Malaria Flashcards

1
Q

Malaria organism

A

Plasmodium protozoa

  • P. falciparum (most severe)
  • P. vivax
  • P. ovale
  • P. malariae
  • P. knowlesi
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2
Q

Malaria vector

A

female Anopheles mosquito

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3
Q

MC way to acquire malaria

A

mosquito bite in endemic area (tropical and subtropical areas)

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4
Q

High risk groups for malaria infection

A
  • young children
  • pregnant women
  • travelers/migrants
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5
Q

Is malaria in the US??

A
  • 1,700 cases a year
  • Anopheles mosquito is in the US
  • risk of resurgence
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6
Q

4 ways Malaria is transmitted

A
  • bite from female Anopheles mosquito (MC)
  • Airport malaria: mosquito on plane from endemic to non endemic area
  • Congenital
  • Transfusion (rare in US)
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7
Q

Pathophysiology

A
  • two hosts: mosquito and human
  • Anopheles transmits plasmodia (in saliva) into host when bite
  • In human, parasite grow and multiply in liver and then RBC
  • in RBC, grow and destroy cells, release merozoites which invade other RBC
  • RBC cytolysis = release toxic metabolites = flulike sx for host
  • Some differentiate into gametocytes which are ingested by another Anopheles, grow and multiply into new sporozoites and get into saliva, start cycle over
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8
Q

P. Falciparum

A
  • Most severe
  • microvascular effects
  • only type can cause death if untx
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9
Q

P. vivax

A
  • Most West Africans have resistance dt lack of Duffy blood group on RBC so plasmodium cannot attach
  • generally causes less severe dz
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10
Q

P. ovale

A

Less common

- tertian pattern of fever: q 48 hour spikes

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11
Q

P. Malariae

A
  • may cause no acute sx
  • can lead to immune mediated nephritic or nephrotic syndomre
  • fever quartan pattern q 72 hours
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12
Q

P. knowlesi

A
  • SE asia
  • Monkey is intermediate **
  • rare but can cause dz in humans
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13
Q

Incubation

A
  • approx 4 weeks
  • vivax and ovale: weeks to months after initial infection, hypnozoite form (can linger in liver longer). Have to treat this stage separately
  • shorter incubation falciparum
  • longer incubation malariae
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14
Q

common S/sx

A
  • HA
  • fever, shaking chills, sweats (q48-72 hr depending on species)
  • cough
  • fatigue
  • malaise
  • arthralgia
  • myalgia
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15
Q

less common s/sx

A
  • anorexia/lethargy
  • n/v
  • diarrhea
  • jaundice
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16
Q

PE

A
  • splenic/liver enlargement
  • fever
  • mild jaundice
  • cerebral malaria (coma?)
  • anemia
  • resp abnl
  • renal failure
    • no rash or lymphadenopathy
17
Q

Dx

- general tests

A
  • history!! Travel
  • Labs: blood culture, CBC, iron panel, CMP, liver/renal fn tests, electrolytes, LDH
  • CXR if resp sx
  • CT if CNS sx
18
Q

Dx

- malaria specific tests

A
  • Giemsa stained peripheral blood smear. multiple smears needed
  • Rapid dx tests via dipstick
  • PCR assay (to confirm after blood smear)
19
Q

ABCDs of malaria

A
  • Awareness: recognize malaraia
  • Bite prevention: control mosquitoes, use a net
  • Chemo prophylaxis: use preventative meds
  • Dx: early recognition
20
Q

Malaria prevention

A
  • long clothing to reduce exposed skin (esp dusk to dawn)
  • topical repellants
  • other repellants
    • no chemoprophylaxis regime = 100% protection!!