Take a look at malaria.
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
So your patient has now been exposed
to whatever type of mosquito.
And the type of Anopheles mosquito.
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.
I’m not going to go to the microbiology.
That's a different conversation,
but quotidian, variable.
Tertian: vivax, every 48 hours.
every 72 hours.
Okay, so Falciparum being
the most lethal of them all
and then the one that’s extremely
common will be the vivax.
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?
There is another antigen for you, Duffy.
So if your patient has
rendered Duffy negative,
then he or she is completely resistant to
the most common type of malaria, the vivax.
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.
And so therefore,
what this means is that every time
these RBCs come in to the circulation,
well, maybe you seen
the movie Alien.
And in there, the alien then burst
through the stomach, right?
That’s what the plasmodium does.
It will burst through the RBC membrane.
And every time it comes out, is the fever.
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.
Welcome to malaria.
That’s crazy, but that’s
exactly how it works.
You tell me as to what
kind of anemia this is?
It’s a normocytic hemolytic
intravascular type of anemia.
It’s that simple.
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.
Vivax being the most
common, every 48 hours.
Falciparum being the most lethal.
Quartan malaria, 72 hours.