Cestodes 12- April 2024

1. A 20 year old gel presented with darrhea, vanssing, abdominal pain and loss of weight,
the routine stool examination revealed an egg of a giant fluke. This is most likely a

A. Fasciola gigantica

B. Clonorchis sinesis

C. Fasciolopsis bunk

D. Fascioła hepatica

2A 23/F refugee from indochina walfered recurving episodes of upper abdominal pan for
several months before developing acute cholangitis and pancreatitis. A posable Bake
infection in highly entertained. Which of the following is a relevant information in the chnical
history

A. recent consumption of raw fish

C. works as a farmer

B. a known vegetarian

D. a known alcoholic dinker

3. What is the first intermediate host of intestinal fluke

A. snail

B. Pigs

C fish

D. water plants

4. Once the stage of this parasite leaves the fint intermediate host, it Dansfenes first as
attaches itself to the second intermediata. stage and

A. miracıdaum

B. cercaria

C. sporocyst

D. redia
5 Incidence of human infection is poorly assessed due the aggs close resemblance to the
eggs of Clonorchis sinensis

A Heterophyes

B. Paragonimus

C. Echinostome

D. Fasciola

6. The adult Schistesema marant resides in the

A.liver

B. Inferoor mesentric veins

C. Urinary bladder

D.gallbladder

7. Chronic Schistosoma infection will most likely ends with:

A. portal hypertension

B. pulmonary mass

C. urinary incontinence

D. cardiomegaly

8. Which of the following is an important clinical data in the diagnosis of Echinostoma.

A. eating raw fish

B. eating raw snail

C. eating aquatic vegetations

D. all of these

9. A 63-year-old male developed a febrile illness 2 months after eating watercress.

Diagnostic tests revealed eosinophilia and liver lesions on imaging. What is/are the probable
causative agent/s?

A. Clonorchis sinensis
B. Opistorchis viverinni

C. Fasciola gigantica

D.A and B

10. What is the infective stage of all intestinal flukes

A metacercaria

B. unembryonated eggs

C. embryonated eggs

D. cercaria

11. Which among the parasites listed below passes out in the stool as immature eggs
EXCEPT:

A.Paragonimus

B. Fasciolopsis

C.Heterophyse

D. Fasciola

12. The diagnostic eees in lune fluke infection can be seen

A.sputum

B. stool

C. blood

D. A and B

13. A 57 y/o male underwent cystectomy because of a 2.0x2.0cm. solid mass which on
histopathologic examination revealed a malignant neoplasm. This is most associated with
infection with Schistosoma:

A. mansoni

B. hematobium

C. japonicum

D. indicum
14. The following are TRUE about Heterophyse EXCEPT

A. Excystation of metacercaria happens in the small intestine

B. Infective stage is metacercaria

C. unembryonated eggs are passed out to external environment via feces

D. snail is the first intermediate host

15. Schistosoma japonicum exhibits an egg with

A. lateral spine

B. minute lateral knob

C. terminal spine

D. bipolar plugs

16. Schistosomiasis is highly entertained based on stool and clinical findings. He may have
most likely acquired the infection by eating the following:

A. raw fish

B. vegetable salads

C. raw crabs

D. none of these

17. Which of the following schistosoma is more often associated with liver cirrhosis.

A. japonicum

8. hematobium

C mekongi

D. intercalatum

18. This parasite characteristically has ventral longitudinal groove.

A. Clonorchis sinensis

B. male Schistosoma
C. female Paragonimus

D. male Fasciola

19. Oncomelania quadrasi is utilized by this parasite as its snail intermediate host:

A. S. mansoni

B. S. japonicum

C. S. hematobium

D. S. Indicum

20. The larval stages of Paragonimus which is infective to the first intermediate host?

A. cercaria

B miracidium

C. redia

D metacercaria

Quiz 19 - April 2024

1. This cestode adult form has genital pore on both lateral sides

A. Hymenolepis nana

B. Echinococcus granulosus.

C. Hymenolepis diminuta

D. Dipylidium caninum

2. Which larval form of Diphyllobothrium latum is infective to the first intermediate host

A. procercoid

B. plerocercoid

C. coracidium

D. diaptomus
3. How many intermediate host does Diphyllobotrium latum have?

A. 1

B. 2

C3

D.4

4. The ova is characterized with a thin outer transparent shell and inner embryophore which
is thick walled with radial striations

A. Taenia solium

B. Taenia saginata

C. D. latum

D. A and B

5. The ova of this cestode is characterized as having an inconspicuous operculum at one

end and a small knob on the other end

A. Taenia solium

B. Taenia saginata

C. D. latum

D. A and B

6. Which cestode is also known as broad fish tapeworm

A. Dipylidium

B. Hymenolepis nana

C. Diphyllobothrium

D. Echinococcus

7. The scolex has a rostellurn armed with a double row of alternating large and small
hooklets

A. Taenia solium
B Taenia saginata

C. D. latum

D. A and B

8. This is also known as the double-pored tapeworm.

A. T. solium

B. T. saginata

C. Echinococcus

D. Dipylidium

9. What is the intermediate host of Hymenolepis diminuta?

A. Cyclops

B. Larval fleas and adult beetles

C. Sheep/cattle

D. None

10. The gravid proglottids of this tapeworm separate from the strobila singly or in groups of 2
or 3 and could creep out of the anus.

A. Hymenolepis diminuta.

B. Echinococcus granulosus

C. Spirometra sp.

D.Dipylidium caninum

11. Which cestode is known to cause a hydatid cyst in the liver of human host.

A. T. solium

B. T. saginata

C. Echinococcus

D. Dipylidium
12. Which of the following tapeworms will most likely evoke an inflammatory reaction of the
surrounding tissues and produce a fibrous capsule?

A. Dipylidium caninum

B. Echinococcus granulosus

C. Railletina celebensis

D.Spirometra sp.

13. In majority of cases of hydatid disease, the hydatid cyst is located in

A. Bone marrow

B. Liver

C. Brain

D.Lungs

14. This specific larval stage of Hymenolepis nana develops within the intestinal villus of the
vertebrate host.

A. Plerocercoid

B. Procercoid

C. Cysticercoid

D. Cercocystis

15. One way to prevent Dipylidium caninum infection is to

A. Avoid eating raw fish.

B. Avoid swimming in contaminated water.

C. Subject dogs to deworming

D. Cook meat properly.

16. It has pumpkin-seed-shaped mature and grazid proglottids

A. Hymenolepis nana

B. Raillietina celebensis
C. Hymenolepis diminuta.

D. Dipylidium caninum

17. intermediate host of Dipylidium caninum

A. Larval fleas of dogs

B. Beetle

C. Sheep

D. Fish

18. Common parasite of rats in the Orient

A. Raillietina celebensis

B. Hymenolepis nana

C. Hymenolepis diminuta

D. All of the above

19. Also called dwarf tapeworm

A. Hymenolepis nana

B. Hymenolepis diminuta

C. Echinococcus

D. Dipylidium

20. Which of the following tapeworm/s has an acetabulate scolex

A. D. Latum

B. Taenia solium

C. Taenia Saginata

D. B and C
 Paracito Midterm 2024 second sem

Which of the follwing statements is TRUE regarding Trichomonas vaginalis?

It has a tear drop shaped trophozoite

It lacks a cyst form

Metronidazole is used for treatment

Infected men commonly present with purulent urethral discharge

An East African man is asked to leave his job after repeatedly falling asleep. He visits
the doctor hoping to cure his somnolence, as well as accompanying headache and
dizziness. During the interview, the patient explains that he had suffered recurring
bouts of fever and enlarged lymph nodes before the sleepiness started. The doctor
decides to perform a lumbar puncture, and after finding a flagellated protozoan in the
CSF, he plans to start the patient on melarsoprol. What is the etiologic agent for this
case?

Toxoplasma gondii

Leishmania spp.

Trypanosoma brucei

Trypanosoma cruzi

Which among the following statements regarding Giardia lamblia is FALSE?

A sucking disc is used by the trophozoite for attachment to the bowel wall

Asymptomatic carrier state may be a clinical presentation

Bloody diarrhea is the classic symptomatology

Tear-shaped trophozoites are often seen in diarrheic specimen

What is the gold standard for diagnosing Plasmodium infection?

• PCR

• Biopsy

• Thick and thin blood smear microscopy

Stool antigen test

A medical student traveled to the Philippines for the summer, hoping to integrate into
rural life and better understand the language and culture. His host family herded
swine, and shortly after their first dinner together, he developed severe vomiting and
bloody diarrhea. Stool examination showed ciliated, round, single-cell
microorganisms. What is the causative agent for this case?

Balantidium coli

Giardia lamblia

• Entamoeba histolytica

Cryptosporidium parvum

This nematode (roundworm) is a common cause of human eosinophilic meningitis

and occasionally ocular disease.

) rat lungworm

• Gnathostomiasis

• old world hookworm

• new world hookworm

A pig farmer visits his doctor with muscle aches, fever, and periorbital and facial
edema. These symptoms were preceded 2 weeks earlier by an upset stomach and
diarrhea. Blood labs show eosinophilia, 1 IgE, and muscle enzymes. Because the
symptoms are not severe, the doctor opts not to perform a muscle biopsy; however,
if she had performed the biopsy, she would have expected to find cysts. Which
among the following is the most likely diagnosis?

Trichinosis

• Gnathostomiasis

• Anisakis

• Amebiasis

The cysts of this free living protozoan are typically 10-25 um in diameter. The cysts
have a two-layered wall with pores: a wrinkled fibrous outer wall (exocyst) and an
inner wall (endocyst) that may be hexagonal, spherical, star-shaped or polygonal.

Cysts contain only one nucleus with a large karyosome. Cysts may be found in the
brain, eyes, skin, lungs and other organs.

Toxoplasma gondit

Acanthanoeba spp

Balantidium coli

Loa loa

Peripheral blood smear reveals the presence of intraerythocytic parasites with a

tetrad or maltese cross configuration in a 50 year old man complaining of fever and
chills. Identify the parasite in question.

• Wuchereria bancrofti

• Plamodium falciparum
• Brugia malayi

Babesia microtii

A case of a 9-year-old child, who presented to our clinic with painful, red left eye,
associated with photophobia, and decreased visual acuity, wais reported. The clinical
examination revealed a discoid opacity inferiorly bounded by a dense, gray infiltrate.

The progressive nature of the corneal infiltrate, the epithelial defect, and the lack of
response to treatment was highly suggestive for keratitis. Which of the following is
the etiologic agent?

Onchocerca volvulus

Naegleria fowleri

Cryptosporidium parvum

Acanthamoeba spp

A South Carolina woman visits her doctor after developing diarrhea. The doctor
performs a blood test and finds elevated eosinophils. Suspecting a parasite
infection, the doctor examines a stool specimen. After finding larvae without eggs,
the doctor solidifies a diagnosis upon learning that the patient frequently walks
around her house barefoot. The patient is started on thiabendazole to cure the
symptoms as well as to prevent complications such as peritonitis. What is the
parasite in question?

• Entamoeba histolytica

• Giardlia lamblia

• Strongyloides stercoralis

• Enterobius vermicularis

A man in Louisiana develops coughing, fever, and abdominal pain. His doctor orders
a series of X-rays that show pulmonary infiltrates characteristic of pneumonia, as
well as intestinal images consistent with obstruction. On CBC, the patient has
increased eosinophils. The doctor examines a stool sample from the patient and
discovers microscopic oval eggs with rough surfaces. The doctor makes a
diagnosis, administers pyrantel pamoate, and forewarns the patient to expect worms
in his stool. What is the etiologic agent for the case?

Necator americanus

• Ascaris lumbricoides

Trichuris trichiura

Ancylostoma duodenale

A student cuts short an extended backpacking trip in Yosemite Park after developing
diarrhea. He explains to his doctor that the diarrhea is nonbloody but smells very
bad. On further questioning, the student tells his doctor that he has been drinking
water from a fresh water spring. The patient appears malnourished on physical
exam.

A diarrhea sample reveals 2-nuclei motile amoeba with a tear-drop shape and 4 pairs
of flagella. The student is given metronidazole. What is the parasite involved in the
case?

• Giardia lamblia

• Cryptosporidium parvum

Balantidium coli

• Entamoeba histolytica

An AIDS patient is brought to the EW after suffering a grand mal seizure. The man
informs the EW physician that he has suffered a persistent headache in the past few
weeks but denies any sensory problems or weakness. Fearing a brain tumor, the EW
physician orders a CT scan of the patient. However, the scan, instead, reveals several
ring-enhancing masses in the patient's brain. The physician confirms his suspicions
when he learns the patient has many cats at home. He expects that a brain biopsy
would show crescent-shaped trophozoites. What is the diagnosis?
• Balantidium coli

• Acanthamoeba infection

• Toxoplasmosis

• Naegleria fowleri infection

Infection with this nematodes is frequently asymptomatic. The most typical

symptom is perianal pruritus, especially at night, which may lead to excoriations and
bacterial superinfection. Occasionally, invasion of the female genital tract with
vulvovaginitis and pelvic or peritoneal granulomas can occur. Other symptoms
include, teeth grinding, enuresia, insomnia, anorexia, irritability, and abdominal pain,
which can mimic appendicitis.

• all of these

• hookworm

• pinworm

• threadworm - enterobius vermicularis

An 18-year-old college student sought medical attention because she felt something
moving in the sclera of her right eye and observed a worm when she looked in the
mirror. She had similar symptoms 2 years ago but ignored it at that time because
symptoms abated after about 2h. Currently, she presented with painless swelling at
the base of her right thumb and the dorsum of her right hand that lasted for a few
days at a time and had waxed and waned over the past year.

Which of the following could be a potential vector for this infection?

• Louse

• Tick bite

Chrysops fly
Anopheles mosquito

A child from a small Alabama community presents with severe weakness and pallor.
A CBC shows reduced hematocrit with hypochromic microcytic RBCs as well as
increased eosinophils. To investigate the possibility of parasites, the physician
orders a stool sample in which she finds numerous eggs. The physician prescribes
mebendazole and iron tablets and explains that the child may have acquired the
illness by walking barefoot. What is the diagnosis?

Amoebiasis

• Giardiasis

• Hookworm infection

) Ascaris infectiom

After a camping trip to Mexico, a patient visits her doctor complaining of loose
stools and abdominal cramps. The patient describes the stools as having flecks of
blood and lots of mucus. The doctor orders a stool specimen in which she finds
motile amoeba with ingested RBCs. She starts the patient on metronidazole and
considers a. CT scan to detect any liver abscesses. What is the most likely etiologic
agent of the case?

• Entamoeba histolytica

• Balantidium coli

• Naegleria fowieri

• Giardia lamblia

Which of the following statements is TRUE regarding hookworm infection?

Rhabditiform larvae is the infective stage

•Diagnostic stage is finding larvae in stool sample

May cause pneumonia

• Manner of transmission is by oral route

An HIV patient becomes alarmed after developing a persistent diarrhea. He tells his
physician that the diarrhea is watery and without blood. Upon learning that the
patient visited a vacation farm before the diarrhea started, the doctor orders an
acid-fast stain of the patient's stool sample. What is the parasite causing this
infection?

• Entamoeba hartmanii

• Entamoeba histolytica

• Balantidium coli

• Cryptosporidium spp.

Paracito pre finals 2024 second sem

May 10, 2024 10:00 AM

Question 1 (1 point)
A 12-year-old boy reports feeling tingling and itching of his legs 30 minutes after
swimming in a lake. Over the next day, small papules develop followed by blisters of
the legs. Dermatitis due to schistosome infection is diagnosed. What larval stage
most likely caused the infection?

Correct: Cercaria

● Miracidium
● Filariform larva
● Cysticercus
Question 2 (1 point)
How do humans typically acquire Fasciola hepatica infection?

Correct: Ingesting metacercariae-contaminated vegetation

● Ingesting undercooked beef

● Through direct contact with infected cattle
● Skin penetration of fork-tailed cercaria

Question 3 (1 point)
In the life cycle of P. westermanii, what is the name of the larval stage that develops
in the intermediate host?

Correct: Redia

● Miracidium
● Sporocyst
● Metacercaria

Question 4 (1 point)
A 35-year-old man presents with a 2-week history of fever, fatigue, and abdominal
pain. Physical exam reveals hepatosplenomegaly. Stool examination shows
Schistosoma mansoni eggs with lateral spines. Which of the following is the most
likely stage of infection?

Correct: Acute schistosomiasis (Katayama fever)

● Chronic intestinal schistosomiasis

● Chronic hepatosplenic schistosomiasis
● Neuroschistosomiasis

Question 5 (1 point)
A stool sample from a patient revealed operculated eggs with a characteristic
'shoulders.' What is the most likely parasite?

Correct: Clonorchis sinensis

 ● Hymenolepis nana
● Taenia saginata
● Taenia solium

Question 6 (1 point)
How do humans become infected with P. westermanii?

Correct: By eating undercooked freshwater crabs or crayfish

● By drinking contaminated water

● By eating undercooked freshwater fish
● By coming into contact with infected cats or dogs

Question 7 (1 point)
In taeniasis, which of the following is considered the definitive host?

Correct: Humans

● Humans, pigs, and cattle

● Pigs or cattle

Question 8 (1 point)
What is the vector responsible for transmitting Chagas disease?

Correct: Triatomine bug

● Black fly
● Tsetse fly
● Sandfly

Question 9 (1 point)
In the life cycle of P. westermanii, how do metacercariae excyst and migrate to the
lungs in the definitive host?

Correct: They penetrate the intestinal wall and migrate through the thoracic cavity
 ● They penetrate the intestinal wall and migrate through the abdominal cavity
● They penetrate the intestinal wall and migrate through the lymphatic system
● They penetrate the intestinal wall and migrate through the bloodstream

Question 10 (1 point)
The main route of transmission of E. ilocanum to humans is:

Correct: Ingestion of undercooked freshwater snails

● Ingestion of undercooked fish

● Ingestion of undercooked meat
● Ingestion of contaminated water

Question 11 (1 point)
Which of the following is the definitive host for Echinococcus granulosus?

Correct: Dogs

● Goats
● Sheep
● Humans

Question 12 (1 point)
A 7-year-old boy presents with abdominal pain, diarrhea, and loss of appetite. Stool
examination reveals the presence of Hymenolepis nana eggs. Which of the following
is the most likely source of infection in this case?

Correct: Ingestion of contaminated food or water

● Inhalation of eggs
● Transmission from a pet rodent
● Skin penetration of the proglottid segment

Question 13 (1 point)
Which of the following is a host in the life cycle of all trematodes that infect humans?
Correct: Mollusk

● Mosquito
● Flea
● Flour weevil

Question 14 (1 point)
A 65-year-old woman presented with fever, jaundice, weight loss, and abdominal
discomfort. She lives in the countryside with her 2 dogs. CT scan of liver revealed 2
large cystic masses, suspected to represent an echinococcal cyst. Which of the
following is the most likely microscopic feature?

Correct: Cystic lesions with inner, middle, and outer layers and protoscolices

● Ingested red blood cells

● Numerous cystic lesions similar to solitary cysts, covered by cuboidal
epithelium
● Organisms with foamy cytoplasm and eccentric round nucleus

Question 15 (1 point)
Which of the following is a characteristic feature of Schistosoma mansoni eggs?

Correct: Lateral spine

● Rudimentary spine
● Absent spine
● Terminal spine

Question 16 (1 point)
What is the infective stage of F. buski ingested by humans?

Correct: Metacercaria

● Miracidium
● Redia
Question 17 (1 point)
Cyclops crustaceans are intermediate hosts for which parasitic disease?

Correct: Dracunculiasis

● Onchocerciasis
● Schistosomiasis
● Lymphatic filariasis

Question 18 (1 point)
In D. latum infection, in the human intestine, the plerocercoid larva develops into
what adult structure?

Correct: Scolex

● Proglottid
● Strobila

Question 19 (1 point)
The infective stage of F. gigantica is:

Correct: Metacercaria

● Cercaria
● Miracidium

Question 20 (1 point)
Sandflies are vectors for which of these diseases?

Correct: Leishmaniasis

● Lymphatic filariasis
● Lyme disease
● Onchocerciasis
Question 21 (1 point)
Which of the following statements is FALSE regarding Taenia saginata infection?

Correct: When humans ingest infected raw or incompletely cooked beef, the
cysticercus develops into a reproductive adult in the large intestine in 2-3 months

● Humans are the sole definitive host.

● Taenia saginata taeniasis produces only mild abdominal symptoms.
● Eggs or gravid proglottids are passed with feces.

Question 22 (1 point)
A 10-year-old girl presents with recurrent abdominal pain and difficulty sleeping.
Stool examination is positive for Hymenolepis nana eggs. Which of the following is
the most likely reason for the persistence of symptoms in this case?

Correct: Autoinfection

● Presence of an intermediate host

● Coinfection with other parasites
● Resistance to treatment

Question 23 (1 point)
Tsetse flies are vectors for which parasitic disease?

Correct: African trypanosomiasis

● Leishmaniasis
● Malaria
● Chagas disease

Question 24 (1 point)
Reduviid bugs are vectors for which of these diseases?

Correct: Chagas disease

● Malaria
 ● Lymphatic filariasis
● Leishmaniasis

Question 25 (1 point)
After ingestion by an intermediate host, the Echinococcus egg hatches and releases
what?

Correct: Oncosphere

● Protoscolices
● An adult worm
● A proglottid

Question 26 (1 point)
What is the primary mode of transmission of Echinococcus granulosus to humans?

Correct: Ingestion of contaminated food or water

● Skin contact with infected animals

● Inhalation of eggs
● Vertical transmission from mother to child

Question 27 (1 point)
What larval stage of D. latum is ingested by the first intermediate host?

Correct: Coracidium

● Plerocercoid
● Procercoid

Question 28 (1 point)
A 35-year-old man presents with a 2-week history of severe pruritus, especially at
night. Physical examination reveals erythematous papules and burrows on the
interdigital spaces of the hands. Which of the following is the most likely causative
agent?
Correct: Sarcoptes scabiei

● Ixodes ticks
● Head lice
● Demodex mites

Question 29 (1 point)
In the life cycle of Taenia, the oncosphere hatches from the egg and penetrates the
intestinal wall of the intermediate host to reach the:

Correct: Muscles

● Brain
● Lungs
● Liver

Question 30 (4 points)

Humans get infected with Clonorchis sinensis by:

● Correct: Ingesting undercooked freshwater fish containing metacercariae

● Incorrect: Ingesting contaminated water containing cercaria
● Incorrect: From insect vectors transmitting miracidia
● Incorrect: Skin penetration of L3 larva

Question 31 (1 point)

A 45-year-old man presented with weakness, weight loss, and abdominal pain for a
month. An ultrasound showed a cystic lesion in the liver. The cystic lesion was
resected and revealed cysts consisting of inner, middle, and outer layers. Which of
the following is the best diagnosis?

● Correct: Echinococcus granulosus cysts

● Incorrect: Hemorrhagic cysts of Fasciolopsis buskii
● Incorrect: Fasciola hepatica cyst
● Incorrect: Schistosoma mansoni granulomatous inflammation and pseuocyst
formation

Question 32 (1 point)
A 35-year-old man from rural Thailand presents with intermittent abdominal pain and
diarrhea for the past 6 months. He reports occasionally finding large reddish-brown
worms in his stool. His dietary habits include eating raw aquatic plants collected
from local ponds and streams. What is the most likely parasite causing his
symptoms?

● Correct: Fasciolopsis buski

● Incorrect: Echinococcus granulosus
● Incorrect: Taenia saginata
● Incorrect: Taenia solium

Question 33 (1 point)

A 45-year-old man presents with a 6-month history of recurrent abdominal pain,

diarrhea, and weight loss. He reports eating undercooked crab dishes while traveling
in Asia 1 year ago. Stool examination reveals the presence of operculated eggs.
Which of the following is the most likely diagnosis?

● Correct: Intestinal paragonimiasis

● Incorrect: Fasciolopsiasis
● Incorrect: Hymenolepis nana infection
● Incorrect: Echinococcosis

Question 34 (4 points)

Aquatic snails are intermediate hosts for which parasitic disease?

● Correct: Schistosomiasis
● Incorrect: Dracunculiasis
● Incorrect: Onchocerciasis
● Incorrect: Lymphatic filariasis

Question 35 (1 point)

Humans get infected with Taenia saginata by ingesting:

● Correct: Raw or undercooked beef

● Incorrect: Unwashed vegetables
● Incorrect: Raw or undercooked pork
● Incorrect: Contaminated water
Question 36 (4 points)

What larval stage of D. latum infects humans when they consume raw or
undercooked fish?

● Correct: Plerocercoid
● Incorrect: Procercoid
● Incorrect: Scolex
● Incorrect: Strobila

Question 37 (1 point)

The adult tapeworm develops from the cysticercus in the:

● Correct: Small intestine

● Incorrect: Large intestine
● Incorrect: Liver
● Incorrect: Stomach

Question 38 (1 point)

A 32-year-old woman from a rural area in Mexico presents to the clinic with
intermittent abdominal pain and disturbing reports of passing proglottid segments in
her stool. She has no other significant symptoms. The gravid proglottid upon further
examination has 7-13 lateral branches. Identify the parasite.

● Correct: T. saginata
● Incorrect: E. granulosus
● Incorrect: D. latum
● Incorrect: T. solium

Question 39 (1 point)

What is released from the proglottids of the adult Echinococcus worm in the
definitive host?

● Correct: Eggs
● Incorrect: Cysts
● Incorrect: Protoscolices
● Incorrect: Larvae
Question 40 (4 points)

The larval stage of Taenia saginata and Taenia solium that develops in the
intermediate host is called:

● Correct: Cysticercus
● Incorrect: Proglottid
● Incorrect: Oncosphere
● Incorrect: Scolex

Question 41 (4 points)

Kissing bugs are vectors for which parasitic disease?

● Correct: Chagas disease

● Incorrect: Lymphatic filariasis
● Incorrect: Malaria
● Incorrect: Leishmaniasis

Question 42 (4 points)

A 25-year-old woman presents with a 1-month history of fatigue, shortness of breath,

and palpitations. She reports a 6-month history of abdominal discomfort and
diarrhea. Labs show a hemoglobin of 8 g/dL and a mean corpuscular volume of 110
fL. Stool ova and parasite exam reveals numerous operculated eggs measuring
60-70 µm in length. What is the most likely diagnosis and what is the underlying
cause of her anemia?

● Correct: Diphyllobothriasis causing vitamin B12 deficiency anemia

● Incorrect: Hymenolepis nana infection causing occult gastrointestinal
bleeding
● Incorrect: Schistosomiasis causing chronic blood loss anemia
● Incorrect: Hookworm infection causing iron deficiency anemia

Question 43 (1 point)

The adult worms of C. sinensis live in the:

● Correct: Biliary duct

● Incorrect: Lung parenchyma
 ● Incorrect: Splenic sinusoids
● Incorrect: Bladder plexus

Question 44 (1 point)

In the definitive host, the adult Echinococcus worm resides in which organ?

● Correct: Small intestine

● Incorrect: Lungs
● Incorrect: Liver
● Incorrect: Bladder

Question 46 (1 point)

Which of these is NOT a characteristic of the eggs of F. buski?

● Correct: Embryonated when passed

● Incorrect: Oval shape
● Incorrect: Thick shell
● Incorrect: Operculum at one end

Question 47 (1 point)

How is Pediculus humanus typically transmitted?

● Correct: Through close contact with an infested person or their belongings

● Incorrect: Through the air by coughing and sneezing
● Incorrect: Through contaminated water
● Incorrect: Through sexual contact

Question 48 (4 points)

What is the most common way for humans to become infected with D. latum?

● Correct: Eating raw or undercooked freshwater fish

● Incorrect: Eating raw or undercooked marine fish
● Incorrect: Drinking contaminated water
● Incorrect: Eating raw vegetables

Question 49 (1 point)
In the life cycle of Schistosoma, the miracidia hatch from the eggs and infect:

● Correct: Freshwater snails

● Incorrect: Humans
● Incorrect: Cercariae
● Incorrect: Aquatic plants

Question 50 (1 point)

Humans can be infected by Echinococcus granulosus by ingesting what?

● Correct: Eggs from canid feces

● Incorrect: Protoscolices
● Incorrect: Cysts in infected organs
● Incorrect: Adult worms

Question 51 (4 points)

A 25-year-old woman with a history of chronic schistosomiasis presents with

hematemesis. Upper endoscopy reveals large esophageal varices. Which of the
following is the most likely cause of her varices?

● Correct: Periportal fibrosis

● Incorrect: Portal vein thrombosis
● Incorrect: Budd-Chiari syndrome
● Incorrect: Cirrhosis

Question 52 (1 point)

A 35-year-old man from a rural area in Latin America presents to the emergency
department with a 2-day history of severe headache and a single generalized
tonic-clonic seizure. He has no significant past medical history. On examination, he is
afebrile and his vital signs are stable. Neurological exam reveals no focal deficits. A
CT scan of the head shows multiple cystic lesions with scolices in the brain
parenchyma and subarachnoid space. Serum antibody testing for cysticercosis is
positive. How did the definitive host get infected?

● Correct: Ingesting infective eggs

● Incorrect: Ingesting cysticerci
● Incorrect: Skin penetration of cysticerci
 ● Incorrect: Skin penetration of L3 larva

Question 53 (1 point)

What is the first intermediate host in the life cycle of Diphyllobothrium latum?

● Correct: Copepod
● Incorrect: Freshwater fish
● Incorrect: Crustacean
● Incorrect: Marine fish

Question 54 (1 point)

Which of the following is an example of a biological vector that transmits typhus?

● Correct: Flea
● Incorrect: Tick
● Incorrect: Louse
● Incorrect: Mosquito

Question 55 (1 point)

A patient from an endemic area presents with fever, abdominal pain, and obstructive
jaundice. An ERCP (endoscopic retrograde cholangiopancreatography) reveals
dilated bile ducts with filling defects. What is the most likely diagnosis?

● Correct: Clonorchiasis
● Incorrect: Paragonimiasis
● Incorrect: Hymenolepiasis
● Incorrect: Echinococcosis

Question 56 (4 points)

Blackflies are vectors for which parasitic disease?

● Correct: Onchocerciasis
● Incorrect: Mansonellosis
● Incorrect: Loiasis
● Incorrect: Lymphatic filariasis
Question 57 (1 point)

What is the proposed pathogenesis for the development of calcified cysticerci in

neurocysticercosis?

● Correct: Chronic inflammation causing dystrophic calcification

● Incorrect: Antihelminthic treatment causing calcification
● Incorrect: Immune response leading to fibrosis around the
● Question 58 (1 point): What is the second intermediate host in the life cycle of
Diphyllobothrium latum?
○ ( ) Copepod
○ (✓) Freshwater fish
○ ( ) Marine fish
○ ( ) Crustacean
● Question 59 (4 points): An oil field worker who has lived in Brazil for 10 years
has mild gastrointestinal symptoms. Brazil is the only country ever visited by
the patient outside of the United States. The patient is diagnosed by his
physician of having Schistosoma mansoni because of which of the following?
○ ( ) Round eggs with a prominent terminal spine were observed in a
rectal biopsy.
○ (✓) Nonoperculated eggs with a miracidium inside were observed in
stool samples.
○ ( ) Eggs were found in a urine sample.
○ ( ) Blood was detected in the stool.
● Question 60 (1 point): The life cycle of Taenia saginata and Taenia solium is:
○ ( ) None of the above
○ (✓) Direct
○ ( ) Indirect with two intermediate hosts
○ ( ) Indirect with one intermediate host