Malaria Flashcards
Subtypes of malaria
P. falciparum,
P. vivax,
P. ovale,
P. malariae
How is Malaria transmitted?
Female anopheles mosquito
Malaria incubation period
7 to 30 days, depending on the species of malaria
infection
True/False
Malaria is vaccine preventable
False
What types of Malaria are lethal?
P. falciparum
P. malariae (maybe)
Malaria – Lifecycle, What phase?
Sexual cycle in Female Anopheles Mosquito:
(a) Begins when a female anopheles mosquito takes a blood meal
from an infected human.
(b) Ends when the mosquito salivary glands are filled with
malaria parasites
Sporogony Phase
Malaria – Lifecycle, What phase?
Asexual cycle in human liver (Patient is asymptomatic in this stage):
(a) Female anopheles mosquito takes another blood meal from an uninfected human and injects parasite into blood stream, infecting them.
(b) Parasites make its way to the liver via lymph system and blood stream.
(c) Parasites undergo asexual maturation in liver cells.
(d) When fully matured, parasites burst out of liver cells & are released into the bloodstream.
Exoerythrocytic Phase
Malaria – Lifecycle, What phase?
Asexual reproduction in RBCs (Patient is symptomatic in this stage)
(a) Matured parasite released from the liver attach to red blood cells in the blood stream.
(b) Parasite asexually reproduce inside RBCs, forming new parasites in each infected RBC.
(c) Infected RBCs then burst & release more merozoites that infect other RBCs.
(d) RBCs lysing causes massive inflammation and decreases O2 carrying capacity (anemia).
Erythrocytic Phase
What phase of Malaria is Symptomatic?
Erythrocytic
The presentation of Malaria can be broken down into what 2 broad
categories?
Uncomplicated Malaria & Severe Malaria
What broad category of malaria
(a) Paroxysmal (cyclical) fever
(b) Influenza-like symptoms including chills, headache,
myalgias, and malaise.
(c) Jaundice & mild anemia secondary to hemolysis
Uncomplicated Malaria
What broad category of malaria?
(a) Small blood vessels infarction, capillary leakage and organ dysfunction
(b) Altered consciousness
(c) Hepatic failure & renal failure
(d) Acute respiratory distress syndrome
(e) Severe anemia
Severe malaria
__________ are typical of Malaria and considered a clinical
hallmark of the infection
Paroxysmal fevers
Malaria Paroxysmal Fevers
(a) Cold stage – lasts approximately ____
(b) Febrile stage – lasts ____ hours
(c) Diaphoretic stage where fever drops – lasts ____ hours
(d) Patient then returns to normal
(e) Cycle repeats itself in ____ hours depending on species of
infection
a) 1 hour
b) 2-6
c) 2-4
e) 48 – 72
Life cycles of Malaria ranges from ____ hours depending on
species.
48-72
Consider _____ in any febrile patient returning from a malaria
endemic country.
malaria
What is diagnosis based on for Malaria?
-Clinical findings consistent with Malaria infection
-Rapid diagnostic testing or laboratory confirmation via blood
smear.
True/False
For simplicity you can use the same or related drug to treat Malaria as the one used for chemoprophylaxis.
FALSE
What are reliable-supply treatment regimens available in the U.S for Malaria
(a) Atovaquone-proguanil (Malarone)
(b) Artemether-lumefantrine (Coartem)
What does this define?
(a) Complete course of approved treatment regimen obtained in
the U.S.
(b) Is not counterfeit or substandard
(c) No adverse interactions with the patient’s other medicines,
including prophylaxis
(d) Will not deplete local resources in the destination country
Reliable Supply
Treatment of Uncomplicated Malaria
(a) Chloroquine phosphate 1g (600mg base) PO
(b) THEN 0.5g in 6 hours
(c) THEN 0.5g daily for 2 days
Treatment of malaria in areas with chloroquine resistance
Malarone (Atovaquone 250mg/Proguanil 100mg) 4 tabs PO QD for 3 days
Treatment of Severe Malaria
(a) Artesunate 2.4mg/kg IV at 0, 12, 24, 48 hours
(b) Followed by Doxycycline 100mg BID x 7 days after parenteral therapy
Treatment of P.ovale
(a) ADD primaquine 52.6mg (30mg base = 2 tablets) PO QD x
14 days
(b) Added to regiment for hypnozoites
What are the most important protective measures for Malaria
proper clothing and awareness
Administration of Malaria prophylactic medication such as Chloroquine, & Mefloquine
1. should begin __-___ weeks prior to the expected embarkation to an endemic area
2. and continued for __ weeks after leaving the endemic area
- 1-2 weeks
- 4 weeks
True/False
Malaria - Disposition
Patients presenting with signs and symptoms of the mild form of
the disease can be retained onboard.
FALSE
Even patients presenting with signs and symptoms of the mild form of the disease should be evacuated to definitive medical care facility as soon as possible
Malarone, Primaquine, & Doxycycline; start _ days prior to entry & continue till __ days after departing
- Doxycycline to be continued till ____ after departing
2 days prior, 7 Days
Doxy 1 month after leaving
True/False
Malaria - Disposition
Patients presenting with signs and symptoms of the mild form of
the disease can be retained onboard.
FALSE
Even patients presenting with signs and symptoms of the mild form of the disease should be evacuated to definitive medical care facility as soon as possible
True/False
Malaria - Disposition
Patients presenting with signs and symptoms of the mild form of
the disease can be retained onboard.
FALSE
Even patients presenting with signs and symptoms of the mild form of the disease should be evacuated to definitive medical care facility as soon as possible
Treatment of Uncomplicated Malaria
(a) Chloroquine phosphate 1g (600mg base) PO
(b) THEN 0.5g in 6 hours
(c) THEN 0.5g daily for 2 days
