Malaria Flashcards
Banana-shaped gametocytes
P.falciparum
Schuffner’s dots
P.vivax
P.ovale
Preference to senescent/older cells
P.malariae
Ability to relapse
P.vivax
P.ovale
(due to dormant hypnozoites)
Pathogenesis of malaria
Direct effects of RBC invasion and destruction by the asexual parasite and the host’s reaction
Merozoites invading the RBCs
Trophozoites
Trophozoite consuming 2/3 of the RBCs hemoglobin and grown to occupy most of the cell
Schizont
Survival of mosquito to adequately transmit malaria
7 days
MC measure of malaria transmission rate
Entomologic Inoculation Rate
Protection against death from falciparum malaria
Sickle cell disease Hemoglobin C and E Hereditary ovalocytosis Thalassemias G6PD deficiency
Ominous feature of falciparum malaria
Coma
MC ophathalmologic finding in cerebral malaria
Retinal hemorrhages
Convulsions in cerebral malaria
More than 2 generalized seizures in 24 hours
Drugs that causes hyperinsulinemic hypoglycemia in malaria (stimulates pancreatic insulin secretion)
Quinine
Quinidine
Best biochemical prognosticators in severe malaria
Plasma bicarbonate and lactate
Common renal manifestation in severe falciparum malaria
ATN
Poor prognosis in malaria
Liver dysfunction + another organ dysfunction
Treatment for transfusion malaria
Primaquine
no need for vivax and ovale
Malaria causing nephrotic syndrome
P.malariae
Diagnosis of malaria
Demonstation if ASEXUAL forms of parasite in stained PBS
(Romanowsky, Giemsa at 7.2)
thin and thick smears-concentrates parasites this increasing sensitivity
Level of parasitemia with inc risk of dying
> 105 parasites/L
Treatment for uncomplicated malaria
Chloroquine-sensitive: Chloroquine or Amodiaquine
Sensitive-falciparum: Artesunate + sulfadoxine/pyrimethamine
Radical treatment for Vivax or Ovale
Chloroquine/Amodiaquine + Primaquine
Primaquine: eradicates hepatic forms of Vivax and Ovale; kills gametocytes of Falciparum
Treatment for multidrug-resistant falciparum
Artemether-lumefantrine or Artesunate + Mefloquine or Dihydroartemisin-piperaquine
Treatment for severe malaria
Artesunate or Artemether or Quinine or Quinidine
Has a broader stage specificity and more rapid than other drugs
Artemisin and its derivatives
Drug causing massive hemolysis in patient with severe G6PD deficiency
Primaquine
Drug causing megaloblastic anemia and pancytopenia
Pyrimethamine
Only drug advised for pregnant women traveling to areas with drug-resistant malaria
Mefloquine
Malaria chemoprophylaxis
2 days-2 weeks prior to departure and continue up to 4 weeks after leaving the area; except Atovaquone-proganuil or primaquine can be discontinued after 1 week
