Revision - Malaria Flashcards
What is malaria caused by?
Plasmodium PROTOZOA (spread by the female Anopheles mosquito).
Which species of malaria causes nearly all severe episodes?
Plasmodium falciparum
Features of malaria?
1) Prodrome:
- malaise
- headache
- fatigue
- myalgia
- arthralgia
2) Fever –> periodic episodes of fever accompanied by chills and rigors
3) GI symptoms:
- N&V
- abdo pain
- diarrhoea
- may have hepatomegaly
4) Respiratory symptoms:
- ARDS
- cough
- SOB
- pleural effusion
5) Neurological symptoms:
- altered mental status, seizures, ataxia, or coma
- nystagmus, cranial nerve palsies, and focal neurological deficits
6) Anaemia & haemolysis
7) Splenomegaly
8) Renal dysfunction –> AKI
9) Coagulation abnormalities –> DIC
10) Derm manifestations e.g. jaundice
What is the gold standard investigation for diagnosis of malaria?
Blood film
What blood film result confirms diagnosis of malaria?
trophozoites
How can malaria affect platelets?
Can cause thrombocytosis
How can malaria affect RBCs?
normochromic normocytic anaemia
How can malaria affect reticulocytes?
reticulocytosis
What is the recommended treatment of uncomplicated P. falciparum malaria?
Artemisinin combination therapy –> Artemether + lumefantrine
Name medications used for malaria prophylaxis
1) Atovaquone + proguanil (Malarone)
2) Chloroquine
3) Doxycycline
4) Mefloquine (Lariam)
5) Proguanil (Paludrine)
6) Proguanil + chloroquine
What is a key contraindication of chloroquine?
Epilepsy
How long after leaving the malaria-prone area should prophylaxis continue?
4 weeks
What are 2 key side effects of doxycycline?
1) photosensitivity
2) oesophagitis
What is a key contraindication of Mefloquine (Lariam)?
Epilepsy
Why may detecting malaria in pregnant women be difficult?
Diagnosis can be difficult as parasites may not be detectable in the blood film due to placental sequestration.
