1. INTERSTINAL AND UROGENITAL PROTOZOA

2.  DISEASE: AMEBIASIS DYSENTERY  - inverted flask-shaped lesions in the large intestine with extension to the peritoneum, liver, lungs, brain and heart.  -blood and puss in stools  -liver abscesses- most severe complication  Transmission- fecal-oral  Diagnosis- trophozoites or cysts in stool  Treatment- metronidazole followed by iodoquinol

3.  In the Us: most prevalent enteric parasite  Leading infections agent in water borne out breaking of diarrhea.  Disease: Giardasis: ventral sucking disk attaches to lining of duodenal wall, causing fatty, foul- smelling diarrhea  Diarrhea- malabsoption duodenum and jejunum  transmission: fecal oral  Diagnosis: trophozoites or cysts in stool  Treatment: metronidazole

4.  CRYPTOSPORIDIOSIS: Transient diarrhea in healthy and severe in immunocompromised  Forms/transmission:  Cyst  Undercooked meat and water  Diagnosis: acid fast occysts in stool( round)  Treatment: healthy-self limiting  IC- nothing has proven completely successful

5.  Disease: Isosporiasis- Transient diarrhea in healthy and SEVERE in IC  FORMS/TRANSMISSION  Cyst  Fecal oral ingestion of occyst  Diagnosis: acid fast& elliptical occyst  Treatment: TMP-SMX or pyrimethamine/sulfadiazine  Causes malabsorption similar to giardia

6.  SEVERE DIARRHEA IN AIDS  TRANSMISSION: FECAL ORAL  DIAGNOSIS: ACID FAST, SPHERICAL OCCYTS  TREATMENT: TMS

7.  Persistent diarrhea in Aids  Transmission: spores, fecal oral  Diagnosis: Gram(+), acid fast spores in stool  Treatment: no proven treatment

8.  Abnormal alkalinity of vaginal favour disease  Disease: trichomoniasis  Asymptomatic: frothy, malidorous, yellow- green vaginal discharge  Inflammation of the vagina( strawberry vagina), vulva, cervix  Forms/transmission  Trophozoites  Sexual  Formites( sharing a towel)  Diagnosis: motile trophozoites in methylene blue in wet mount  Treatment: metronidazole

9.  A 40yrs woman develop bloody mucoid diarrhea with abdomial cramping after eating fresh fruit in a small mexican village. 4 mouths later, she still has intermittent abdominal pain. A CT scan of the abdomen shows evidence of a necrotic liver lesion.  Which of the following is the best treatment for this patient  A. course of ampicillin, gentamicin  B. course of metronidazole  C. surgical excision of hepatic lesion  D. biopsy of the hepatic lesion

10.  A 24 year old AIDS patient develops chronic abdominal pain, low-grade fever, diarrhea and malabsorption. Acid-fast oocyst are demonstrated in the stool. Which of the following organisms is most likely the course of the patients diarrhea?  A. Diphyllbothrium latum  B. Crytosporidium parvum  C. Entamoeba histolytical  D. Isospora belli  E.Giardia lambia  F. Microsporidia

11.  An 18yo woman went hiking on th appalachian trail. Most of the time, she used a filter for drinking from streams. Upon returning home, she experienced laodorous, gressy diarrhea for about 3 wks but no fever, abdominal pain or occult blood. Her hiking companion who used a water filter on every occasion, did not experience diarrhea, she denies recent foreign travel. Which organism is responsible for this patients diarrhea  A. entamoeba histolytica  B. giardia lamblia  C.salmonella enteritidis  D. shigella glexneri  E. vibrio cholera

12.  A 43 yo man presents to your service with complaining of 3 day history of loose bulky greasy foul smelling stool and excessive flatulence. He denies blood or mucus in the stool. Denies fever, nause, vomiting and recent travel. Which of the following is the most likely diagnosis  A. amebiasis  B. celiac sprue  C. enteritis due to crytosporidium  D. giardiasis  E. irritable bowel syndrome

13.  The flagellates on the left were found in a vaginal smear of a female student (obviously) who complained of vaginitis. The trophozoites measured about 25 micrometers long x 17 micrometers wide. What species do they represent?  A.Giardia lamblia B.Pentatrichomonas hominis C. Trichomonas tenax D. Trichomonas vaginalis

14.  A 20 year-old female was admitted into the hospital complaining of 10 to 15 bloody mucous stools per day, fever, gastrointestinal disturbances, abdominal pain, and nausea. The preliminary O & P report went out as "Probable Entamoeba histolytica trophozoites and cysts, confirmation pending." This patient is most likely suffering from:  A. Traveler's diarrhea  B.Extraintestinal amebiasis  C.Intestinal amebiasis  D.Giardiasis

15.  A 21 year old male presented in the emergency room with symptoms resembling a liver infection. The patient complained of abdominal pain, fever, cough, nausea, vomiting and constipation alternating with diarrhea. Further examination revealed the presence of a hepatic abscess. This suspicious form was recovered following parasitic examination of a sample from the abscess and measures 20 µm. What condition is the patient most likely suffering from?  Please select the single best answer  A.Intestinalamebiasis  B.Meningoencephalitis  C.Giardiasis  D.Extraintestinal amebiasis