12.8.2013(malaria)

Question 0

How heme is inactivated by malaria parasite?

Answer 0

Lipid mediated crystallisation of heme to hemozoin

Question 1

New malaria species

Answer 1

Knowelsi

Question 2

Cytoadherence

Answer 2

Adhesion of RBC to capillaries and venules and other cells

Question 3

Cytoadherence is mediated by

Answer 3

PfEMP1 in erythrocyte
ICAM1 in vessels of brain
Chondroitin sulphate in placenta
CD34 in other areas

Question 4

Rosettes

Answer 4

Adherence of infected RBCs to uninfected RBCs

Question 5

Agglutination

Answer 5

Adhesion of infected RBCs

Question 6

Most common enzymopathy in humans

Answer 6

G6PD deficiency

Question 7

How HbF protects against malaria?

Answer 7

Resistant plasmodium Hb protease

Reduced antioxidant property

Question 8

AS heterozygotes and malaria

Answer 8

Not protected against cerebral malaria

Question 9

How are women with G6PD polymorphisms protected against malaria

Answer 9

Difficulty of parasite in switching between different populations

Question 10

South east Asian ovalocytosis is due to

Answer 10

Deletion in band 3

Question 11

HbE

Answer 11

Glutamate is replaced by lysine in 26th position

Question 12

HbC

Answer 12

Glutamate is placed by Lysine in 6th position

Question 13

SAO heterozygotes and malaria

Answer 13

Reduction in incidence of cerebral malaria

Question 14

Acquired immunity against malaria

Answer 14

Anti disease immunity not sterilising immunity

Question 15

Acquired immunity in malaria

Answer 15

Anti disease immunity

Question 16

Exception to acquired immunity to malaria

Answer 16

Pregnant women

New CSA binding parasites sequester in placenta

Question 17

Asplenia and malaria

Answer 17

High parasitemia and mature forms of Pf are seen in smear

Question 18

How are neonates protected against malaria

Answer 18

HbF

Maternal antibodies

Question 19

Pre-munition

Answer 19

Anti disease immunity

Question 20

Mechanism of pre-munition in malaria

Answer 20

Antibody repertoire against all variants of PfEMP

Question 21

Cause of malaria paroxysms

Answer 21

TNF A release stimulated by GPI moieties in ruptured schizhonts

Question 22

Why is Pf more pathogenic?

Answer 22

Cytoadherence- binding of RBCs to endothelium
Rosette- binding of infected to uninfected erythrocytes
Reduced RBC deformability

Question 23

What plays a central role in falciparum pathogenesis

Answer 23

PfEMP1

Question 24

Cytoadherence is reminiscent of

Answer 24

Leukocyte adhesion

Question 25

Rosetting is mediated by

Answer 25

PfEMP binding to CR-1(complement receptor 1),blood group A antigen

Question 26

How is cerebral malaria different from thrombotic stroke?

Answer 26

No permanent neurologic sequelae

Question 27

Hypoglycemia in malaria

Answer 27

Children- normal insulin levels,reduced gluconeogenesis,increased consumption by hypermetabolic tissues,parasite consumption Adults- Hyperinsulinemia due to islet stimulation by parasite derived factors,parenteral quinine

Question 28

Pulmonary Edema in malaria is common in

Answer 28

Adults | Rare in children

Question 29

Earliest sign of impending pulmonary Edema

Answer 29

Dyspnea Increased respiratory rate Occurs before accessory muscle use or increased interstitial markings

Question 30

Time of onset of pulmonary Edema in malaria

Answer 30

After other changes of severe malaria develops | May even occur at time of recovery

Question 31

Respiratory distress in malaria

Answer 31

``` Noncardiogenic pulmonary Edema Met acidosis Acute respiratory infections Sepsis lated ARDS aspiration Nosocomial pneumonia Cheyne stokes due to cerebral pathological processes ```

Question 32

Why vivax and ovale infections are benign?

Answer 32

Parasitemia< 1% No sequestration Increased RBC deformability

Question 33

Duration of intraerythrocytic cycle in knowlesi

Answer 33

24hrs