malaria Flashcards

0
Q

What are the main types of plasmodium causing malaria

A

P. Falciparum and P. vivax

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1
Q

What organs are predominately affected in malaria

A

Brain, lungs and placenta

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2
Q

What is the difference in global distribution of P. Falciparum and P. Vivax

A

Falciparum - mostly central Africa

Vivax - mostly South America and Indonesia

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3
Q

Outcomes of malaria during pregnancy

A

Low birth weight
Still births
Miscarriage

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4
Q

Which type of plasmodium causes the most disease and which has a dormant liver stage

A

Most disease - falciparum

Liver stage - vivax

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5
Q

Which type of plasmodium can cross species infect

A

P. knowlesi

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6
Q

Explain the life cycle of malaria

A

Sporozoites Injected by Mosquitos –> travels to the liver where they replicate for 7-10 days –> burst out of the hepatocytes as merozoites –> infect red blood cells –> replicate to huge numbers = disease –> parasite becomes sexual form –> taken up again by Mosquitos

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7
Q

Malarial disease is only during which stage of infetion

A

Blood stage

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8
Q

Is malaria carried in female or male Mosquitos

A

Female

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9
Q

What are the symptoms of mild uncomplicated malaria

A

Flu like symptoms - fever, headache and malaise

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10
Q

What are the three main complications of severe malaria

A

Severe anaemia
Cerebral complications
Respiratory distress and metabolic acidosis

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11
Q

What are the cerebral complications of severe malaria

A

Convultions
Coma
Long term neurological deficits

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12
Q

What is the treatment for mild malaria

A

Short course of anti malarial tablets

Need extra drug (primaquine) if infected with P. vivax

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13
Q

What is the treatment of severe malaria

A
Anti malarials
Blood transfusion if required
IV saline
Supportive treatment 
Anticonvulsants and anticoagulants if needed
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14
Q

What is the run of the mill anti malarial drug

A

Artemisinin

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15
Q

What three things contribute to the development of severe malaria

A

Parasite accumulating in vital organs
Inflammation
Destruction of red blood cells

16
Q

What are the three main types of immunity against malaria

A

Immunity against severe malaria during early childhood
Immunity against any malaria
Immunity to malaria during pregnancy

17
Q

What are there parasite factors that contribute to having such a slow development of immunity against malaria

A

Multiple antigenic targets
Antigenic diversity
Antigenic variation

18
Q

What host factors contribute to having such a slow development of immunity against malaria

A
Inadequate response (especially in young children)
Non functional/irreverent immune response 
Poor development of memory responses
19
Q

How do antibodies contribute to the immune response for malaria

A

Neutralisation
Opsonisation for phagocytosis
Complement for lysis

20
Q

How does the cell mediated response contribute to the immune response to malaria

A

CD4 cells contribute to the activation of B cells and macrophages
CD8 cells to help combat intracellular pathogens
Activated macrophages

21
Q

What genetic factors contribute to immunity against malaria

A

Sickle cell anaemia - heterogenous
Beta-thalassemia
Blood groups

22
Q

What part of the immune system targets sporozoites

A

Antibodies and T cells

23
Q

What part of the immune system targets infected red blood cells

A

T cells

24
Q

What part of the immune system targets merozoites

A

Antibodies

25
Q

What parts of the immune system target infected red blood cells

A

Antibodies and T cells

26
Q

How do antibodies against sporozoites give us some immunity

A

Binding prevents infection of the hepatocytes

27
Q

What is the main way in which we provide immune response to the liver phase of malarial replication

A

Via CD8 T cells

28
Q

The majority of immune response to malaria occurs at what stage of malarial infection

A

Blood stage

29
Q

What are the cell mediated immune responses to the blood stage of malarial infection

A
  • CD4 T cells - for antibody and macrophage activation
  • Macrophage action to remove infected red blood cells via the spleen
  • IFN-gamma
30
Q

What are the antibody responses to the blood stage of malaria

A
  • antibodies against merozoites (prevent invasion, and antibody dependent-cell mediated inhibition of parasite growth)
  • antibodies against infected RBCs (opsonization for phagocytosis)
31
Q

what are the three strategies for a malaria vaccine

A
  1. action on sporozoites in the liver (antibodies, CD8 T cells blocking development in the liver, blocking entry into the blood)
  2. action on merozoites (block replication and entry into the blood cells)
  3. block the sexual stages of the parasite so it cant get into mosquitos