219 Malaria

Question 1

Effect of malaria in early pregnancy

Answer 1

Abortion

Question 2

How does malaria lead to nephrotic syndrome

Answer 2

Chronic related infections with P. Malaria cause soluble immune complex injury to the renal glomerulii resulting in nephrotic syndrome

Question 3

How is malaria diagnosed

Answer 3

Demonstration of asexual forms of the parasite in stained peripheral blood smears

Question 4

How is malaria transmitted?

Answer 4

Bite of infected female Anopheles mosquito

Question 5

Monkey malaria parasite

Answer 5

P Knowlesi

Question 6

Species of malaria which causes almost all death

Answer 6

P. Falciparum

Question 7

Dormant form of the malaria pathogen

Answer 7

Hypnozoites

Question 8

Phenotype found in West African making time resistant to P vivax

Answer 8

Duffy negative FyFy phenotype

Question 9

Plays a critical role in binding to red cell

Answer 9

PfRh5

Question 10

Malaria pigment

Answer 10

Hemozoin

Question 11

Longest intra hepatic phase? Shortest intra hepatic phase?

Answer 11

P malariae: 15 days
P falciparum: 5.5 days
P vivax and ovale: 8 days

Question 12

Longest duration of erythrocytic cycle?

Answer 12

P malariae: 72 hours
P ovale: 50 hours
P falciparum and vivax: 48 hours

Question 13

Red cell preference. Older cells? All stages? Reticulocyte?

Answer 13

Older cells: P malariae
Reticulocytes: P vivax and ovale
All stages: P falciparum

Question 14

Matured zygote that penetratws the mosquitos gut wall

Answer 14

Ookinete

Question 15

What is main host of P Knowlesi

Answer 15

Long tailed and pigtail macaques

Question 16

Central to the pathogenesis of falciparum

Answer 16

Cytoadherence
Rosetting
Agglutination

Question 17

True or false. Malaria like leptospirosis and viral fever develop rash.

Answer 17

False.

Question 18

Characteristic and ominous feature of falciparum malaria

Answer 18

Coma

Question 19

Important case of death from sever malaria

Answer 19

Acidosis from accumulation of organic acids

Question 20

Important and common complication of severe malaria

Answer 20

Hypoglycemia

Question 21

Cause of AKI in malaria

Answer 21

Erythrocyte sequestration and agglutination interfering with renal microcirculaory flow and metabolism

Question 22

In malaria patients recoving from AKI, when doses urine flow turn to normal? When does Creatinine return to normal?

Answer 22

Urine flow resumes in median 4 days

Creatinine return to normal in mean 17 days

Question 23

What’s the cause of anemia in malaria?

Answer 23

Anemia results from accelerated RBC removal by the spleen and obligatory RBC destruction by the parasite and ineffective erythropoeisis

Question 24

Type of anemia in malaria

Answer 24

Hemolytic anemia with massive hemoglobinuria (blackwater fever)

Question 25

Why does hemolysis follow days artesunate treatment?

Answer 25

Synchronous loss of once parasitized pitted RBC

Question 26

Severe jaundice is associated with which malaria specie?

Answer 26

P falciparum

Question 27

What concurrent parasitic infection worsens malaria

Answer 27

Intestinal helminth, hookworm

Question 28

In P vivax infection, reduction in infant birth weight is more pronounce in what subset of pregnant women

Answer 28

Complications are more pronounce in multigravid than in primigravid women

Question 29

True or false. Primaquine is given to transfusion tramitted P vivax and P ovale infection

Answer 29

False

Question 30

What parasite density is associated with increased risk of dying

Answer 30

Patients with parasites more than 10 to the power of 5 /uL

Question 31

Recommend by WHO as the first line treatment for uncomplicated falciparum malaria in malaria endemic areas

Answer 31

Artemisinin based combination

Question 32

Now the drug of choice if all patients with severe malaria everywhere

Answer 32

Artesunate

Question 33

Oil based formulation of Artemisinin based combination therapy

Answer 33

Artemether and artemotil

Question 34

Anti malarial drug associated with QT syndrome

Answer 34

Quinidine

Question 35

When should quinidine infusion be stopped, signaling QT prolongation

Answer 35

QT interval exceed 0.6 seconds or | QRS complex widens by 25% over baseline

Question 36

Safe alternative to quinidine which does not require cardiovascular monitoring

Answer 36

Quinine

Question 37

Antimalarial drug. Toxicity: neuropsychiatric reactions

Answer 37

Mefloquine

Question 38

Antimalarial drugs. Toxicity: hemolytic anemia, severe G6PD deficiency

Answer 38

Primaquine

Question 39

Antimalarial drug. Toxicity: Megaloblastic anemia, pulmonary infiltration

Answer 39

Pyrimethamine

Question 40

Antimalarial drug. Toxicity: retinopathy in chronic use

Answer 40

Chloroquine

Question 41

Antimalarial drug. Toxicity: agranulocytosis

Answer 41

Amodiaquine

Question 42

ACT regimen associated with nausea and vomiting

Answer 42

Mefloquine

Question 43

What causes ARDS in malaria

Answer 43

Increases pulmonary capillary permeability

Question 44

Should be suspected when patient deteriorates for no obvious reason during antimalarial treatment

Answer 44

Hypoglycemia | Gram negative septicemia

Question 45

Fixed dose once daily prophylactic agent for malaria

Answer 45

Atovaquone-proguanil

Question 46

Antimalarial drug that may exacerbate psoriasis

Answer 46

Hydroxychloroquine

Question 47

Classic malarial paroxysms

Answer 47

Fever spikes, chills and rigors occur at regular intervals

Question 48

How does quinine lead to hypoglycemia

Answer 48

Quinine is powerful stimulant if pancreatic insulin secretion

Question 49

Best biochemical prognosticators in severe malaria

Answer 49

Plasma concentration of Bicarbonate or lactate