Malaria + EBV + HIV

Question 1

What is Malaria?

Answer 1

Notifibale Protozoal Infection

Question 2

What Is it carried by and caused by?

Answer 2

Female anopheles mosquitos carry plasmodium Falciparum/ Ovale/ Vivax/ malariae (many diff species but 5 cause malaria)

Question 3

Which is the worse infection?

Answer 3

Plasmodium Falciparum

Question 4

Where and who is it most common in?

Answer 4

In africa, very young/old
Pregnant woman

Question 5

Pathology of malaria

Answer 5

Sporozoites (plasmodium in stage if development) in mosquitos saliva inoculate in human host

Multiply in hepatocytes as merozoites
(P.Vivax + Ovale go dormant as hypnozoites)
(P. Falciparum, malariae and Knowlesi multiply and form merozoites)

Then into RBCs; Merozoites –> Trophozoites (invade RBCs) –> Schizont (grows by digesting Hb - replicating) –> Mew merozoites

RBCs repture + cause systemic infection

Question 6

what do we consider Malaria as in?

Answer 6

A differential diagnosis in ferverish patient with recent travel history

Question 7

In Children with convulsions (60-80%), high ICP and hypoglycaemia, what should we rule out? How?

Answer 7

Meningitis - examination
CSF analysis (if no high ICP)

Question 8

Symptoms of Malaria?

Answer 8

Fever + exotic travel, Haemolytic anemia, BLACKWATER FEVER (malarial hameoglobinuria), hepatosplenomegaly (massive)

Question 9

Diagnosis?
Test and result?

Answer 9

Blood smear/film
Thick - malaria?
Thin species?

need 3 separate negative readings before declared negative (like TB)

Question 10

Treatment for Malaria

Answer 10

Quinine + Doxycyclin (anti malarial)
or artesunate IV if severe

Question 11

SE of quinine?

Answer 11

hypoglycaemia

Question 12

What is EBV associated with?

Answer 12

Many other conditions: Hodgekins, Burkitts, nasopharyngeal carcinoma

Question 12

What is EBV associated with?

Answer 12

Many other conditions: Hodgekins, Burkitts, nasopharyngeal carcinoma

Question 13

Typical Px?
How is it spread?

Answer 13

15-24y/o
Saliva or bodily fluids

Question 14

What does EBV affect?

Answer 14

B cells in tonsils

Question 15

Symptoms of EBV?

Answer 15

Varies mild Sx (sore throat, hepatosplenomegaly) and self limiting

Question 16

Diagnosis?

Answer 16

Atypical lymphocytes on blood film

Question 17

What is HIV?
what are the 2 types?

Answer 17

Retrovirus (uses reverse transcriptase)
HIV 1 = MC more virulent (severe)
HIV 2 = LC less virulent

Question 18

Risk factor for HIV?

Answer 18

sharing needles/needle stick injury
MSM, unprotected anal sex

Question 19

Pathology of HIV

Answer 19

HIV gp120 binds to CD4 on Thelper cells
Endocytoses RNA + enzymes into cell
Reverse transcriptase; RNA TO DNA
Integrase; Viral DNA integrated into hosts
Protein Synthesis
Viral Proteins + RNA exocytose + take part of CD4+ cell CSM

Therefore high viral copies and low CD4+ cells

Question 20

Draw the graph showing HIV RNA copies and CD4+ Count in body over time

Answer 20

Look at notes

Question 21

Diagnosis of HIV

Answer 21

history + Anti HIV Ig
p24 Ab - ELISA test
Monitor progression - HIV RNA copies and CD4 count

Question 22

Treatment for HIV

Answer 22

HAART (Highly active anti retroviral therapy)
3 drugs < ; reverse transcriptase inhibitors
Aim: maintain CD4 count and decrease HIV RNA copies