Parasitology - Entomology Revision Quiz 1

3/18/24, 12:39 PM Parasitology/entomology revision quiz 1: Attempt review | Moodle2
Started on Monday, 18 March 2024, 4:35 AM

State Finished
Completed on Monday, 18 March 2024, 4:38 AM
Time taken 2 mins 48 secs
Grade 0.00 out of 20.00 (0%)
https://moodle.gla.ac.uk/mod/quiz/review.php?attempt=4116093&cmid=2120548 1/22
Question 1
Not answered
Marked out of 1.00
Identify this organism. The approximate size is 14 µm.
List four possible complications of an infection with this organism.
This is a cyst of Entamoeba histolytica/Entamoeba dispar in a concentrated wet mount stained with iodine.
Mature Entamoeba histolytica/Entamoeba dispar cysts have 4 nuclei that characteristically have centrally-located karyosomes and fine, uniformly distributed
peripheral chromatin. Cysts usually measure 12 to 15 µm.
List four possible complications of an infection with this organism.
1. Amoebic abcess - most commonly in the liver

2. Ameoboma - chronic inflammatory mass, single or multiple, most commonly developing in the ileocaecal region, presenting as and
acute/subactue obstruction or causing an intussusception.
3. Haemorrhage - resulting in anaemia or shock
4. Post dysenteric ulcerative colitis - mimicking classical ulcerative colitis. usually resolves slowly without specific treatment
The original image can be found here: DPDx - Laboratory Identification of Parasitic Diseases of Public Health Concern
Question 2
Not answered
Marked out of 1.00
Identify this organism.

How is an established infection usually diagnosed?
Image source
This image shows an adult female of Ascaris lumbricoides
Adults of Ascaris lumbricoides are large roundworms. Females measure 20-35 cm long with a straightened tail; males are smaller at 15-31 cm and tend to have a curved
tail. Adults of both sexes possess three 'lips' at the anterior end of the body.
How is an established infection usually diagnosed?
Microscopic identification of eggs in the stool is the most common method for diagnosing intestinal ascariasis. The recommended procedure is to concentrate the
specimen prior to microscopy. Fertile eggs are oval and measure about 60 × 45 µm. The shell is transparent, is surrounded by an outer mamillated shell stained by bile
pigments and contains an unsegmented embryo. Unfertile eggs are longer and narrower (90 × 40 µm), have a thinner shell, more irregular outer covering and are found in
about two-thirds of infections, due either to a shortage or absence of males.
Where concentration procedures are not available, a direct wet mount examination of the specimen is adequate for detecting moderate to heavy infections. For
quantitative assessments of infection, various methods such as the Kato-Katz can be used. Larvae can be identified in sputum or gastric aspirate during the pulmonary
migration phase (examine formalin-fixed organisms for morphology). Adult worms are occasionally passed in the stool or through the mouth or nose and are
recognizable by their macroscopic characteristics.
The WHO definition of a heavy infection is ≥50 000 eggs/g of faeces .
Question 3
Not answered
Marked out of 1.00
Identify this organism. The approximate size is indicated on the image.

What is the treatment can be used to eliminate this organism?
Image bank
This image shows eggs of Paragonimus spp. taken from a lung biopsy stained with hematoxylin and eosin (H&E). These eggs measured 80-90 µm by 40-45
µm. The species was not identified in this case.
Paragonimus westermani eggs range from 80-120 µm long by 45-70 µm wide. They are yellow-brown, ovoid or elongate, with a thick shell, and often
asymmetrical with one end slightly flattened. At the large end, the operculum is clearly visible. The opposite (abopercular) end is thickened. The eggs are
unembryonated when passed in sputum or faeces.
What is the treatment can be used to eliminate this organism?
Triclabendazole, 20 mg/kg, in two divided doses of 10 mg/kg, to be administered on the same day, and praziquantel 25 mg/kg of body weight, 3 times a day for 3 days, are
both WHO-recommended medicines for treatment of paragonimiasis.
Source
Question 4
Not answered
Marked out of 1.00
Identify this sausage shaped organism in a thin blood smear from patient in Mozambique
Which are the life cycle stages of these parasites than can normally bee seen in blood smears?
This image shows a gametocyte of Plasmodium falciparum in a thin blood smeas. Ring-form trophozoites and an RBC exhibiting basophilic stippling can also
be seen.
Gametocytes of Plasmodium falciparum are crescent- or sausage-shaped, and are usually about 1.5 times the diameter of an RBC in length. The cytoplasm of the
macrogametocytes (female) are usually a darker, deeper blue; the cytoplasm of the microgametocytes (male) is usually more pale. The red chromatin and
pigment is more coarse and concentrated in the macrogametocytes than the microgametocytes.
Which are the life cycle stages of these parasites than can normally bee seen in blood smears?
In P. falciparum infections, typically only rings and gametocytes are seen unless the blood sat before the smears were prepared.
Image source
Question 5
Not answered
Marked out of 1.00
Identify this organism, found in the blood smear of a severely ill pregnant woman in Tanzania.
Why does this infection pose a significant risk for this patient?
This slide shows a schizont of Plasmodium falciparum in a thin blood smear.

Schizonts are rarely seen in peripheral blood of Plasmodium falciparum infections, except in severe cases. When seen, schizonts contain anywhere from 8-24
merozoites. A mature schizont usually fills about 2/3 of the infected RBC.
Why does this infection pose a significant risk for this patient?
Pregnant women are at high risk of
maternal anaemia,
increased risk of severe malaria,
retardation of foetal growth,
stillbirth
Image source
Question 6
Not answered
Marked out of 1.00
Identify this organism. The magnification is 1000x, the specimen is from a patient in Gabon.
What are the treatment options for this patient?
Image source
This image shows microfilariae of Onchocerca volvulus in tissue.
Microfilariae of Onchocerca volvulus are unsheathed and measure 300-315 µm in length. The tail tapers to a point and is often sharply bent. The nuclei do not extend to the
tip of the tail. Microfilariae typically reside in skin but may be found in blood or urine during heavy infections, or invade the eye and cause a condition known as river
blindness.
The agent of river blindness, Onchocerca volvulus, occurs mainly in Africa, with additional foci in Latin America and the Middle East.
Onchocerciasis can cause pruritus, dermatitis, onchocercomata (subcutaneous nodules), and lymphadenopathies. The most serious manifestation consists of ocular lesions
that can progress to blindness.
What are the treatment options for this patient?
The treatment of choice for onchocerciasis is ivermectin, which has been shown to reduce the occurrence of blindness and to reduce the occurrence and severity of skin
symptoms. Ivermectin kills the microfilariae (larvae), but not the macrofilariae (adult worms). There is no evidence that prolonged daily treatment provides any benefit
over annual treatment, as one dose results in a significant decrease in m
Question 7
Not answered
Marked out of 1.00
Identify this organism. The size is approximately 30 µm.

Describe the normal life cycle for these organisms?
Image source
This image shows a Taenia spp egg in an unstained wet mount.
The eggs of Taenia spp. are indistinguishable from each other, as well as from other members of the Taeniidae. The eggs measure 30-35 micrometers in
diameter and are radially-striated. The internal oncosphere contains six refractile hooks.
Describe the normal life cycle of these organisms.

Taenia solium and Taenia saginata have similar life cycles but different intermediate hosts (see image).
Image source
Question 8
Not answered
Marked out of 1.00
Identify these parasites (size approximately 2 μm by 4 μm).

List the main types of clinical syndromes this parasite can cause.
This image shows amastigotes of Leishmania sp

Leishmania amastigotes are spherical to ovoid and measure 1-5 µm long by 1-2 µm wide. They possess a large nucleus, a prominent kinetoplast, and a short axoneme, the
last of which is rarely visible by light microscopy. The organisms reside in macrophages of the host and can be found throughout the body
This slide shows a bone marrow smear from an HIV patient with visceral leishmaniasis. The parasite has been identified as Leishmania donovani.
List the main types of clinical syndromes this parasite can cause.
Human Leishmaniasis encompasses multiple clinical syndromes, most notably visceral, cutaneous, and much-cutaneous forms.
Image source
Question 9
Not answered
Marked out of 1.00
Identify these parasites.
Describe the course of an average infection with this parasite
This slide shows ring-form trophozoites of Plasmodium falciparum in a thin blood smear, exhibiting Maurer's clefts.
Ring-form trophozoites (rings) of Plasmodium falciparum are often thin and delicate, measuring on average 1/5 the diameter of the red blood cell. Rings may
possess one or two chromatin dots. They may be found on the periphery of the RBC (accolé, appliqué) and multiply-infected RBCs are not uncommon. Ring
forms may become compact or pleomorphic depending on the quality of the blood or if there is a delay in making smears. There is usually no enlargement of
infected RBCs
Maurer's clefts can be seen in Plasmodium falciparum infections containing older ring-form trophozoites and asexual stages. Maurer’s clefts are finely granular
irregular cytoplasmic particles that usually occur diffusely in red blood cells infected with the trophozoites of Plasmodium falciparum.
Maurer's clefts resemble the Schüffner's dots seen in P. vivax and P. ovale, but are usually larger and more coarse. Visualization of these structures is dependent
on the quality of the smear preparation and the pH of the Giemsa stain. Like Schüffner's dots, Maurer's clefts appear to play a role in the metabolic pathways of
the infected RBCs.
Describe the course of an average infection with this parasite
Incubation period in the liver 7-10 days

Fever usually begins 2 days later, however may precede detectable parasitaemia
At onset of fever adult has 108 parasites in body = 20-20000 parasites/l blood (0.0004-0.4% of all red cells infected)
Parasite infection is synchronous - merogony associated with fever and rigors ‘paroxysm’.
Parasite growth continues unless checked – up to 50% parasitaemia (P. falciparum), although <1% is more usual in semi-immunes.
Other species - parasitaemia stabilises between 104 - 105 parasites/l (0.2-2%)
Infections with different genotypes of the same species are common; mixed infections of different species also seen
Image source
Question 10
Not answered
Marked out of 1.00
Identify these organisms. The approximate length of each is 130 μm.

Where in the body do the adult forms of this organism reside?
These are eggs of Schistosoma mansoni in an unstained wet mount.

Schistosoma mansoni eggs are large (114 to 180 µm long by 45-70 µm wide) and have a characteristic shape, with a prominent lateral spine near the posterior
end. The anterior end is tapered and slightly curved. When the eggs are excreted in stool, they contain a mature miracidium
Where in the body do the adult forms of this organism reside?

Schistosomes ive as pairs within capillary blood vessels, in different anatomic locations depending on the species: S. mansoni, S. japonicum, S. mekongi and S.
intercalatum in the mesenteric veins and S. haematobium in the vesical plexus
The original image can be found DPDx - Laboratory Identification of Parasitic Diseases of Public Health Concern.
Question 11
Not answered
Marked out of 1.00
Identify this parasite (size approximately 25 μm)
How is this infection acquired?
This slide shows Trypansoma brucei ssp. in a thick blood smear stained with Giemsa.
The two Trypanosoma brucei subspecies that cause African trypanosomiasis, T. b. gambiense and T. b. rhodesiense, are indistinguishable morphologically. A
typical trypomastigote has a small kinetoplast located at the posterior end, a centrally located nucleus, an undulating membrane, and a flagellum running along
the undulating membrane, leaving the body at the anterior end. Trypomastigotes are the only stage found in patients. Trypanosomes range in length from 14
to 33 micrometers.
Trypanosoma brucei ssp are pleomorphic, showing a variety of forms. In the early stages of acute African trypanosomiasis, long slender trypanosomes can be
found (often dividing). In the later stages, intermediate and short trypanosomes appear.
How is this infection acquired?

Human African trypanosomiasis is a vector-borne parasitic disease. Trypanosomes are transmitted to humans by tsetse fly (Glossina genus) bites which have
acquired their infection from other humans or from animals harbouring human pathogenic parasites.
Image source
Question 12
Not answered
Marked out of 1.00
Identify these organisms. They are approximately 250-300 µm long and approximately 15-20 µm wide.
In which environment are these organisms commonly found?
Image source
These images show hookworm L1 larvae, also known as rhabditiform larvae.

Rhabditiform (L1) larvae that hatch from eggs are 250-300 µm long and approximately 15-20 µm wide. They have a long buccal canal and an inconspicuous
genital primordium.
In which environment are these organisms commonly found?
Rhabditiform larvae of hookworm are usually found in the soil. They are not normally found in stool, but may be found there is a delay in processing the stool
specimen. If larvae are seen in stool, they must be differentiated from the L1 larvae of Strongyloides stercoralis
Question 13
Not answered
Marked out of 1.00
Identify this organism in a thick blood smear of a patient in a rural clinic in Ethiopia.
What is the approximate peak parasitaemia at which fever occurs of this species? Parasites per μl of blood.
Image source
This image shows a gametocyte of Plasmodium vivax in a thick blood smear.
Gametocytes of Plasmodium vivax are round to oval and usually fill the host cell. The infected RBC is usually noticeably larger than uninfected RBCs. The cytoplasm is
usually a darker blue and contains fine pigment granules throughout. Schüffner's dots may be seen with proper staining. Small forms may also be seen, this are usually the
size of an uninfected RBC and have a paler blue, pink or grey cytoplasm.
What is the approximate peak parasitaemia at which fever occurs of this species? Parasites per μl of blood.
The parasitaemia at which fever (>37.3°C) occurs is termed the ‘pyrogenic density’. This varies considerably. The pyrogenic density for P. vivax is generally lower than that
of P. falciparum; in 76% of cases reported by Kitchen, the pyrogenic density was <100 parasites/µL.
Question 14
Not answered
Marked out of 1.00
Identify the dotted organisms on this slide. Each dot is about 4 μm long.
The travel history of this patient includes an excursion along the Amazon River. What are your concerns for this patient?
These slides show leishmania amastigotes in a biopsy section taken from lesions on the patients left ear.
This was the case of a 41-year-old woman who presented to her health care provider with ulcerative lesions on her left ear and neck. Travel history included an
excursion along the Amazon River in Brazil four months prior. She also reported numerous insect bites during her. The diagnosis was based on observing
amastigotes in the Giemsa-stained biopsy section. Amastigotes are characterized as being small spherical to ovoid structures approximately 1-5 micrometers in
length by 1-2 micrometers wide. In addition, both a nucleus and a kinetoplast must be visualised.
The travel history of this patient includes an excursion along the Amazon River. What are your concerns for this patient?
There is a risk that this patient might develop mucocutaneous leishmaniasis. This is a rare complication of cutaneous leishmaniasis in the New World presenting
in less than 5% of cutaneous leishmaniasis cases several years after cure. Bolivia, Brazil and Peru report most of the mucocutaneous cases. Initially it was
believed that only L. braziliensis caused this syndrome. The current concept is that most New World Leishmania species can cause MCL, depending on host
immune response and parasite strain among other factors. (information from Manson's Tropical Diseases, chapter 47)
Image source
Question 15
Not answered
Marked out of 1.00
Identify this organism. The size is approximately 40 µm.

What are the clinical features of an infection with this organism?
Image source
This image shows an egg of Hymenolepis nana in unstained wet mounts.

Eggs of Hymenolepis nana. These eggs are oval, with a size range of 30 to 50 . On the inner membrane are two poles, from which 4-8 polar filaments spread out
between the two membranes. The oncosphere has six hooks.
What are the clinical features of an infection with this organism?
A variety of symptoms have been attributed to H. nana infection, including abdominal pain and anorexia, as well as systemic complaints such as irritability and
headache. Eosinophilia is common. Several reports have associated infection with growth retardation. It is difficult to be certain whether these features are
truly a direct result of the parasite or whether it is acting as a marker of faecal–oral infection, insanitation and poverty, but heavy infections probably do have
significant clinical consequences.
Question 16
Not answered
Marked out of 1.00
Identify this organism (approximate size 60 µm)
What is the geographic distribution of this organism?
Image source
This image shows a fertilised Ascaris lumbricoides egg in an unstained wet mount.
Fertilised and unfertilised Ascaris lumbricoides eggs are passed in the stool of the infected host. Fertilised eggs are are rounded and have a thick shell with an external
mammillated layer that is often stained brown by bile. In some cases, the outer layer is absent (known as decorticated eggs). Fertile eggs range from 45 to 75 µm in
length. Unfertilsed eggs are elongated and larger than fertile eggs (up to 90 µm in length). Their shell is thinner and their mammillated layer is more variable, either with
large protuberances or practically none. Unfertile eggs contain mainly a mass of refractile granules.
What is the geographic distribution of this organism?
Ascaris lumbricoides is the most common human helminthic infection and has a worldwide distribution. Highest prevalence in tropical and subtropical regions, and areas
with inadequate sanitation.
Question 17
Not answered
Marked out of 1.00
Identify these structures. The image was taken at a magnification of 200x
Which species is the definite host for the organisms seen?
Image source
This images shows protoscoleces in a hydatid cyst of Echinococcus granulosus removed from lung tissue, stained with hematoxylin and eosin (H&E).
Protoscoleces are larva tapeworms contains in an echinococcal cyst. The embryo released from an egg develops a hydatid cyst, which grows to about 5–10 cm.
Once a cyst has reached a diameter of 1 cm, its wall differentiates into a thick outer, non-cellular membrane, which covers the thin germinal epithelium. From
this epithelium, cells begin to grow within the cyst. These cells then become vacuolated, and are known as brood capsules, which are the parts of the parasite
from which protoscolices bud. Often, daughter cysts also form within cysts.
Which species is the definite host for the organisms seen?

Dogs and other canids are the definitive hosts for Echinococcus spp.; humans are are only infected by the larvae after ingestion of eggs from food, water or
fomites contaminated with dog feces. Upon ingestion of the eggs by the human host, the oncospheres migrate from the intestinal lumen to other body sites
and develop into hydatid cysts. These cysts can be found in any part of the body, but are most common in the liver, lung and central nervous systems
Question 18
Not answered
Marked out of 1.00
Identify this organism. The approximate length of this organism is 100 μm.
Describe the clinical presentation(s) of an infection with this organism.
Image bank
This image shows eggs of Paragonimus spp. (lung fluke) in unstained wet mounts.
Paragonimus westermani eggs range from 80-120 µm long by 45-70 µm wide. They are yellow-brown, ovoid or elongate, with a thick shell, and often
asymmetrical with one end slightly flattened. At the large end, the operculum is clearly visible. The opposite (abopercular) end is thickened. The eggs are
unembryonated when passed in sputum or feces.
Describe the clinical presentation(s) of an infection with this organism.
Humans may become infected when they eat raw, salted, pickled, smoked, marinated, dried, partially cooked or poorly processed crustaceans, thus ingesting
the metacercariae. In humans, the earliest stages of paragonimiasis may present an elusive clinical picture, and be asymptomatic or scarcely symptomatic.
Conversely, when worms reach the lungs, symptoms may be significant and typically include chronic cough with blood-stained sputum; chest pain with
dyspnoea and fever; pleural effusion and pneumothorax are possible complications.
Symptoms and signs mimic those of tuberculosis, and paragonimiasis should always be suspected in patients with tuberculosis who are non-responsive to
treatment. Ectopic paragonimiasis may result from erratic migration of the juvenile worms: the most frequent locations include the abdominal cavity and
subcutaneous tissues and, most frequently, the brain: cerebral paragonimiasis is a severe condition that may be associated with headache, visual impairment
and epileptic seizures.
Source
Question 19
Not answered
Marked out of 1.00
Identify this organism. The approximate length is 40 mm.
How is the infection caused by this organism treated?
Image source (case 393)
This image shows a Trichuris trichiura adult.

Adult males of Trichuris trichiura are 30-45 millimeters long, with a coiled posterior end. Adult females are 35-50 millimeters with a straight posterior end. Both
sexes have a long, whip-like anterior end. Adults reside in the large intestine, cecum and appendix of the host.
This specimen was isolated from a 59-year-old female immigrant to the USA who presented at a local hospital with microcytic/hypochromic anemia and
eosinophilia. She underwent an exploratory colonoscopy during which the worm was observed and recovered. It measured 40 mm in length. Results for routine
ova-and-parasite (O&P) exams were not available.
How is the infection caused by this organism treated?

Whipworm is effectively treated with mebendazole, albendazole or ivermectin.
Mebendazole: single oral dose, 500 mg

Albendazole: single organ does 400 mg
Albendazole 400 mg plus ivermectin 200 μm/kg. Single dose
Severe infections:
Mebendazole: 100 mg twice daily, three days

Albendazole: 400 mg daily, three days
Question 20
Not answered
Marked out of 1.00
Identify this organism. The approximate length is 23 μm.
During what stage of infection would this be a diagnostic image?
This slide shows trypomastigotes of Trypanosoma cruzi in a thin blood smear stained with Giemsa. A typical trypomastigote has a large, subterminal or
terminal kinetoplast, a centrally located nucleus, an undulating membrane, and a flagellum running along the undulating membrane, leaving the body at the
anterior end. Trypanosomes measure from 12 to 30 µm in length. Trypomastigotes may be seen in cerebrospinal fluid (CSF) in central nervous system
infections.
During what stage of infection would this be a diagnostic image?
Trypansoma cruzi trypomastigotes are the only stage found in the blood of an infected person. Motile circulating trypomastigotes are readily seen on slides
of fresh anticoagulated blood during acute infection but are rarely detectable by microscopy in chronic infection.
The original image can be found here DPDx - Laboratory Identification of Parasitic Diseases of Public Health Concern

Parasitology - Entomology Revision Quiz 1

Uploaded by

Copyright:

Available Formats

You might also like

Parasitology - Entomology Revision Quiz 1

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Parasitology - Entomology Revision Quiz 1

Uploaded by

Copyright:

Available Formats

3/18/24, 12:39 PM Parasitology/entomology revision quiz 1: Attempt review | Moodle2

Started on Monday, 18 March 2024, 4:35 AM

Marked out of 1.00

Identify this organism. The approximate size is 14 µm.

List four possible complications of an infection with this organism.

List four possible complications of an infection with this organism.

1. Amoebic abcess - most commonly in the liver

Marked out of 1.00

Identify this organism.

This image shows an adult female of Ascaris lumbricoides

How is an established infection usually diagnosed?

Marked out of 1.00

Identify this organism. The approximate size is indicated on the image.

What is the treatment can be used to eliminate this organism?

Marked out of 1.00

Marked out of 1.00

This slide shows a schizont of Plasmodium falciparum in a thin blood smear.

Marked out of 1.00

This image shows microfilariae of Onchocerca volvulus in tissue.

What are the treatment options for this patient?

Marked out of 1.00

Identify this organism. The size is approximately 30 µm.

Describe the normal life cycle of these organisms.

Marked out of 1.00

Identify these parasites (size approximately 2 μm by 4 μm).

This image shows amastigotes of Leishmania sp

Marked out of 1.00

Identify these parasites.

Describe the course of an average infection with this parasite

Describe the course of an average infection with this parasite

Incubation period in the liver 7-10 days

Marked out of 1.00

Identify these organisms. The approximate length of each is 130 μm.

These are eggs of Schistosoma mansoni in an unstained wet mount.

Where in the body do the adult forms of this organism reside?

Marked out of 1.00

Identify this parasite (size approximately 25 μm)

How is this infection acquired?

How is this infection acquired?

Marked out of 1.00

These images show hookworm L1 larvae, also known as rhabditiform larvae.

In which environment are these organisms commonly found?

Marked out of 1.00

This image shows a gametocyte of Plasmodium vivax in a thick blood smear.

Marked out of 1.00

Marked out of 1.00

Identify this organism. The size is approximately 40 µm.

This image shows an egg of Hymenolepis nana in unstained wet mounts.

What are the clinical features of an infection with this organism?

Marked out of 1.00

Identify this organism (approximate size 60 µm)

What is the geographic distribution of this organism?

What is the geographic distribution of this organism?

Marked out of 1.00

Identify these structures. The image was taken at a magnification of 200x

Which species is the definite host for the organisms seen?

Which species is the definite host for the organisms seen?

Marked out of 1.00