Protozoa (malaria, )

Question 1

P. knowlesi similar to . . .

Answer 1

P. malariae

increasingly recognized in Myanmar, Phillipines, Indonesia, and Thailand.

causes high parasitemia

Question 2

Malaria with high parasitemia ?

Answer 2

P. falciparum;

P. knowlesi;

P. malariae ?

Question 3

Chloroquine resistance Plasmodium

Answer 3

P. vivax

P. falciparum

Question 4

Malaria Disease relapse risk

Answer 4

P. vivax

P. ovale

P. malariae

Question 5

Treatment of P. falciparum

Answer 5

 artemether/lumefantrine (Coartem) x 3 days

 atovaquone/proguanil (Malarone) x 3 days

 2nd line: quinine x 3 days + doxycycline x 7 days

Severe
 IV artesunateavailable

 IV quinidine (or quinine) (ICU monitoring QTc)

Question 6

Tx P. vivax, P. ovale, P. malariae, P. knowlesi

Answer 6

chloroquine x 3 days

THEN primaquine (30 mg base) x 14 days (P. vivax/ovale)

Need to check G6PD before primaquine as can cause severe hemolysis in G6PD deficiency

Question 7

Chloroquine resistant P. vivax treatment . . .

Answer 7

Quinine + doxy
or
atovaquone/proguanil + primaquine

Question 8

Safe drugs for malaria in pregnancy

Answer 8

Chloroquine

Quinine / quinidine

Mefloquine

Question 9

Malaria prophylaxis

Answer 9

atovaquone/proguanil (Malarone)

Mefloquine (ok in pregnancy)

Doxy

Question 10

Consider malaria co-infection

Answer 10

P. vivax and P. falciparum

Question 11

Leishmaniasis

Answer 11

Transmitted by sand flies

Skin, mucosal and visceral

L. braziliensis on causing cutaneous and mucosal

L. donovani and chagasi causes visceral “only”

Question 12

Sleeping sickness

African trypanosomiasis

Answer 12

> transmitted by tsetse fly

> T. brucei rhodesiense in East African (severe initial disease.)

> T. brucei gambiense in West Africa.