[MCQ] Malaria- Part 5

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Malaria- Part 5

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Congratulations - you have completed Malaria- Part 5. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

Indication for slowing infusion rates of quinidine is ?

A	Total plasma levels >8 μg/mL
B	QTc interval >0.6 seconds
C	QRS widening beyond 25% of baseline
D	All of the above

Question 2

What is the total plasma concentrations of quinine at which it is effective & does not cause serious toxicity ?

A	1 - 6 mg/L
B	8 - 15 mg/L
C	18 - 31 mg/L
D	36 - 55 mg/L

Question 2 Explanation:

Total plasma concentrations of 8 - 15 mg/L for quinine is effective & does not cause serious toxicity

Question 3

In renal failure, the initial dose of quinine should be reduced by ?

A	Nil
B	10 %
C	25 %
D	50 %

Question 3 Explanation:

If patient remains seriously ill or is in acute renal failure for >2 days, maintenance doses of quinine should be reduced by 30-50%. The initial doses should never be reduced.

Question 4

For recrudescence of malaria following first-line therapy, secondline treatment is given for what duration ?

A	3 days
B	5 days
C	7 days
D	10 days

Question 4 Explanation:

As second-line treatment for recrudescence following first-line therapy, a 7-day course of either artesunate or quinine plus tetracycline, doxycycline, or clindamycin is effective.

Question 5

Which of the following statements about falciparum malaria in endemic areas is false ?

A	Should not be treated with single drug
B	Should be treated with drug combinations
C	Combination drugs should have different modes of action
D	None of the above

Question 5 Explanation:

To prevent resistance, PF malaria should be treated with drug combinations and not with single drugs in endemic areas. Combination drugs (two or more) must be used simultaneously and must have different modes of action.

Question 6

Cinchonism comprises of all of the following except ?

A	Tinnitus
B	Dysphoria
C	High-tone deafness
D	Diarrhoea

Question 6 Explanation:

Cinchonism comprising tinnitus, high-tone deafness, nausea, vomiting, and dysphoria.

Question 7

In drug resistance areas, quinine can be given with all of the following except ?

A	Tetracycline
B	Doxycycline
C	Clarithromycin
D	Clindamycin

Question 7 Explanation:

As second-line treatment for recrudescence following first-line therapy, a 7-day course of either artesunate or quinine plus tetracycline, doxycycline, or clindamycin is effective

Question 8

In drug resistance areas, quinine can be given with all of the following except ?

A	Tetracycline
B	Doxycycline
C	Clarithromycin
D	Clindamycin

Question 8 Explanation:

As second-line treatment for recrudescence following first-line therapy, a 7-day course of either artesunate or quinine plus tetracycline, doxycycline, or clindamycin is effective

Question 9

Artemisinin derivative in combination regimens can be combined with which of the following ?

A	Lumefantrine
B	Mefloquine
C	Sulfadoxine / pyrimethamine
D	All of the above

Question 9 Explanation:

Artemisinin combination regimens now constitute first-line treatment for Pf malaria. In multidrugresistant Pf malaria, artemether-lumefantrine or artesunate-mefloquine should be used. In drugsensitive areas, atovaquone-proguanil, mefloquine, artesunate-amodiaquine or artesunatesulfadoxine/ pyrimethamine can be used. Other combinations are Dihydroartemisinin-piperaquine, Dihydroartemisinin-napthoquine-trimethoprim

Question 10

Artemisinin derivative in combination regimens can be combined with which of the following ?

A	Lumefantrine
B	Mefloquine
C	Sulfadoxine / pyrimethamine
D	All of the above

Question 10 Explanation:

Question 11

If a malaria patient vomits within one hour of administration of any oral antimalarial drug, what should be done ?

A	Repeat the same dose
B	Reduce the dose
C	Give parenteral preparation
D	Change to another oral preparation

Question 11 Explanation:

If a malaria patient vomits within one hour of administration of any oral antimalarial drug, the dose should be repeated.

Question 12

Which of the following antimalarial drugs exacerbate the orthostatic hypotension associated with malaria ?

A	Chloroquine
B	Mefloquine
C	Quinine
D	All of the above

Question 12 Explanation:

All the antimalarial quinolines like chloroquine, mefloquine, and quinine exacerbate the orthostatic hypotension associated with malaria.

Question 13

Antimalarial drug resistance is likely if parasitemia ?

A	Does not fall < 25 % of admission value in 6 hours
B	Does not fall < 25 % of admission value in 12 hours
C	Does not fall < 25 % of admission value in 24 hours
D	Does not fall < 25 % of admission value in 48 hours

Question 14

Antimalarial drug resistance is likely if ?

A	Parasitemia has not cleared by 2 days
B	Parasitemia has not cleared by 5 days
C	Parasitemia has not cleared by 7 days
D	Parasitemia has not cleared by 10 days

Question 14 Explanation:

If the level of parasitemia does not fall to <25% of admission value in 48 hours or if parasitemia has not cleared by 7 days, drug resistance is likely

Question 15

Primaquine is given for how many days to eradicate persistent liver stages & to prevent relapse ?

A	5 days
B	10 days
C	14 days
D	21 day

Question 15 Explanation:

To eradicate persistent liver stages & prevent relapse (radical treatment), primaquine should be given daily for 14 days after ruling out G6PD deficiency

Question 16

Peak feeding time for mosquitoes is ?

A	Dusk
B	Dawn
C	Throughout the night
D	All of the above

Question 16 Explanation:

Prevention of malaria includes avoidance of exposure to mosquitoes at their peak feeding times - dusk, dawn and throughout the night

Question 17

Which of the following drugs is used for prophylaxis against malaria in travellers ?

A	Mefloquine
B	Pyrimethamine
C	Quinine
D	Artesunate

Question 18

Which of the following drugs is used for prophylaxis against malaria in travellers ?

A	Doxycycline
B	Pyrimethamine
C	Quinine
D	Artesunate

Question 18 Explanation:

Recommendations for prophylaxis include drugs effective against resistant P. falciparum like atovaquone-proguanil, doxycycline, mefloquine, or primaquine

Question 19

Which antimalarial drug is used for chemoprophylaxis for pregnant women ?

A	Mefloquine
B	Artesunate
C	Primaquine
D	Doxycycline

Question 19 Explanation:

Mefloquine is the only drug advised for pregnant women traveling to areas with drug-resistant malaria. Doxycycline & primaquine should not be given to pregnant women.

Question 20

Malarial chemoprophylaxis should be continued for what duration after leaving the endemic area ?

A	1 week
B	2 week
C	3 week
D	4 week

Question 21

Which malarial chemoprophylactic agent can be discontinued after 1 week of leaving the endemic area ?

A	Doxycycline
B	Mefloquine
C	Atovaquone-proguanil
D	None of the above

Question 21 Explanation:

Antimalarial prophylaxis should continue for 4 weeks after the traveler has left endemic area, except if atovaquone-proguanil or primaquine is taken. These have significant activities against liver stage of infection (causal prophylaxis) & can be discontinued 1 week after departure from endemic area.

Question 22

Malarial chemoprophylaxis should be started for what duration before arriving in the endemic area ?

A	1 week
B	2 week
C	3 week
D	4 week

Question 22 Explanation:

Travelers should start taking antimalarial drugs 2 days to 1-2 weeks before departure so that any untoward reactions can be detected and so that therapeutic antimalarial blood concentrations will be present when needed.

Question 23

Chemoprophylaxis with which of the following antimalarial drugs can be given to pregnant women at risk in endemic areas ?

A	Chloroquine
B	Proguanil
C	Intermittent treatment with pyrimethamine-sulfadoxine
D	All of the above

Question 24

Which of the following antimalarial drug is associated with a high risk of agranulocytosis ?

A	Proguanil
B	Amodiaquine
C	Atovaquone
D	Mefloquine

Question 24 Explanation:

When used continuously, amodiaquine is associated with a high risk of agranulocytosis and hepatotoxicity and should not be used for prophylaxis

Question 25

Which of the following antimalarial drug has “sporonticidal activity” ?

A	Proguanil
B	Amodiaquine
C	Atovaquone
D	Mefloquine

Question 25 Explanation:

Dihydrofolate reductase inhibitor proguanil inhibit development in mosquito (sporontocidal activity).

Question 26

Insecticide DDT refers to ?

A	Dichlorodiphenyltrichloroethane
B	Dichlorodipropyltrichloroethane
C	Dichlorodiphenyltrichloroethylene
D	Dichlorodipropyltrichloroethylene

Question 26 Explanation:

Insecticide DDT refers to Dichlorodiphenyltrichloroethane

Question 27

Which of the following programmes is related to the control of malaria ?

A	MACEPA
B	PATH
C	MMV
D	All of the above

Question 27 Explanation:

Malaria Control and Evaluation Partnership in Africa (MACEPA), Program for Appropriate Technology in Health (PATH) and Medicines for Malaria Venture (MMV) are programmes for the control of malaria

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See all quizzes of Malaria- Part 5 here:

1 Indication for slowing infusion rates of quinidine is ?
A, Total plasma levels >8 μg/mL
B. QTc interval >0.6 seconds
C. QRS widening beyond 25% of baseline
D. All of the above
2 What is the total plasma concentrations of quinine at which it is
effective & does not cause serious toxicity ?
A. 1 – 6 mg/L
B. 8 – 15 mg/L
C. 18 – 31 mg/L
D. 36 – 55 mg/L
3 In renal failure, the initial dose of quinine should be reduced by ?
A. Nil
B. 10 %
C. 25 %
D. 50 %

4 For recrudescence of malaria following first-line therapy, secondline
treatment is given for what duration ?
A. 3 days
B. 5 days
C. 7 days
D. 10 days

5 Which of the following statements about falciparum malaria in
endemic areas is false ?
A. Should not be treated with single drug
B. Should be treated with drug combinations
C. Combination drugs should have different modes of action
D. None of the above

6 Cinchonism comprises of all of the following except ?
A. Tinnitus
B. Dysphoria
C. High-tone deafness
D. Diarrhoea

7 In drug resistance areas, quinine can be given with all of the
following except ?
Harrison’s 18th Ed. 1702
A. Tetracycline
B. Doxycycline
C. Clarithromycin
D. Clindamycin

8 Artemisinin derivative in combination regimens can be combined
with which of the following ?
A. Lumefantrine
B. Mefloquine
C. Sulfadoxine / pyrimethamine
D. All of the above

9 If a malaria patient vomits within one hour of administration of
any oral antimalarial drug, what should be done ?
A. Repeat the same dose
B. Reduce the dose
C. Give parenteral preparation
D. Change to another oral preparation

10 Which of the following antimalarial drugs exacerbate the
orthostatic hypotension associated with malaria ?
A. Chloroquine
B. Mefloquine
C. Quinine
D. All of the above

11 Antimalarial drug resistance is likely if parasitemia?
A. Does not fall < 25 % of admission value in 6 hours
B. Does not fall < 25 % of admission value in 12 hours
C. Does not fall < 25 % of admission value in 24 hours
D. Does not fall < 25 % of admission value in 48 hours
12 Antimalarial drug resistance is likely if ?
A. Parasitemia has not cleared by 2 days
B. Parasitemia has not cleared by 5 days
C. Parasitemia has not cleared by 7 days
D. Parasitemia has not cleared by 10 days

13 Primaquine is given for how many days to eradicate persistent
liver stages & to prevent relapse ?
A. 5 days
B. 10 days
C. 14 days
D. 21 days

14 Peak feeding time for mosquitoes is ?
A. Dusk
B. Dawn
C. Throughout the night
D. All of the above

15 Which of the following drugs is used for prophylaxis against
malaria in travellers ?
A. Mefloquine
B. Pyrimethamine
C. Quinine
D. Artesunate
16 Which of the following drugs is used for prophylaxis against
malaria in travellers ?
A. Doxycycline
B. Pyrimethamine
C. Quinine
D. Artesunate

17 Which antimalarial drug is used for chemoprophylaxis for
pregnant women ?
A. Mefloquine
B. Artesunate
C. Primaquine
D. Doxycycline

18 Malarial chemoprophylaxis should be continued for what duration
after leaving the endemic area ?
A. 1 week
B. 2 week
C. 3 week
D. 4 week

19 Which malarial chemoprophylactic agent can be discontinued
after 1 week of leaving the endemic area ?
A. Doxycycline
B. Mefloquine
C. Atovaquone-proguanil
D. None of the above

20 Malarial chemoprophylaxis should be started for what duration
before arriving in the endemic area ?
A. 1 week
B. 2 week
C. 3 week
D. 4 week

21 Chemoprophylaxis with which of the following antimalarial drugs
can be given to pregnant women at risk in endemic areas ?
A. Chloroquine
B. Proguanil
C. Intermittent treatment with pyrimethamine-sulfadoxine
D. All of the above
22 Which of the following antimalarial drug is associated with a high
risk of agranulocytosis ?
A. Proguanil
B. Amodiaquine
C. Atovaquone
D. Mefloquine

23 Which of the following antimalarial drug has “sporonticidal
activity” ?
A. Proguanil
B. Amodiaquine
C. Atovaquone
D. Mefloquine

24 Insecticide DDT refers to ?
A. Dichlorodiphenyltrichloroethane
B. Dichlorodipropyltrichloroethane
C. Dichlorodiphenyltrichloroethylene
D. Dichlorodipropyltrichloroethylene

25 Which of the following programmes is related to the control of malaria ?
A. MACEPA
B. PATH
C. MMV
D. All of the above

Malaria

[MCQ] Malaria- Part 5

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Malaria- Part 5

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