NBME Free 120 Ingestion of soil (NBME Answers)

Retired NBME Free 120 Answers

free120/Block 2/Question#19 (reveal difficulty score)
A 7-year-old boy who lives in Kentucky is ...
Ingestion of soil 🔍 / 📺 / 🌳 / 📖
tags:

+8 upvote downvote
submitted by ∗madden875(25)

get full access to all content ⋅ pick a username

This worm is Ascaris. From an infectious disease doctor:

"The clue is the size- if you can see it move and it looks like an earth worm, it’s ascsaris! In dirt, kids get it from licking their dirty fingers! The adult looks like an earthworm and it causes the symptoms described with the worst cases causing bowel obstruction."

get full access to all content ⋅ pick a username

+0 upvote downvote
submitted by ∗b1ackcoffee(115)

get full access to all content ⋅ pick a username

I am wondering which parasite is this actually? --

get full access to all content ⋅ pick a username

mdmofongo The clinical presentation sounds like a GI parasite, which are transmitted via fecal-oral route, so ingestion of soil would be the most sensible answer. All the other routes are of parasites with more severe or systemic infection. +

b1ackcoffee @mdmofongo I know this. But which parasite is this? +

drblu92 The parasite is most likely Trichuris trichiura (human whipworm). Trichuriasis is often asymptomatic and adult forms can reach 2 cm in length (visible with naked eye). A lot more common in tropical areas but there have been cases in the southeastern US (ex: Kentucky). All other GI worms would present with either a fever or a cough. Treat with mebendazole or albendazole. +6

dhkahat not trichuris....ascaris +1

+0 upvote downvote
submitted by ∗freemanpeng(7)

get full access to all content ⋅ pick a username

For those choosing puppies: Puppies, New pet-----Toxocara canis Pet feces(eg puppies)---Yersinia

get full access to all content ⋅ pick a username

+0 upvote downvote
submitted by ∗dixie96(3)

get full access to all content ⋅ pick a username

trichuris trichiura can present with rectal prolapse in kids which perhaps accounts for why this boy thought he defacated in his pants

get full access to all content ⋅ pick a username

mes1717 will also see presence of worm on stoop O&P +

madden875 this is ascaris, NOT trichuris +6

j44n i agree trichiura only get to 50mm +1

chaosawaits Definitely, Ascaris. True story: at our school, rumor says a med student was in the shower when one of these fell worms fell out of her. +

-6 upvote downvote
submitted by ∗basic_pathology(25)

get full access to all content ⋅ pick a username

The gravid female pinworms (Enterobius vermicularis) migrate through the colon towards the rectum at a rate of 12 to 14 cm per hour.They emerge from the anus, and while moving on the skin near the anus, the female pinworms deposit eggs either through (1) contracting and expelling the eggs, (2) dying and then disintegrating, or (3) bodily rupture due to the host scratching the worm. After depositing the eggs, the female becomes opaque and dies.The female emerges from the anus to obtain the oxygen necessary for the maturation of the eggs.

get full access to all content ⋅ pick a username

lakshmi Rectal exam showed no abnormalities. Wouldn't it more likely be a hookworm? +

shieldmaiden Still Ascaris +

Must-See Comments from free120

sugaplum on It is a polymorphism
bwdc on Elaboration of proteases and urease with ...
bwdc on Hypercoagulability from advanced malignancy
bwdc on Ribosomal assembly
bwdc on Aspiration
bwdc on Amygdala
imnotarobotbut on von Willebrand disease
bwdc on Trinucleotide repeat expansion
bwdc on Mediation of cell entry via a fusion protein
bwdc on Metabolism
bwdc on Basement membrane
melchior on Aspiration
hungrybox on Immune complex deposition in tissues
aejinkim on Decreased activity in the enzyme that ...