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Basic Pathology 2 > 15 Plasmodium and Malaria > Flashcards

15 Plasmodium and Malaria Flashcards

1
Q

Factors affecting malaria

A 
Temperature
Altitude
Humidity
Rainfall
Seasons
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2
Q

Causative agent of malaria

A

Plasmodium

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3
Q

Plasmodium is transmitted through the bite of what genus of mosquito

A

Anopheles

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4
Q

Most important parasitic infection
Most virulent
Responsible for malignant tertian fever

A

P. falciparum

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5
Q

Numerous smaller rings
Crescent-shaped gametocytes
Maurer’s clefts

A

P. falciparum

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6
Q

Irregular blotches developed by infected erythrocyte

A

Maurer’s clefts

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7
Q

Schizonts of P. falciparum contain how many merozoites

A

8-24

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8
Q

Responsible for benign tertian fever

A

P. vivax (along with P. ovale)

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9
Q

Enlarged erythrocyte
Schuffner’s dots
Amoeboid-shaped trophozoite

A

P. vivax

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10
Q

Peculiar stippling pattern observed from an enlarged red cell as a trophozoite grows inside it

A

Schuffner’s dots

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11
Q

Schizonts of P. vivax contain how many merozoites

A

12-24

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12
Q

Not endemic in the Philippines unless imported

Also involved in benign tertian fever

A

P. ovale

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13
Q

Trophoizotes are compact

Also contain Schuffner’s dots

A

P. ovale

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14
Q

Schizonts of P. ovale contain how many merozoites

A

6-14

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15
Q

Compact parasite

Merozoites form rosette pattern

A

P. malariae

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16
Q

P. malariae schizonts contain how many merozoites

A

6-12

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17
Q

Mostly known to infect Simian malaria

Considered zoonotic, infect humans

A

P. knowlesi

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18
Q

P. knowlesi forms what kind of stippling when observed under microscope

A

Sinton and Mulligan’s

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19
Q

Clinical presentation of P. knowlesi infection

A

Severe anemia
Thrombocytopenia
Acute respiratory distress syndrome

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20
Q

Definitive host of Plasmodium

Found in rural areas with clean, stagnant or running water

A

Anopheles

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21
Q

Intermediate host of Plasmodium

A

Man

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22
Q

Human liver stage

Schizonts and merozoites

A

Exo-erythrogenic schizogony

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23
Q

Ring-stage trophozoites
Schizonts
Merozoites

A

Erythocytic schizogony

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24
Q

Infective stage of Plasmodium

End product of the sporogonic cycle

A

Sporozoites

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25
Q

The primary site of plasmodium infection

A

Liver

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26
Q

Mature sporozoites in the liver

A

Schizonts

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27
Q

Individual small dots within the schizont
Daughter cells from the schizonts
Produced via asexual reproduction

A

Merozoites

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28
Q

Manifest with liver symptoms: jaundice and abdominal pain in the right upper quadrant/epigastric area

A

Exo-erythrocytic schizogony

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29
Q

Human blood stage

Daughter merozoites infect the RBCs

A

Erythrocytic schizogony

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30
Q

Stages of erythrocytic schizogony

A

Ring stage trophozoite
Schizonts
Merozoites

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31
Q

Early/young stage of trophozoite

Has a red chromatin dot and small amount of blue cytoplasm when stained with Giemsa or Wright’s stain

A

Ring stage trophozoite

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32
Q

Trophozoites dividide within the RBC

Contain multiple merozoites

A

Schizonts

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33
Q

Form the zygote via sexual reproduction

A

Macrogametocyte and microgametocyte

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34
Q

Mosquito phase

A

Sporogonic cycle

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35
Q

Stages of sporogonic cycle

A 
Zygote
Ookinetes
Oocysts
Sporocysts
Sporozoites
36
Q

Produces antigenic Pf proteins on the surface of RBCs, which serve as an escape mechanism from destruction by the spleen

A

P. falciparum

37
Q

Most common and most well-documented complication of P. falciparum infection

A

Cerebral malaria

38
Q

Renewal of parasitemia and/or clinical features arising from persistent unpredictable asexual parasitemia in the absence of exo-erythrocytic cycle
Only applicable for P. falciparum, P. malaria and P. knowlesi

A

Recrudescence

39
Q

Dormant stage found in liver

A

Hypnozoites

40
Q

Which Plasmodium species have hyponozoites in their life cycle

A

P. vivax and P. ovale

41
Q

Results from the reactivation of hypnozoite forms of the parasite in the liver

A

Malaria relapse

42
Q

Affects RBCs of all ages

A

P. falciparum

43
Q

Affect young erythrocytes

A

P. vivax

P. ovale

44
Q

Affect old or mature RBCs

A

P. malariae

P. knowlesi

45
Q

Incubation period of P. falciparum

A

9-14 days

46
Q

Incubation period of P. vivax/ovale

A

12-18 days

47
Q

Incubation period of P. malariae

A

18-40 days

48
Q

Incubation period of P. knowlesi

A

11-12 days

49
Q

Cold stage
Midday
15 mins-1 hour
RBCs simultaneously burst out because of infection, releasing cytokines due to anemia

A

Chills

50
Q

Hot stage, high grade fever, lasts up to 6 hours
High grade fever would be >39 deg C
Due to recruitment of tumor necrosis factor and interleukins
Length of phase depends on the species of malaria

A

Fever

51
Q

Peaks every 48 hours

P. vivax and P. ovale

A

Benign tertian fever pattern

52
Q

Fever peaks every 72 hours

P. malariae

A

Quartan fever pattern

53
Q

Fever peaks in a range (24-48 hours) and is not exactly predictable
P. falciparum

A

Malignant tertian fever pattern

54
Q

Fever peaks at about the same time every day (24 hours)

A

Quotidian fever pattern

55
Q

Sweating stage with gradual resolution of fever
Merozoites infect uninfected RBCs
Reset of thermoregulatory system

A

Profuse sweating

56
Q

Death of RBC leads to ____ state due to less oxygen delivery

A

Acidic

57
Q

Converts lactic acid into pyruvate

A

Plasmodium lactate dehydrogenase

58
Q

Sever malaria clinical manifestations

A 
Cerebral malaria
Severe anemia
Renal failure
Pulmonary edema/ARDS
Hypoglycemia
59
Q

Caused by widespread sequestration of infected erythrocytes in the cerebral microvasculature

A

Cerebral malaria

60
Q

Most patients with particularly complicated malaria present with _____

A

Hypoglycemia

61
Q

Diagnostic tools for Plasmodium

A 
Antigen/enzyme determination
Blood thick and thin smears
Polymerase chain reaction
Antibody detection
Drug resistance
62
Q

Dip stick or casette formation

Determines if the sample is P. falciparum or P. vivax

A

Antigen/enzyme determination

63
Q

Antigens being tested in rapid diagnostic test

A

Histidine-rich protein II (HRP-2)

Plasmodium lactate dehydrogenase (pLDH)

64
Q

Only for epidemiology studes

A

Antibody detection

65
Q

In vitro tests

Molecular characterization

A

Drug resistance tests

66
Q

Gold standard for diagnosis
Used for confirmation
Giemsa-stained

A

Blood thick and thin smears

67
Q

When do you usually conduct blood smears to catch the rupture of the RBCs and the fever spike?

A

Every 6-12 hours for 48-72 hours

68
Q

Greater sensitvity for screening of the presence of malarial infection

A

Thick smear

69
Q

For species identification
For parasite density quantification
For visualizing schizonts/gametes

A

Thin smear

70
Q

Characteristic of a P. falciparum gametocyte

A

Banana-shaped/elongated

unlike others that have circular shape

71
Q

Stippling differentiation;

Maurer’s cleft

A

P. falciparum

72
Q

Stippling differentiation James dots

A

P. ovale

73
Q

Stippling differentiation Schuffner’s dots

A

P. vivax

74
Q

Stippling differentiation:

Ziemann’s dots

A

P. malariae

75
Q

Used as backup or confirmation of microscopy

Used to differentiate P. malariae from P. knowlesi

A

PCR

76
Q

First-line drug

Schizonticidal

A

Artemeter/Lumefantrine

77
Q

Acts on exo-erythrocytic stages

14-day treatment against P. vivax to kill hypnozoites and gametocytes

A

Primaquine

78
Q

Used to be the primary drug for treatment of malaria

No longer used due to widespread resistance

A

Chloroquine

79
Q

First-line treatment of unconfirmed malaria

A

AL

80
Q

First-line treatment of P. falciparum

A

AL + PQ

81
Q

Treatment failure of P. falciparum

A

QN (chloroquine, amodiaquine, quinines) + T (trimethroprim-sulfamethoxazole)

82
Q

Treatment of severe malaria

A

QN + T

83
Q

Treatment of P. vivax

A

CQ + PQ

84
Q

Effective for both chemoprophylaxis and treatment of P. falciparum and P. vivax

A

Atovaquone

Proguanil

85
Q

Other chemoprophylactic drugs

A

Chloroquine
Doxycycline
Mefloquine
Primaquine

Basic Pathology 2 (8 decks)

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