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Medical Parasitology > Plasmodium sp. (Part 2) > Flashcards

Plasmodium sp. (Part 2) Flashcards

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USMLE® Step 1 flashcards
1
Q

Describe some of the pathogenic effects of malaria?

A
  • Haemolysis of RBC’s
  • Liberation of parasite metabolites
  • Immunologic response to parasite antigens
  • Cytoadherence (clumping of cells) (P.Falciparum only)
  • Causes occlusion of brain capillaries and leads to cerebral malaria
  • Production of proteins (cytokines). TNF, interleukin; leads to symptoms and pathologic changes.
  • Production of malaria pigment (haemozoin).
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2
Q

What is the name of the malaria pigment?

A

Haemozoin

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3
Q

What is haemozoin derived from and what does this cause?

A
  • Derived from haemoglobin

- Causes depletion of iron stores and exacerbates the anaemic condition of patients

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4
Q

Cytoadherence (clumping of cells) causes microcirculatory arrest in certain organs for patients infected with P. Falciparum, how does this affect the stomach?

A

Hepatosplenomegaly

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5
Q

Cytoadherence (clumping of cells) causes microcirculatory arrest in certain organs for patients infected with P. Falciparum. How does this effect the intestines?

A

Vomiting and diarrhea

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6
Q

Cytoadherence (clumping of cells) causes microcirculatory arrest in certain organs for patients infected with P. Falciparum. How does this affect the Brain?

A

Delerium, stupor, coma, disorientation, and convulsions

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7
Q

Cytoadherence (clumping of cells) causes microcirculatory arrest in certain organs for patients infected with P. Falciparum. How does this affect the eyes?

A

Retinal hemorrhage (blindness)

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8
Q

Cytoadherence (clumping of cells) causes microcirculatory arrest in certain organs for patients infected with P. Falciparum. How does this effect the kidneys?

A

Renal failure

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9
Q

Cytoadherence (clumping of cells) causes microcirculatory arrest in certain organs for patients infected with P. Falciparum. How does this effect the liver?

A

Jaundice and fever

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10
Q

Cytoadherence (clumping of cells) causes microcirculatory arrest in certain organs for patients infected with P. Falciparum. How does this effect the lungs?

A

Edema

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11
Q

What is the best known severe manifestation of malaria? What symptoms does it cause?

A

Cerebral Malaria

  • reduction of consciousness
  • coma
  • convulsion
  • abnormal posturing
  • disconjugate gaze
  • retinal hemorrage.
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12
Q

What are the prodromal symptoms of malaria?

A

-May be influenza like in all 4 species.

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13
Q

How does one confidently diagnose malaria?

A
  • Requires blood film

- Thick (10 para/ml sensitivity) and thin (200 para/ml sensitivity)

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14
Q

Describe the morphology of P. falciparum

A
  • Numerous fine ring forms
  • Double chromatin dots
  • Marginal forms
  • Red cells are not enlarged
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15
Q

What are the treatments used for P. falciparum?

A

1) Artemether/lumefantrine = Coartem
2) Meflaquine/sulfadoxine/pyramethamine combos for chloroquine resistant
3) quinine or IV quinadine as reserve drug bc no resistance yet

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16
Q

What is the PPP for P. vivax/ovale?

A

10-17 days

17
Q

What is the PPP for P. malarie?

A

18-40 days

18
Q

Which forms of Plasmodium are reoccurring?

A

Vivax and Ovale (due to hypnozoites in liver)

19
Q

Describe the morphology of P. vivax

A
  • Developing and thick (signet) ring forms

- Enlarged red cells

20
Q

Describe the morphology of P. ovale

A
  • “Oval” red cell

- Enlarged red cell

21
Q

Describe the morphology of P. malariae

A
  • Band shape

- Red cell not enlarged

22
Q

What is the treatment for P. vivax/ovale?

A
  • Chloroquine (blood only)

- Primaquine (for hypnozoites in liver to prevent relapse)

23
Q

What is the treatment for P.malariae?

A

-Chloroquine

24
Q

Define autochthonous.

A
  • indigenous or endemic to a region
  • contracted in the area where reported
    (e. g. Jamaica)
25
Q

If a person travels to an malaria endemic area, gets bitten and returns to Grenada, after how many days would you screen for autochthonous cases?

A
  • gametocytes in blood: 16-17 days

- if the patient having just been infected on day 1: then 27 days.

Medical Parasitology (34 decks)

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