Archive Of Standardized Exam Questions: Amebiasis


This page is dedicated to organizing various examples of standardized exam questions whose answer is amebiasis. While this may seem a odd practice, it is useful to see multiple examples of how amebiasis will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a traditional question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.


When it comes to standardized exams, each condition has its own “code” marked by key buzzwords, lab findings, clues, etc. If you are well versed in this code you will be able to more quickly identify the condition that is being discussed, and get the right answer on the exam you are taking. Below is the “code” for amebiasis

Chief Complaints:

  • Fever is often present in symptomatic patients
  • Diarrhea: patients may suffer from frequent slimy stools (can be coated in mucus)
  • Abdominal pain: can often be RUQ/over the liver field

Patient History:

  • Recent travel/residence/presence to endemic areas (developing nations): Mexico, Nepal, Pakistan, Uganda, Kenya are some examples

Clinical Workup:

  • Liver cyst/abscess: usually a solitary liver cyst/abscess is present (can be seen on imaging)
  • Trophozoites in the stool that can demonstrate engulfed RBCs
  • Cysts in the stool can be present with up to 4 nuclei.
  • Intestinal ulcers can be seen on a colonoscopy

Question # 1

A 30 year old migrant worker from Mexico presents with a fever to the ER. He appears to have mild jaundice, and a physical exam reveals mild tenderness over the liver when the area is percussed. He has leukocytosis and his ALP is mildly elevated. An abdominal ultrasound reveals a normal biliary tree and an abscess in the liver. What is the likely diagnosis in this patient?

Explanation # 1

Presence in Mexico (endemic area) + liver abscess = amebiasis

Question # 2

A 45 year old woman is taken to the ER for rich super quadrant abdominal pain and jaundice. She recently returned form a trip to Mexico where she went hiking through the jungle. She saw her PCP and reeeivedall of her pre-travel vaccinations before going. Her vital are within normal limits. A physical examination reveals the presence of scleral icterus, mild jaundice, and there is tenderness with percussion of the liver. An abdominal ultrasound shows an unremarkable biliary tree, and an abscess is present in the liver. What is the likely diagnosis?

Explanation # 2

Presence in Mexico (endemic area) + liver abscess = amebiasis

Question # 3

A 50 year old woman comes to the clinic because she has been suffering from a fever and frequent slimy stools for the past 10 days. She recently emigrated from Kenya to the US. Her temperature is currently 101.3°F. An abdominal exam revels tenderness over the upper right quadrant. A gross examination of the stool revel as the presence of mucus. A colonocospy is ordered and demonstrates the presence of multiple ulcers that have destroyed the intestinal epithelium. What is a possible diagnosis in this patient?

Explanation # 3

Presence in Kenya (endemic area) + fever + diarrhea + abdominal pain (upper right quadrant) + intestinal ulcers = amebiasis

Question # 4

A 42 year old woman comes to the ER because she has been experiencing abdominal pain for the past week. She also complains of watery, and bloody diarrhea. She recently returned from visiting her family in Uganda a few of weeks ago. Currently her vital signs are all within normal limits. A physical exam reveals abdominal distention and tenderness that is diffuse. Her stool is sent to the pathology lab, and microscopic examination revels the presence of 12-µm trophozoites displaying erythrophagocytosis. What is this patient’s likely diagnosis?

Explanation # 4

Abdominal pain + diarrhea + presence  in Uganda (endemic area) + trophozoites with engulfed red blood cells = amebiasis

Question # 5

A 40 year old male come sot the hospital because he has been experiencing persistent right upper quadrant abdominal pain. He also complains of a fever that he has had for the past week. About 2 months ago he returned from a vacation in Nepal, where he spent considerable time hiking outdoors. During his trip, the patient explains that he had several episodes of isolated diarrhea that he attributed to the local cuisine. He also mentioned that he had unprotected sexual intercourse with a stranger he met on one of his hikes. Currently his temperature is 101.5°F, blood pressure is 125/75 mm Hg, and pulse is 95 bpm. An abdominal exam demonstrates a palpable liver that is 4 cm below the right costal margin. It is tender to palpation. Labs are ordered revel a the presence of a WBC count of 13,500, and elevated liver enzymes. An abdominal ultrasound is performed and is remarkable for the presence of a solitary cystic lesion in the right lobe of the liver. What is this patient’s likely diagnosis?

Explanation # 5

Abdominal pain + fever + recent presence in Nepal (endemic region) + solitary cystic lesion in liver = amebiasis

Question # 6

A 39 year old immigrant from Pakistan comes to the clinic because of a progressive pain in his abdomen. He also has been complaining of a fever for the past 8 days. Currently his temperature is 102.0°F, and an abdominal exam reveals a palpable liver hat is tender to the touch. Lab results are below:

  • Hemoglobin: 1.5 g/dL
  • Total bilirubin: 1.3 mg/dL
  • ALT: 105 U/L
  • AST: 45 U/L

An abdominal ultrasound reveals the presence of a single, cystic mass on the right side of the liver. What is this patient’s diagnosis?

Explanation # 6

Presence in Pakistan + abdominal pain + fever + singly cystic lesion on liver = amebiasis 


Many questions on standardized exams go beyond simply recognizing the underlying condition. Often there are specific testable questions regarding some aspect of the diseases pathophysiology/management/clincial implications that are commonly asked. Some of these are listed below:



  • What medication do we use to treat? Typically metronidazole is used to treat this condition.
  • Do we drain cysts in this condition? NO this is one of the few times a cyst will not be drained.


Page Updated: 03.07.2017