Malaria/Test 2 Flashcards
What is the only species of malaria that can use animals as a vector?
Knowlesi
Where do merozoites transform into trophozoites?
RBCs
What are the two most common species of malaria?
vivax and ovale
Many of the symtpoms of malaria are thought to be caused by what cytokine?
TNF
What two cytokines inhibit erythropoiesis in malaria infected people?
TNF and IL1
Which two species of malaria infect both mature and young erythroctes?
falciparum and knowlesi
Which two species of malaria infect only young erythroctes?
vivax and ovale
Which species of malaria prefers older erythrocytes?
Malariae
The most severe form of anemia is caused by what species of plasmodium?
Falciparum
What are the two metabolic symptoms of Plasmodium infection?
hypoglycemia and lactic acidosis
What anti-malarial drug can release insulin? In what species could this cause a deleterious effect?
Quinine
falciparum
What is the most serious side effect of Vivax and Ovale infection?
splenic rupture
Which species of malaria causes RBCs to produce knobs? What is the effect of this?
Falciparum
adhere to microvascular endothelium
What are the three most common complications of falciparum malaria?
renal failure
pulmonary edema
cerebral edema
Vivax uses what RBC protein to gain access? What two population groups express this protein?
Duffy antigen
Caucasians and and Asians
What antibiotic is used to treat malaria?
Doxycycline
What two species are resistant to Chloroquine?
falciparum and vivax
Which anti-malarial is equally effective for all plasmodium species?
Mefloquine
Primaquine is effective against which two species?
vivax and ovale
In what patient group is primaquine contraindicated?
G6PDase deficiency
What drug is most effective in the Tx of Falciparum?
Malarone
What does clinical cure mean?
eradication of erythrocytic forms of malaria
What does radical cure mean?
elimination of hypozite of vivax and ovale
Babesiosis is carried by what organism?
Tick
Does Babesiosis effect animals?
yes
What are the two most common babeiosis species?
microti
divergens
What genus of tick carries babeoisis?
Lxodes
What three patient populations are at risk of babesiosis?
elderly, asplenic, immunocompromised
Does sexual reproduction of Babesia occur in the tick or human?
tick
What two drugs are used to treat babeoisis?
Quinine and Clindamycin
What genus of species transmits malaria?
Anopheles
Where is Knowlesi found?
Malaysia
How often does Plasmodium Malariae present with symptoms?
every 72 hours
What stage of replication of plasmodium destroys RBCs in humans?
asexual
Lack of which antigen on RBCs can confer resistance to plasmodium?
Duffy
Maltese cross = ?
Babesia
Where is the use of chloroquine recommended?
west of panama canal
What is the only drug that can kill the liver forms? What species?
Primaquine
vivax and ovale
Are there differences in clinical outcome of new blood vs. old blood ?
nope
What is the best strategy, restrictive or non-restrictive? What does this mean?
restrictive
wait until Hb is low to transfuse
What is the most common reason to leukoreduce?
CMV
How many RBC units in the US have been leukoreduced?
all
What is irradiation used for?
to prevent graft versus host disease
In what patient type is it necessary to irradiate?
immunocompromised
When is volume reduction used?
circulatory overload
When is plasma given?
when you want to replease coagulation factors
What does platelet refractoriness mean?
pt’s receiving platelets may make antibodies to platelets
What are the four components of cryoprecipitate?
vWF, fibrinogen, 8 and 13
Which four factors are found in prothrombin complex concentrate?
two, seven, nine and ten
What is a normal WBC count in newborns?
9K - 30K
AML presents most often in what age group?
adults
What is more common, BALL or TALL?
BALL
Are ALL seen more common in children or adults?
children
What is the average age of Dx for CLL?
70
What is a normal Hb level for a 6-month old?
11.5 mg/dL
At what age should a child and adults Hb be roughly the same?
Age 12
How often do Vivax and ovale cause fever?
every 48 hrs
How often does Knowlesi cause fever?
24 hours
What is the name for the characteristic appearance of vivax and ovale in infected RBCs?
Schuffner dots
What does P. malariae look like in an infected RBC?
band
What two animals serve as a reservoir for ticks?
cattle and rodents
What are the two side effects of quinine?
cinchocism and hypoglycemia
What drug is used in the replacement of chloroquine?
Mefloquine
What antibacterial can be used for malaria?
doxycycline
What are the two major side effects of doxycycline?
staining of the teeth
photosensitivity
What immunoglobulin can cross the placenta?
IgG
What is the function of H-antigen?
precursor antigen for A and B
What is the antigen of type A blood?
N-acetylgalactosamine
What is the antigen of type B blood?
galactosamine
Around what week of fetal life do antigens develop?
6th week
When do ABO antibodies develop?
6th month of life
What deficiency is a reason to wash RBCs?
IgA deficiency
What three diseases are cryoprecipitate used?
Hemphilia A
vWF deficiency
Factor XIII deficiency
When is the transfusion of blood best indicated?
massive trauma
What is the result of a febrile transfusion reaction?
almost always benign
What is the most common cause of febrile transfusion reaction?
cytokines being released by leukocytes
What medicine is given to avoid a febrile transfusion rxn?
acetaminophen
What are the two most often reasons for an allergic transfusion reaction?
plasma
platelets
An anaphylactic rxn to a transfusion is most often caused by what deficiency? Does pretreatment work in these patients?
IgA
no
What are the two most common signs of TACO?
increased BP and HR
TRALI is most often caused by what two components of blood?
platelets and plasma
What is the timespan for TRALI?
within six hours
What is the treatment for TRALI?
O2
What should not be given during TRALI? What is given?
diuretic
pressors
What is the common antibody responsible for hemolytic anemia?
anti-Kidd
What does Rho-GAM do?
bind to RH antigen on baby’s cells
In a child, when is WBC highest?
at birth
An I:T ratio greater than what indicates a risk of sepsis?
0.20
Why are Hb and HCT high at birth?
High affinity of HbF is interpreted as hypoxia and EPO is released
What are normal Hb values for a newborn?
14-22
What is the definition of polycythemia in an infant ?
greater than 65%
Does polycythemia need to be taken from a venous or arterial sample?
venous
What is the lifespan of RBCs in a newborn?
80 days
What is a nadir ?
trough of HB concentration
When is nadir usually reached?
6-8 weeks
What is the equation for the low-end of MCV in children under 10?
70 + age
What is the equation for the high-end of MCV in children under 10?
84 + (0.6*age)
What type of milk can cause a folate deficiency?
goat
What is the most common cause of iron deficiency anemia in an infant?
excessive milk intake
What causes Diamond Blackfan anemia?
congenital abnormality in ribosomal protein synthesis
What is the Tx of iron overload in infants?
deferoxamine
Which species causes the highest parasitemia?
falciparum
Does TRALI have hypertension or hypotension?
hypotension
What blood component is most likely to contain bacteria?
platelets
Does TACO present with fever?
no
What are the two mutations in essential thrombocytosis? What cell is over-produced?
JAK2 and MPL
megakaryocytes
What are the two mutations in primary myelofibrosis?
JAK2 and MPL
Is the reticulocyte count high or low in TEC?
low
Is the reticulocyte count high or low in DBA?
low
What is increased during DBA?
HbF
WHat drug is given to treat DBA?
prednisone
What species of malaria can remain dormant for years?
vivax and ovale
Which species of malaria can only infect RBCs containing Duffy antigens?
Vivax
What form of malaria does chloroquine kill?
intra-erythrocytic
In what two patient populations is doxycycline contraindicated?
children and pregnant women
Do RBC carbohydrate antigens tend to stimulate IgG or IgM?
IgM
Do RBC protein antigens tend to stimulate IgG or IgM?
IgG
What is the anitgen of H-antigen?
H-antigen
How long can a febrile rxn take place after a transfusion?
up to 4 hours
At what age does Hb reach adult levels?
two years
What is the treatment for TEC?
supportive
What dietary supplement is given during sickle cell disease?
folic acid
What is the most fatal cancer?
lung
What is the most important prognostic criteria for cancer?
staging
Why can malaria cause hypoglycemia?
induced insulin release from pancreas
Which malarial species likes to consume blood glucose?
falciparum
Which malarial species likes to consume blood glucose?
falciparum
Is glycophorin A an IgG or IgM antigen?
IgM
Is glycophorin A an IgG or IgM antigen?
IgM
Is glycophorin B an IgG or IgM antigen?
IgG
What sugar is present in H-antigen?
fucose
What happens sooner, TACO or TRALI?
TACO
At what age should iron supplementation begin for a child that is exclusively breast fed?
4 months
At what age should iron supplementation begin for a child that is exclusively breast fed?
6 months
What procedure is used to Dx most plasma cell disorders?
Bone marrow biopsy
How big is a Stage 1A renal cell carcinoma?
less than 4 centimeters
What did Nish say two drugs are used to treat liver?
doxorubicin and irinotecan
What three cancers can cause a malignant pleural effusion?
lung, breast and ovarian
What three types of cancer are relatively resistant to radiation?
sarcoma, melanoma, renal cell
What does radiosensitive mean?
melts to radiation
What does radioresponsive mean?
melts quickly to radiation
Does radiation work better on poorly oxygenated or well oxygenated cancer cells?
well oxygenated
What is the radiosensitive phase of the cell cycle?
G2/M
What is the radioresistant phase of the cell cycle?
S
What penetrates superficially, electrons or photons?
electrons
What penetrates deep, electrons or photons?
photons
What is IGRT useful for?
tumors that can move
What does radical cure mean?
parasites are no longer present in liver
What does recrudescence mean?
reappearance of detectable blood stream forms
What are the two platelet antibodies?
anti-HLA and anti-HPA
What is given to support a patient with TRALI?
O2
What is the normal WBC at birth?
9K-30K
At what age should a child and adults WBC be roughly the same?
12 years
What is a normal lymphocyte percentage?
35%
What is a normal nadir for a full-term infant?
9 mg/dL
What is the upper limit of MCV for children?
96
What are the two viruses that are known to cause HCC?
HBV and HCV
Hepatic tumors have almost exclusive blood supply from what vessel?
hepatic artery
What two cancers are radioemobilization used for?
HCC and colorectal carcinoma
What two species of malaria can lay dormant for years?
vivax and ovale
According to Nguyen, what cells expand during CLL?
granulocytic and megakaryocytic
