exam 5 - malaria

Question 1

prophylaxis for malaria endemic regions

Answer 1

-atovaquone/proguanil
-doxy
-tafenoquine

Question 2

prophylaxis for chloroquine-sensitive regions

Answer 2

chloroquine
hydroxychloroquine

Question 3

prophylaxis for p vivax regions

Answer 3

primaquine

Question 4

prophylaxis for mefloquine sensitive regions

Answer 4

mefloquine

Question 5

instructions for atovaquone/proguanil

Answer 5

start 1-2 days before through 7 days after leaving

Question 6

when to avoid atova/proguanil

Answer 6

CrCl < 30
breastfeeding
pregnant
kids < 5kg

Question 7

instructions for chloroquine

Answer 7

start 1-2 wks through 4ks afters

Question 8

when to avoid chloroquine

Answer 8

leaving in < 1 wk

Question 9

instructions for hydroxychloroquine

Answer 9

starts 1-2 wks through 4 wks after

Question 10

when to avoid hydroxychloroquine

Answer 10

leaving in < 1 week

Question 11

instructions for doxycycline

Answer 11

start 1-2 days before through 4 wks after

Question 12

when to avoid doxy

Answer 12

pregnant
< 8 years
allergy
yeast infections

Question 13

instructions for mefloquine

Answer 13

starts >= 2 wks before through 4 wks after

Question 14

when to avoid mefloquine

Answer 14

allergy
depression
psych
cardiac conduction

Question 15

instructions for primaquine

Answer 15

start 1-2 days before through 7 day after

Question 16

when to avoid primaquine

Answer 16

G6PD deficiency
pregnant

Question 17

instructions for tafenoquine

Answer 17

start 3 days before through 1 wk after

Question 18

when to avoid tafenoquine

Answer 18

G6PD
pregnant
psych
children

Question 19

when is malaria onset

Answer 19

2-4 weeks after bite

Question 20

clinical symptoms of malaria

Answer 20

fever
HA
weakness
night sweats
GI
neuro

Question 21

lab presentation of malaria

Answer 21

anemia
thrombocytopenia
hyponatremia
acidemia
inc Cr
hypoglycemia

Question 22

criteria for severe malaria

Answer 22

> = 1 of the following:
impaired conscious/coma
Hg < 7
AKI
ARDS
circulatory shock
acidosis
parasitic density >= 5%
coagulation

Question 23

falciparum/unknown
chloroquine resistance
1st line

Answer 23

arthemeter/lumefantrine

Question 24

falciparum/unknown
chloroquine resistance
2nd line

Answer 24

atovaquone, quin + doxy or clinda

Question 25

P falciparum/unknown no resistance 1st line

Answer 25

chloroquine hydroxy

Question 26

p ovale or vivax chloroquine resist 1st line

Answer 26

arthem/lum + primaquine

Question 27

p ovale or vivax no resistance 1st line

Answer 27

chloro or hydroxy + primaquine

Question 28

p knowlesi or malariae 1st line

Answer 28

chloro or hydroxy

Question 29

severe malaria treatment

Answer 29

IV artesunate x7 days transition to oral treatment

Question 30

IV artesunate dosing

Answer 30

1st day: 2.4 mg/kg IV @ 0,12,24hrs then 2-7 day: 2.4 mg/kg IV daily until density < 1%

Question 31

oral options for severe malaria

Answer 31

arte/lum atovaquone quinine + doxy/clinda mefloquine