Malaria Flashcards
1
Q
Categories of malaria
A
- severe
- moderately severe
- uncomplicated malaria
2
Q
Non-drug measures to prevent malaria
A
- remain indoors
- wear long-sleeved clothing
- screen doorways and windows
- apply a DEET-containing repellent
- use mosquito mats and coils
- use insecticide-treated bed nets
- spray aerosol insecticide
- use ceiling fans/air conditioner
3
Q
Options for malaria chemoprophylaxis
A
- doxycycline
- mefloquine
- atovaquone-proguanil
4
Q
Management problems of malaria in Cape Town
A
- delay in presentation
- delay in diagnosis
- underassessment of disease severity
- choice of antimalarial
5
Q
Symptoms of uncomplicated malaria
A
- fever
- headache, lassitude, fatigue
- abdominal discomfort
- muscle and joint aches
- chills and perspiration
- anorexia and vomiting
- worsening malaise
6
Q
Symptoms of malaria in young children
A
- lethargy
- poor feeding
- vomiting, diarrhoea
- seizures
- sleepiness
- cough
- rapid respiration
7
Q
Choice of anti-malarial in uncomplicated malaria
A
Arthemisinin-based combination
- artemether + Lumefantrine = Coartem
8
Q
Contraindications for Coartem
A
- allergic
- <5kg
- pregnant in 1st trimester
- severe malaria
9
Q
Instructions for taking Coartem
A
- take all 6 doses over 3 days
- take with food or milk containing >1.2g of fat
- take fluids and paracetamol if needed
- expect response in 24-48 hours
- return if temp not settled y day 3
- return if vomiting or deteriorating
10
Q
Clinical features of severe malaria
A
- impaired consciousness
- severe weakness
- convulsions
- low BP
- resp distress
- visible jaundice
- macroscopic haematuria
- abnormal bleeding
11
Q
Laboratory features of severe malaria
A
- severe anaemia
- hypoglycaemia
- acidosis
- renal impairment
- hyperlactataemia
- hyperparasitaemia
- elevated BR
12
Q
Management of severe malaria
A
- rapid clinical assessment
- empiric glucose if LOC decreased
- urgent bloods
- parenteral Artesunate (preferred)/ Quinine
- transfer to highest level of care
- monitor constantly
- support failing organs
13
Q
Problems associated with quinine use
A
- needs a loading dose
- infusion rate often not controlled
- hypoglcaemia
14
Q
Dosing of IV quinine
A
- loading dose of 20mg/kg by slow IV infusion over 4 hours
- then 10mg/kg by slow intravenous infusion over 4 hours, repeated every 8 hours
- follow with coartem
15
Q
Organism that can cause severe malaria
A
P. falciparum
