Flashcards in MALARIA Deck (52):
What are the four species that cause malaria?
What is the name of the vector that is responsible for transmitting malaria?
The female Anopheles mosquito
What do we call the stage of the plasmodium life cycle where human are infected via the bite of the mosquito?
Where do the sporozoites of plasmodium travel to when a human is bitten by the mosquito?
What stage of the plasmodium life cycle occurs in the human liver?
What do we call the stage of the plasmodium life cycle which gets released into the blood from the liver in malaria?
At what stage of the life cycle of plasmodium does the patient start feeling fever?
When the merozoites are released into the blood stream from the hepatocytes
What happens to the merozoites of plasmodium in the blood stream during a malaria infection?
They infect red blood cells to further reproduce asexually. Each release of new merozoites causes a spike in fever, which gives malaria the characteristic cyclical spikes in fever.
Which species of plasmodium parasite can lay dormant in the liver leading to relapse of malaria?
Which species of plasmodium parasite can lay dormant in the blood stream leading to relapse of malaria?
What is the incubation period for P. falciparum parasite?
What is the incubation period for P. ovale parasite?
What is the incubation period for P. vivax parasite?
What is the incubation period for P. malariae parasite?
What is the time between each fever cycle (typical of malaria) of P. falciparum?
What is the time between each fever cycle (typical of malaria) of P. ovale?
What is the time between each fever cycle (typical of malaria) of P. vivax?
What is the time between each fever cycle (typical of malaria) of P. malariae?
Which red blood cells does P. falciparum tend to infect?
All of them especially the younger ones
Which red blood cells does P. ovale tend to infect?
Which red blood cells does P. vivax tend to infect?
Which red blood cells does P. malariae tend to infect?
What is the mortality rate for someone infected with P. falciparum?
What are P. ovale, P. vivax and P. malariae collectively called?
How might someone with malaria present?
Periodic high fevers
What species of malaria is now considered resistant to chloroquine in many parts of the world?
Can people from endemic areas build immunity to malaria?
Does the immunity to malaria built up in those from endemic areas last forever?
No, if they live somewhere else for a few years they will lose their immunity, but may travel without knowing this.
What might you notice on examination of someone with malaria?
Fevers up to 41 degrees
Conjunctival pallor - anaemia
Jaundice - haemolysis
Which species of plasmodium is most likely to cause splenomegaly? Why?
P. malariae - chronicity of disease
Which species of plasmodium causes cerebral malaria?
What are the features of cerebral malaria?
Rapid decline from reduced consciousness to coma and then death
Many suffer fits
On examination may elicit upper motor neuron pattern and nystagmus.
What investigations should be ordered for someone with suspected malaria?
What might the blood tests of someone with malaria show?
Raised bilirubin - haemolysis
Raised lactate dehydrogenase - haemolysis
What might be seen on a blood film of someone with malaria?
Schizont - cell with replicating parasites
From a blood film, how might you determine the severity of malaria?
Presence of a schizont indicates severe malaria
Parasitaemia of more than 2% indicates severe malaria
How many blood films would you need to take from a patient to confirm that a patient does not have or no longer has malaria?
Three films on consecutive days
Why is it important to check glucose level in a malaria patient?
Hypoglycaemia will complicate P. falciparum
Hypoglycaemia is a possible side effect of quinine
What might the urine dipstick of someone with malaria reveal?
Why is an ECG important in someone with malaria?
Quinine can induce arrythmias and conduction defects
Why would you perform an LP in someone with suspected cerebral malaria?
To rule out bacterial meningitis
What is the gold standard treatment for malaria caused by P. falciparum or by unknown cause?
Artemisinin combination therapy (ACT):
These are now accepted to be better than quinine, doxycycline or clindamycin
What drug can be used to treat malaria known to be caused by non-falciparum malaria?
Chloroquine + Primaquine
Always use different drug to prophylaxis though
What prophylactic drugs can be given to travellers to protect them against malaria?
Chloroquine - not useful in a lot of areas of resistance
What are the side effects of mefloquine?
Neuropsychiatric side effects
Other than anti-malarial agents, what other treatment do malaria patients need?
Supportive care - fluids
Paracetamol for fever
Blood transfusions - platelets and red cell
ITU - especially if cerebral malaria
What are the complications of falciparum malaria?
ARDS (adult respiratory distress syndrome)
Severe anaemia and thrombocytopenia
What are the side effects of doxycycline?
What are the side effects of chloroquine?
What are the side effects of quinine?
Lichnoid planus (skin reaction)
What are the side effects of primaquine?
Haemolysis in those with G6PD deficiency.