Malaria

Question 1

What species are responsible for malaria and they are under phylum what?

Answer 1

Plasmodium species under phylum Apicomplexa

Question 2

Vector of Malaria?

Answer 2

Female Anopheles mosquito

Female Anopheles minimus flavirostris

Question 3

Malaria came from the italian word that means bad air

Answer 3

mal-air

Question 4

Final host of Plasmodium?

Answer 4

Female Anopheles mosquito

Anopheles minimus flavirostris

Question 5

Intermediate host of Plasmodium?

Answer 5

Man

Question 6

Infective stage of Plasmodium to man?

Answer 6

sporozoites

Question 7

Infective stage of Plasmodium to mosquito?

Answer 7

gametocytes

Question 8

Diagnostic stage of Plasmodium spp?

Answer 8

• Trophozoite (imma & mature)
• Schizonts
• Gametocytes

Question 9

MOT of Plasmodium spp?

Answer 9

• bite of female anopheles
• Blood transfusion
• Congenital transmission

Question 10

Habitat of malarial parasites in our body?

Answer 10

Liver and RBCs

hepatocytes (or parenchymal cells) in liver

Question 11

Sporozoites that are inoculated in the blood stream must reach the liver within how many minutes to undergo schizogony?

invading its parenchymal cells

Answer 11

40 mins

30-60 from markell

Question 12

What do you call the asexual reproduction that is undergone by sporozoites in the parenchymal cells?

Answer 12

Schizogony

this results in the production of merozoites

Question 13

What do you call the cell that contains the merozoites?

apparently, same lang siya sa exoerythrocytic pati erythrocytic stage

Answer 13

Schizont

Question 14

What do you call the resting stage of some malarial parasites and which of the parasites have this stage?

Answer 14

Hypnozoites; P. ovale & P. vivax

hypnozoite may also be called as cryptozoite

Question 15

What do you call the recurrence when there is reinvasion of the bloodstream by hypnozoites after being cleared of erythrocytic infection?

Answer 15

Relapse

Question 16

What do you call the recurrence of symptoms in a patient whose initial bloodstream infection levels are too low to be demonstrated clinically?

from ineffective treatment where there is high antimalarial resistance

Answer 16

Recrudescence

Question 17

What do you call the recurrence of symptoms wherein the individual was healed, but a new infection of malaria caused new symptoms?

take note n there is no immunity acquired but increased tolerability to malaria lng

Answer 17

Reinfection

Question 18

The immature trophozoite or its early form is also known as what form?

Answer 18

ring form

Question 19

What do you call the process wherein gametocytes are produced?

Answer 19

Gametogony

Question 20

Among the gametocytes, which are male and female?

Answer 20

Micro = male; Macro = female

Question 21

What do you call the sexual reproduction that gametocytes undergo in order to produce a zygote?

this happens in the mosquito

Answer 21

Sporogony

Question 22

What do you call the process where 8 sperm-like structures are released by microgametes to fertilize the macrogametes?

Answer 22

Exflagellation

Question 23

What is the most prevalent (predominant) malarial parasite worldwide and the only one whose range extends into the temperate regions?

Answer 23

P. vivax

Question 24

This malarial parasite has a very active ameboid motility that is exhibited during growth period. It may also assume bizarre and irregular forms w/in the RBC.

Answer 24

P. vivax

it was this ameboid activity that suggested the specific name vivax

vivax = latin for vigorous

Question 25

The morphologic feature that originally led to the establishment of P. ovale as a separate species, is its ____ shape of many of the infected red blood cells,

Answer 25

ovoid shape

Question 26

What is the Gold Standard for diagnosing Malaria?

Answer 26

Thick and Thin Smear ## Footnote thick for quantification/general screening; thin for species identification

Question 27

EDTA-blood may be used for blood smear but must be made within how many hours?

Answer 27

w/in 1 hour ## Footnote bcoz true stipplings of infected RBCs may not be retained

Question 28

Blood specimens ideally are collected when?

Answer 28

**before the next** anticipated fever or **onset of fever**

Question 29

If parasites are not found in the first blood films, it is advisable to take additional thick and thin films every how many hours?

Answer 29

every 6-12 hours | for as long as 48 hours if necessary

Question 30

For a patient to be declared ABSENT OF INFECTION, morning and afternoon afternoon thick smears during symptomatic period must be negative for how many consecutive days?

Answer 30

3 consecutive days ## Footnote meaning, kapag 3 days sunod-sunod walang nakita, absence of infection

Question 31

The first level of diagnosis is the presumptive differentiation of ____ from the other species, as the presence of this parasite in a non-native constitutes a medical emergency

Answer 31

*P. falciparum*

Question 32

A presumptive diagnosis of ____ can be made on the basis of finding exclusively ring forms with or without characteristic gametocytes in a blood film

Answer 32

*P. falciparum*

Question 33

The incubation period of malaria is longest in ____ and shortest in ____.

Answer 33

*P. malariae*; *P. falciparum*

Question 34

Chronic *P. malariae* infections in children may result in immune-complex deposition on the glomerular walls, leading to ____.

Answer 34

nephrotic syndrome

Question 35

What is identified as the most serious complication of *P. falciparum* and a frequent cause of death?

Answer 35

Cerebral malaria

Question 36

This is a consequence of the lysis of the RBCs and the formation of hemozoin due to the heavy parasite load in falciparum malaria

Answer 36

Anemia

Question 37

Along with malarial malaria, this disease is common too in falciparum malaria. What is it? ## Footnote characteried as a result of tubular necrosis and then acute glomerulonephritis

Answer 37

renal disease

Question 38

What do you call the syndrome that results from massive intravascular hemolysis and the passage of usually black urine?

Answer 38

Blackwater fever ## Footnote from falciparum

Question 39

what do you call the result of the expression on the surface of the parasitized RBC that is characterized as the formation of *knobs* on its surface?

Answer 39

Cytoadherence ## Footnote small vessels may be plugged by masses of RBCs then result to Ischemia

Question 40

Rupture of the infected red blood cells brings on the malarial ____

Answer 40

paroxysm

Question 41

Lysis of numerous uninfected cells during the paroxysm, plus enhanced phagocytosis of normal cells in addition to the cell remnants and other debris produced by schizogony, leads both to ____ and to ____ of the spleen and liver

Answer 41

anemia; enlargement

Question 42

____ is derived from the hemoglobin of the infected red blood cell, and, as it is insoluble in plasma

Answer 42

Hemozoin ## Footnote its formation depletes the iron stores of the body, thus adding to the anemia **IDA** (higher hemozoin higher # of parasites)

Question 43

Drugs for Malaria

Answer 43

Chloroquine, Primaquine, Quinine | these are all quinone compounds

Question 44

formula to calculate for # of malarial parasite/ul

Answer 44

(#of parasites counted / WBC) x 8000 (or WBC count per uL)

Question 45

formula for %infected RBCs

Answer 45

(infected RBCs/total RBCs counted) x 100

Question 46

two types of stain that can be used for thick and thin smear

Answer 46

- Giemsa (ideal) - Wright's (alternative)

Question 47

what do you call the diagnosis technique that uses a capillary tube stained with acridine orange then its **positive result will be bright green and yellow under** fluorescent microscope?

Answer 47

Quantitative Buffy Coat

Question 48

What is the antigen produced by *P. falciparum* that is detected by rapid diagnostic tests (immunochroma)?

Answer 48

HRP-II | histidine-rich protein

Question 49

# Identify the species based on characteristics Malignant Tertian Fever; Blackwater fever

Answer 49

*P. falciparum* ## Footnote with paroxysmal cycle of 36-48 hrs

Question 50

# Identify the species based on characteristics Benign Tertian Malaria

Answer 50

*P. vivax* ## Footnote paroxysms every 48 hours

Question 51

# Identify the species based on characteristics Ovale Tertian Malaria

Answer 51

*P. ovale* ## Footnote paroxysms every 48 hours

Question 52

# Identify the species based on characteristics Quartan Malaria

Answer 52

*P. malariae* ## Footnote paroxysms every 72 hours

Question 53

# Identify the species based on characteristics Infects all RBCs regardless of senescence

Answer 53

*P. falciparum*

Question 54

# Identify the species based on characteristics Infects young RBCs (reticulocytes)

Answer 54

*P. ovale* & *P. vivax*

Question 55

# Identify the species based on characteristics Infects senescent RBCs | or old

Answer 55

*P. malariae*

Question 56

# Identify the species based on characteristics Normal parasitized RBC

Answer 56

*P. falciparum* & *P. malariae*

Question 57

# Identify the species based on characteristics Parasitized RBCs are enlarged by 1.5 to 2x

Answer 57

*P. vivax*

Question 58

# Identify the species based on characteristics Parasitized RBCs are oval in shape and some may be enlarged

Answer 58

*P. ovale*

Question 59

# Identify the species based on characteristics Ring form has 2 chromatin dots; arranged in Accole or Applique forms

Answer 59

*P. falciparum*

Question 60

# Identify the species based on characteristics Ring form is 1/3 the diameter of the RBC and has a heavy chromatin dot | Signet ring appearance

Answer 60

*P. vivax*

Question 61

# Identify the species based on characteristics Has similar rings to *P. vivax* but larger

Answer 61

*P. ovale*

Question 62

# Identify the species based on characteristics Ring form covers 1/8 of the RBC and has a Heavy Chromatin Dot | Bird's eye appearance

Answer 62

*P. malariae*

Question 63

# Identify the species based on characteristics Its developing trophozoite has heavy ring forms and not commonly seen

Answer 63

*P. falciparum*

Question 64

# Identify the species based on characteristics Its developing trophozoite is amoeboid in shape

Answer 64

*P. vivax*

Question 65

# Identify the species based on characteristics Its developing trophozoite has a ring appearance which is usually maintained until late in development

Answer 65

*P. ovale*

Question 66

# Identify the species based on characteristics Its developing trophozoite is band-shaped and basket forms may be seen

Answer 66

*P. malariae*

Question 67

# Identify the species based on characteristics 8-36 merozoites in schizonts | 24 average number

Answer 67

*P. falciparum*

Question 68

# Identify the species based on characteristics 12-24 merozoites in schizonts

Answer 68

*P. vivax*

Question 69

# Identify the species based on characteristics 8 merozoites

Answer 69

*P. ovale* ## Footnote 4-12 (12-18 sometimes) - Markell & Voge's

Question 70

# Identify the species based on characteristics 6-12 merozoites in schizonts and has a rosette or fruitpie appearance | daisy-head or flower-like in appearance

Answer 70

*P. malariae*

Question 71

# Identify the species based on characteristics Gametocytes may be sausage-shaped w/ diffuse chromatin and crescent-shaped w/ compact chromatin

Answer 71

*P. falciparum*

Question 72

# Identify the species based on characteristics Gametocytes are round with a large chromatin mass colored pink to purple and is surrounded by a pale halo. May also be round w/ eccentric chromatin mass

Answer 72

*P. vivax* ## Footnote *P. ovale* & *P. malariae* has d same gametocyte description as w/ vivax but smaller in size

Question 73

# Identify the species based on characteristics Stipplings are called Maurer's Clefts which are comma-like red dots

Answer 73

*P. falciparum*

Question 74

# Identify the species based on characteristics Stipplings are called Schuffner's dots or eosinophilic stipplings ## Footnote these are very fine, reddish granules

Answer 74

*P. vivax*

Question 75

# Identify the species based on characteristics Stipplings present are called Jame's dots (in old terminology) or Schuffner's dots which are larger and thicker than in vivax

Answer 75

*P. ovale*

Question 76

# Identify the species based on characteristics Stipplings are called as Ziemann's dots

Answer 76

*P. malariae*

Question 77

What *Plasmodium* parasite resembles *P. malariae* and originally was described as such by microscopy in the infected humans and is seen in long-tailed macaque monkeys?

Answer 77

*P. knowlesi*

Question 78

What is the causatige agent of quotidian malaria which is characterized by 24-hour cyclic paroxysmal attacks?

Answer 78

*P. knowlesi*

Question 79

Are malaria parasites obligate or facultative?

Answer 79

obligate ## Footnote "Malarial parasites are generally *obligate intracellular* parasites"

Question 80

life cycle of malaria ## Footnote own words hehe (pls press 5 na agad hehe)

Answer 80

- sporozoite entry through proboscis of *Anopheles minimus flavirostris* - liver invasion of sporozoites w/in 30-60 mins - schizogony of sporozoites (to merozoite) - schizont rupture then merozoite RBC parasitism - schizogony in the RBCs w/ 4-36 merozoites (depends on species) - RBC schizogony (w/ 4-36 merozoites inside each RBC) - then schizont rupture then gametogony to produce gametocytes - gametocyte ingestion by female*Anopheles* mosquito - then gametocytes will undergo sporogony then sporozoites will enter salivary gland of female *Anopheles* mosquitoes

Question 81

What do you call the trophozoites with a red dot of nuclear material that has a small wisp of blue cytoplasm at one side?

Answer 81

comma trophozoite

Question 82

What do you call the trophozoites with a red dot of nuclear material that has thin lines of cytoplasm on either side of the nucleus?

Answer 82

swallow trophozoite

Question 83

what species of malaria is almost entirely confined to the tropics and the subtropics?

Answer 83

*Plasmodium falciparum*

Question 84

In falciparum malaria, schizogony usually does not take place in the peripheral blood. Thus, what forms of the parasite are usually seen?

Answer 84

- young trophozoites (rings) - gametocytes

Question 85

Due to the ischemic changes in the intestinal wall capillary bed, what complication of falciparum malaria may arise? ## Footnote characterized by abdominal pain, nausea, vomitin, and upper gastrointestinal bleeding

Answer 85

Dysenteric malaria

Question 86

What do you call term used for falciparum malaria attacks characterized by rapid development of hypotension and impairment of vascular perfusion?

Answer 86

Algid malaria

Question 87

African descent people who have the Duffy blood group characteristic of Fy (a-b-) have resistance to what malarial parasites?

Answer 87

*P. vivax* and *P. knowlesi*

Question 88

This is the main stay malarial treatment and is the treatment of choice for uncomplicated malarial infections. What is it?

Answer 88

Chloroquine

Question 89

What drug is used for severe malarial infections and for infected pregnant women?

Answer 89

Quinine

Question 90

What do u call the drug that's an Artemisinin derivative and is used for severe malarial infections?

Answer 90

Artesunate

Question 91

This drug is used for relapsing *P. vivax* & *P. ovale*. What is it?

Answer 91

Primaquine ## Footnote Only primaquine is effective against tissue stages, including the hypnozoites of vivax and ovale

Question 92

What antibiotics for malarial prophylaxis must u intake?

Answer 92

Tetracycline and Doxycycline