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Medicine Infection a06f1cff

Cerebral malaria is caused by-

A
P. falciparum
B
P. vivax
C
P. ovale
D
None of the above
High-Yield Explanation
Ans. is 'a' i.e., P. falciparum* Cerebral malaria is a manifestation of severe falciparum malaria.* Other manifestations of severe falciparum malaria areManifestations of severe falciparum malariaSignsManifestationsMajorUnarousable coma/ cerebral malariaFailure to localize or respond appropriately to noxious stimulf; coma persisting for >30 min after generalized convulsionAcidemia/acidosisArterial pH of <7.25 or plasma bicarbonate level of <15 mmol//L; venous lactate level of > 5 mmol/L; manifests as labored deep breathing, often termed "respiratory distress"Severe normochromic, normocytic anemiaHematocrit of <15% or hemoglobin level of <50g/L (<5 g/dL) iwth parasitemia level of >> 100,000 mlRenal failureUrine output (24 h) of <400 mL in adults or <12 mL/kg in children; no improvement with rehydration; serum creatinine level of >265 mmol/L (>mg/dL)Pulmonary edema/ adult respiratory distress syndromeNoncardiogenic pulmonary edema, often aggravated by overhydrationHypoglycemiaPlasma glucoss level of <2.2 mmol/L (40 mg/dL)Hypotension/shockSystolic blood pressure of <50 mmHg in children 1-5 years or <80 mmHg in adults; core/ skin temperature difference of >10degC; capillary refill >2 sBleeding/ disseminated intravascular coagulationSignificant bleeding and hemorrhage from the gums, nose, and gastrointestinal tract and/ or evidence of disseminated intravascular coagulationConvulsionsMore than two generalized seizures in 24 h; signs of continued seizure activity sometimes subtle (e.g., tonic-clonic eye movements without limb or face movement)HemoglobinuriaMacroscopic black, brown, or red urine; not associated with effects of oxidant drugs and red blood cell enzyme defects (such as G6PD deficiency)OtherImpaired consciousness/ arousableUnable to sit or stand without supportExtreme weaknessProstration; inability to sit unaidedHyperparasitemiaParasitemia level of >5% in nonimmune patients (>20% in any patient)JaundiceSerum bilirubin level of >50 mmol (>3 mg/dL) if combined with other evidence of vital-organ dysfunction

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