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MCQs: Anti-Malarials MCQs: Anti-Malarials
Question # 1 (Multiple Answer) Antimalarials: dihydrofolate reductase inhibitors
A) chloroquine (Aralen)
B) chloroguanide
C) pyrimethamine (Daraprim)
D) trimethoprim (generic)
E) primaquine
Question # 2 (Multiple Answer) Characteristics of significant parasitization, i.e. P falciparum:
A) vasoconstriction
B) hemoglobinuria
C) microthrombi formation
D) if > 20% of erythrocytes are parasitized, mortality = 50% (P falciparum)
Question # 3 (Multiple Answer) One cycle of liver invasion and multiplication:
A) P vivax
B) P falciparum
C) P. malariae
D) P ovale
Question # 4 (Multiple Choice) Factors which determine antimalarial agent efficacy:
A) species
B) life-cycle stage-dependencies
C) both
D) neither
Question # 5 (Multiple Choice) Asserting a malarial diagnosis:
A) fever/flu-like symptoms in individual returning from travel (or native to) a malarious geographical region
B) disease ruled out the patient has taken prophylactic drugs during travel
C) both
D) neither
Question # 6 (Multiple Answer) Malaria prophylaxis:for regions with chloroquine (Aralen)-resistant P falciparum malaria
A) preferred: mefloquine (Lariam)
B) alternative #1:doxycycline (Vibramycin, Doryx)
C) alternative #2: chloroquine (Aralen) plus proguanil (Paludrine)
Question # 7 (Multiple Answer) Malaria: etiology --
A) only arthropod vector-byte to the female anopheline mosquito
B) transmission does not occur at < 60 degrees Fahrenheit or at >100 degrees Fahrenheit
C) incubation period: typically three-four weeks
Question # 8 (Multiple Answer) Antimalarials: classification based on site of drug action:
A) gametocides
B) tissue schizonticides
C) blood schizonticides, e.g. chloroquine (Aralen), proguanil (Paludrine), pyrimethamine (Daraprim), mefloquine (Lariam), quinine (Quinamm)
D) gametocides: primaquine (P falciparum; chloroquine (Aralen) (P vivax, P. malariae, P ovale)
Question # 9 (Multiple Answer) Treatment of malaria-all species except chloroquine (Aralen)-resistant P falciparum
A) Oral treatment (P falciparum or P. malariae): chloroquine phosphate (Aralen)
B) Oral treatment (P vivax or P ovale): chloroquine (Aralen) plus primaquine phosphate
C) Parenteral treatment (severe attacks): quinidine gluconate (Quinaglute, Quinalan) followed by oral chloroquine (Aralen) when possible {followed by primaquine if infection is caused by P vivax or P ovalea brace
Question # 10 (Multiple Answer) Malaria: objective clinical presentations
A) orthostatic hypotension
B) faint scleral icterus
C) meningismus
D) during paroxysmal phase: high fever (up to 106 degrees Fahrenheit)
Question # 11 (Multiple Answer) Malaria:
A) about one million deaths per year due to malaria
B) most important parasitic infection
C) most U.S. cases found in transfusion recipients and intravenous drug users
D) increase in incidence secondary to increasing drug- resistance to P falciparum & failure of mosquito eradication programs
Question # 12 (Multiple Answer) Major malarial symptoms:
A) cold phase-patient complains of chills
B) hot phase-associated with high fever, headache, vomiting, nausea, delirium
C) defervescence;profuse sweating and sleep
D) none of the above
Question # 13 (True/False) Treatment of malaria caused by chloroquine (Aralen)-resistant P falciparumral:quinine sulfate and clindamycin (Cleocin)
A) True
B) False
Question # 14 (Multiple Answer) Treatment must eliminate parasites from both liver and erythrocytes:
A) P falciparum
B) P. malariae
C) P vivax
D) P ovale
Question # 15 (Multiple Choice) Of the plasmodium species causative for human malaria, the one producing most serious complications:
A) Plasmodium vivax
B) Plasmodium malariae
C) Plasmodium ovale
D) plasmodium falciparum
Question # 16 (Multiple Answer) Concerning definitive malaria diagnosis:
A) if thin blood smear is negative, examine thick smear {may be positive than 20%-25% of patients}
B) examination of blood smear should be done once approximately seven days after initial visit
C) a critical factor is to determine if patient has falciparum malaria which may be fatal due to high-rate of erythrocyte parasitization
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Correct Answers
[HIDE]
Question # 1 (Multiple Answer) Antimalarials: dihydrofolate reductase inhibitors
(B) chloroguanide
(C) pyrimethamine (Daraprim)
(D) trimethoprim (generic)
Question # 2 (Multiple Answer) Characteristics of significant parasitization, i.e. P falciparum:
(B) hemoglobinuria
(C) microthrombi formation
(D) if > 20% of erythrocytes are parasitized, mortality = 50% (P falciparum)
vasodilation
Question # 3 (Multiple Answer) One cycle of liver invasion and multiplication:
(B) P falciparum
(C) P. malariae
Question # 4 (Multiple Choice) Factors which determine antimalarial agent efficacy:
Answer: (C) both
Question # 5 (Multiple Choice) Asserting a malarial diagnosis:
Answer: (A) fever/flu-like symptoms in individual returning from travel (or native to) a malarious geographical region
Question # 6 (Multiple Answer) Malaria prophylaxis:for regions with chloroquine (Aralen)-resistant P falciparum malaria
(A) preferred: mefloquine (Lariam)
(B) alternative #1:doxycycline (Vibramycin, Doryx)
(C) alternative #2: chloroquine (Aralen) plus proguanil (Paludrine)
Question # 7 (Multiple Answer) Malaria: etiology --
(A) only arthropod vector-byte to the female anopheline mosquito
(B) transmission does not occur at < 60 degrees Fahrenheit or at >100 degrees Fahrenheit
incubation period: 8-10 days
Question # 8 (Multiple Answer) Antimalarials: classification based on site of drug action:
(A) gametocides
(B) tissue schizonticides
(C) blood schizonticides, e.g. chloroquine (Aralen), proguanil (Paludrine), pyrimethamine (Daraprim), mefloquine (Lariam), quinine (Quinamm)
(D) gametocides: primaquine (P falciparum; chloroquine (Aralen) (P vivax, P. malariae, P ovale)
Question # 9 (Multiple Answer) Treatment of malaria-all species except chloroquine (Aralen)-resistant P falciparum
(A) Oral treatment (P falciparum or P. malariae): chloroquine phosphate (Aralen)
(B) Oral treatment (P vivax or P ovale): chloroquine (Aralen) plus primaquine phosphate
(C) Parenteral treatment (severe attacks): quinidine gluconate (Quinaglute, Quinalan) followed by oral chloroquine (Aralen) when possible {followed by primaquine if infection is caused by P vivax or P ovalea brace
Question # 10 (Multiple Answer) Malaria: objective clinical presentations
(A) orthostatic hypotension
(B) faint scleral icterus
(C) meningismus
(D) during paroxysmal phase: high fever (up to 106 degrees Fahrenheit)
Question # 11 (Multiple Answer) Malaria:
(A) about one million deaths per year due to malaria
(B) most important parasitic infection
(D) increase in incidence secondary to increasing drug- resistance to P falciparum & failure of mosquito eradication programs
most U.S. cases found in travelers
Question # 12 (Multiple Answer) Major malarial symptoms:
(A) cold phase-patient complains of chills
(B) hot phase-associated with high fever, headache, vomiting, nausea, delirium
(C) defervescence;profuse sweating and sleep
Question # 13 (True/False) Treatment of malaria caused by chloroquine (Aralen)-resistant P falciparum
Answer: True
Question # 14 (Multiple Answer) Treatment must eliminate parasites from both liver and erythrocytes:
(C) P vivax
(D) P ovale
Question # 15 (Multiple Choice) Of the plasmodium species causative for human malaria, the one producing most serious complications:
Answer: (D) plasmodium falciparum
Question # 16 (Multiple Answer) Concerning definitive malaria diagnosis:
(A) if thin blood smear is negative, examine thick smear {may be positive than 20%-25% of patients}
(C) a critical factor is to determine if patient has falciparum malaria which may be fatal due to high-rate of erythrocyte parasitization
blood smear examinations required at intervals over several days
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