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13 Exercises

  1. Gambia. A mother asks for advice. Her daughter’s faeces contained several worms. You ask the length of the parasites. What do you think if the mother replies 30 cm, or 1 cm, or 3 cm?
  2. Is there a clinically important difference between Taenia solium and Taenia saginata? Is it possible to differentiate the eggs under a microscope?
  3. Congo. A 29-year-old man has been coughing for five weeks. There is eosinophilia. Sputum for acid-fast bacilli is negative. Your colleague asks whether the man ate crabs a few months ago. What diagnosis is he considering?
  4. Mexico. Epilepsy is common in the region where you work. Which parasitic cause needs to be ruled out? What would you advise as prevention?
  5. Brazil. A woman has had problems for one week with a swollen, puffy face, chiefly around the eyes. Do you consider trichinellosis, Chagas’ disease or nephrotic syndrome? What do you do? Are there simple tests which can help in your diagnosis?
  6. Vietnam. A man has diarrhoea. Examination of the faeces for parasites shows: "Countless eggs of Trichinella spiralis". What do you think and what do you do?
  7. Northern Thailand. You are asked if eating raw fish is dangerous. What is your answer, what are your reasons?
  8. Jamaica. A 15-year-old girl is suffering from anal itch. There are no haemorrhoids and repeated Scotch tape tests have shown no oxyurids. She has not noticed any Taenia proglottids. There are a few itching lines moving under the skin. What do you think and what do you do?
  9. Tobago (Trinidad). Which worms lead to important anaemia?
  10. Haiti. A girl has had fever for 2 months and is clearly emaciated. She coughs often. In the stools Ascaris eggs are observed. What do you think?
  11. If all the snails in an area are destroyed, will this have an effect on nematode, trematode or cestode infections?
  12. Do all the trematode infections transmitted by food involve hermaphrodite parasites?
  13. Farouk is a deeply devout Muslim and works as an archaeologist in rural Mexico, together with his German friend Jurgen and his American colleague John. Jurgen is a vegetarian and John likes his daily portion of meat. Can Farouk and Jurgen develop cysticercosis? Can John?
  14. See last question. If Farouk should develop cysticercosis, should he then ask himself whether he has sinned by eating "impure" pork?
  15. Lesotho. A Swiss family of 4 people. The father suffers regularly from anal itch. He has noticed oxyurids and taken mebendazole (Vermox®). After a month the same symptoms return. The whole family is now treated with Vermox®. However, there is another relapse after 4 weeks. Do you now consider resistance, exogenous re-infection or incomplete treatment?
  16. Congo. You suspect trichinellosis in a patient. A small muscle biopsy is surgically removed from the quadriceps. This muscle fragment is pressed between 2 glass slides. Can you look at the whole biopsy to find the encapsulated larvae with a simple magnifying glass or do you need a microscope?
  17. Bolivia. You are working in the northern Altiplano, between Lake Titicaca and the capital. This is a region with many animals (sheep, cattle, pigs, goats, horses, donkeys, llamas, alpacas). Would this information be important to explain the high incidence of fasciolasis?

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