Zaporozhyan state medical university departement of infectious diseases

59 

Appendix№4 

Task for self control: 

 

1. The patient of 42 years old complains on acute headache, tenderness of 

the muscles of the extremities. The general weakness, fever, edemas around the 

eyes developed a week ago. The physician diagnosed influenza and prescribed 

Amixin IC. An improvement didn’t come. His wife also fell ill. She complaints of 

muscle pain, bad condition. They had eaten fried pork, bought 12 days ago. The 

temperature is 38, 3

C, the face is edematous. The muscles of extremities are 

painful.  The abdomen is soft. Stool is 2 times per day. In the blood count: Нв-133 

g/l, L-15,0, B-1 %,E-40 %, U-1 %,B-7  %,S-3%,L-8  %, М-6%, ESR-25 mm /h. 

1.

 

What is the preliminary diagnosis?  

2.

 

What methods are used for diagnostics of the disease? 

3.

 

What therapy would you prescribe? 

2. The patient of 40 years old was referred with complaints of high 

temperature to 39

C, pains in the eyes and muscles. The disease began with 

general weakness, digestive disturbances. The patient had pork, bought from the 

neighbour 2 weeks ago.  Objectively: there are edema of the face, plentiful  

exudative-papular eruption on the body, adynamia, symptoms of myocarditis. In 

the blood count eosinophilia (45 %) is marked. 

1.

 

What is the preliminary diagnosis?  

2.

 

What methods are used for diagnostics of the disease? 

3.

 

What therapy would you prescribe? 

3. The patient of 42 years old complains of acute headache, tenderness of the 

muscles of the extremities. The general weakness, fever, edemas around the eyes 

developed a week ago. The physician diagnosed influenza and prescribed 

Amidopyrinum. An improvement didn’t come. His  wife also fell ill. She 

complaints of muscle pain, bad condition. They had eaten fried pork, bought 12 

days ago. The temperature is 38,3

C. the face is edematous. The muscles of 

extremities are painful.  The  abdomen is soft. Stool is 2 times per day grueled. In 

the blood count: Нв-133 g/l, L-15,0, B-1 %,E-40 %, U-1 %,B-7  %,S-3%,L-8  %, 

М-6%, ESR-25 mm /h. 

1. 

What is the preliminary diagnosis?  

2. 

What methods are used for diagnostics of the disease?  

3. 

What therapy would you prescribe? 

4. The patient of 25 years old complains of weakness, nausea, pain in the 

right iliac area, stool 3-4 times a day, without pathological admixtures, periodically 

meteorism. She has been sick for 2 years. The sharp increase of the appetite, and 

following its decrease was marked in the beginning of the disease. At the last time 

she paid attention on discharge of the tape formations in defecation and in the bad 

in the morning. These formations have white color and size 1-2 cm in diameter. 

Epidemiological anamnesis: she is a cook. She frequently taste uncooked beef 

mince. Objectively: The skin and visible mucous membrane are pink. The tongue 

is coated with white fur. The peripheral lymphatic nodules are no palpated. The 

pulse rate is 72 beats per minute, rhythmical. Heart sounds are muffled. The lungs 

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60 

are without peculiarities. The abdomen is soft, inflated and painless during 

palpation. The liver and the spleen are no palpated. There is eosinophilia and 

anemia in general blood analysis.  

1.

 

What is the preliminary diagnosis? 

2.

 

What methods are used for diagnostics of the disease?  

3.

 

What therapy would you prescribe? 

5. The patient of 21 years old complains of pain in the epigastrium, 

heartburn, nausea, decreased appetite, weakness, loss of weight, irritability, 

constipations, alternated by diarrhea. She works as an accountant on a fish farm. 

On examination: paleness of her skin and mucous membranes, the tongue of bright 

red color with flatted papillas are reveled, the pains are on percussion of the 

breastbone. The liver and spleen are enlarged a little. There are decreased level of 

hemoglobin, erythrocytes of large sizes, color index – 1.2 in general blood 

analysis. The number of eosinophiles in increased. Gastric acholia is determined in 

the investigation of the gastric contents. 

6. The woman of 36 years old is a worker of the fish plant. She came to the 

polyclinic with complaints of heartburn, unstable stool, weakness. The itching rash 

periodically developed on the body. On examination: her skin is pale, single 

elements of urticaric rash are marked. The stomach is soft, slightly painful around 

the umbilicus. On examination of the blood: hyperchromatic anemia, eosinophilia 

to 9% are marked.  

1.

 

What is the preliminary diagnosis?  

2.

 

What methods are used for diagnostics of the disease? 

3.

 

What therapy would you prescribe? 

 

7. 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?  

 

8. Is there a clinically important difference between Taenia solium and Taenia 

saginata? Is it possible to differentiate the eggs under a microscope? 

9. 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? 

10. Mexico. Epilepsy is common in the region where you work. Which 

parasitic cause needs to be ruled out? What would you advise as prevention? 

11. 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? 

12. 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? 

13. Northern Thailand. You are asked if eating raw fish is dangerous. What is 

your answer, what are your reasons? 

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61 

14. 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? 

15. Tobago (Trinidad). Which worms lead to important anaemia? 

16. 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? 

17. If all the snails in an area are destroyed, will this have an effect on 

nematode, trematode or cestode infections? 

18. Do all the trematode infections transmitted by food involve hermaphrodite 

parasites? 

19. 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? 

20. See last question. If Farouk should develop cysticercosis, should he then 

ask himself whether he has sinned by eating “impure” pork? 

21. 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?  

22. 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? 

23. 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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62 

Appendix№5 

Tests for self control 

 

1)

 

Where do the eggs of Ascaris lumbricoides develop into invasive stage? А. 

in intestines of human, B. in perianal folds during 4-6 hours, C. in the ground 

during 2 weeks by temperature 25ºC, D. in lungs, E. in liver of human. 

2)

 

The source of Enterobiosis invasion is infected: A. cattle, B. pig, C. human, 

D. cat, E. fish. 

3)

 

What is the main method of diagnostics of Enterobiosis? A. indirect 

hemagglutination test, B .immune-enzyme analysis, C coprogram, D. investigation 

the scrape from the perianal skin, E. coproculture. 

4) For 

what 

helminthiasis 

percutaneous way of transmission is typical?: A. 

strongyloidiasis, B. necatoriasis, C. ankylostomiasis, D. B and C are correct, E. 

everything is right. 

5) 

At serious ascariasis following surgical complications are typical, except:  

A. asphyxia, B. suppurative cholangitis, C. rectal prolapse, D. intestinal bstruction,  

E. abscesses of the liver. 

6)  Which method of treatment of Enterobiosis is the most correct: A. 

anthelmintic drugs combined with strict hygiene regime, B. anthelmintic drugs 

ombined with daily night spasmolytic enemas, C. 3-4 courses of treatment with 

metronidazole, D. surgical treatment, E. daily night enemas with ammonia soda to 

prevent  perianal itching. 

7) 

Indicate which type of worms belongs to contagious?: 

A. trichuriasis, B.teniasis, C. enterobiasis, D. opisthorchiasis, E. ascariasis. 

8) 

The patient 30 years old has weakness, fever up to 39 ° C. On R-graphy 

eosinophilic lung infiltrates migratory nature were revealed. What disease the 

patient has? A. pulmonary tuberculosis, B. lobular pneumonia, C. ascariasis, 

migration phase, D. polisihmentarna pneumonia, E. lung cancer. 

9) 

The patient complains of weakness, poor appetite, intermittent abdominal 

pain. In ovoskopy study of feces roundworm's eggs were found. What treatment 

should be prescribed to patient for deworming? A. hygienic treatment, B. 

levamisole, C. ceftriaxone, D. norfloxacin, E. fenasal. 

10)  The patient with ancylostomiasis has manifestation of iron deficiency 

anemia (decreased absolute number of red blood cells, decreased hemoglobin and 

color index). Indicate the cause of this clinical manifestation in ancylostomiasis? 

A. bleeding, B. hookworm are true hematophah, C. toxic-allergic action of 

ankilostom metabolites, D. perforation of vessels, E. violation vascular 

permeability. 

11)   In the specific diagnostics of trichinellosis  the main is to detect: A. ovum in 

feces, B. helminthiasis in feces, C. larva in biopsy material, D. ovum in scraping 

from perianal folds, E. eosinophilia in blood. 

12)  The symptoms of which helminthic invasion are: acute onset, fever, 

muscular pains, conjunctivitis, allergic rash? A. echinococcosis, B. ascaridiasis, C. 

diphyllobothriasis, D. opisthorchiasis, E. trichinellosis. 

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63 

13)  The patient A. has headache, deltoid muscles pains, appearance of skin rash. 

The medical examination has detected painfulness of muscles of left shoulder joint. 

The eosinophilia in the blood is up to 40%. The rontgenography of left shoulder 

joint has shown calsifications (size 3mm x 1,2mm) with effect of perifocal 

inflammation in soft tissues of deltoid muscle. What disease is characterized by 

these clinical signs? A. nonspecific polyarthritis, B. trichinellosis, C. leptospirosis, 

D. toxicoallergic dermatitis, E. extrapulmonary tuberculosis. 

14)  Trans-dermal route of transmission is typical? A. trichocephalosis, B. 

teniasis, C. strongylosis, D. opisthorchiasis, E. ascariasis. 

15)  Leading syndrome in trichinellosis? A. immunosuppressive, B. toxic-

allergic,C. adynamic – neurotic, D. dyspepsial, E. all not true.  

16)  The development of mature forms of Trichinella are: A. on the microvilli in 

the small intestine, B. in the striated muscle, C. in the submucosal layer of the 

small intestine, D. in the large intestine, E. in the stomach. 

17)  The development of the larval stage of Trichinella are: A. on the microvilli 

in the small intestine, B. in the intermuscular septa of the striated muscle, C. in the 

submucosal layer of the small intestine, D. in the large intestine, E. in the stomach. 

18)  Transmissible mechanism of transmission is typical: A. dirophylariosis,  

B. teniasis, C. strongylosis, D. opisthorchiasis, E. ascariasis. 

19)  By biohelminths include all, exept: A. difilobotrios, B. strongylosis, C. 

teniasis, D. teniarinhosis, E. trichinellosis. 

20)  Dogs are the source of contamination: A. teniasis, B. opisthorchiasis, C. 

strongylosis, D. toxocarosis, E. ascariasis.  

21)  What is the agent of pork worm disease? А. Taenia soleum, B. Hymenolepis 

nana, C. Taeniarhynchus saginatus, D. Trichinella spiralis, E. Dyphylobotrium 

latum 

22)  What are the principal clinical syndromes in pork worm disease? А. 

respiratory syndrome, B. cholestatic syndrome, C. dyspeptic syndrome, D. 

meningeal syndrome, E. everything is right 

23)  How is the source of invasion in case of cystecercosis? А. cattle, B. dog, 

C. pig, D. human, E. fish 

24)  What methods are used for diagnostics of cystecercosis? А. General blood 

analysis, B. biochemistry methods, C. computed tomography, D. investigation of 

faeces, E. nothing is right  

25)  The invasion of the human with Dyphillobotirum latum is possible to get 

after eating: А. fresh water fishes, B. sea fishes, C. pork, D. beef, E. milk. 

26)  What is the duration of the life of the adult forms in echinoccosis? А. It is 

continued from 6 months till 1 year, B. It is continued 1 week, C. It is continued 10 

weeks, D. It is continued more than 10 years, E. It is continued 7 days,   

27)  What is epidemiology of echinoccosis? А. It is transmissive helminthiasis, 

B. It is heohelminthiasis, C. It is biohelminthiasis, D. It is contagious 

helminthiasis, E. It is especially dangerous disease 

28)  What is the possible localization of hydatid cyst? А. liver, B. lungs, C. brain, 

D. everything is right, E. nothing is right 

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64 

29)  What is treatment should be administered in pork tapeworm? А. vermitin 

(phenasalum; Niclosamidum), B. Filicis maris rhizome, C. mebendazol, D. decaris 

(levamysol), E. chloxil 

30)  How is the definitive host in case of Taeniarhynhosis? А. cattle, B. dog, C. 

pig, D. human, E. fish 

31)  What is epidemiology of hymenolepiasis? А. It is peroral helminthiasis, B. It 

is percutaneous helminthiasis, C. It is contagious helminthiasis, D. It is 

transmissive helminthiasis, E. It is especially dangerous disease 

32)  What is epidemiology of fascioliasis? А. It is anthroponosis, B. It is 

zoonosis, C. The definitive host is human and cattle, D. The intermediate hosts are 

the pigs, E. The intermediate hosts are mollusks, 

33)  What is epidemiology of fascioliasis? А. It is anthroponosis, B. It is 

zoonosis,  C. The definitive host is human and cattle, D. The intermediate hosts are 

the pigs, E. The intermediate hosts are mollusks. 

 

 

 

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65 

 

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