Wk18D1 Malaria+Babesiosis Flashcards Preview

MIS > Wk18D1 Malaria+Babesiosis > Flashcards

Flashcards in Wk18D1 Malaria+Babesiosis Deck (18):
1

The 5 species that cause malaria in humans

Plasmodium falciparum
P. vivax
P. malariae
P. ovale
P. knowlesi (primarily infects monkeys)

2

Best treatment choice for:
P. falciparum
P. vivax
Prophylaxis

Coartem/Malarone
Chloroquin+Primaquine
Malarone/Doxycycline

3

Plasmodium asexual propagation is called ___ and occurs in ____. Sexual propagation is called ___ and occurs in ____.

Schizogony
Human host
Sporogony
Female mosquito (Anopheles)

4

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

5

How to get malaria without being in an endemic area (3 ways).

traveler/immigrant->mosquito->you
Blood transfusion
Mother->Fetus transmission (merozoite)

6

____ 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.

Plasmodium falciparum
P. vivax (hypnozoites in the liver)
P. knowlesi

But endemic areas overlap!

7

Most serious Plasmodium infection is ____.
Severe disease occurs in ___
Effects/symptoms?
Serious complications?

P. falciparum
Children <18 months old
Hemolytic anemia, hypoglycemia, TNF-alpha, microvascular obstruction, splenomegaly
Cerebral malaria, shock, ARDS, renal failure

8

List the 5 genetic polymorphisms in malaria endemic areas that confer resistance

Duffy RBC antigens (DARC) - vivax/knowlesi
Glycophorin A - falciparum
Ovalocytosis/elliptocytosis
G-6P dehydrogenase - falciparum
Sickle cell/thallassemia - falciparum

9

Can you be re-infected with malaria? Is a vaccine in use?

Yes, but subsequent infections have lessened symptoms. No vaccine :(

10

Symptoms occur during ___ cycle. Fever can be ___ or ___. Symptoms in non-immune persons resemble ___.

intra-erythrocytic.
tertian or quartan (in cases of re-infection)
Flu (FEVER, head/backache, myalgia, ab pain, nausea, vomiting, diarrhea).

11

P. malariae can cause ___ problems such as __.

chronic
nephrotoxic syndrome (Ag/Ab complex deposition)

12

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
speciation
unhemolyzed; ID level of parasitemia
Dual infections
PCR-based assays

13

In blood smears, how do they look?
falciparum
vivax
ovale
malariae/knowlesi

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)

14

Define:
Suppressive treatment
Clinical cure
Radical cure
Suppressive cure

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

15

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)

16

Malaria treatment drugs include

Artemisinins- free rads, +lumefantrine=Coartem
Quinine/Quinidine- cinchonism, +doxy = clinical cure
Primaquine-radical cure for Pv/o, prophylaxis for Pv

17

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

18

Babesiosis affects ___ hosts
Typical findings are...
Diagnosis by...

Compromised (splenectomy, HIV, elderly)
hepatosplenomegaly, hemolytic anemia
Blood films show intra-RBC falciparum-like parasite with no gametocyte or malaria pigment, tetrads.