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Which of the following species of Plasmodium is the most widely distributed?
Which of the following species of Plasmodium is the most widely distributed?
What is the type of malaria caused by Plasmodium ovale?
What is the type of malaria caused by Plasmodium ovale?
Where is Plasmodium ovale mainly found?
Where is Plasmodium ovale mainly found?
What is the interval between the rupture of infected red blood cells in Plasmodium vivax?
What is the interval between the rupture of infected red blood cells in Plasmodium vivax?
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During which phase of the life cycle of malaria is the patient asymptomatic?
During which phase of the life cycle of malaria is the patient asymptomatic?
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What is the infective stage of the malaria parasite?
What is the infective stage of the malaria parasite?
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Which of the following species of Plasmodium causes malignant tertian malaria?
Which of the following species of Plasmodium causes malignant tertian malaria?
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How does the female Anopheles mosquito transmit malaria?
How does the female Anopheles mosquito transmit malaria?
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What is the result of incomplete quinine therapy and repeated attacks of Plasmodium falciparum infection?
What is the result of incomplete quinine therapy and repeated attacks of Plasmodium falciparum infection?
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What is the purpose of Giemsa-stained thin blood film examination?
What is the purpose of Giemsa-stained thin blood film examination?
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What is the function of primaquine?
What is the function of primaquine?
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What is the name of the remnants of haemoglobin that was digested by Plasmodium parasite?
What is the name of the remnants of haemoglobin that was digested by Plasmodium parasite?
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What is the term for the degeneration process occurring in Plasmodium infected RBCs?
What is the term for the degeneration process occurring in Plasmodium infected RBCs?
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What type of drug is used to treat blood gametocytes?
What type of drug is used to treat blood gametocytes?
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What is the recommended treatment for radical cure of Plasmodium vivax and Plasmodium ovale?
What is the recommended treatment for radical cure of Plasmodium vivax and Plasmodium ovale?
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What is the name of the vaccine engineered using genes from the outer protein of Plasmodium falciparum?
What is the name of the vaccine engineered using genes from the outer protein of Plasmodium falciparum?
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What is the treatment of choice for healthy individuals entering an endemic area?
What is the treatment of choice for healthy individuals entering an endemic area?
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What is the reason for natural resistance to Plasmodium vivax infection?
What is the reason for natural resistance to Plasmodium vivax infection?
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What is necessary for the existence of malaria in a certain locality?
What is necessary for the existence of malaria in a certain locality?
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What is the enzyme necessary for Plasmodium falciparum parasite growth?
What is the enzyme necessary for Plasmodium falciparum parasite growth?
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What is the result of knob formation on the surface of infected RBCs in Plasmodium falciparum infection?
What is the result of knob formation on the surface of infected RBCs in Plasmodium falciparum infection?
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Which of the following organs is affected by malaria, leading to diarrhoea and dysentery?
Which of the following organs is affected by malaria, leading to diarrhoea and dysentery?
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What is the result of hyper-reactive malarial splenomegaly?
What is the result of hyper-reactive malarial splenomegaly?
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What is the term for the complication of malaria characterized by massive intravascular haemolysis?
What is the term for the complication of malaria characterized by massive intravascular haemolysis?
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In which of the following situations does black water fever occur?
In which of the following situations does black water fever occur?
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What is a common feature of cerebral malaria, a complication of Plasmodium falciparum infection?
What is a common feature of cerebral malaria, a complication of Plasmodium falciparum infection?
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What is the typical sequence of symptoms in a malaria patient?
What is the typical sequence of symptoms in a malaria patient?
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What is the cause of hemolytic anemia in malaria patients?
What is the cause of hemolytic anemia in malaria patients?
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What is the reason for the reappearance of clinical attacks in Plasmodium vivax and Plasmodium ovale infections?
What is the reason for the reappearance of clinical attacks in Plasmodium vivax and Plasmodium ovale infections?
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What is the complication of chronic Plasmodium malariae infection?
What is the complication of chronic Plasmodium malariae infection?
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What is the cause of hepatosplenomegaly in malaria patients?
What is the cause of hepatosplenomegaly in malaria patients?
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What is the stage of malaria characterized by sudden chill and extreme cold?
What is the stage of malaria characterized by sudden chill and extreme cold?
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What is the duration of the hot stage of malaria?
What is the duration of the hot stage of malaria?
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Which Plasmodium species causes the most severe anemia?
Which Plasmodium species causes the most severe anemia?
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Study Notes
Plasmodium Species
- Plasmodium vivax: causes benign tertian malaria, most widely distributed
- Plasmodium ovale: causes ovale tertian malaria, confined to West Africa
- Plasmodium malariae: causes quartan malaria, rare except in Africa
- Plasmodium falciparum: causes malignant tertian malaria, most predominant in Africa
Global Distribution of Malaria
- Mode of infection: infective female Anopheles mosquito injects sporozoites with its saliva at the site of bite
Life Cycle of Malaria
- Infective stage: when a female Anopheles mosquito bites a patient, it ingests infected RBCs
- Liver phase: hypnozoites (P.vivax & P.ovale) present, patient is asymptomatic
- Blood phase: rupture of infected red blood cells occurs every 3rd day in P.vivax & P.ovale, 4th day in P.malariae, and irregularly in P.falciparum
Pathogenesis of Malaria
- Incubation period followed by influenza-like symptoms
- Malaria paroxysms (clinical attack) appears: symptoms coincide with rupture of infected RBCs, release of parasite metabolites, and host immunologic response
Clinical Picture of Malaria
- Patient passes through three consecutive stages:
- Cold stage: sudden chill, extreme cold, and temperature rises (15 minutes)
- Hot stage: headache, high fever, and hot, dry, and flushed skin (2-6 hours)
- Sweating stage: profuse sweating and temperature falls (few hours)
- Clinical attacks gradually decrease and finally disappear as patients' immune cells clear the circulation from most of blood merozoites, Plasmodium metabolites, and Malaria pigment
- Clinical attacks reappear due to presence of hypnozoites in the liver (relapse) or presence of low-grade parasitaemia when the patient becomes immunosuppressed (recrudescence)
Clinical Picture of Malaria (continued)
- Hemolytic anemia: severity of anemia varies according to the invading Plasmodium species
- P.vivax & P.ovale: prefer to invade young RBCs, less severe anaemia
- P.malariae: prefers to invade old RBCs, less severe anaemia
- P.falciparum: invades RBCs of any age, severe anaemia
- Hepatosplenomegaly: due to enhanced phagocytosis of remnants of ruptured red cells, blood merozoites, Plasmodium metabolites, and Malaria pigment
Complications
- Chronic P.malariae infection: complicated by Nephrotic syndrome
- P.malariae parasite produces excess amount of antigen
- Patient's immune system produces excess amount of antibody
- Immune complexes are produced and circulate to deposit on glomerular wall, leading to kidney tissue damage
- P.falciparum infection: complicated by:
- Knob formation on the surface of infected RBCs, adherence to receptors on endothelium of blood capillaries, leading to blood supply and death of organ tissue
- Examples of affected organs and tissues: brain (cerebral malaria), intestine, lungs, liver, and kidney
Laboratory Diagnosis of Malaria
- 1- Giemsa-stained thin & thick blood film examination to demonstrate the parasite stages
- 2- Detection of circulating parasite antigen using monoclonal antibodies
- 3- Detection of parasite DNA and RNA in patient's blood using PCR
Treatment of Malaria
- Groups of drugs used to treat malaria: tissue schizonticides, blood schizonticides, and blood gametocytes
- Recommended regimen for treatment of malaria:
- During clinical attack: Chloroquine
- Radical treatment after clinical attack: Primaquine (for P.vivax and P.ovale)
- Treatment of drug-resistant cases: combination of drugs (recently artimisinin)
- Chemoprophylaxis: for healthy human entering an endemic area
Epidemiology of Malaria
- Circumstances responsible for existence of malaria in a certain locality:
- Infected human (gametocyte carrier)
- Suitable species of Anopheles mosquito vector
- Human (susceptible to infection)
People Naturally Resistant to Malaria Infection
- Those having the following medical problems:
- Absence of Duffy antigen: resistant to P.vivax infection
- Haemoglobin S (in sickle-cell disease): shape of RBC and type of haemoglobin are not suitable for P.falciparum parasite growth
- Deficiency of G6PD enzyme: P.falciparum parasite needs this enzyme for its growth
Control of Malaria
- Treatment of cases
- Mosquito control
- Chemoprophylaxis
- Vaccination trials: RTS, S/AS01 was engineered using genes from the outer protein of P.falciparum
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Description
This quiz covers the different species of Plasmodium, such as P. vivax, P. ovale, P. malariae, and P. falciparum, and their corresponding types of malaria. It is essential for medical students and healthcare professionals to understand the characteristics of each species.
