Malaria

Question 1

Etio Malaria

Answer 1

Plasmodium

Question 2

Vektor Malaria

Answer 2

Nyamuk anopheles

Question 3

Klinis Malaria

Answer 3

Trias Malaria: Demam, menggigil, berkeringat dingin

+ Riwayat berpergian ke daerah endemis (NTT, NTB, Papua)

Question 4

PP Malaria

Answer 4

Sediaan Apusan Darah Tepi (tebal/tipis)
Tebal → u/ dx
Tipis → u/ jenis plasmodium

Question 5

Jenis Plasmodium Berdasarkan Eritrosit (2)

Answer 5

Eritrosit Tetap
Eritrosit Membesar

Question 6

Jenis Plasmodium: Eritrosit Tetap

Answer 6

Falciparum
Malariae

Question 7

Jenis Plasmodium: Eritrosit Membesar

Answer 7

Ovale → Comet Shape/Fimbrae
Vivax

Question 8

Jenis Plasmodium Berdasarkan Nama Lain

Answer 8

FaTro Falciparum Tropikana

ViOTer Vivax Ovale Tertiana

MaKu Malariae Kuartana

Question 9

Jenis Plasmodium Berdasarkan Jenis Dot

Answer 9

Faling Mantap = Falciparum Maurer dots

Vas Sakit = Vivax Schuffner dots

Obatnya Janda = Ovale James dots

Muda Zeksi = Malariae Ziemann dots

Question 10

Nama Lain Malaria Falciparum

Answer 10

Malaria Tropicana

Question 11

Pola Demam Malaria Falciparum

Answer 11

Tidak menentu

Question 12

Eritrosit Malaria Falciparum

Answer 12

Membesar (-)

Question 13

Tanda Khas Malaria Falciparum

Answer 13

Maurer Dots

Question 14

Trofozoit Malaria Falciparum

Answer 14

Ring form, accole, headphone, marginal/applique

Question 15

Gametosit Malaria Falciparum

Answer 15

Banana/crescent/sausage shaped

Question 16

Nama Lain Malaria Vivax

Answer 16

Malaria Tertiana → demam setiap hari ke-3

Question 17

Pola Demam Malaria Vivax

Answer 17

2 hari bebas demam

Question 18

Eritrosit Malaria Vivax

Answer 18

Membesar (+)

Question 19

Tanda Khas Malaria Vivax

Answer 19

Schuffner dots

Question 20

Trofozoit Malaria Vivax

Answer 20

Amoeboid, ringform

Question 21

Nama Lain Malaria Ovale

Answer 21

Malaria Tertiana → demam setiap hari ke-3

Question 22

Pola Demam Malaria Ovale

Answer 22

2 hari bebas demam

Question 23

Eritrosit Malaria Ovale

Answer 23

Membesar (+) → Comet shape/Fimbrae

Question 24

Tanda Khas Malaria Ovale

Answer 24

James dots

Question 25

Nama Lain Malaria Malariae

Answer 25

Malaria Kuartana → demam setiap hari ke-4

Question 26

Pola Demam Malaria Malariae

Answer 26

3 hari bebas demam

Question 27

Eritrosit Malaria Malariae

Answer 27

Membesar (-)

Question 28

Tanda Khas Malaria Malariae

Answer 28

*Ziemann dots*

Question 29

Trofozoit Malaria Malariae

Answer 29

*Rectangular shape* *Band form* *Basket form*

Question 30

Gametosit Malaria Malariae

Answer 30

Titik kasar pada sitoplasma → *Rosette* → *Skizont*

Question 31

Tx Malaria

Answer 31

Obat malaria → iritasi lambung → sesudah makan

Question 32

Tx Malaria Non Komplikasi

Answer 32

ACT = Artemisin Combination Therapy → DHP = Dihidroartemisinin-Piperakuin → DHA 40 mg + Piperakuin 320 mg = DHP tab 360 mg +/- Primakuin tab 15 mg

Question 33

Tx Malaria Non Komplikasi Lini I

Answer 33

- Falciparum: DHP 3 hari + Primakuin 1 hari - Vivax/Ovale: DHP 3 hari + Primakuin 14 hari u/ bunuh stadium hipnozoid - Malariae: DHP 3 hari

Question 34

Tx Malaria Non Komplikasi Lini II

Answer 34

- Falciparum: Kina + Doxy/Tetra → 7 hari + Primakuin 1 hari - Vivax/Ovale: Kina + Doxy/Tetra → 7 hari + Primakuin 14 hari - Malariae: Kina + Doxy/Tetra 7 hari ## Footnote DHP 3 hari diganti Kina + Doxy/Tetra 7 hari Kina 3x10 mg/kgBB Doksisiklin Dewasa 2x3,5 mg/kgBB 8-14 tahun 2x2,2 mg/kgBB Tetrasiklin 4x4-5 mg/kgBB

Question 35

Tx Malaria Bumil

Answer 35

KI: Primakuin, tetrasiklin, doksisiklin 1. DHP 3 hari ATAU 2. Kina + Klindamisin → 7 hari ## Footnote Kina 3x10 mg/kgBB Klindamisin 2x10 mg/kgBB

Question 36

Malaria Berat/Komplikasi

Answer 36

Paling sering falciparum P enurunan Kesadaran → Malaria Serebral A sidosis Laktat K ejang → Malaria Serebral E dema Paru G agal Ginjal Akut A nemia berat (Hb<9) S yok → Malaria Algid H2 Hipoglikemia Hemoglobinuria → *Black Water Fever*

Question 37

Tx Malaria Berat/Komplikasi Lini 1

Answer 37

Artesunat 2,4 mg/kgBB IV/IM (jam 0, 12, 24) → setiap 24 jam s/d mampu PO Artesunat vial 60 mg + pelarut (Na bikarbonat 5%) = Sodium Artesunat 1 ml Sodium Artesunat 1 ml + D5%/NaCl 0,9% 5 ml = 60 mg/6 ml (10 mg/ml)

Question 38

Tx Malaria Berat/Komplikasi Lini 2

Answer 38

Artemeter 3,2 mg/kgBB IM

Question 39

Profilaksis Malaria

Answer 39

FR (+), sakit (-) Tergantung lokasi

Question 40

Profilaksis Malaria Sensitif Klorokuin

Answer 40

Klorokuin 300 mg/**minggu** (**1 minggu sebelum**, selama, 4 minggu sesudah)

Question 41

Profilaksis Malaria Resisten Klorokuin

Answer 41

Doksisiklin 100 mg/**hari** (**2 hari sebelum**, selama, 4 minggu sesudah) **maks. 3 bulan** KI: Ibu hamil, anak <8 tahun

Question 42

Profilaksis Malaria Alternatif

Answer 42

Meflokuin 200 mg/**minggu** (**2 minggu sebelum**, selama, 4 minggu sesudah) Bisa bumil, anak <8 tahun

Question 43

Dosis DHP dan Primakuin Berdasarkan BB dan Umur

Answer 43

- **≤5 kg, 0-1 bulan** DHP 1/3 tab - **>5**-6 kg, **2**-<6 bulan DHP 1/2 tab - **>6**-10 kg, **6-12** bulan DHP 1/2 tab Primakuin 1/4 tab - **>10**-17 kg, **<5** tahun DHP 1 tab Primakuin 1/4 tab - **>17**-30 kg, **5**-9 tahun DHP 1 1/2 tab Primakuin 1/2 tab - **>30**-40 kg, **10**-14 tahun DHP 2 tab Primakuin 3/4 tab - **>40**-60 kg, **≥15** tahun DHP 3 tab Primakuin 1 tab - **>60**-80 kg, ≥15 tahun DHP 4 tab Primakuin 1 tab - **>80** kg, ≥15 tahun DHP 5 tab Primakuin 1 tab