Human Parasitology Tutorial Problem Questions

7/27/2019 Human Parasitology Tutorial Problem Questions

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Tutorial Problem QuestionsHuman Parasitology

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Q.1: A young child presented with an enlarging head, left sided microphthalmia

(Abnormal smallness of the eye), seizures and brain calcifications.

a. What parasitic organism is likely to cause such pathology?

b. What caused the microphthalmia?

c. How did this child become infected?

d. What signs and/or symptoms might the mother demonstrate?

Q.2: An indigent Mexican mother presented a two and one-half year old child toan Emergency Room after a 6 week illness characterized by fever, irritability,anorexia and weight loss. Physical examination revealed fever, wasting and ahuge tender liver. A chest X-ray demonstrated an elevated right hemidiaphragm,

CAT scan of the patients liver.

a. What is the diagnosis?

b. What can you conclude from the CATscan?

c. What is the drug of choice?

d. Do such patients always show intestinalparasites when they present with liverabscesses?


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Q.3 A young Honduran female patient presented with a huge cutaneous ulcerinvolving the right shoulder. She had been involved in an agricultural clearance

project in the interior of the country.

a. What parasite/s might cause such a lesion?

b. How is the infection usually acquired?

c. How might the parasite reach the skin?


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Q.4 A 32 year old Brazilian immigrant male with a long history of cardiacarrhythmia died suddenly. Autopsy revealed an apical left ventricular aneurysm

and severe cardiac inflammatory reaction around nestsof very small organisms.


b. How is this disease usually acquired?

c. What other organ systems may be involved?

d. Are other mammals susceptible? How is this important to the humancondition?


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Q.5 A 25 year old, white male presented to the Emergency Room with classicalsigns and symptoms of appendicitis, which had become progressively worse over

a period of 48 hours. An appendectomy was performed with removal of aseverely necrotic appendix.

Organism removed from the appendix(~12 um diameter).


b. How is infection acquired?

c. What complication commonly follows

such surgery assuming the patient has

had no appropriate medication?

d. What is appropriate medical therapy?


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Q.6 A middle aged female patent presented with flatulence and intermittentdiarrhoea. She also complained of frequent bouts of tiredness. A stool analysis

revealed 1000s of 15um long cysts:

Photomicrograph of cyst

What is the parasite involved?

How was the infection acquired?

What epidemiological intervention is indicated?

How are infections treated?


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Q.7A barely conscious 6 year old Ugandan male was presented by his mother

with intermittent fever (every day or so), significant weight loss, severe anaemia.A thick blood file revealed the following parasitological result.

What is your diagnosis?

Why do fevers occur every day rather thanevery 2-3 days (as expected?)

What is the main chemotherapeutic agent?

What are the main obstacles to control?


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Q.8A 54 year old Puerto Rican male presented to Emergency Room short of

breath, feverish and coughing. Examinations revealed right-sided cardiacenlargement and reticular-nodular markings in the lung. He was admitted but

died within the week. Autopsy showed an unusual liver. Multiple

pseudotubercles were present in the liver (photograph) and lungs. Right-sidedcardiac enlargement was confirmed.

What pathogenic sign does the liver show?

What caused this patients pulmonary and cardiac problems?

What simple test might have been performed that would have suggested

the right diagnosis?

What therapy might have saved the patients life had it been prescribedearlier?


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Q.9

A 7 year old Italian-born female fell down, unconscious, but recoveredquickly. This was followed by a week of vomiting. One month later she

developed headaches, intermittent drowsiness, and convulsions. She presented

to an Emergency Room, where physical examination showed neck stiffness,hyperactive knee jerks, a positive Kernig sign and a Babinski reflex. The patientwent into a deep coma with occasional involuntary motions. She died two dayslater.

At autopsy, a 250 gram, 5 by 10 cm white-walled cyst (arrow) bulged out ofthe cerebrum....

a. Diagnosis please?

b. In what organs are these cysts usually found?

c. How is the infection acquired?

d. What therapy is appropriate?


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Q.10

A four year old child was brought to the medical clinic with signs andsymptoms of acute small bowel obstruction. The child was transported to

hospital, but died the following day. An autopsy was performed, this revealed...

What parasitic infection may induce small bowel obstruction

How is this infection acquired?

What therapies are appropriate?

Why do children suffer the greatest morbidity.

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A Jamaica man was brought to the Emergency Room because of analarming serpiginous track on his arm. The lesions itched continuously, and

were painful to touch. He had just returned from holiday where he spentconsiderable period relaxing on public beaches, and had observed stray dogs on

the beach.

Diagnosis please


What therapy is appropriate?

Why are dogs and cats not permitted on beaches in resort areas?


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Q.12A 22 year old Italian born male was pronounced DOA at the Emergency

Room. He had been in perfect health until he married two days earlier. Heexpired suddenly during intercourse. Photograph shows a transacted cyst which

has separated from the surrounding kidney parenchyme.

Diagnosis please


What are the two mechanisms most likely to kill patients infected with this

parasite?

Q.13


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An adult male presented with complaints of multiple seizures. Physicalexamination was remarkable for the presence of multiple, pearl-like

subcutaneous nodules.

What larval parasite is pearl-like in size and induces seizures when

appropriately placed in the brain?

How is infection acquired?

What imaging modalities are useful in suggesting the right diagnosis?

What is the drug of choice?


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Q.14A five year old child presented to the Emergency Room suffering a prolapsed

rectum. Multiple worms were seen on the mucosa.

Diagnosis please?

How was infection acquired?

What therapy is indicated?

Name 3 other clinical signs of this infection.


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Q.15A 30 plus year old Black African presented to the Emergency Room complaining

of a moving vein in his scrotum. Physical examination was almost compatiblewith a diagnosis of a varicocele. The correct diagnosis was established after

minor surgery of the scrotum and limb.

Diagnosis please?

How is the infection acquired?

What is the most common presentation of this parasite?

What is the current public health status of this parasite?


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Q.16

A routine chest X-ray revealed a single 2 cm, non-calcified nodule in theright lower love of a 45-year old hunter. This was removed surgically. Biopsy

examination revealed cross sections through adolescent parasites in the nodule.

No larvae were observed in the blood.

What type of parasite is present here?

What is the most likely candidate re. diagnosis?

What are the normal hosts of this candidates?

How is this parasite transmitted?


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Q.17

A JDF airman temporarily stationed in the Far East complained of apainless, fluctuant, moving, subcutaneous mass in his thigh. A CT scan revealed

a low-density subcutaneous round area surrounded by a thin inflammatory

reaction. The photograph shows a parasite that was surgically removed from thecutaneous mass. The anterior end is thicker than the posterior.

Diagnosis please?


How does the inflammatory host reaction change if the parasite dies?


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Q.18

A 30 year old woman presented with complaints of dyspareunia,dysmenorrhea, and lower abdominal discomfort. Physical examination revealed a

pelvic mass, which was excised. A section through the necrotic mass showed

multiple eggs that were flattened on one side...

Questions:

Diagnosis please

What sample would you send to the laboratory for diagnosis

How did this infection get to this unusual location?

What is the normal location for infections?

How is this infection usually acquired?

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Human Parasitology Tutorial Problem Questions