Michael was excited when his boss sent him to work on a 6-month project with the Vice President of International Affairs at their corporation in Beijing, China. Before leaving the United States, he visited his family doctor for a complete physical and to receive his immunizations. The physician reviewed Michael?s medical history and current lab results and declared that he was a healthy 32-year-old. Michael adjusted well to the move and made many new friends. They would often get together on the weekends to go swimming at a nearby lake, to play volleyball at the local park, or to watch movies and cook dinner. He quickly found that his favorite meal was a stir-fry containing a mixture of pork, fresh raw vegetables, and noodles. He would eat this combination of foods three to four times a week. To his surprise, within 3 months of moving to China, Michael started losing weight. He was not trying to lose weight and when asked about his diet, Michael would say that he ate all the time. At first, he thought the weight loss was just a result of his metabolism adjusting to his new Asian diet and was not a cause for concern. However, after 2 months of continuous weight loss, the non-stop eating was replaced by nausea and slight abdominal pain. At this time, Michael began to think something might be wrong. Michael scheduled an appointment with Dr. Clark at the local medical center. During his appointment, the two of them discussed where Michael had traveled since he had been in China, the types of foods he had eaten, the specifics of his exercise regimen, and his extracurricular activities. They also discussed the lack of symptoms other than the weight loss and recent bouts of nausea. After talking with Michael, Dr. Clark requested that multiple stool specimen be sent to the laboratory for examination. He also ordered serological testing of Michael?s blood to determine his antibody titer levels. He was concerned that Michael may have an intestinal parasite infection, even though many are asymptomatic. Part A Why does Dr. Clark request stool samples for examination? Select all that apply. Hint 1. The human host?s involvement in the life cycle of an intestinal parasite Humans are the definitive host for tapeworm infections. Adult worms live and reproduce in the gastrointestinal tract of the human host. Eggs are produced and released from the human and can contaminate food that is eaten by the intermediate host (i.e. cattle, pigs, deer, etc...). Inside the intermediate host larvae hatch from the eggs and migrate from the intestinal tract to other host tissues where they are encysted as cysticerci. Humans are then infected when they ingest items contaminated with the cysts, which then become adults in the intestinal tract and complete the cycle. ANSWER: He will have the laboratory prepare the samples for an ova and parasite (O&P) exam. Fresh or preserved stool samples can be observed microscopically for the presence of parasites or their eggs/cysts. Dr. Clark is hoping to find whole adult parasitic worms in Michael?s fecal matter. Tapeworms are pathogens of the gastrointestinal tract; as a natural progression of digestion some of the tapeworm pieces will be expelled along with fecal matter. The stool sample will tell Dr. Clark more information about the vegetables in Michael?s diet. Correct Investigation of stool samples is an important diagnostic tool for physicians and other medical personnel. The stool is prepared in such a way that any parasite eggs or proglottids remain in the sample. After processing, the sample is placed on a microscope slide for observation. Staining can be performed, but is not always necessary. Morphological examination of any specimen found in the stool will help with identification.
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