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Infectious Diseases > Malaria > Flashcards

Malaria Flashcards

1
Q

Malaria

5 species

A
  • Plasmodium vivax
  • Pl falciparum
  • Pl ovale
  • Pl malariae
  • Pl knowlesi
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2
Q

Malaria

Definitive host?

A

Host where the sexula phase of the parasite takes place
* Female anopheles culicifacies mosquito

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3
Q

Malaria

Intermediate host

A

Human

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4
Q

Malaria

Which species have hypnozoites

A
  • Pl vivax
  • Pl ovale
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5
Q

Malaria

Hypnozoites

A

Live stage of the parasite in the human. Cause relapses of fever

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6
Q

Malaria

Life cycle stages

A
  • Human- Sporozoite stage, Pre- erythrocytic stage, erythrocytic stage, Gametocyte formation
  • Mosquito - Sporogonic stage
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7
Q

Malaria

Sporozoite stage

A

Infected mosquito bites humans and inject sporozoites.

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8
Q

Malaria

Sporozoites

A

infectious form of the parasite

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9
Q

Malaria

Pre- erythocytic stage

A
  • Sporozoites enter the liver within minutes from the bite
  • Invade hepatocytes and multiply
  • 1-2 weeks after they become merozoites
  • Liver cells rupture and release merozoites into blood
  • Hypnozoites in Pl. Ovale and vivax stay dormant and cause relapses months or years later.
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10
Q

Malaria

Erythrocytic stage

A
  • Merozoites infect RBCs
  • Inside RBCs they become trophozoites and feed on Hb.
  • Trophozoites»»> schizonts»» divide and form merozoites»» continue infecting RBCs.
  • This infecting RBCs stage gives Sx
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11
Q

Malaria

Gametocyte formation stage

A
  • Merozoites become gametocytes inside humans
  • Gametocytes circulate in blood stream
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12
Q

Malaria

Sporogonic stage

A
  • Mosquito bites infected humans
  • gametocytes enter the mosquito
  • Gametocytes develop into male and female gametes in the female mosquito stomach
  • Gametes fuse and form zygotes
  • zygotes»> ookinete»> form sporozoites
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13
Q

Malaria

Incubation period of Pl. falciparum

A

around a week ( 7-10 days)

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14
Q

Malaria

Incubation period of Pl. vivax

A

around 1- 2 weeks ( 10- 12 days)

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15
Q

Malaria

Incubation period of Pl. malariae

A

18- 40 days ( around a month)

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16
Q

Malaria

Clinical manifestations of malaria is due to….. stage of the plasmodium life cycle

A

erythrocytic stage - infect RBCs

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17
Q

Malaria

Febrile paroxysms stages

A
  • Cold stage
  • Hot stage
  • Sweating stage
18
Q

Malaria

Cold stage

A
  • 15- 60 mins
  • Intense cold and uncontrollable shivering
19
Q

Malaria

Hot stage

A
  • 2-6 hrs
  • intense high fever, severe headache, Nausea, Vomiting
20
Q

Malaria

Sweating stage

A
  • Drenched in severe profuse sweating
  • temp drops rapidly
21
Q

Malaria

Fever periodicity

A

Synchronous rupture of mature schizonts

22
Q

Malaria

Fever periodicity is not seen in

A

falciparum

23
Q

Malaria

Sx

A
  • Headache
  • Anorexia
  • lethargy
  • myalgia
  • diarrhea
  • Abd pain
  • cough
    * fever w chills and rigors
  • Nausea
  • Vomiting
24
Q

Malaria

Signs

A
  • Fever
  • Anemia
  • jaundice ( mild)
  • Hepatosplenomegaly
  • NO RASH OR LYMPHADENOPATHY
25
Q

Malaria

CLINICAL CLUES FOR MALARIA!!

A
  • Fever w chills and rigors
  • Recent travel Hx to India, Africa
  • Pallor + Jaundice
26
Q

Malaria

DDs for chills and rigors

A
  • Acute pyelonephritis
  • Cholangitis
  • Abscess
27
Q

Malaria

Complications of falciparum

A
  • Cerebral malaria
  • Confusion
  • Coma +/- fits
  • Unusual focal signs
  • Variable tone, extensor posturing, upgoing plantar, dysconjugate gaze
  • Metabolic acidosis
  • Hypoglycemia
  • ARF - ATN, hemoglobinuria
  • Pulm edema
  • ARDS
28
Q

Malaria

Hemoglobinuria is due to

A

intravascular hemolysis

29
Q

Malaria

Black water fever

A

malaria due to hemoglobinuria ( dark urine)

30
Q

Malaria

Dx to confirm the parasite

A

Thick film of blood

31
Q

Malaria

Dx to identify the species

A

thin film of blood

32
Q

Malaria

Rapid stick test ?

A

to detect the malaria Ag

33
Q

Malaria

Ix

A
  • serial thick and thin film
  • Rapid stick test
  • FBC- reduced Hb, Plts
  • BU and SE for falciparum renal failure
  • Urinalysis - hemoglobinuria, proteinuria, cells
34
Q

Malaria

Mx for P. vivax

A
  • Chloroquine for 3d»» Primaquine for 14 d ( to destroy hypnozoites and gametocytes)
35
Q

Malaria

Mx for P falciparum ( uncomplicated)

A
  • Artemisinin based combo therapy (ACT)&raquo_space;» single dose of primaquine ( to get rid of gametocytes)
36
Q

Malaria

Mx of P falciparum ( severe and complicated)

A
  • IV artesunate ( more effective than IV quinine)
  • Once improving and can take oral meds , except children < 5 years should be given ACT ( weight appropriate)
  • Followed by a single dose of primaquine
37
Q

Malaria

primaquine ADRS

A

can cause hemolysis in pts w G6PD deficiency

38
Q

Malaria

What should be done ideally before giving primaquine

A

check G6PD levels

39
Q

Malaria

Differences between P falciparum and vivax

A

Pl. vivax
* Entry into reticulocytes
* Single parasite in one RBC
* Enlarged RBCs
* hypnozoites +
* Round gametocytes

Pl. falciparum
* Can enter into any stage of the RBC
* Multiple parasites in one RBC
* Not enlarged
* No hypnozoites
* Crescenteric shaped gametocytes

40
Q
A

Infectious Diseases (7 decks)

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