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Question # 1 (Multiple Answer) Antimalarials: dihydrofolate reductase

inhibitors B) Oral treatment (P vivax or P ovale): chloroquine (Aralen) plus primaquine
A) chloroquine (Aralen)
B) chloroguanide C) Parenteral treatment (severe attacks): quinidine gluconate (Quinaglute,
C) pyrimethamine (Daraprim) Quinalan) followed by oral chloroquine (Aralen) when possible {followed by
D) trimethoprim (generic) primaquine if infection is caused by P vivax or P ovalea brace
E) primaquine
Question # 10 (Multiple Answer) Malaria: objective clinical presentations
Question # 2 (Multiple Answer) Characteristics of significant parasitization, i.e.
P falciparum: A) orthostatic hypotension
B) faint scleral icterus
A) vasoconstriction C) meningismus
B) hemoglobinuria D) during paroxysmal phase: high fever (up to 106 degrees Fahrenheit)
C) microthrombi formation
D) if > 20% of erythrocytes are parasitized, mortality = 50% (P falciparum) Question # 11 (Multiple Answer) Malaria:

Question # 3 (Multiple Answer) One cycle of liver invasion and multiplication: A) about one million deaths per year due to malaria
B) most important parasitic infection
A) P vivax C) most U.S. cases found in transfusion recipients and intravenous drug users
B) P falciparum D) increase in incidence secondary to increasing drug- resistance to P
C) P. malariae falciparum & failure of mosquito eradication programs
D) P ovale
Question # 12 (Multiple Answer) Major malarial symptoms:
Question # 4 (Multiple Choice) Factors which determine antimalarial agent
efficacy: A) cold phase-patient complains of chills
B) hot phase-associated with high fever, headache, vomiting, nausea, delirium
A) species C) defervescence;profuse sweating and sleep
B) life-cycle stage-dependencies D) none of the above
C) both
D) neither Question # 13 (True/False) Treatment of malaria caused by chloroquine
(Aralen)-resistant P falciparum Oral:quinine sulfate and clindamycin (Cleocin)
Question # 5 (Multiple Choice) Asserting a malarial diagnosis:
A) True
A) fever/flu-like symptoms in individual returning from travel (or native to) a B) False
malarious geographical region
B) disease ruled out the patient has taken prophylactic drugs during travel Question # 14 (Multiple Answer) Treatment must eliminate parasites from
C) both both liver and erythrocytes:
D) neither
A) P falciparum
Question # 6 (Multiple Answer) Malaria prophylaxis:for regions with B) P. malariae
chloroquine (Aralen)-resistant P falciparum malaria C) P vivax
D) P ovale
A) preferred: mefloquine (Lariam)
B) alternative #1:doxycycline (Vibramycin, Doryx) Question # 15 (Multiple Choice) Of the plasmodium species causative for
C) alternative #2: chloroquine (Aralen) plus proguanil (Paludrine) human malaria, the one producing most serious complications:

Question # 7 (Multiple Answer) Malaria: etiology -- A) Plasmodium vivax
B) Plasmodium malariae
A) only arthropod vector-byte to the female anopheline mosquito C) Plasmodium ovale
B) transmission does not occur at < 60 degrees Fahrenheit or at >100 degrees D) plasmodium falciparum
C) incubation period: typically three-four weeks Question # 16 (Multiple Answer) Concerning definitive malaria diagnosis:

Question # 8 (Multiple Answer) Antimalarials: classification based on site of A) if thin blood smear is negative, examine thick smear {may be positive than
drug action: 20%-25% of patients}
B) examination of blood smear should be done once approximately seven
A) gametocides days after initial visit
B) tissue schizonticides C) a critical factor is to determine if patient has falciparum malaria which may
C) blood schizonticides, e.g. chloroquine (Aralen), proguanil (Paludrine), be fatal due to high-rate of erythrocyte parasitization
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)