Malaria 2

Question 1

What are the symptoms of uncomplicated malaria?

Answer 1

Malaise, vomiting, headache, cyclical temperature change.

Question 2

Discuss Anemia and malaria (Complicated)

Answer 2

Reticulocyte production is delayed (greater than predicted on basis of parasitemia).
MUST CLEAR parasites from blood for rebound.

Question 3

Discuss Cerebral malaria (Complicated)

Answer 3

Altered consciousness, rapid onset.

Question 4

Discuss acidosis and malaria (complicated)

Answer 4

Kussmaul respirations, associated with elevated plasma and CSF lactate

Question 5

What must be ruled out before considering cerebral malaria?

Answer 5

Meningitis: Lumbar puncture
Severe Anemia: Hematocrit
Hypoglycemia: Blood glucose
Sepsis: Blood Culture

Question 6

In general, pts with uncomplicated disease take what route of treatment?

Answer 6

Oral agents; complicated pts use parenteral

Question 7

What life cycle stage does not cause systems?

Answer 7

Gametocytes

Question 8

What is the only effective medication against hynozoites?

Answer 8

Primaquine; Toxic in patients with G6PD deficiency

Question 9

Discuss Antimalarial drugs

Answer 9

Chloroquine: Widespread resistance
Sulfadoxine/Pyrimethamine: Single dose
Mefloquine: expensive 
Atovaquone/Proguanil: expensive
Quinine: bitter, 5-7 tx
Halofantrine: Risky cardiac side effects
Artimesins: BEST

Question 10

Discuss current tx for uncomplicated malaria

Answer 10

Artemisinin w/ primaquine (if ovale)

Chloroquine w/ primaquine (if vivax)

Question 11

Discuss current tx for complicated malaria

Answer 11

IV artesunate or quinine; complete with Artimesinin