2009 parasitology MCQs
PARASITOLOGY Physician’s Licensure Examination June 3, 2009; 1:00pm- 5:00pm 1. Hookworms can cause iron deficiency anemia which is characterized as: A. Hypochromic, microcytic B. Hypochromic macrocytic C. Hyperchromic macrocytic D. Normochromic microcytic 2. Ancylostoma duodenale is characterized by the following, EXCEPT : A. the infective filariform larvae penetrates skin. B. larvae migrate through the lungs and are swallowed C. iron deficiency anemia occurs in chronic cases D. the most prevalent soil-transmitted helminth in the Philippines 3. All cestodes (tapeworms) have the following structures, EXCEPT: A. Proglottids B. Scolex C. Neck D. Spicules 4. This tapeworm may complete its life cycle in man without the need of an intermediate host: A. Taenia solium B. Taenia saginata C. Hymenolepis nana D. Echinococcus granulosus 5. This tapeworm may cause cysticercosis when its eggs are ingested by man. A. Taenia solium B. Taenia saginata C. Hymenolepis nana D. Echinococcus granulosus 6. This tapeworm may cause a hydatid cyst in man: A. Taenia solium B. Taenia saginata C. Hymenolepis nana D. Echinococcus granulosus 7. A 10 year old female from Samar presents with hepatosplenomegaly. You would want to run diagnostic tests to rule out A. Ascariasis B. Hydatid Cyst C. Schistosomiasis D. Amebiasis 8. The following areas are endemic for schistosomiasis, EXCEPT: A. Leyte, Mindoro, Samar B. Davao, Sorsogon, Bukidnon C. Cebu, Pampanga, D. None of the above 9. The COPT is a diagnostic test which demonstrates the presence of antibodies against: A. Entamoeba histolytica B. Strongyloides stercoralis C. Schistosoma japonicum D. Plasmodium spp.
PARASITOLOGY Physician’s Licensure Examination June 3, 2009; 1:00pm- 5:00pm 10. A 10 year old girl from Samar presented with an enlarged abodmen. Splenomegaly was apparent and a Kato Thick Smear showed eggs with laterla knobs. This child is probably infected with: A. Taenia saginata, B. Ascaris lumbricoides C. Trichuris trichiura D. Schistosoma japonicum 11. The drug of choice for schistosomiasis and most trematode (fluke) infections is: A. Metronidazole B. Albendazole C. Niclosamide D. Praziquantel 12. The drug of choice for taeniasis and most cestode (tapeworm) infections is: A. Metronidazole B. Albendazole C. Niclosamide D. Praziquantel 13. The drug of choice for invasive amebiasis, giardiasis, and trichomoniasis is: A. Metronidazole B. Albendazole C. Niclosamide D. Praziquantel 14. The recommended diagnostic test for Enterobius vermicularis (seatworm/pinworm) is : A. direct fecal smear B. Kato-Katz or Kato Thick Smear C. Formol Ether Concentration Test D. Peri-anal or Cellulose Tape Swab 15. Which of the following laboratory examinations would be the BEST step in identifying parasites responsible for chronic diarrhea: A. direct fecal smear B. examination of concentrated stools using formol-ether concentration technique C. examination of concentrated stools using Kato-Katz technique D. serology for antibody titers 16. Giardiasis can be diagnosed with the following methods, EXCEPT A. Formol Ether Concentration Test B. The string test – where a ball of weighted string is ingested and pulled out to examine trophozoites C. Immunofluroescence D. Kato-Katz Smear 17. Trypanosoma cruzi is endemic in: A. East Africa B. West Africa C. South Asia D. South America 18. The tse-tse flies, Glossina sp., are the vectors for A. Trypanosoma cruzi : B. Leishmania donovani : C. Leishmania spp. : D. Trypanosoma brucei 2
PARASITOLOGY Physician’s Licensure Examination June 3, 2009; 1:00pm- 5:00pm 19. Romana’s sign, a swelling of the periorbital area, may be seen in : A. Trypanosoma cruzi: B. Trypanosoma brucei : C. Leishmania donovani : D Leishmania braziliense 20. In cases of chronic diarrhea in communities where raw or inadequately cooked fish is traditionally eaten, which parasite would most likely be implicated? A. Cryptosporidium parvum B. Giardia lamblia C. Capillaria philippinensis D. Ascaris lumbricoides 21. Which of these parasites is fish-borne and causes chronic diarrhea? A. Paragonimus westermani B. Heterophyes heterophyes C. Cryptosporidium parvum D. Angiostrongylus cantonensis 22. Which of these parasites is snail-borne and causes diarrhea? A. Angiostrongylus cantonensis B. Paragonimus westermani C. Echinostoma ilocanum D. Capillaria philippinensis 23. In cases of chronic diarrhea with an underlying HIV infection, which parasite is most likely to be involved? A. Cryptosporidium parvum B. Giardia lamblia C. Entamoeba histolytica D. hookworm infection 24. For which parasitic infections are repeated (periodic) chemotherapy of population groups a valid preventive and control measure? A. Entamoeba histolytica, Giardia lamblia B. Taenia and Echinostoma C. Ascaris, Trichuris, Hookworms, and Schistosoma D. Capillaria philippinensis and heterophyid flukes 25. Why would Schistosoma japonicum persist despite identifying and treating all infected individuals in a community? A. Ineffective drug B. Farm and domestic animals are reservoir hosts of Schistosoma japonicum C. latent / quiescent stages are harbored in man and are eventually reactivated D. Drug resistance 26. Autoinfection occurs in the following, EXCEPT: A. Capillaria philippinensis B. Strongyloides stercoralis C. Enterobius vermicularis D. Schistosoma japonicum 27. Entamoeba histolytica and Entamoeba dispar are best differentiated by: A. stool microscopy B. stool ELISA C. stool culture D. None of the above 3
PARASITOLOGY Physician’s Licensure Examination June 3, 2009; 1:00pm- 5:00pm 28. Bloody diarrheea can be due to this parasitic infection: A. Ascariasis B. Entamoeba histolytica C. Giardia lamblia D. Cryptosporidium parvum 29. The following can be acquired by drinking fecally-contaminated water, EXCEPT: A. Entamoeba histolytica B. Giardia lamblia C. Capillaria philippinensis D. Cryptosporidium parvum 30. Intestinal obstruction is a complication of : A. Ascaris B. Hookworm C. Trichuris D. Schistosoma 31. Skin penetration is the mode of infection of: A. Ascaris B. Hookworm C. Trichuris D. Taenia 32. Erratic migration into the bile duct occurs in: A. Ascaris B. Schistosoma C. Trichuris D. Echinostoma 33. The stage of Enterobius vermicularis that is infective to man is : A. embryonated egg B. larva C. adult D. cyst 34. The stages of development of Plasmodium which are responsible for malaria transmission : A. B. C. D.
schizonts ring forms gametocytes merozoites
35. The following provinces are endemic for malaria, EXCEPT: A. B. C. D.
Palawan Mindoro Sulu Cebu
36. As a malaria preventive measure, chemoprophylaxis is indicated for the following high risk groups EXCEPT: A. pregnant women B. tourists C. occupationally exposed groups D. permanent residents 4
PARASITOLOGY Physician’s Licensure Examination June 3, 2009; 1:00pm- 5:00pm 37. As a malaria control measure, the use of Permethrin-treated mosquito nets is effective, EXCEPT: A. B. C. D.
in killing the larval stages of Anopheles in killing the adult stages in repelling the adult stages in preventing man-vector contact
38. The drug of choice for severe and complicated malaria is: A. B. C. D.
Chloroquine Quinine Primaquine none of the above
39. The presence of schizonts in a P. falciparum smear indicates the following: A. B. C. D.
good prognosis bad prognosis no bearing in prognosis none of the above
40. Malabsorption and steattorhea (fatty stools) may be a clinical feature of this infection: A. Giardia lamblia B. Entamoeba histolytica C. Cryptosporidium D. Balantidium coli 41. Strawberry cervix may be a clinical feature of this infection: A. B. C. D.
Giardia lamblia Entamoeba histolytica Cryptosporidium Trichomonas vaginalis
42. Tse-tse fly is the vector for: A. Trypanosoma brucei B. Trypanosoma cruzi C. Leishmania donovani D. Leishmania tropica 43. Skin penetration is the mode of infection of: A. Echinostoma B. Schistosoma C. Trichuris D. Paragonimus 44. The natural mode of transmission of Plasmodium is A. B. C. D.
blood transfusion congenital transmission mosquito bite inoculation through contaminated needles
PARASITOLOGY Physician’s Licensure Examination June 3, 2009; 1:00pm- 5:00pm 45. The predominant species of Plasmodium in the Philippines is A. B. C. D.
Plasmodium ovale Plasmodium knowlesi Plasmodium falciparum Plasmodium malariae
46. The species which causes cerebral malaria is A. B. C. D.
P. vivax P. falciparum P. malariae P. ovale
47. The most common site in extra-intestinal amoebiasis is A. lung B. cerebral hemisphere C. Right lobe of the liver D. Left lobe of liver 48. The infective stage of this nematode is a larval stage, EXCEPT: A. B. C. D.
hookworms Capillaria philippinensis Strongyloides stercoralis Trichuris trichiura
49. The following statements are true regarding Capillaria philippinensis, EXCEPT: A. The intermediate host is a fish B. The natural definitive host is most probably migratory birds C. Diarrhea, abdominal pain and borborygmi compose the clinical triad of capillariasis. D. The infective stage is the embryonated egg 50. The main pathology in schistosomiasis is: A. B. C. D.
obstruction of blood vessels liver failure granuloma formation around eggs toxemia
51. The habitat of the adult Schistosoma japonicum is the: A. B. C. D.
liver brain mesenteric veins small intestines
52. Most common cause of death in chronic schistosomiasis is: A. B. C. D.
anoxia bleeding esophageal varices liver failure sepsis
PARASITOLOGY Physician’s Licensure Examination June 3, 2009; 1:00pm- 5:00pm 53. The following statements are true regarding paragonimiasis and TB: A. B. C. D.
Chest X-ray can differentiate one from the other Ziehl Neilsen smear can diagnose both paragonimiasis and TB Clinical manifestations (chronic cough, hemoptysis) are similar The drugs of choice are similar
54. The following statements are true regarding transmission of Paragonimus, EXCEPT: A. The infective stage is found in the muscles and gills of the mountain crab. B. The crab is commonly eaten inadequately cooked C. The ova are expelled only in feces D. Snails serve as first intermediate hosts. 55. Cholangiocarcinoma is associated with: A. B. C. D.
Opistorchis spp. Fasciola hepatica Fasciolopsis buski Echinostoma ilocanum
56. The best time to collect blood to diagnose bancroftian filariasis: A. B. C. D.
between 10 am and 2 pm between 10 pm and 2 am between 10 am and 2 am between 10 pm and 2 pm
57. The pathology caused by adult Ascaris include the following EXCEPT: A. B. C. D.
intestinal obstruction cholecystitis volvulus pneumonitis
58. Clinical manifestations of angiostrongylosis may be any of the following EXCEPT: A. B. C. D.
asthma impairment of memory disorientation incoherence
59. Which of the following preventive measures are specific for strongyloidiasis and hookworm infection? A. avoidance of eating raw meat B. use of protective shoes and gloves C. hygienic personal habit D. boiling water 60. One of the following is not true about the seatworm (Enterobius): A. B. C. D.
eggs undergo development in the soil eggs can infect man via inhalation parasite exhibits familial tendency parasite may cause eczematous perianal lesions
PARASITOLOGY Physician’s Licensure Examination June 3, 2009; 1:00pm- 5:00pm 61. Respiratory symptoms can be observed in the following conditions, EXCEPT: A. Ascariasis B. Necatoriasis C. Strongyloidiasis D. Trichuriasis 62. The trematode which is transmitted by skin penetration of infective cercaria A. Fasciola hepatica B. Clonorchis sinensis C. Echinostoma ilocanum D. Schistosoma japonicum 63. Granuloma formation and subsequent fibrosis around schistosome eggs result in the following EXCEPT: A. portal hypertension B. hepatosplenomegaly C. portosystemic collateral circulation D. intestinal fistulas 64. Relapse which is caused by reactivation of hypnozoites is present in the following Plasmodial species: A. B. C. D.
P. falciparum P. malariae P. vivax P. cynomolgi
65. Malignant tertian fever is present in the following Plasmodial species: A. B. C. D.
P. vivax P. falciparum P. malariae P. ovale
66. The following mechanisms cause severe malarial anemia EXCEPT: A. B. C. D.
post - schizogonic mechanical destruction of RBCs complement- mediated lysis of RBCs immune-mediated depression of erythropoiesis severe blood loss
67. The vector for malaria in the Philippines: A. Aedes aegypti B. Anopheles flavoristris C. Culex sp. D. Mansonnia sp. 68. Quartan malaria is characterized by a 72-hour (3-day) cycle of fever, chills and sweating. This is caused by: A. Plasmodium ovale B. Plasmodium malariae C. Plasmodium falciparum D. Plasmodium vivax
PARASITOLOGY Physician’s Licensure Examination June 3, 2009; 1:00pm- 5:00pm 69. The flask-shaped ulcer is the characteristic lesion of this protozoan: A. B. C. D.
Giardia lamblia Entameba histolyitca Blastocystis hominis Cryptosporidium parvum
70. The species of ameba which causes primary amebic meningoencephalitis is: A. Acanthameba B. Naegleria C. Entameba histolytica D. Endolimax nana 71. In communities of high socio- economic status, food borne amebiasis is transmitted through: A. B. C. D.
inadequate cooking of food mechanical vectors food handlers who are asymptomatic cyst passers inadequate washing of fruits and vegetables
72. “Barbers-pole” is one of the diagnostic features of: A. B. C. D.
Trichinella spiralis Capillaria philippinensis Angiostrongylus cantonensis Strongyloides stercoralis
73. Man acquires infection with Trichinella spiralis by: A. B. C. D.
ingestion of half-cooked meat containing encysted larvae ingestion of green leafy vegetables contaminated with human feces ingestion of fresh water fish, raw or half cooked skin penetration by filariform larvae
74. Trichinosis in man can be diagnosed by the following EXCEPT: A. B. C. D.
stool examination biopsy of superficial skeletal muscle Bentonite flocculation test (BFT) Fluorescent antibody test
75. Chiclero’s ulcer, usually found in the ear lobe, may be seen in : A. Trypanosoma cruzi B. Trypanosoma brucei C. Leishmania donovani D. Leishmania braziliense 76. Winterbottom’s sign, a swelling of posterior cervical nodes, may be seen in : A. Trypanosoma cruzi B. Trypanosoma brucei C. Leishmania donovani D. Leishmania braziliense
PARASITOLOGY Physician’s Licensure Examination June 3, 2009; 1:00pm- 5:00pm 77. Espundia, a form of mucocutaneous ulcer, may be seen in : A. Trypanosoma cruzi B. Trypanosoma brucei C. Leishmania donovani D. Leishmania braziliense 78. Kala azar is characterized by hyperpigmentation of the skin and splenomegaly with amastigotes found in the involved organs. The protozoan that causes this is: A. Leishmania mexicanus B. Leishmania tropicana C. Leishmania braziliensis D. Leishmania donovani 79. Hydrocoele is most likely caused by : A. Wuchereria bancrofti B. Brugia malayi C. Onchocerca volvulus D. Mansonella sp. 80. Nocturial periodicity is demonstrated by : A. Wuchereria bancrofti B. Brugia malayi C. Onchocerca volvulus D. Mansonella sp. 81. Confluent body nuclei is characterstic of : A. Wuchereria bancrofti B. Brugia malayi C. Onchocerca volvulus D. Mansonella sp. 82. The large intestine is the natural habitat of this adult worm : A. Ascaris lumbricoides B. Trichuris trichiura C. Ancylostoma duodenale D. Necator americanus 83. Which is true concerning cutaneous larva migrans: A. Man is the natural definitive host B. Man is an accidental host C. Man is a paratenic host D. Man is a reservoir host 84. Rectal prolapse can occur with this infection : A. Ascaris lumbricoides B. Trichuris trichiura C. Ancylostoma duodenale D. Necator americanus 85. Perianal itching is a manifestation of infection with : A. Enterobius vermicularis B. Trichuris trichiura C. Ascaris lumbricoides D. Necator americanus
PARASITOLOGY Physician’s Licensure Examination June 3, 2009; 1:00pm- 5:00pm 86. The lungs are the natural habitat of this adult worm : A. Paragonimus westermani B. Echinostoma ilocanum C. Heterophyes D. Opistorchis 87. Larvae pass through the lungs for all of these worms, EXCEPT : A. Ascaris lumbricoides B. Trichuris trichiura C. Ancylostoma duodenale D. Necator americanus 88. These parasites can all cause significant anemia, EXCEPT: A. Ascaris lumbricoides B. Trichuris trichiura C. Ancylostoma duodenale D. Plasmodium falciparum 89. These parasites can involve the heart, EXCEPT : A. Heterophyes B. Trypanosoma cruzi C. Trypanosoma brucei D. Haplorchis sp. 90. These parasites have obligate intracellular stages, EXCEPT : A. Entamoeba histolytica B. Cryptosporidium parvum C. Plasmodium falciparum D. Leishmania sp. 91. The species of ameba which can cause keratitis is: A. Acanthameba B. Naegleria C. Entameba histolytica D. Endolimax nana 92. The following molecules are associated with the virulence of E. histolytica, EXCEPT: A. lectin B. cystein protease C. amebapore D. excretions / secretions 93. In the circumoval precipitin test (COPT), the specimen to be collected from the patient is: A. feces B. urine C. whole blood D. anticoagulated blood 94. The stage of the filaria parasite which is responsible for chronic deforming disease is: A. Adult B. microfilaria C. L1 D. L3
PARASITOLOGY Physician’s Licensure Examination June 3, 2009; 1:00pm- 5:00pm 95. Man is an accidental host of the following parasites, EXCEPT: A. Raillietina garissoni B. Dipylidium caninum C. Hymenolepis nana D. Taenia sagniata 96. The following statements are true of animal hookworms, EXCEPT: A. They do not develop into adult stage in man B. They produce respiratory symptoms in man C. They produce serpiginous lesions on human skin D. They are provided with definite dentition 97. A 4-year old boy had skin lesions which showed burrowing tracks in the skin and intense itching in the affected area. Application of lindane resulted in improvement. The lesions were most probably due to: A. dermatophytosis B. sporotrichosis C. tinea versicolor D. scabies 98. The infective stage of Ascaris and Trichuris is the : A. rhabditiform larva B. filariform larva C. embryonated egg D. feritilized egg. 99. An 18 year old female complained of vaginal discharge. A smear of the discharge showed a pear-shaped, flagellated organism. This pathogen is: A. Neisseria gonorhea, B. Trichomonas vaginalis C. Chlamydia trachomatis D. Candida albicans 100.The reduviid or kissing bugs are vectors for : A. American trypanosomiasis B. African trypanosomiasis C. Visceral leishmaniasis D. Cutaneous leishmaniasis