[MCQ] Malaria- Part 3

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Malaria- Part 3

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Congratulations - you have completed Malaria- Part 3. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

Poor prognostic laboratory features in severe falciparum malaria are all except ?

A	Hypoglycemia
B	Acidosis
C	Hyperuricemia
D	Hypercalcemia

Question 1 Explanation:

Acidosis results from accumulation of organic acids and carries poor prognosis.

Question 2

Which of the following is the best biochemical prognosticator in severe malaria ?

A	pH
B	Bicarbonate concentration
C	PO2
D	PCO2

Question 3

Which of the following is the best biochemical prognosticator in severe malaria ?

A	pH
B	PCO2
C	Lactate concentration
D	Serum Bilirubin

Question 4

In severe malaria, lactic acidosis is caused by ?

A	Anaerobic glycolysis in tissues
B	Lactate production by parasites
C	Failure of hepatic & renal lactate clearance
D	All of the above

Question 4 Explanation:

Plasma concentrations of bicarbonate or lactate are the best biochemical prognosticators in severe malaria. Lactic acidosis is caused by the combination of anaerobic glycolysis in tissues where sequestered parasites interfere with microcirculatory flow, hypovolemia, lactate production by the parasites, and a failure of hepatic and renal lactate clearance.

Question 5

Which of the following statements about renal impairment in severe falciparum malaria is false ?

A	More common in adults, rare in children
B	Manifests as acute tubular necrosis
C	Renal cortical necrosis never develops
D	None of the above

Question 6

Which of the following is “uncommon” among children with severe malaria ?

A	Convulsions, coma
B	Hypoglycemia
C	Acute pulmonary edema
D	Metabolic acidosis

Question 7

Which of the following is “uncommon” among children with severe malaria ?

A	Convulsions, coma
B	Hypoglycemia
C	Acute renal failure
D	Severe anemia

Question 8

Which of the following is “uncommon” among children with severe malaria ?

A	Metabolic acidosis
B	Hypoglycemia
C	Deep jaundice
D	Severe anemia

Question 8 Explanation:

Convulsions, coma, hypoglycemia, metabolic acidosis & severe anemia are relatively common among children with severe malaria, whereas deep jaundice, acute renal failure & acute pulmonary edema are unusual

Question 9

Which of the following is “uncommon” among pregnant women with severe malaria ?

A	Renal failure
B	Hypoglycemia
C	Convulsions
D	Pulmonary edema

Question 9 Explanation:

Congenital malaria occurs in <5% of newborns whose mothers are infected.

Question 10

Severe anaemia in malaria is due to ?

A	Direct destruction of parasitised RBC’s
B	Destruction of non-parasitised RBC’s
C	Bone-marrow suppression
D	All of the above

Question 10 Explanation:

Anemia results from accelerated RBC removal by the spleen, obligatory RBC destruction at parasite schizogony, and ineffective erythropoiesis

Question 11

Severe jaundice in P. falciparum infections is due to ?

A	Hemolysis
B	Hepatocyte injury
C	Cholestasis
D	All of the above

Question 11 Explanation:

Severe jaundice in P. falciparum infections results from hemolysis, hepatocyte injury & cholestasis

Question 12

Malaria can be transmitted by ?

A	Blood transfusion
B	Organ transplantation
C	Sharing of needles by infected drug addicts
D	All of the above

Question 12 Explanation:

Malaria can be transmitted by blood transfusion, needle-stick injury, sharing of needles by infected injection drug users, or organ transplantation

Question 13

Tropical Splenomegaly is also called ?

A	Hyperactive malarial splenomegaly
B	Hypertrophic malarial splenomegaly
C	Hyperreactive malarial splenomegaly
D	Hypercongestive malarial splenomegaly

Question 13 Explanation:

Tropical splenomegaly is also called Hyperreactive malarial splenomegaly (HMS).

Question 14

Which of the following can cause nephrotic syndrome ?

A	P. vivax
B	P. ovale
C	P. malariae
D	P. falciparum

Question 15

Quartan malarial nephropathy usually responds poorly to treatment with ?

A	Antimalarial agents
B	Glucocorticoids
C	Cytotoxic drugs
D	All of the above

Question 15 Explanation:

Quartan nephropathy usually responds poorly to treatment with either antimalarial agents or glucocorticoids and cytotoxic drugs

Question 16

Which of the following about blood smear prepared for visualising malarial parasite is false ?

A	Thin blood smear should be fixed in anhydrous methanol
B	RBC’s in tail of thin blood smear should be examined
C	Thick blood film should be of even thickness
D	Thick smear should be stained without fixing

Question 16 Explanation:

Both thin and thick blood smears should be examined. Thin blood smear should be rapidly airdried, fixed in anhydrous methanol, and stained. RBCs in tail of the film should then be examined. Level of parasitemia is expressed as number of parasitized RBC’s per 1000 RBCs. Thick blood film should be of uneven thickness, dried thoroughly and stained without fixing

Question 17

Patients with what count of parasite are at increased risk of dying ?

A	> 102 parasites/μL
B	> 103 parasites/μL
C	> 104 parasites/μL
D	> 105 parasites/μL

Question 17 Explanation:

Patients with > 105 parasites/μL are at increased risk of dying, though nonimmune patients may die with lower counts, and partially immune persons may tolerate parasitemia levels many times higher with only minor symptoms.

Question 18

In severe malaria, a poor prognosis is indicated by ?

A	> 20 % of parasites with visible pigment in PBF
B	Presence of circulating schizonts in PBF
C	Phagocytosed malarial pigment in >5% of neutrophils
D	All of the above

Question 18 Explanation:

In severe malaria, a poor prognosis is indicated by a predominance of more mature P. falciparum parasites (>20% parasites with visible pigment) in PBF or by presence of phagocytosed malarial pigment in >5% of neutrophils and. peripheral schizontaemia

Question 19

In P. falciparum infections, gametocytemia peaks how many weeks after the peak of asexual parasites ?

A	1
B	2
C	3
D	4

Question 19 Explanation:

In P. falciparum infections, gametocytemia peaks 1 week after the peak of asexual parasites.

Question 20

At low levels of parasitemia, staining of malaria parasite with which of the following stains allows more rapid diagnosis ?

A	Giemsa’s
B	Wright’s
C	Leishman’s
D	Fluorescent dye acridine orange

Question 20 Explanation:

Of the Romanowsky stains, Giemsa at pH 7.2 is preferred. Wright’s, Field’s, or Leishman’s stain can also be used. Staining of parasites with fluorescent dye acridine orange allows more rapid diagnosis of malaria in patients with low-level parasitemia

Question 21

Specific antibody-based diagnostic stick or card test for malaria detect which P. falciparum specific antigen ?

A	PfHRP1
B	PfHRP2
C	PfHRP3
D	PfHRP4

Question 21 Explanation:

Rapid, simple, sensitive & specific antibody-based diagnostic stick or card tests detect P. falciparum

Question 22

Which laboratory finding is not found in malaria ?

A	Normochromic, normocytic anemia
B	Elevated C-reactive protein
C	Reduced platelet count
D	Elevated levels of antithrombin III

Question 22 Explanation:

Laboratory findings in malaria include normochromic, normocytic anemia, normal TLC, raised ESR, raised plasma viscosity, raised CRP, reduced platelet count, reduced antithrombin III even in mild infection

Question 23

Trophozoites and schizonts of Plasmodium knowlesi is morphologically similar to which of the following ?

A	P. falciparum
B	P. vivax
C	P. malariae
D	P. ovale

Question 24

Which of the following is a blood-stage schizonticide ?

A	Atovaquone - proguanil
B	Doxycycline
C	Mefloquine
D	All of the above

Question 24 Explanation:

Blood-stage schizonticides are Atovaquone-proguanil, Doxycycline, Mefloquine and Chloroquine. They interrupt schizogony within red cells, preventing clinical manifestations of malaria infection

Question 25

Which of the following statements is false ?

A	Atovaquone-proguanil acts on liver schizonts of all four Plasmodial species
B	Primaquine kills quiescent hypnozoites
C	Atovaquone-proguanil does not act on hypnozoites
D	None of the above

Question 25 Explanation:

Schizonts are multinucleated stages of parasites that undergo mitotic division within host cells. Hepatic stage schizonticides - atovaquone-proguanil & primaquine kill malaria parasites within hepatocytes and act on liver schizonts of all four species of plasmodia. Primaquine kills quiescent hypnozoites while Atovaquone-proguanil does not act on hypnozoites.

Question 26

RTS,S/AS02A is an experimental vaccine against ?

A	Hepatitis A
B	Hepatitis C
C	Malaria
D	Leishmania

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See all quizzes of Malaria- Part 3 here:

1 Poor prognostic laboratory features in severe falciparum malaria
are all except ?
A. Hypoglycemia
B. Acidosis
C. Hyperuricemia
D. Hypercalcemia

2 Which of the following is the best biochemical prognosticator in
severe malaria ?
A. pH
B. Bicarbonate concentration
C. PO2
D. PCO2
3 Which of the following is the best biochemical prognosticator in
severe malaria ?
A. pH
B. PCO2
C. Lactate concentration
D. Serum Bilirubin
4 In severe malaria, lactic acidosis is caused by ?
A. Anaerobic glycolysis in tissues
B. Lactate production by parasites
C. Failure of hepatic & renal lactate clearance
D. All of the above

5 Which of the following statements about renal impairment in
severe falciparum malaria is false ?
A. More common in adults, rare in children
B. Manifests as acute tubular necrosis
C. Renal cortical necrosis never develops
D. None of the above
6 Which of the following is “uncommon” among children with
severe malaria ?
A. Convulsions, coma
B. Hypoglycemia
C. Acute pulmonary edema
D. Metabolic acidosis
7 Which of the following is “uncommon” among children with
severe malaria ?
A. Convulsions, coma
B. Hypoglycemia
C. Acute renal failure
D. Severe anemia
8 Which of the following is “uncommon” among children with
severe malaria ?
A. Metabolic acidosis
B. Hypoglycemia
C. Deep jaundice
D. Severe anemia

9 Which of the following is “uncommon” among pregnant women
with severe malaria ?
A. Renal failure
B. Hypoglycemia
C. Convulsions
D. Pulmonary edema

10 Severe anaemia in malaria is due to ?
A. Direct destruction of parasitised RBC’s
B. Destruction of non-parasitised RBC’s
C. Bone-marrow suppression
D. All of the above

11 Severe jaundice in P. falciparum infections is due to ?
A. Hemolysis
B. Hepatocyte injury
C. Cholestasis
D. All of the above

12 Malaria can be transmitted by ?
A. Blood transfusion
B. Organ transplantation
C. Sharing of needles by infected drug addicts
D. All of the above

13 Tropical Splenomegaly is also called ?
A. Hyperactive malarial splenomegaly
B. Hypertrophic malarial splenomegaly
C. Hyperreactive malarial splenomegaly
D. Hypercongestive malarial splenomegaly

14 Which of the following can cause nephrotic syndrome ?
A. P. vivax
B. P. ovale
C. P. malariae
D. P. falciparum
15 Quartan malarial nephropathy usually responds poorly to
treatment with ?
A. Antimalarial agents
B. Glucocorticoids
C. Cytotoxic drugs
D. All of the above

16 Which of the following about blood smear prepared for visualising
malarial parasite is false ?
A. Thin blood smear should be fixed in anhydrous methanol
B. RBC’s in tail of thin blood smear should be examined
C. Thick blood film should be of even thickness
D. Thick smear should be stained without fixing

17 Patients with what count of parasite are at increased risk of dying
?
A. > 102 parasites/μL
B. > 103 parasites/μL
C. > 104 parasites/μL
D. > 105 parasites/μL

18 In severe malaria, a poor prognosis is indicated by ?
A. > 20 % of parasites with visible pigment in PBF
B. Presence of circulating schizonts in PBF
C. Phagocytosed malarial pigment in >5% of neutrophils
D. All of the above

19 In P. falciparum infections, gametocytemia peaks how many weeks
after the peak of asexual parasites ?
A. 1
B. 2
C. 3
D. 4

20 At low levels of parasitemia, staining of malaria parasite with
which of the following stains allows more rapid diagnosis ?
A. Giemsa’s
B. Wright’s
C. Leishman’s
D. Fluorescent dye acridine orange

21 Specific antibody-based diagnostic stick or card test for malaria
detect which P. falciparum specific antigen ?
A. PfHRP1
B. PfHRP2
C. PfHRP3
D. PfHRP4

22 Which laboratory finding is not found in malaria ?
A. Normochromic, normocytic anemia
B. Elevated C-reactive protein
C. Reduced platelet count
D. Elevated levels of antithrombin III

23 Trophozoites and schizonts of Plasmodium knowlesi is
morphologically similar to which of the following ?
A. P. falciparum
B. P. vivax
C. P. malariae
D. P. ovale
24 Which of the following is a blood-stage schizonticide ?
A. Atovaquone – proguanil
B. Doxycycline
C. Mefloquine
D. All of the above

25 Which of the following statements is false ?
A. Atovaquone-proguanil acts on liver schizonts of all four
Plasmodial species
B. Primaquine kills quiescent hypnozoites
C. Atovaquone-proguanil does not act on hypnozoites
D. None of the above

26 RTS,S/AS02A is an experimental vaccine against ?
A. Hepatitis A
B. Hepatitis C
C. Malaria
D. Leishmania

Malaria

[MCQ] Malaria- Part 3

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Malaria- Part 3

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