Block 14 GI Protozoa Helminths N Acute Abdomen

17 Questions | By Chachelly | Last updated: Mar 21, 2022 | Total Attempts: 684

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Block 14 GI Protozoa Helminths N Acute Abdomen - Quiz

CTL Week 7 - GI Protozoa CTL Week 7 - GI Helminths CTL Week 7 - Acute abdomen

Questions and Answers

1.

A 34 year-old man and his 30 year-old wife went on a camping trip in the Colorado Mountains in September. They cooked over campfires and drank water from cold streams. The following week they noted diarrhea 2-3 times a day. The stools were nonbloody and floated on toilet water showing a greasy film. The diarrhea tended to occur after eating meals that included milk or ice cream. They lost about 20 pounds while the diarrhea lasted for 3 weeks until they sought treatment. What caused the illness?
- A.
  
  A parasite in water that results in diarrhea with excretion of acid-fast cysts in stool
- B.
  
  A parasite that forms cysts with nuclei that have central karyosomes.
- C.
  
  A protozoan that forms flask-shaped ulcers in the colon and can cause liver abscesses.
- D.
  
  A flagellated protozoan that is pear-shaped.
2.

A 30-year-old man with AIDS swam in a farmer’s pond near a pasture for cows. A week later he complained of watery diarrhea several times a day and, despite eating food normally, lost 6 pounds within a week’s time. Which image corresponds to the most likely stool microbe in this case?
- A.
  
  A
- B.
  
  B
- C.
  
  C
- D.
  
  D
- E.
  
  E
3.

Carl presents with watery diarrhea for 10 days after traveling to Mexico. He is subsequently diagnosed with the following organism: On examination of Carl, one would expect to find:
- A.
  
  High fever
- B.
  
  Severe abdominal pain
- C.
  
  Rapid deep breathing
- D.
  
  Markedly foul smelling stools
- E.
  
  All of the above
4.

A visiting physician to the Mayo Clinic, Rochester, MN, was delighted to be surrounded by so many lakes and in the summer would delight in taking his wife and 2 daughters to camp at one of these lakes. He and his family were avid swimmers and they thought that living in MN was just delightful. However, ten days after their last trip the whole family suddenly became sick, with persistent watery, extremely foul smelling diarrhea. There was very little cramping and the physician was still able to go to work. He took fecal samples from all of the family and borrowed a microscope as he thought the family had picked up a parasitic infection and he guessed that he would be able to spot the motile trophozoites. However, after examining samples from all of the family, he found no evidence of anything moving in the fecal samples. In the meantime, the whole family was treated with metronidazole and eventually the diarrhea went away. What is your conclusion from this?
- A.
  
  It is unlikely that trophozoites would be found in the feces and he should have looked for cysts
- B.
  
  The family members were probably infected with coliform bacteria and not parasites
- C.
  
  The samples were too dilute and he should have concentrated them before looking for trophozoites
- D.
  
  The infection was probably a protozoan but was self-limiting and the family would have no evidence of parasites in the feces after nearly two weeks post infection
5.

A 6-year-old boy who lived on a farm in Louisiana went barefooted at home in the summer. He complained of a red rash on his legs that was itchy. When he started school, the school nurse noticed that he was pale and lethargic. What is a likely helminthic infection in this case?
- A.
  
  Enterobius
- B.
  
  Schistosoma
- C.
  
  Ascaris
- D.
  
  Taenia
- E.
  
  Ancyclostoma
6.

A 35-year-old petroleum engineer went to work in Ecuador for a year. His work required him to eat and drink local food and water. Six months after arriving, he experienced a bout of dysentery, which resolved slowly while he took antibiotics. A month later, he noticed fever, tiredness, and pain in the right upper quadrant. A liver scan showed an abscess that measured 5X3 cm and was associated with elevated blood levels of liver enzymes. How did this disease develop?
- A.
  
  Motile trophozoites from the colon invaded the liver.
- B.
  
  Parasitic cysts from the small intestine invaded the liver
- C.
  
  Parasitic eggs traveled in intestinal veins to the liver
- D.
  
  Bacteria from ulcers in the colon migrated to the liver
- E.
  
  A hepatitis virus infected the liver to cause an abscess
7.

In a child with anal itching, a scotch tape test revealed this ovum: What infection is this?
- A.
  
  Ascaris lumbricoides
- B.
  
  Taenia solium
- C.
  
  Enterobius vermicularis
- D.
  
  Necator americanus
- E.
  
  Ancyclostoma duodenale
8.

The definitive diagnosis of parasitic infections is frequently made by the examination of stool samples for ‘ova and parasites’. However, some parasites do not produce ova that may be voided in stool and diagnosis may be made by other means such as tissue biopsy or from a blood smear. Which of the following parasites may be found in tissue sections but not in a stool sample?
- A.
  
  Trichinella spiralis
- B.
  
  Entamoeba histolytica
- C.
  
  Giardia lamblia
- D.
  
  Necator americanus
- E.
  
  Taenia saginata
9.

A member of the United Nations mission to Thailand was served 'bolli', a highly seasoned pork delicacy during a diplomatic reception. A few months later, she noticed thin, white, rectangular segments in her stool. There were no other symptoms. She received a single dose of niclosamide, which eliminated the organism. What was the most probable diagnosis?
- A.
  
  Echynococcosis
- B.
  
  Schistosomiasis
- C.
  
  Taeniasis
- D.
  
  Trichinosis
- E.
  
  Trichuriasis
10.

During an epidemiological survey, a student observed that many school children in a rural community appeared to be lethargic and pale looking. The children spent a lot of time running around on the local beaches and often complained of an intense pruritic and erythematous rash on the feet. Most of them had a low-grade fever with abdominal pain and intermittent diarrhea. Blood examination showed evidence of hypochromic, microcytic anemia and many ova were found in the stool specimens. Which of the following organisms was most probably responsible for the infection?
- A.
  
  Ascaris lumbricoides
- B.
  
  Ancylostoma duodenale
- C.
  
  Enterobius vermicularis
- D.
  
  Taenia solium
- E.
  
  Strongyloides stercoralis
- F.
  
  Trichuris trichiura
11.

A 40-year-old man was seen by his family doctor following complaints of problems with his memory. He also developed migraine-like headaches and signs of progressive psychosis. His other symptoms included nausea, vomiting, dizziness and focal seizures. Physical examination was essentially normal except for decreased visual acuity. A CT scan showed the presence of a brain lesion. CSF anticysticercal antibodies were demonstrated. Which of the following would be the most probable mode of the infection?
- A.
  
  The ingestion of undercooked pork
- B.
  
  The bite of an infected mosquito
- C.
  
  The ingestion of contaminated food
- D.
  
  The bite of a sand fly
- E.
  
  The ingestion of fish from contaminated water
12.

This 59 year old male suddenly developed severe abdominal pain and was taken to the emergency room. He had a decreased level of consciousness. Vitals: Heart rate 110, Blood pressure 90/60, Temperature 99⁰F The most likely diagnosis is:
- A.
  
  Ruptured diverticuli
- B.
  
  Volvulus of large intestine
- C.
  
  Infarction of splenic artery
- D.
  
  Ruptured aortic aneurysm
13.

A 31 year old man presents to the ER by ambulance following a collision between the car he was driving and a much larger truck. While he has mild shortness of breath, his main complaint is pain in his upper abdomen with no abdominal wall movement during respiration. You examine his X-ray (above). Your next action after resuscitation, would be to contact the
- A.
  
  Radiologist on call.
- B.
  
  General surgeon on call.
- C.
  
  Inpatient resident team for admission to the respiratory ward.
- D.
  
  Cardiologist on call
14.

A 35 year old man with a history of multiple abdominal surgeries secondary to a past motor vehicle accident, presents to the ER with abdominal pain and distention. X-ray shows:
- A.
  
  Large bowel obstruction secondary to constipation
- B.
  
  Small bowel obstruction secondary to diverticulitis
- C.
  
  Large bowel obstruction secondary to history of splenectomy
- D.
  
  Small bowel obstruction secondary to adhesions
- E.
  
  Normal bowel pattern
15.

A 48-year-old man presents to the ER by ambulance following an acute onset of abdominal pain. He has noticed some left lower quadrant pain over the last week. Temp 99⁰F RR 24 BP 90/60 mmHg. You examine his x-ray: As the chief resident on call, your next action after resuscitation would be to contact:
- A.
  
  The cardiologist on call
- B.
  
  The inpatient resident team for admission to the respiratory ward
- C.
  
  The general surgeon on call to perform an exploratory laparotomy
- D.
  
  The general surgeon on call for placement of a chest tube
16.

A 42-year-old woman is hospitalized with a shock-like condition. She is hypovolemic and physical exam and laboratory tests reveal multisystem organ failure. She has a moderate fever, a rapid pulse and diaphoresis. She also complains of constant vague upper right quadrant abdominal pain. She is diagnosed with sepsis and given supportive treatment and antibiotics. An abdominal CT scan reveals an enlarged gall bladder but no calculi. Which of the following would be the most likely cause of her gall bladder condition?
- A.
  
  Acute acalculus cholecystitis
- B.
  
  Carcinoma of the gall bladder
- C.
  
  Choledocholithiasis
- D.
  
  Chronic cholecystitis
- E.
  
  Primary biliary cirrhosis
17.

An elderly man with a recent irreducible swelling in the right groin complains of severe abdominal pain, projectile vomiting and absolute constipation. You did an abdominal X-Ray and it showed massive dilatation of the small intestine. What it the probable diagnosis?
- A.
  
  Pyloric stenosis
- B.
  
  Intussusceptions
- C.
  
  Indirect inguinal hernia
- D.
  
  Superior mesenteric artery embolism
- E.
  
  Direct inguinal hernia