Malaria Flashcards
What is the type of mosquitoes that cause malaria here?
Anopheles
What is the causative agent of malaria?
Plasmodium spp.
What are the five species of plasmodium
Falciparum Vivax Malariae Ovale Knowlesi
Where is falciparum found?
World wide
Where is vivax found?
Sub-saharan africa
Where is p. malariae found?
World wide
Where is p. ovale found?
Africa
Where is p. Knowlesi found?
Malaysia
Most cases of malaria are caused by what two strains?
P. Falciparum
P. Vivas
What is the general life cycle of malaria?
Hepatocytes, then RBCs
What are the two forms of malaria that can lie dormant in the liver for years at a time?
Vivax
Ovale
What is malarial paroxysm?
Synchronous release of malarial parasites, destruction of RBCs causing the symptoms of malaria
What are the three stages of malaria?
cold stage (rigors, dry skin) Hot stage (HA, palps, confusion) Sweat stage
What are the strains of malaria that cause symptoms every 48 hours?
vivax
Ovale
Falciparum
What are the strains of malaria that cause symptoms every 72 hours?
Malariae
What is the blood disease that prevents infection with malaria falciparum?
Beta thalassemia
What are the strains of malaria that cause symptoms every 24 hours?
Knowlesi
What is the incubation period for falciparum?
1-2 weeks
What is the most severe complication with falciparum malaria?
Cerebral malaria–red cells get sticky, and bind to endothelial cells, causing decreased organ perfusion
True or false: jaundice is never a symptom of malaria
False–falciparum can cause this
What are the primary symptoms of vivax/ovale infx?
flu like
What is the most serious complication of vivax/ovale?
Splenic rupture
What is the incubation period for vivax/ovale?
2-3 weeks
What is the incubation period of malariae?
3-6 weeks
What is symptomatic recrudescence?
Hard to see low level or replication of malariae, so can recur
What is the most common complication of malaria?
Anemia
What are the three mechanisms that are involved in the pathogenesis of malaria?
- RBC lysis by parasite
- Suppression of erythropoiesis (TNFa, IL1)
- Destruction of RBCs by spleen
Why is plasmodium falciparum one of the most dangerous?
No preference for RBCs
What are the blood cells that vivax and ovale infx?
Reticulocytes
What are the blood cells that malariae infx?
Old RBCs
What are the three major side effects of plasmodium?
Splenomegaly
Hypoglycemia
Cerebral malaria
What are the two cytokines that are circulating when RBCs lyse with malaria? How does this affect glycemic levels?
TNFalpha
IL1
Inhibits gluconeogenesis
What is the gold standard for diagnosing malaria?
PBS
What are the histological findings of falciparum?
Purple bananas
What are the histological findings of vivax and ovale?
Bloated RBCs
Schuffner dots
What are the histological findings of malariae?
Band forms
NO stippling
What are the diseases that protect pts from malaria?
Sickle cell
Thalassemia
G6PD deficiency
True or false: drug resistance to malaria is a major concern
True
What is babesiosis?
Babesia parasite transmitted by ticks that normally fed on rodents
What are the symptoms of babesiosis?
Fever, chills, myalgias
Hemolytic anemia
True or false: most cases of babesiosis are asymptomatic
True
Who are the people are susceptible to babesiosis?
Elderly, asplenic
Immunosuppressed
What are the histological characteristics of babesiosis?
Maltese cross
What is the treatment for babesia?
Quinine and clindamycin
Most drugs against malaria target what?
Asexual blood forms
What does clinical cure mean vs radical cure?
Clinical = feel better Radical = total destruction of parasite
What is the drug that kills malaria? How useful is this?
Chloroquine
High resistance rates
Where is chloroquine still effective?
West of the panama canal
What is the therapeutic to toxic ratio of quinine?
Poor
What is the major side effect of quinine?
Hypoglycemia
Cinchonism
What is the derivative form of quinine?
Mefloquine
What is the abx that is useful against malaria?
Doxycycline
What are the major side effects of doxycycline?
photosensitivity dermatitis
What is the drug that kills the liver forms of malaria?
Primaquine
What are the major toxicities of primaquine?
RBC lysis with G6PD deficiency
What disease should you screen for before giving primaquine?
G6PD deficiency
When is primaquine administered?
After clinical cure achieved with other antimalarial
What are the two drugs that are combined in malarone?
Atovaquone
Proguanil
What is the prophylaxis treatment for malaria without chloroquine resistant plasmodium?
Chloroquine
What is the prophylaxis treatment for malaria with chloroquine resistant plasmodium?
Mefloquine, malarone, doxycycline
What are the adverse effects of mefloquine?
CNS effects
What is the treatment for babesiosis?
Quinine and clindamycin