Malaria

Question 1

Malaria parasite infects liver cells and _____ cells

Answer 1

Red blood

Question 2

The asexual life cycle of malarial parasite occurs in _____

Answer 2

Humans

Question 3

The sexual life cycle and the definitive host of the malaria parasite is the _____

Answer 3

Mosquito

Question 4

90% of cases of malaria infection occur in Africa and the main population that dies are _______

Answer 4

Children

Question 5

The females anopheles sp. of mosquito takes what what kind of meals?

Answer 5

Blood

• the major vector is female!

Question 6

Where in the body of a human is the first place that the malaria parasite travels?

Answer 6

Liver

Question 7

When the malaria parasite is in the liver, does the host show symptoms of infection?

Answer 7

No

Question 8

______ (life stage) travel to the liver through the lymphatics and blood

Answer 8

Sporozoites

Question 9

When the malaria parasite erupts from the liver, it enters into what cell type next and undergoes asexual stage of replication. This stage is then symptomatic and associated with the disease state.

Answer 9

Red blood cells

Question 10

Malaria merozoites enter _____ cells

Answer 10

Red blood

Question 11

In the red blood cells the malaria merozoites matures into the ring structure —> trophozoite–> _____ and then that ruptures and forms gametocytes that are infectious

Answer 11

Schizont

Question 12

Plasmodium ____ is the most deadly cause of malaria

Answer 12

Falciparum

Question 13

Plasmodium ____ and ____ infects reticulocytes only

all causes of malaria

Answer 13

Vivax; Ovale

• falciparum
• vivax
• ovale
• malariae
• knowlesi

Question 14

Plasmodium _____ infects all RBC and this is likely the reason that is is most deadly

Answer 14

Falciparum

Question 15

Plasmodium vivax and ____ have dormant stages (hyponozoites)

Answer 15

ovale

Question 16

Plasmodium malariae infects [new/old] RBCs

Answer 16

Old

Question 17

Plasmodium ____ has the longest asexual period inside of a human host (72 hrs)

Answer 17

Malariae

Question 18

Where does the prepatent period of malaria infection occur and is it symptomatic or asymptomatic?

Answer 18

Liver; asymptomatic (7-14 days)

Question 19

Periodic fever, nausea, vomiting, chills, malaise, etc. may be seen in what stage of infection with malaria?

Answer 19

Paroxysm

Question 20

Paroxysm occurs when merozoites burst from _____ cells

Answer 20

Red blood

Question 21

Acute febrile illness is seen in malaria after the ____ burst from red blood cells

Answer 21

Merozoites

Question 22

Severe malaria is almost always due to Plasmodium _____

Answer 22

Falciparum

Question 23

Symptoms of severe malaria include cerebral malaria (coma, seizures, etc.), severe ____, and multi organ failure

Answer 23

Anemia

Question 24

Plasmodium falciparum protein PfEMP1 binds to ___ on the surface of red blood cells and platelets

Answer 24

CR1

Question 25

Plasmodium falciparum protein PfEMP1 binds ____ on the cerebral microvascular endothelium

Answer 25

ICAM-1

Question 26

Plasmodium falciparum protein PfEMP1 binds ____ on placental microvascular endothelium leading to [low/high] birth weight and premature death

Answer 26

CSA; low

Question 27

Plasmodium falciparum protein PfEMP1 binds ____ on tissue microvascular endothelium leading to mild malaria

Answer 27

CD36

Question 28

Plasmodium falciparum causes clogging of the ______

Answer 28

Microvasculature

Question 29

Humans host immune response is what causes more of the symptoms of malaria. Plasmodium falciparum is unique in that it actually ____ red blood cells

Answer 29

Restructures

Question 30

Women pregnant for the first time (primigravida) are at a [higher/lower] risk of infections with Plasmodium falciparum

Answer 30

higher; they do not have immunity

Question 31

Plasmodium falciparum turn on the genes VAR2CSA to promote cytoadherance to the placenta by binding to ____ and that leads to ___ birth weights

Answer 31

CSA; low

Question 32

In a woman who has Plasmodium falciparum expressing VAR2CSA and is pregnant for the third time may be immune bc she can produce _____ to the VAR2CSA protein

Answer 32

Antibodies

Question 33

Malaria kills children in 3 ways:

Answer 33

1. Infection in pregnancy (low birth wt, premature)2. Acute febrile illness (cerebral malaria, respiratory distress, hypoglycemia)3. Chronic repeated infections (severe anemia)

Question 34

In places with low immunity to malaria, who is at risk of having serious disease?

Answer 34

Children and adults due to them not having a lot of continual infectious bites

Question 35

In areas of high immunity (Sub-Saharan Africa, Papua New Guinea), people may be bit more than 100 times per year. Infections in adults are usually[symptomatic/asymptomatic]

Answer 35

Asymptomatic

Question 36

Children under the age of ___ may become seriously ill from malaria in places of high immunity

Answer 36

5

Question 37

In areas of [high/low] immunity, adults must be continually exposed to infectious bites to be semi-immune

Answer 37

high

Question 38

What are some mechanisms that humans have evolved to have to protect from severe malaria infection?

Answer 38

Sickle cell trait and G6PD deficiency, thalassemia

Question 39

Loss of this receptor in people in Africa means that infection with Plasmodium vivax is less severe and there is increased resistance to infection

Answer 39

Duffy antigen receptor for chemokines (DARC)

Question 40

Ovalocytosis causes a rigid membrane in the ____ cells and that inhibits invasion of malaria parasites

Answer 40

Red blood

Question 41

What are the 3 main genetic resistance mechanisms that people in Africa have developed over time to create an inhospitable red blood cell for malaria to grow in?

Answer 41

- Sickle cell trait- G6PD deficiency- Thalassemia

Question 42

Relapse of infection with Plasmodium vivax (and ovale) occurs due to the dormant stage in the _____

Answer 42

Liver

Question 43

Liver stages can only be treated with ______

Answer 43

Primaquine

Question 44

Primaquine causes hemolytic anemia in people with ____ deficiency

Answer 44

G6PD

Question 45

What are 2 ways to diagnose malaria?

Answer 45

- Blood smear- Rapid diagnostic tests (RDTs)

Question 46

Rapid Diagnostic Tests are the gold standard to diagnosing malaria. In ____ there is resistance occurring that may be detrimental

Answer 46

Eritrea

Question 47

Insecticide treated bed nets (ITNs) have an average decrease in child mortality of __%

Answer 47

20

Question 48

Indoor residual spraying (IRS) is effective only if there is an infrastructure to spray. What is the main chemical that is sprayed that targets female anopheles mosquitoes when the land on a surface?

Answer 48

DDT

Question 49

Bark of cinchona tree =

Answer 49

quinine

Question 50

Treatment of malaria began with Quinine --> Chloroquinine and Mefloquinine ---> _____ --> Artemisinin combo therapies (Coartem)

Answer 50

Fansidar

Question 51

What is the treatment for Falciparum?

Answer 51

Artemisinin combo therapy (ACT)

Question 52

What are the treatments for Vivax?

Answer 52

Chloroquine, Artemisinin combo therapy (ACT) if there is chloroquine resistance; have to watch the people with G6PD deficiency bc they cannot be treated with primaquine

Question 53

Artemisinin combo therapy (ACT) is derived from ________ and is fast acting so need to use in combo with long acting drug such as mefloquine to treat malaria

Answer 53

Chinese herbal remedy

Question 54

RTS,S vaccine has an efficacy of __% against malaria and is in stage 3

Answer 54

30

Question 55

"Money is the best anti_______"

Answer 55

malarial