Medical Parasitology final revision
A) In each parasite we have to know
Habitat
Definitive host (D.H).
Reservoir host (R.H).
Intermediate host (I.M.H).
Infective stage
Methods of infection (autoinfection?, retroinfection?)
Clinical picture
Diagnostic stage
Drug of choice
Control
B) Collections
Enumerate parasites causing(………..)
(Small intestine)..diarrhea.
(Large intestine)..dysentery.
(Blood)..fever.
(Lung)..pneumonia…………..(sputum).
(C.N.S)..meningitis…………….(CSF).
(Liver)…..(hepatitis or hepatic mass).
Reticuloendothelial cells (R.E.Cs)…..lymph node (L/N)
enlargement..splenomegaly…..(smear)
(Eye) cornea(keratitis)……..corneal smear.
Blindness,exophthalmos,blindness.
Eye lid.
(Bone).
Enumerate 4 opportunistic parasites(mention complications):
Strongyloides stercoralis.
Toxoplasma.
Cryptosporidium.
Isospora belli.
Giardia.
Enumerate parasites transmitted via(……)&mention infective
stage(s):
Congenital (transplacental or vaginaldelivery).
Blood transfusion.
Water borne infection.
Fish borne infection.
Pork borne infection.
Beef borne infection.
Arthropod borne infection.
Nosocomial infection.
Sexual transmitted infection.
Skin transmitted infection.
Autoinfection.
Enumerate zoonotic parasites&mention infectivestage(s):
3 direct zoonotic parasites(Trichinella,Taenia saginata,Taenia solium).
3 saprozoonotic parasites: (Toxoplasma,visceral larva migrans (VLM),
hydatid disease,Fasciola)
3 metazoonotic parasites:
1. Paragonimus(crabs).
2. Diphylobothriummansoni(Cyclops).
3. Dipylidium caninum(man,dog ,cat fleas).
4. Hymenolepis diminuta(rat fleas).
5. Wucherariamalayi(Anopheles).
6. Loa loa(Chrysops).
7. Medina worm(Cyclops).
8. Leishmania(sand fly).
9. Trypansoma brucei (Glossina).
10.Trypansoma cruzi(Triatoma).
11.Plasmodium malariae(Anopheles).
In arthropods we should know
Breeding places
Metamorphosis
Medical importance
Disease transmitted:
a)Name of organism.
b) Method of infection
c) Type of transmission (mechanical and biological)
Arthropodes
Mosquitos(Anopheles,Culex,Aedes).
Sand fly.
Flies→Myiasis.
Fleas → chigger disease.
Lice → pediculosis
Bugs
Ticks tick paralysis
Mites
 Sarcoptes scabiei → scabies
 Demodex folliculorum → acne
 Dust mites → bronchitis,dermatitis
Crustaceans(cyclops, crabs)
CONTROL OF ARTHROPODES
Paris green.
Pyrethrum.
C) Revision
Halazoun disease.
False fascioliasis
Why avoidance of eating liver is important before stool examination for
diagnosis of fascioliasis?
Why Schistosoma japonicum is more dangerous than other types of
schistosomes?
Swimmers itch.
Why Schistosomahaematobium causes cancer bladder?
Snail control.
Copper sulphate.
Why copper sulphate must be applied every 3 months?
Rectal swab.
Compare between schistosomes eggs.
Compare between dead and living schistosomesova.
Compare between trematodes cercariae.
Compare between operculated eggs.
Why Taenia solium is more dangerous than Taenia saginata?
Why Diphylobothriumlatum causes pernicious anaemia?
Sparganosis.
Cysticercosis.
Why niclosamide is not the drug of choice for treatment of
Taeniasolium?
Compare between Taenia saginata and Taenia soliumeggs.
Compare between unilocular hydatid cyst and Coenurous cerebralis
cyst.
Casoni test.
Compare between different types of Ascaris eggs.
Why female Oxyuris causes perianal itching(pruritis ani)?
Why Trichocephalus causes 2 types of anaemia?
Compare between Ancylostoma and Trichostrongylus eggs.
Trichina capsule.
Bachman's test.
Creeping eruption.
Loffler's syndrome.
Tropical pulmonary eosinophilia(TPE) and occult filariasis.
Compare between different types of microfilariae.
Mazzoti reaction.
Skin patch test.
Uses of heterazan.
Provocative test in filarialdiseases.
Kering's sign.
Acanthamoeba keratitis .
Amoebic liver abscess.
Amoeboma.
Compare between amoebic and bacillary dysentery.
Why Balantidiumcoli has no extra intestinal spread?
Why Giardia causessteatorrhea?
Why breast fed babies are less affected by Giardia infection?
Diamond's medium.
Compare between morphology of different haemosomatic flagellates.
Oriental sore.
Espundia.
Anemia in kala azar.
Post kala-azar dermal leishmaniasis(PKDL).
Montenegro (leishmanin) test.
Winter bottom's sign.
Morula cell of mott.
Why sleeping sickness is characterized by intermittent fever?
Why there are high levels IgM in sleeping sickness?
Chagoma.
Romana's sign.
Xenodiagnosis.
What is cause of death in chagas' disease?
NNN medium.
Tropical splenomegalysyndrome(TSS).
Black water fever.
Malignant malaria.
Why Plasmodium malariae causes nephritic syndrome?
What is the difference between relapse and recrudescence in malaria?
Why relapse does not happen in Plasmodium falciparum and
Plasmodium malariae?
Why there is no liver affection in blood transfusion malaria?
Compare between different species of malaria as regards ring forms.
Compare between different species of malaria as regards schizonts.
Compare between different species of malaria as regards female
gametocytes?
Why 8- aminoquinoline is used in blood transfusion malaria inspite of
absence of liver affection?
Provocative test in malaria.
Chemoprophylaxis in malaria.
Why cats are dangerous for pregnant women(especially in first
trimester)?
Compare between true tissue cyst& pseudocyst of Toxoplasma.
Congenital toxoplasmosis(c/p &diagnosis).
Why autoinfection occurs in Cryptosporidium&absent in Isospora belli?
Compare between oocyst of cryptosporidium & Isospora.
Medical importance of arthropods.
Mosquito control(Larvicidal agents e.g. paris green…….mosquitos
repellents).
Types of transmission e.g. Transovarian transmission.
Myiasis,Jiggers disease, chigger dermatitis,tick
paralysis,scabies,Demodex folliculorum).
CASES:
Mention the name of causative parasite,infective stage(s),method of
infections,diagnostic stage(s), and treatment in the following cases:
1-Patient complains of enlarged tender liver, jaundice, eosinophilia and
increase in liver enzymes.
2-Farmer complains of painful urination and terminal haematuria.
3-Farmer complains of ascites, haematemesis, melena, splenomegaly,
piles.
4-Child ate beef and after 2 months, he complains of abdominal colic,
hunger pain, loss of weight, perianal itching and passing white segment 2
cm with or without defecation.
5-Boy complains of diarrhea associated with loss of appetite and loss of
weight and by stool examination, we found oval egg measures 30- 50 u
containing onchosphere and surrounded by translucent membrane with
filamentous bipolar thickenings.
6- Patient dealing with dogs complained of enlarged liver, X-ray showed
round space occupying lesion & by surgery we found hepatic cyst.
7-Farmer complains of abdominal colic, dyspepsia, allergy and passed
worm about 20 cm long in stool.
8-Child complains of anal itching especially at night as well
asnervousness, and nocturnal enuresis. Also his younger sibling has
similar symptoms.
9-Farmer complained of diarrhea for 7- days followed by chronic
dysentery associated with hypochromic anaemia.
10-Farmer complained of fatigue, pallor, diarrhea and microcytic
hypochromic anaemia and on stool examination showed transparent oval
egg with 4-cell stage(egg in fresh stool &larva in non fresh stool).
11-Immune suppressed patient complained of cough & dyspnea then
intermittent painless diarrhea. He died after 30 days and autopsy showed
larva in internal organs.
12-A 4- year child has puppy, he complained of hepatomegaly,
eosinophilia (21%) and hypergammaglobulinaemia.
13-Man complains of oedema and swelling of lower limbs and scrotum
with thickened rough skin associated with inguinal lymph
nodeenlargement and eosinophilia (28%).
14-Patient complained of bloody mucoid diarrhea & his stool
examinationrevealed amoeboid trophozoites and charcot-lyden crystals.
15-Child swims in local pond in hot summer, after few days, he
complained of fever, headache, runny nose, and neck rigidity.
16-A 3 -year child complained of watery diarrhea (lentil soap), flatulence
& epigastric pain.
17-Woman suffers from vaginal itching , burning of vulva, vaginal
discharge, and dyspareunia.
18-Laborer came from Jordan to Egypt, suffering from chronic multiple
skin ulcers on face & extremities. Aspiration from ulcer showed non
motile parasite (2-3u).
19-Patient complained of chills, fever & night sweat every 48 hours
associated with jaundice and low haemoglobin concentration.
20-Woman complained of repeated abortions and she gave history of
having cat in her home.
21-Immunocompromized child complained of severe watery diarrhea,
and vomiting. ZiehlNeelsen staining of stool reveals pinkish red round
cyst measure 4-6 u.
22-Child complained of ear discharge and small larva like structures
coming out of his ear.
23-Soldier complains of severe nocturnal itching at groin, elbow, neck,
wrists and interdigital spaces with scratches, red tunnels in skin with
small papular lesions in affected areas.