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Flashcards in 12.8.2013(malaria) Deck (34):
0

New malaria species

Knowelsi

1

How heme is inactivated by malaria parasite?

Lipid mediated crystallisation of heme to hemozoin

2

Cytoadherence

Adhesion of RBC to capillaries and venules and other cells

3

Cytoadherence is mediated by

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

4

Rosettes

Adherence of infected RBCs to uninfected RBCs

5

Agglutination

Adhesion of infected RBCs

6

Most common enzymopathy in humans

G6PD deficiency

7

How HbF protects against malaria?

Resistant plasmodium Hb protease
Reduced antioxidant property

8

AS heterozygotes and malaria

Not protected against cerebral malaria

9

How are women with G6PD polymorphisms protected against malaria

Difficulty of parasite in switching between different populations

10

South east Asian ovalocytosis is due to

Deletion in band 3

11

HbE

Glutamate is replaced by lysine in 26th position

12

HbC

Glutamate is placed by Lysine in 6th position

13

SAO heterozygotes and malaria

Reduction in incidence of cerebral malaria

14

Acquired immunity against malaria

Anti disease immunity not sterilising immunity

15

Acquired immunity in malaria

Anti disease immunity

16

Exception to acquired immunity to malaria

Pregnant women
New CSA binding parasites sequester in placenta

17

Asplenia and malaria

High parasitemia and mature forms of Pf are seen in smear

18

How are neonates protected against malaria

HbF
Maternal antibodies

19

Pre-munition

Anti disease immunity

20

Mechanism of pre-munition in malaria

Antibody repertoire against all variants of PfEMP

21

Cause of malaria paroxysms

TNF A release stimulated by GPI moieties in ruptured schizhonts

22

Why is Pf more pathogenic?

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

23

What plays a central role in falciparum pathogenesis

PfEMP1

24

Cytoadherence is reminiscent of

Leukocyte adhesion

25

Rosetting is mediated by

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

26

How is cerebral malaria different from thrombotic stroke?

No permanent neurologic sequelae

27

Hypoglycemia in malaria

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

28

Pulmonary Edema in malaria is common in

Adults
Rare in children

29

Earliest sign of impending pulmonary Edema

Dyspnea
Increased respiratory rate

Occurs before accessory muscle use or increased interstitial markings

30

Time of onset of pulmonary Edema in malaria

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

31

Respiratory distress in malaria

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

32

Why vivax and ovale infections are benign?

Parasitemia< 1%
No sequestration
Increased RBC deformability

33

Duration of intraerythrocytic cycle in knowlesi

24hrs