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Infectious Disease > 219 Malaria > Flashcards

219 Malaria Flashcards

1
Q

Effect of malaria in early pregnancy

A

Abortion

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2
Q

How does malaria lead to nephrotic syndrome

A

Chronic related infections with P. Malaria cause soluble immune complex injury to the renal glomerulii resulting in nephrotic syndrome

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3
Q

How is malaria diagnosed

A

Demonstration of asexual forms of the parasite in stained peripheral blood smears

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4
Q

How is malaria transmitted?

A

Bite of infected female Anopheles mosquito

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5
Q

Monkey malaria parasite

A

P Knowlesi

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6
Q

Species of malaria which causes almost all death

A

P. Falciparum

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7
Q

Dormant form of the malaria pathogen

A

Hypnozoites

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8
Q

Phenotype found in West African making time resistant to P vivax

A

Duffy negative FyFy phenotype

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9
Q

Plays a critical role in binding to red cell

A

PfRh5

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10
Q

Malaria pigment

A

Hemozoin

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11
Q

Longest intra hepatic phase? Shortest intra hepatic phase?

A

P malariae: 15 days
P falciparum: 5.5 days
P vivax and ovale: 8 days

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12
Q

Longest duration of erythrocytic cycle?

A

P malariae: 72 hours
P ovale: 50 hours
P falciparum and vivax: 48 hours

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13
Q

Red cell preference. Older cells? All stages? Reticulocyte?

A

Older cells: P malariae
Reticulocytes: P vivax and ovale
All stages: P falciparum

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14
Q

Matured zygote that penetratws the mosquitos gut wall

A

Ookinete

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15
Q

What is main host of P Knowlesi

A

Long tailed and pigtail macaques

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16
Q

Central to the pathogenesis of falciparum

A

Cytoadherence
Rosetting
Agglutination

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17
Q

True or false. Malaria like leptospirosis and viral fever develop rash.

A

False.

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18
Q

Characteristic and ominous feature of falciparum malaria

A

Coma

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19
Q

Important case of death from sever malaria

A

Acidosis from accumulation of organic acids

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20
Q

Important and common complication of severe malaria

A

Hypoglycemia

21
Q

Cause of AKI in malaria

A

Erythrocyte sequestration and agglutination interfering with renal microcirculaory flow and metabolism

22
Q

In malaria patients recoving from AKI, when doses urine flow turn to normal? When does Creatinine return to normal?

A

Urine flow resumes in median 4 days

Creatinine return to normal in mean 17 days

23
Q

What’s the cause of anemia in malaria?

A

Anemia results from accelerated RBC removal by the spleen and obligatory RBC destruction by the parasite and ineffective erythropoeisis

24
Q

Type of anemia in malaria

A

Hemolytic anemia with massive hemoglobinuria (blackwater fever)

25
Q

Why does hemolysis follow days artesunate treatment?

A

Synchronous loss of once parasitized pitted RBC

26
Q

Severe jaundice is associated with which malaria specie?

A

P falciparum

27
Q

What concurrent parasitic infection worsens malaria

A

Intestinal helminth, hookworm

28
Q

In P vivax infection, reduction in infant birth weight is more pronounce in what subset of pregnant women

A

Complications are more pronounce in multigravid than in primigravid women

29
Q

True or false. Primaquine is given to transfusion tramitted P vivax and P ovale infection

A

False

30
Q

What parasite density is associated with increased risk of dying

A

Patients with parasites more than 10 to the power of 5 /uL

31
Q

Recommend by WHO as the first line treatment for uncomplicated falciparum malaria in malaria endemic areas

A

Artemisinin based combination

32
Q

Now the drug of choice if all patients with severe malaria everywhere

A

Artesunate

33
Q

Oil based formulation of Artemisinin based combination therapy

A

Artemether and artemotil

34
Q

Anti malarial drug associated with QT syndrome

A

Quinidine

35
Q

When should quinidine infusion be stopped, signaling QT prolongation

A

QT interval exceed 0.6 seconds or

QRS complex widens by 25% over baseline

36
Q

Safe alternative to quinidine which does not require cardiovascular monitoring

A

Quinine

37
Q

Antimalarial drug. Toxicity: neuropsychiatric reactions

A

Mefloquine

38
Q

Antimalarial drugs. Toxicity: hemolytic anemia, severe G6PD deficiency

A

Primaquine

39
Q

Antimalarial drug. Toxicity: Megaloblastic anemia, pulmonary infiltration

A

Pyrimethamine

40
Q

Antimalarial drug. Toxicity: retinopathy in chronic use

A

Chloroquine

41
Q

Antimalarial drug. Toxicity: agranulocytosis

A

Amodiaquine

42
Q

ACT regimen associated with nausea and vomiting

A

Mefloquine

43
Q

What causes ARDS in malaria

A

Increases pulmonary capillary permeability

44
Q

Should be suspected when patient deteriorates for no obvious reason during antimalarial treatment

A

Hypoglycemia

Gram negative septicemia

45
Q

Fixed dose once daily prophylactic agent for malaria

A

Atovaquone-proguanil

46
Q

Antimalarial drug that may exacerbate psoriasis

A

Hydroxychloroquine

47
Q

Classic malarial paroxysms

A

Fever spikes, chills and rigors occur at regular intervals

48
Q

How does quinine lead to hypoglycemia

A

Quinine is powerful stimulant if pancreatic insulin secretion

49
Q

Best biochemical prognosticators in severe malaria

A

Plasma concentration of Bicarbonate or lactate

Infectious Disease (8 decks)

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