L12-Malaria Year 4 Internal Medicine Notes OmpathStudy

L12-Malaria Year 4 · Internal Medicine Collection: 4TH YEAR ALL NOTES / IMED / I MED BEAUTIFUL NOTES / INFECTIOUS -- Malaria Lecture objectives: ● Know the 5 species of malaria that infect humans ● Describe the life cycle of malaria, morphology and clinical\npicture ● Compare pathogenesis of different malaria species ● Know endemic countries of malaria species ● Know malaria paroxysm ● Know complications of malaria ● Describe methods for laboratory diagnosis of malaria ● Know action of anti malarial drugs in different life stages of\nmalaria parasite\n\nColor index:\nImportant\nFound in Girls’ slides\nDoctors’ note\nFound in Boys’ slides\nExtra\n\n EDITING FILE \n\n 1\nMalaria\n● Overview\n● Malaria is the most important of all tropical parasitic disease,causes death and\ndebility and is endemic throughout the tropics and subtropics.\n● The main symptoms and signs are periodic fever, headache,anorexia and anemia.\n\n Plasmodium falciparum\nthe most dangerous one\nPlasmodium vivax\n\n Five species of malaria\nPlasmodium ovale Plasmodium malaria\ninfect humans \nPlasmodium knowlesi\n\n ● Epidemiology (explained better in the next slides)\nAsexul stage2 Sexual stage3 \nSporozoites are injected by an infected Male and female Gametocyte are taken up\nAnopheles Mosquito into the blood of human from the blood of an infected human by\nand enter liver cells and will become schizonts biting mosquito. Further sexual development\nthen become Merozoites which are released in takes place in the mosquito gut to produce\nthe circulation and penetrate the Red Blood SPOROZOITES.\nCell and cause the main pathology of the\ndisease hemolysis and anemia. Some parasites\ndevelop into male and female Gametocyte. \n∘ Human to human transmission can occur by blood transfusion or vertical transmission\nacross the placenta.\n\n Anopheles Mosquito\nThe devil itself\nMalaria –Endemic Countries\n\n1. The most dangerous species, causing severe illness 2. Inside the human body 3. Inside the mosquito \n\n 2\nMalaria\n● Life Cycle of Malaria\n\n Explanation for the picture:\n1. Malaria is mainly carried by female anopheles mosquito.\n2. The infected mosquito will bite and inject sporozoites from it salivary gland into the bloodstream of human.\n3. Which then will travel through blood until it reaches the liver and enter the hepatocytes where it will multiply\nasexually to form merozoites inside the schizont (Exoerythrocytic schizont).\n4. When the hepatic schizont rupture the merozoites will be released into blood, then it will enter the erythrocytes\nforming immature trophozoites (ring stage) which will have 2 pathways:\na. First pathway: It goes through the erythrocytic cycle starting from ring stage then into Mature trophozoites,\nthen the merozoites will multiply inside the RBCs forming schizont (Erythrocytic schizont), which will\nrupture (hemolysis) and release the merozoites into the bloodstream (Clinical attack of malaria is due to this\nstage) and the cycle will repeat over and over again.\nb. Second pathway: Some immature trophozoites will become gametocytes (male and female) those\ngametocytes will be ingested by another mosquito; in the mosquito:\ni. There are Micro(Male) and Macro(Female) gametocytes, the microgametocytes will enter into the\nmacrogametocytes in which they will form Ookinete then it will develop into Oocyst which will\nrupture releasing sporozoites in mosquito, then the cycle will go over and over again.\n\n The pattern of fever in different species of malaria: \nplasmodium Vivax1\nOccurs every\n48hrs - tertian\nplasmodium Ovale1\nTime to rupture\n\n quotidian, tertian,\nPlasmodium Falciparum\nirregular\n\n Occurs every\nPlasmodium Malariae\n72hrs - quartan\n\n1. Can stay latent in the hepatocytes (Hypnozoites) thereby causing chronic/recurrening infection. \n\n 3\nMalaria ● Malarial Paroxysm\nCold stage:\n● feeling of intense cold\n● vigorous shivering\n● lasts 15-60 minutes \nHot stage:\n● due to rupture blood schizonts.\n● intense heat Chills Fever\n● dry burning skin\n● throbbing headache\n● lasts 2-6 hours \nsweating stage:\n● profuse sweating\n● declining temperature\nSweating\n● exhausted and weak → sleep\n● lasts 2-4 hours \nThen the cycle starts again\n\n● Pathogenesis of malaria ∘ Symptoms are due to:\n1. Hemolysis of Red Blood Cells:\nwith release of metabolites and\npigments from Malaria parasite. \n2. Plugging of capillaries by parasitized\nerythrocytes:\nIn cerebral malaria there is\nsequestration of parasites in central\nnervous system capillaries caused by\nPlasmodium Falciparum. \n\n 4\nMalaria\n● Clinical picture \nAcute Chronic \nNon-severe Acute Febrile Chronic Asymptomatic\nInfection During Pregnancy\ndisease Infection\n\n Severe malaria Anemia Placental Malaria\ne.g.Cerebral Malaria \nDevelopmental Disorders, Low Birth weight\nDeath Transfusions & Death.\n\n Increased Infant Mortality\n\n ● Complication of severe Malaria:\n● Severe malaria is defined as: symptomatic malaria in a patient wit