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Malaria Flashcards

1
Q

What is the infectious form of malaria?

A

Sporozoites. Injected from mosquito

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2
Q

Where does malaria travel within host?

A

First, liver, then RBCs.

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3
Q

What’s unique about vivax?

A

It’s got a “resting stage” in the liver. Can stay dormant for months

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4
Q

How does malaria cause disease?

A

Infects RBCs, which lyse and release new infectious forms. Causes fevers and eventually gametocytes

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5
Q

What is the incubation period for malaria?

A

10-40 days

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6
Q

What are the sx of malaria?

A

Fever spikes, headache, arthralgia, chills, sweats

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7
Q

Why is falciprum an emergency?

A

Can progress rapidly–well to death in 6 hrs. In a feverish ill traveler, falciprum should be at the TOP of your differential

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8
Q

What is a serious complication of malaria?

A

Cerebral malaria, where cells clog the venules causing coma.

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9
Q

How do you diagnose malaria?

A

blood films
dipstick
PCR

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10
Q

Why is it hard to develop immunity to malaria?

A

The surface antigen is always changing and a vaccine is not available

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11
Q

What would protect you from malaria? What would increase your risk?

A

sickle cell protective
G6PD deficiency protective

Duffy blood antigen increases your risk

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12
Q

How do you treat malaria?

A

Chloroquine and primaquine.

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13
Q

How do you get babesia?

A

From ticks

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14
Q

What do you see on blood film of babesia?

A

Both INTRA and EXTRAcellular ring forms that look like malaria. MALTESE CROSS is classic

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15
Q

How do you treat babesia?

A

If asymptomatic, do not treat.

  • -Atovaquone and azith
  • -Clindamycin and quinine.

–Consider a transfusion is serious

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16
Q

How does babesia present?

A

With nonspecific symptoms and fever

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17
Q

What would u see on smear of falciprum?

A

banana form. Aside from that, they should ALL be rings. Vivax has many different forms.

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18
Q

What is the technical name for the pin worm?

A

Enterobius vermicularis

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19
Q

What is the dx stage for pinform?

A

The perianal egg

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20
Q

WHat is the diagnostic stage of ascaris?

A

egg in the feces. These are destroyed by sunlight or dehydration.

21
Q

What is the clinical presentation of ascaris?

A

light infection=malabsorption
heavy infection=intestinal obstruction or hemorrhagic pneumonitis w/ N/V/abdominal pain

Most are ASYMPTOMATIC!

22
Q

Where does strongyloides mature in the human host?

A

Within the alveoli of the lungs. Once they are coughed up and swallowed, they mature again in the intestines.

23
Q

What is the hyperinfection cycle of stronyloides?

A

Newly laid eggs hatch and stay in the intestine rather than being excreted in the feces

24
Q

How do you get strongyloides?

A

From walking barefoot

25
Q

How do you diagnose visceral larva migrans?

A

antibodies to worm antigens and liver biopsy. You will NOT see eggs in the stool!

26
Q

What causes cuteanea larva migrans?

A

the dog/cat hookworm

27
Q

Which type of schisto likes the bladder in particular?

A

S. hematobium

28
Q

How do you tell apart the three different types of schistos?

A

mansoni has one spine poking out to the side
hematobium has a pointy hat
japonicum is round

29
Q

How long does schisto live in your system?

A

DECADES. THey use human antigens to avoid the immune system

30
Q

How long is the incubation period with schisto?

A

6 weeks

31
Q

What is the one “key word” with schisto?

A

PIPESTEM fibrosis of the liver

32
Q

What key constellations of sx would make you suspect schisto?

A

eosinophilia
hepatosplenomegaly
bloody vomit
hematuria

FRESH WATER CONTACT

33
Q

What is the name for the pork tape worm? Who is the definitive host?

A

taenia solium.
Human are the definitive host. They live in our guts. In pigs, they stay in the muscle. You can get it from eating undercooked pork.
–cysticercosis is life threatening

34
Q

What’s the diagnostic stage of giardia?

A

cyst in stool OR trophozoite in diarrhea

35
Q

How do you diagnose toxo?

A

sabin-feldman dye test
Elisa
PCR

36
Q

Symptoms of toxo?

A

myalgia, headache, fever
-encephalitis, myocarditis, hepatitis

If perinatal infection, blindness and mental retardation

37
Q

What do you give to a pregnant mom who is asymptomatic but positive for toxo?

A

Chemo (spiramycin) during pregnancy

Sulfadiazine after birth

38
Q

Can you have a latent crypto infection like with toxoplasma?

A

NO–must be a new infection. Cannot be reactivated

39
Q

What are the most serious sequelae of falciprum?

A
  1. cerebral malaria (headache/coma/paralysis)
  2. GI hemorrhage
  3. Tubular necrosis in the kidneys
    - ->All of these stem from micro infarcts
40
Q

What is unique about the blood smear in plasmodium vivax?

A
  1. Large, infected reticulocytes
  2. All forms seen
  3. ROUND not banana gametocytes
  4. Schuffner’s dots
41
Q

What do you use for malaria prophylaxis?

A

Mefloquine

42
Q

What drug is effective for P vivax in particular?

A

Primaquine

43
Q

HOw do you treat babesia?

A

atovaquone + azithro or clindamycin

44
Q

Where does vivax sleep?

A

In the liver

45
Q

What would you see in the blood tests of someone with falciprum (no smear)

A 
Decreased hgb (hemolytic anemia)
Decreased platelets (thrombocytopenia)
Increased creatinine (acute renal failure)
46
Q

In a patient with influenza, what common OTC is absolutely contraindicated?

A

Aspirin–Can cause Reyes syndrome!

47
Q

How do you treat strep throat?

A

Penicillin. If allergic, use erythromycin

48
Q

What are pneumonia red flags?

A

hilar adenopathy
heart failure
diffuse infiltrate (viral/atypical)
Upper lobe infiltrate with granulomas

ID (24 decks)

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