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39 Cards in this Set
- Front
- Back
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1.how much of world is at risk for malaria?
2.how many people diagnosed with symptomatic disease in 2010 3.how many people died in 2010 from malaria? 4.) is malaria the single most important infectious killer of children on planet? |
1.) 50%
2.) 225 million diagnosed in 2010 3.) 1.2 million died 4.) yes |
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describe life cycle of malaria:
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-transmitted by infectious female anopheles mosquito during blood meal
-injects sporozoites that infect hepatocytes -undergo asexual multiplication (pre-erythroyte stage) -after 6 days up to 40,000 merozoites rupture from each hepatocyte (P. falc) -each merozoite infects single RBC (schizogony occurs i.e. asexual reproduction produces 8-24 merozoites every 48 hours) --the merozoites rupture RBC and infect additional RBC's -occasionally merozoite differentiate into male/female gametocyte ingested by mosquito/// fuse to form ookinete (attach to gut wall in mosquito and migrate to salivary glands) |
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How long is the liver stage and how many merozoites are produced?
How long is the erythrocyte stage in falciparum/ovale/vivax versus malariae |
liver stage is 5.5-15 days; produce 10,000 merozoites
erythrocyte stage: FOV: 48 hours and malariae: 72 hours |
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What is the dormant hepatic form which can reemerge to cause bloodstage many years later and in what two species?
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hypnozoite in P.v and P.o
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list the five malaria strains and their locations:
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1.) P. falciparum (worldwide)
2.) P. vivax (s. america and asia) 3.) p. ovale (s. africa) 4.) p. malariae (Africa, s. america, asia) 5.) p. knowlesi: primates in asia |
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list four erythrocyte-associated genes that select for malaria:
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1.) Sickle cell
2.) beta thalessemia 3.) G6PD 4.) duffy antigen for p. vivax |
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list the mild malaria clinical presentations (severe flu fever symptoms (5) and ____ and ______
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severe flu like symptoms
-headaches, myalgia, bone pain, abdominal pain, recurrent chills and defervescence two additional ones: anemia and splenomegaly |
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Define tertian and quartian and give examples of types of parasites?
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tertian: (every second day/ 1/2/3: fever spike; every 48 hours : FOV
quartian: every third day: 1/2/3/4: malariae |
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list 7 severe malaria syndromes associated with falciparum and 1 each associated with vivax and malariae
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falciparum: cerebral malaria, placental malaria, pulmonary malaria, hypoglycemia, bacterial sepsis, backwater fever, severe anemia
vivax: splenic rupture malariae: nephrotic syndrome |
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How does P. falciparum cause disease?
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-infected red cells have knob like protrusions on surface: stick to walls and clog small vessels and capillaries
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Epidemiology of malaria: what age group affected most?
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severe: under 5; mild: up to 12; asymptomatic: around 20's
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What is chloroquine and what are the chloroquine sensitive areas?
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-eradicate the malaria
-only Central America, Haiti, and Middle East are still sensitive |
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What are limitations to developing anti-malarials?
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-no vaccine, multidrug resistance, and cost
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What stage of pregnancy (primigravid, secundigravid, or multigravid) is the worst?
-What does the parasite pFEMP1 bind to in placenta? -what congenital problems does malaria cause? |
-first (primigravid > secundigravid >>> multigravid)
-CSA (chondroitin sulfate A) -low birth weight, prematurity, perinatal infant mortality, mortalitu in mother |
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Diagnosis of malaria: (microscopy, rapid diagnostic tests; PCR, and ___)
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microscopy:
blood smears: thick for diagnosis and thin for speciation at least 3 tests if smear is negative -rapid: binaxNOW and Paracheck -PCR -leukopenia, anemia, (panpenia) |
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vaccines for malaria:
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-new malaria in phase 3 trial, RTS, S: (30-50% effective)
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long term and short term malaria prevention:
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-short term: IRS (indoor residual spraying); reduce mosquito breeding sites; bednets)
-long term: vaccine, distribution, |
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incubation period for malaria:
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7-30 days or longer
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what insect transmits leishmaniasis and during white time period?
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female sandlfly from dusk to dawn (at night)
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what are the three forms of leishmaniasis (and define what organs are involved) and name the types of species associated with them:
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-cutaneous: L. tropica, major, mexicane, braziliense (skin at site of bite)
-visceral: L. donovani (spleen, liver, bone marrow) -mucocutaneous: L. braziliense (mouth and mucus membranes) |
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Describe the geographic distribution (90/90/90): of the three types of Leishmaniasis:
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90% cutaneous: (SSABIP): saudi arabia, syria, afghanistan, brazil, iran, peru
90% visceral in BBINS: brazil, bangladesh, india, nepal, saudia arabia 90% mucucutaneous in bolivia, brazil, peru |
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what are the two parasite form names of leishmaniasis?
describe life cycle of Leishmaniasis: |
-promastigote
-amastigote -8 steps of life cycle: 1.) sandfly takes a blood meal (injects promastigote) 2.) promastigote phagocytozed by macrophages 3.) promastigotes transform into amastigotes inside macrophages 4.) amasitogotes multiply in cells (obligate) 5.) sandfly takes a bloodmeal and ingests of parasitized cell 7.) amastigote transform into promastigote in midgut -8.) divide in midgut and move to saliva |
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Are leishmaniasis obligate intracellular pathogens?
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YES!!!!
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what is the most common form of leishmaniasis?
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cutaneous leishmaniasis
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when do lesions develop in cutaneous leishmaniasis? Can they heal on own and do they leave scars?
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weeks to months; they heal on own but leave scars
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what are the clinical symptoms of mucocutaneous leishmaniasis? when do develop?
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-cutaneous lesion on face spread to involve mouth and nose
-months to years after original skin lesion and can be disfiguring (espundia) |
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what is another name of visceral leishmaniasis and what are the clinical features?
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-kala azar (hindi for fatal fever/illness)
-most severe form of disease: may be fatal -spiking fever, weight loss, enlarged spleen and liver ; (pancytopenia) |
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kala azar is associated with what virus?
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HIV/AIDS
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When should visceral leishmaniasis be considered?
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-in any chronic FEVER patient returning from an endemic area
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why is there usually a delay in diagnosing visceral leishmaniasis?
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-symptom are non-specific and symptoms occur months after bite
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What is essential for diagnosing cutaneous leishmaniasis? Where can you send biopsy specimens?
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-biopsy (giemsa stain of tissue smears)
-Walter Reed AIR: for diagnosis |
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What is essential for diagnosing visceral leishmaniasis?
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-need to find leishmania on biopsy of bone marrow, liver, lymph node, or spleen
-antibodies to leishmania in patient serum (will not distinguish between time of infection); |
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Treatment of cutaneous and mucocutaneous leishmania (FAM)
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-miltefosine for cutaneous and visceral disease
-antimony/ sodium stibogluconate is former drug of choice (20 days IV) -Fluconazole: decrease healing time in L. major infection (need biopsy for species determination) and 6 weeks of therapy ) |
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Treatment for visceral Leishmaniasis: (
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liposomal amphotericin B is drug of choice (3 mg/kg/day on days 1-5 day 14, day 21)
-sodium stibogluconate is alternate (28 days) -oral miltefosine (99% cure rate 6 months) |
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prevention of Leishmaniasis:
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-control reservoir (rodents)
-control vector: sandfly -indoor residual spraying -protect at night |
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What insect causes babesiosis?/ injects the parasite?
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tick (young nymph size of poppy seed); ixodes scapularis );
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What is the life cycle of babesia:
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tick -> injects sporozoites --> host --> merozoites infect RBCs --> ingested by tik where gametes form and zygotes then ookinetes, migrate to salivary gland
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Where is babesia located?
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Northeast
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What is the characteristic image of babesia in a blood smear? and what is the treatment?
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-maltese cross:
-clindamycine and quinine -atovaquone and azithromycin |
