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Infectious Disease > Malaria > Flashcards

Malaria Flashcards

1
Q

Malaria is caused by what organism type

A

Protozoan parasites of the genus Plasmodium

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2
Q

Subtypes of malaria organism

A

P. falciparum, P. vivax, P. ovale, or P. malariae.

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3
Q

Predisposing factors for malaria

A
  • Mosquito exposure
  • operating in endemic areas
  • lack of PPE
  • lack of chemoprophylaxis
  • lack of bed nets
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4
Q

How is malaria transmitted

A

Female anopheles mosquito

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5
Q

Incubation period of Malaria

A

7 to 30 days, depending on the species of malaria
infection

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6
Q

Malaria lifecycle phases

A
  • Sporogony Phase
  • Exoerythrocytic Phase
  • Erythrocytic Phase
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7
Q

Which phase of the malaria life cycle is the Sexual cycle in Female Anopheles Mosquito

A

Sporogony Phase

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8
Q

Which phase of the malaria life cycle is the Asexual cycle in human liver (Patient is asymptomatic in this stage)

A

Exoerythrocytic Phase

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9
Q

Which phase of the malaria life cycle is the Asexual reproduction in RBCs (Patient is symptomatic in this stage)

A

Erythrocytic Phase

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10
Q

When can sx of malaria develop

A

early as 7 days after mosquito bite and as late as several months or more after exposure.

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11
Q

2 broad categories of malaria

A

Uncomplicated Malaria & Severe Malaria.

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12
Q

Presentation:
- Paroxysmal (cyclical) fever
- Influenza-like symptoms including chills, headache, myalgias, and malaise.
- Jaundice & mild anemia secondary to hemolysis

A

Uncomplicated Malaria

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13
Q

Presentation:
- Small blood vessels infarction, capillary leakage and organ dysfunction
- Altered consciousness
- Hepatic failure & renal failure
- Acute respiratory distress syndrome
- Severe anemia

A

Severe malaria

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14
Q

What is a clinical hall mark malaria

A

Paroxysmal fevers

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15
Q

Stages of paroxysmal fevers

A
  • Cold stage – lasts approximately 1 hour
  • Febrile stage – lasts 2-6 hours
  • Diaphoretic stage where fever drops – lasts 2-4 hours
  • Patient then returns to normal
  • Cycle repeats itself in 48 – 72 hours depending on species of infection
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16
Q

Dx of malaria based on

A
  • Clinical findings consistent with Malaria infection
  • Rapid diagnostic testing or laboratory confirmation via blood smear.
17
Q

Treatment of malaria is dependent on

A
  • Species of malaria
  • Severity of infection
  • Likelihood of drug resistance (where infection was acquired)
  • Patient’s age & Pregnancy status
18
Q

Two reliable-supply malaria treatment regimens available in the U.S

A
  • Atovaquone-proguanil (Malarone)
  • Artemether-lumefantrine (Coartem)
19
Q

Reliable Supply definition

A
  • Complete course of approved treatment regimen obtained in the U.S.
  • Is not counterfeit or substandard
  • No adverse interactions with the patient’s other medicines, including prophylaxis
  • Will not deplete local resources in the destination country
20
Q

Should you use the same or related drug to treat malaria that was used for chemoprophylaxis

A

No

21
Q

Treatment of Uncomplicated Malaria

A
  • Chloroquine phosphate 1g (600mg base) PO
  • THEN 0.5g in 6 hours
  • THEN 0.5g daily for 2 days
22
Q

Treatment of malaria in areas with chloroquine resistance

A

Malarone (Atovaquone 250mg/Proguanil 100mg) 4 tabs PO QD for 3 days

23
Q

Treatment of Severe Malaria

A
  • Artesunate 2.4mg/kg IV at 0, 12, 24, 48 hours
  • Followed by Doxycycline 100mg BID x 7 days after parenteral therapy
24
Q

Treatment of P.ovale

A
  • ADD primaquine 52.6mg (30mg base = 2 tablets) PO QD x 14 days
  • Added to regiment for hypnozoites
25
Q

Prevention of Malaria

A
  • The most important protective measures are proper clothing and awareness.
  • Long sleeve shirts, long pants, insect repellant, and head nets, will
    keep mosquitoes from biting.
  • Addition precautions include closed sleeping quarters, insecticides, and prophylaxis.
26
Q

Where would you find most up to date information for malaria resistance

A

ww.CDC.gov, or the cognizant EPMU prior to travel to an endemic area.

27
Q

Prophylactic for malaria

A
  • Chloroquine, & Mefloquine: 1-2 weeks prior to the expected embarkation to an endemic area and continued for 4 weeks after leaving the endemic area
  • For Malarone, Primaquine, & Doxycycline: start
    2 days prior to entry & continue till 7 days after departing; Doxycycline to be continued till 1 month after departing
28
Q

Malaria Disposition

A

MEDEVAC

29
Q

Malaria Complications

A
  • neurologic abnormalities
  • acute renal failure
  • anemia
  • metabolic acidosis
  • hypovolemia
  • Acute Respiratory Distress Syndrome

Infectious Disease (20 decks)

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