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Infection Diseases > Malaria > Flashcards

Malaria Flashcards

1
Q

What are the five species of malaria which affect humans?

A

Plasmodium falciparum
Plasmodium vivax
Plasmodium ovale
Plasmodium malariae
Plasmodium knowlesi

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2
Q

What is the most severe species of malaria

A

Plasmodium falciparum

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3
Q

What is the vector for malaria?

A

Female Anopheles mosquito

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4
Q

Incubation period for malaria

A

6 days to 1 year
P. falciparum - up to 4 weeks
P. vivax/ovale - up to 1 year

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5
Q

What can the incubation time of plasmodium falciparum be?

A

Up to 4 weeks

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6
Q

What can the incubation time of plasmodium vivax/ovale be?

A

Up to 1 year

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7
Q

Presentation of malaria

A
  • rigors
  • paroxysmal fever
  • malaise
  • headache
  • myalgia
  • abdominal pain
  • N+V
  • jaundice + hepatosplenomegaly in later stage
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8
Q

What is paroxysm fever?

A

Fever that occurs in short bursts

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9
Q

Investigation needed for suspected malaria

A

Blood film x3 - thick + thin
Blood tests -FBC, U&E, LFT
Chest X ray
Head CT - neurological symptoms

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10
Q

Investigation findings of malaria

A
  • seen on blood film
  • anaemia
  • thrombocytopenia
  • leukopenia
  • abnormal LFTs
  • high urea, bilirubin + CRP
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11
Q

What is the characteristic image in malaria blood film?

A

Headphone/wedding ring

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12
Q

What investigation findings exclude malaria?

A

three negative blood film samples taken over 3 consecutive days

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13
Q

How do you grade the severity of malaria?

A

Parasitaemia
>5% indicates severe malaria
Calculated by the thin blood film

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14
Q

Complicated vs uncomplicated malaria

A
  • uncomplicated is less severe symptoms i.e no signs of organ dysfunction or life threatening complications | often caused by P.vivax/ovale/malariae
  • complicated is life threatening + involves organ dysfunction + high parastic load | most commonly caused by P.falciparum
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15
Q

Treatment of uncomplicated malaria

A
  • first line: artemether + lumefantrine
  • quinine + doxycycline
  • malarone (proguanil + atovaquone)
  • chloroquine (not P.falciparum)
  • primaquine
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16
Q

Treatment of complicated malaria

A
  • first line: IV artesunate
  • quinine dihydrochloride
17
Q

What drug should be used to treat liver related dormant malaria?

A

primaquine

18
Q

What drug shouldn’t be used for P. falciparum malaria?
Why?

A

Chloroquine
Widespread resistance

19
Q

Who should you not give primaquine to and why?

A

G6PD patients
can cause severe haemolysis

20
Q

Describe the life cycle of plasmodium falciparum

A

1- female Anopheles mosquito bites human
2- injects sporozoites
3- sporozoites infect hepatocytes
4- sporozoites mature to merozoites
5- merozoites burst out of cell + infect bloodstream
6- merozoites attach erythrocytes
7- plasmodium asexually replicate + mature in RBCs
8- merozoites burst out of erthyrocytes (schizont)
9- process repeats

21
Q

What is schizont?

A

The name of a erythrocyte when merozoites are ready to burst out of them

22
Q

Name of erythrocytes when merozoites are ready to burst out of them

A

Schizont

23
Q

How does malaria cause symptoms of haemolytic anaemia?
What is the exception?

A

Destruction of erthyrocytes

Plasmodium falciparum doesn’t

24
Q

What is icterus

A

Yellow eye - jaundice

25
Q

Prevention of malaria

A

Insecticide spray
Clothing that covers whole body
Mosquito nets
Avoid still lakes
Chemoprophylaxis

26
Q

Examples of antimalarial medications

A
  • malarone (proguanil with atovaquone)
  • doxycycline
  • mefloquine
27
Q

Side effects of doxycycline

A
  • diarrhoea
  • thrush
  • headache
  • angioedema
  • skin sensitivity to sunlight (increases sunburn risk)
28
Q

Side effects of mefloquine

A
  • psychiatric side effects
  • anxiety
  • depression
  • diarrhoea
  • dizziness
  • sleep disorders
  • psychosis or seizures (rare)
29
Q

Why should you avoid still lakes to prevent malaria?

A

Anopheles mosquitoes lay eyes in stagnant water

30
Q

What are the categories for recurrent malaria?

A
  • Recrudescence - original parasite not killed
  • Relapse - cleared merozoites, dormant hypnozoites in liver are no longer dormant
  • Reinfection - original cure, new case of infection
31
Q

Why does malaria caused by plasmodium falciparum not cause haemolytic anaemia?

A

1- P. falciparum cerastes sticky protein
2- protein coats surface of RBCs
3- RBCs clump together + occlude blood vessels
4- organ ischaemia

32
Q

where do plasmodium species remain dormant within the human body?

A

Liver

33
Q

ABCs of malaria prevention

A

Assess risk
Bite prevention
Chemoprophylaxis

34
Q

What group of people have immunity to malaria?

A

Those with Sickle cell anaemia

35
Q

Complications of plasmodium falciparum malaria

A
  • cerebral malaria > seizures + neurological deterioration > death
  • AKI
  • pulmonary oedema
  • DIC
  • hypoglycaemia

Infection Diseases (22 decks)

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