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Parasitology Laboratory > MALARIA > Flashcards

MALARIA Flashcards

1
Q

True or False: Apicomplexans are extracellular protozoans

A

FALSE: Apicomplexans are intracellular organisms—lives inside a host/cell. For this particular parasite, Apicomplexans they are found inside the red cells

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2
Q

Which species of Plasmodium is the most prevalent in the Philippines? Give the complete scientific name

A

Plasmodium falciparum : most prevalent in the Philippines and the most dangerous

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3
Q

________ are dormant exo-erythrocytic stages present in the liver of P. vivax infected patients.

A

Hypnozoite : the dormant stage that are found inside the liver; the stage primarily responsible for malarial relapse

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4
Q

What is the preferred stain for the preparation of malarial smears

A

Giemsa : best for detecting blood parasites—malarial parasites

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5
Q

True or False: The detection of hrp-2 antigen in blood samples is associated with P. vivax infections

A

False : Histidine-rich protein 2 (hrp-2) is a specific marker for Plasmodium falciparum

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6
Q

Take note, the malarial parasite belong to the Phylum

A

Phylum Apicomplexa

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7
Q

The unique characteristic of Apicomplexa:

A

apex/apical complex which is used for penetration. Remember that Apicomplexans are intracellular and they use this component—apex/apical complex—to penetrate the cell

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8
Q

Apicomplexans have complex life cycle which is

A

Alternating sexual and asexual stages

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9
Q 
Final Host:
Intermediate host
Habitat
MOT
IS to FH
IS to IH
A 
Final Host: Mosquito (Female Anopheles)
Intermediate host: Man
Habitat: : Liver, RBCs
MOT : Bite of mosquito
IS to FH: Gametocyte
IS to IH: Sporozoites
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10
Q

Vector of malaria

A

Bite of mosquito

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11
Q

Only one that can feed on blood and the sporozoite must live long enough to develop and move to the salivary gland which is found only in

A

Female Anopheles

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12
Q

Harbor sexual stage of the parasite

A

Final Host: Mosquito (Female Anopheles)

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13
Q

harbors the asexual stage of the parasite

A

Intermediate Host: MAN

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14
Q

Habitat of malaria if it undergoes exo-erythrocytic cycle

A

Liver

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15
Q

Habitat of malaria if it undergoes erythrocytic cycle

A

Red blood cell

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16
Q

Female Anopheles are usually

A

night-biter

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17
Q

For the mosquito to be infected by the malarial parasite, the mosquito must get this stage found in humans

A

gametocyte

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18
Q

Mosquito bites inject this stage to the human

A

sporozoites

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19
Q

Gametocyte:
Sporozoites:

A

Gametocyte: Humans
Sporozoites: Female Anopheles

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20
Q

what are the 5 Species:

A 
Plasmodium falciparum
Plasmodium vivax
Plasmodium ovale
Plasmodium malariae
Plasmodium knowlesi
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21
Q

In the Philippine setting, this is the most common malarial parasite, followed by Plasmodium vivax

A

Plasmodium falciparum

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22
Q

Roughly 90% of the total infection in the Philippine setting is actually brought by the combination of

A

Plasmodium falciparum and Plasmodium vivax

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23
Q

a malarial parasite that is rare or not encountered in the Philippines

A

Plasmodium ovale

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24
Q

a malarial parasite that is also detected in Philippines

A

Plasmodium malariae

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25
Q

a malarial parasite that is a zoonotic infection because this is isolated from monkeys

A

Plasmodium knowlesi

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26
Q

This is the malarial parasite of the old world monkeys

Also detected in Philippines and other Southeast Asian countries

A

Plasmodium knowlesi

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27
Q

mistaken as P. malriae because they are morphologically the same

A

Plasmodium knowlesi

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28
Q

the major way to differentiate P. knowlesi from P. malariae is through

A

Polymerase Chain Reaction (PCR) – a nucleic acid test

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29
Q

most common cause of malarial infection in the Philippine setting

A

Plasmodium falciparum

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30
Q

three (3) malarial stages detected in humans:

A

trophozoite
schizont
gametocyte

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31
Q

Malarial stage detected in human:
growing form
ring form (young)
amoeboid form

A

trophozoite

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32
Q

Malarial stage detected in human:

dividing form

A

Schizont

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33
Q

1 schizont =

A

multiple merozoites

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34
Q

P. falciparum is said to be the deadliest because it has

A

more merozoites compared to other Plasmodium species

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35
Q

Malarial stage detected in human:
Sexual form
infective stage to the mosquito
has two forms

A

Gametocyte

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36
Q

2 forms of gametocyte

A

Microgametocyte (male)

Macrogametocyte (female)

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37
Q

both malarial specie infects red cells of normal size

A

P. falciparum and P. malariae

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38
Q

Red cell of this Form of P. falciparum in thin smear that has single chromatin mass and abundant cytoplasm

A

Plasmodium falciparum ring form (trophozoite stage)

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39
Q

P. falciparum ring form in thick smear has (2)

A

no red cells and not dehemoglobinized

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40
Q

ring forms found protruding on the surface of red cells mostly in P. falciparum infection

A

Appliqué or Accollé

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41
Q

Characteristic that is common in P. falciparum infection (but can be found in other species as well)

A

Double ring form / Double chromatid dot

42
Q

ratio of red cell infected to parasite for–
Most malarial parasites:
P. falciparum:

A

Most malarial parasites: 1:1

P. falciparum: 1:1 or 1:2 (one red cell infected by two parasites resulting to the double ring form)

43
Q

most of the malarial parasites (except P. falciparum) have

A

ring forms inside the red cells

44
Q

stage of p. falciparum in a thin blood smear has numerous merozoites = multiple infection in one red cell

can be mature or immature

once the red cell ruptures, merozoites are released and can infect another red cell

A

Schizont of P. falciparum

45
Q

P. falciparum is considered the most dangerous malarial parasite because it has

A

the highest number of merozoites in a single red cell

46
Q

Stage of P. falciparum that is usually not detected in blood smear unless it is already a severe malaria

A

Schizont of P. falciparum

47
Q

another way to identify malarial parasite is

A

by determining the number of merozoites in a schizont (each malarial parasite has a corresponding merozoite number

48
Q

Schizont of P. falciparum characteristics

A

Accole, applique form, double chromatin

49
Q

Stage of P. falciparum that is Banana-shaped or sausage shaped; usually elongated;

A

Gametocyte of P. falciparum

50
Q

Type of gametocyte that has
Chromatin mass - dots inside
Compact chromatin mass

A

Macrogametocyte

51
Q

Type of gametocyte that has dispersed / scattered chromatin mass

A

Microgametocyte

52
Q

Second most common parasite in the Philippines

A

Plasmodium vivax

53
Q

Type of Plasmodium specie in which:
Infected RBCs are usually larger as compared to the uninfected cell (including that of P. ovale)

Has enlarged RBCs

A

Plasmodium vivax

54
Q

rare to see the mature trophozoite form in what Plasmodium specie

A

Plasmodium falciparum

55
Q

Common to see trophozoite form in what Plasmodium specie

A

Plasmodium vivax

56
Q

A distinct characteristic seen in mature trophozoite stage (not seen in ring form) or P. vivax

Seen in almost all erythrocytes that contain the mature stages of the malarial parasite

Denotes the Degradation product of hemoglobin

A

Hemozoint pigments

57
Q

Type of malarial specie by which:
Merozoites are seen

1 merozoite will infect 1 red cell

Number of merozoite is one way to differentiate malarial parasites.

A

P.vivax Schizonts Stage

58
Q

Usually rounded (for vivax, ovale, malariae); sausage or banana-shaped (for falciparum)

A

P.vivax Gametocyte

59
Q

Hemozoint pigment of P. vivax

A

Schuffner dots

Other types: Stephen, Christopher, Maurer’s dots

60
Q

Fifth malarial parasite of man

A

Plasmodium malariae

61
Q

Malarial specie (and stage) that has Band trophozoite

A

Plasmodium malariae

62
Q

Malarial specie (and stage) in which the Infected red cells are normal in size

A

Plasmodium malariae trophozoite

63
Q

Malarial specie (and stage) in which:
Merozoite in fruit pie or rosette appearance
Paikot ang merozoite formation

A

Plasmodium malariae schizont stage

64
Q

Red cell of this malarial specie is fimbriated (irregular projection) though not yet encountered in PH

A

Plasmodium ovale

65
Q

Cycle found in the red cell

when Red cells are infected

A

Febrile/Erythrocytic Cycle

66
Q 
What do you call the Febrile/Erythrocytic Cycle of each malarial species
Plasmodium falciparum:
Plasmodium vivax: 
Plasmodium ovale:
Plasmodium malariae:
Plasmodium knowlesi:
A

Plasmodium falciparum: Malignant Tertian

Plasmodium vivax: Benign Tertian

Plasmodium ovale: Ovale Tertian

Plasmodium malariae: Quartan Malaria

Plasmodium knowlesi: Quotidian Malaria

67
Q

Febrile/Erythrocytic Cycle

Fever every 36-48 hrs

A

Plasmodium falciparum: Malignant Tertian

68
Q

Febrile/Erythrocytic Cycle

Fever every 48hrs

A

Plasmodium vivax: Benign Tertian
and
Plasmodium ovale: Ovale Tertian

69
Q

Febrile/Erythrocytic Cycle

Fever every 72hrs

A

Plasmodium malariae: Quartan Malaria

70
Q

Febrile/Erythrocytic Cycle
Non-relapsing
Lacks exoerythrocytic stage

A

Plasmodium knowlesi: Quotidian Malaria

71
Q

GOLD standard in diagnosing malarial infection

A

Thick and Thin Smear

72
Q

Best stain for malarial/blood parasite is ___

alternative is ___

A

Giemsa

Wright stain

73
Q

Smear for parasite screening, sensitivity

A

Thick smear

74
Q

Smear for identification, specificity

A

Thin smear

75
Q

3 Factors to consider in examining smears

A

Appearance of the infected Red cell

Appearance of the parasite

Stages found

76
Q

Dehemoglobinizing agent in thick smear

77
Q

type of smear:

Dehemoglobinize using water prior to staining

A

Thick smear

78
Q

type of smear:

Stain immediately; no need to fix with MEOH (methanol)

A

Thick smear

79
Q

Utilizing more blood – more sensitive to detect presence or absence of malarial parasite

A

Thick smear

80
Q

Use this type of smear for qualitative reporting

A

Thick smear

81
Q

We can report negative if there is no malarial parasite present per

A

100 FIELDS

82
Q

Use this type of smear to determine the number of malarial parasites per ul of blood

A

Thick smear

83
Q

Formula of #malarial parasites/ul

A

of parasites counted / 200 WBCs x 8000

we use 8000, if not provided exact WBC count of the patient and if provided then we use the actual WBC count provided

84
Q

type of smear:
Fix with MEOH (methanol)
Stain with Giemsa-recommended stain for malarial parasite, kung wala they can use Wright stain

A

Thin smear

85
Q 
Developing trophozoite (ameboid form)
is not usually detected in
A

Falciparum infection

86
Q

presence of this in smear of Plasmodium falciparum infected cell means bad prognosis

A

presence of merozoite

87
Q

The most common here is the amoeboid form

A

Plasmodium vivax

88
Q

Malarial stage that is not usually detected in P. falciparum but is common in P. vivax

A

matured trophozoite / ameboid form

89
Q

Form of P. vivax that is rounded compared to the P. falciparum which has sausage shape

A

Gametocyte form of P. vivax

90
Q

3 Diagnostic tests for malarial infection

A

Rapid diagnostic test (RDTs)

Quantitative Buffy Coat (QBC)

Indirect Fluorescent antibody test (IFAT)

91
Q

The principle of this test is immunochromatography (in nature)

A

Rapid diagnostic test (RDTs)

92
Q

Advantages of this diagnostic test include:
you can have the result as fast as 15-30 mins. depending on the manufacturer

can be used without electricity and special equipment,

No need for training in microscopy

A

Rapid diagnostic test (RDTs)

93
Q

Disadvantages of this diagnostic test include:

Lack of sensitivity at low levels of parasitemia, can result to a false negative result

can detect presence of malarial parasite but unable to quantify the parasite density *for malaria – we need both identity and count

Cannot differentiate plasmodium ovale, plasmodium malarae, and plasmodium vivax

That’s why In every RDT, it is reported as Plasmodium falciparum or other plasmodium species since there are no antigens yet to differentiate plasmodium ovale, plasmodium malarae, and plasmodium vivax

Persistent positive despite parasite clearance
You will be positive even if you are already treated. Maybe because there is still presence of circulating antigen

More expensive than thick and think blood smear

A

Rapid diagnostic test (RDTs)

94
Q

This test Detect Plasmodium specific antigens:
-HRP-II or the Histidine Rich Protein II
specific for Plasmodium falciparum. produced by trophozoite and young gametocyte of Plasmodium falciparum

-Plasmodium Lactate Dehydrogenase (PLDH)
produced by sexual and asexual stage
can distinguish Plasmodium falciparum form non-Plasmodium falciparum

Plasmodium aldolase
This is produced by all plasmodium species

A

Rapid diagnostic test (RDTs)

95
Q

This diagnostic test makes use of:
Capillary tube with acridine orange stain (florescence stain)

Blood will be centrifuged in a microhematocrit tube,

Then you will apply acridine orange stain and it will bind with to the nucleic acid of the malarial parasite
Bind particularly in the nucleus – contains nucelic acid

*rbcs are not stained, they do not have the nucleus

A

QUANTITATIVE BUFFY COAT (QBC)

96
Q

color of a Positive result in QBC

A

(positive +) bright green and yellow under florescence microscope

97
Q

Band formation, rosette arrange of merozoites and normal sized infected RBCs are all associated with which species of plasmodium? give the complete scientific name

A

Plasmodium malariae

98
Q

True or False: IFAT detects antibodies against plasmodium

A

True

indirect – detection of antibodies; direct – detection of antigen

99
Q

Which species of plasmodium is endemic in Southeast Asia and can be mistaken for P. malariae?

A

Plasmodium knowlesi

100
Q

sausage shaped gametocytes, accole and applique ring forms are all associated with which species of plasmodium? give the complete scientific name

A

Plasmodium falciparum

101
Q

True or False: Fixation of the thick smear is required

A

False

This is also used to the detect the malarial parasite

Parasitology Laboratory (12 decks)

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