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8 -InfectiousClinical > Malaria > Flashcards

Malaria Flashcards

1
Q

Pathogens Responsible For malaria

A

Plasmodium falciparum
Plasmodium vivax
Plasmodium malariae
Plasmodium ovale

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2
Q

Incidence of malaria in the world

A

214 million cases

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3
Q

Percentage of malaria cases from Africa

A

88 percent

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4
Q

Why is there a resurgence of malaria since 1970

A

Plasmodium falciparum became resistant to chloroquine and sulfadoxine-pyrimethamine

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5
Q

People at risk of malaria

A

Children
pregnant women
travelers
migrants from endemic countries who have been a long period of time in an endemic countries and go back to their home country
People living near airport

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6
Q

Life cycle of malaria parasites

A

Female anopheline becomes infected by feeding on human blood containing gametocytes

Developments of gametocytes to sporozoites in 7 to 20 days

Sporozoites Accumulates in the salivary glands and get inoculated into human bloodstream

After Half an hour , sporozoites get to the liver (primary exo-erythrocytic)
If P.ovale or vivax, can stay long in the liver as hypnozoites and induce clinical illness months later

After some days , merozoites leave liver and invade red blood cells

Asexual cycle of multiplication in RBC producing shizonts

Schizont rupture producing more merozoites into blood -> fever

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7
Q

Pathology of malaria

A

Infected red blood cell prone to hemolysis.

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8
Q

Why is hemolysis of red blood cell worse in plasmodium falciparum

A

Because it infects red cells of all ages especially young cells

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9
Q

Peridiocity of fever in the different type of plasmodium

A

Alternate days in plasmodium vivax and ovale

Every three days in plasmodium Malariae

No periodicity in plasmodium falciparum

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10
Q

Type of red cell invaded by plasmodium vivax an ovale

A

Reticulocytes

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11
Q

Type of red cell invaded by plasmodium Malariae

A

Normoblasts

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12
Q

What happens in plasmodium falciparum infection when the red cell contain trophozoites

A

Form knob proteins which adhere to vascular endothelium in post capillary venules in the brain the kidney liver lungs and gut

Form rosettes and rouleaux with infected red cells

Leads to vessel congestion with organ damage

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13
Q

What are some protective mutation in the human against plasmodium falciparum

A

Sickle cell
thalassemia
glucose 6 phosphate dehydrogenase deficiency
HLA-B53

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14
Q

Which human evolution protects against plasmodium vivax

A

Red cell lacking Duffy blood group

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15
Q

Clinical features of plasmodium falciparum infection

A

Insidious onset -Malaise headache vomiting
Cough, mild diarrhea common
Fever with no particular pattern
jaundice common
enlargement / tenderness of the spleen and liver

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16
Q

Severe manifestation or complication of falciparum malaria

A

cerebral malaria with coma
Hyperpyrexia
Convulsions
hypoglycemia
severe anemia
acute pulmonary edema
acute kidney injury
spontaneous bleeding and coagulopathy
metabolic acidosis
shock
aspiration pneumonia
hyper parasitemia

17
Q

Manifestation of cerebral malaria in falciparum malaria

A

Delirium
seizures
coma

18
Q

Manifestation of falciparum malaria in pregnant women

A

Abortion
intrauterine growth retardation

19
Q

Clinical features of plasmodium vivax and ovale

A

Several days of fever and then becomes alternate
fever starts with Rigor
Patient feels cold - high temperature about 40°
Hot and flush phase - perspiration, gradual fall in temp
Cycle every 48h
Tender and enlarged spleen and liver
Slow developing anemia

20
Q

Clinical features of plasmodium malariae and knowlesi

A

 mild symptoms
fever every third day
If chronic over the years can cause glomerulonephritis and long-term nephrotic syndrome in children

21
Q

Malaria investigation

A

Giemsa stained thick and thin blood film

Immuno chromatographic rapid diagnostic tests (optiMAL for plasmodium LDH of falciprum and vivax, parasight-F for p falciparum histidine rich protein 2

PCR

22
Q

Goal of Giemsa stained blood film

A

Giemsa stained thick for low level parasitemia

thin blood film to confirm diagnosis, identify species, parasite load

23
Q

Management of mild falciparum

A

Artemisin based treatment - co-artemeter like coartem or riamet

24
Q

Can you use coartemeter in pregnancy

A

Yes except early pregnancy

25
Q

Treatment of complicated falciparum

A

Iv artesunate

26
Q

Non falciparum treatment

A

Oral chloroquine

27
Q

Prophylaxis in malaria

A

Chloroquine , at ova quote, proguanil, doxycycline or mefloquine

8 -InfectiousClinical (7 decks)

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