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Haematology > Malaria > Flashcards

Malaria Flashcards

1
Q

What is malaria?

A

A protozoan parasite that can infect humans

It is passed to humans via mosquitoes

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2
Q

Which mosquitoes transmit the protozoa to humans?

  • Species
  • Male or female
A

Anophales species

Female mosquitos

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3
Q

Name the types of parasitic protozoa that cause malaria?

A

Plasmodium falciparum
Plasmodium vivax
Plasmodium ovale
Plasmodium malariae

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4
Q

Describe the lifecycle of the malaria protozoa?

A

Mosquito bites human infecting them with protozoa (called sporozoites at this stage)

Multiply inside hepatocytes (called merozoites at this stage)

Hepatocytes rupture, merozoites released into bloodstream

Taken up by RBCs, they continue to multiply

Rupture the RBCs

Once in the blood, protozoa can be passed on to the next mosquito that bites that person,

This mosquito will then bite someone else, infecting them

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5
Q

Which is the most hazardous protozoa?

A

Plasmodium falciparum

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6
Q

Which protozoa(s) can result in a chronic illness?

A

Plasmodium malariae

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7
Q

Which protozoa(s) ca relapse?

A

Plasmodium vivax and ovale

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8
Q

How does the protozoa infection cause so much damage?

A

Ruptures hepatocytes: liver dysfunction

Ruptures erythrocytes: anaemia and release of pyrogens which cause fever

RBCs infected with protozoa adhere to endothelium of small vessels = vascular occlusion = organ damage

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9
Q

Why does fever occur in malaria?

A

Rupture of the RBCs by the protozoa causes release of pyrogens

Pyrogens cause pyrexia

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10
Q

Which organs are worse affected in malaria?

A

Liver
Gut
Kidney
Brain

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11
Q

How can P. vivax and ovale cause relapsing malaria?

A

The protozoa remain latent/dormant in the liver

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12
Q

Incubation period of protozoa?

A

10-14 days in all except malariae which can be 18 days to 6 weeks

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13
Q

Clinical features of malaria?

A 
Severe headache
Fever
Tachycardia
Rigors
Cough
Diarrhoea + vomiting
Hepatosplenomegaly
Anaemia

Cyclical cold/fever/sweating stages

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14
Q

What are some severe complications of malaria?

A

Cerebral malaria: when RBCs infected with protozoa cause occlusions in the brain

Blackwater fever: dark brown-black urine caused by severe intravascular haemolysis

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15
Q

Clinical features of cerebral malaria?

A 
Diminished consciousness
Confusion
Convulsions
Coma
Death
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16
Q

Some people are protected against some types of malaria. How?

A

Sickle cell trait, i.e. carrier of gene but not affected
- protection against P. falciparum

Duffy blood group negative RBCs are resistant to P. vivax

17
Q

Diagnosis of malaria?

A

Thin and thick blood films
3 separate films are usually needed

Look for protozoa
Calculate % RBCs affected

18
Q

Management of malaria?

A

Depends on type!

Complicated F. infection

  • IV quinine
  • IV artesunate

Uncomplicated F. infection

  • quinine PO
  • doxycycline

Non-F infection
- Chloroquinine PO

P. vivax + ovale
- Primaquine used to clear dormant infection

19
Q

Which protozoa is IV quinine used for?

A

Complicated falciparum infection

20
Q

Which protozoa is IV artesunate used for?

A

Complicated falciparum infection

21
Q

Which protozoa is PO quinine used for?

A

Uncomplicated falciparum

22
Q

Which protozoa is PO doxycycline used for?

A

Uncomplicated falciparum

23
Q

Which protozoa is chloroquinine used for?

A

Non-falciparum

24
Q

Which protozoa is primaquinine used for?

A

Dormant P. vivax and ovale

25
Q

At what stage of their cycle are sporozoites?

A

When they are in the mosquito and are just injected into the human

26
Q

At what stage of their cycle are merozoites?

A

When they are multiplying in the hepatocytes

27
Q

At what stage of their cycle are hypnozoites?

A

Dormant (P. vivax and ovale only)

28
Q

When you see a case of malaria, what do you need to do?

A

Notify public health england

29
Q

Prevention of malaria?

A

Mosquito nets, well covering clothing especially at night

Insect repellent

Prophylaxis medication

30
Q

Which prophylaxis medications are available?

A

Doxycycline

Malarone

Larium

31
Q

When are the prophylactic medications taken?

A

Usually 2 weeks prior to visiting endemic area

And 4 weeks after returning

Except malarone: 2 days prior and 7 days post

Haematology (9 decks)

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