PBL 2 Flashcards

1
Q

outline the lifecycle of malaria between human and mosquito?

A

an infected female mosquito bits a person, injecting plasmodium parasites from their salivary glands into the blood stream. sporozoites pass to the liver where they multiply asexually in the hepatocytes. merozoites are released from hepatocytes In vesicles and move to the lungs where the vesicles eventually disintegrate freeing merozoites into the blood. they invade RBCs and multiply until the cell bursts- this cycle repeats causing fever each time
some merozoites develop into gametocytes that circulate the blood stream
when an uninfected mosquito bites an infected human it ingests gametocytes which will sexually reproduce to form an oocyst. oocysts eventually burst to release sporozoites into the mosquito and they then move to the salivary gland

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2
Q

what are the symptoms of malaria?

A
period cycles of fever every 48-72 hours
headaches
muscle aches
cough
high HR
hepatomegaly
splenomegaly
nausea
vomiting
jaundice
anaemia
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3
Q

outline the stages of the cyclic fever that occurs with malaria?

A

16-60 minutes of shivering and cold, 2-6 hours of fever flushing dry skin headache nausea and vomiting, 2-4 hour sweating stage as fever drops rapidly

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4
Q

what causes the period fever symptoms of malaria?

A

fever is cause whenever parasites are released from rupturing cells as they activate pyrogenic cytokines

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5
Q

why does malaria cause jaundice?

A

liver dysfunction and intravascular haemolysis

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6
Q

how can malaria be transmitted?

A

bites of infective female mosquitos
blood transfusions
using contaminated needles and syringes
form mother to child

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7
Q

outline the ABCD approach to prophylaxis of malaria?

A

awareness of risk
bite prevention
checking if you need antimalarials
diagnosis

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8
Q

how can you get partially naturally acquired immunity to malaria?

A

over years of exposure to infections and acquisitions of anti-malarial antibodies
this can take up to 20 years

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9
Q

what can change the choosing strategy for which antimalarial to give for malaria treatment?

A

the type of malaria parasite
severity of symptoms
age
pregnancy

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10
Q

what is the first line drug choice to treat malaria?

A

chloroquine phosphate

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11
Q

why might cloroquine phosphate not be able to be used?

A

because some areas of the world have malaria strains that have developed resistance

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12
Q

which drug do you give if the malaria strain is chloroquine phosphate resistant?

A

ACTs

artemisinin-based combination therapies

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13
Q

how does chloroquine phosphate work?

A

it inhibits heme polymerase which converts toxic heme to non-toxic hemazoin = accumulation of toxic free heme within parasite

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14
Q

how do ACTs work?

A

they kill the parasite through many steps but free radicals eventually end up damaging susceptible proteins

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15
Q

what is pyrexia?

A

having a temperature above the normal range due to an increase in the body’s temperature set point

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16
Q

what is a normal temperature?

A

between 36.5 and 37.5 degrees

17
Q

why are fevers important?

A

they slow down the growth of pathogens
accelerate tissue repair
boost the immune response e.g. by increasing neutrophil recruitment

18
Q

outline the physiology of pyrexia

A

pyrogens trigger the immune response causing pyrogenic cytokines to release PGE2 from the anterior hypothalamus
PGE2 acts on thermoregulatory neurones in the hypothalamus, generating a systemic response and raising the set point
this causes…
-vasoconstriction
-shivering
- thermogenesis of muscle and fat

19
Q

when does fever stop and how does it do it?

A

when there’s no more pyrogens

it works by causing vasodilation, sweating

20
Q

what are some vaccines needed to travel?

A

Hep A, malaria, diphtheria, HepB, HPV, infleunza, MMR, pertussis, pneumococcal disease, polio, rotavirus, tetanus, TB, varicella, cholera, rabies, yellow fever, COVID-19 etc

21
Q

what is a ‘yellow card’

A

proof of vaccination against diseases such as yellow fever

been around since 1969 and is WHO approved

22
Q

what is a vaccine passport?

A

digitalised yellow card which will allow government/airlines to collect, access and share information related to vaccination status prior to travel

23
Q

what are some concerns with vaccine passports?

A

security, privacy and fraud