S13C153 - Malaria

Question 1

Species of malaria (protozoan)

Answer 1

• plasmodium vivax (can remain dormant)
• p ovale (can remain dormant)
• p malariae
• p falciparum (most common, accounts for 62% of cases) (african)
• p kowlesi

Question 2

Malaria pathophys

Answer 2

• female anopheles bites, injects sporozoites
• go to liver, merozoites form and release into blood and invade RBC becoming trophozoites and schizonts, lyse and reinfecgt

Question 3

Malaria - clinical presentation

Answer 3

• signs appear once RBC have been invaded
• lyse an re-invade q2-3d producing a cycle of periodic symptoms
• recurring febrile paroxysm = hemolysis of infected RBC and release of antigens
• fever, malaise, myalgia, h/a, chills, cyclical
• unusual to hav ea rash or lymphadenopathy

Question 4

Malaria complications

Answer 4

• hemolysis
• splenic enlargement/rupture
• glomerulonephritis
• cerebral malaria: somnolence, coma, delierium, seizures
• respiratory failure

Question 5

Malaria: Dx

Answer 5

-thick and thin blood smear (Field or giemsa-stained)

Question 6

Malaria: Tx

Answer 6

• vivax/ovale/malariae/chloroquine-sensitive falciparum: chloroquine phosphate PLUS primaquine phosphate
• chloroquine resistant falciparum: quinine PLUS doxy / or malarone / or mefloquine PLUS doxy
• if complicated: artesunate then malaronePLUS doxy or mefloquine

Question 7

Side effects of antimalarial drugs:

Answer 7

• chloroquine: retinopathy with prolonged use, avoid in psoriasis, n/v/d, rash, fever, h/a
• quinine: cincchonism, coombs+ hemolysis, abortions, myasthenia, contraindicated in cardiac dz, caution in pregnancy, MG, hypoglycemia
• mefloquine: nightmares, seizures, precaution in kids

Question 8

Chemoprophylaxis for malaria

Answer 8

• chloroquine
• doxycycline
• malarone

if chloroquine resistance:

• mefloquine
• malarone
• doxy
• primaquine

Question 9

Non-med prophylaxis

Answer 9

-nets
-don’t be out a dark
-long-sleeved clothing
-insecticide impregnated nets
-DEET
-