Final

Question 1

55. A 6-year old girl who lives in Miami has been experiencing diarrhea for about a week and
    her mother decides that it is time to see a doctor. The mother tells the physician that she has a
    habit of eating soil while playing in the park. She has no other symptoms, including fever, rash,
    etc. Because of the subtropical environment and the frequency of diagnosis for a particular
    34
    parasite, what is the most logical conclusion the doctor can come up with?
    a. Trichuris Trichiura
    b. Strongyloides stercoralis
    c. Trichinella spiralis
    d. Wuchereria bancrofti

Answer 1

a. Trichuris Trichiura

Question 2

54.
In this parasite, ________, the red blood cell ruptures, releasing the merozoites, which may
invade new red blood cells to repeat the asexual erythrocytic cycle.
a. Plasmodium ovale
b. Plasmodium vivax
c. Balantidium coli
d. Trypanosoma cruzi

Answer 2

b. Plasmodium vivax

Question 3

56. Patient X recently visited South America two weeks ago and has since developed the
    following symptoms: abdominal pain, diarrhea, cramps, weight loss, and has even begun to
    demonstrate geophagy, the craving to eat dirt. For a given intestinal biopsy sample (from
    the jejunum area) of patient X, a physician identifies a parasite containing a buccal capsule
    complete with a pair of semilunar cutting plates at the upper (ventral) side of the buccal cavity;
    the physician also notes a second, smaller set of plates on the lower side. In addition, the
    physician notes a vulva present at the anterior half of the body. Given this information, you
    diagnose the patient with which of the following?
    a. Ancylostoma duodenale
    b. Ascaris lumbricoides
    c. Necator americanus
    d. Diphyllobothrium latum

Answer 3

c. Necator americanus

Question 4

57. Which of the following flagellates live in the duodenum and often do not produce disease?
    a. Dientamoeba fragilis
    b. Giardia lamblia trophozoites
    c. Giardia lamblia cyst
    d. Chilomastix mesnili cyst

Answer 4

b. Giardia lamblia trophozoites

Question 5

58. A patient came in due to an abdominal pain and nausea. His radiograph showed cloudy
    infiltrates and nodules in his lung. After finding out that the patient ate crabs few weeks ago,
    the doctor thought that the patient could’ve been infected with Paragonimus Westermani.
    What procedure would the doctor perform next in order to confirm his thought?
    a. Blood Smear
    b. Fecal sedimentation
    c. take a urine sample
    d. MRI
    35

Answer 5

b. Fecal sedimentation

Question 6

Given that the above parasite is a Sarcocystis species, what body tissue sample of the definitive
host was being stained to obtain the picture?
a. lung tissue
b. liver tissue
c. brain tissue
d. muscle tissue

Answer 6

d. muscle tissue

Question 7

The image above depicts the ring forms of Plasmodium falciparum with multiple infections.
Which protozoan parasite(s) is this depiction not seen in? (select all that apply)
a. Plasmodium malariae
b. Plasmodium ovale
c. Plasmodium vivax
d. Plasmodium fallax

Answer 7

a. Plasmodium malariae

c. Plasmodium vivax

Question 8

61. Although malaria is a disease that has essentially been eliminated from the US, it’s still
    found worldwide. Clinical signs and observations of the parasite in thick and thin blood films are
    ideally obtained:
    a. within the first 24 hours post exposure
    b. during the infectious cycle
    c. during the fever cycle
    d. within the 24-48 hour time frame, post exposure

Answer 8

c. during the fever cycle

Question 9

62. Sporozoa are protozoa that have both a sexual and asexual phase in their life cycle. The
    asexual phase is found in the human _________ host while the sexual phase occurs in the
    __________, the Anopheles mosquito.
    a. intermediate; definitive
    b. definitive; intermediate
    c. intermediate; vector
    d. vector; definitive

Answer 9

a. intermediate; definitive

Question 10

63. Which nematode is unique in that it is best diagnosed from blood specimens collected
    between the hours of 9 P.M. and 3 A.M. because microfilariae are most prevalent in peripheral
    blood at night?
    a. Trichuris Trichiura
    b. Strongyloides stercoralis
    c. Trichinella spiralis
    d. Wuchereria bancrofti

Answer 10

d. Wuchereria bancrofti

Question 11

64. The clinical symptoms of malaria vary with the species of parasite, but all cause:
    a. diarrhea
    b. anemia
    c. malnutrition
    d. seizures
    e. none of the above

Answer 11

b. anemia

Question 12

The picture above represents eggs found in a patient’s stool sample. This organism’s eggs do
not have an operculum and contain a conspicuous lateral spine. Which organism are these eggs
from?
a. Schistosoma mansoni
b. Schistosoma japonicum
c. Schistosoma haematobium
d. Paragonimus westermani
e. None of the above

Answer 12

a. Schistosoma mansoni

Question 13

The picture above represents an organism that was coughed up in sputum from a patient. The
patient had recently returned from a trip to Asia where they consumed raw crab on multiple
occasions. The patient came to the doctor presenting tuberculosis-like symptoms. Which
organism is this?
a. Schistosoma mansoni
b. Paragonimus westermani
c. Clonorchis sinensis
d. Fasciolopsis buski
e. None of the above

Answer 13

b. Paragonimus westermani

Question 14

The above picture is of ____________ that is used for _____________ in _____________.
a. flagella; motility; protozoa
b. proglottids; reproduction; cestodes
c. proglottids; reproduction; trematodes
d. flagella; motility; trematodes
38
e. proglottids; defense and capturing food; cestodes

Answer 14

b. proglottids; reproduction; cestodes

Question 15

68. A Trichuris trichiura infection is discovered in a young adult. What is the most likely way this
    parasite was transmitted?
    a. Person to person through inhalation
    b. Ingestion of food contaminated with eggs
    c. Person to person through blood or saliva
    d. Through open wounds of the skin

Answer 15

b. Ingestion of food contaminated with eggs

Question 16

People who contract Lyme Disease after being bitten by ticks always exhibit a perfect bullseye
rash, such as the one pictured above.
True
False

Answer 16

False

Question 17

In this picture of Wucheria bancrofti microfilaria, what are the defining characteristics of this
stage of the parasite?
a. The parasite is sheathed
b. The parasite is unsheathed
c. The pattern of cell nuclei in the body
d. Both A and C
e. Both B and C

Answer 17

d. Both A and C

Question 18

71. Seven-year-old Lucas comes into the clinic with his mother complaining about gas and
    abdominal cramp pains. His mother also mentions that he has been having episodes of
    diarrhea and vomiting the last few days. At first you think it is just the stomach flu, but after
    further conversation, a recent summer trip to Costa Rica is brought up where Lucas talks about
    playing in a local lake. You go on to ask if his stools look unusual and his mother says they
    look greasy. After taking a fecal immunoassay and finding cysts, you confirm that Lucas has
    contracted:
    a. Typhus fever transmitted by a bite from a flea infestation surrounding the lake
    b. Taenia saginata from eating undercooked beef prepared near the lake
    c. Giardiasis by swallowing cysts in the lake water which had fecal contamination.
    d. River blindness by opening eyes under infested lake waters

Answer 18

c. Giardiasis by swallowing cysts in the lake water which had fecal contamination.

Question 19

72. What is the difference between Necator americanus and Ancylostoma duodenale?
    a. One is a tapeworm and one is a hookworm
    b. one is a new world hookworm and one is a old world hookworm.
    c. one uses mouthparts for attachment the other uses cilia
    d. none of the above

Answer 19

b. one is a new world hookworm and one is a old world hookworm.

Question 20

73. Sammy, a 5 year old girl living in the tropics, was rushed to the hospital due to fever and
    obstructive appendicitis. Sammy has recently been caught eating dirt around the pig farm near
    her house. Ascaris lumbricoides parasites seem to be the cause of Sammy’s symptoms. Which
    of the following is true for Ascaris lumbricoides infections?
    a. Ascaris lumbricoides parasites are prolific egg producers
    b. Pigs are the significant reservoirs of Ascaris
    c. Ascaris eggs can only be dispersed by feces or animals
    d. a and c
    e. a and b

Answer 20

e. a and b

Question 21

74. Which of the following is FALSE about Brugia malayi?
    a. causes meningitis like symptoms
    b. it is primarily found in Southeast Asia
    c. nocturnal periodicity in the blood
    d. uses mosquito vectors

Answer 21

a. causes meningitis like symptoms

Question 22

75. What is the vector for Loa loa?
    a. Tsete fly
    b. Mosquito
    c. Flea
    d. Mango fly

Answer 22

d. Mango fly

Question 23

The above image shows a sexually mature adult Echinococcus granulosus parasite, which is only
found in the \_\_\_\_ of the \_\_\_\_ host.
a. lungs; canine
b. lungs; sheep
c. small intestine; canine
d. small intestine; sheep

Answer 23

c. small intestine; canine

Question 24

Which of the following is true, regarding the Ascaris lumbricoides egg, pictured above?

a. The egg is round shaped.
b. The outer coat is albuminous and mamillated.
c. Eggs without coats may occasionally be found.
d. Both b and c are true.
e. All of the above are true.

Answer 24

d. Both b and c are true.

Question 25

1.
What blood fluke is displayed in this image that lives in the veins of the urinary bladder?
a. Schistosoma japonicum
b. Schistosoma haematobium
c. Schistosoma mansoni
d. Trichomonas vaginalis

Answer 25

b. Schistosoma haematobium

Question 26

2.
What blood fluke is displayed in this image that lives in the portal veins that drain the large
intestine?
a. Schistosoma japonicum
b. Schistosoma haematobium
c. Schistosoma mansoni
d. Trichomonas vaginalis

Answer 26

c. Schistosoma mansoni

Question 27

3.
The above photo shows a bowel obstructed by a parasitic infection. A photo of this parasite’s
egg is shown to the right. With the information given above the parasite is most likely:
15
a. Toxoplasma gondii
b. Trypanosoma brucei
c. Diphyllobothrium latum
d. Ascaris lumbricoides

Answer 27

d. Ascaris lumbricoides

Question 28

4.
What are possible ways this Enterobius vermicularis egg can be contracted by a person?
a. Ingestion and inhalation of airborne eggs
b. Bedding and night clothing containing the worm eggs
c. Contacting house dust with the eggs
d. all of the above

Answer 28

d. all of the above

Question 29

5.
The above picture is most likely a \_\_\_\_\_\_ infection of the \_\_\_\_\_\_\_\_ tissue?
a. Trypanosoma cruzi; epithelial
b. Balantidium coli; epithelial
c. Trypanosoma cruzi; cardiac
d. Balantidium coli; cardiac

Answer 29

c. Trypanosoma cruzi; cardiac

Question 30

The above picture is ______ in its diagnostic stage microfilariae in a tissue scraping from a skin

nodule. It differs from ______ microfilariae by the tail’s shape and amount of nuclei.
a. Onchocerca Volvulus; Drancunculus medinensis
b. Mansonella streptocerca; Onchocerca Volvulus
c. Onchocerca Volvulus; Mansonella streptocerca
d. Drancunculus medinensis; Mansonella streptocerca

Answer 30

c. Onchocerca Volvulus; Mansonella streptocerca

Question 31

7.
The above image is of a man with an open skin lesion on his forehead, most likely a symptom of
this disease?
a. Bilharzia
b. Angiostrongyliasis
c. Leishmaniasis
d. Fascioliasis

Answer 31

c. Leishmaniasis

Question 32

8. A mother brings her 6 year old daughter into the ER. She presents with itchy skin (hives),
   fever, and abdominal pain. After some testing, the physician finds high levels of eosinophilia.
   She is diagnosed with visceral larval migrans. How was the girl infected?
   a. Drinking a glass of contaminated water
   b. Ingesting infected soil from the local playground where many dogs are walked.
   c. Being bitten by a mosquito carrying the disease
   d. Eating an undercooked pork hotdog at the park

Answer 32

b. Ingesting infected soil from the local playground where many dogs are walked.

Question 33

9. The Leishmania parasites have two forms in their life cycle. The _________ form is the one
   that multiplies in the macrophages in humans.
   a. trypomastigote
   b. epimastigote
   c. promastigote
   d. amastigote

Answer 33

d. amastigote

Question 34

10.
Someone becomes infected with the parasite in the image above. The symptoms start out
minor, however it turns into a heavy infection, causing pneumonia, diarrhea, bowel obstruction
and perforation of the appendix. What is the parasite and the diagnosis?
a. Ascarsis Lumbricoides; Large intestinal hookworm
b. Ascarsis Lumbricoides; Large intestinal roundworm
c. Ancylostoma duodenale; Large intestinal roundworm
d. Ancylostoma duodenale; Large intestinal hookworm

Answer 34

b. Ascarsis Lumbricoides; Large intestinal roundworm

Question 35

11. Look at the image library http://dpd.cdc.gov/dpdx/HTML/ImageLibrary/Filariasis_il.htm
    and http://www.stanford.edu/class/humbio103/ParaSites2006/Lymphatic_filariasis/
    Introduction.htm and answer the question: Wuchereria bancrofti, Loa loa, Brugia malayi and
    Brugia timori: What is the difference?
    a. Wuchereria bancrofti and Loa loa have nuclei to the tip of the tail
    b. Brugia malayi and Wuchereria bancrofti are the only ones that are sheathed
    c. W. bancrofti, are sheathed, and range from approximately 245 to 300 μm and is mainly
    transmitted by Anopheles.

Answer 35

c. W. bancrofti, are sheathed, and range from approximately 245 to 300 μm and is mainly
transmitted by Anopheles.

Question 36

12. To detect certain types of parasites a blood smear has to be done. http://dpd.cdc.gov/
    dpdx/HTML/DiagnosticProcedures.htm What is the difference between a thin and a thick blood
    smear?
    a. Thick smears consist of a thick layer of dehemoglobinized (lysed) red blood cells where the
    blood elements are less concentrated, while thin smears consist of blood spread in a layer such
    that the thickness decreases towards the edge.
    b. Thick smears are more concentrated than in an equal area of a thin smear
    c. Thick smears allow for adequate species identification of malaria parasites; thin smears do
    not.
    d. Thin smears consist of a blood layer that gets thicker towards the edge, while thick smears
    are equally even in concentration.

Answer 36

b. Thick smears are more concentrated than in an equal area of a thin smear

Question 37

13. You are an intern just about to complete your first shift in the local ER, when an 18 year
    old male walks in. While the attending is examining him, you notice what looks like a string
    underneath the skin on the underside of his right foot. Having taken a parasitology class in
    your undergraduate years, you immediately know that this is a “worm” known in scientific
    terminology as…
    a. Ancylostoma braziliense
    b. Ancylostoma duodenale
    c. Ancylostoma tubaeforme
    d. Ancylostoma caninum

Answer 37

a. Ancylostoma braziliense

Question 38

14. A concerned mother brings her seven year old son into your office. He presents with
    unilateral, painless swelling around his left eye. She only shares that her son started rubbing his
    eye often about two weeks ago when they were on vacation in South America. What does this
    clinical presentation suggest are the parasite and corresponding disease?
    a. L. braziliensis, cutaneous Leishmaniasis
    b. Trypanosoma cruzi, Chagas Disease
    c. L. chagasi, cutaneous Leishmaniasis
    d. Trypanosoma brucei brucei, Chagas Disease

Answer 38

b. Trypanosoma cruzi, Chagas Disease

Question 39

15. One day at the office, you have two patients, a six year old boy attending a summer
    daycare, and a college student who returned from a backpacking trip two weeks ago, present
    with the same symptoms: They both have had prolonged diarrhea. How can this best be
    explained?
    a. No conclusions can be made until a diarrheic stool sample reveals cysts
    b. Amebic Colitis is the definite explanation and you must treat immediately to prevent the
    more serious symptoms like amebic liver abscess
    c. Both are infected with the most prevalent intestinal parasite, Giardia lamblia.
    d. Most likely these symptoms are from viral not parasitic pathogens

Answer 39

c. Both are infected with the most prevalent intestinal parasite, Giardia lamblia.

Question 40

16. There has been a recent outbreak of liver tissue becoming fibrotic, chronic diarrhea, and
    ulceration of the bile ducts in your community, with the only observed change in the habits
    of the affected being their increased consumption of watercress, water chestnut, and water
    bamboo. You suspect the affected may be infected with Fasciola hepatica or Fasciolopsis buski.
    What is your next step to differentially diagnose the infections?
    a. Take a blood sample in order to study the whether the microfilariae are sheathed or contain
    nuclei at their tips
    b. Look for the types of eggs found in fecal samples, as the eggs of Fasciola hepatica are
    characteristically yellowish and operculate
    c. Look for the eggs found in fecal samples, as the eggs of Fasciolopsis buski are
    characteristically yellowish and operculate
    d. You must inquire about patients’ history and geographical whereabouts because both eggs
    have an indistinct operculum.

Answer 40

d. You must inquire about patients’ history and geographical whereabouts because both eggs
have an indistinct operculum.

Question 41

17. Coming from the Northeast, you are now starting your residency in pediatrics at UF in the
    summer. You are surprised by the local prevalence of pruritis, or itchy skin, that school-aged
    children present with around the edges of their bathing suits. You have not seen this in your
    previous colder home and you are not surprised to learn from the attending physician that this
    rash is associated with a parasite acquired from swimming in a body of water. You are surprised
    to learn, however, that it is specifically occurs because… Pick all that apply
    a. Schistosome cercariae are killed by the host immune system
    b. The parasite can’t directly penetrates the skin.
    c. Humans are the parasites’ definitive hosts.
    d. The parasites enter the blood vessels and mature.

Answer 41

a. Schistosome cercariae are killed by the host immune system

Question 42

18. Upon suspecting a filarial infection, you take a blood smear to look for microfilariae. How
    can you differentiate between W.bancrofti and B. malayi?
    a. Ask your patients about their overseas travels, as W. bancrofti is primarily in Southeast Asia
    and B.malayi is found worldwide
    b. Look at the size, because W.bancrofti microfilariae are half the size of those of B. malayi
    c. Take samples at different times of the day, because W. bancrofti microfilarae are periodic
    and those of B.malayi are subperiodic
    d. Look at the posterior end of the microfilariae because W. bancrofti microfilariae are free of
    nuclei at the very tip and B. malayi microfilariae have nuclei at their tip.

Answer 42

d. Look at the posterior end of the microfilariae because W. bancrofti microfilariae are free of
nuclei at the very tip and B. malayi microfilariae have nuclei at their tip.

Question 43

19.
In the above photo, an adult Guinea worm (Dracunculus medinensis) is being pulled from a local
lesion. How did the infected patient most likely contract this parasite?
a. by drinking water infected D. medinensis larvae.
b. farming in soil contaminated by D. medinensis
c. a bite from the parasite’s vector, the Tsetse fly
d. by consuming improperly cooked beef infected by D. medinensis

Answer 43

a. by drinking water infected D. medinensis larvae.

Question 44

20.
The photo above shows trophozoites of Giardia lamblia attaching to what type of tissue?
a. fundic stomach
b. esophageal lymphatic nodule
c. crypts of Lieberkuhn
d. duodenal mucosa

Answer 44

d. duodenal mucosa

Question 45

21.
A heavy infection of the parasitic worm in the above photo can lead to the development of
neurocysticercosis, which can in turn cause seizures and tumor-like growths in the brain. As
infection by this organism is seldom found in predominantly Islamic nations, what is likely to be
true about a 30 year old patient who suffers from this infection?
a. His infection was alleviated upon taking prescribed Praziquantel.
b. The patient’s dietary history consists purely of vegetarian foods
c. The patient was exposed to unsanitary living conditions, especially soil contaminated with
human feces
d. The patient’s diet included freshwater crustaceans and watercress

Answer 45

a. His infection was alleviated upon taking prescribed Praziquantel.

Question 46

22. What are the two extensions called that are present on the anterior portion of this
pinworm?
21
a. Buccal Cavity
b. Cephalic alae
c. Dorsal Cilia
d. flagellum

Answer 46

b. Cephalic alae

Question 47

23.
What is this parasite and what does it cause?
a. Trichuris trichiura; blindness
b. Trichuris trichiura; rectal prolapse
c. Ascaris lumbricoides; bowel obstruction
d. Ascaris lumbricoides; dermatitis

Answer 47

b. Trichuris trichiura; rectal prolapse

Question 48

24.
What is the intermediate host of the parasite, Fasciola hepatica, shown above?
a.dog
22
b.cat
c.human
d.fish
e. semiaquatic snail

Answer 48

e. semiaquatic snail

Question 49

25.
The slide above is taken from your patient who recently traveled to India. She is complaining of
slight diarrhea and vomiting. What is her diagnosis?
a. Trypanosoma brucei
b. Trichuris trichiura
c. Ascaris lumbricoides
d. Hymenolepis nana

Answer 49

d. Hymenolepis nana

Question 50

26.
For better diagnosis, it is important to understand the function of visible structures. What is the
purpose of the four suckers above?
a. to help the Drancunculus medinensis male attach to the female during reproduction
b. to help the Drancunculus medinensis feed on the blood of its host
c. to help the Hymenolepis nana attach to the intestinal mucosa.
d. to help the Hymenolepis nana male attach to the female during reproduction

Answer 50

c. to help the Hymenolepis nana attach to the intestinal mucosa.

Question 51

In the image above you can see an example of in copula schistosomes. This occurs when the
female schistosome resides in the ____ of the male.

Answer 51

{gynecophoral canal}

Question 52

28.
The image above shows a hookworm filariform larva. These larvae are carried throughout the
body via lymphatic and blood circulation, and complete maturation in the intestine. How does
infection occur?
a. larvae are consumed through contaminated food
b. larvae penetrate the skin, especially between the toes
c. larvae are inhaled
d. larvae are injected by a vector, such as a mosquito
e. none of the above

Answer 52

b. larvae penetrate the skin, especially between the toes

Question 53

29. You encounter a child who has noticeable round patches of hair missing. You suspect the
    presence of adult worm and microfilariae of Onchocerca volvulus, as the female is known to discharge microfilariae that migrate through the skin but do not enter the bloodstream. This
    disease is known to be ________ and _________.
    a. chronic; fatal
    b. chronic; nonfatal
    c. acute; fatal
    d. acute; nonfatal

Answer 53

b. chronic; nonfatal

Question 54

30. The Digenea (flukes) have several unique characteristics used for diagnosis. Which of the
    following would NOT be a good indicator for the identification of these parasites?
    a. size
    b. flat, elongated shape
    c. Oral and ventral cup-shaped suckers
    d. all of the above are good indicators

Answer 54

a. size

Question 55

31. Fasciola hepatica, the sheep liver fluke, is a parasite found worldwide. Encysted
    metacercariae on aquatic vegetation consumed by humans, sheep or cattle, excyst, burrow
    through the intestinal wall and eventually end up in the _______, where they become adults.
    a. heart
    b. liver
    c. bile duct
    d. lungs

Answer 55

c. bile duct

Question 56

32. A patient comes to you with symptoms of diarrhea, vomiting, anorexia and general edema.
    They attempted to self-diagnose themselves and therefore tell you that they think they have a
    Fasciolopsis buski (large intestinal fluke) infection. Although the symptoms match the infection,
    you highly doubt this due to how this fluke is primarily found in ________, and the patient has
    never left the United States.
    a. Caribbean
    b. Africa
    c. Australia
    d. Asia

Answer 56

d. Asia

Question 57

Dientamoeba fragilis, pictured above, has a unique diagnostic feature as far as other flagellates.
What is it?
a. Only flagellate that forms cysts
b. Only ameboid trophozoite to have more than 1 nucleus
c. Non-pathogenic
25
d. Can only be collected from urine samples

Answer 57

b. Only ameboid trophozoite to have more than 1 nucleus

Question 58

34.
Entamoeba histolytica trophozoite, pictured above, is seen to contain five engulfed red blood cells. The
presence of these when examining a fecal sample is a diagnostic feature as no other amoeba contains
these.
True
False

Answer 58

True

Question 59

35.
From the image above. What type of worm produces this type of egg which can be found in
feces of infected individuals?
a. Threadworm
b. Pinworm
c. Hookworm
d. earthworms

Answer 59

c. Hookworm

Question 60

36. A little girl is brought into your office complaining of having a very itchy bum, pain below
    her abdomen and when she urinates, as well as something odd coming out of her vagina. You
    notice that there is scarring in the perianal region and a mucoid discharge from her vagina. You
    then decide to take cellophane tape and apply it near her anus. Next, you put the tape under a
    microscope and see the image below. What should you prescribe her?
    26
    a. cyclobendazole
    b. peperazine
    c. mebendazole
    d. pyrantel pamoate
    e. a,c
    f. b, d
    g. c, d
    h. all of the above

Answer 60

g. c, d

Question 61

37.
The image above is of Ascaris lumbricoides eggs. Ascaris lumbricoides is the largest of common
nematode parasites that infect humans. What are some characteristics of the Ascaris egg?
a. Ascaris eggs are killed by prolonged wet conditions
b. Ascaris eggs are ingested by dirt-eating or by eating raw vegetables
c. Ascaris eggs can be dispersed by animals or beetles that eat human feces
d. A and C
e. B and C
f. All of the above

Answer 61

e. B and C

Question 62

38. The image above is the egg of
Paragonimus westermani. Thin shell and thickened rim surround what structure that resembles
a lid?
a. operculum
b. egg shell
c. hood
d. lid
e. none of the above

Answer 62

a. operculum

Question 63

39.
In the picture we see a rhabditiform of a threadworm larva. The adult pathogenic female worms live
in the upper small intestine submucosal area. Therefore, the eggs are passed through the mucosa and
the rhabditiform larva hatch in the lumen to be shed in feces. However, it is possible for autoinfection
to occur if the larva hatch before passing through feces and then they can penetrate the mucosa of the
colon. Afterwards, they travel the blood lung route to return to the intestine and mature into adults.
What features are used to differentiate this rhabditiform larva of a threadworm from a hookworm?
a. blood-lung route
b. esophageal bulb
c. skin penetration
d. GI tract infection

Answer 63

b. esophageal bulb

Question 64

40. Skin lesions characterized by a macular and depigmented eruption are observed several
    years after a successful treatment of this particular disease, __________.
    a.Visceral Leishmania
    b.Chagas disease
    c.Post-kala-azar dermal leishmaniasis
    d.Espundia
    e.Cutaneous Leishmania

Answer 64

a.Visceral Leishmania

Question 65

41. A patient in Africa comes to the clinic claiming that he or she has the sleeping sickness or
African Trypanosomiasis. Which of the following species of Trypanosoma can cause disease in
humans in Africa?
a. T. brucei brucei
b. T. brucei rhodesiense
c. T. brucei gambiense
d. a and b
e. b and c
f. all of the above

Answer 65

e. b and c

Question 66

42. A 7 year old child in Mexico has been suffering from Romana sign in the eye, fever, malaise,
    anorexia, megaespohagus, and megacolon. What parasite is the cause of the symptoms?
    a. Trypanosoma cruzi
    b. Trypanosoma brucei brucei
    c. Trypanosoma brucei gambiense
    d. Trypanosoma brucei rhodesiense

Answer 66

a. Trypanosoma cruzi

Question 67

43.
You find this parasite trophozoite in a patient’s retic (young) red blood cells when you took a
blood smear. The patient has clinical malarial symptoms where their fever peaks every third
day, and they have chills, fatigue, and altered consciousness. Obviously the parasite belongs to
the Plasmodium genus, but which species could it likely have been?
29
a. P. falciparum
b. P. ovale
c. P. malariae
d. P. knowlesi

Answer 67

b. P. ovale

Question 68

44.
A woman comes into the doctor’s office with uncontrollable scratching of her genital region–
the doctor believes she has a pinworm infection. What would be the most efficient method of
obtaining the pinworm eggs in the picture above from the woman in order to properly diagnose
her with pinworms?
a. check a fecal sample for the eggs, as that was where they are most commonly found
b. check a urine sample for the eggs, as the pinworm often ejects their eggs from their hosts
that way
c. stick cellophane tape to the patient’s bottom
d. stick cellophane tape to the perianal folds of the patient.

Answer 68

d. stick cellophane tape to the perianal folds of the patient.

Question 69

45.
Which of the following was not true in regards to the Ascaris lumbricoides nematodes in the
above picture?
a. The female worm was a prolific egg producer, able to produce over 200,000 eggs per day
b. The female worm was the smaller one, the male worm was the larger worm.
c. The female worm was the larger one, the male worm was the smaller worm
30
d. The females are didelphic

Answer 69

b. The female worm was the smaller one, the male worm was the larger worm.

Question 70

46.
The eggs of that fluke were found in fecal samples of many people living in rural Hong Kong. All
of the eggs were mature upon release, with distinctive operculums upon them. The symptoms
of the patients were diarrhea, vomiting, intermittent jaundice, and prolonged low grade fever.
When questioned, all of the patients being treated were found to be from a small fishing village
that did not practice safe cooking procedures of the raw fish they caught. What fluke may have
been the problem here?
a. Clonorchis sinensis
b. Fasciolopsis buski
c. Fasciola hepatica
d. Paragonimus westermani

Answer 70

a. Clonorchis sinensis

Question 71

47. John cooks for the charity BBQ event with pork ribs and beef briskets. Many of the
    members who consumed food at this event experience abdominal discomfort and perforation
    of the intestinal wall. What is the parasite responsible for these symptoms?
    a. Taenia saginata
    b. Taenia solium
    c. Hymenolepsis nana
    d. Hymenolepsis dimmunita
    e. a and b

Answer 71

b. Taenia solium

Question 72

48. Sue is a vegan who regularly consumes watercress and tofu fresh. She washes the
    vegetables, but she never heat treats them for the fear of damaging the nutritional value. She
    initially starts to experience intense headache, fever, and backache. After a couple of weeks,
    she starts to notice abscesses and ulcers forming in her inner ear. What is the parasite causing
    these symptoms?
    a. Schistosoma
    b. Paragonimus
    c. Fasciola
    d. Opisthorchis
    e. Clonorchis

Answer 72

c. Fasciola

Question 73

49.

The above picture is of an Old World Hookworm’s [] end.

Answer 73

anterior

Question 74

Fasciolopsis buski (pictured above) is most commonly found on vegetation in:

a. North America
b. South America
c. Asia
d. Europe

Answer 74

c. Asia

Question 75

51.
When a person if positively infected with Toxoplasma gondi parasites, the trophozoites are
viewed by fluorescent microscopy in the indirect fluorescent antibody test. A negative result
of no fluorescence means the patient’s serum has no detectable antibody to T. gondi, while
a positive result of fluorescence means there was the presence of antibodies in the patient’s
serum bound to the surface of the trophozoites. Which picture has a positive result, and which
has a negative result?
a. Left=positive; right=negative
b. Left=negative; right=positive

Answer 75

a. Left=positive; right=negative

Question 76

52.
Leishmania parasites are passed to humans through the bite of the Phlebotomus sandfly. The
picture above displays the infective form of the disease, called a(n)….
a. amastigote
b. epimastigote
c. trypomastigote
d. promastigote

Answer 76

d. promastigote