Malaria

Question 1

Malaria

Answer 1

Most important parasitic disease in humans

Infection of RBC w/ protozoan parasites inoculated into the human host by a feeding female anopheline mosquito

Question 2

Erythrocytic cycle

Answer 2

responsible for disease

rupture of schizonts and release of merozoites present clinically as paroxysms

Question 3

Responsible for disease relapses

Answer 3

Hypnozoites

Question 4

Plasmodium species

Answer 4

P. falcifarum
P. vivax
P. ovale
P. malariae
P. knowlesi

Question 5

Severe malaria

Answer 5

P. falcifarum

Question 6

P. falcifarum

Answer 6

Trophozoites seen as ring forms

banana shaped gametocytes

Maurer dots

Question 7

P. vivax

Answer 7

irregularly shaped large rings and trophozoites

enlarged erythrocytes

Schuffner dts

can cause RELAPSE

Question 8

P. ovale

Answer 8

infected erythrocytes, enlarged oval w/ tufted ends

Schuffner dots

can cause RELAPSE

Question 9

P. malariae

Answer 9

band/rectangular forms of trophozoites

not enlarged erythrocytes

Question 10

P. knowlesi

Answer 10

not enlarged erythrocytes

difficut=l to accurately diagnose by microscopy because of the morphologic similarity of the trophozoites to P. falcifarum and P. malariae

Question 11

Classic malaria paroxysms

Answer 11

cold stage (chills)
hot stage (fever spikes)
sweating stage

Question 12

Gold standard for the diagnosis of malaria

Answer 12

thin and thick smear

Question 13

CBC malaria

Answer 13

normocytic normochromic anemia

thrombocytopenia

Question 14

ABG malaria

Answer 14

HAGMA

dec bicarbonate
inc lactate

Question 15

First line drug for confirmed uncomplicated and severe (IV formulation) P. falcifarum malaria

Answer 15

Artemether-Lumefantrine

Question 16

Side effects of Artemether-Lumefantrine

Answer 16

CI - pregnant and children <8 y/o

artemether - anaphylaxis, urticaria, fever

lumefantrine - none

Question 17

2nd line of treatment and in cases of treatment failure

Answer 17

Quinine + Tetracycline/Doxycycline

Quinine + Clindamycin for pregnant women and children <8 y/o

Question 18

For treatment of uncomplicated or severe falciparum malaria

Answer 18

Artesunate

Question 19

Side effects of Quinine

Answer 19

cinchonism
tinnitus
high tone hearing loss
hypoglycemia
very bitter taste

Question 20

Side effects of artesunate

Answer 20

neurotoxicity

cardiotoxicity

Question 21

For radical cure because it eradicates hepatic forms of P. vivax and P. ovale (to prevent relapse)

Not used to treat erythrocytic stage of malaria

Answer 21

Primaquine

Question 22

Side effects of primaquine

Answer 22

massive hemolysis in G6PD deficieny

Question 23

DOC for P. vivax, malariae, ovale and knowlesi cases

Can be used for prophylaxis or treatment

Answer 23

Chloroquine

Question 24

Side effects of chloroquine

Answer 24

nausea
dysphoria
pruritus
retinopathy

Question 25

Acts as blood schizonticide Used for prophylaxis or treatment of drug resistant malaria Only prophylaxis permitted in pregnancy

Answer 25

Mefloquine

Question 26

Side effects of mefloquine

Answer 26

neuropsychiatric ractions