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2ND YR 1S > PR MALARIAL > Flashcards

PR MALARIAL Flashcards

1
Q

Intracellular protozoans

A

Malarial Parasites

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2
Q

Phylum of Malarial Parasites

A

Phylum Apicomplexa

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3
Q

Life cycle of Malarial Parasites

A

alternating sexual (sporogony) and asexual
stages (schizogony)

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4
Q

Vector of Malarial Parasites

A

Female Anopheles minimus flavirostris mosquito

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5
Q

Immediate Host

A

Man

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6
Q

Habitat

A

Livers and RBCs of humans

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7
Q

Infective stage to mosquito

A

gametocytes

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8
Q

Infective stage to man

A

sporozoites

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9
Q

MOT

A

mosquito bite, blood transfusion, congenital

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10
Q

Asexual cycle of parasite

A

Exo-erythrocytic cycle / Schizogony Cycle

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11
Q

where does schizogony cycle happen

A

in liver cells

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12
Q

life cycle when Mosquito bites human, injects sporozoites

A

Schizogony cycle

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13
Q

EXO-ERTHROCYTIC CYCLE

minutes before it reaches liver

A

30-40 minutes

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14
Q

merozoites undergo asexual reproduction

A

schizogony

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15
Q

what cells do sporozoites infect

A

liver cells

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16
Q

dormant merozoites seen in P. ovale and P. vivax

A

hypnozoites

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17
Q

life cycle when merozoites from liver infect RBCs

A

Eryrthrocytic cycle

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18
Q

sexual cycle

A

Sporogonic cycle

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19
Q

entire cycle of mosquito (days)

A

8-35 days

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20
Q

Sequential Phase of Paroxysms

A
  1. Chills
  2. Fever
  3. Sweating / Diaphoresis
  4. Normal
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21
Q

pigment found in Plasmodium species as a result of the parasite feeding on hemoglobin

A

Hemozoin

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22
Q

Most prevalent Plasmodium in the Philippines

A

Plasmodium falciparum

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23
Q

P. falciparum

Merozoites develop in _______

A

parasitophorous vacuolar membrane (PVM)

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24
Q

P. falciparum

what happens when merozoites invade RBCs

A

RBC reduce their deformability

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25
Q

P. falciparum

Type of Malaria

A

Malignant Tertian Malaria

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26
Q

P. falciparum

Paroxysmal Cycle

A

36-48 hours

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27
Q

P. falciparum

Type of RBC infected
Size of Parasitized RBC

A

Type of RBC infected - all forms
Size of Parasitized RBC - normal

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28
Q

P. falciparum

Presence of RBC stages

A

Ring forms, gametocytes

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29
Q

P. falciparum

Ring Forms

A
  • 2 chromatin dots
  • multiple ring forms
  • has Accole/applique
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30
Q

P. falciparum

Developing Trophozoite
Merozoites

A
  • Developing Trophozoite : Heavy ring forms
  • Merozoites : 20-24
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31
Q

P. falciparum

Schizont (# of merozoites)

A

8-36
Average : 22-24

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32
Q

P. falciparum

Microgametocyte
Macrogametocyte

A
  • Microgametocyte : Sausage shaped & Diffuse Chromatin
  • Macrogametocyte : Crescent shaped & Compact Chromatin
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33
Q

seen in macrogametocyte of P. falciparum and is a remnant of RBC

A

Laveran Bib

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34
Q

P. falciparum

Stipplings

A

Maurer’s Cleft

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35
Q

P. falciparum Incubation Period

A

8-11 days

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36
Q

P. falciparum

where does schizogony occur

A

internal organs

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37
Q

metabolic product of parasite

A

Hemozoin

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38
Q

most severe clinical manifestation of P. falciparum

A

Cerebral malaria

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39
Q

happens if malaria if complicated and not treated immediately

A

Cerebral malaria

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40
Q

Massive intravascular hemolysis and hemoglobinuria due to P. falciparum

A

Severe blackwater fever

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41
Q

Increase in RBC destruction leads to release of hemoglobin in the urinary system

A

Hemoglobinuria

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42
Q

Causes abdominal pain, hepatomegaly, upper GI bleeding, nausea (with or without
jaundice)

A

Dysenteric Malaria

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43
Q

Rapid development of hypotension

A

Algid Malaria

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44
Q

Because of hemoglobin to the kidneys

A

Acute renal failure

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45
Q

Blood clots form throughout the body (blocking the small blood vessels)

A

Disseminated intravascular coagulation (DIC)

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46
Q

P. falciparum

Shortest pre-patent period

A

9-10 days

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47
Q

P. falciparum

Pre-erythrocytic stage

A

5 1⁄2 - 7 days

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48
Q

concept of Recrudescence

A

renewal of parasitemia from persistent undetectable asexual parasitemia

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49
Q

Most prevalent species (widest distribution)

A

Plasmodium vivax

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50
Q

Target RBC of P. vivax

A

Young RBCs - reticulocytes

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51
Q

T/F Relapses can occur in P. vivax

A

True

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52
Q

what is more severe ovale or vivax

A

vivax

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53
Q

P. vivax

Incubation period
Pre-patent period
Pre-erythrocytic stage

A
  1. Incubation period : 8-17 days
  2. Pre-patent period : 11-13 days
  3. Pre-erythrocytic stage : 6-8 days
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54
Q

P. vivax

Type of Malaria

A

Benign Tertian Malaria

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55
Q

P. vivax

Paroxysmal Cycle

A

48-72 hours

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56
Q

P. vivax

Type of RBC infected
Size of Parasitized RBC

A

Type of RBC infected : Young RBCs
Size of Parasitized RBC : enlarged RBCs (1.5-2 times)

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57
Q

P. vivax

Presence of RBC stages

A

All stages present

58
Q

P. vivax

Ring forms

A
  • Large ring form
  • Big/heavy chromatin dot
  • Signet ring appearance
59
Q

P. vivax

Developing Trophozoite

A

Ameboid/bizarre looking

60
Q

P. vivax

Schizont

A

12-24 merozoites

61
Q

P. vivax

Microgametocyte
Macrogametocyte

A

Microgametocyte : round, large pink to purple chromatin mass
Macrogametocyte : round, eccentric chromatin mass

62
Q

P. vivax

Stipplings

A

Schuffner’s dots
- infected RBC with red dots

63
Q

Infections usually benign

A

Plasmodium ovale / vivax

64
Q

occurs after 6-10 paroxysms

A

Spontaneous recovery

65
Q

P. ovale

Presence of 2 distinct nonrecombining species

A
  1. Classic: Plasmodium ovale curtisi
  2. Variant: Plasmodium ovale wallikeri
66
Q

P. ovale

Incubation period
Pre-patent period
Pre-erythrocytic stage

A

Incubation period: 10-17 days
Pre-patent period: 11-13 days
Pre-erythrocytic stage: 9 days

67
Q

P. ovale

Type of Malaria

A

Ovale Tertian Malaria

68
Q

P. ovale

Paroxysmal Cycle

A

48 hours-72 hours

69
Q

P. ovale

Type of RBC infected
Size of Parasitized RBC

A

Type of RBC infected : Young
Size of Parasitized RBC : Enlarged RBC with serrated or fimbriated edge

70
Q

P. ovale

Presence of RBC stages

A

All stages present

71
Q

P. ovale

Ring Forms

A

Large rings

72
Q

P. ovale

Developing trophozoite

A
  • Non-ameboid
  • Ring-shaped
  • Similar to vivax
  • Serrated/fimbriated
73
Q

P. ovale

Schizont

A

8 merozoites

74
Q

P. ovale

Microgametocyte
Macrogametocyte

A

Microgametocyte : round gametocytes
Macrogametocyte : Smaller than P. vivax

75
Q

P. ovale

Schizont

A

8 merozoites

76
Q

P. ovale

Stipplings

A

James’ dots

77
Q

plasmodium with longest incubation

A

Plasmodium malariae

78
Q

P. malariae

Type of Malaria

A

Quartan Malaria

79
Q

P. malariae

Paroxysmal Cycle

A

72 hours

80
Q

P. malariae

Type of RBC infected
Size of Parasitized RBC

A

Type of RBC infected : Old RBCS (Senescent RBCS)
Size of Parasitized RBC : Normal

81
Q

P. malariae

Presence of RBC stages

A

Few ring forms seen (mostly trophozoites and schizonts)

82
Q

P. malariae

Ring Forms

A
  • Heavy chromatin dot (bird’s eye appearance)
  • Small form
83
Q

P. malariae

Developing Trophozoite

A

Band formation or Inverted basket form

84
Q

P. malariae

Schizont

A
  • 6-12 merozoites
  • rosette/fruit-pie appearance
85
Q

P. malariae

Microgametocyte
Macrogametocyte

A

Microgametocyte : Round gametocytes
Macrogametocyte : Same ^^ (smaller than vivax)

86
Q

P. malariae

Stipplings

A

Ziemann’s dots

87
Q

Quartan Malaria incubation period

A

27-50 days (longest)

88
Q

Complication of P. malariae

A
  • Nephrotic syndrome is common
  • Immune complex deposition (antigen-antibody complex) in the glomerulus/kidney
89
Q

same morphology with malariae and differentiated through molecular methods (PCR) and molecular characterization

A

Plasmodium knowlesi

90
Q

P. knowlesi

Type of Malaria

A

Simian Malaria, Quotidian Malaria

91
Q

P. knowlesi

Paroxysmal Cycle

A

24 hours (has the shortest erythrocytic cycle)

92
Q

P. knowlesi

Type of RBC infected
Size of Parasitized RBC

A

Type of RBC infected : can infect all
Size of Parasitized RBC : normal

93
Q

P. knowlesi

Ring forms

A
  1. Early ring form: like falciparum
  2. Later ring form: like malariae
94
Q

P. knowlesi

Developing Trophozoite

A

Band formation

95
Q

Plasmodium that undergoes recrudescence

A

P. malariae and P. falciparum

96
Q

Plasmodium that undergoes relapse

A

P. ovale and P. vivax

97
Q

Primary mosquito vector

A

Anopheles minimus flavirostris

98
Q

Characteristics of Anopheles minimus flavirostris

A
  • Only female bites (for egg nourishment and ovulation, males only go to flowers)
  • Night biter (10pm – 2am)
  • Exophagic and Endophagic
  • Antropophilic and zoophilic
99
Q

Transmits malaria in hilly or high altitudes

A

Anopheles maculatus

100
Q

Characteristics of Anopheles maculatus

A
  • Zoopholic
  • Exophagic
101
Q

transmits in coastal areas

A

Anopheles litoralis

102
Q

Characteristics of Anopheles litoralis

A
  • larvae breeds in salt or brackish (mix of fresh and salt water) waters
  • anthropophilic
  • exophagic
103
Q

transmits in forest-fringe areas

A

Anopheles mangyanus

104
Q

transmits in forests

A

Anopheles balabacensis

105
Q

secondary vector of malaria in the country

A

Anopheles balabacensis

106
Q

Characteristics of Anopheles balabacensis

A
  • breed in stagnant water, hoof prints (when water goes inside the prints), dug wells
  • anthropophilic
107
Q

primary mosquito vector in Africa

A

Anopheles gambiae

108
Q

Reason why Anopheles gambiae best vector of malaria

A
  • bites humans only
  • longer life span compared to other species
  • more time to bite people
109
Q

A sequence of Chills, Fever, and Sweat and a characteristic periodicity

A

Classical Paroxysm

110
Q

Intense Cold phase that would last for ________ mins

A

15 - 60 mins

111
Q

what happens during

Chills

A
  • Shatter (vigorous shivering)
  • There is muscle contraction
  • Coincide with the bursting of RC
112
Q

what happens during

Fever

A
  • There will be a release of fever-inducing substances
    can promote inflammation
  • Intense Heat, drying burning skin
  • Throbbing headache
113
Q

Fever-inducing substances

A
  1. Release of pyrogens
  2. Release of tumor necrosis factor (TNF) that
114
Q

Duration of Fever

A

2-6 hours

115
Q

Duration of Sweating

A

2-4 hours

116
Q

what happens during

Sweating

A
  • The body cannot maintain the high body temperature, and the body will decrease this by sweating
  • There will be profuse sweating
  • Exhausted and weak → sleep
117
Q

Pathogenesis is due to

A
  1. RBC hemolysis
  2. Release of parasite metabolites
  3. Immunologic response
  4. Malarial pigment (hemozoin)
118
Q

3 components of apical complex

A

rhoptries, dense granules, micronemes

119
Q

Purpose of apical complex

A

cell invasion to the host cell

120
Q

Formation of knobs on infected RBCs

A

Cytoadherence

121
Q

What does P. falciparum form during cytoadherence

A

parasite forms parasitophorous vacuole in the RBC (merozoite is inside)

122
Q

bind and attach RBCs to the wall of the blood vessels

A

PfEMP1

123
Q

main component of the knob

A

PfEMP1

124
Q

PfEMP1

A

Plasmodium falciparum erythrocyte membrane protein

125
Q

receptors on surface of blood vessels

A

ICAM-1

126
Q

ICAM-1

A

intercellular adhesion molecule 1

127
Q

Sample used for laboratory diagnosis

A

capillary blood, peripheral blood

128
Q

gold standard for detecting Plasmodium spp.

A

microscopic examination of the thick and thin smear

129
Q

purpose of thick smear

A

quantification and screening of parasite

130
Q

purpose of thin smear

A

species identification

131
Q

other diagnostic method used

A

Quantitative Buffy Coat (QBC)

132
Q

stain used in QBC

A

acridine orange stain

133
Q

seen when Plasmodium is detected using QBC

A

(+) bright green and yellow under fluorescence
microscope

134
Q

Antigen produced by Falciparum trophozoite and gametocytes

A

HRP-II: histidine rich protein

135
Q

can distinguish Falciparum from non-Falciparum
species

A

pLDH: parasite lactate dehydrogenase

136
Q

Main treatment for uncomplicated P. falciparum, vivax,
malariae, and ovale

A

Chloroquine

137
Q

WHO recommended drug for falciparum and malariae

A

Arthemether combination treatment

138
Q

severe malaria and DOC for pregnant women

A

Quinine

139
Q

severe malaria

A

Artesunate

140
Q

relapsing vivax or ovale malariae

A

Primaquine

141
Q

not given to women and children (target the bones)

A

Doxycycline

142
Q

Prevention for Plasmodium spp.

A
  • Early diagnosis
  • Prophylaxis
  • Use of insecticide treated nets and repellants (target
    vector)
  • Use of larviparous fish (prevent transmission)
  • Use of larvicides (kill larva)
    (secretes toxin that kills larva)
  • Health education
  • No clear vaccine

2ND YR 1S (16 decks)

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