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[malaria] Flashcards

1
Q
A

p. vivax
p. malariae
p. falciparum
p. ovale

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2
Q
A

P. malariae

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3
Q
A

7-10 days

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4
Q
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36-48 hours

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5
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A

Ovale

vivax

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6
Q
A

female anopheles

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7
Q
A

shivering (“feel cold”)
hot
sweats (as temperature falls)

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8
Q
A

synchronous release of merozoites from schizonts

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9
Q
A

G-6-PD lack
Sickle cell anaemia
Melanesian ovalocytosis (^haemolysis)
HLA-B53 alleles

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10
Q
A

Needed to produce anti-oxidant (glutathione)
Without it haemolytic anaemia occurs in times of oxidative stress
RBCs become imbalanced and are phagocytosed
Parasite destroyed.

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11
Q
A

X linked recessive

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12
Q
A

increased rate of phagocytosis

unsure

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13
Q
A

Headache
Myalgia
malaise
anorexia (+-)

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14
Q
A

Anaemia
Jaundice
Hepatosplenomegaly

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15
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A

Rash

Lymphadenopathy

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16
Q
A

Anaemia

thrombocytopenia

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17
Q
A 
Decreased conciousness (cerebral malaria)
convulsions
Co-existing chronic illnes
acidosis 
renal failure (ATN)
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18
Q
A

Serial thin and thick blood films

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19
Q
A

level of parasitaemia

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20
Q
A

ParaSight F

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21
Q
A

Ring with Schnuffners dots (multiple red dots) in RBC

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22
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A

sausage like in RBC

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23
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A

Band like forms across the RBC

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24
Q
A

anaemia

thrombocytopenia

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25
[malaria]: why would you check Clotting
DIC
26
[malaria]: why would you check glucose levels
hypoglycaemia
27
[malaria]: Why would you perform an ABG
Lactate levels
28
[malaria]: Why woulf you check U&Es
ATN/ renal function
29
[malaria]: Why would you perform urine analysis (3)
Haemoglobinuria ("blackwater fever") Proteinuria casts
30
[malaria]: How would you rule out septicaemia
Blood culture
31
[malaria][Tx]: P.falciparum is (as good as) resistant to what 2 drugs?
Chloroquine | Fansidar
32
[malaria][Tx]: Falciparum is resistant to Fancipar, what is in Fancipar? (2)
Pyrimethamine + Sulfadoxine
33
[malaria][Tx]: Would you Tx malaria with the same drug as used in prophylaxis?
NO
34
[malaria][Tx]: 1st line for Ovale, Malariae and Vivax; what is the 1st dose given?
1st dose : Chloroquine 10mg/kg (max 620mg)
35
[malaria][Tx]: 1st line for Ovale, Malariae and Vivax; what and when are the 2/3/4th doses given?
Chloroquine 5mg/kg (max 310mg) 6hrs, 24, 48 hrs
36
[malaria][Tx]: Ovale and Vivax require 14 days of concurrent drug Tx with chloroquine. Why do they need this?
prevent relapse by targeting liver stage
37
[malaria][Tx]: Ovale and Vivax 1st line is Chloroquine + ... for 14 days to treat liver stage?
Primaquine
38
[malaria][Tx]: Ovale dose of primaquine?
250 microg/kg (15mg max) 14 days
39
[malaria][Tx]: Vivax dose of primaquine?
500 microg/kg (30mg max) 14 days
40
[malaria][Tx]: 1st line for RESISTANT Ovale, Malariae and Vivax? (3)
Malarone Quinine Riamet
41
[malaria][Tx]: what is in malarone (2)
atovaquone | proguanil
42
[malaria][Tx]: BEFORE Tx of ovale, vivax or malariae what should you do? (2)
screen for G6PD deficiency | Pregnant?
43
[malaria][Tx]: What drug is CI in pregnancy which is used in the Tx of ovale, vivax or malariae
Primaquine
44
[malaria][Tx]: falciparum: 1st line Tx drug?
Riamet
45
[malaria][Tx]: what is in Riamet?
Artemether-lumefantrine
46
[malaria][Tx]: falciparum: a Riamet 4 tablet stat is given if patient is heavier than ...
35kg
47
[malaria][Tx]: falciparum: Describe the pattern of Riamet drug delivery in 1st line treatment if the pt. is >35kg
4 tablet stat 4 tablets at 8, 24, 36, 48, 60 hours
48
[malaria][Tx]: falciparum: when are the Riamet drugs given post the 4 tablet stat.
4 tablets at 8, 24, 36, 48, 60 hours
49
[malaria][Tx]: falciparum: What is contained in Coarsucam?
Artesunate-amodiaquine
50
[malaria][Tx]: falciparum: Coarsucam is 2nd in the 1st line for falciparum after Riamet, what is the dosing regimens?
2 pills/day for 3 days (adults)
51
[malaria][Tx]: falciparum: What is the dose of Coarsucam in those aged 13-17
1 pill/ day for 3 days
52
[malaria][Tx]: falciparum: Malarone regimens for falciparum?
4 tablets once daily for 3 days
53
[malaria][Tx]: falciparum: Artemisinin derived drugs are better than quinine derived. What would a quinine regimens be concurrently given with (2)
``` Quinine salt 600mg /8hrs + Doxycycline 200mg/24hrs OR Clindamycin 450mg/8hrs ``` all for 7 days
54
[malaria][Tx]: falciparum: when can you not use artemisinin derivatives in falciparum patients
Pregnant <13 weeks (1st trimester)
55
[malaria][Tx]: falciparum: If the patient is pregnant in 1st trimester what is the treatment regimens
Quinine salt 600mg /8hrs + Clindamycin 450mg/8hrs all for 7 days
56
[malaria][prophylaxis]: how lopng prior to travel should you take your prophylaxis
1 week (reveal SEs)
57
[malaria][prophylaxis]: how long after travel should you take prophylaxis
4 weeks
58
[malaria][prophylaxis]: which drugs do not require taking 1 week before travel (2)
Malarone | Mefloquine (18 days before )
59
[malaria][prophylaxis]: 1st line prophylactic if non-chloroquine resistant? (2)
Proguanil 200mg/24hrs + Chloroquine 300mg/week
60
[malaria][prophylaxis]: 1st line prophylactic if chloroquine resistant? i.e. falciparum (3)
``` Mefloquine 250mg/week OR Doxycycline 100mg/day OR atovaquine+ proguanil (malarone) 1tab/day ```
61
[malaria][prophylaxis]: How long prior to travel does mefloquine need to be taken
18 days
62
[malaria][prophylaxis]: if poor medical care and not pregnant is likely to be encountered what 2 standby treatments should you give.
malarone | Riamet
63
[malaria][SEs]: Primaquine?
Haemolysis if G6PD deficiency
64
[malaria][SEs]: Mefloquine? (3)
Neuropsychiatric signs nausea dizziness
65
[malaria][SEs]: when should you avoid mefloquine ? (3)
``` Family Hx of epilepsy/psychosis risk of pregnancy within 3 months of last dose Delicate work (pilots) ```
66
[malaria][SEs]: chloroquine? (2)
Psychosis | Retinopathy
67
[malaria][SEs]: Malarone? (3)
Abdominal pain nausea headache
68
[malaria][severefalci.]: when should you start antimalarials
ASAP
69
[malaria][severefalci.]: 1st line Tx for severe falciparum with swallowing difficulties?
Artesunate IV | if immediately available
70
[malaria][severefalci.]: 2nd line Tx with swallowing difficulties?
Quinine salt 20mg/kg IVI over 4hrs after 8 hours give: 10mg/kg IVI over 4 hours every 8 hours
71
[malaria][severefalci.]: Stop giving Tx IV and give orally as soon as the pt is ...
able to swallow
72
[malaria][severefalci.]: During tx what should you monitor for
Hypoglycaemia
73
[malaria][severefalci.]: 1st line Tx with no swallowing difficulties or CIs is?
Artemether-Lumefantrine (Riamet)
74
[malaria][severefalci.]: Tx for severe malaria is the same as tx for normal falciparum if.... (2)
the patient has no swallowing difficulties | no CIs
75
[malaria][severefalci.]: what are contraindications to Tx with normal anti-falciparum regimens? (4)
Poor swallowing Shock ARDS Renal failure
76
[malaria][cerebral]: If haemocrit is <...% you should crossmatch blood
20%
77
[malaria][cerebral]: why do you monitor for hypoglycaemia
Quinine causes hypogycaemia
78
[malaria][cerebral]: <20% haemocrit is indicative of what action?
Crossmatching blood
79
[malaria][cerebral]: Fluid requirements must be measured. What is the respiratory worry?
Pulmonary oedema
80
[malaria][cerebral]: Parasite count should be continually measured. After 48 hours what % decrease in count shoudl you expect?
75%
81
[malaria][cerebral]: Pulmonary oedema indicates?
Ventilation
82
[malaria][cerebral]: Renal failure indicates ?
Haemofiltration
83
[malaria][cerebral]: Tx for severe anaemia?
transfusion | not just cerebral
84
[malaria]: what is algid malaria
malaria characterised by severe hypotension and shock
85
[malaria]: you should treat algid malaria as if it is 2 different diseases. Malaria and ....
Bacterial shock

INFECTIOUS DISEASES (8 decks)

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