Reference no: EM134005865
Questions
1. You are working in family practice in Tennessee and diagnose a 45 year old with malaria after he recently returned from a safari trip to Mana Pools National Park in Zimbabwe. His test results indicate an infection with Plasmodium falciparum with a parasitemia level of 7%. Further lab studies reveal normocytic normochromic anemia and an elevated serum creatinine level of 3.0 mg/dl. Which of the following is the most appropriate next step?
Chloroquine 1 gram immediately, followed by 500 mg at 6, 24 and 48 hours
Artemether/lumefantrine 80/480 BID x 3 days taken with a high fat meal
Tafenoquine 300 mg single dose
Admit the patient
2. A 29 year old is diagnosed with an infection of Plasmodium vivax after a safari trip in Chobe National Park in Botswana. She has no signs or symptoms of a complicated severe infection. She is otherwise healthy with no chronic medical conditions. Prior to starting treatment, which of the following actions should be performed?
None of these labs need to be ordered prior to initiating treatment
Draw a serum G6PD
Obtain a urine culture
Obtain a stool culture
3. A 23 year old patient has a positive histidine-rich protein 2 test after coming in for complaints of three days of cyclic fever, headache, aches, fatigue, nausea, vomiting and abdominal pain. Which of the following is the most appropriate next step?
Order a blood smear
Order an aldolase rapid test
Initiate droplet precautions
Order a Plasmodium lactate dehydrogenase test
4. A 53 year old male is diagnosed with an infection of Plasmodium ovale after a trip to Papua New Guinea. He does not have any signs or symptoms of complicated severe infection. His health history is below. Which of the following is the most appropriate treatment option for this patient?
Allergies: NKDA
Current Medications: None
Pertinent History: Severe hepatic impairment secondary to alcoholism
Health Maintenance: Immunizations: Current, not deficient in G6PD
Family History: Father with prostate cancer, congestive heart failure, diabetes, hypertension (passed age 70)
Social History: Alcohol intake of 7-10 beers a day, nicotine dependence 1 pack per day
Group of answer choices
Chloroquine 1 gram followed by 500 mg at 6, 24 and 48 hours + tafenoquine 300 mg single dose
Artemether/lumefantrine 80/480 mg BID + chloroquine 1 gram followed by 500 mg at 6, 24 and 48 hours + tafenoquine 300 mg single dose
Quinine 648 mg TID x 3 days + doxycycline 100 mg BID x 7 days + tafenoquine 300 mg single dose
Artemether/lumefantrine 80/480 mg BID + tafenoquine 300 mg single dose
5. Which of the following statements is accurate regarding the fever associated with malaria infection?
The fever occurs each time the infected hepatocytes break down and the parasites exit in vesicles (constantly)
The fever occurs each time a cycle of parasites breaks free and invades new erythrocytes (every 1-3 days)
The fever occurs each time the sporozoites invade the hepatocytes (every 4-5 days)
The fever occurs during all of these stages
6. Which of the following species can lie dormant in the liver of an infected host?
Plasmodium falciparum and Plasmodium ovale
Plasmodium falciparum and Plasmodium malaria
Plasmodium vivax and Plasmodium ovale
Plasmodium falciparum and Plasmodium vivax
7. Why is artemisinin therapy combined with lumefantrine for malaria treatment?
To eradicate gametocytes and hypnozoites
To decrease the duration of therapy and the development of resistance
All of these
To provide coverage for gram-negative bacteria, which are often involved with malaria infections
8. Which of the following principles should be used to guide treatment of malaria?
The number of previous malaria infections
The patient's history of previous infections of tropical diseases
The patient's nationality
The geographic area where the infection was acquired
9. Which of the following is an expected finding in a patient infected with malaria?
Generalized lymphadenopathy, often most noticeable in the inguinal lymph nodes
Left upper quadrant abdominal pain that radiates to the left shoulder
Maculopapular non-pruritic rash starting on the trunk and spreading to the extremities within three day of the onset of fever
Bilateral non-purulent conjunctivitis
10. Work-up for a patient who presents with cyclic fever and who traveled to a malaria-endemic area within the last month should include which of the following?
Complete blood count with differential
All of these
Blood smear
Comprehensive metabolic panel