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109 Cards in this Set
- Front
- Back
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This species of malaria is lethal and has developed drug resistance, making it more of a problem for man.
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Plasmodium falciparum
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This species of malaria parasitizes RBCs and makes them"sticky". The RBCs containing mature parasites adhere to the walls of capillaries and mature parasites are difficult to detect in a peripheral blood smear. Often only ring forms and gametocytes are present.
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Plasmodium falciparum
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This malarial parasite has a characteristic fever periodicity that produces a fever spike every 3 days (72 hours). This periodicity has led to a common clinical name. Name the genus and species as well as this clinical description of the fever cycle.
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Plasmodium malariae, quartan malaria.
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Name the genus and species of the malaria that is sometimes described as benign tertian malaria.
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Plasmodium vivax
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Name the genus and species of malaria that is sometimes described as malignant tertian malaria.
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Plasmodium falciparum
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This species of malaria can infect liver cells and "hide" there, providing opportunities for a "relapse".
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Plasmodium vivax
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This species of malaria produces a sausage-shaped gametocyte that is diagnostic when seen in a blood smear.
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Plasmodium falciparum
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This form of the malarial parasite is ingested by the mosquito in a blood meal.
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Gametocyte
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This form of the parasite is injected by the mosquito while taking a blood meal.
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Sporozoite
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A definitive host is the host in which the sexual stage of reproduction takes place. What is the definitive host of malaria?
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Mosquito
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The intermediate host of a parasite is the host where the asexual stages of the parasites live. What is the intermediate host of malaria?
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Humans.
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What type of reproduction do malaria parasites use to multiply in the liver?
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Asexual reproduction - one cell divides to make two, etc. Process is called schizogony. Progeny are called schizonts - from schizo - meaning split - these are "splitters".
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How are soldiers protected against malaria?
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Prophylactic doses of anti-malarial drugs can be given, use of insect repellent, mosquito netting while sleeping. Immunization is not effective.
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What is the insect vector of malaria? What is the sex of the appropriate vector?
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Mosquito, female
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Malaria infected cells rupture and release the many progeny of the parasite - what is the name of the stage released from the red cell?
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Merozoites
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There are microgametocytes and macrogametocytes of malarial parasites. What is the difference in these two?
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Macrogametocytes are analagous to the female, and microgametocytes are analagous to male. The union of a microgamete and a macrogamete produces an ookinete.
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Describe a typical patient presentation for a person infected with malaria.
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Recent travel history (outside USA). Complain of high fever (maybe with chills/maybe not).Headache, myalgia, arthralgia, vomiting, diarrhea. Physical findings of splenomegaly.Add malaria to your differential diagnosis.
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True/False:I never have to consider malaria in the USA, since malaria is not endemic in the USA.
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False. Remember that Plasmodium vivax can infect liver cells and the patient might "relapse" upon return to the USA from an endemic area. Be watchful of anyone with a travel history to a malarious area, especially if they did NOT take prophylactic drugs.
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Plasmodium falciparum is more dangerous than the other species of malaria. Can you explain why?
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Plasmodium falciparum will infect all red cells, regardless of age, where other species are more selective. P. falciparum is sometimes drug resistant, and the infection can progress to death if not treated.
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100% of the patents with malaria complain of this
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fever and headache
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91% of patient with malaria complain of this
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profuse night sweats
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94 % of patients with malaria complain of this
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Weakness
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How many people a year does malaria infect
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300-500 million
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Most deaths occur amongst this group
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African children
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How many world wide death per year
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1.5 to 2 million
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Malaria is a member of what family
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Apicomplexians
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Babesia, Toxoplasma, and Cryptosporidium
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the three apicomplexians that produce malaria
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Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, and Plasmodium malariae
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the four species of malaria that infect humans
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Red cell enlargements, very ameboid cytoplasm of the trophozoites and the presence of schuffner's stippling are present in which type of malaria
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Plasmodium vivax
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This form of malaria will present only ring forms and gametocytes in the peripheral blood.
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Plasmodium falciparum
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This form RBCs become sticky and will be caught in small vessels and will be caught in small vessels and removed from circulation
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Plasmodium falciparum
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What is the primary source of pathology in cerebral malaria
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the clogging of small vessels caused by Plasmodium falciparum
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Band forms and rosettes containing 8-12 merozoites are characteristic of what type
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Plasmodium malariae
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Do cells infected with P malariae and P falciparum become enlarged
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no only in those infected with P. vivax
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Malarial parasites are member of what class
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sporozoa
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How many cases of malaria does the military see each year
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45-50
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How many deaths each year in the US for malaria
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5-10
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benign tertian
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Plasmodium vivax
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found in tropical and subtropical and predominant species in temperate zones
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Plasmodium vivax
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moderate to severe it invades only reticulocytes, 2-5% of available RBCs and about 64% of reported cases of malaria
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Plasmodium vivax
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oval or benign tertian malaria
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Plasmodium ovale
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west and central africa; south america, asia is where this malaria is found
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Plasmodium ovale
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low to moderate and invades only reticulocytes 2-5% of available RBCs. less than 1% reported cases
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Plasmodium ovale
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quartan
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Plasmodium m
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found in subtropical and temperate zones
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Plasmodium malariae
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invades mature erythrocytes and considered very low parasitemia with less than 3% reported cases
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Plasmodium malariae
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malignant tertian
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Plasmodium falciparum
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predominant species in the tropics, frequency very high
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Plasmodium falciparum
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infects all erythrocytes, and can invade the same erythrocyte multiple times
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Plasmodium falciparum
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about 32% of the reported cases of malaria
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Plamodium falciparum
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exoerythrocytic schizogony
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initial replication in the liver
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erythrocytic schizogony
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parasites under go asexual multiplication in the erythrocytes
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What do the ring stage trophozoites mature into
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schizonts
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After the sporozoites infect the liver cells the mature into what
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schizonts
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Schizonts rupture and release what
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merozoites
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Some merozoites differentiate into sexual erythrocytic stages called
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gametocytes
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When the parasites multiply in the mosquito this is known as what?
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sporogonic cycle
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While in the misquitoes stomach the microgamets generate a what
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zygote
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The zygote becomes motile and enlogated this is a what
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ookinetes
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what does the ookinets invade
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the midgut wall of the mosquitoe
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What does the ookinets develop into
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oocyts
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The oocysts grow and rupture and release what
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sporozoites
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sexual cycle of the anopheles definitive host
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sporogony
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what is the definitve host of malaria
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mosquito
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What is the vertebrate host malaria
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human with the asexual cycle
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what is the name of the asexual cyle that occurs in the human host
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schizogony
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means of transmission for the malaria
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misquito, transfusion, congenital-it crosses the placental barrier
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What is the erythrocytic phase called
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ExoErythrocytic
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What happens during the exoerythrocytic phase
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sporozoites to the liver
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what are the symptoms of the preerythrocytic phase
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asymptomatic
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what is another name for the exoerythrocytic phase
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preerythrocytic phase
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Schizogony
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exoerythrocytic phase
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what happens in the exoerythrocytic phase
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liver schizogony (relapses)
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What are the morphological stages of the erythrocytic phase
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trophozoites, schizonts, gametocytes
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What are the symptoms of the schizogony phase
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chills and fever
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ookinete form a what in the misquote
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oocyst
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the oocyst becomes a what
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sporocyst
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sporozoites produced in what?
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sporocyst
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sporozoites migrant to what
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salivary glands
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What is the best lab test for morphology in malaria testing
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capillary puncture
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time of collection for malaria testing
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at six hour intervals 3 to 4 days midway between fever peaks for plamodium falciparum
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the paroxysm begins with a chill followed by fever and terminates with a sweating stage caused by release of what
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merozoites
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the paroxysm cycle recurrs periodically for benign tertian about when
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48 hours
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the paroxysm cycle recurrs periodically for benign quartan about when
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72 hours
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the paroxysm cycle recurrs for malignant tertian when
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indefinite, but frequent about 48 hours
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diagnosis is done by
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recovery and identification of parasites in circulation with thick blood films, IHA, IIF, and serodiagnosis
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treatment
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chemoprophylaxix is highly recommended for travelers in malarious areas of the world. The 3 separate stages cannot be treated successfully with one drug
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best for morphology in the stages
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giemsa blood stain
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What will you find with a blood smear
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morphological stage of the parasite intracellular
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the most widely used test
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indirect immunofluorescence with 95% sensitivity and 1:64 titer
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the test used for screening
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soluble antigen fluorescent antibody (SAFA)
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acute stage
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intermittent febrile paroxysms with fever and chill cycle and you can compare among the species
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The fever chill cycle corresponds to the what
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schizogonic cycle in the erythrocytic phase
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the paroxysms occur when what
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the merozoites of the mature schizonts, together with their pigments and residual erythrocytic debris, erupt from the RBCc into the blood stream
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What is the characteristic of malaria
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the intermittent paroxysms. fever chills
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the intermittent febrile paroxysms occur when with the P. Vivax
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48 hours
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the intermittent febrile paroxysm occur when with P ovale
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48 hours
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The intermittent febrile paroxysms occur when with the P. malariae
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72 hours
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the intermittent febrile paroxysms occur when with P falciparum
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36 to 48 hours
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temperature 103-106; headache-periocular pain, lethargy, lack of appetite, vague pain in joints proteinuria
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acute stage symptoms
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in children malaria mimics what
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nephrotic syndrome
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Pernicious malaria
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P. falciparum
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nausea vomiting cyanosis, adhesive infected cells (sequestration) oliguria, auria, hematuria black water fever
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symptoms of pernicious malaria
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hemorrhaging, coma, convulsions, black water fever
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symptom of pernicious malaria
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What causes the chronic stages of malaria
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P vivax
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latency, benign acquired immunity
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occurs in chronic stages
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What happens in the vascular disorders of malaria
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erythrocyte destruction, anemia, blockage of capillaries, anoxiemia
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What happens in the tissue disorders of malaria
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splenomegaly, impairment of parenchymal cells, phagocytosis by reticuloendothelial cells
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what are the tissue disorders caused by malaria
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edematous lesions, kidney, cerebral involvement, cardiac muscles, and gastrointestinal tract
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