Lecture 01 - Malaria and Babesia

Question 1

What is the scientific name of malaria

Answer 1

plasmodium

Question 2

Why are pregnant woman at increased risk for malaria

Answer 2

severe maternal anemia, death, miscarriage

Question 3

How does malaria cause miscarriage

Answer 3

placenta gets plugged up with organisms and RBCs so baby cannot get nutrients and dies

Question 4

What is the most severe form of malaria

Answer 4

falciparum

Question 5

What is the least harmful form of malaria

Answer 5

malariae

Question 6

What is Plasmodium knowlesi

Answer 6

a type of malaria from long tailed Maques that is now being seen in humans

Question 7

What is the vector for malaria

Answer 7

Anopheles gambesi

Question 8

What are the symptoms of malaria

Answer 8

headache, nausea, chills, diarrhea, fever, anemia and splenomegaly

Question 9

What is the gold standard for diagnosis of malaria

Answer 9

microscopic analysis

Question 10

How do rapid diagnostic tests for malaria work

Answer 10

detects an antigen

Question 11

What antigens are seen with falciparum

Answer 11

HRP2, pLDH-Pf, pLDH-pan, aldolase

Question 12

What antigens are seen with vivax

Answer 12

pLDH-pan, pLDH-Pvom, pLDH-Pv, aldolase

Question 13

What antigens are seen with malariae

Answer 13

pLDH-pan, pLDH-Pvom, aldolase

Question 14

What antigens are seen with ovale

Answer 14

pLDH-pan, pLDH-Pvom, aldolase

Question 15

Why is treatment different for ovale and vivax

Answer 15

they are hypnozites

Question 16

What does hypnozite mean

Answer 16

they remain latent in the liver

Question 17

Why is falciparum the most deadly

Answer 17

it can infect all ages of red blood cells and can cause cerebral malaria, blackwater fever and severe anemia

Question 18

What is cerebral anemia

Answer 18

cerebral anoxia associated with increased glucose catabolism and lactate production by infected sticky RBC clumps

Question 19

What is the clinical presentation of cerebral anemia

Answer 19

altered states of consciousness, confusion, hallucinations, seizures, motor abnormalities and coma

Question 20

What is blackwater fever

Answer 20

hemoglobinuria secondary to massive hemolysis

Question 21

What are exosomes

Answer 21

formed by the endocytosis of segments of the plasma membrane they infect RBCs and act as intracellular communication mediators

Question 22

What allows falciparum to sequester in deep vasculature

Answer 22

the formation of rosettes

Question 23

What is pfEMP1

Answer 23

it is expressed on the surface of mature RBCs infected with falciparum and undergoes antigenic variation to allow it to bind to several different cell receptors

Question 24

What does pfEMP1 bind to

Answer 24

CR1, CD36, ICAM-1, CSA and blood group antigen A

Question 25

How is anemia caused by malaria

Answer 25

lysis of RBC, splenic removal of infected cells and the release of TNF-a decreasing erythropoeitin

Question 26

What is the best way to prevent malaria

Answer 26

a bed net to prevent getting bitten in the first place

Question 27

What were the first malaria treatments

Answer 27

quinine and chloroquine

Question 28

What is the current malaria treatment

Answer 28

a combination therapy called artemisinin based combination therapy

Question 29

Why is a vaccine not very effective

Answer 29

it needs to target every part of the lifecycle

Question 30

What vaccine is somewhat effective in babies

Answer 30

anti-sporozoite vaccine RTS.S/A01

Question 31

When is the malaria vaccine given to children

Answer 31

between 6-12 weeks and again between 5-7 months

Question 32

How effective is the malaria vaccine

Answer 32

shows a 63% reduction in severe deadly disease but wane to 11% at 1 year and 3% at 5 years

Question 33

What animal did babesia originally effect

Answer 33

cows

Question 34

What does babesia cause

Answer 34

nantucket fever

Question 35

What is the vector of babesia

Answer 35

Ixodes scapularis

Question 36

Who is most susceptible to babesia

Answer 36

>50 years old, diabetics, immunocompromised

Question 37

What are the symptoms of babesia

Answer 37

fever, headache, myalgia, anorexia, abdominal pain

Question 38

When do symptoms of babesia occur

Answer 38

1-4 weeks after a tick bite

Question 39

How is babesia diagnosed

Answer 39

giemsa stain, PCR, serology

Question 40

How does babesia cause disease

Answer 40

sporozoites injected by the tick attach to the RBC (AMA1 on sporozoites attach to glycosylphosphatidylinositol anchored proteins on RBC, they then develop into trophozoites and then undergo fission to become 2-4 merozoites which when released cause hemolysis

Question 41

What is the treatment for babesia

Answer 41

antimalarial and an antibiotic like clindamycin or azithromycin