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Exercise No. 1 The Microscope
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
II. Give the functions of the following parts of the microscope.
1. Mirror
2. Condenser
3. Diaphragm
4. Coarse adjustment knob
5. Fine adjustment knob
6. Body tube
7. Objective lenses
8. Low power objective
9. High power objective
10. Oil immersion
11. Eyepiece
III. Enumerate the different types of microscopes and their uses.
Exercise No. 2 The Cell
I. Differentiate eukaryotic cell from prokaryotic cell.
Features Eukaryotic Cell Prokaryotic Cell
Nucleus with nuclear membrane
DNA associated histones
Membrane-bound organelles
Cell wall
Reproduction
II. Label the parts:
1. Prokaryotic cell
2. Eukaryotic cell
III. Indicate the function/s of each of the following parts of the cell.
Cell Part Function
Nucleus
Nucleolus
Cell Wall
Cell membrane
Mitochondria
Ribosomes
Endoplasmic reticulum
Golgi apparatus
Lysosomes
IV. Differentiate the medically important organisms.
Characteristic Bacteria Fungi Viruses Protozoa Alga
Type of
nucleus
Outer covering
Nucleic acid
present
Ribosome
Mitochondria
Type of
reproduction
Exercise No.3 Gram-staining
I. Perform the Gram-staining procedure (Refer Book)
II. Indicate the function of the different reagents used in Gram-staining.
Reagent Function Expected Result:
Gram-positive
Expected Result:
Gram-positive
Crystal violet
Gram’s iodine
95% Alcohol
Safranin
III. Differentiate gram positive cell wall from gram negative cell wall.
Features Gram positive Cell Wall Gram negative Cell Wall
Peptidoglycan
Complexity
Teichoic acid
Lipopolysaccharide complexes
Endotoxin
Exercise No. 4 Acid-fastStaining
I. Perform the Acid-fast staining procedure (Refer Book)
II. What is responsible for the acid fastness of these organisms?
III. Why is the Ziehl Neelsen method called the “hot method”while the Kinyoun method the “cold
method?” Explain briefly.
IV. Differentiate the two methods of acid-fast staining.
Reagent Function Expected Result:
Ziehl Neelsen
Expected Result:
Kinyoun
Carbol fuchsin
Acid alcohol
Safranin
Exercise No. 5 Sterilization and Disinfection
Answer the following:
1. Differentiate sterilization from disinfection.
2. Enumerate the factors that may influence the efficiency of chemical agents.
3. What is thermal death time?
4. Define the following terms:
a. Bactericidal
b. Bacteriostatic
c. Antisepsis
5. Identify the method of sterilization/chemical agent described. Write your answers on the space
provided. a. A method of sterilization that involves the physical separation of micro-organisms from the
fluid.
b. This method is utilized to deprive the organisms of moisture.
c. This method is used to destroy disease producing microorganisms in milk, milk products, food, and
beverages.
d. At 15 psi, the temperature reaches 121 °C requiring only 15 to 20 minutes to sterilize the material.
e. The material to be sterilized is exposed to live steam for 30 minutes for 3 consecutive days
f. This chemical agent is used as a standard for evaluating new chemical agents.
g. This chemical agent is used as water disinfectant.
h. A phenol derivative that is less toxic and more potent than phenol.
i. Considered the best antiseptic
Exercise No.6 Bacterial Structures
I. Identify the bacterial structure shown and give the special stain used to demonstrate this structure:
Structure:
Stain used:
Structure:
Stain used:
Structure:
Stain used:
II. Identify the type of flagella
1.
2.
3.
4.
III. Give the functions of the following bacteria lstructures.
1. Cell wall
2. Cell membrane
3. LPS
4. Ribosomes
5. Nucleoid
6. Granules
7. Pili
8. Flagella
9. Endospores
10. Capsule
Exercise No. 7 Antimicrobial Susceptibility Testing
INTERPRETATION OF RESULTS
Antibiotic Zone Size Interpretatio
Answer the following:
1. What are the characteristics of an ideal antimicrobial agent?
2. List down the different antibiotics used for the exercise and give the mechanism of action.
3. What is meant by resistance? Give the mechanisms by which organisms develop resistance
Exercise No. 8 Bacteria and Disease
I. Answer the following:
1. Differentiate:
a. disease from infection
b. virulence from pathogenicity
c. mutualism from commensalism and parasitism
2. What are the different mechanisms of disease production?
3. Enumerate the different stages of an infectious disease and what occurs during each stage?
II. Compare exotoxin from endotoxin by filling out the table below.
Feature Exotoxin Endotoxin
Relation to cell
Toxicity
Stability
Antigenicity
Conversion to toxoid
III. Define the following types of infection:
1. Endemic
2. Epidemic
3. Sporadic
4. Exotic
IV. Match the following terms with their respective definitions:
1. Carrier a. Insects that transmit infection
2. Fomite b. Presence of bacteria in the blood
3. Vector c. Person harboring the organism without signs and symptoms of the
disease
4. Vehicle d. Hospital acquired infections
5. Septicemia e. Infection confined to a limited area
6. Fulminant infection f. Inanimate object which can carry microorganisms
7. Nosocomial infection g. Multiplying bacteria in the bloodstream
8. Local infection h. biological substances that can carry organisms
9. Bacteremia i. Presence of toxin in the bloodstream
10. Toxemia j. Infection that always leads to death
Exercise No. 9 Immunology
I. Answer the following:
1. Differentiate the following:
a. innates from adaptive immunity
b. antigen from immunogen
c. cell mediated from humoral immunity
2. Enumerate the primary and secondary lymphoid organs
II. Enumerate the different hypersensitivity reactions and give examples for each reaction.
Hypersensitivity
Reaction
Mechanism Mediator/s Example/s
Type I
Type II
Type III
Type IV
III. Give the function/s of the different immunoglobulins
Immunoglobulin Function/s
IgA
IgD
IgE
IgG
IgM
Exercise No.10 Protozoans
I. Compare the different Plasmodium species.
Feature P. falciparum P. vivax P. ovale P. malariae
Type of RBC
infected
Production of
hypnozoites
Occurrence of
relapse
Timing of
paroxysms
Blackwater fever
Cerebral malari
II. Compare the important protozoans.
Parasite Source of Infection Mode of Transmission Characteristic
Manifestation
Entamoeba histolytica
Naegleria sp.
Acanthamoeba sp.
Giardia lamblia
Trichomonas vaginalis
Trypanosoma cruzi
Trypanosoma brucei
Leishmania donovani
Toxoplasma gondii
Plasmodium falciparu
III. The following protozoans are transmitted by bite of a vector. Indicate the vector for each of these
parasites.
1. Trypanosoma cruzi
2. Trypanosoma spp.
3. Leishmania spp.
4. Plasmodium spp
Exercise No.11 Cestodes
I. Fill out the table below with appropriate answers.
Parasite Source of Infection Mode of Transmission Characteristic
Manifestation
Taenia saginata
Taenia solium
Diphyllobothrium
latum
Hymenolepis nana
Echinococcus
granulosus
II. Answer the following: 1. What is cysticercosis? How is it treated?
2. What is hydatid cyst disease? What complication/scan occur
III. Fill out the table below with the necessary information.
Parasite Common Name Infective Form Intermediate Host
Taenia solium
Taenia saginata
Diphyllobothrium
latum
Echinococcus
granulosus
Hymenolepis nan
EXERCISE NO. 12 Trematod
I. Fill out the table below with appropriate answers.
Parasite Source of Infection Mode of Transmission Characteristic
Manifestation
Schistosoma spp.
Clonorchis sinensis
Paragonimus
westermani
Fasciolopsis buski
Fasciola hepatic
II. Indicate the first and second intermediate hosts of the different trematodes.
Parasite First Intermediate Host Second Intermediate Host
Schistosoma spp.
Clonorchis sinensis
Paragonimus westermani
Fasciolopsis buski
Fasciola hepatica
III. Differentiate blood flukes.
Parasite Site of Infection AssociatedComplication
Schistosoma japonicum
Schistosoma mansoni
Schistosoma haematobiu
EXERCISE NO. 13 Nematodes
I. Fill out the table below comparing the various nematodes.
Parasite Source of Infection Mode of Transmission Characteristic
Manifestation
Ascaris lumbricoides
Trichuris trichiura
Strongyloides
stercoralis
Hookworms
Capillaria philippinensis
Trichinella spiralis
Wuchereria bancrofti
Brugia malay
II. Answer the following:
1. What is Loeffler’s syndrome? This condition is associated with which nematode?
2. Which among the nematodes are transmitted by skin penetration?
3. Which of the nematodes have a lung phase in their life cycle?
4. Differentiate Wuchereria bancrofti and Brugia malayi infection clinically
EXERCISE NO. 14 Infections of the Skin
I. Case Study 1. A 6-year-old boy was brought to a physician because of skin lesions with “honey-colored
crusts” over the lower extremities. The condition started a week prior to consultation as vesicular lesions
which later ruptured and formed crusts. a. What is the most probable diagnosis?
a. What is the most probable diagnosis?
b. What is the most probable causative agent for this condition?
c. What are the distinctive characteristics of the causative agent?
d. What diagnostic tests would you request to establish the diagnosis?
e. What advice will you give to the parents of the child?
f. How can the infection be prevented?
2. A 15-year-old girl consulted a physician because of hypo pigmented macules over the right cheek. On
physical examination, the lesions appear scaly and dry, with a “chalky” appearance. There are no other
accompanying signs and symptoms.
a. What is the probable diagnosis
b. What is the most likely etiologic agent?
c. What tests or procedures should be requested to establish the diagnosis?
II. Identify the dermatophytic fungal infections affecting the following sites:
1. Scalp
2. Groin
3. Hands
4. Bearded area
5. Nails
6. Feet
7. Body or trunk
EXERCISE NO. 15 Infections of the
Respiratory Tract
I. CaseStudy
1. A 7-year-old child was brought to the emergency room because of fever and a prolonged episode of
forceful, dry hacking cough with a distinct inspiratory whoop. The patient has no history of
immunization.
a. What is the most probable diagnosis?
b. What is the most probable causative agent and its characteristics?
c. What tests should you request for the diagnosis of this infection?
d. What is the proper way of collecting specimen for sputum examination?
e. Give the characteristics of M. tuberculosis based on the following:
i. Staining reaction
ii. Cell wall components
iii. Growth characteristics
iv. Virulence factors
f. Discuss ways by which the disease can be prevented and controlled
EXERCISE NO. 16 Infections of the Gastrointestinal Tract
I. Case Study 1. A 50-year-old woman was brought to the emergency room because of prolonged fever of
two weeks duration and crampy abdominal pain. The condition started two weeks prior to consultation
as moderate grade fever with loose bowel movement that was later replaced by constipation.
a. What is the most probable diagnosis?
b. What are the common sources of this infection
c. Give the characteristics of the probable causative agent.
d. How is this condition managed?
e. What are ways by which the condition can be prevented?
2. A 25-year-old male was brought to the hospital because of fever and yellowish discoloration of the
skin and sclerae. On physical examination, the liver is enlarged and tender. Laboratory results reveal (+)
HBs Ag. Gram stain was negative for bacteria.
a. What is the probable condition involved in this case? What is the most likely etiologic agent?
b. Based on your answer on no. 1, what are the ways by which the most likely etiologic agent is
transmitted
c. Which of the hepatitis viruses is/are associated with the following?
i. Fulminant infection:
ii. Most common cause of post transfusion hepatitis:
iii. Vaccine preventable hepatitis:
iv. Occur as co infection or super infection with HBV:
v. Caused by a DNA virus:
II. Answer the following:
1. Define diarrhea.
2. What are some ways by which diarrhea can be prevented?
3. What is the mainstay in the management of diarrhea
EXERCISE NO. 17 UTI and Sexually transmitted Infections
I. Case Study 1. A 28-year-old seaman consulted a physician because of a solitary nodule on the shaft of
his penis that is hard and painless accompanied by painless enlargement of his inguinal lymph nodes.
The nodule later formed an ulcer with smooth edges.
a. What is the most probable diagnosis and the most likely etiologic agent?
b. Give two other conditions that can present with a lesion like what is presented by the patient. How
are they different from the case presented
c. Differentiate syphilis from gonorrhea by answering yes or no on the table below.
Syphilis Gonorrhea
Congenital transmission
Neonatal transmission
Systemic spread
Presence of skin lesions
Purulent discharge
d. In a patient with HIV infection, what is the specific target of the virus and what will be the effect on
the infected person?
e. What is reverse transcriptase and what is its importance in the management of HIV infection?
2. A 25-year-old sexually active female sought consultation because of a burning sensation during
urination. She also complained of frequency and urgency in urination. The attending physician is thinking
of a probable urinary tract infection.
a. Enumerate and explain briefly the factors that can predispose the development of UTI
b. Differentiate lower UTI from upper UTI as to clinical manifestations. How do bacteria reach the
kidneys?
c. Why is urinary tract infection more common in females than in males?
d. What is the proper way of collecting urine specimen? What instructions should be given to the patient
when collecting a urine sample?
e. What possible complications can arise in persons with untreated and repeated urinary tract infection?
EXERCISE NO. 18 Infections of the Eyes and Central
Nervous System
I. CaseStudy
1. A 30-year-old male was attacked by a stray dog on his way home. He went to the hospital where you
are working as an emergency nurse.
a. How will you manage the patient?
b. What factors will affect the length of the incubation period for the development of rabies infection?
c. Other than animal bite, what are the other modes of transmission of rabies?
d. What is the most distinctive manifestation of rabies?
e. What is the recommended management of rabies?
2. A 6-year-old child was brought to the hospital because of seizures. This was accompanied by fever,
nausea, vomiting, and stiff neck.
a. What is the difference between encephalitis and meningitis?
b. How do you elicit Kernig’s and Brudzinski’s signs? What is the expected positive result for each test?
c. What are the most common causes of bacterial meningitis and the corresponding age groups most
commonly affected?
3. A 30-year-old male sought consultation because of “eye redness” accompanied by purulent discharge.
a. What are the common causes of conjunctivitis?
b. What are the ways by which conjunctivitis can be prevented?
c. How would you differentiate bacterial conjunctivitis from viral conjunctivitis clinically?
EXERCISE NO. 19 Viral Exanthems
I. Case Study
A 3-year-old child was brought to the emergency room because of difficulty in breathing. The condition
started four days prior to admission as fever, colds, cough, and conjunctivitis with associated
photophobia. Three days prior to admission, maculopapular rashes were noted over the face and trunk
of the patient which later spread to the extremities. Immunization history: the patient has been given
OPV and BCG immunization during the first year of life.
• Physical examination: Temp: 38.7 °C; RR: 30/min; PR: 90 beats/min
• Skin: Maculopapular rashes over the face, trunk, and extremities
• Eyes: Reddish conjunctivae with tearing and non-purulent discharge
• Nose: (+) Flaring of alae nasi
• Chest and lungs: Intercostal and subcostal retractions on inspection. On auscultation,(+) crepitant rales
on both lung fields. No wheezes
1. What is the most probable diagnosis? How is the disease transmitted?
2. What do you call the pathognomonic enanthem associated with this disease? Where is it located and
how is it described?
3. What are the most common complications associated with this infectious disease?
4. How is this disease prevented?
II. Differentiate rubeola from rubella.
Features Rubeola Rubella
Etiology
Common name
Mode of transmission
Enanthem
Exanthem
Conjunctivitis
Post auricular lymphadenopathy
Arthralgia
Congenital viral infection
Vaccine
III. Differentiate varicella from variola.
Features Varicella Variol
Etiology
Common name
Mode/s of transmission
Lesion
Lesion
Severity
Vaccine
EXERCISE NO. 20 Other Systemic Infections
I. Case Study
A 7-year-old boy was brought to the emergency room because of nose bleeding (epistaxis) and vomiting
of blood (hematemesis). The patient was apparently well until 7 days prior to admission when the
patient developed moderate to high grade fever, headache, and muscle pains over the lower extremities.
Two days prior to admission, maculopapular rashes were noted over the trunk and extremities. Few
minutes prior to admission, the patient had epistaxis and two bouts of hematemesis.
1. What is the most probable diagnosis and etiologic agent for this case?
2. What is the mode of transmission of this infection?
3. If this is dengue fever, what are the manifestations of classical dengue fever?
4. What is the WHO definition for Dengue Shock Syndrome?
5. What measures should be done to prevent this disease?
II. Answer the following:
1. What are arthropod borne infections? Give examples
2. How can you prevent arthropod borne infections?
3. What are the congenital abnormalities associated with CMV infection?
4. Give the similarities and differences between infectious mononucleosis syndrome due to Epstein Barr
virus and Mononucleosis like syndrome due to cytomegalovirus.
5. Tabulate the different Rickettsial infections, their corresponding causative agents, and vectors.

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Microbiology & Parasitology Exercises Parts of the Microscope

  • 1. Exercise No. 1 The Microscope a. b. c. d. e. f. g. h. i. j. k. II. Give the functions of the following parts of the microscope. 1. Mirror 2. Condenser 3. Diaphragm 4. Coarse adjustment knob 5. Fine adjustment knob 6. Body tube 7. Objective lenses 8. Low power objective 9. High power objective 10. Oil immersion 11. Eyepiece
  • 2. III. Enumerate the different types of microscopes and their uses. Exercise No. 2 The Cell I. Differentiate eukaryotic cell from prokaryotic cell. Features Eukaryotic Cell Prokaryotic Cell Nucleus with nuclear membrane DNA associated histones Membrane-bound organelles Cell wall Reproduction
  • 3. II. Label the parts: 1. Prokaryotic cell 2. Eukaryotic cell III. Indicate the function/s of each of the following parts of the cell. Cell Part Function Nucleus Nucleolus Cell Wall Cell membrane Mitochondria Ribosomes Endoplasmic reticulum Golgi apparatus Lysosomes
  • 4. IV. Differentiate the medically important organisms. Characteristic Bacteria Fungi Viruses Protozoa Alga Type of nucleus Outer covering Nucleic acid present Ribosome Mitochondria Type of reproduction Exercise No.3 Gram-staining I. Perform the Gram-staining procedure (Refer Book) II. Indicate the function of the different reagents used in Gram-staining. Reagent Function Expected Result: Gram-positive Expected Result: Gram-positive Crystal violet Gram’s iodine 95% Alcohol Safranin III. Differentiate gram positive cell wall from gram negative cell wall. Features Gram positive Cell Wall Gram negative Cell Wall Peptidoglycan Complexity Teichoic acid Lipopolysaccharide complexes Endotoxin Exercise No. 4 Acid-fastStaining I. Perform the Acid-fast staining procedure (Refer Book) II. What is responsible for the acid fastness of these organisms? III. Why is the Ziehl Neelsen method called the “hot method”while the Kinyoun method the “cold method?” Explain briefly.
  • 5. IV. Differentiate the two methods of acid-fast staining. Reagent Function Expected Result: Ziehl Neelsen Expected Result: Kinyoun Carbol fuchsin Acid alcohol Safranin Exercise No. 5 Sterilization and Disinfection Answer the following: 1. Differentiate sterilization from disinfection. 2. Enumerate the factors that may influence the efficiency of chemical agents. 3. What is thermal death time? 4. Define the following terms: a. Bactericidal b. Bacteriostatic c. Antisepsis 5. Identify the method of sterilization/chemical agent described. Write your answers on the space provided. a. A method of sterilization that involves the physical separation of micro-organisms from the fluid. b. This method is utilized to deprive the organisms of moisture. c. This method is used to destroy disease producing microorganisms in milk, milk products, food, and beverages. d. At 15 psi, the temperature reaches 121 °C requiring only 15 to 20 minutes to sterilize the material. e. The material to be sterilized is exposed to live steam for 30 minutes for 3 consecutive days f. This chemical agent is used as a standard for evaluating new chemical agents. g. This chemical agent is used as water disinfectant. h. A phenol derivative that is less toxic and more potent than phenol. i. Considered the best antiseptic
  • 6. Exercise No.6 Bacterial Structures I. Identify the bacterial structure shown and give the special stain used to demonstrate this structure: Structure: Stain used: Structure: Stain used: Structure: Stain used: II. Identify the type of flagella 1. 2. 3. 4. III. Give the functions of the following bacteria lstructures. 1. Cell wall 2. Cell membrane
  • 7. 3. LPS 4. Ribosomes 5. Nucleoid 6. Granules 7. Pili 8. Flagella 9. Endospores 10. Capsule Exercise No. 7 Antimicrobial Susceptibility Testing INTERPRETATION OF RESULTS Antibiotic Zone Size Interpretatio Answer the following: 1. What are the characteristics of an ideal antimicrobial agent? 2. List down the different antibiotics used for the exercise and give the mechanism of action. 3. What is meant by resistance? Give the mechanisms by which organisms develop resistance
  • 8. Exercise No. 8 Bacteria and Disease I. Answer the following: 1. Differentiate: a. disease from infection b. virulence from pathogenicity c. mutualism from commensalism and parasitism 2. What are the different mechanisms of disease production? 3. Enumerate the different stages of an infectious disease and what occurs during each stage? II. Compare exotoxin from endotoxin by filling out the table below. Feature Exotoxin Endotoxin Relation to cell Toxicity Stability Antigenicity Conversion to toxoid III. Define the following types of infection: 1. Endemic 2. Epidemic 3. Sporadic 4. Exotic
  • 9. IV. Match the following terms with their respective definitions: 1. Carrier a. Insects that transmit infection 2. Fomite b. Presence of bacteria in the blood 3. Vector c. Person harboring the organism without signs and symptoms of the disease 4. Vehicle d. Hospital acquired infections 5. Septicemia e. Infection confined to a limited area 6. Fulminant infection f. Inanimate object which can carry microorganisms 7. Nosocomial infection g. Multiplying bacteria in the bloodstream 8. Local infection h. biological substances that can carry organisms 9. Bacteremia i. Presence of toxin in the bloodstream 10. Toxemia j. Infection that always leads to death Exercise No. 9 Immunology I. Answer the following: 1. Differentiate the following: a. innates from adaptive immunity b. antigen from immunogen c. cell mediated from humoral immunity 2. Enumerate the primary and secondary lymphoid organs II. Enumerate the different hypersensitivity reactions and give examples for each reaction. Hypersensitivity Reaction Mechanism Mediator/s Example/s Type I Type II Type III Type IV III. Give the function/s of the different immunoglobulins Immunoglobulin Function/s IgA
  • 10. IgD IgE IgG IgM Exercise No.10 Protozoans I. Compare the different Plasmodium species. Feature P. falciparum P. vivax P. ovale P. malariae Type of RBC infected Production of hypnozoites Occurrence of relapse Timing of paroxysms Blackwater fever Cerebral malari II. Compare the important protozoans. Parasite Source of Infection Mode of Transmission Characteristic Manifestation Entamoeba histolytica Naegleria sp. Acanthamoeba sp. Giardia lamblia Trichomonas vaginalis Trypanosoma cruzi Trypanosoma brucei Leishmania donovani Toxoplasma gondii Plasmodium falciparu III. The following protozoans are transmitted by bite of a vector. Indicate the vector for each of these parasites. 1. Trypanosoma cruzi 2. Trypanosoma spp. 3. Leishmania spp.
  • 11. 4. Plasmodium spp Exercise No.11 Cestodes I. Fill out the table below with appropriate answers. Parasite Source of Infection Mode of Transmission Characteristic Manifestation Taenia saginata Taenia solium Diphyllobothrium latum Hymenolepis nana Echinococcus granulosus II. Answer the following: 1. What is cysticercosis? How is it treated? 2. What is hydatid cyst disease? What complication/scan occur
  • 12. III. Fill out the table below with the necessary information. Parasite Common Name Infective Form Intermediate Host Taenia solium Taenia saginata Diphyllobothrium latum Echinococcus granulosus Hymenolepis nan EXERCISE NO. 12 Trematod I. Fill out the table below with appropriate answers. Parasite Source of Infection Mode of Transmission Characteristic Manifestation Schistosoma spp. Clonorchis sinensis Paragonimus westermani Fasciolopsis buski Fasciola hepatic II. Indicate the first and second intermediate hosts of the different trematodes. Parasite First Intermediate Host Second Intermediate Host Schistosoma spp. Clonorchis sinensis Paragonimus westermani Fasciolopsis buski Fasciola hepatica III. Differentiate blood flukes. Parasite Site of Infection AssociatedComplication Schistosoma japonicum Schistosoma mansoni Schistosoma haematobiu EXERCISE NO. 13 Nematodes I. Fill out the table below comparing the various nematodes. Parasite Source of Infection Mode of Transmission Characteristic Manifestation Ascaris lumbricoides Trichuris trichiura
  • 13. Strongyloides stercoralis Hookworms Capillaria philippinensis Trichinella spiralis Wuchereria bancrofti Brugia malay II. Answer the following: 1. What is Loeffler’s syndrome? This condition is associated with which nematode? 2. Which among the nematodes are transmitted by skin penetration? 3. Which of the nematodes have a lung phase in their life cycle? 4. Differentiate Wuchereria bancrofti and Brugia malayi infection clinically EXERCISE NO. 14 Infections of the Skin I. Case Study 1. A 6-year-old boy was brought to a physician because of skin lesions with “honey-colored crusts” over the lower extremities. The condition started a week prior to consultation as vesicular lesions which later ruptured and formed crusts. a. What is the most probable diagnosis? a. What is the most probable diagnosis? b. What is the most probable causative agent for this condition? c. What are the distinctive characteristics of the causative agent? d. What diagnostic tests would you request to establish the diagnosis? e. What advice will you give to the parents of the child? f. How can the infection be prevented?
  • 14. 2. A 15-year-old girl consulted a physician because of hypo pigmented macules over the right cheek. On physical examination, the lesions appear scaly and dry, with a “chalky” appearance. There are no other accompanying signs and symptoms. a. What is the probable diagnosis b. What is the most likely etiologic agent? c. What tests or procedures should be requested to establish the diagnosis? II. Identify the dermatophytic fungal infections affecting the following sites: 1. Scalp 2. Groin 3. Hands 4. Bearded area 5. Nails 6. Feet 7. Body or trunk EXERCISE NO. 15 Infections of the Respiratory Tract I. CaseStudy 1. A 7-year-old child was brought to the emergency room because of fever and a prolonged episode of forceful, dry hacking cough with a distinct inspiratory whoop. The patient has no history of immunization. a. What is the most probable diagnosis? b. What is the most probable causative agent and its characteristics? c. What tests should you request for the diagnosis of this infection? d. What is the proper way of collecting specimen for sputum examination?
  • 15. e. Give the characteristics of M. tuberculosis based on the following: i. Staining reaction ii. Cell wall components iii. Growth characteristics iv. Virulence factors f. Discuss ways by which the disease can be prevented and controlled EXERCISE NO. 16 Infections of the Gastrointestinal Tract I. Case Study 1. A 50-year-old woman was brought to the emergency room because of prolonged fever of two weeks duration and crampy abdominal pain. The condition started two weeks prior to consultation as moderate grade fever with loose bowel movement that was later replaced by constipation. a. What is the most probable diagnosis? b. What are the common sources of this infection c. Give the characteristics of the probable causative agent. d. How is this condition managed? e. What are ways by which the condition can be prevented? 2. A 25-year-old male was brought to the hospital because of fever and yellowish discoloration of the skin and sclerae. On physical examination, the liver is enlarged and tender. Laboratory results reveal (+) HBs Ag. Gram stain was negative for bacteria. a. What is the probable condition involved in this case? What is the most likely etiologic agent? b. Based on your answer on no. 1, what are the ways by which the most likely etiologic agent is transmitted
  • 16. c. Which of the hepatitis viruses is/are associated with the following? i. Fulminant infection: ii. Most common cause of post transfusion hepatitis: iii. Vaccine preventable hepatitis: iv. Occur as co infection or super infection with HBV: v. Caused by a DNA virus: II. Answer the following: 1. Define diarrhea. 2. What are some ways by which diarrhea can be prevented? 3. What is the mainstay in the management of diarrhea EXERCISE NO. 17 UTI and Sexually transmitted Infections I. Case Study 1. A 28-year-old seaman consulted a physician because of a solitary nodule on the shaft of his penis that is hard and painless accompanied by painless enlargement of his inguinal lymph nodes. The nodule later formed an ulcer with smooth edges. a. What is the most probable diagnosis and the most likely etiologic agent? b. Give two other conditions that can present with a lesion like what is presented by the patient. How are they different from the case presented c. Differentiate syphilis from gonorrhea by answering yes or no on the table below. Syphilis Gonorrhea Congenital transmission Neonatal transmission Systemic spread Presence of skin lesions Purulent discharge
  • 17. d. In a patient with HIV infection, what is the specific target of the virus and what will be the effect on the infected person? e. What is reverse transcriptase and what is its importance in the management of HIV infection? 2. A 25-year-old sexually active female sought consultation because of a burning sensation during urination. She also complained of frequency and urgency in urination. The attending physician is thinking of a probable urinary tract infection. a. Enumerate and explain briefly the factors that can predispose the development of UTI b. Differentiate lower UTI from upper UTI as to clinical manifestations. How do bacteria reach the kidneys? c. Why is urinary tract infection more common in females than in males? d. What is the proper way of collecting urine specimen? What instructions should be given to the patient when collecting a urine sample? e. What possible complications can arise in persons with untreated and repeated urinary tract infection? EXERCISE NO. 18 Infections of the Eyes and Central Nervous System I. CaseStudy 1. A 30-year-old male was attacked by a stray dog on his way home. He went to the hospital where you are working as an emergency nurse. a. How will you manage the patient? b. What factors will affect the length of the incubation period for the development of rabies infection? c. Other than animal bite, what are the other modes of transmission of rabies?
  • 18. d. What is the most distinctive manifestation of rabies? e. What is the recommended management of rabies? 2. A 6-year-old child was brought to the hospital because of seizures. This was accompanied by fever, nausea, vomiting, and stiff neck. a. What is the difference between encephalitis and meningitis? b. How do you elicit Kernig’s and Brudzinski’s signs? What is the expected positive result for each test? c. What are the most common causes of bacterial meningitis and the corresponding age groups most commonly affected? 3. A 30-year-old male sought consultation because of “eye redness” accompanied by purulent discharge. a. What are the common causes of conjunctivitis? b. What are the ways by which conjunctivitis can be prevented? c. How would you differentiate bacterial conjunctivitis from viral conjunctivitis clinically? EXERCISE NO. 19 Viral Exanthems I. Case Study A 3-year-old child was brought to the emergency room because of difficulty in breathing. The condition started four days prior to admission as fever, colds, cough, and conjunctivitis with associated photophobia. Three days prior to admission, maculopapular rashes were noted over the face and trunk of the patient which later spread to the extremities. Immunization history: the patient has been given OPV and BCG immunization during the first year of life. • Physical examination: Temp: 38.7 °C; RR: 30/min; PR: 90 beats/min • Skin: Maculopapular rashes over the face, trunk, and extremities • Eyes: Reddish conjunctivae with tearing and non-purulent discharge
  • 19. • Nose: (+) Flaring of alae nasi • Chest and lungs: Intercostal and subcostal retractions on inspection. On auscultation,(+) crepitant rales on both lung fields. No wheezes 1. What is the most probable diagnosis? How is the disease transmitted? 2. What do you call the pathognomonic enanthem associated with this disease? Where is it located and how is it described? 3. What are the most common complications associated with this infectious disease? 4. How is this disease prevented? II. Differentiate rubeola from rubella. Features Rubeola Rubella Etiology Common name Mode of transmission Enanthem Exanthem Conjunctivitis Post auricular lymphadenopathy Arthralgia Congenital viral infection Vaccine III. Differentiate varicella from variola. Features Varicella Variol Etiology Common name Mode/s of transmission Lesion Lesion Severity Vaccine EXERCISE NO. 20 Other Systemic Infections I. Case Study A 7-year-old boy was brought to the emergency room because of nose bleeding (epistaxis) and vomiting of blood (hematemesis). The patient was apparently well until 7 days prior to admission when the patient developed moderate to high grade fever, headache, and muscle pains over the lower extremities. Two days prior to admission, maculopapular rashes were noted over the trunk and extremities. Few minutes prior to admission, the patient had epistaxis and two bouts of hematemesis. 1. What is the most probable diagnosis and etiologic agent for this case?
  • 20. 2. What is the mode of transmission of this infection? 3. If this is dengue fever, what are the manifestations of classical dengue fever? 4. What is the WHO definition for Dengue Shock Syndrome? 5. What measures should be done to prevent this disease? II. Answer the following: 1. What are arthropod borne infections? Give examples 2. How can you prevent arthropod borne infections? 3. What are the congenital abnormalities associated with CMV infection? 4. Give the similarities and differences between infectious mononucleosis syndrome due to Epstein Barr virus and Mononucleosis like syndrome due to cytomegalovirus. 5. Tabulate the different Rickettsial infections, their corresponding causative agents, and vectors.