Paper II
2017 February (2010 Scheme) · 40 marks · 120 min

Question

Read the case history and answer the following questions: Mr. Ramu 40 years presented with H/o fever with chills for the past two days and diagnosed as a case of plasmodium falciparum malaria.

  • (a) Prescribe for acute attack of plasmodium falciparum malaria. 2 mark(s)
  • (b) Mention the mechanism of action of any one anti malarial drug. 2 mark(s)
  • (c) List two drugs for chemoprophylaxis of malaria. 2 mark(s)
Q16 marksEssays

Answer

(a) Prescription for acute uncomplicated P. falciparum malaria

  • Artemisinin-based combination therapy (ACT) — e.g., Artesunate + Sulfadoxine-pyrimethamine, or Artemether-Lumefantrine, for 3 days
  • (If severe/complicated: IV Artesunate, followed by a full course of ACT)

(b) Mechanism of action (Chloroquine, as an example)

  • Concentrates in the parasite’s food vacuole and inhibits haem polymerase, which normally converts toxic free haem into inert haemozoin
  • Accumulation of toxic free haem damages parasite membranes, killing the parasite

(c) Drugs for chemoprophylaxis of malaria

  • Mefloquine
  • Doxycycline (Chloroquine + Proguanil is also used in areas without chloroquine resistance)

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