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CC May 2016 Malaria Diagnosis

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echoecho's version from 2016-07-24 17:12

Section

Question Answer
Malaria is a ______ infection?parasitic
List 5 protozoans that cause malaria?1) Plasmodium falciparum 2) Plasmodium malariae 3) Plasmodium knowlesi 4) Plasmodium ovale 5) Plasmodium vivax
What country or countries are Plasmodium falciparum seen in?1) sub Saharan Africa 2) Southeast Asia
What country or countries are Plasmodium malariae seen in?tropics of all continents
What country or countries are Plasmodium knowlesi seen in?Southeast Asia (especially Malaysia)
What country or countries are Plasmodium ovale seen in?1) Africa 2) Asia
What country or countries are Plasmodium vivax seen in?1) Asia 2) South America
What is the website for country-by-country information about malaria risk?http://www.ced.gov/malaria/travelers/country_table/a.html
What is the website for traveler prevention information for patients?http://www.ced.gov/malaria/resources/pdf/travelers.pdf
Although malaria was eliminated from the US in the 1950s, about 1,500-2,000 cases are reported in the US annually, reaching a 40-year high of 1,925 cases in what year?2011
Most of the new cases of malaria are reported in what type of travelers?those returning from endemic countries
What type of patient should be evaluated for malaria?a patient with a hx of fever and travel to a malaria-endemic region
Does the CDC consider malaria a potential medical emergency?yes and it should be addressed in a prompt manner
Appropriate treatment depends on what 5 conditions?1) high index of clinical suspicion 2) determination of disease severity/clinical status 3) microscopic dx 4) species identification 5) travel hx
What is the web sight that is a useful algorithm?http://www.cdc.gov/malaria/resources/pdf/algorithm.pdf
List the physical exam findings in malaria?1) fever 2) chills 3) sweats 4) headaches 5) myalgias 6) nausea 7) vomiting
The above physical findings are non-specific and may mimic what? more common infectious diseases like influenza
*** What is the gold standard of lab dx?microscopy
Describe how a slide is prepared?1) a blood specimen from the patient is spread as a thick or thin smear 2) stained with Romanovsky stain (most often Giemsa). Some labs use the more Wright stain, albeit with LESS accurate species identification. 3) slide is examined under an oil immersion lens
What is the website for diagnostic reference resources for interpreting microscopy?http://www.ced.gov/dpdx
What is the major drawback to microscopy?operator-dependent (those who do not perform many exams may miss the dx)
Describe what does the thick smear preparation do to the blood cells and what is it used for?1) involves lysis of blood cells so that the organisms are more readily identified 2) allows for screening of a relatively LARGE amount of blood 3) used to screen for the organism and estimate parasite density
What does the thin smear do to the blood cells and what is it used for?1) leaves the red cells intact 2) allows for identification of the infecting species 3) ACTUAL measurement of parasite density
True of false, a single rapid diagnostic test available in the US to aid in the dx of malaria?true
Describe this single rapid diagnostic test?1) it detects an antigen from Plasmodium falciparum and an antigen that is found in ALL species of malaria 2) Its sensitivyt for detection of falciparium and nonfalciparum species is 94% and 84%, respectively
If the single rapid diagnostic test is positive, what should be done next?a microscopy to identify the SPECIFIC pathogen and determine the extent of the RBC infection and destruction
Since the single rapid diagnostic test has limited ability to detect P. ovale, P. malariae, a negative test in a traveler from an endemic area should be followed by what test?microscopy
A third test to aid in the detection of malaria is the _______?IFA test (indirect fluorescent antibody)
What does the IFA detect? Disadvantages? It may be used for what?1) if a patient has been infected with Plasmodium 2) it takes time to run and the antibodies persist over time, so it is impractical as a test for acute malaria 3) it may be used to SCREEN blood from donors from endemic areas or used to EVALUATE patients who were treated for malaria but in whome the dx is in question
Why is blood culture ineffective for malaria detection?malaria is a parasite
Describe a research tool that is available and while more sensitive than microscopy, results are delayed, making it of minimal utility for acute dx?a molecular test that DETECTS parasite nucleic acids
*** SUMMARY = What type of patient should be evaluated for malaria?1) hx of fever 2) travel to a malarial-endemic region
*** SUMMARY = What is the gold standard of dx due to rapid turnaround time and species identification to guide medication selection?microscopy using thick and thin peripheral blood smears
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