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INFECTIOUS DISEASES > [malaria] > Flashcards

[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
A

36-48 hours

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5
Q
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
Q
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
Q
A

sausage like in RBC

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23
Q
A

Band like forms across the RBC

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24
Q
A

anaemia

thrombocytopenia

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25
Q
A

DIC

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26
Q
A

hypoglycaemia

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27
Q
A

Lactate levels

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28
Q
A

ATN/ renal function

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29
Q
A

Haemoglobinuria (“blackwater fever”)
Proteinuria
casts

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30
Q
A

Blood culture

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31
Q

[malaria][Tx]: P.falciparum is (as good as) resistant to what 2 drugs?

A

Chloroquine

Fansidar

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32
Q

[malaria][Tx]: Falciparum is resistant to Fancipar, what is in Fancipar? (2)

A

Pyrimethamine
+
Sulfadoxine

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33
Q

[malaria][Tx]: Would you Tx malaria with the same drug as used in prophylaxis?

A

NO

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34
Q

[malaria][Tx]: 1st line for Ovale, Malariae and Vivax; what is the 1st dose given?

A

1st dose : Chloroquine 10mg/kg (max 620mg)

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35
Q

[malaria][Tx]: 1st line for Ovale, Malariae and Vivax; what and when are the 2/3/4th doses given?

A

Chloroquine 5mg/kg (max 310mg)

6hrs, 24, 48 hrs

36
Q

[malaria][Tx]: Ovale and Vivax require 14 days of concurrent drug Tx with chloroquine. Why do they need this?

A

prevent relapse by targeting liver stage

37
Q

[malaria][Tx]: Ovale and Vivax 1st line is Chloroquine + … for 14 days to treat liver stage?

A

Primaquine

38
Q

[malaria][Tx]: Ovale dose of primaquine?

A

250 microg/kg (15mg max) 14 days

39
Q

[malaria][Tx]: Vivax dose of primaquine?

A

500 microg/kg (30mg max) 14 days

40
Q

[malaria][Tx]: 1st line for RESISTANT Ovale, Malariae and Vivax? (3)

A

Malarone

Quinine
Riamet

41
Q

[malaria][Tx]: what is in malarone (2)

A

atovaquone

proguanil

42
Q

[malaria][Tx]: BEFORE Tx of ovale, vivax or malariae what should you do? (2)

A

screen for G6PD deficiency

Pregnant?

43
Q

[malaria][Tx]: What drug is CI in pregnancy which is used in the Tx of ovale, vivax or malariae

A

Primaquine

44
Q

[malaria][Tx]: falciparum: 1st line Tx drug?

A

Riamet

45
Q

[malaria][Tx]: what is in Riamet?

A

Artemether-lumefantrine

46
Q

[malaria][Tx]: falciparum: a Riamet 4 tablet stat is given if patient is heavier than …

A

35kg

47
Q

[malaria][Tx]: falciparum: Describe the pattern of Riamet drug delivery in 1st line treatment if the pt. is >35kg

A

4 tablet stat

4 tablets at 8, 24, 36, 48, 60 hours

48
Q

[malaria][Tx]: falciparum: when are the Riamet drugs given post the 4 tablet stat.

A

4 tablets at 8, 24, 36, 48, 60 hours

49
Q

[malaria][Tx]: falciparum: What is contained in Coarsucam?

A

Artesunate-amodiaquine

50
Q

[malaria][Tx]: falciparum: Coarsucam is 2nd in the 1st line for falciparum after Riamet, what is the dosing regimens?

A

2 pills/day for 3 days (adults)

51
Q

[malaria][Tx]: falciparum: What is the dose of Coarsucam in those aged 13-17

A

1 pill/ day for 3 days

52
Q

[malaria][Tx]: falciparum: Malarone regimens for falciparum?

A

4 tablets once daily for 3 days

53
Q

[malaria][Tx]: falciparum: Artemisinin derived drugs are better than quinine derived. What would a quinine regimens be concurrently given with (2)

A 
Quinine salt 600mg /8hrs 
\+
Doxycycline 200mg/24hrs
OR
Clindamycin 450mg/8hrs

all for 7 days

54
Q

[malaria][Tx]: falciparum: when can you not use artemisinin derivatives in falciparum patients

A

Pregnant <13 weeks (1st trimester)

55
Q

[malaria][Tx]: falciparum: If the patient is pregnant in 1st trimester what is the treatment regimens

A

Quinine salt 600mg /8hrs
+
Clindamycin 450mg/8hrs

all for 7 days

56
Q

[malaria][prophylaxis]: how lopng prior to travel should you take your prophylaxis

A

1 week (reveal SEs)

57
Q

[malaria][prophylaxis]: how long after travel should you take prophylaxis

A

4 weeks

58
Q

[malaria][prophylaxis]: which drugs do not require taking 1 week before travel (2)

A

Malarone

Mefloquine (18 days before )

59
Q

[malaria][prophylaxis]: 1st line prophylactic if non-chloroquine resistant? (2)

A

Proguanil 200mg/24hrs
+
Chloroquine 300mg/week

60
Q

[malaria][prophylaxis]: 1st line prophylactic if chloroquine resistant? i.e. falciparum (3)

A 
Mefloquine 250mg/week  
OR
Doxycycline 100mg/day
OR
atovaquine+ proguanil (malarone) 1tab/day
61
Q

[malaria][prophylaxis]: How long prior to travel does mefloquine need to be taken

A

18 days

62
Q

[malaria][prophylaxis]: if poor medical care and not pregnant is likely to be encountered what 2 standby treatments should you give.

A

malarone

Riamet

63
Q

[malaria][SEs]: Primaquine?

A

Haemolysis if G6PD deficiency

64
Q

[malaria][SEs]: Mefloquine? (3)

A

Neuropsychiatric signs
nausea
dizziness

65
Q

[malaria][SEs]: when should you avoid mefloquine ? (3)

A 
Family Hx of epilepsy/psychosis
risk of pregnancy within 3 months of last dose
Delicate work (pilots)
66
Q

[malaria][SEs]: chloroquine? (2)

A

Psychosis

Retinopathy

67
Q

[malaria][SEs]: Malarone? (3)

A

Abdominal pain
nausea
headache

68
Q

[malaria][severefalci.]: when should you start antimalarials

A

ASAP

69
Q

[malaria][severefalci.]: 1st line Tx for severe falciparum with swallowing difficulties?

A

Artesunate IV

if immediately available

70
Q

[malaria][severefalci.]: 2nd line Tx with swallowing difficulties?

A

Quinine salt 20mg/kg IVI over 4hrs

after 8 hours give:
10mg/kg IVI over 4 hours every 8 hours

71
Q

[malaria][severefalci.]: Stop giving Tx IV and give orally as soon as the pt is …

A

able to swallow

72
Q

[malaria][severefalci.]: During tx what should you monitor for

A

Hypoglycaemia

73
Q

[malaria][severefalci.]: 1st line Tx with no swallowing difficulties or CIs is?

A

Artemether-Lumefantrine (Riamet)

74
Q

[malaria][severefalci.]: Tx for severe malaria is the same as tx for normal falciparum if…. (2)

A

the patient has no swallowing difficulties

no CIs

75
Q

[malaria][severefalci.]: what are contraindications to Tx with normal anti-falciparum regimens? (4)

A

Poor swallowing
Shock
ARDS
Renal failure

76
Q

[malaria][cerebral]: If haemocrit is <…% you should crossmatch blood

A

20%

77
Q

[malaria][cerebral]: why do you monitor for hypoglycaemia

A

Quinine causes hypogycaemia

78
Q

[malaria][cerebral]: <20% haemocrit is indicative of what action?

A

Crossmatching blood

79
Q

[malaria][cerebral]: Fluid requirements must be measured. What is the respiratory worry?

A

Pulmonary oedema

80
Q

[malaria][cerebral]: Parasite count should be continually measured. After 48 hours what % decrease in count shoudl you expect?

A

75%

81
Q

[malaria][cerebral]: Pulmonary oedema indicates?

A

Ventilation

82
Q

[malaria][cerebral]: Renal failure indicates ?

A

Haemofiltration

83
Q

[malaria][cerebral]: Tx for severe anaemia?

A

transfusion

not just cerebral

84
Q
A

malaria characterised by severe hypotension and shock

85
Q
A

Bacterial shock

INFECTIOUS DISEASES (8 decks)

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