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Parasitic Information and Courses from MediaLab, Inc.

These are the MediaLab courses that cover Parasitic and links to relevant pages within the course.

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Laboratories Individuals

CLIA Hematology / Hemostasis Review
Eosinophilia is commonly found in which of the following disorder(s):View Page

CLIA Microbiology / Serology Review
The iodine prep is most helpful to identify which of the following parasitic stages:View Page

Introduction to Bone Marrow
Mott Cell

Another rare but abnormal type of plasma cell is the Mott cell (morula cell). The compartments visible in the cytoplasm are immunoglobulins which have not been released. Mott cells may be seen in parasitic infections and malignant tumors.

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Normal Peripheral Blood Cells
Match functions with the corresponding cells.View Page
Match the characteristics with the cells.View Page
Eosinophils in Parasitic Infections and Allergic Reactions

Eosinophils are active in parasitic infections and in allergic reactions such as asthma and hay fever, and may be present in great numbers in the peripheral blood during these conditions.Stress, shock, or burns may also cause an increase in this type of cell.Eosinophils modulate an allergic response by liberating substances which can neutralize mast cell and basophil products.

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Eosinophils are increased in all of the following conditions EXCEPT:View Page

Parasitology Review
Which of the following is the recommended protocol for collecting stool samples in order to rule out a parasitic infection?View Page
The ideal stool sample for parasitic examination is one that is freshly collected and submitted to the laboratory at:View Page
Which of the following safety measures must be in place when handling initial samples for parasite study?View Page
A 38 year-old male presented to the E.R. complaining of severe cough, chest pain, shortness of breath and general fatigue. Parasitic examination of his bloody sputum revealed this suspicious form. The patient is most likely suffering from:View Page
This suspicious form is associated with which of the following conditions?View Page
These suspicious forms were recovered in cerebral spinal fluid (CSF). They are responsible for causing:View Page
This suspicious form, recovered in stool, measures 12 µm in length. Which of the following conditions is this form responsible for causing when present?View Page
A 68-year-old female, who recently vacationed in Brazil, presented to her physician exhibiting overall weakness, fever, and enlarged lymph nodes. Blood was collected for culture and parasitic examination. The culture was negative. This suspicious form was recovered upon examining the Giemsa-stained preparation. This patient is most likely suffering from:View Page
Match each parasite listed here with its respective classification:View Page
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?View Page
A 31 year old male missionary worker recently returned from Africa where he helped a small rural community update their sanitation practices. He presented to his physician weak and complained of recent weight loss, abdominal pain, and diarrhea that was often bloody. The doctor ordered a battery of tests including a complete blood count (CBC) and stool for parasite examination. The CBC revealed eosinophilia and anemia. This suspicious form was seen on the wet preparations. It measured 52 µm by 27 µm. What parasite is mostly likely present?View Page
An 18 year old female athlete, who recently competed in a barefoot run for charity in Southern Georgia, presented to her doctor for a routine check-up. Other than complaining of being exhausted and having occasional diarrhea, she was in good health. The doctor ordered a stool for culture and parasite examination. The culture was negative. Numerous suspicious forms, as that shown here, were seen upon microscopic examination of the stool. The name of this suspicious form is:View Page
A 58 year old male, who recently returned from an extensive overseas business trip to Africa, presented to the local clinic complaining of nausea, vomiting, and an achy feeling all over his body. At first he thought it was just the flu, but it persisted. The doctor ordered a battery of tests including blood smears for parasitic study. This suspicious form was recovered. The patient is most likely suffering from:View Page
An 18 year old immigrant from the Philippines presented to the local clinic shortly after relocating to the United States complaining of fever and chills. Examination of the young adult revealed enlarged lymph nodes. Blood was drawn and submitted for culture and parasitic examination. The culture was negative. This suspicious form was seen on the Giemsa-stained blood smear. It measures 225 µm in length. This patient is most likely infected with:View Page
A 16 year old male champion athlete went to his doctor complaining of a persistent cough, fever, bloody diarrhea and overall weakness. Upon questioning the patient, it was learned that he had recently competed in a freshwater swimming competition in the Caribbean. Examination revealed a dermatitis on the patient's right calf. A battery of tests were ordered including a CBC, chemistry profile, and a stool for culture and parasitic examination. The CBC revealed the presence of eosinophilia. The other hematology and chemistry tests were unremarkable. The culture was negative. This suspicious form was seen on all parasite preparations made from the stool sample submitted. This form measures 165 µm by 68 µm. This patient is most likely suffering from an infection with:View Page
A 7 year old male presented to the local clinic experiencing mild, yet annoying, abdominal pain, diarrhea and nausea. Patient history revealed that the child lives in a shack where sanitation practices are marginal, at best. The dwelling is infested with rats and multiple insects. Stool was collected and submitted for parasitic study. Numerous suspicious forms, measuring 60 µm by 75 µm were seen. This child is most likely infected with:View Page
A 27 year old female graduate student recently returned from South America, where she completed a nature study of the rain forest. She spent months "living off the land." The woman went to her physician seeking treatment for a sinus infection, which she thought was responsible for several recent bouts of diarrhea. Upon questioning the patient, the doctor decided to collect stool for culture and parasitic examination. The stool culture was reported as "no enteric pathogens isolated." This suspicious form was seen on both wet preparations and on permanent stain. It measures 17 µm. The identify of this form is most likely:View Page
A fresh stool sample was submitted to the laboratory for parasitic examination on a 30 year old male who presented to a local clinic complaining of gastrointestinal discomfort and overall weakness. The only patient history available about the patient was that he was here job hunting and that he is originally from rural Mississippi. The sample was immediately processed and this suspicious form was seen. No other suspicious forms resembling eggs were seen. The patient is most likely infected with:View Page
A 31 year old female with a known history of amebiasis, presented to her physician complaining of bloody diarrhea and fever. Previous patient history revealed that she lives in substandard conditions. Parasitic examination of the woman's stool revealed this suspicious form that measures 20 µm. The identification of this form is:View Page
A 10 year old male presented to the local Appalachian Mountain clinic complaining of vomiting, fever and severe abdominal pain. Patient history revealed that the child lives in the area in substandard conditions and receives only one balanced meal per day. A stool was collected and submitted for parasite study. This suspicious form, measuring 50 µm by 35 µm was found. This patient is most likely infected with:View Page
A 40 year old male recently completed a two-week hiking expedition in Russia. Upon his return to the United States, the man presented to his physician complaining of severe foul-smelling diarrhea and abdominal discomfort. The doctor immediately suspected a parasitic infection and ordered stool for examination. The sample was loaded with this suspicious form that averaged 13 µm in length. This patient is most likely suffering from:View Page
A 4 year old female from South Carolina was rushed to the emergency room who was suffering from malaise, bloody diarrhea and abdominal pain. Examination revealed rectal prolapse. Stool was submitted for parasitic examination and this suspicious form was seen. It measures 45 µm by 20 µm. Which of the following is the correct identity of this suspicious form?View Page
A 54 year old Finnish male presented at the local clinic with abdominal pain, weight loss, overall weakness and digestive discomfort. Patient history revealed that the man's diet was rich in raw fish. A complete blood count (CBC) was performed and revealed macrocytic anemia. A stool for parasitic examination was ordered. This suspicious form was seen upon initial screening of the sample. It measures 77 µm by 48 µm. This patient is most likely suffering from an infection with:View Page
A 40 year old male just returned from a six-month tour of the Far East. He went to his doctor upon his return complaining of weakness, diarrhea, fever and cough. Upon questioning the patient it was learned that he spent many an evening swimming in the various local fresh water ponds. The doctor, suspicious of a parasitic infection, ordered a stool for examination. Two suspicious forms were seen: form 1 is roundish and measures 77 µm by 62 µm. Form 2 is long and ladder-like and lays on the edge of form 1. What are these two structures?View Page
A stool collected at a local doctor's office was received in the laboratory for parasitic examination. The sample was not received in fixative and due to the new courier system did not arrive in the lab within the traditionally acceptable time frame. Due to logistical difficulties of the patient collecting and submitting another sample, the laboratory director authorized the sample to be processed. The comment "specimen delayed in transit, please evaluate results accordingly" was included in the report. These two suspicious forms were seen upon examination of the specimen. Label these two forms:View Page
A 6 year old female presented to the local clinic complaining of intense perianal itching and diarrhea. The doctor ordered a cellophane tape prep and stool for routine culture and parasitic examination. The cellophane tape prep revealed suspicious form on the left. The stool culture was negative. The form on the right was seen upon examination of the stool for parasites, which measures 10 µm. Label these two suspicious forms:View Page
A 27 year old West African immigrant went to the local clinic complaining of fever, chills, and joint pain. The physician immediately ordered blood for parasitic examination. The Giemsa-stained thin blood smear revealed the three suspicious forms below. This patient is most likely suffering from an infection with:View Page
A 29 year old male steak house owner from Arizona presented to his doctor complaining of weight loss, abdominal pain and diarrhea. Patient history revealed that the man eats all of his meals at his restaurant and his favorite meat is rare sirloin steak. The man also noted that he had recently been on anti-parasitic medication. The doctor ordered a stool for parasitic examination. These two suspicious forms were seen. The patient is most likely suffering from an infection with:View Page
A stool was received in the laboratory for parasitic examination on a 49 year old female who just returned from missionary work in numerous third world countries around the world. The patient had been suffering from mild diarrhea over the past two weeks. These two suspicious forms were seen. Form 1 measures a mere 6 µm whereas form 2 measures 35 µm. Label these two forms:View Page
The artifact that when seen is indicative of intestinal inflammation and is characteristic of a number of parasitic infections is known as (a):View Page

Red Cell Disorders: Peripheral Blood Clues to Nonneoplastic Conditions
The photograph is representative of the peripheral blood smear of a five-month-old immigrant from Asia. Her mother was concerned that the child was not eating well. Her spleen was palpable.The hemogram revealed the following:Hb 9.6g/dL (normal 12.0 - 16.0 g/dL)RBC 5.48 X 1012/L (normal 4.2 - 5.9 X 1012/LHCT 30.4% (normal 37 - 48%)MCV 55.4 fl (normal 86 - 98 fl)MCH 17.5 pg (normal 27 - 32 pg)MCHC 31.6 g/dL (normal 31 - 37 g/dL)RDW 34.9% (normal 11 - 15%)Reticulocyte count 10.9% (normal 0.5 - 1.5%)Select the most likely diagnosis based on the clinical information and peripheral blood findings.View Page

The Urine Microscopic: Microscopic Analysis of Urine Sediment
Parasites

Parasites which may be found in urinary sediments include Trichomonas vaginalis, Enterobius vermicularis and Schistosoma haematobium. It is also important to note that parasites and parasitic ova may be seen in urine sediments as a result of fecal or vaginal contamination. This slide shows examples of Trichomonas vaginalis. In the female, Trichomonas is usually found as a contaminant from vaginal infection and is often accompanied by an increase in the number of white cells. Trichomonas is highly motile, measuring 5 - 15 microns with a characteristic pear shape. It has multiple anterior flagella and the nucleus is often apparent.

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White Cell and Platelet Disorders: Peripheral Blood Clues to Nonneoplastic Conditions
Select the letter representing the cell that may be seen in increased numbers in the peripheral blood smear in immediate hypersensitivity reactions:View Page
Eosinophilia Follow-Up

As mentioned on the previous page, high percentages of eosinophils may be present in the peripheral blood smears of patients with a variety of conditions--asthma, urticaria, Loeffler's syndrome, larval parasitic infections and in chronic eosinophilic leukemia. One exception to the association of eosinophilia with parasitic infections is a fatal case of disseminated strongyloidiasis reported many years ago by Miale (Hematology--5th Edition, Mosby, pg. 776, 1977) in which the peripheral blood eosinophilia was masked by the administration of corticosteroids.

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The peripheral blood smear presented here was submitted for morphological/clinical review. Conditions in which this picture may be seen include:View Page
Eosinophil description

The cytoplasm of eosinophils is evenly filled by numerous orange-red granules of uniform size. They do not overlie the nucleus. The eosinophil granules contain numerous enzymes including peroxidase, phospholipase D, catalase, acid phosphatase, and vitamin B12-binding proteins. Their ability to kill bacteria is less than that of neutrophils. Their main purpose is to counteract parasitic infections and to participate in immune allergic reactions. They may also be increased in a variety of nonimmunologic inflammatory responses from bacteria and fungi causing chronic infections. Malignancies, collagen vascular diseases, and myeloproliferative disorders may also may be settings for prominent eosinophils.

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