Blood and Tissue Protozoa - PLASMODIUM

Question 1

MOST IMPORTANT PARASITIC DISEASE IN MAN

Answer 1

Plasmodium spp

Question 2

SEXUAL LIFE CYCLE (MOSQUITO)

Answer 2

SPOROGONY

Question 3

ASEXUAL LIFE CYCLE (MEN)

Answer 3

SCHIZOGONY

GAMETOGONY

Question 4

Transmission of Plasmodium

Answer 4

Bite of infected female mosquito (Anopheles minimus flavirostris)

across the placenta
blood transfusions
IV drug use

Question 5

Infective Stage of Plasmodium

Answer 5

Sporozoites

Question 6

Diagnostic tests for Malaria

Answer 6

THICK AND THIN SMEARS W/ GIEMSA STAIN

Thick smear - to screen for the presence of organism

Thin smear - for species identification

highest yield - blood sample taken during FEVER or 2-3 hrs after peak

Question 7

Malaria Spectrum of Disease

Answer 7

paroxysmal fever w/ malaise and bone pains

hemolytic anemia, jaundice, splenomegaly

parasitic pneumonitis

CEREBRAL MALARIA
*malarial or Durck granulomas

ACUTE RENAL FAILURE
*Blackwater Fever

SEPTIC SHOCK
*algid malaria

Question 8

RECURRENCE of symptoms after temporary abatement (2-4 weeks)

Answer 8

RECRUDESCENCE

*seen in P. falciparum and P. malariae

Question 9

RETURN of disease after its apparent cessation (1-6 mos) d.t. REACTIVATION IF HYPNOZOITES

Answer 9

RELAPSE

*P. ovale and P. vivax

Question 10

Life Cycle Plasmodium

Answer 10

1. infected mosquito injects SPOROZOITES
2. sporozoites migrate to the LIVER where they form MEROZOITES
3. merozoites are released and invade RBC
4. in the RBC - merozoites becomes TROPHOZOITE
5. in RBC trophozoite multiplies
6. some merozoites become GAMETOCYTES
7. female mosquito picks up gametocytes from infected human

Question 11

Infected RBC w/ 1-2 small chromatim dots and ring form stage

Answer 11

P. falciparum

• malignant tertian
• MOST SEVERE
• BANANA shaped gametocytes
• MAURER DOTS - coarse granulations

Question 12

Infected RBC w/ presence of band form stages

Answer 12

P. malariae

• benign quartan
• ZIEMANN - fine dots

Question 13

Punctate granulations

Answer 13

SCHUFFNER - P. vivax and P. ovale

Question 14

Treatment for Chloroquine sensitive P. falciparum and P.malariae infections

Answer 14

CHLOROQUINE

Question 15

Treatment for P. vivax and P. ovale

Answer 15

CHLOROQUINE + PRIMAQUINE

Question 16

Treatment for uncomplicated infections w/ chloroquine-resistant P. falciparum

Answer 16

QUININE + DOXYCYCLINE/ CLINDAMYCIN

Alternative Drug:
Melarone (Atovaquone-Proguanil)
OR
Mefloquine
OR
Co-Artemether+ Lumefrantine

Question 17

Treatment for Severe or Complicated infections w/ P. falciparum

Answer 17

Artesunate + Doxycline/ Clindamucin
OR
Mefloquine/Malarone
OR
Quinidine gluconate

Alternative Drug:
Artemether + Doxycycline/Clindamycin
OR
Mefloquine/Malarone

Question 18

Treatment for Chloroquine-resistance

Answer 18

Mefloquine+Doxycycline

Question 19

Treatment for eradication of hypnozoites

Answer 19

Primaquine

Question 20

Treatment for severe cases or pregnancy

Answer 20

Quinidine or Quinine

Question 21

Prophylaxis for areas W/O resistant P. falciparum

Answer 21

Chloroquine

Question 22

Prophylaxis for areas WITH resistant P. falciparum

Answer 22

Malarone

Mefloquine

Question 23

Prophylaxis for areas WITH MULTIDRUG-RESISTANT P. falciparum

Answer 23

Doxycycline

Question 24

Terminal prophylaxis of P. vivax and P. ovale infection

Alternative for primary prevention

Answer 24

Primaquine

Question 25

Drugs effective against ERYTHROCYTIC FORM

Answer 25

Artemisin
Atovaquone/Proguanil
Chloroquine
Quinine
Mefloquine
Pyrimethamine

Question 26

Drug effective against GAMETOCYTIC form

Answer 26

Primaquine

Question 27

Drug effective against EXOERYTHROCYTIC form

Answer 27

Primaquine

Question 28

Areas of High Endemicity

Answer 28

Palawan
Kalinga-Apayao
Ifugao
Agusan del Sur

Question 29

Areas of Chloroquine Resistance

Answer 29

Palawan
Davao del Norte
Compostela Valley