Name: Richard Owens

Theme: Parasites

 

OPTION LIST

 

A

Ancylostoma duodenale

I

Schistosoma mansoni

B

Clonorchis sinensis

J

Taenia saginata

C

Echinococcus granulosus

K

Toxoplasma gondii

D

Entamoeba histolytica

L

Trichinella spiralis

E

Giardia lamblia

M

Wucheria bancrofti

F

Leishmania donovani

 

 

G

Loa-Loa

 

 

H

Plasmodium falciparam

 

 

 

For each scenario below, choose the most appropriate aetiological organism from the list above. Each option may be used once, more than once or not at all.

 

1. A 16 yr old boy C/O 1/52 history of fever, muscle aches, nausea/vomiting/diarrhoea with general malaise following a trip to Zimbabwe visiting relatives. On further questioning he remembers developing an itchy rash on his R thigh following wading in Lake Kariba whilst on holiday. O/E He has generalised lymphadenopathy with hepatosplenomegaly. Initial blood tests reveal raised WCC with eosinophillia.  

 

2. A 25 yr old female humanitarian volunteer C/O swinging fever, profound abdominal pain with severe malaise. On further questioning she reveals a history of self limiting diarrhoeal illness 3/52 ago during which she passed mucus and some blood. You are also informed she recently returned from a humanitarian mission to Ghana 6/52 ago. O/E she is unwell with exquisitely tender hepatomegaly. You also find increased breath sounds and a dull percussion note in the lower region of the R lung.

 

3. A 24 yr old male C/O 3/52 history of fever/chills with muscular aches and spasms. On further questioning he reveals the he also an episode of diarrhoea/vomiting with a headache lasting 48hrs. This followed his participation in an amateur eating competition 1/12 ago, during which he may have eaten some improperly cooked pork. O/E he has marked periorbital oedema with conjunctivitis. Blood tests reveal a marked eosinophillia, while gastrocnemius biopsy demonstrates the presence of encysted larvae.

 

4. An acutely unwell 42 yr old male presents to A&E with high fever accompanied by chills, sweats and vomiting with a 24 hour history. O/E he is clinically jaundiced with cool clammy skin. He is tachypnoeic and tachycardic. You note hepatosplenomegaly and that he is producing small amounts of dark brown urine in his catheter bag. His wife tells you that they recently returned from safari in Tanzania 10 days ago.

 

5. A 32 yr old female C/O the presence of small pale bodies in her stools on a number of occasions. On further questioning she admits some occasional mild epigastric pain over the past 4/12. O/E she appears clinically well. There is no significant travel history.

 

 

 

ANSWERS

1. I

2. D

3. L

4. H

5. J