Parasitology SIMs + Lab Manual
Parasitology SIMs + Lab Manual
Parasitology SIMs + Lab Manual
School of Medicine
Department of Parasitology
Guide questions
1. Define parasitology, tropical medicine and tropical diseases
2. What are biologic relations?
3. What are the modes of transmission of parasites?
4. Discuss the effects of a parasite on a host and vice versa.
5. How does a host respond to parasitic invasion?
6. How does parasites evade the host immune system?
7. What are the adverse effects of immune response in the host during a parasitic infection?
8. What are the major groups of medically important parasites? Give their general characteristics.
Emilio Aguinaldo Educational Corporation
School of Medicine
Department of Parasitology
Learning Objectives
1. To discuss the importance of blood, stool and body fluid analysis in medical parasitology
2. To discuss importance of tissue biopsy in medical parasitology
3. To recognize recent advances in diagnostic parasitology
4. To explain the quality assurance in a parasitology laboratory
5. To apply the techniques of diagnostic parasitology
Guide questions
1. How are blood, stool and body fluids analyzed for parasitic evaluation? Give the methods and
cite its application.
2. What are the common preservatives used for diagnostic parasitology?
3. Give the application of tissue biopsy in parasitology. Explain briefly.
4. Discuss the following diagnostic techniques and give its application.
A. Immunodiagnosis
B. Molecular diagnosis
C. Rapid diagnostic tests
5. Apply the principles of quality assurance in the performance of diagnostic techniques in
Parasitology.
Emilio Aguinaldo Educational Corporation
School of Medicine
Department of Parasitology
Guide questions
1. What are the general and specie specific characteristics of each of the pathogenic and
nonpathogenic intestinal protozoans?
2. What are the common and specie specific clinical manifestations of diseases caused by
intestinal protozoans? Explain the pathogenesis.
3. What are the diagnostic modalities and criteria required in the evaluation of intestinal
protozoan infections?
4. What are the treatment and management options in handling intestinal protozoan infections?
5. How are intestinal protozoan infections prevented and controlled?
Emilio Aguinaldo Educational Corporation
School of Medicine
Department of Parasitology
Guide questions
1. What are the general and specie specific characteristics of each blood and tissue protozoan?
2. What are the common and specie specific clinical manifestations of diseases caused by blood
and tissue protozoans? Explain the pathogenesis.
3. What are the diagnostic modalities and criteria required in the evaluation of blood and tissue
protozoan infections?
4. What are the treatment and management options in handling blood and tissue protozoan
infections?
5. How are blood and tissue protozoan infections prevented and controlled?
Emilio Aguinaldo Educational Corporation
School of Medicine
Department of Parasitology
NAME: _________________________________________________YEAR/SECTION________
Learning Objectives
1. Correlate the clinical history, physical examination, diagnostic tests and gross and microscopic
characteristics in the diagnosis of the given cases.
Evaluation
Score: __________
Emilio Aguinaldo Educational Corporation
School of Medicine
Department of Parasitology
Case 1: Amoebaiasis
A 25-year old male is complaining of vague crampy abdominal pain with loose bowel movement
characterized as bloody mucoid stools since yesterday. He self-medicated with hyoscine which only
prompted temporary relief. He admits he usually eats his lunch and supper at a kitchenette in front of his
office. Currently he is feverish and still has loose bowel movement characterized as bloody mucoid with a
fishy odor.
Guide questions
2. Discuss the diagnostic tests which may be utilized in the diagnosis of amoebiasis.
4. What are the treatment options for the different presentations of amoebiasis?
Emilio Aguinaldo Educational Corporation
School of Medicine
Department of Parasitology
Case 2: Giardiasis
A 24-year-old man visits his physician complaining of significant weight loss, flatulence, and foul-
smelling stools. He reports feeling fatigued since his return from China months previously and has
suffered abdominal cramping and intermittent loose, nonbloody stools since then. The patient’s stool ova
and parasite studies demonstrated characteristic trophozoites on two occasions. He was prescribed a
course of drug therapy and warned that consumption of alcohol during treatment could lead to nausea and
vomiting.
Guide questions
2. What are the diagnostic tests which may be utilized to diagnose giardiasis?
Case 3: Trichomoniasis
A 30-year-old woman presents to the clinic with complaints of increased frothy vaginal discharge.
She is married and is a full-time house wife. Speculum examination shows the cervix is strawberry red
with whitish discharge. A urinalysis and pap smear is done. The urinalysis showed a flagellated
trophozoite with a jerky movement while the pap smear showed flagellated trophozoites containing
siderophile granules.
Guide questions
Case 4: Balantidiasis
A 45-year-old farmer sought consult due to persistent loose bowel movement associated with crampy
abdominal pain. He has recently shifted his livelihood from mostly vegetable production to hog raising.
At presentation, he looks weak and febrile. Fecalysis and urinalysis were requested. Significant finding is
a large ciliated protozoan was noted in his stool.
Guide questions
Case 5: Malaria
While doing a rotation in Palawan, a medical student encounters a patient who has been having nearly
continuous high-grade fevers with occasional chills and sweats. Physical examination reveals a palpable
spleen. A drop of the patient’s blood placed in a copper sulfate solution reveals anemia. Over the next
few days, while waiting for medication to arrive, the patient’s level of consciousness waxes and wanes,
and he is somnolent at times.
Guide questions
1. When is the best time to get the peripheral smear in cases of suspected malaria?
2. Differentiate the five (5) species of malaria (P. knowlesi, P. malariae, P. vivax, P. ovale, P. falciparum)
according to stages found in blood, appearance of erythrocyte and appearance of parasite in thin smear.
3. Enumerate the diagnostic procedures that may be used in the diagnosis of malaria.
Intestinal Nematodes
Learning Objectives
1. To discuss characteristics and life cycle of medically important intestinal nematodes
2. To discuss pathogenesis and clinical manifestations caused by intestinal nematodes
3. To discuss the diagnostic techniques utilized in the isolation and identification of intestinal
nematodes
4. To discuss the treatment modalities and management of intestinal nematodes
5. To discuss the prevention and control of intestinal nematodes
6. To apply the concepts learned in this activity in theoretical situations.
Guide questions
1. What are the general and specie specific characteristics of each intestinal nematodes?
2. What are the common and specie specific clinical manifestations of diseases caused by
intestinal nematodes? Explain the pathogenesis.
3. What are the diagnostic modalities and criteria required in the evaluation of intestinal
nematodes infections?
4. What are the treatment and management options in handling intestinal nematodes infections?
5. How are intestinal nematodes infections prevented and controlled?
Emilio Aguinaldo Educational Corporation
School of Medicine
Department of Parasitology
Guide questions
1. What are the general and specie specific characteristics of each blood and tissue nematodes?
2. What are the common and specie specific clinical manifestations of diseases caused by blood
and tissue nematodes? Explain the pathogenesis.
3. What are the diagnostic modalities and criteria required in the evaluation of blood and tissue
nematode infections?
4. What are the treatment and management options in handling blood and tissue nematode
infection?
5. How are blood and tissue nematodes infections prevented and controlled?
Emilio Aguinaldo Educational Corporation
School of Medicine
Department of Parasitology
NAME: _________________________________________________YEAR/SECTION________
Learning Objectives
1. Correlate the clinical history, physical examination, diagnostic tests and gross and microscopic
characteristics in the diagnosis of the given cases.
Evaluation
Case 1: Ascariasis
A 45-year-old woman from Pampanga presents with diffuse, crampy abdominal pain that has persisted for
the previous 3 days. She has had no bowel movements since the pain started and has noticed a weight
loss of about 3.0 kgs over the past month. Stool sample reveals rough-surfaced eggs. Complete
blood count and liver function test results are as follows:
White blood cell (WBC) count: 16,000/mm³ Albumin: 3.0 g/dL
(30% eosinophils) Aspartate transaminase (AST): 25 IU/L
Hemoglobin: 10 g/dL Alanine transaminase (ALT): 25 IU/L
Hematocrit: 28% Alkaline phosphatase: 300 IU/L
Platelet count: 190,000/mm3 Bilirubin, total: 3.0 mg/dL
Bilirubin, direct: 3.0 mg/dL
Guide questions
Case 2: Ancylostomiasis
An 8-year-old boy is brought to the local health center by her mother. Her mother reports the boy seems
very small for his age and has been continually lethargic for quite some time. Physical examination
reveals a small boy with a thin, scaphoid abdomen. Relevant laboratory findings are as follows:
Hematocrit: 32%
Mean corpuscular volume: 70 fL
WBC count: 12,000/mm3
Differential: 30% segmented cells, 1% bands, 30% lymphocytes, 39% eosinophils
Guide questions
1. What are the different species of hookworms and how are differentiated form one another?
Case 3: Strongyloidiasis
A 26-year-old man from Tondo presents with abdominal pain and diarrhea of 4 days’ duration. He
denies nausea, vomiting, or fever. He has no sick contacts or significant travel history. A complete blood
count shows eosinophilia. A stool sample reveals larva. On further questioning, he describes that he
frequently gardens in his neighbor’s backyard barefooted.
Guide questions
1. Differentiate the rhabditiform larva and filariform larva from those of hookworms.
Case 4: Enterobiasis
A 4-year-old girl is brought to the pediatrician because of perianal itching, which is worse at night. She
attends preschool during the day, where she shares toys and play areas with other children. The patient’s
mother recalls her daughter playing with another child who had been “scratching his backside” and
wonders
if there is a connection.
Guide questions
Case 5: Trichiuriasis
A 10-year-old male presents with bloody diarrhea associated with abdominal pain, nausea and vomiting
and weight loss. He is also pale-looking and with some signs of dehydration. On physical examination,
his rectum seems to prolapse thru his anus.
Guide questions
1. What are the factors which will determine the severity of infection?
Guide questions
Case 7: Trichinosis
A 45-year-old man was admitted in emergency room for headache, fever, general muscle aches, and
weakness. Laboratory work-up on his blood specimen revealed significantly elevated eosinophilia. The
patient reported that he had gone on a camping and hunting trip the month before in the mountains. He
shot and killed a wild and brought several pounds of meat home. In the weeks before onset of symptoms,
he ate several meals that included wild boar meat.
Guide questions
1. What other diagnostic tests may be utilized to diagnose this patient adequately?
Case 8: Elephantiasis
A 52-year-old man from Mindoro presents to his physician with extreme swelling of his legs and scrotum.
The skin associated with the swollen areas is thick and scaly. The patient admits to an episode of fever
associated with enlarged inguinal lymph nodes some time ago.
Guide questions:
1. Differentiate the six (6) different species of filarial worms based on: periodicity, presence or absence of
sheath, posterior end curves and vectors.
Cestodes
Learning Objectives
1. To discuss characteristics and life cycle of cestodes
2. To discuss pathogenesis and clinical manifestations caused by medically important cestodes
3. To discuss the diagnostic techniques utilized in the isolation and identification of cestodes
infections
4. To discuss the treatment modalities and management of cestodes infections
5. To discuss the prevention and control of cestode infections
6. To apply the concepts learned in this activity in theoretical situations.
Guide questions
1. What are the general and specie specific characteristics of each cestode?
2. What are the common and specie specific clinical manifestations of diseases caused by
cestodes? Explain the pathogenesis.
3. What are the diagnostic modalities and criteria required in the evaluation cestode infections?
4. What are the treatment and management options in handling cestode infection?
5. How are cestodes prevented and controlled?
Emilio Aguinaldo Educational Corporation
School of Medicine
Department of Parasitology
NAME: _________________________________________________YEAR/SECTION________
Learning Objectives
1. Correlate the clinical history, physical examination, diagnostic tests and gross and microscopic
characteristics in the diagnosis of the given cases.
Evaluation
Case 1: Diphyllobothriasis
A nine-year-old pale Filipino girl was brought to the provincial hospital with complaints of vomiting and
loose stools that had started three days earlier. The vomit did not have a foul smell and contained no
blood or mucus, but it did contain undigested food particles. She has a history of recurrent abdominal pain
but was often treated by a traditional healer. Her diet is mostly composed of fresh fruits and fresh water
fish.
Guide questions
2. What are the first and the second intermediate hosts of Diphyllobothrium latum?
Case 2: Taeniasis/cysticercosis
A 45-year-old man who works in a pork processing plant presents to his physician with new-onset
seizures and bilateral lower extremity weakness. CT of the head reveals several calcified regions and
cystic masses but no solid mass lesion or evidence of bleeding. A complete blood count reveals mild
anemia and a WBC count of 55,000/mm3 with 15% eosinophils.
Guide questions
1. What are the infective stages of Taenia solium and Taenia saginata that occurs in man?
Case 3: Hymenolepiasis
A 24-year-old man sought medical attention from his health care provider for intermittent abdominal
cramping and mild diarrhea. A stool specimen was collected in 10% formalin. A formalin-ethyl acetate
concentration was performed and shoed a spherical egg with an inner membrane having two (2) polar
thickening from which arise 4-6 slender polar filaments. The inner membrane enclosed an embryo with 3
pairs of hooklets.
Guide questions
Case 4:Diphylidiasis
A worried mother of an 8-month-old male child sought consult because of white objects found in the
diaper of her child. On examination, it resembles rice particles and are noticeably coming out of the anus
of the child. The family has a number of pet dogs which often interacts with their child. The sample was
sent to the laboratory for microscopic analysis.
Guide questions
1. Describe the gravid proglottid and egg pockets often associated with this specie.
Guide questions
Trematodes
Learning Objectives
1. To discuss characteristics and life cycle of trematodes
2. To discuss pathogenesis and clinical manifestations caused by medically important
trematodes
3. To discuss the diagnostic techniques utilized in the isolation and identification of
trematodes
4. To discuss the treatment modalities and management of parasitic trematodes infections
5. To discuss the prevention and control of trematodes infections
6. To apply the concepts learned in this activity in theoretical situations.
Guide questions
1. What are the general and specie specific characteristics of each trematode?
2. What are the common and specie specific clinical manifestations of diseases caused by
trematodes? Explain the pathogenesis.
3. What are the diagnostic modalities and criteria required in the evaluation trematode
infections?
4. What are the treatment and management options in handling trematode infection?
5. How are trematodes prevented and controlled?
Emilio Aguinaldo Educational Corporation
School of Medicine
Department of Parasitology
NAME: _________________________________________________YEAR/SECTION________
Learning Objectives
1. Correlate the clinical history, physical examination, diagnostic tests and gross and microscopic
characteristics in the diagnosis of the given cases.
Evaluation
Guide questions
Case 2: Clonochiasis/Opisthorchiasis
A 38-year-old man with fever and yellowish discoloration sought consult at the emergency room. The
patient was brought in by his wife after she found him disoriented and sick in bed. Vital signs are notable
for a temperature of 38°C, heart rate of 100/min, blood pressure of 110/60 mm Hg, and respiratory rate of
24/min. Physical examination reveals tenderness and guarding in the right upper quadrant (RUQ).
Guide questions
1. Differentiate Clonorchis sinensis from Opisthorcis felinues based on adult and larval forms, eggs
intermediate hosts.
2. List down the complications that may arise from this parasitic infection.
Case 3: Fasciolopsiasis
A 40 year-old female farmer patient complained of crampy abdominal pain and fever for a duration of
two weeks, associated with loss of appetite and loss of weight. Laboratory findings show leukocytosis
with elevated eosinophils. Urinalysis shows increased pus cells. Incidentally stool examination was
positive for the eggs of Fasciolopsis buski.
Guide questions
Case 4: Echinostomiasis
A 10-year-old boy presented with vomiting, diarrhea and swelling of the feet for six days. The child is
fairly nourished with mild pallor and pedal edema. There was mild distension of abdomen. The liver was
enlarged 2 cm below costal margin, non tender with smooth surface. A few hours after admission, the
child vomited reddish grey, small leaf like worms.
Guide questions
2. What is the morphological characteristic of the egg that will differentiate it from the other intestinal
flukes
Case 5: Heterophysiasis
A 5-year-old female child recently came back from southeast Asia and was suffering for repeated bouts of
diarrhea. She was treated empirically with metronidazole pending laboratory stool analysis of all possible
parasitic infection. Small operculated oval eggs were recovered from her stool.
Guide questions
Case 6: Paragonimiasis
A 21-year-old male presented with cough of more than 2 weeks with occasional blood tinged sputum. He
immediately tested for tuberculosis which show negative results. Due to the persistence of cough with
increasing episodes of hemoptysis, he was then advised to undergo bronchoalveolar lavage to sample his
respiratory tree. Small ovoid eggs with flattened operculum and thickened abopercular ends were noted.
Guide questions
Case 7: Schistosomiasis
A 19-year-old college student presents to the clinic with fever, hives, headache, weight loss, and cough.
On review of systems, she reports doing field research in Samar over the summer. He recalls an intense
itching sensation while collecting samples in a river. Physical examination reveals lymphadenopathy and
hepatosplenomegaly.
Guide questions
Arthropods
Learning Objectives
1. To discuss characteristics and life cycle of medically important arthropods
2. To discuss pathogenesis and clinical manifestations caused by arthropods
3. To discuss the diagnostic techniques utilized in the isolation and identification of
arthropods
4. To discuss the treatment modalities and management of parasitic arthropods
5. To discuss the prevention and control of arthropods
6. To apply the concepts learned in this activity in theoretical situations.
Guide questions
1. What are the general and specie specific characteristics of each arthropod?
2. What are the common and specie specific clinical manifestations of diseases caused by
arthropods? Explain the pathogenesis.
3. What are the diagnostic modalities and criteria required in the evaluation arthropod infections?
4. What are the treatment and management options in handling arthropod infection?
5. How are arthropods prevented and controlled?
Emilio Aguinaldo Educational Corporation
School of Medicine
Department of Parasitology
NAME: _________________________________________________YEAR/SECTION________
Learning Objectives
1. Correlate the clinical history, physical examination, diagnostic tests and gross and microscopic
characteristics in the diagnosis of the given cases.
Evaluation
Case 1: Scabies
65-year-old nursing home resident presents with a 1-month history of intensely pruritic, erythematous
papules on his torso, groin, and extremities. The pruritus is worse at night. He was treated with
prednisone and loratadine without improvement.
Guide questions
Case 2: Pediculosis
A 75-year old homeless man complains of an itchy scalp. On examination of the pruritic area, it is
almost devoid of hair and has abrasions. Close inspection show numerous nits along the hair shafts.
Guide questions
Parasitic Zoonoses
Learning Objectives
1. To define the zoonoses and its classification
2. To determine the impact of zoonoses on health and economy
3. To explain the factors that contribute to the propagation of zoonotic parasites
4. To discuss the importance of zoonoses as a public health indicator
5. To apply the concepts learned in this activity in theoretical situations
Guide questions
1. Define zooinoeee.
2. What are the difereint typee of zooinoeee?
3. What ie the impact of zooinoeee oin health aind the ecoinomy?
3. What are the factore that cointribute to propagatoin of zooinoeee?
4. How doee paraeitc zooinoeee iinfueince public health programe?
5. What are the curreint programe of the goverinmeint that target paraeitc zooinoeee iin our couintry?
Emilio Aguinaldo Educational Corporation
School of Medicine
Department of Parasitology
Guide questions
1. What are the components of the immune system tat deal with parasitic infections?
2. What are the risk factors increase the susceptibility of immunocompromised to parasitic
infections?
3. Discuss the etiology and pathogenesis of protozoans and helminths of special importance to
immunocompromised individuals.
4. What are the medically important parasites that infect immunocompromised individuals?
Include also nosocomial parasitic infections.
5. What are the diagnostic methods used in the assessment of immunocompromised individuals
to determine parasitism?
Emilio Aguinaldo Educational Corporation
School of Medicine
Department of Parasitology
Guide questions
1. What is the prevalence/incidence of parasitic infections? Locally and internationally.
2. What factors affect the distribution of parasitic infections?
3. What are the methods that have contributed to failure/control of health programs that target
parasitic infections?
4. How does a changing environment influence the distribution of parasitic infections?
5. Recall the economic impact of parasitic infections to humans and livestock.
6. What local and international agencies have committed themselves in the control of parasitism
in the community?
Emilio Aguinaldo Educational Corporation
School of Medicine
Department of Parasitology
Guide questions
1. What is the significance of international and local statistics of parasitic infections?
2. What is the role of local and international institutions in the control of management of
parasitic infections?
3. How are suspected uncommon parasitic infections referred to local and international
institutions?