Chapter 7: Malaria

Question 1

Apical Complex

Answer 1

Organelles that secrete enzymes to enter host
Present in infective stage
Includes micronemes and rhoptries, electron dense structures

Question 2

Benign Tertian Malaria

Answer 2

48 hour intervals
Plasmodium vivax (Latin America, Caribbean, India and Pakistan)
Plasmodium ovale (Exclusive to Africa)

Question 3

Malignant Tertian Malaria

Answer 3

Plasmodium falciparum

Question 4

Quartan Malaria

Answer 4

72-hour interval

Plasmodium malariae

Question 5

Malaria Vector

Answer 5

Female Anopheles

Question 6

Environmental Conditions

Answer 6

High Humidity
16 to 30 degrees Celsius
Standing or Moving Water

Question 7

Schizogony

Answer 7

Asexual reproduction phase that occurs in humans during exo-erythrocytic and erythrocytic cycles
The nucleus divides

Question 8

Exo-Erythrocytic Cycle

Answer 8

o (2) Sporozoites infect liver cells

o (3) Schizogony (asexual reproduction) develops into merozoites, which then become Schizonts

Question 9

Erythrocytic Cycle

Answer 9

o (4) Liver cells rupture and release merozoites
o (5) Merozoites infect red blood cells
o Merozoites undergo erythrocytic schizogony in erythrocytes
o (6) Ring stage trophozoites mature into schizonts, which rupture releasing more merozoites
o (7) Some differentiate into gametocytes

Question 10

Relapse

Answer 10

P. vivax and P. ovale contain hypnozoites which can remain dormant for many years

Question 11

Recrudescence

Answer 11

P. malariae can have low levels of merozoites and then explosive multiplication causing clinical illness

Question 12

Classic Malaria Attack Symptoms

Answer 12

o Cold stage (sensation of cold, shivering)
o Hot stage (fever, headaches, vomiting; seizures in young children)
o Final sweating stage (sweats, tiredness)

Question 13

Blackwater Fever

Answer 13

Massive red blood cell lysis
Blood in urine due to high amount of hemoglobin
High mortality

Question 14

Cerebral Malaria

Answer 14

Parasite-filled blood cells black blood vessels leading to the brain causing swelling or brain damage, could cause coma

Question 15

General Life Cycle in Mosquito

Answer 15

Syngamy between micro- and macrogamete creating a zygote.
Zygote elongates and becomes ookinete, which invade midgut wall and become oocyst.
Oocyst grows, ruptures, and releases sporozoites that travel to salivary glands

Question 16

Benign Tertian Malaria

Answer 16

48-hour cycle
low parasitemia (<1%)
infect older RBCs
infected RBCs larger than unaffected
Schuffner's dots
Hemozoin granules

Question 17

Quartan Malaria

Answer 17

72-hour clinical interval
P. malariae infects older RBC
does not enlarge RBCs
Low parasitemia (0.2%)
Patchy dark-staining Ziemann's dots

Question 18

Malignant Tertian Malaria

Answer 18

•	48-72-hour clinical interval
•	Most common form and most deadly
•	High parasitemia (10%)
o	Crescent-shaped gametocytes
o	Mauer’s dots/clefts

Question 19

Uncomplicated Malarial Treatment

Answer 19

Oral anit-malarial drugs

Chloroquine/Chloroquine + primaquine

Question 20

Sever Malaria Treatment

Answer 20

Intravenous Route
Quinidine gluconate and doxycycline, tetracycline, or clindamycin
Artesunate – artemisinins
Coartem: combination of synthetic artemether and lumefatrine used against chloroquine resistant Plasmodium

Question 21

Malaria Resistance

Answer 21

Duffy (Fy glycoprotein) negativity
Gerbich antigen receptor negativity
Glucose 6 Phosphate dehydrogenase deficiency
Ovalcytosis and alpha-thalassemia