Malaria

Question 1

When does malaria become symptomatic?

Answer 1

When merozoites that have been replicating and maturing from sporozoites in the liver escape into the bloodstream.

The merozoites invade and attack the RBCs.

Question 1

List the parasite species causing malaria

Answer 1

Plasmodium
1. Falciparum
2. Vivax
3. Knowlesi
4. Malariae
5. Ovale

Question 2

List at least 3 clinical features of malaria

Answer 2

Fever, chills, sweats, fatigue, muscle ache, headache and nausea

Question 3

What is the most severe form of P. Falciparum?

Answer 3

Cerebral Malaria: impaired consciousness, seizures and other neurological symptoms

Question 4

What is another clinical manifestation of P. Falciparum?

Answer 4

Rosetting where infected RBCs clump together with uninfected RBCs.

Impair blood flow in small blood vessls by obstructing the flow.

Question 5

When is malaria suspected?

Answer 5

If patient had recent travel history to AFRICA

Question 6

What is BEST diagnostic test for malaria?

Answer 6

Blood smear microscopy

Question 7

Which type of blood smear is clearer and used to identify species?

Answer 7

Thin

Thick is used to confirm presence of parasite.

Question 8

What is the characteristic feature of P. knowlesi and P. malariae?

Answer 8

Band forms

Question 9

List all 4 features of P. Falciparum in a blood smear

Answer 9

1. Sickle cell shaped
2. Accole form (parasite at the edge, almost protruding out)
3. Same size as uninfected cells
4. Multiple infections in a single RBCs

Question 10

List the 2 features of P. vivax in a blood smear

Answer 10

1. Enlarged infected cells
2. Schuffner dots

Question 11

Other than blood smear, how else can P. Falciparum be identified?

Answer 11

Antigen test which uses histidine-rich proteins

Question 12

What is the main treatment highly effective against P. Falciparum?

Answer 12

Artemisinin-based combination therapy:
1. Artesunate - Mefloquine
2. Artemether - Lumefantrine