Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

HemOnc > Malaria > Flashcards

Malaria Flashcards

1
Q

What causes malaria?

A

Plasmodia species

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where are the 2 places plasmodia bugs can live?

A
  1. Liver

2. RBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which place are malaria bugs if you have symptoms?

A

RBC

if in liver- no symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What transmits malaria?

A

Mosquito (female anophele)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do plasmodia reproduce in mosquito and humans?

A

Sexual in mosquio

Asexual in human

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What do you see in the RBCs with malaria?

A

Ring forms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is plasmodia called when it initially affects you and then heads to the liver?

A

Sporozoites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is plasmodia called when it affects RBC?

A

Meroaotes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the sexual stage of P. Falciparum called?

A

Gametocytes (these can be taken up by mosquitoes and then transmitted to other people)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a hypnozoite?

A

When plasmodia is in the dormant stages in the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What 2 species of plasmodia have hypnozoites and what can this cause?

A

P. Vivax and P. Ovale

-Causes relapses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Fever?

A

IL-1, IL-6, TNF-alpha

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What cycle are the relapsing symptoms due to?

A

Asexual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is really important in diagnosing malaria?

A

History of travel

  • Falciprum: Africa
  • Vivax: SE Asia or SA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Who will you see malaria in?

A

Travelers for foreign countries
Vets: Vivax (relapsing)
Peace Core

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does plasmodia work?

A

It breaks gown hemoglobin leaving iron behind which is toxic, so it turns it into hemozoin (crystal that alters the host inflammatory mediator production)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where does plasmodia get it’s energy?

A

GLUCOSE

-Metabolizes it a lot faster than RBCs so you get hypoglycemia and lactic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What do you die from in malaria?

A

Respiratory arrest because the RBCs cannot carry oxygen to tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What 3 things cause anemia in malaria?

A
  1. Lysis of pRBC and RBC
  2. Suppression of hemtopoeisis
  3. Increased clearance of RBC by spleen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are 2 other things besides anemia that malaria can cause?

A

Thrombocytopenia and heptospenomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What’s the general description of symptoms with malaria?

A

Flu-like symptoms that cycle and repeat…. fever, chills, rigor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What 2 species are benign tertian that cycle in 48 hours?

A

Vivax and ovale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What species is malignant tertian malaria that cycles in 36-48 hours?

A

Falciparum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What species is quartan malaria that cycles in 72 ours?

A

Malariae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Who is uncomplicated malaria seen in?

-General symptoms with cyclical fevers

A

Semi-immune adults in P. Falciparum endemic areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Who gets severe malarial amenia (Hb under 5)?

A

Infants and children in P. Falciparum endemic areas

Have high parasite levels in blood and resp. complication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Who gets cerebral malaria?

A

Nonimmune people with low transmission areas

lower parasite levels in blood… milder anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What type of malaria is the most common cause of death?

A

Cerebral: Coma, AMS, seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What other issue is seen in nonimmune adults with P. Falciparum?

A

Renal Failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is blackwater fever?

A

Hemoglobinuria (with hemolysis and hemoglobinemia) seen with P. Falicparum and it’s treatment
-Dark urine, fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are 3 other manifestations associated with renal failure in malaria?

A
  1. Hypoglycemia
  2. Lactic acidosis
  3. Hemolysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is used to dx. malaria?

A

Blood smears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What a thick smear for?

A

Detect organisms (drop of blood)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is a thin smear for?

A 
Detect species (1 RBC) 
-Where you would see the ring form
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Englarged RBC with Schuffner (Schueffner) dots?

A

P. Vivax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Oval shaped RBCs with Ragged cell walls and Schuffner dots?

A

P. Ovale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Bar and band forms with a rosette schizont?

A

P. Malariae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Ring form with in RBC

Crescent/bannana/sausage shaped mature gametocyte?

A

P. Falicaparum (erythrocytic forms)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

True or False: All species of malaria have the ring form, but only P. Falciparum has the gametocyte form

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is hemozoin?

A

Detoxified heme which alters the inflammatory mediator production in monocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are 3 other options for diagnosing malaria that aren’t really too useful?

A
  1. Antigen detection (ELISA)
  2. Molecular diagnosis (PCR)
  3. Serology (IFA/ELISA- HISTORY OF INFECTION)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What form of sickle cell anemia offers protection against malaria?

A

HbAS - Heterozygote

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What offers 100% protections against Vivax?

A

Duffy antigen deletion (receptor on RBC for vivax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are 3 other diseases that offer protection against malaria?

A

G6PD deficiency, Thalassemia, HbC polymorphisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What are 2 other ways you could get protection from malaria?

A
  1. Inflammatory mediatory production: TNF-a, NO, COX-2, IL-1b, IL-10
  2. Cell surface adhesion proteins: ICAM1, CD34, ect.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the treatment for malaria for non-severe, non-resistant cases?

A

Chloroquine

47
Q

What is the treatment for malaria for severe cases (or resistant ones)?

A

Quinine

48
Q

What are 2 toxicities that quinine can cause?

A

Renal and oto

49
Q

What is given for anti-relapse therapy for vivax and ovale that is active versus hypnozoites only?
-LIVER

A

Primaquine

50
Q

Who can you not give primaquine to?

A

Children, preggers, G6PD

51
Q

Would you give primaquine to someone with falciparum?

A

NO

52
Q

If someone had vivax (like they had malaria a long time ago and now it’s back) how would you treat it?

A

Chloroquine and primaquine

53
Q

How do heme metabolism inhibitors work?

A

They stop parasite enzymes from making hemozoin from heme…you get a build-up of heme which is toxic to parasites

54
Q

What are some heme matabolism inhibitors?

A

Cholorquine, quinine, mefloquine (Lariam), halofantrine

55
Q

What are the 3 proposed mechanisms of actions of heme metabolism inhibitors?

A
  1. Bind to ferriprotoporphyrin 9 released from Hb- Heme build-up
  2. Raise pH of parasites intracellular acid vesicles (intereferes with Hb degradation)
  3. Bind to DNA and interfere with DNA replication
56
Q

When do you use quinoline derivatives?

A

Erythrocytic malaria (NOT FOR HEPATIC STAGE)

57
Q

What are 2 properties of chloroquine?

A
  1. Rapid onset of action

2. Long half life

58
Q

What is the mechanisms of resistance to chloroquine?

A

Drug efflux (falciparum and vivax)

59
Q

Who do you need to be careful in giving chloroquine to?

A

G6PD and preggers

60
Q

Who do you see toxicity and SE due to chloroquine in?

A

SLE and RA patients (b/c they are treated with higher doses)

61
Q

What are the 3 areas of SE from chloroquine?

A

SKIN: pruritus (dark skin)
HEART: conduction/cardiomyopathy
NEURO: reinopathy ,general

62
Q

What is qunine and quinidine?

A

Cinchona alkaloids

63
Q

With chloroquine-resistant strains, what do you give quinine and quinidine with?

A

Doxy or clindamycin

64
Q

Can you give quinine or quinidine to preggers?

A

YES

65
Q

How do you give quinine/quinidine?

A

Oral: Mild
IV: Acute (multidrug-resistance P. Falciparum

66
Q

Why can’t you give quinine/quinidine as prophylaxis?

A

short half life

67
Q

What are the 2 main toxicities of quinine and quinidine?

A

Renal and oto

68
Q

Is quinine and quinidine effective against the asexual stage of malaria?

A

YES… it’s gametocidal for vivax and malaria (BUT NOT FALCIPARUM)

69
Q

SE (Cinchonism) with normal dosing of quinine and quinidine?

A

TINNITUS…. flushed/sweaty skin, burry vision, confusion, drug-induced lichenoid reaction, vertigo, vomiting/diarrhea

70
Q

Large doses of quinine/quinidine can lead to?

A

Skin rashes, deaf, blind, conduction cardiac, BLACKWATER FEVER (hemolysis, hemoglinemia, hemoglobinuria, renal failure)

71
Q

What other 2 things can qunine/ quinidine cause?

A

Hypoglycemia (IV) and hypotension

72
Q

Who needs precaution for quinine/quinidine?

A 
G6PD deficient (but okay for preggers)
Class 1A antiarrythmic (inhibit P450)
73
Q

What are the 2 synthetic quinoline compounds?

A

Mefloquine and halofantrine

74
Q

What is mefloquine used for?

A

Monotherapy prophylaxis and treatment of malaria (ORAL)

75
Q

What is the toxicity of mefloquine?

A

PSYCHIATRIC DISORDERS, gi issues, seizures, bradycardia, qt long, arrythmia

76
Q

What can mefloquine cause?

A

Still births

77
Q

What are the 2 oxidative phosphorylation inhibitors?

A

Atovaquone and primaquine

78
Q

What is primaquine used for?

A

Radical cure of vivax/ovale (hypnozoites)
RELAPSE THERAPY
(LIVER)
(ORAL)

79
Q

How does primaquine work?

A

Inhibits ETC increasing ROS in parasite

80
Q

What are the SE of primaquine?

A

GI distress, pruritus, methemoglobinemia, HA

81
Q

What are the contraindicatations of primaquine?

A 
G6PD deficiency (hemolytic anemia) 
Preggers
82
Q

What is atovaquone?

A

Hydroxynapthoquinone

83
Q

What does atovaquone do?

A

Inhibits ETC in parasitic mitochondria
(it inhibits malaria cytochrome C complex and collapses mitrochondrial membrane potential…this blocks nucleic acid synthesis and inhibits replication)

84
Q

What is atovaquone used for?

A

Treat liver stage (hypnozoites), but not relapse

85
Q

How is atovaquone best work?

A

Given with proguanil (folate?)

-Oral absorption is also increased with fatty foods

86
Q

What the mechanism of resistance for atovaquone?

A

mutations in mitochondrial B-gene

87
Q

Toxicity and SE of atovaquone?

A

Abd pain, N/V, HA, Diarrhea

88
Q

What are some precautions for atovaquone?

A

Rifampin induces p450 which reduces atovaquone effectiveness (induces metabolism of atovaquone)

89
Q

What are contraindications of atovaquone?

A

Preggers, lactating mothers, children

90
Q

What is a folic acid antagonist used for malaria?

A

Sulfadoxine- pyrimethamine

91
Q

Why are protozoa susceptible to folate synthesis inhibitors?

A

Can’t absorb exogenous folate and need it for nucleic acid synthesis

92
Q

What do diaminopyrimidines do?

A

Inhibit dihydrofolate reductase

proguanil, pyrimethamine, trimethoprim

93
Q

What do sulfonamides do?

A

Inhibit the conversion of aminobenzoic acid to dihydropteroic acid
(sulfadoxine and sulfamethoxazole)

94
Q

What combo is used for malaria?

A

Sulfadozine/pyrimethamine

95
Q

What combo is used for toxoplasmosis?

A

TMP/SMX

96
Q

What are the 3 SE for folic acid antagonists?

A
  1. BM depression (pancytopenia)
  2. Erythma multiforme
  3. Epidermal necrolysis
97
Q

Who are folic acid antagonists contraindicated in?

A

Lactating mothers and infants under 2 months

-precaution in IC patients

98
Q

What drug is a combo of atovaquone and proguanil?

A

Malarone

99
Q

What is proguanil?

A

Antifolate that inhibits plasmodia dihydrofolate reductase

-Synergizes with atovaquone to inhibit ETC

100
Q

True or false: Malarone is effective against all stages of P. Falciparum

A

TRUE

101
Q

What can malarone be used for?

A

Prophylaxis and treatment of erythrocytic stage of vivax and ovale

102
Q

What are 2 inhibitors of protein synthesis?

A

Doxy and clindamycin

103
Q

What is dozy used for?

A

Prevention (short-term) not treatment (unless combo)

104
Q

How does doxy work?

A

Slow-acting blood schizontocide that prevents apicoplast function (which is an essential biosynthetic organelle)
-In bacteria it is a 30S inhibitor

105
Q

What are toxicities of doxy?

A

Bone and teeth

106
Q

Who can’t you give doxy to?

A

Kids under 8 and preggers

107
Q

What is the only disease where you can give doxy to a child?

A

Rocky mountain spotted fever

108
Q

What are sesquiterpenes?

A

Artemisnin derivatives (artemether and artesunate)

109
Q

What do artemisinins treat?

A

Erythrocytic malaria by reacting with the heme moiety (bind heme itself to block enzyme)

110
Q

How are arteminsinins the most active antimalaria compound?

A

They are effective against small-ring forms and maturing schizonts and the reduce gametocyte carriage and transmission

111
Q

Who do you need to be precautious with in artemisinins?

A

Preggers and infants

112
Q

Chloroquine is the DOC for malaria in non-sever cases, but in high areas of resistance what can be given?

A

Mefloquine, malarone, anti-folates

113
Q

What are the 3 main drugs for prevention of malaria?

A

Doxy (no in children or preggers), mefloquine*, malarone

114
Q

Even though there is no effective malaria vaccine, what is the best shot they have at it and what are the problems right now with it?

A

Irradiated sporozoites… problems with cost and storage

HemOnc (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions