Flashcards in Wk18D1 Malaria+Babesiosis Deck (18):
The 5 species that cause malaria in humans
P. knowlesi (primarily infects monkeys)
Best treatment choice for:
Plasmodium asexual propagation is called ___ and occurs in ____. Sexual propagation is called ___ and occurs in ____.
Female mosquito (Anopheles)
Life cycle of Plasmodium
Exo-erythrocytic cycle--Sporocytes invade hepatocytes, develop into merozoites. P. ovale and P. vivax have hypnozoite stage.
Intra-erythrocytic cycle--Merozoites release and infect RBCs, become trophozoites which mature to schizonts. These release many merozoites.
Sexual cycle--Gametocytes taken up by mosquito, produce sporogony and new sporozoites in salivary glands
How to get malaria without being in an endemic area (3 ways).
Mother->Fetus transmission (merozoite)
____ is in hot tropical countries with year-round presence of mosquito vector. ______ is more common in temperate because it survives cold season in its ___ form. ____ is endemic in SE Asia.
P. vivax (hypnozoites in the liver)
But endemic areas overlap!
Most serious Plasmodium infection is ____.
Severe disease occurs in ___
Children <18 months old
Hemolytic anemia, hypoglycemia, TNF-alpha, microvascular obstruction, splenomegaly
Cerebral malaria, shock, ARDS, renal failure
List the 5 genetic polymorphisms in malaria endemic areas that confer resistance
Duffy RBC antigens (DARC) - vivax/knowlesi
Glycophorin A - falciparum
G-6P dehydrogenase - falciparum
Sickle cell/thallassemia - falciparum
Can you be re-infected with malaria? Is a vaccine in use?
Yes, but subsequent infections have lessened symptoms. No vaccine :(
Symptoms occur during ___ cycle. Fever can be ___ or ___. Symptoms in non-immune persons resemble ___.
tertian or quartan (in cases of re-infection)
Flu (FEVER, head/backache, myalgia, ab pain, nausea, vomiting, diarrhea).
P. malariae can cause ___ problems such as __.
nephrotoxic syndrome (Ag/Ab complex deposition)
To diagnose, take ___ if patient has ___.
Thin blood smears with Giemsa/Wright's stain for ___.
Thick smears are ___ and used for ___.
Rapid tests may miss ___.
___ is good but not widely available.
Travel history; febrile illness of unknown etiology
unhemolyzed; ID level of parasitemia
In blood smears, how do they look?
F: high density, often >1 ring/RBC with 2 chromatin dots. Banana-shaped gametocytes.
V: large RBCs, Schueffner's dots
O: Oval/fimbriated RBCs, Schueffner's dots
M/K: "band" form (trophozoite)
Prevent intra-erythrocytic stage, preclude symptoms
Eliminate intra-erythrocytic stage, resolve symptoms
Eliminate pre- (primaquine) AND intra-RBC (chloroquine) in vivax/ovale
Continue suppression beyond pre-RBC lifespan in falciparum
Malaria prophylactic drugs include
Atovaquone and proguanil (mitochondria/FH2 reductase inhib)
Doxycycline (daily; multidrug-resistant falciparum)
Chloroquine (DOC for P v/o/m)
Mefloquine (CNS tox, funky dreams, for chloroquin-resistant malaria)
Malaria treatment drugs include
Artemisinins- free rads, +lumefantrine=Coartem
Quinine/Quinidine- cinchonism, +doxy = clinical cure
Primaquine-radical cure for Pv/o, prophylaxis for Pv
Babesiosis caused by these 3 parasites
___borne parasite resembling ___ trophozoites
Carried by ___ in ___ areas
Babesia microti (US), B. bovis (EUR), B. divergens (EUR)
Blood borne; P. falciparum
Deer tick (Ixodes scapularis); NE coastal