Antiparasitic Drugs

Microhemorrhages in the brain and other organs associated with Falciparum
parasites mainly due to:
1. increased platelet count
2. reduced blood flow
3. stickiness of falciparum parasites to the vascular epithelium
4. falciparum parasite-induced thrombocytopenic purpura
5. falciparum parasite induced polycythemia vera
Incidents those P falciparum imported cases (USA) has risen > 10 times over the past ten years:
1. true
2. false
Most U.S. cases of malaria are found in:
1. transfusion recipients
2. travelers
3. IV drug users
Increased incidence of P falciparum imported cases is due to:
1. failure of mosquito eradication programs
2. increasing resistance of P falciparum to antimalarial drugs
3. both
4. neither
Of about 156 species of plasmodium,this species, causative of human malaria, produces the most serious complications, including death:
1. Plasmodium malariae
2. Plasmodium falciparum
3. Plasmodium vivax
4. Plasmodium ovale
Malaria transmission: only arthropod vector through the bite of the female anopheline mosquito:
1. true
2. false
Most critical factor in malarial diagnosis:
1. time since infection
2. presence of a fever
3. causative agent
4. whether the patient has traveled to malarious geographical region
5. none of the above
Definitive diagnosis of malaria:
1. presence of both cold phase & hot phase
2. mild, "viral"-like prodrome preceding by 24-48 hours major symptoms
3. direct observation of intraerythrocytic parasites in thick/thin smears
4. the patient has or has not taken prophylactic drugs during travel
Malaria-incubation period
1. 1-2 days
2. 8-10 days
3. three weeks
4. six weeks
Objective clinical presentations in a patient with malaria:
1. during paroxysmal period, severe hypothermia
2. meningismus
3. faint scleral icterus
4. B & C
5. A & C
Concerning infection by P. falciparum in a nonimmune individual:
1. mortality equals 50% of > 20% of erythrocytes are parasitized
2. medical emergency
3. death may occur within several hours
4. B & C
5. A, B & C
Consequences of significant parasitization associated with P falciparum infection:
1. vasoconstriction
2. rapidly progressing hemolytic anemia
3. microthrombus formation (capillary sludging)
4. B & C
5. A, B & C
Important factors resulting in fatal outcomes following infection with P falciparum:
1. failure to take prophylaxis
2. delay in obtaining medical attention
3. misdiagnosis
4. advanced age
5. all of the above
Parasitic life-cycle: replication in the liver:
1. exoerythrocytic schizogony
2. erythrocytic schizogony
A dormant stage (hypnozoites) can persist in the liver and can cause relapses by invading the bloodstream weeks remain years later.
1. P vivax
2. P falciparum
3. P ovale
4. A & C
5. A, B & C
After four weeks, treatment of erythrocytic infection would be curative
1. P ovale
2. P. malariae
3. both
4. neither
Treatment must eliminate parasites from both liver erythrocytes:
1. P vivax & P ovale
2. P falciparum & P. malariae
3. all four species
Antimalarial drug classification:
1. mitotic spindle inhibitors
2. DNA gyrase inhibitors
3. dihydrofolate reductase inhibitors
An example of a 4-aminoquinoline antimalarial drug:
1. pyrimethamine (Daraprim)
2. sulfadiazine
3. doxycycline (Vibramycin, Doryx)
4. mefloquine (Lariam)
All dihydrofolate reductase inhibitors: chloroguanide, pyrimethamine (Daraprim), trimethoprim (generic)
1. true
2. false