Plasmodium II Flashcards
[2] Phase
- Invertebrate phase
- Vertebrate phase
4-15 days after ingestion of gametocyte.
[phase]
Invertebrate phase
Mosquito takes a blood meal containing gametocytes from infected person.
Female Anopheles
[2] gametocytes
- Microgametocytes
- Macrogametocytes
male
[gametocytes]
Microogametocytes
Nuclear division and exflagellation.
[gametocytes]
Microgametocytes
female
[gametocytes]
Macrogametocytes
Shifting of nucleus to the surface to form a
projection.
[gametocytes]
Macrogametocytes
Microgamete penetrates macrogametes producing an ookinete.
[gametocytes]
Macrogametocytes
Mosquito injects sporozoites to man.
[phase]
Vertebrate phase
Sporozoites disappear from the blood.
[phase]
Vertebrate phase
– Some are destroyed by the host immune system.
– Enters liver parenchymal cells (hypnozoites in P. vivax and P. ovale)
Vertebrate phase
[9] Insect Vector in the Philippines
- Anopheles Flavirostris
- Anopheles Balabacensis
- Anopheles Lesteri
- Anopheles Philippinensis
- Anopheles Umbrosus
- Anopheles Leucosphyrus
- Anopheles Litoralis
- Anopheles Maculates
- Anopheles Mangyanu
Primary vector in the Philippines, night biter, breeds in slow-flowing clean water mountain streams.
[anopheles]
Anopheles Flavirostris
Rest either indoors or outdoors, in puddles, pools, ponds, and in shades.
[anopheles]
Anopheles Balabacensis
rest either indoors or outdoors, in pools, ponds, lakes, and in ricefields.
Anopheles lesteri
rest either indoors or outdoors, in pools ponds or lakes.
Anopheles philippinensis
rest out of doors, in pools, ponds, lakes, running streams and canals in shades.
Anopheles umbrosus
Vector of Plasmodium knowlesi, typically found in forest areas in South East Asia but with a greater clearing of forest areas for farmland.
Anopheles leucosphyrus
can occur over months or years.
[malaria transmission]
recrudescences and relapses
Can develop severe complications (especially P. falciparum).
Malaria transmission
Periodic episodes of fever alternating with symptom-free periods.
Malaria transmission
[3] Clinical features of Malaria transmission
- Cold stage
- Hot stage
- Sweating stage
Chilly sensations that progresses to a teeth chattering, frankly shaking chill. The peripheral blood vessels are constricted and the lips and nails are cyanotic.
[clinical features of MT]
Cold stage
The body temperature begins to mount rapidly as the blood vessels dilate.
[clinical features of MT]
Hot stage
Temperature peaks at 39-41 C, skin is hot and the face flushed.
[clinical features of MT]
Hot stage
Sign and symptoms includes nausea, vomiting headache and rapid pulse.
[clinical features of MT]
Hot stage
High fever may produce convulsion in children.
[clinical features of MT]
Hot stage
The patient perspires profusely, temperature falls and the headache disappears.
[clinical features of MT]
Sweating stage
The patient is exhausted but symptomless. And the next day the patient can feel quite well, before the next paroxysm occurs.
[clinical features of MT]
Sweating stage
feeling of intense cold.
[clinical features of MT]
Cold stage
vigorous shivering, rigor.
[clinical features of MT]
Cold stage
lasts 15-60 min.
[clinical features of MT]
Cold stage
intense heat and dry burning skin.
[clinical features of MT]
Hot stage
throbbing headache.
[clinical features of MT]
Hot stage
lasts 2-6 hours.
[clinical features of MT]
Hot stage
profuse sweating and declining temperature.
[clinical features of MT]
Sweating stage
exhausted, weak — sleep.
[clinical features of MT]
Sweating stage
lasts 2-4 hours.
[clinical features of MT]
Sweating stage
Periodicity varies according to species.
Malarial paroxysms
Depends on the length of the asexual cycle.
Malarial paroxysyms
[3] Malarial Paroxysms
- Plasmodium falciparum
- Plasmodium vivax and P. Ovale
- Plasmodium malariae
Malignant tertian malaria (36 hours or less).
Plasmodium falciparum
Benign tertian malaria (48 hours).
Plasmodium vivax and P. ovale
Quartan malaria (72 hours).
Plasmodium malariae
In P. falciparum infections, as the parasite begins to grow, the red cell membrane becomes sticky and cells adhere to the endothelial lining of the capillaries of the internal organs.
Pathogenicity of Malaria
thus, only ring forms and gametocytes appear in the peripheral blood.
Pathogenicity of Malaria
More pronounced in P. falciparum.
Anemia
[3] Anemia
- Hemolytic
- Normochromic
- Normocytic
Decrease Oxygen carrying capacity leading to what?
[anemia]
Anoxia
Caused by an increase in splenic activity.
Splenomegaly
Parasitized red cells pass through the spleen, loss their deformability, thus destroyed in the process.
Splenomegaly
Normal RBC’s are destroyed due to increase activity of macrophages.
Splenomegaly
Parasitized red cells pass through the spleen, loss their deformability, thus destroyed in the process.
Splenomegaly
Seen in Plasmodium Malariae infection.
Nephrotic Syndrome
Antibody complexes causes thickening of the capillary walls of the basement membrane.
[nephrotic syndrome]
Deposition of antigen
Presence of focal hyalinizing lesions of the tuft of the glomerulus and segmental endothelial cell proliferation progressing to glomerular sclerosis.
Nephrotic Syndrome
Syndrome of acute intravascular hemolysis, accompanied by hemoglobinemia and hemoglobinuria.
Black water fever
Abrupt onset, passage of dark red or almost black urine, vomiting of bile stained fluid, jaundice.
Black water fever
High mortality.
Black water fever
Rapid and severe hemolysis of both parasitized and non parasitized red cells.
Black water fever
Presence of the parasite changes the antigenic structure of individual erythrocytes and stimulates the production of antibodies.
Black water fever
Most serious hematologic complication.
Disseminated Intravascular Coagulation (DIC)
Activation of the clotting system resulting to thrombin generation and intravascular coagulation.
Disseminated Intravascular Coagulation (DIC)
Present in P. ovale and P. vivax.
Relapse
Activation of hypnozoites (liver stages) resulting to renewal of malarial infection.
Relapse
Renewal of parasitemia or clinical features arising from persistent undetectable asexual parasitemia in the absence of an exo erythrocytic cycle.
Recrudescense
P. falciparum: Due to infected RBC sequestered by the spleen.
Recrudescense
screening for positivity and parasite count.
[blood smear]
Thick film
species identification easier.
[blood smear]
Thin film
[4] Diagnosis of Malaria
- Quantitative Buffy Coat (QBC)
- Rapid Diagnostic Test (RDT)
- Serological Test
- Polymerase Chain Reaction (PCR)
Usually prepared capillary tube coated with acridine orange.
[diagnosis of malaria]
Quantitative Buffy Coat (QBC)
Malaria parasites take up the stain and appear bright green and yellow under a fluorescent microscope.
[diagnosis of malaria]
Quantitative Buffy Coat (QBC)
Detects parasitic antigens:
- Pan malaria: p-LDH (Diamed Optimal IT)
- Falciparum malaria: HRP-II (Paracheck Pf Test, ParaHIT f Test)–
[diagnosis of malaria]
Rapid Diagnostic Test (RDT)
Makes use of immunochromatographic methods in order to detect Plasmodium specific antigens in a finger-prick blood sample.
[diagnosis of malaria]
Rapid Diagnostic Test (RDT)
Cannot differentiate current and past infections.
[diagnosis of malaria]
Serological tests
Most helpful in epidemiological studies.
[diagnosis of malaria]
Serological test
To significantly enhance the microscopic diagnosis of malaria especially in cases of low parasitemia and in cases of mixed infection.
[diagnosis of malaria]
Polymerase Chain Reaction (PCR)
IHA means
Indirect Hemagglutination
IFAT means
Indirect Fluorescent Antibody Test
ELISA
Enzyme-linked Immunosorbent Assay