
Eosinophilia peaks in approximately 1
month in gastrointestinal phase (Bailey’s
83. A 4-year-old child presents to the physician.
The mother claims the child has been
persistently irritable and has not slept well in
approximately 2 weeks. The child attends
day care regularly, and the mother states
that the day care provider has claimed there
have been no other children complaining of
illness. A urine sample was collected, and
upon microscopic analysis an oval, flat-sided
ovum was identified. The most probable
diagnosis is:
a. Taenia solium
b. Enterobius vermicularis
c. Schistosoma japonicum
d. Ascaris lumbricoides
84. Which of the following can bypass the need
for an intermediate host?
a. D. latum
b. D. caninum
c. H. diminuta
d. H. nana
H. nana has an unusual life cycle; ingestion
of the egg can lead to the development of
the adult worm in humans, thus
bypassing the need for an intermediate
host Humans can serve as both
intermediate and definitive hosts
85. Which tapeworm cannot be identified to the
species level based on its egg morphology;
instead, proglottids must be examined?
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a. Diphyllobothrium Sheep liver / Temperature Fasciola hepatica

Liver Fluke
b. Dipylidium
Giant Liver Fluke / Fasciola gigantica
c. Hymenolepis
Tropical Liver Fluke PH: Water buffaloes
d. Taenia and cattles

Chinese Liver Fluke Clonorchis sinensis

86. Which of the following pairs of helminths
cannot be reliably differentiated by the Cat Liver Fluke Opisthorchis felineus
appearance of their eggs?
a. Ascaris lumbricoides and Necator Lanceolate/Lancet Fluke Dicrocoelium
americanus Cirrhosis/Fibrosis of the dentriticum /
b. Hymenolepis nana and H. diminuta liver lanceolala

c. Necator americanus and Ancylostoma Giant Intestinal Fluke Fasciolopsis buski

duodenale Largest fluke of man
d. Diphyllobothrium latum and Fasciola Garrison’s fluke Echinostoma ilocanum
hepatica
Von Siebold Fluke Heterophyes
Teardrop shaped fluke heterophyes
87. If the ova of this parasite are ingested by Smallest fluke of man
humans, the oncosphere form can migrate
Oriental Lung Fluke Paragonimus
through the body via the bloodstream, westermani
resulting in the condition known as Oriental Schistosomiasis Schistosoma
cysticercosis. Which of the following is or Katayama’s Disease japonicum

correct? Manson’s Blood Fluke Schistosoma mansoni

a. Taenia solium Smallest adult blood fluke
b. Entamoeba histolytica
c. Hymenolepis nana
91. Which of the following is not an appropriate
d. Clonorchis sinensis
prevention measure for cestodes?
It is important to note that the eggs of Taenia a. Controlling the flea/rat population
are identical. To speciate in the laboratory, a b. Avoiding the consumption of raw meat
gravid proglottid or scolex must be recovered or fish
and examined. c. Immunization
d. Practicing good hygiene
88. Sheathed, nuclei absent in tail: Hymenolepis diminuta: Prevention is attained
a. M. perstans primarily by controlling the mice and rat
b. B. malayi populations along with good hygiene and
c. W. bancrofti sanitation
d. Loa loa

89. In the life cycle of hermaphroditic flukes the

92. Which of the following is a characteristic of
infective stage for the snail is
Echinococcus?
a. Miracidium
a. Longest tapeworm found in humans
b. Cercariae
b. Vitamin B12 deficiency
c. Metacercariae
c. Hydatid cysts
d. Pleurocercariae
d. Cysticercus
MS RC Munoz

1. Miracidium
2. Sporocyst
3. Redia
4. Cercaria
5. Metacercaria

90. Sheep liver / Temperature Liver Fluke

a. Fasciola gigantica • Echinococcus is the smallest of all
b. Fasciola hepatica tapeworms
c. Clonorchis sinensis • D. latum’s nutritional requirements may
d. Opisthorchis felineus decrease the host’s vitamin B12 level,
resulting in megaloblastic anemia

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Largest/Longest tapeworm Diphyllobothrium
infecting man latum

Smallest tapeworm infecting Hymenolepis

man nana

93. The primary pathology associated with a D.

latum infection is which of the following?
a. Eosinophilic pneumonitis
b. Vitamin D deficiency
c. Vitamin B12 deficiency
d. Fat malabsorption

94. First intermediate host of D. latum are

a. Copepods
b. Water plants
c. Crab
d. Freshwater fish

95. Second intermediate host of D. latum are:

a. Copepods
b. Water plants
c. Crab
d. Freshwater fish

The infected copepod is ingested by

the second intermediate host, a freshwater
fish. Once inside the fish, the procercoid 98. The egg of D. latum is unique among the
develops into a pleurocercoid larva in the cestodes in that it contains which of the
muscle tissue. following?
A. An operculum and terminal knob
B. Radial striations and oncosphere
96. The only known human tapeworm with an
C. An operculum and lateral spine
operculum is:
D. A ciliated rhabditiform larva
a. Diphyllobothrium latum
b. Hymenolepis nana
99. Humans acquire infections with
c. Giardia lamblia
Diphyllobothrium latum adult worms by:
d. Schistosoma haematobium
a. Ingestion of freshwater crabs
b. Skin penetration of cercariae
97. Two helminth eggs that may resemble one
c. Ingestion of water chestnuts
another are:
d. Ingestion of raw freshwater fish
a. Diphyllobothrium latum and
Paragonimus westermani The ingestion of raw freshwater fish
b. Opisthorchis sinensis and Fasciolopsis containing the encysted larvae of D. latum will
buski result in the development of an adult
c. Taenia saginata and Hymenolepis nana tapeworm within the human intestine
d. Ascaris lumbricoides and
Trichostrongylus
100. Humans become infected with E.
Both D. latum and P. westermani eggs are multilocularis when they:
operculated and approximately the same size. a. Ingest an oncosphere from an infected
The morphology is similar, although D. latum deer
has a knob at the abopercular end and P. b. Ingest coracidia from an infected
westermani has a thickened abopercular end copepod
and shoulders into which the operculum fits. c. Ingest eggs from an infected fox
d. Ingest eggs from human feces

Echinococcus Eggs from dog

granulosus tapeworm
E. multilocularis Eggs from fox
tapeworm

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Taenia solium Eggs from human a. Albendazole

(pork) tapeworm b. Bithionol
c. Niclosamide
d. Praziquantel
101. Which of the following flukes has an
operculated flask-shaped egg with The drug of choice for Fasciola is bithionol
(praziquantel is not effective)
prominent shoulders and a knob at the
opposite end?
108. Examination of 24-hour unpreserved
a. Opisthorchis
urine specimen is sometimes helpful in the
b. Paragonimus
recovery of:
c. Fasciola
a. Trichomonas vaginalis trophozoites
d. Fasciolopsis
b. Schistosoma haematobium eggs
c. Enterobius vermicularis eggs
102. Infection with Clonorchis or Opisthorchis
d. Strongyloides stercoralis larvae
may result from eating raw or undercooked:
a. Aquatic vegetation S. haematobium blood flukes reside in the
b. Crabs veins over the bladder. When the eggs are
c. Crayfish passed from the body, they are often found in
d. Freshwater fish urine; egg viability can also be determined in
unpreserved urine
103. The eggs of Fasciola hepatica are
indistinguishable from those of:
a. Clonorchis sinensis
b. Heterophyes heterophyes
c. Opisthorchis viverrini
d. Fasciolopsis buski

The eggs of Fasciolopsis buski, which are

indistinguishable from those of Fasciola
hepatica are oval and elongated, transparent, 109. The eggs in the figure below were found
and yellow-brown with an operculum (lid) at in the urine of a Peace Corp worker who had
one end just returned to the United State after
spending 2 years in the Middle East. The eggs
104. The mode of transmission of measured about 160 mm long 60 mm wide.
schistosomal infection is by: Which of the following organisms is the most
a. Ingestion of contaminated aquatic likely identity?
vegetation a. Diphyllobothrium latum
b. Direct penetration of the skin by b. Schistosoma haematobium
cercariae c. Schistosoma japonicum
c. Ingestion of raw fish d. Schistosoma mansoni
d. Mosquito bite
MR. HUJI
105. What intermediate host is required in Mansoni Rectum
the life cycle of all trematodes? Haematobium Urinary Bladder
a. Freshwater snail Japonicum Intestine
b. Crayfish
c. Aquatic vegetation
d. Freshwater crab 110. The following are characteristic of S.
haematobium EXCEPT:
106. What is the common name for I. Found in urine specimen
Clonorchis sinensis II. Terminal spine
a. Intestinal fluke III. Causes Katayama fever
b. Kidney fluke IV. Prominent large lateral spine.
c. Lung fluke
d. Chinese liver fluke a. I, II, IV
b. I, II III
107. The drug of choice for treatment of c. I, II
Fasciola hepatica infections is: d. IV

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HTML Definitive Host Parasite

S. haematobium – terminal spine Sheep F. hepatica
S. mansoni – prominent large lateral spine Cattle/Water F. gigantica
S. japonicum – small lateral spine buffaloes
Cats Opistorchis felineus
Man Clonorchis sinensis
111. A diagnostic characteristic of the egg of
S. mansoni is:
a. A large lateral spine 116. Mode of transmission of Hookworms
b. No spine a. Ingestion
c. A pointed terminal spine b. Inhalation
d. A small lateral spine c. Skin penetration
d. B and C
112. The following can be diagnosed from
blood smear EXCEPT: 117. The typical transmission route of
a. Plasmodium spp. Paragonimus to humans consists of which of
b. Babesia microti the following?
c. Brugia malayi a. Consumption of contaminated crayfish
d. Onchocerca volvulus or crabs
b. Swimming in contaminated water
Parasites that may be recovered in blood
c. Hand-to-mouth contamination
include:
d. Walking barefoot on contaminated
1. Leishmania donovani
2. Trypanosoma spp., sandy soil
3. Plasmodium
4. Babesia spp., 118. The specimen of choice for the recovery
5. Microfilariae (except O.volvulus of Schistosoma japonicum is which of the
(skin snips)) following?
a. Tissue biopsy
b. Urine
c. Sputum
113. A fibrous skin nodule is removed from
d. Stool
the back of patient from Central America. A
microfilaria seen upon microscopic exam of
119. A systemic hypersensitivity reaction
the nodule is most likely:
caused by the presence of Schistosoma is
a. Wuchereria bancrofti
called which of the following?
b. Brugia malayi
a. Bilharziasis
c. Onchocerca volvulus
b. Katayama fever
d. Loa loa
c. Swamp fever
d. Schistosomiasis

114. The following are hermaphroditic

120. The drug of choice for treatment of
EXCEPT:
schistosome infections is:
a. Tapeworm
a. Metrifonate
b. Roundworm
b. Praziquantel
c. Flukes
c. Bilarcil
d. None of the above
d. Niclosamide
Hermaphroditic – self fertilizing
121. Which of the following is a major
Except for the schistosomes (blood flukes), contributing factor to infection with
flukes are hermaphroditic. S. japonicum?
a. Absence of animal reservoir hosts
The mature cestode is hermaphroditic b. Easily controlled snail population
c. Easily passed from person-to-person
115. What is the definitive host of Fasciola d. Large number of humans working in rice
gigantica? paddies
a. Sheep
b. Cattle/Wafter buffaloes Human schistosome infection is caused by
c. Snail fecal (and urine) contamination of small
d. Cats bodies of water that favor the growth of
the snail hosts. Infection with S.

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japonicum is especially prevalent in areas d. Human

where humans work in rice paddies.
Humans serve as accidental intermediate
hosts for E. granulosus
122. Consumption of the infective larval stage
encysted on aquatic plants that have not The definitive host, the dog or wild canine,
been cooked results in infection with: contracts the parasite by consuming infected
a. Clonorchis sinensis sheep viscera
b. Fasciola hepatica
c. Heterophyes heterophyes 126. The incorrect match between disease
d. Paragonimus westermani and symptoms is:
a. Paragonimiasis—hemoptysis
1 IH 2 IH b. Cryptosporidiosis—watery diarrhea
Snail Plant/Vegetation Fasciola c. Toxoplasmosis in compromised host—
hepatica
F. gigantica
central nervous system symptoms
Fasciolopsis d. Enterobiasis—dysentery
buski
Fish Clonorchis Infections with E. vermicularis (the pinworm)
sinensis may cause anal itching, sleeplessness, and
Opistorchis possibly some vaginal irritation or discharge;
felineus however, dysentery (bloody diarrhea) has not
H. heterophyes been associated with this infection

Crabs P. westermanni
127. The incorrect match between organism
and characteristic is:
a. Chilomastix mesnili—Shepherd’s crook
123. Kato-Katz accurate only for the following and lemon shape
EXCEPT: b. Plasmodium malariae—“band troph”
a. Hookworm c. Hymenolepis nana—striated shell
b. Ascaris d. Wuchereria bancrofti—sheathed
c. Entamoeba microfilariae
d. Schistosoma
H. nana has a thin eggshell containing a six-
Kato-katz provide quantitative diagnosis by hooked embryo (oncosphere) and polar
determining the intensity of infection filaments that lie between the eggshell and
in terms of number of helminth eggs the embryo. The striated eggshell is generally
per gram of feces associated with Taenia spp. Eggs

The procedure is useful for assessing the Pear-shaped

intensity of infection with Schistosoma and 1. Giardia lamblia
common soil-transmitted helminths like 2. Chilomastix
Ascaris, Trichuris, and hookworm 3. Trichomonas
(Belizario, 2013)
Shepherd’s crook
1. Mansonella streptocerca – tail
124. Location in host of Hymenolpis nana 2. Marburg virus
a. Urinary bladder 3. Chilomastix mesnili
b. Intestine
c. Eyes
d. Bones 128. The incorrect match between method
and method objective is:
Intestinal cestodes a. Direct wet examination—detection of
1. Taenia spp. organism motility
2. D. latum b. Knott’s concentration—the recovery of
3. H. nana operculated helminth eggs
4. H. diminuta
c. Baermann’s concentration—the
5. Dipylidium caninum
recovery of Strongyloides
d. Permanent stained fecal smear—
125. Definitive Host of E. granulosus
confirmation of protozoa
a. Dogs
b. Cow The Knott concentration is designed to allow
c. Pig the recovery of microfilariae from a blood

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specimen. Dilute formalin (2%) is used; blood A. Entamoeba histolytica cysts

is introduced into the formalin, the red cells B. Toxoplasma gondii tachyzoites
lyse, and the sediment can be examined as a C. Dientamoeba fragilis trophozoites
wet preparation or permanent stained smear D. Cyclospora cayetanensis oocysts
(Giemsa’s or hematoxylin-based stain) for the
presence of microfilariae Autofluorescence requires no stain and is
often recommended for confirmation of
Cyclospora cayetanensis oocysts
129. Microsporidial infections can be
confirmed using:
133. In some individuals, particularly those of
a. Light microscopy and modified
Scandinavian extraction, this worm can
trichrome stains
cause megaloblastic anemia
b. Phase contrast microscopy and routine
a. D. latum
trichrome stains
b. D. caninum
c. Electron microscopy and modified acid-
c. T. solium
fast stains
d. N. americanus
d. Fluorescence microscopy and
hematoxylin stains

An infection with microsporidia can be

confirmed using modified trichrome stains
(10X the normal dye content found in routine
trichrome stains) and light microscopy.

130. The crown of the scolex _____may be

smooth or armed with hook
a. Rostellum
b. Proglottids
134. A medical technologist conducted a
c. Scolex
formal ether sedimentation technique. Upon
d. Oncosphere
centrifugation 4 layers have been observed.
Tapeworms have a long, segmented, From top to bottom, the 3rd layer contains?
ribbonlike body with a specialized structure a. Ether
for attachment, or scolex, at the anterior end. b. Debris
c. Formalin
The adult tapeworm consists of a chain of egg- d. Sediment
producing units called proglottids, which
develop posteriorly from the neck region of
the scolex.

Oncosphere - larva tapeworm within an

embryonic envelope, infective stage

131. The morphologic forms recovered in

cases of pinworm infection are which of the
following? 135. Life span of D. latum
a. Eggs and adult females a. Up to 25 years
b. Adult males and females b. Usually <1 year
c. Eggs and larvae c. Many years
d. Larvae and adult males d. Up to 6 months

Up to 25 years
Although eggs are the primary morphologic 1. D. latum
form seen, adult females may also be present 2. T. saginata
if the sample is collected when the females 3. T. solium
enter the perianal region to lay their eggs
Usually <1 year
1. D. caninum
2. H. diminuta
132. Autofluorescence requires no stain and Many years
is recommended for the identification of: 1. H. nana

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Tille, Patricia M., author. (2014). Bailey & Scott's Diagnostic
Microbiology 13th ed. St. Louis, Missouri :Elsevier
Common name for D. latum are Broad or Fish
tapeworm
136. Mode of transmission of H. diminuta
a. Ingestion of dog lice
b. Ingestion of infected arthropod 140. Eggs are mature when laid EXCEPT:
c. Ingestion of pork a. Schistosoma
d. Ingestion of beef b. H. heteropyhes
c. O. felineus
D. latum Ingestion of d. Fasciola spp.
plerocercoid in
flesh of infected fish Mature when laid DESHOC
T. saginata Ingestion of beef
T. solium Ingestion of pork Schistosoma
H. nana Ingestion of Heterophyes
infected arthropod Opistorchis
Clonorchis
H. diminuta Ingestion of
Dicrocoelium
infected arthropod
Eurytema
Dipylidium Ingestion of fleas,
caninum lice
Immature when FFPE
laid Fasciola
Fasciolopsis
137. Taenia solium Paragonimus
1. Dichotomous Echinostoma
2. 15-20 lateral branches
3. Dendritic
4. 7-13 lateral branches

a. 1,3, 4
b. 1,2
c. 3,4
d. 3,2

T. solium T. saginata
7-13 lateral branches 15- 20 lateral
branches
Dendritic/Finger-like Dichotomous/tree-
like

138. Which of the following features of Taenia

saginata helps distinguish it from T. solium?
a. Egg with a radially striated wall
b. Pork tapeworm
c. Proglottid with <13 uterine branches
d. Unarmed rostellum

T. saginata T. solium
None, no rostellum With rostellum armed
hooks with 2 rows of large
and small hooklets

139. Scolex is spatulate/spoon-

shaped/almond shaped with sucking organ
called Bothria
a. Broad tapeworm
b. Dwarf tapeworm
c. Beef tapeworm
d. Dog tapeworm

D. latum’s scolex is spatulate; no rostellum or

hooklets; has 2 shallow grooves (bothria)

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Trematode Adult Location Food Source Description of Egg

Fasciola hepatica Bile ducts Freshwater vegetation Operculated, brownish-
yellow, unembryonated
Clonorchis sinensis Bile ducts Freshwater fish Operculated with
shoulders, opposite end
knob, yellow-brown,
embryonated
Opisthorchis viverrini Bile ducts Freshwater fish Operculated with
shoulders, opposite end
knob, yellow-brown,
embryonated
Paragonimus Lungs Freshwater crabs or Operculated with
westermani crayfish shoulders, thick shelled,
brownish-yellow,
unembryonated
Fasciolopsis buski Small intestine Freshwater vegetation Operculated, yellow-
brown, unembryonated
Heterophyes Small intestine Pickled or uncooked fish Operculated with slight
heterophyes opercular shoulders,
yellow-brown,
embryonated
Metagonimus yokogawai Small intestine Pickled or uncooked fish Operculated with slight
opercular shoulders,
yellow-brown,
embryonated
Reference: Tille, Patricia M., author. (2014). Bailey & Scott's Diagnostic Microbiology 13th ed. St. Louis, Missouri :Elsevier

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