TROPICAL MEDICINE
MCQs
1. The fol low ing are re co gnise d ca us es of
e o s i n o ph i l i a
a. visceral leishmaniasis
b. malaria
c. Churg-Strauss syndrome
d. drug hypersensitivity
e. visceral larva migrans (toxocariasis)
Answer 1
Eosinophilia F F T T
T
The upper limit of normal for eosinophils is usually taken to be
0.4x10^9/l. The causes of eosinophilia may conveniently be divided
into two groups: parasitic and non-parasitic. In general protazoal
infections do not produce eosinophilia. Helminths do cause eosinophilia
and the degree of eosinophilia is related to the extent of tissue invasion
by the helminth. Filarial worms often cause a high eosinophilia whereas
the intestinal nematodes tend to cause only a
,modest increase in the eosinophil
count.
Ta b l e 1 . 1
Important parasitic
c a u s e s of
eosinophilia
Filarial worms
Tapeworms
Strongyloidias
is Hydatid
disease
Hookworm
Fascioliasis
Toxocariasis (visceral larva
migrans) Schistosomiasis
Trichinella spiralis
Intestinal
nematodes
Tropical pulmonary eosinophilia (usually
results from hypersensitivity to
microfi lariae)
Non-parasitic causes
Ta b l e 1 .2
of e o s i n o p h i l i a
Allergic
disorders
Allergic
Asthma
disorder
s Eczema
Hayfeve
r
Drug
hyperse
nsitivity
Churg-Strauss
Auto-immune syndrome Wegener's
granulomatosis
Polyarteritis nodosa
Hodgkin's disease
Haematologic
Eosinophilic
al
leukaemia
Bullous
Dermatologica
pemphigoid
l
Pemphigus
vulgaris
Allergic
bronchopulmonary
Respiratory
aspergillosis
Hypereosinophilic
syndrome Asthma
Eosinophilia-myalgia
Miscellaneous
syndrome caused by L-
, Spanish toxic oil
syndrome Eosinophilic
gastroenteritis
2. Giardia
l a m usually
a.is blia acquired by ingestion of food or water
contaminated by the trophozoites
b. trophozoites have four flagella
c. can eff ectively be treated by mepacrine
d. cysts are killed by standard chlorination of water
e. cysts survive in water boiled for ten minutes
Answer 2
Giardiasis
Giardia lamblia is a protozoon. During the trophozoite phase it
lives in the proximal small bowel where it adheres to the
mucosa. Each trophozoite has four pairs of fl agella. Infection is
acquired though water contaminated with giardial cysts.
Infection is not confi ned to the tropics; although common in
India and Africa, attacks are notoriously common in various
Russian cities.
C l i n i c a l f e a t u re s : diarrhoea, fl atulence,
abdominal pain, malabsorption.
Tr e a t m e n t : usually metronidazole. Mepacrine and
furazolidone are also effective.
P r e v e n t i o n : standard chlorination of water does not kill
cysts but drinking water can be made safe by boiling for 10
minutes.
3. M os qui t oe s are the vector in the fol low ing
di sonchocerciasis
a. o rde rs
b. visceral
leishmaniasis
c. myiasis
d. African
trypanosomiasis
e. Bancroftian filariasis
Answer 3
Mosquitoe
s F F F F T
, Ta b l e 3 . 1
Diseases and
Ve c t o r s
Disease Ve c t o r
Onchocerciasis Simulium sp
Sandfl y (Plebotomus
Visceral leishmaniasis
or Lutzomyia)
Myiasis No vector
African
Tsetse fl y (Glossina)
Trypanosomias
is
Various
Bancroftian filariasis
mosquito
species
In myiasis the tumbu fl y larva itself is the pathogen. The
tumbu fly lays its eggs on clothing. When in contact with
human skin, larvae hatch and burrow into the skin causing
painful boils.
Ta b l e 3 . 2
Diseases with mosquito vectors
Disease Mosquito vector
Malaria Anopheles sp
Dengue fever Aedes aegypti
Yellow fever Aedes aegypti
Viral
various species
haemorrhagic
fevers
Japanese encephalitis culex sp
Mosquitoes are not thought to be vectors for HIV or Ebola
virus.
4.C o n s u m p t i o n o f r a w fi s h o r s h e l l fi s h i s a s s o c i a t e d
with i n f e c t i o n c a u s e d b y
a. Clonorchis sinensis
b. Ancylostoma duodenale
MCQs
1. The fol low ing are re co gnise d ca us es of
e o s i n o ph i l i a
a. visceral leishmaniasis
b. malaria
c. Churg-Strauss syndrome
d. drug hypersensitivity
e. visceral larva migrans (toxocariasis)
Answer 1
Eosinophilia F F T T
T
The upper limit of normal for eosinophils is usually taken to be
0.4x10^9/l. The causes of eosinophilia may conveniently be divided
into two groups: parasitic and non-parasitic. In general protazoal
infections do not produce eosinophilia. Helminths do cause eosinophilia
and the degree of eosinophilia is related to the extent of tissue invasion
by the helminth. Filarial worms often cause a high eosinophilia whereas
the intestinal nematodes tend to cause only a
,modest increase in the eosinophil
count.
Ta b l e 1 . 1
Important parasitic
c a u s e s of
eosinophilia
Filarial worms
Tapeworms
Strongyloidias
is Hydatid
disease
Hookworm
Fascioliasis
Toxocariasis (visceral larva
migrans) Schistosomiasis
Trichinella spiralis
Intestinal
nematodes
Tropical pulmonary eosinophilia (usually
results from hypersensitivity to
microfi lariae)
Non-parasitic causes
Ta b l e 1 .2
of e o s i n o p h i l i a
Allergic
disorders
Allergic
Asthma
disorder
s Eczema
Hayfeve
r
Drug
hyperse
nsitivity
Churg-Strauss
Auto-immune syndrome Wegener's
granulomatosis
Polyarteritis nodosa
Hodgkin's disease
Haematologic
Eosinophilic
al
leukaemia
Bullous
Dermatologica
pemphigoid
l
Pemphigus
vulgaris
Allergic
bronchopulmonary
Respiratory
aspergillosis
Hypereosinophilic
syndrome Asthma
Eosinophilia-myalgia
Miscellaneous
syndrome caused by L-
, Spanish toxic oil
syndrome Eosinophilic
gastroenteritis
2. Giardia
l a m usually
a.is blia acquired by ingestion of food or water
contaminated by the trophozoites
b. trophozoites have four flagella
c. can eff ectively be treated by mepacrine
d. cysts are killed by standard chlorination of water
e. cysts survive in water boiled for ten minutes
Answer 2
Giardiasis
Giardia lamblia is a protozoon. During the trophozoite phase it
lives in the proximal small bowel where it adheres to the
mucosa. Each trophozoite has four pairs of fl agella. Infection is
acquired though water contaminated with giardial cysts.
Infection is not confi ned to the tropics; although common in
India and Africa, attacks are notoriously common in various
Russian cities.
C l i n i c a l f e a t u re s : diarrhoea, fl atulence,
abdominal pain, malabsorption.
Tr e a t m e n t : usually metronidazole. Mepacrine and
furazolidone are also effective.
P r e v e n t i o n : standard chlorination of water does not kill
cysts but drinking water can be made safe by boiling for 10
minutes.
3. M os qui t oe s are the vector in the fol low ing
di sonchocerciasis
a. o rde rs
b. visceral
leishmaniasis
c. myiasis
d. African
trypanosomiasis
e. Bancroftian filariasis
Answer 3
Mosquitoe
s F F F F T
, Ta b l e 3 . 1
Diseases and
Ve c t o r s
Disease Ve c t o r
Onchocerciasis Simulium sp
Sandfl y (Plebotomus
Visceral leishmaniasis
or Lutzomyia)
Myiasis No vector
African
Tsetse fl y (Glossina)
Trypanosomias
is
Various
Bancroftian filariasis
mosquito
species
In myiasis the tumbu fl y larva itself is the pathogen. The
tumbu fly lays its eggs on clothing. When in contact with
human skin, larvae hatch and burrow into the skin causing
painful boils.
Ta b l e 3 . 2
Diseases with mosquito vectors
Disease Mosquito vector
Malaria Anopheles sp
Dengue fever Aedes aegypti
Yellow fever Aedes aegypti
Viral
various species
haemorrhagic
fevers
Japanese encephalitis culex sp
Mosquitoes are not thought to be vectors for HIV or Ebola
virus.
4.C o n s u m p t i o n o f r a w fi s h o r s h e l l fi s h i s a s s o c i a t e d
with i n f e c t i o n c a u s e d b y
a. Clonorchis sinensis
b. Ancylostoma duodenale
