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PARASITOLOGY > MIDTERM: PLASMODIUM SPP. > Flashcards

MIDTERM: PLASMODIUM SPP. Flashcards

1
Q

● leading parasitic disease
● one of 3 major infectious disease threats
● chronic malaria leads to anemia

A

Plasmodium spp.

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2
Q

Plasmodium spp.

A
  1. Plasmodium falciparum
  2. Plasmodium vivax
    (microscopically indistinguishable based on life cycle)
  3. Plasmodium ovale
  4. Plasmodium malariae
  5. Plasmodium knowlesi
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3
Q

are 90% responsible of human malaria cases

A

Plasmodium falciparum & Plasmodium vivax

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4
Q

described in humans in the Philippines and most of Southeast Asia. a parasite of long-tailed macaques (Macaca fascicularis)

A

Plasmodium knowlesi

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5
Q

ANOPHELES MOSQUITO
 principal malaria vector in the Philippines
 a night biter, which prefers to breed in slow flowing, partly shaded streams that abound in the foothill areas.
 ability to adapt to or utilize new habitats such as
irrigation ditches, rice fields, pools, and wells.
 In Palawan, it was observed to be mildly exophagic and zoophilic.

A

Anopheles minimus var. flavirostris

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6
Q

ANOPHELES MOSQUITO
- associated with malaria transmission in the
coastal areas of Mindanao, particularly in Sulu

A

Anopheles litoralis

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7
Q

coexists with A. flavirostris in the portion of streams exposed to sunlight.
 responsible for malaria transmission at higher
altitudes.

A

Anopheles maculatus

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8
Q

 has the same breeding habitats and seasonal
prevalence as A. flavirostris
 but prefer habitats located in forest fringe.

A

Anopheles mangyanus

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9
Q

➢ is also known as Erythrocytic Schizogony
➢ Where P. vivax and ovale forms its dormant stage and become hypnozoites

A

Exo-erythrocytic Cycle

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10
Q

 MOST DANGEROUS AND DEADLY
 Affects Erythrocytes of all ages
 BLACK WATER FEVER (severe malaria)
o caused by hemoglobinuria (presence of hemoglobin in urine)
o characterized by intravascular hemolysis
caused by P. falciparum-induced red cell
destruction.
 has Maurer’s dots - dark, irregular to commashaped cytoplasmic dots

A

Plasmodium falciparum

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11
Q

 Benign Tertian Malaria
o Causes REPEATED RELAPSES from a single mosquito
o mimic those usually seen in cases of the flu, including nausea, vomiting, headache, muscle pains, and photophobia.
 Most widespread
 infects RETICULOCYTES
 Schuffner’s dots are often present

A

Plasmodium vivax

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12
Q

 Benign Tertian (same as P. vivax)
 Infects RETICULOCYTES
 Has Jame’s dots

A

Plasmodium ovale

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13
Q

 Quartan Malaria (also known as “Malarial malaria”)
o typically experience an incubation period
of 18 to 40 days followed by the onset of
flulike symptoms.
o Cyclic paroxysms occur every 72 hours
(thus, the name quartan malaria).
 Infects OLD RBCs
 Has Ziemman’s dots

A

Plasmodium malariae

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14
Q

 A parasite of Old World Monkeys
 Long-tailed macaques (Macaca fascicularis)
 Morphologically resembles P. malariae
 Causes Malaria to humans and other primates
 Life cycle: Microscopically indistinguishable from P. malariae
 Requires infection of both mosquito and a
warm blooded host
 Natural Host: Cynomolgus Monkeys
- SINTON & MULLIGANS STIPPLINGS

A

Plasmodium knowlesi

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15
Q

Differentiation of P. knowlesi and P.
malariae is achieved through ?

A

Polymerase Chain Reaction (PCR) Assay and Molecular characterization

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16
Q

MORPHOLOGICAL FEATURES
- only mature cells
- infected rbc: larger than normal, pale, often bizarre, SCHUFFNER’S DOT are often present
- MAURER’S CLEFT

A

Plasmodium falciparum

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17
Q

MORPHOLOGICAL FEATURES
- only young and immature cells
- infected rbc: larger than normal, pale, often bizarre or distorted,
- SCHUFFNER’S DOT are often present

A

Plasmodium vivax

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18
Q

MORPHOLOGICAL FEATURES
- only young and immature cells
- infected rbc: enlarged, oval in shape, often with fringed or irregular edge; SCHUFFNER’S DOT appear even with younger stages
- JAME’S DOT

A

Plasmodium ovale

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19
Q

MORPHOLOGICAL FEATURES
- only young and immature cells
- infected rbc: larger than normal, pale, often bizarre or distorted, SCHUFFNER’S DOT are often present
- ZIEMANN’S STRIPPING

A

Plasmodium malariae

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20
Q

Range from 11 days-4 weeks

A

PREPATENT PERIOD

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21
Q
  • Sporozoite injection & the appearance of clinical symptoms typically
  • Initial mosquito bite and exoerythrocytic cycle of malarial infection
A

INCUBATION PERIOD

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22
Q

a sudden attack or increase of symptoms of a disease (such as pain, coughing, shaking, etc.) that often occurs again and again

A

Paroxysms

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23
Q

Prodromal Symptoms

A

o Feeling of weakness and exhaustion
o Desire to stretch and yawn
o Aching bones, limbs, back
o Loss of appetite
o Nausea and vomiting
o Sense of chilling

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24
Q

At disease onset:

A

o Malaise
o Backache
o Diarrhea
o Epigastric discomfort

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25
Q

3 Stages of Classical Malaria Paroxysms:
* Coldness & apprehension
* Mild shivering quickly turns to violent teeth chattering and shaking
of the entire body
* Convulsion may last 15-60 minutes

A

COLD STAGE

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26
Q

3 Stages of Classical Malaria Paroxysms:
* Headaches, palpitations, tachypnea, epigastric discomfort, thirst, nausea and vomiting
* Temperature may reach a peak of 41°C
* Last for 2-6 hrs

A

HOT STAGE/FLUSH PHASE

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27
Q

3 Stages of Classical Malaria Paroxysms:
*Defervescence or diaphoresis
*Temperature lower over the next 2-4 hrs
* Total duration of typical attack is 8-12 hrs

A

SWEATING STAGE

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28
Q
  • only infect the aging cells
A

Plasmodium malariae

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29
Q

infect young Red Blood Cell

A

Plasmodium vivax and Plasmodium ovale

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30
Q

infect all ages of erythrocytes

A

Plasmodium falciparum & Plasmodium knowlesi

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31
Q
  • RENEWAL OF PARASITEMIA or clinical features arising from persistent undetectable asexual parasitemia in the absence of an exo-erythrocytic
  • Recurrence of malaria due to the SURVIVAL OF THE PARASITE in the RBCs of the patient
A

Recrudescence

32
Q
  • is RENEWED ASEXUAL PARASITEMIA following a period in which the blood contains no detectable parasites
  • Recurrence of malaria even though the
    patient has been cured
  • Usually occurs with Plasmodium vivax and
    Plasmodium ovale due to the reactivation of
    HYPNOZOITES in the liver
A

Relapse

33
Q

The rupturing of RBCs causes _______________ to be
released. Due to these factors, it causes the infected
body to experience the familiar symptoms of malaria:
o Fever
o Chills
o Headache
o Excessive perspiration

A

TUMOR NECROSIS FACTOR (TNF) & OTHER CYTOKINES

34
Q
  • are the ligands for rosette formation.
  • adhere to parasitized and non-parasitized
A

Rosettins and PfEMP-1

35
Q
  • act like the endotoxin of gram negative bacteria, lipopolysaccharide
    (LPS).
A

Glycosy|phosphatidylinositol (GPI)

36
Q

SEVERE FORMS OF MALARIA:

A

● impairment of consciousness
● signs of cerebral dysfunction (delirium and generalized convulsions)
● severe hemolytic anemia

37
Q

characterized by a hematocrit less than 7 g/dL and hyperbilirubinemia with levels more than 50 mmol/L

A

SEVERE HEMOLYTIC ANEMIA

38
Q
  • manifest diffuse symmetrix encephalopathy
  • FATAL
    o Signs & Symptoms: retinal hemorrhage, bruxism (fixed jaw closure and teeth grinding), and mild neck stiffness.
A

Cerebral Malaria

39
Q
  • is common, and it includes air flow obstruction, impaired ventilation and gas transfer, and increased pulmonary phagocytic activity
A

Altered Pulmonary Function

40
Q

__________ reaches up to 60% of patients with severe falciparum malaria
- Serum creatinine of more than 265 mmol/L
- 24-hour urine output of less than 1 ml/kg/hr

A

Acute Renal Failure (ARF)

41
Q

o Increases the risk of maternal death, maternal
anemia, intrauterine growth retardation,
spontaneous abortion, stillbirth, and low birth
weight associated with risk for neonatal death

A

PLACENTAL MALARIA

42
Q

MICROSCOPIC DETECTION OF MALARIA

A

GIEMSA STAIN (specimen of choice) & WRIGHT’S STAIN (GOLD STANDARD)

43
Q

BLOOD SMEARS( under OIO)
- used as SCREENING SLIDES, locates parasites
sitting in RBCs

A

Thick smears

44
Q

BLOOD SMEARS( under OIO)
- used in DIFFERENTIATING Plasmodium spp.

A

Thin smears

45
Q

Is the MEASUREMENT OF PARASITE LOAD in the sample and the indication of the degree of active parasitic infection

A

Parasitemia

46
Q

Blood smears are usually obtained every _________

A

every 6-8 hours

47
Q

Not seriously ill

A

once daily is sufficient

48
Q

Seriously ill

A

2-3 times daily

49
Q
  • Immunochromatographic methods to detect
    Plasmodium-specific antigens in a finger prick
    blood sample
  • Performed in 15-30 mins without use of electricity,
    special equipment, or any training in microscopy
  • Easily taught and interpreted
  • 90% specificity
A

Malaria rapid diagnostic tests (RDTs)

50
Q

Malaria rapid diagnostic tests (RDTs)
Antigens being targeted:

A
  • Histidine-rich protein II (HRP II)
  • plasmodium lactate dehydrogenase
    (pLDH)
  • Plasmodium aldolase
51
Q

 cannot differentiate between current and past
infections and are therefore most helpful in
epidemiologic studies.
 presently available methods are not capable of
making a definitive diagnosis of acute malaria

A

Serologic tests

52
Q

to significantly enhance microscopic diagnosis of
malaria especially in cases of low parasitemia and
in cases of mixed infection

A

Polymerase chain reaction (PCR) techniques

53
Q

ANTIMALARIAL DRUGS MAIN USES:
- preventing either the occurrence of the infection or any of its symptoms.

A

PROTECTIVE (prophylactic)

54
Q

ANTIMALARIAL DRUGS MAIN USES:
- use refers to action on the established infection, which involves the use of blood schizonticidal drugs for the treatment of the acute attack and in the case of relapsing malaria

A

Curative

55
Q

ANTIMALARIAL DRUGS MAIN USES:
- deterrence of infection of mosquitoes with the use of gametocytocidal drugs to attack the gametocytes in the blood of the human host; interruption of the development of the sporogonic phase

A

Preventive

56
Q

destroy the sexual forms of the parasite in the blood

A

Gametocytocidal drugs

57
Q

which kill the dormant forms in the liver

A

HYPNOZOITOCIDAL OR ANTIRELAPSE DRUGS

58
Q

Inhibit the development of the oocysts on the gut wall of the mosquito

A

Sporonticidal drugs

59
Q

TREATMENT
first line antimalarial treatment in africa

A

Lumefantrine

60
Q

2nd line drug

A

QUININE SULFATE PLUS DOXYCYCLINE OR
CLINDAMYCIN

Disadvantage of Quinine: produces
toxic side effects such as cardiotoxicity
and cinchonism, characterized by
tinnitus, headache, and blurring of vision

61
Q

contraindicated in pregnant women and children below 8 years.

A

Tetracycline

61
Q

known to be effective antimalarials, although they kill the parasite rather slowly.

A

TETRACYCLINE and CLINDAMYCIN

62
Q
  • Drug of choice in severe malaria
A

Quinine/quinidine

63
Q

drug choice for plasmodium vivax; mainstay of antimalarial treatment for the last 50 years

A

Chloroquine

64
Q

intermittent preventive treatment combined with sulfadoxine

A

Pyrimethamine

65
Q

severe/uncomplicated falciparum malaria

A

Artemisinin-based Combination Therapies (ACTs)

66
Q

Classification of response to malaria
treatment can be divided into?

A
  • early treatment failure
  • late treatment failure, and
  • adequate clinical and parasitological response
67
Q

Early diagnosis and prompt treatment of malaria are essential for malaria control. Breeding sites of ______________should be detected early and contained.

A

Anopheles flavirostris

68
Q

ANTIMALARIAL OF CHOICE IN PREGNANCY

A

Quinine plus Clindamycin taken for 7 days

69
Q
  • DRUG OF CHOICE FOR GAMETOCYTES AND HYPNOZOITES
  • should NOT be given in pregnancy
    and in children less than 4 years of age
A

Primaquine

70
Q

Resistance of a parasite to drugs is graded according to the PATTERNS OF _______after initiation of treatment

A

asexual parasitemia

71
Q

TYPES OF RESISTANCE OF PARASITE TO DRUGS
- is the MILDEST FORM of resistance which is characterized by initial clearance of parasites but recrudescence occurs within a month after the start of treatment

A

RI

72
Q

TYPES OF RESISTANCE OF PARASITE TO DRUGS
- INITIAL REDUCTION IN PARASITEMIA after treatment but there is failure to clear the blood of asexual parasites and soon after an increase of parasitemia follows.

A

RII

73
Q

TYPES OF RESISTANCE OF PARASITE TO DRUGS
-SEVEREST FORM OF RESISTANCE which parasitemia will either show no significant change with treatment or will eventually increase.

A

RIII

74
Q

ADDITIONAL TREATMENTS
- important especially in children to prevent convulsions.

A

Antipyretics and sponging

75
Q

administered with care to avoid pulmonary edema.

A

Fluid replacement or blood transfusion

76
Q

o To control seizures
o 10 mg intravenous

A

Diazepam

PARASITOLOGY (23 decks)

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