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Heme/Lymph 1 > Malaria and Babesiosis > Flashcards

Malaria and Babesiosis Flashcards

1
Q

Most parasitic disease have

A

Acute and chronic phases

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2
Q

Types of hosts

A

Host - animal on or within a parasite can establish an infection
Definitive - adult phase or sexual reproductive phase occurs
Intermediates - larval or asexual phase of life cycle…obligatory for completion of life cycle
Accidental - Dead end and cannot reproduce

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3
Q

Periods of parasites

A

Incubation - time to symnptoms
Prepatent period - time to detection
Patent period - time during which detection can occur in the body

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4
Q

Malaria genus and transmission

A

Plasmodium

Anopheles mosquito

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5
Q

Species of malaria

A

Falciparum (most severe and causes most issues)
Vivax - most prevalent
Ovale
Malariae

Restricted to a single vertebrate host

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6
Q

Anopheles mosquito

A

Only the female can transmit
Bloodmeal needed for eggs
4-5 times during life they will lay eggs
Undergo sexual cycle completion in the mosquito

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7
Q

Life cycle of plasmodium

A

INfectious form - sporozoite from the mosquio
Then to liver (extraerythrocytic stage with no symptoms)…differentiate and form schizonts which produce merozoites…merozoites are what infect RBCs
Then to erythrocytic stage where symptoms occur…merozoites differentiate to ring stage…trophozoite increases mass by eating and undergoes mitosis without cytokineses…cytokinesis occurs to make RBC schizont…merozoites released and infectious to RBCs
A small subset will become gametocytes that will go back to mosquito to make sporozoites

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8
Q

Thick and thin blood smears

A

Thick requires more experience

Thin is longer but easier

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9
Q

Detection of malaria

A

Detection of erythrocytic stages establishes active infection
ID the species
History
Drug sensitivity/resistance profile
Can see ring stage with nucleus at head of the ring

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10
Q

Prepatent periods for each species

A 
Occurs in the liver...up until erythrocytic cycle commences 
Falcip - 6-12 days 
Vivax - 10-17 days
Ovale - 14 days 
Malariae - 28-35 days
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11
Q

Basic symptoms of erythrocytic malaria

A

High fever with periodicity defined by releasing of paraiste from blood cells

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12
Q

Tertain and Quartran malarias

A

Tertian - vivax and to a degree, falciparum

Quartran - malariae

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13
Q

Number of merozoites released from the liver

A

Correlates with severity of dz - falcip will have most and malariae has least

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14
Q

IMportant of hemoglobin for malaria

A

Where most nutrients come for parasitic growht in RBC

Hemoglobin degraded in the food or digestive vacuole…leaves behind toxic heme…detoxed by polymerizing into hemozoin (malarial pigment)

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15
Q

Chloroquine target

A

Heme polymerization and its inhibition

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16
Q

Plasmodia modification to cell membrane and cytosol

A

Cell membrane - Knobs that have adhesive ability to bind endothelial cells…important in cerebral malaria

Cytosol - TVN and maurers clefts

17
Q

Plasmodium falciparum

A

Incubation of 8-24 days
Pre-patent - 5-12 days
Patent - 4-6 weeks (treated), 18 months (untreated)

Relapses due to erythrocytic stage

Tertian malaria but not always exactly

Infects mature erythrocytes (50,500000 parasites/mL)
As many as 2.5 million

18
Q

P falcip symptoms

A

Headache
Coma and death can occur in 24 hours
Can cause cerebral malaria - plasmodium infected erythrocytes stick to capillaries and other RBCs…blockage of blood vessels leads to coma and death

19
Q

Adhesive properties of cerebral malaria

A

Knob parasite proteins PfEMP-1 (Var family)

Exhibit antigenic variation which challenges immune system

20
Q

P falcip in pregancny

A

Blocks placental circulation to the fetus
Cannot cross the barrier like Toxo gondii
Risk highest for first pregnancy
LEad to fetal anoxia, fetal edema, or abortion after 1st trimester

21
Q

Renal and P falcip

A

Blackwater fever with anoxia and acidosis
Hemoglobinuria
Acute renal failure
Mortality - 20-30%

22
Q

P vivax

A 
Rarely fatal
Regular tertian pattern
Incubation - 12-18 days
Prepatent - 8-17 days
Patent - 5-7 years

High potential of rescrudence…due to liver stages (dormant liver schizonts called hypnozoites)

23
Q

P vivax blood smear

A

Parasitemia is lower at 20,000/ mL
Infects reticulocytes more often

Enlarged, schauffners dots, and rings

P ovale is similar to P vivax

24
Q

P malariae

A

Old erythrocytes
Very long patent period
Reactivation in heptaocytes
Quartan pattern for fevers

25
Q

Quinine and chloroquine

A

Block hemozoin ofrmation…attacks erythrocytic stages
Resistance is problem
Used for prophylaxis

26
Q

Mefloquine

A

Only in regions with chloroquine and drug resistant forms
Neuro complications???
Erythrocytic cycle

27
Q

Pyrimethamine and sulfonamides

A

Uncomplicated malaria…don’t used in SE asia of S america

28
Q

Proguanil

A

Component of combination therapy to retard resistance

29
Q

Doxyclyclin and clindamycin

A

Target the apicoplast (used in combo with others)

30
Q

Arteminisin/quinhousu

A

Last resort in cerebral malaria…high reactivation rates

31
Q

Atovaquone

A

Mitochondrial respiration in blood stages

32
Q

Primaquine

A

Only one for liver stages

Used to prevent reactivation of all but P falciparum

33
Q

Babesia

A

Use mammals as IM hosts
Transmitted by ixodes ticks (same as lyme dz)
No liver stage
Divide by binary fission

34
Q

Bebesia infection in humans

A

B microti
Asymptomatic mostly but splenomectomised patients are at highest risk
Between May and Septmeber
Symptoms - fever, generalizxed flu
Incubation - 1-4 weeks, prepatent - 1 weeks
Diagnosis - blood smear
Tx - can used quinine/clindamicin or atovaquone/azithromycin but normally self resolving

35
Q

What to look for on smear of babesia

A

Maltese cross

Heme/Lymph 1 (14 decks)

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