PARA MALARIA Flashcards
Related to primate malaria parasite
P. vivax
P. malariae
P. ovale
related to avian malaria parasites
P. falciparum
long tailed macaques malaria parasite
P. knowlesi
TRANSMISSION of MALARIA IS THROUGH THE BITE OF A ____________________________
female Anopeheles mosquito
malaria is known as ________________________ in French
Paludisme= swamp fever
malaria is known as ________________________ in German
Wechselfieber= changing fever
Discovered Malaria n the RBCs of a patient in 1880
Charles Louis Alphonse Laveran
described the asexual development called the Golgi Cycle
Camillo Golgi
Established the mode of transmission of Malaria in 1897
Ronald Ross
P. ovale was identified during _____
1922
GROUP OF PARASITES CAUSING MALARIA belongs to the genus Plasmodium
Plasmodium vivax
Plasmodium ovale
Plasmodium malariae
Plasmodium falciparum
Plasmodium knowlesi
considered to be the fifth human malaria parasite has been described in humans in the Philippines and SEA
Plasmodium knowlesi
Malaria parasite requires specific __________ and ______________ to complete its life cycle
human, mosquito tissues
In the Philippines, principal malarial vector is the _______________________________________________
Anopheles minimus var. flavirostris
Lifespan of Female Anopheles mosquito
few weeks to a month
intermediate host of Malaria parasite
HUMANS
Gametocyte appearance in the circulation:
P. vivax= _____________
P. falciparum= ________________
4-5 days, 10-12 days
A person with a malaria gametocyte
Carrier or Resevoir
infective stage of Malaria for humans
Sporozoites
Process of schizogony forms ____________________
Merozoites (individual things)
Schizonts (if grouped pa)
the asexual reproduction of a sporozoan parasite by the multiple fission of the nucleus of the parasite followed by segmentation of the cytoplasm
Schizogony
Schizogony forms
MEROZOITES
Sexual reproduction by multiple fission of a spore or zygote, characteristic of many sporozoans
Sporogony
Sporogony results in a production of ______________________________
SPOROZOITES
Process of the malaria parasite to undergo gamete formation
GAMETOGONY
Name of gametocyte for male and female respectively
MICROGAMETOCYTE- MALE, MACROGAMETOCYTE- FEMALE
the exoerythrocytic cycle occurs in the ______________________
LIVER
the erythrocytic cycle occurs in the ______________________
CIRCULATION
Definitive host of MALARIA
MOSQUITO
infective stage of MALARIA for mosquito
GAMETOCYTE
The MALARIA parasite develops and multiplies inside the human host causing ____________________
periodic bouts of flu-like symptoms
Classical malarial paroxysms/ MALARIAL TRIAD
Chills (cold stage)
Fever (Hot stage)
Sweating (Sweating stage)
symptoms of MALARIA are related to the periodic destruction of _____ and diffusion of the pigment __________
RBCs, Hemozoin
The interval of time from sporozoite injection to detection of parasites in the blood
PREPATENT PERIOD
30 MINSt
The time between sporozoite injection and the appearance of clinical symptoms
INCUBATION PERIOD/ CLINICAL IP
the sudden inappropriate feeling of coldness and apprehension
COLD PHASE
Cold phase rigor lasts for ——————
15-60 mins
Patient is hot/ flush phase begins, moreover patient has headache, palpitations, tachypnea, epigastric discomfort, thirst, nausea, vomiting
HOT PHASE
HOST PHASE LASTS FOR _____________________________
2-6 hours
HOT PHASE TEMP peaks at _____________________________
40-41 deg C
is due to the bursting of the RBCs in the body
COLD PHASE
is due to the immune response of the body
HOT PHASE
defervescence or diaphoresis- patient manifest sweating
SWEATING PHASE
SWEATING PHASE temp lower over the next ___________________
2-4 hours
TOTAL DURATION of typical malarial attack
8-12 hours
Interval between attack is determined by the length of ___________________________________
Erythrocytic Cycle
is due to the compensation of the body to the immune response of the body to the parasite
SWEATING PHASE
malaria may cause ___________ and ________________
anemia and jaundice
infection with one type of malaria, _________________________, if not properly treated may cause kidney failure, seizures, mental confusion, coma, and death
Plasmodium falciparum
it is a medical emergency that should be treated aggressively with intravenous fluids and respiratory support
SEVERE MALARIA
long term health complications of severe malaria include __________________________
liver and kidney failure, and a ruptured spleen
the pathological process of malaria are the result of ___________________
Erythrocytic Cycle
allows fluid leak to tissues and blood vessel congestion leading to infarction and necrosis
Increased capillary permeability
severe form of MALARIA are usually caused by ______________________
Plasmodium falciparum
electron dense membranous structure, so called ________ causes cytoadherence, rosette formation, and sequestration of parasitized erythrocytes lead to decrease in tissue perfusion resulting in decreased renal blood flow
KNOBS (MAIN VIRULENCE FACTOR)
proteins necessary for cytoadhesion which has the function of antigenic variation
ROSETTINS
proteins necessary for cytoadhesion which has the function of association in severe, malaria; antigenic function
RIFFINS
proteins necessary for cytoadhesion which has the function of increasing the effectivity of ligand binding
Histidine-rich Protein (HRP)
proteins necessary for cytoadhesion which has the function of acting like LPS, stimulate monocyte to release TNF
Glycosylphosphatidyl inositol (GPI)
proteins necessary for cytoadhesion which has the function of cytoadherence; antigenic variation
Plasmodium falciparum erythrocyte membrane protein 1
most adhesive protein for cytoadhesion
Plasmodium falciparum erythrocyte membrane protein 1
Seen in Plasmodium vivax and Plasmodium ovale infections
RELAPSE PERIOD
Seen in P. falciparum and P. malariae infections
RECRUDESENCE PERIOD
is due to persistence of drug resistant parasites, even after completion of treatment
RECRUDESENCE
Few sporozoites don’t develop into pre-erythrocytic schizont, but remain dormant (Hypnozoites) for 3 weeks to 1 year
RELAPSE
Hypnozoites can only be observed in ___________________________
P. vivax and P. ovale
erythocytic cycle of P. vivax, P. falciparum, P. malariae, P. ovale
P. vivax- 48 hours
P. falciparum- 36-48 hours
P. malariae- 72 hours
P. ovale- 42 hours
gold standard method for malarial diagnosis
MICROSCOPY EXAMINATION
are usually ring forms, immature, and mature
TROPHOZOITES
occasionally found; indicative of severer infection and should consider organ damage
SCHIZONTS
have sexual stages, infective stage to mosquitos
GAMETOCYTES
non staining part of MALARIA
VACUOLE
staining red part for MALARIA
NUCLEUS/ CHROMATIN DOT
staining blue part for MALARIA
cytoplasm
most prevalent human malaria parasite
Plasmodium vivax
found in Asia, Latin America, and in some parts of Africa
Plasmodium vivax
Plasmodium vivax has dormant liver stages (________________________) that can activate and invade the blood (__________________________________) several months or years after the infecting mosquito bite
hypnozoites, causes relapse
infected RBC of P.vivax and P. ovale
young and immature
P. vivax eosinophilic stippling ____________________________-, all stages except early ring forms
Shuffner’s dots
infected RBC of P. vivax will increase ________________ the size of a normal cell
1.5 times
pigment for infected RBC of P. vivax
Golden Brown, inconspicuous
ring form with heavy red dot and blue cytoplasmic ring
SIGNET
relatively large and have delicate cytoplasmic ring and connected by single chromatin dot
P. vivax trophozoites
growing trophozoites will have a _____________________________________________ pigment granules in cytoplasm
small-yellowish brown
has loose, irregular, or close compact cytoplasm. Increasing the amount of brown pigments. Parasite fill cells in 30 to 40 hours
LARGE TROPHOZOITE
mature schizont of P. vivax contains ____________ , __________, Parasite almost fills enlarged cells
12-24 merozoites, and pigments in 1 to 2
parasite almost fills enlarged cells
Mature Schizont
large pink to purple chromatin mass surrounded by colorless to pale halo yellow structure
P. vivax microgametocyte
round to oval cytoplasm, smaller nucleus, eccentric chromatin mass, light brown pigment through out the cell
P. vivax Macrogametocyte
PHASES OF P. vivax
Schizogony phase:
Prepatent phase:
Incubation phase:
length of asexual period:
Internal between parasite patency and gametocyte appearance:
Developmental period in mosquito
48 hours
11-15 days
12-20 days (ave 14)
48 hours
3-5 days
10 days at 28 deg C to 30 deg C
P. vivax and P. ovale causes the disease
Benign Tertian Malaria
found mostly in Africa and the islands of the western pacific
P. ovale
Though P. ovale is biologically and morphologically similar to P. vivax, it is able to infect ____________ which is the case for many residents of sub-Saharan Africa
Duffy blood group negative
infected RBC of P. ovale will become _____________ and increase ________________ the size of a normal cell
oval & enlarged, 1.5 times
P. ovale eosinophilic stippling ____________________________-, all stages except early ring forms
James dots
pigment for infected RBC of P. ovale
Dark Brown, conspicuous
somewhat thick and ameboid appearance, larger than in P. vivax
Trophozoite (P. ovale)
medium in size often maintains circular shape early in development
Immature Schizont
round to oval cytoplasm, smaller nucleus, eccentric chromatin mass, light brown pigment through out the cell, smaller than in P. vivax
P. ovale macrogametocyte
large pink to purple chromatin mass surrounded by colorless to pale halo yellow structure. Smaller than in P. vivax
P. ovale microgametocyte
mature schizont of P. ovale contains ____________ ,
Merozoites occupy __________, of the RBC in a rosette formation
6-14 (ave, 8), 3 quarters
PHASES OF P. ovale
Schizogony phase:
Prepatent phase:
Incubation phase:
length of asexual period:
Internal between parasite patency and gametocyte appearance:
Developmental period in mosquito
48 hours
14-26 days
11-16 days (ave 14)
48 hours
5-6 days
16 days at 25 deg C; 14 days at 27 deg C
found worldwide, is the only human malaria parasite species that has a quartan cycle (three day cycle)
Plasmodium malariae
disease caused by plasmodium malariae
Quartan Malaria
causes a long lasting, chronic infection that in some cases can last a lifetime
Plasmodium malariae
In some chronically infected patients with P. malariae can cause serious complications such as the _________________________
nephrotic syndrome
infected RBC of P. malariae
only mature cells
P. malariae eosinophilic stippling ____________________________
Ziemann’s dots
infected RBC of P. malariae will have _____________ size, no distortion and __________________________
normal, cell maybe smaller
pigment for infected RBC of P. malariae
Dark Brown, coarse, conspicuous- occurs almost all stages
P. malariae cytoplasm: rounded, compact trophozoites, with dense cytoplasm, __________ trophs usually seen
band form
occupies 1/6 of the RBC, smaller than in P. vivax, heavy chromatin dot, vacuole may appear “filled-in”
P. malariae trophozoite
Contains coarse dark pigment, basket shaped, vacuole is absent in mature stages
Developing trophozoite (P. malariae)
appears compact in thick smear, band forms seen usually in thin smear
Old Trophozoite (P. malariae)
similar to P. vivax, smaller containing coarse dark peripheral or central granules
Immature schizont (P. malariae)
mature schizont of P. malariae contains ____________ ,
Merozoites arranged in a __________,________
6-12 Merozoites (ave 8-10), rosette or irregular clusters
similar but smaller to P. vivax. Contains dark, coarse pigment. Older forms assume an oval shape
P. malariae Microgametocyte and macrogametocyte
PHASES OF P. malariae
Schizogony phase:
Prepatent phase:
Incubation phase:
length of asexual period:
Internal between parasite patency and gametocyte appearance:
Developmental period in mosquito
72 hours
3-4 weeks
18-40 days (ave 30)
72 hours
10-14 days
30-35 days at 20 deg C; 25-28 days at 22-24 deg C
found worldwide, approximately 1 million people are are killed especially in Africa where this species predominates
Plasmodium falciparum
P. falciparum causes the disease
Malignant Tertian Malaria
causes severe malaria because it multiplies rapidly in the blood, and can thus cause severe blood loss
Plasmodium falciparum
parasites can clog small blood vessels, when this occurs in the brain, cerebral malaria results, a complication that can be fatal
Plasmodium falciparum
infected RBC of P. falciparum will have _____________ size, _______________
normal, no distortion
P. falciparum eosinophilic stippling ____________________________-, not clearly visible
Maurer’s dots
infected RBC of P. falciparum
infects all stages
circle configuration with one or two chromatin dot (headphone shape)
trophozoite
has heavy rings, fine granules, mature forms seen in severe infection
P. falciparum Developing Trophozoite
sausage or crescent shaped, dispersed central chromatin, black pigment is visible
P. falciparum microgametocyte
sausage or crescent shaped, compact chromatin, black pigment is visible
P. falciparum macrogametocyte
PHASES OF P. falciparum
Schizogony phase:
Prepatent phase:
Incubation phase:
length of asexual period:
Internal between parasite patency and gametocyte appearance:
Developmental period in mosquito
36-48 hours
11-14 days
8-15 days
48 hours or less
8-11 days
22-23 days at 20 deg C; 10-12 days at 27 deg C
found in SEA as a natural pathogen of long tailed and pig tailed macaques
Plasmodium knowlesi
Disease caused by Plasmodium knowlesi
Zoonotic malaria
Plasmodium knowlesi has a __________________ and so can rapidly progress from an uncomplicated to a severe infection
24-hour replication cycle
recently shown to be a significant cause of zoonotic malaria in that region particularly in ______________________
Malaysia
Early trophozoite resembles P. falciparum. Developing trophozoites, schizonts and gametocytes are similar to P. malariae
P. knowlesi
P. knowlesi is confirmed through _________________
Molecular detection methods (PCR)
Determines the parasitological severity of malaria infection
Malaria Parasite Counting
200 WBCs counted with 100 parasites counted, QUANTIFICATION
Thick Smear
counting of parasitized RBC in 10-20 fields. IDENTIFICATION
Thin Smear
Rapid Staining method for Malaria smear stain
10% giemsa solution for 10-15mins
slow Staining method for Malaria smear stain
3% giemsa solution for 30-45mins
test that detects P. falciparum
Paracheck Pf
test that detects Plasmodium spp
OptiMal, ICT
Paracheck Pf uses ________________________ to detect the presence of P. falciparum
Histidine-rich Protein II
OptiMal, ICT uses ________________________ to detect the presence of other Plasmodium spp
Lactate dehydrogenase
based combination therapy used for all Plasmodium spp. and mixed infection
ARTEMENSIN
1st degree- ARTMETER-LUMEFANTRINE
2nd degree- QUININE+ TETRACYCLINE/ DOXYCYCLINE, CLINDAMYCIN
increasing dosage of _______________ in treating relapsing P. vivax
PRIMAQUINE
1st vaccine for malaria
RTS,S/ ASO1 (Mosquirix)
2nd vaccine for malaria
R21- Matrix-M