Malaria

00:00 Take a look at malaria.

00:02 So finally, we’re done with autoimmune hemolytic anemias and this is our last little example of what we need to take a look at here with anemias with extrinsic problem.

00:14 So your patient has now been exposed to whatever type of mosquito.

00:17 And the type of Anopheles mosquito.

00:21 And the type of protozoa that you’re looking for here is going to be, of course, your Plasmodium, isn’t it? You have different types.

00:28 I’m not going to go to the microbiology.

00:28 That's a different conversation, but quotidian, variable.

00:33 Falciparum.

00:36 Tertian: vivax, every 48 hours.

00:38 Quartan: malaria, every 72 hours.

00:42 Okay, so Falciparum being the most lethal of them all and then the one that’s extremely common will be the vivax.

00:50 Right? Vivax.

00:51 Luckily enough, with vivax, it's interesting because do you remember what plasmodium vivax was to bind on your RBCs? It’s called the Duffy antigen, right? Duffy.

01:02 There is another antigen for you, Duffy.

01:04 Crazy! So if your patient has rendered Duffy negative, then he or she is completely resistant to the most common type of malaria, the vivax.

01:15 That’s unbelievable, isn’t it? Now, what we’re looking at here in this picture is going to be those RBCs especially the one that you see in the middle there, little up to the left there, and that's one that has plasmodium species in it.

01:30 Ring forms.

01:30 And so therefore, what this means is that every time these RBCs come in to the circulation, well, maybe you seen the movie Alien.

01:40 And in there, the alien then burst through the stomach, right? That’s what the plasmodium does.

01:46 It will burst through the RBC membrane.

01:49 And every time it comes out, is the fever.

01:52 So depending as to when it wishes to literally rear its ugly head is when the patient is going to feel his or her fever.

02:03 Welcome to malaria.

02:04 That’s crazy, but that’s exactly how it works.

02:07 You tell me as to what kind of anemia this is? It’s a normocytic hemolytic intravascular type of anemia.

02:15 It’s that simple.

02:18 What kind of symptoms is your patient going to have apart from the fever and such and the pattern that you need to know oh so well from malaria? Well, hemoglobinuria, right? In terms of its anemia.

02:29 Vivax being the most common, every 48 hours.

02:33 Falciparum being the most lethal.

02:36 Quartan malaria, 72 hours.