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Malawi prep > Malaria > Flashcards

Malaria Flashcards

1
Q

malaria: which parasite causes malaria?

A

plasmodium

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2
Q

malaria: which types plasmodium cause malarian disease in humans?

A

P. vivax
P. falciparum
P. malariae
P. ovale
P. knowlesi

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3
Q

what type of pathogen is plasmodium?

A

parasites (single cell)

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4
Q

how does plasmodium get spread?

A

via mosquitoes

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5
Q

what kind of cells do plasmodium enter and destroy?

A

liver cells and RBCs

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6
Q

which plasmodium is most lethal in humans?

A

falciparum

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7
Q

malaria: who are at high risk of severe infection?

A

children <5
pregnant women
patients with HIV/AIDS
travellers with no prior infection

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8
Q

sickle cell anemia protects against which plasmodium?

why is this?

A

vivax

vivax needs ‘Duffy receptor’ to enter RBCs. sickle cell anemia patient don’t have this receptor

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9
Q

why do thalassemia and G6DP deficiency protect against malaria?

A

infected RBC’s die more easily because of oxidative stress

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10
Q

in which stage is the plasmodium inside the mosquito’s saliva?

A

stage of development (sporozoite)

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11
Q

malaria: how does the mosquito transfer the sporozoites into the bloodstream (via which fluid)?

A

via saliva

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12
Q

once entered into the bloodstream, where do sporozoites (plasmodium in developmental stages) head first? which organ?

what do they do there?

A

liver, replicate

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12
Q

malaria: what happens in the first 2 weeks after infection?

where are the plasmodium sporozoites and what do they do?

A

liver, multiply (host cells die), mature (into merozoites)

=> exoerythrocytic phase, asymptomatic

(except vivax and ovale -> they do into dormant phase for months-year)

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13
Q

malaria: are the first 2 weeks symptomatic or asymptomatic?

A

asymptomatic

(plasmodium multiply in the liver, not in RBCs)

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14
Q

how do you call the first 2 weeks of malaria infection?

A

exoerythrocytic phase

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15
Q

malaria: what happens 2 weeks after infection?

A

merozoites enter into the bloodstream, start to invade RBCs

=> erythrocytic phase

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16
Q

what is the erythrocytic phase of malaria? what happens during this phase? how long does it last?

A

2 weeks after infection, merozoites enter RBCs: multiply, transformational changes

2-3 days

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17
Q

what are the 3 stages of erythrocytic phase?

A
  1. early trophozoid -> tiny ring
  2. late trophozoid -> bigger ring
  3. schizont (grows by digesting Hb & leaving behind hemozoin) -> brown dot => replicate phase!
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18
Q

what is the 3rd stage of the erythrocytic phase? why is this important?

(p. falciporum)

A

replicate phase

schizonts undergo mitosis, differentiate into lots of merozoites

RBCs breaks and merozoites gets released into the blood

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19
Q

summarize the stages/cycle of the erythrocytic phase: start with merozoites

A

meroziotes invade RBC -> early throphozoid -> late throphozid -> schizont -> ruptured schizont -> meroziotes get released

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20
Q

what is the incubation time of p. falciporum?

A

few days

21
Q

what is the incubation time of p. malariae?

A

few weeks

22
Q

malaria: what causes the short bursts of fever?

A

release of inflammatory cytokines into blood (such as tnf-a)

corresponds to rupture of RBC’s (schizont replicate/differentiate into merozoites -> released into bloodstream)

23
Q

how often does a quartan fever happen?

A

every 72h (3 days)

24
Q

how often does a tertian fever happen?

A

every 48h

25
Q

p. malariae: causes how often fever?

A

every 72h (quartan fever)

26
Q

p.vivax&ovale: causes how often fever?

A

every 48h (tertian fever)

27
Q

quartan fever: which plasmodium?

A

malariae

28
Q

terian fever: which plasmodium? (2)

A

vivax, ovale

29
Q

p. falciporum: how often fever?

A

every 24-48h (malignant tertian fever)

30
Q

p. knowlesi: how often fever?

A

24h

31
Q

every 24-48h (malignant tertian fever)

which plasmodium?

A

falciporum

32
Q

24h cycle: which plasmodium?

A

p. knowlesi

33
Q

malaria: which symptoms does the hemolytic anemia cause?

A

fatigue, headaches, jaundice, splenomegaly

34
Q

which plasmodium causes the worst infections? why is this?

A

p. falciporum
infected RBCs are not destroyed by the spleen, because of a sticky protein coating (look like little bumps) made by the p. falciporum -> also makes the cells clump together, blocks blood flow -> organ failure

35
Q

what causes organ failure in p. falciporum infection?

A

p. falciporum generates a sticky protein -> RBCs clump together -> blood flow blocked to vital organs (sepsis like clinical picture)

36
Q

what are the symptoms of cerebral malaria?

A

alter mental status
seizures
coma

37
Q

what are the symptoms of bilious malaria? (blood flow blocked to liver)

A

vomiting
diarrhea
jaundice
liver failure

38
Q

how do you diagnose malaria?

A

thick blood smear: parasites in RBCs
thin blood smear: plasmodium species

39
Q

why is it important to know the percentage of infected RBCs in malaria?

A

> 5% can have worse outcomes

40
Q

what are common lab findings in malaria?

A
  • thrombocytopenia
  • elevated lactate dehydrogenase (LDH) from hemolysis
  • normochromic & normocytic anemia (normal color and size)

-> (LDH indicates tissue damage)

41
Q

malaria: what does suppressive/preventive treatment do? who is it given to?

A

kill sporozoite before entering the hepatocyte

given to travellers

42
Q

how does the therapeutic treatment of malaria work? when is it given?

A

eliminating meroizites in the erythrocytic phase. given during active infection

43
Q

what is the most common antimalarial drug for uncomplicated malaria? (if no resistance)

A

Chloroquine
=> preferred treatment for any parasite that is sensitive to the drug

some parts of the world highly resistant

44
Q

what is the most common drug for uncomplicated malaria? (in chloroquine resistant areas)

A

Artemisinin-based combination therapies (ACTs), such as Coartem

45
Q

what does malaria treatment depened on?

A

complicated/uncomplicated, pregnancy status, resistancy, plasmodium species

46
Q

recurrent malaria: causes? (3)

A
  • recrudescence: infection not cleared
  • relapse: RBCs cleared, but not liver
  • reinfection: single infection does not confer immunity, but acquired ability to tolerate infection
47
Q

does a single malaria infection confer immunity?

A

no

but an acquired ability to tolerate infection

48
Q

malaria prevention measurements?

A

full body clothing
mosquito net
insecticide spray
no stagnant collections of water

49
Q
A

Malawi prep (12 decks)

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