Infection e.g. malaria

Question 1

Malaria aetiology

Answer 1

Infection by Plasmodium (usually falciparum)

Spread by mosquito

Question 2

Pathphysiology of malaria

Answer 2

Bite by infected mosquito -> Sporozoites in the saliva travel to the liver to mature -> Rupture to release Merozoites into the blood -> invade RBC and undergo asexual reproduction to create sporozoites a mosquito can pick up (hence cycle)

Question 3

Who is more at risk of malaria infection

Answer 3

Poor, young, pregnant, elderly all more at risk.

Consider is recently TRAVELLED ABROAD

Question 4

Clinical presentation of malaria

Answer 4

Most with falciparum present in the first month, others can incubate for months.
No specific symptoms - take effective history.
Feverm chills, rigor, cough, myalgia, splenomegaly, hepatomegaly.
Severe: Impaired consciousness, Shortness of breath, bleeding, fits, hypovolemia

Question 5

Complications of untreated malaria

Answer 5

Multiple organ failure and death

Question 6

*Diagnostic test of malaria

Answer 6

Blood smear with glemsa stain

Question 7

Treatment of Non-falciparum malaria

Answer 7

Chloroquine

Question 8

Treatment of Falciparum malaria

Answer 8

Quinine sulfate, Atovaquone-proguanil

Artemether with lumefantrine

Question 9

Treatment of Severe falciparum malaria

Answer 9

IV quinine dihydrocholride

Question 10

Malaria prevention

Answer 10

Vector control (prevent mosquitos spreading it) - bite prevention advice
Chemoprophylaxis - use antimalarial drugs to prevent clinical disease

Question 11

Investigation in undifferentiated fever after TRAVEL

Answer 11

Malaria film/rapig diagnostic testing
HIV test
FBC
Blood culture x2 prior to antibiotics
LFT

Question 12

FBC in HIV

Answer 12

Lymphopenia

Low platelets

Question 13

FBC of Parasitic/fungal infection e.g. soil-transmitted helminths

Answer 13

Eosinophilia

Question 14

FBC of malaria

Answer 14

Low platelets