Term
| Most cases of Malaria are due to what pathogen? |
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Definition
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Term
| What is the vector for malaria? |
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Definition
| Female Anopheline mosquitos |
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Term
| Once a female anopheline mosquito injects, what can possibly exit its gut to cause infection? |
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Definition
| Sporozoites (linear parasites) |
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Term
| Where does the Sporozoite come to a stop in the bloodstream? |
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Definition
| Liver, where they infect hepatocytes |
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Term
| How do the Sporozoites reproduce? |
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Definition
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Term
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Definition
| A liver cell with lots of replicated sporozoites in it |
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Term
| Eventually the liver Schizont ruptures and releases what and where do they go? |
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Definition
| Merozoites, which home in on RBCs to continue their reproduction |
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Term
| Merozoites enter RBCs in what structure? |
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Definition
| PVM Parasitophorous Vacuole Membrane |
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Term
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Definition
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Term
| How do the female anopheline mosquitos get infected with the sporozoite? |
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Definition
| Blood containing gametocytes (male and female) are found in some RBCs and they reproduce inside the mosquito to form a motile egg |
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Term
| The motile egg formed inside mosquitos is known as what? |
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Definition
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Term
| The Ookinete migrates and forms what? |
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Definition
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Term
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Definition
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Term
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Definition
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Term
| What genetic variants are protective of Malaria? |
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Definition
| Hgb AS, Hgb AC, alpha thal, beta thal, hereditary ovalocytosis, G6PD deficiency, and Absence of Duffy antigen (a non-specific chemokine receptor) |
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Term
| What are the 3 stages of clinical presentation of Malaria that occur within 6 weeks of leaving an endemic area? |
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Definition
| Cold stage, Hot stage, and Sweating stage |
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Term
| How long does the cold stage last and what does it cause? |
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Definition
| 15min to 1hr; causes Rigors |
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Term
| How long does the Hot stage last and what does it cause? |
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Definition
| Several hours; causes high fever, restlessness, myalgia, nausea |
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Term
| What does it mean to be a Tertian malaria? |
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Definition
| Fever occurs on first day, not on second day, then again on Third day |
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Term
| What does it mean to be a Quartan malaria and what is the only species of malaria to present this way? |
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Definition
| Fever on first day, none on second, none on third, fever on Fourth day; P. malariae is the only species that has this characteristic |
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Term
| Why might you actually have fever every day? |
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Definition
| P. malariae + some other malaria |
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Term
| What is the clinical presentaiton of Severe Malaria? |
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Definition
| Impaired consciousness, especially if Cerebral malaria occurs |
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Term
| What is "Blackwater Fever" |
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Definition
| So much hemolysis and hemoglobinuria that it turns black |
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Term
| What is the pathogenesis of Cerebral Malaria? |
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Definition
| anoxia due to blockage of cerebral arterioles |
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Term
| How does cerebral malaria cause clumping of RBCs? |
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Definition
| Sticky knobs on the surface of RBCs attrach more RBCs to cause infarctions |
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Term
| What is the only strain of malaria that causes Cerebral Malaria? |
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Definition
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Term
| How do you diagnose P. falciparum? |
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Definition
| Look for bananas/crescents in blood smear (the gametocyte form of P. falciparum) |
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Term
| What age RBC does P. falciparum affect? |
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Definition
| ALL AGES so as much as 50% of RBCs can be affected |
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Term
| P. malariae affects what age RBCs? |
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Definition
| Senescent RBCs (smaller, fragile RBCs) |
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Term
| Clock faced inclusions and sash-like inclusions are indicative of what strain of malaria? |
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Definition
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Term
| What gives P. ovale its name? |
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Definition
| It forms oval shaped parasitized RBCs |
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Term
| What age RBC does P. ovale attack? |
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Definition
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Term
| What age RBC does P. vivax attack? |
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Definition
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Term
| Why do you usually not see the schizont of P. falciparum? |
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Definition
| P. falciparum schizonts forms RBC rosetts that get hung-up in microvasculature |
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Term
| What is the amino acid source of Plasmodia (malaria)? |
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Definition
| digestion of hemoglobin (which forms pigment breakdown products) |
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Term
| What don't Plasmodia like about the breakdown of hemoglobin and why? |
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Definition
| the Heme component because it produces ROS that are toxic to Plasmodium |
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Term
| What steps does Plasmodia take to deal with the toxic Heme, what enzyme is used, and what ultimately forms? |
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Definition
| first it oxidizes it then it uses Heme Polymerase to form Hemazoin (crystallized hematin that forms the malarial pigment) |
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Term
| What are the four Aminoquinolones? |
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Definition
| Chloroquine, Mefloquine, Quinine, and Quinidine |
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Term
| What do the Aminoquinolones do to kill malaria? |
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Definition
| they inhibit Heme Polymerase, causing a build-up of toxic heme |
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Term
| What are the four Anti-Folates? |
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Definition
| Pyrimethamine, Dapsone, Proguanil, and Sulfadoxine |
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Term
| What is the mechanism of action of the Anti-Folates? |
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Definition
| Inhibits Pterydine synthetase from forming folic acid from PABA (thus reducing purine, pyrimidine, and amino acid synth) |
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Term
| What does the anti-Malarial Atovaquone do? |
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Definition
| Blocks parasite mitochondrial e- transport chain by acting as a structural Analogue of Coenzyme Q |
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Term
| What does the anti-Malarial Artemisinin do? |
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Definition
| generates ROS in the mitochondria of Malaria |
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Term
| Chloroquine is the drug of choice for treating what strains of malaria? |
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Definition
| P. vivax, ovale, malariae |
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Term
| How should P. vivax malaria from Papua New Guinea or Indonesia be treated? |
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Definition
| Atovaquone-Proguanil combination |
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Term
| The more severe P. falciparum should be treated how? |
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Definition
| IV quinidine gluconate in the ICU |
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Term
| Which strains of malaria can relapse and how? |
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Definition
| P. vivax and P. ovale found in liver cells where they form "hypnozoites" |
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Term
| Which drug is an anti-hypnozoite? |
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Definition
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Term
| Where is P. falciparum most commonly located? |
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Definition
| Africa, Haiti, Dominican Republic, Amazon basin |
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Term
| Where is P. vivax most commonly located? |
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Definition
| South/Central America and Souther Mexico |
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Term
| Schuffner's dots are inclusions found in what strains of malaria? |
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Definition
| P. ovale and P. vivax (speckles) |
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