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<\/p>\n\n

Introduction<\/span><\/strong><\/p>\n\n

Access for free at Ch. 5 Introduction - Microbiology | OpenStax<\/a><\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"8982e918-0c42-4ced-b765-aaeb546cd5b6"}},{"content":{"params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-678d09008ca46.png","mime":"image\/png","copyright":{"license":"U"},"width":898,"height":281},"alt":"Malaria is a disease caused by a eukaryotic parasite transmitted to humans by mosquitos"},"library":"H5P.Image 1.1","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"7c8a0273-ce0c-4dd6-8437-dba7480c7b3d"},"useSeparator":"auto"},{"content":{"params":{"text":"

Figure 5.1<\/strong> Malaria is a disease caused by a eukaryotic parasite transmitted to humans by mosquitos. Micrographs (left and center) show a sporozoite life stage, trophozoites, and a schizont in a blood smear. On the right is depicted a primary defense against mosquito-borne illnesses like malaria\u2014mosquito netting. (credit left: modification of work by Ute Frevert; credit middle: modification of work by Centers for Disease Control and Prevention; credit right: modification of work by Tjeerd Wiersma)<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"b8d6c785-8ab3-4751-92a2-98248e95b33a"},"useSeparator":"auto"},{"content":{"params":{"text":"

Although bacteria and viruses account for a large number of the infectious diseases that afflict humans, many serious illnesses are caused by eukaryotic organisms. One example is malaria, which is caused by Plasmodium<\/em>, a eukaryotic organism transmitted through mosquito bites. Malaria is a major cause of morbidity (illness) and mortality (death) that threatens 3.4 billion people worldwide.In severe cases, organ failure and blood or metabolic abnormalities contribute to medical emergencies and sometimes death. Even after initial recovery, relapses may occur years later. In countries where malaria is endemic, the disease represents a major public health challenge that can place a tremendous strain on developing economies.<\/p>\n\n

Worldwide, major efforts are underway to reduce malaria infections. Efforts include the distribution of insecticide-treated bed nets and the spraying of pesticides. Researchers are also making progress in their efforts to develop effective vaccines. The President's Malaria Initiative, started in 2005, supports prevention and treatment. The Bill and Melinda Gates Foundation has a large initiative to eliminate malaria. Despite these efforts, malaria continues to cause long-term morbidity (such as intellectual disabilities in children) and mortality (especially in children younger than 5 years), so we still have far to go.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"f297e23e-31f4-4d0c-a0ed-bc65b8d0aae6"},"useSeparator":"auto"},{"content":{"params":{"visuals":{"fit":true,"controls":true},"playback":{"autoplay":false,"loop":false},"l10n":{"name":"Video","loading":"Video player loading...","noPlayers":"Found no video players that supports the given video format.","noSources":"Video is missing sources.","aborted":"Media playback has been aborted.","networkFailure":"Network failure.","cannotDecode":"Unable to decode media.","formatNotSupported":"Video format not supported.","mediaEncrypted":"Media encrypted.","unknownError":"Unknown error.","invalidYtId":"Invalid YouTube ID.","unknownYtId":"Unable to find video with the given YouTube ID.","restrictedYt":"The owner of this video does not allow it to be embedded."},"sources":[{"path":"https:\/\/youtu.be\/TnzcwTyr6cE","mime":"video\/YouTube","copyright":{"license":"U"}}]},"library":"H5P.Video 1.6","metadata":{"contentType":"Video","license":"U","title":"Genetic Engineering and Diseases - Gene Drive & Malaria"},"subContentId":"676c29c6-3f0c-4035-94fc-8819fa5beeeb"},"useSeparator":"auto"},{"content":{"params":{"media":{"disableImageZooming":false},"answers":[{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"

Distribution of insecticide-treated bed nets<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"Spraying of pesticides<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Effort to develop vaccines against Plasmodium<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Effort to develop vaccines against Plasmodium<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Reduce standing water and mosquito breeding grounds<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Genetic engineering to modify mosquitoes<\/div>\n"}],"overallFeedback":[{"from":0,"to":99,"feedback":"Try again. Remember there can be more than one answer!"},{"from":100,"to":100,"feedback":"Correct! All of the above are current methods of reducing malaria infections worldwide."}],"behaviour":{"enableRetry":true,"enableSolutionsButton":true,"enableCheckButton":true,"type":"auto","singlePoint":false,"randomAnswers":true,"showSolutionsRequiresInput":true,"confirmCheckDialog":false,"confirmRetryDialog":false,"autoCheck":false,"passPercentage":100,"showScorePoints":true},"UI":{"checkAnswerButton":"Check","submitAnswerButton":"Submit","showSolutionButton":"Show solution","tryAgainButton":"Retry","tipsLabel":"Show tip","scoreBarLabel":"You got :num out of :total points","tipAvailable":"Tip available","feedbackAvailable":"Feedback available","readFeedback":"Read feedback","wrongAnswer":"Wrong answer","correctAnswer":"Correct answer","shouldCheck":"Should have been checked","shouldNotCheck":"Should not have been checked","noInput":"Please answer before viewing the solution","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yShowSolution":"Show the solution. The task will be marked with its correct solution.","a11yRetry":"Retry the task. Reset all responses and start the task over again."},"confirmCheck":{"header":"Finish ?","body":"Are you sure you wish to finish ?","cancelLabel":"Cancel","confirmLabel":"Finish"},"confirmRetry":{"header":"Retry ?","body":"Are you sure you wish to retry ?","cancelLabel":"Cancel","confirmLabel":"Confirm"},"question":"
What are some efforts to reduce malaria infections worldwide? Check all that apply.<\/p>\n"},"library":"H5P.MultiChoice 1.16","metadata":{"contentType":"Multiple Choice","license":"U","title":"Preventing Malaria"},"subContentId":"880b1833-7153-4690-a994-ed6e99a4b88d"},"useSeparator":"auto"},{"content":{"params":{"media":{"disableImageZooming":false},"answers":[{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Severe anaemia<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Organ (spleen, liver, kidney) enlargement and failure<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Hypoglycaemia and metabolic acidosis<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
ARDS<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Cerebral malaria<\/div>\n"}],"overallFeedback":[{"from":0,"to":99,"feedback":"Try again!"},{"from":100,"to":100,"feedback":"Correct! These are all complications of malaria."}],"behaviour":{"enableRetry":true,"enableSolutionsButton":true,"enableCheckButton":true,"type":"auto","singlePoint":false,"randomAnswers":true,"showSolutionsRequiresInput":true,"confirmCheckDialog":false,"confirmRetryDialog":false,"autoCheck":false,"passPercentage":100,"showScorePoints":true},"UI":{"checkAnswerButton":"Check","submitAnswerButton":"Submit","showSolutionButton":"Show solution","tryAgainButton":"Retry","tipsLabel":"Show tip","scoreBarLabel":"You got :num out of :total points","tipAvailable":"Tip available","feedbackAvailable":"Feedback available","readFeedback":"Read feedback","wrongAnswer":"Wrong answer","correctAnswer":"Correct answer","shouldCheck":"Should have been checked","shouldNotCheck":"Should not have been checked","noInput":"Please answer before viewing the solution","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yShowSolution":"Show the solution. The task will be marked with its correct solution.","a11yRetry":"Retry the task. Reset all responses and start the task over again."},"confirmCheck":{"header":"Finish ?","body":"Are you sure you wish to finish ?","cancelLabel":"Cancel","confirmLabel":"Finish"},"confirmRetry":{"header":"Retry ?","body":"Are you sure you wish to retry ?","cancelLabel":"Cancel","confirmLabel":"Confirm"},"question":"
<\/p>\n\n
Which of the following are complications of malaria? Check all that apply.<\/p>\n"},"library":"H5P.MultiChoice 1.16","metadata":{"contentType":"Multiple Choice","license":"U","title":"Complications of Malaria"},"subContentId":"84962722-5d0d-4918-a84f-3236a97a8061"},"useSeparator":"auto"}]},"library":"H5P.Column 1.18","subContentId":"20bb40df-3c67-43c3-941c-b73ee65b1db9","metadata":{"contentType":"Column","license":"U","title":"Introduction"}},{"params":{"content":[{"content":{"params":{"text":"
The Circulatory System<\/span><\/strong><\/p>\n\n
Access for free at 25.1 Anatomy of the Circulatory and Lymphatic Systems - Microbiology | OpenStax<\/a><\/p>\n\n
The circulatory and lymphatic systems are networks of vessels and a pump that transport blood and lymph, respectively, throughout the body. When these systems are infected with a microorganism, the network of vessels can facilitate the rapid dissemination of the microorganism to other regions of the body, sometimes with serious results. In this section, we will examine some of the key anatomical features of the circulatory and lymphatic systems, as well as general signs and symptoms of infection.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"083f4717-9be8-4cc2-add4-02c69ad87d99"},"useSeparator":"auto"},{"content":{"params":{"text":"
The circulatory (or cardiovascular) system is a closed network of organs and vessels that moves blood around the body (Figure 25.2). The primary purposes of the circulatory system are to deliver nutrients, immune factors, and oxygen to tissues and to carry away waste products for elimination. <\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"2ee16a7c-43ed-48b7-9eed-5d6ccc1cf954"},"useSeparator":"auto"},{"content":{"params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-678d1e48df4f2.png","mime":"image\/png","copyright":{"license":"U"},"width":677,"height":623},"alt":"The major components of the human circulatory system."},"library":"H5P.Image 1.1","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"a058f1ff-37e1-4682-8888-fff1a30a24e5"},"useSeparator":"auto"},{"content":{"params":{"text":"
Figure 25.2 <\/strong>The major components of the human circulatory system include the heart, arteries, veins, and capillaries. This network delivers blood to the body\u2019s organs and tissues. (credit top left: modification of work by Mariana Ruiz Villareal; credit bottom right: modification of work by Bruce Blaus)<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"1ffbe81e-58d4-4df3-b09b-a51568afa062"},"useSeparator":"auto"},{"content":{"params":{"text":"
The heart is a four-chambered pump that propels the blood throughout the body. Deoxygenated blood enters the right atrium through the superior vena cava and the inferior vena cava after returning from the body. The blood next passes through the tricuspid valve to enter the right ventricle. When the heart contracts, the blood from the right ventricle is pumped through the pulmonary arteries to the lungs. There, the blood is oxygenated at the alveoli and returns to the heart through the pulmonary veins. The oxygenated blood is received at the left atrium and proceeds through the mitral valve to the left ventricle. When the heart contracts, the oxygenated blood is pumped throughout the body via a series of thick-walled vessels called arteries. The first and largest artery is called the aorta. The arteries sequentially branch and decrease in size (and are called arterioles) until they end in a network of smaller vessels called capillaries. The capillary beds are located in the interstitial spaces within tissues and release nutrients, immune factors, and oxygen to those tissues. The capillaries connect to a series of vessels called venules, which increase in size to form the veins. The veins join together into larger vessels as they transfer blood back to the heart. The largest veins, the superior and inferior vena cava, return the blood to the right atrium.<\/p>\n\n
Other organs play important roles in the circulatory system as well. The kidneys filter the blood, removing waste products and eliminating them in the urine. The liver also filters the blood and removes damaged or defective red blood cells. The spleen filters and stores blood, removes damaged red blood cells, and is a reservoir for immune factors. All of these filtering structures serve as sites for entrapment of microorganisms and help maintain an environment free of microorganisms in the blood.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"9ac2e917-8c94-440a-b8da-58ec807c1bd1"},"useSeparator":"auto"},{"content":{"params":{"media":{"disableImageZooming":false},"taskDescription":"
Drag the words into the correct order to represent blood flow in the circulatory circuit from left ventricle contraction to the right atrium.<\/p>\n","overallFeedback":[{"from":0,"to":99,"feedback":"Try again."},{"from":100,"to":100,"feedback":"Correct! This is the right order of how blood flows through the circulatory circuit."}],"checkAnswer":"Check","submitAnswer":"Submit","tryAgain":"Retry","showSolution":"Show solution","dropZoneIndex":"Drop Zone @index.","empty":"Drop Zone @index is empty.","contains":"Drop Zone @index contains draggable @draggable.","ariaDraggableIndex":"@index of @count draggables.","tipLabel":"Show tip","correctText":"Correct!","incorrectText":"Incorrect!","resetDropTitle":"Reset drop","resetDropDescription":"Are you sure you want to reset this drop zone?","grabbed":"Draggable is grabbed.","cancelledDragging":"Cancelled dragging.","correctAnswer":"Correct answer:","feedbackHeader":"Feedback","behaviour":{"enableRetry":true,"enableSolutionsButton":true,"enableCheckButton":true,"instantFeedback":false},"scoreBarLabel":"You got :num out of :total points","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yShowSolution":"Show the solution. The task will be marked with its correct solution.","a11yRetry":"Retry the task. Reset all responses and start the task over again.","textField":"1. Left ventricle \n2. *Aorta*\n3. *Arteries*\n4. *Arterioles*\n5. *Capillaries*\n6. *Venules*\n7. *Veins*\n8. *Superior and inferior vena cava*\n9. Right atrium"},"library":"H5P.DragText 1.10","metadata":{"contentType":"Drag the Words","license":"U","title":"Left Ventricle to Right Atrium Blood Flow"},"subContentId":"81694355-1260-4af7-8593-adcd03230c8b"},"useSeparator":"auto"},{"content":{"params":{"media":{"disableImageZooming":false},"taskDescription":"
Drag the words into the correct order to represent blood flow in the circulatory circuit from right ventricle contraction to the left atrium.<\/p>\n","overallFeedback":[{"from":0,"to":99,"feedback":"Try again!"},{"from":100,"to":100,"feedback":"Correct! This is the right order of how blood flows through the circulatory circuit."}],"checkAnswer":"Check","submitAnswer":"Submit","tryAgain":"Retry","showSolution":"Show solution","dropZoneIndex":"Drop Zone @index.","empty":"Drop Zone @index is empty.","contains":"Drop Zone @index contains draggable @draggable.","ariaDraggableIndex":"@index of @count draggables.","tipLabel":"Show tip","correctText":"Correct!","incorrectText":"Incorrect!","resetDropTitle":"Reset drop","resetDropDescription":"Are you sure you want to reset this drop zone?","grabbed":"Draggable is grabbed.","cancelledDragging":"Cancelled dragging.","correctAnswer":"Correct answer:","feedbackHeader":"Feedback","behaviour":{"enableRetry":true,"enableSolutionsButton":true,"enableCheckButton":true,"instantFeedback":false},"scoreBarLabel":"You got :num out of :total points","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yShowSolution":"Show the solution. The task will be marked with its correct solution.","a11yRetry":"Retry the task. Reset all responses and start the task over again.","textField":"1. Right ventricle\n2. *Pulmonary artery*\n3. *Lungs*\n4. *Pulmonary veins*\n5. Left atrium"},"library":"H5P.DragText 1.10","metadata":{"contentType":"Drag the Words","license":"U","title":"Right Ventricle to Left Atrium Blood Flow"},"subContentId":"7bfeb68c-d163-464e-82f2-4108c9ff7ab9"},"useSeparator":"auto"}]},"library":"H5P.Column 1.18","subContentId":"a03c0a67-ad20-4411-a67d-196077389f67","metadata":{"contentType":"Column","license":"U","title":"The Circulatory System"}},{"params":{"content":[{"content":{"params":{"text":"
The Lymphatic System<\/span><\/strong><\/p>\n\n
The lymphatic system is also a network of vessels that run throughout the body (Figure 25.3). However, these vessels do not form a full circulating system and are not pressurized by the heart. Rather, the lymphatic system is an open system with the fluid moving in one direction from the extremities toward two drainage points into veins just above the heart. <\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"2ff3fd8f-c701-45be-92c1-76bcf5e258e1"},"useSeparator":"auto"},{"content":{"params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-678d22a03ab2a.png","mime":"image\/png","copyright":{"license":"U"},"width":757,"height":686},"alt":"The essential components of the human lymphatic system drain fluid away from tissues."},"library":"H5P.Image 1.1","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"31a4dc5b-3afc-4568-97a8-a6fadf974649"},"useSeparator":"auto"},{"content":{"params":{"text":"
Figure 25.3 <\/strong>The essential components of the human lymphatic system drain fluid away from tissues.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"32a832f1-d4c0-4a0a-9082-34734705288c"},"useSeparator":"auto"},{"content":{"params":{"text":"
The lymphatic system is also a network of vessels that run throughout the body (Figure 25.3). However, these vessels do not form a full circulating system and are not pressurized by the heart. Rather, the lymphatic system is an open system with the fluid moving in one direction from the extremities toward two drainage points into veins just above the heart. <\/p>\n\n
Lymphatic fluids move more slowly than blood because they are not pressurized. Small lymph capillaries interact with blood capillaries in the interstitial spaces in tissues. Fluids from the tissues enter the lymph capillaries and are drained away (Figure 25.4). These fluids, termed lymph, also contain large numbers of white blood cells.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"1473de63-fd34-4e02-9089-ab83e7baf285"},"useSeparator":"auto"},{"content":{"params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-678d23161e5b0.png","mime":"image\/png","copyright":{"license":"U"},"width":581,"height":485},"alt":"Blood enters the capillaries from an arteriole (red) and leaves through venules (blue)."},"library":"H5P.Image 1.1","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"93d0cef2-dca3-4c30-af73-bf2182d3fd76"},"useSeparator":"auto"},{"content":{"params":{"text":"
Figure 25.4<\/strong> Blood enters the capillaries from an arteriole (red) and leaves through venules (blue). Interstitial fluids may drain into the lymph capillaries (green) and proceed to lymph nodes. (credit: modification of work by National Cancer Institute, National Institutes of Health)<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"f37be14d-e44c-4ffc-80b0-2a956bd94202"},"useSeparator":"auto"},{"content":{"params":{"text":"
The lymphatic system contains two types of lymphoid tissues. The primary lymphoid tissue includes bone marrow and the thymus. Bone marrow contains the hematopoietic stem cells (HSC) that differentiate and mature into the various types of blood cells and lymphocytes (see Figure 17.12<\/a>). The secondary lymphoid tissues include the spleen, lymph nodes, and several areas of diffuse lymphoid tissues underlying epithelial membranes. The spleen, an encapsulated structure, filters blood and captures pathogens and antigens that pass into it (Figure 25.5). The spleen contains specialized macrophages and dendritic cells that are crucial for antigen presentation, a mechanism critical for activation of T lymphocytes and B lymphocytes. Lymph nodes are bean-shaped organs situated throughout the body. These structures contain areas called germinal centers that are rich in B and T lymphocytes. The lymph nodes also contain macrophages and dendritic cells for antigen presentation. Lymph from nearby tissues enters the lymph node through afferent lymphatic vessels and encounters these lymphocytes as it passes through; the lymph exits the lymph node through the efferent lymphatic vessels (Figure 25.5).<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"13802ce4-856a-4fa8-bafa-8f935da2aee5"},"useSeparator":"auto"},{"content":{"params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-678d2394d0be2.png","mime":"image\/png","copyright":{"license":"U"},"width":752,"height":391},"alt":"The spleen is a lymphatic organ located in the upper left quadrant of the abdomen near the stomach and left kidney."},"library":"H5P.Image 1.1","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"1b5e12c8-cbc3-48f6-933a-046634a912b1"},"useSeparator":"auto"},{"content":{"params":{"text":"
Figure 25.5 <\/strong>(a) The spleen is a lymphatic organ located in the upper left quadrant of the abdomen near the stomach and left kidney. It contains numerous phagocytes and lymphocytes that combat and prevent circulatory infections by killing and removing pathogens from the blood. (b) Lymph nodes are masses of lymphatic tissue located along the larger lymph vessels. They contain numerous lymphocytes that kill and remove pathogens from lymphatic fluid that drains from surrounding tissues.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"01fa2109-e61e-4ecf-82c0-54968461197d"},"useSeparator":"auto"},{"content":{"params":{"scoreShow":"Check","submit":"Submit","tryAgain":"Retry","scoreExplanation":"Correct answers give +1 point. Incorrect answers give -1 point. The lowest possible score is 0.","question":{"settings":{"size":{"width":620,"height":310},"background":{"path":"images\/background-678d2569681df.png","mime":"image\/png","copyright":{"license":"U"},"width":1002,"height":637}},"task":{"elements":[{"x":26.880716829150913,"y":73.77049185824926,"width":7.736596270973155,"height":3.185421774328859,"dropZones":["0","1"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Bone marrow<\/p>\n"},"subContentId":"d9967b5f-b54c-43e8-8176-4358c9657ecc","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":50.401016927570794,"y":73.76955670092288,"width":7.736596270973155,"height":3.185421774328859,"dropZones":["0","1"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Thymus<\/p>\n"},"subContentId":"b661b64e-8b62-4d4f-bbfd-82b7fe863cb2","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":3.3599162810214214,"y":73.76955670092288,"width":7.736596270973155,"height":3.185421774328859,"dropZones":["1","0"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Spleen<\/p>\n"},"subContentId":"5cc2b765-473c-4b7a-be0b-e27f085d6ca8","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":74.0276648734082,"y":73.76955670092288,"width":8.386764056208053,"height":3.0553882172818794,"dropZones":["1","0"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Lymph nodes<\/p>\n"},"subContentId":"a26a569b-d2d8-48ef-84db-d0ba1e836641","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false}],"dropZones":[{"x":5.038706611860632,"y":6.701996927432941,"width":16.254194630872483,"height":11.703020134228188,"correctElements":["0","1"],"showLabel":false,"backgroundOpacity":0,"tipsAndFeedback":{"tip":""},"single":false,"autoAlign":false,"label":"
Primary Lymphatic Tissue<\/div>\n"},{"x":52.04250025601553,"y":6.692657319630928,"width":16.935064996981012,"height":11.703020134228188,"correctElements":["2","3"],"showLabel":false,"backgroundOpacity":0,"tipsAndFeedback":{"tip":""},"single":false,"autoAlign":false,"label":"Secondary Lymphatic Tissue<\/div>\n"}]}},"overallFeedback":[{"from":0,"to":75,"feedback":"Almost! Try again."},{"from":76,"to":100,"feedback":"Correct! You have identified components of the two lymphoid tissues."}],"behaviour":{"enableRetry":true,"enableCheckButton":true,"singlePoint":false,"applyPenalties":true,"enableScoreExplanation":true,"dropZoneHighlighting":"dragging","autoAlignSpacing":2,"enableFullScreen":false,"showScorePoints":true,"showTitle":true},"grabbablePrefix":"Grabbable {num} of {total}.","grabbableSuffix":"Placed in dropzone {num}.","dropzonePrefix":"Dropzone {num} of {total}.","noDropzone":"No dropzone.","tipLabel":"Show tip.","tipAvailable":"Tip available","correctAnswer":"Correct answer","wrongAnswer":"Wrong answer","feedbackHeader":"Feedback","scoreBarLabel":"You got :num out of :total points","scoreExplanationButtonLabel":"Show score explanation","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yRetry":"Retry the task. Reset all responses and start the task over again.","localize":{"fullscreen":"Fullscreen","exitFullscreen":"Exit fullscreen"}},"library":"H5P.DragQuestion 1.14","metadata":{"contentType":"Drag and Drop","license":"U","title":"Drag and drop the components into their correct type of lymphoid tissue."},"subContentId":"2f76de25-1b38-4ce3-878c-4b996cc70557"},"useSeparator":"auto"}]},"library":"H5P.Column 1.18","subContentId":"dd0cbbb7-b20a-4662-b1b8-fbfaabfd252c","metadata":{"contentType":"Column","license":"U","title":"The Lymphatic System"}},{"params":{"content":[{"content":{"params":{"text":"
Infections of the CV and Lymphatic Systems<\/span><\/h3>\n\n
Infections of the Circulatory System<\/strong><\/span><\/h3>\n\n
Under normal circumstances, the circulatory system and the blood should be sterile; the circulatory system has no normal microbiota. Because the system is closed, there are no easy portals of entry into the circulatory system for microbes. Those that are able to breach the body's physical barriers and enter the bloodstream encounter a host of circulating immune defenses, such as antibodies, complement proteins, phagocytes, and other immune cells. Microbes often gain access to the circulatory system through a break in the skin (e.g., wounds, needles, intravenous catheters, insect bites) or spread to the circulatory system from infections in other body sites. For example, microorganisms causing pneumonia or renal infection may enter the local circulation of the lung or kidney and spread from there throughout the circulatory network.<\/p>\n\n
If microbes in the bloodstream are not quickly eliminated, they can spread rapidly throughout the body, leading to serious, even life-threatening infections. Various terms are used to describe conditions involving microbes in the circulatory system. The term bacteremia refers to bacteria in the blood. If bacteria are reproducing in the blood as they spread, this condition is called septicemia. The presence of viruses in the blood is called viremia. Microbial toxins can also be spread through the circulatory system, causing a condition termed toxemia.<\/p>\n\n
Microbes and microbial toxins in the blood can trigger an inflammatory response so severe that the inflammation damages host tissues and organs more than the infection itself. This counterproductive immune response is called systemic inflammatory response syndrome (SIRS), and it can lead to the life-threatening condition known as sepsis. Sepsis is characterized by the production of excess cytokines that leads to classic signs of inflammation such as fever, vasodilation, and edema (see Inflammation and Fever<\/a>). In a patient with sepsis, the inflammatory response becomes dysregulated and disproportionate to the threat of infection. Critical organs such as the heart, lungs, liver, and kidneys become dysfunctional, resulting in increased heart and respiratory rates, and disorientation. If not treated promptly and effectively, patients with sepsis can go into shock and die.<\/p>\n\n
Certain infections can cause inflammation in the heart and blood vessels. Inflammation of the endocardium, the inner lining of the heart, is called endocarditis and can result in damage to the heart valves severe enough to require surgical replacement. Inflammation of the pericardium, the sac surrounding the heart, is called pericarditis. The term myocarditis refers to the inflammation of the heart's muscle tissue. Pericarditis and myocarditis can cause fluid to accumulate around the heart, resulting in congestive heart failure. Inflammation of blood vessels is called vasculitis. Although somewhat rare, vasculitis can cause blood vessels to become damaged and rupture; as blood is released, small red or purple spots called petechiae appear on the skin. If the damage of tissues or blood vessels is severe, it can result in reduced blood flow to the surrounding tissues. This condition is called ischemia, and it can be very serious. In severe cases, the affected tissues can die and become necrotic; these situations may require surgical debridement or amputation.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"f8967fb4-72eb-46bd-9eca-196a9f4d4969"},"useSeparator":"auto"},{"content":{"params":{"media":{"disableImageZooming":false},"answers":[{"correct":false,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
There is an easy portal for microbes to enter the CV system<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
There is not an easy portal for microbes to enter the CV system<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
There are a lot of immune cells in the CV system<\/div>\n"},{"correct":false,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
There are not a lot of immune cells in the CV system<\/div>\n"}],"overallFeedback":[{"from":0,"to":50,"feedback":"Not quite! Remember there can be more than one answer."},{"from":51,"to":100,"feedback":"Correct! The cardiovascular system lacks normal microbiota as there is not easy way for them to enter, and it contains a high concentration of immune cells."}],"behaviour":{"enableRetry":true,"enableSolutionsButton":true,"enableCheckButton":true,"type":"auto","singlePoint":false,"randomAnswers":true,"showSolutionsRequiresInput":true,"confirmCheckDialog":false,"confirmRetryDialog":false,"autoCheck":false,"passPercentage":100,"showScorePoints":true},"UI":{"checkAnswerButton":"Check","submitAnswerButton":"Submit","showSolutionButton":"Show solution","tryAgainButton":"Retry","tipsLabel":"Show tip","scoreBarLabel":"You got :num out of :total points","tipAvailable":"Tip available","feedbackAvailable":"Feedback available","readFeedback":"Read feedback","wrongAnswer":"Wrong answer","correctAnswer":"Correct answer","shouldCheck":"Should have been checked","shouldNotCheck":"Should not have been checked","noInput":"Please answer before viewing the solution","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yShowSolution":"Show the solution. The task will be marked with its correct solution.","a11yRetry":"Retry the task. Reset all responses and start the task over again."},"confirmCheck":{"header":"Finish ?","body":"Are you sure you wish to finish ?","cancelLabel":"Cancel","confirmLabel":"Finish"},"confirmRetry":{"header":"Retry ?","body":"Are you sure you wish to retry ?","cancelLabel":"Cancel","confirmLabel":"Confirm"},"question":"
Which of the following is a reason why the CV system has no normal microbiota? Check all that apply.<\/p>\n"},"library":"H5P.MultiChoice 1.16","metadata":{"contentType":"Multiple Choice","license":"U","title":"Microbiota in the CV System"},"subContentId":"15c3f937-f2f0-4957-af44-76ffd4885f9a"},"useSeparator":"auto"},{"content":{"params":{"text":"
Infections of the Lymphatic System<\/strong><\/span><\/h3>\n\n
Like the circulatory system, the lymphatic system does not have a normal microbiota, and the large numbers of immune cells typically eliminate transient microbes before they can establish an infection. Only microbes with an array of virulence factors are able to overcome these defenses and establish infection in the lymphatic system. However, when a localized infection begins to spread, the lymphatic system is often the first place the invading microbes can be detected.<\/p>\n\n
Infections in the lymphatic system also trigger an inflammatory response. Inflammation of lymphatic vessels, called lymphangitis, can produce visible red streaks under the skin. Inflammation in the lymph nodes can cause them to swell. A swollen lymph node is referred to as a bubo, and the condition is referred to as lymphadenitis.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"dd5c37f0-2027-46b1-9f3d-ddeabb79f4de"},"useSeparator":"auto"}]},"library":"H5P.Column 1.18","subContentId":"7cc457e3-43df-4f0b-afe4-eee6c4381e7d","metadata":{"contentType":"Column","license":"U","title":"Infections of the CV and Lymphatic Systems"}},{"params":{"content":[{"content":{"params":{"text":"
Signs and Symptoms<\/strong><\/span><\/h2>\n\nAccess for free at 25.4 Parasitic Infections of the Circulatory and Lymphatic Systems - Microbiology | OpenStax<\/a><\/p>\n\n
The classic signs and symptoms of malaria are cycles of extreme fever and chills (Figure 2). The sudden, violent symptoms of malaria start with malaise, abrupt chills, and fever (39-41\u00b0C [102.2-105.8\u00b0F]), rapid and faint pulse, polyuria, headache, myalgia, nausea, and vomiting. <\/span><\/p>\n\n
The incubation period in most cases varies from 7 to 30 days. The shorter periods are observed most frequently with P. falciparum<\/em> and the longer ones with P. malariae<\/em>. Classically the attacks occur every second day with the \"tertian\" parasites (P. falciparum, P. vivax,<\/em> and P. ovale<\/em>) and every third day with the \"quartan\" parasite (P. malariae<\/em>). These symptoms are a result of Plasmodium<\/em> emerging from red blood cells synchronously, leading to simultaneous rupture of a large number of red blood cells.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"715ee36f-c973-4494-a640-a8140ccc0b33"},"useSeparator":"auto"},{"content":{"params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-679413892ea8f.png","mime":"image\/png","copyright":{"license":"U"},"width":506,"height":522},"alt":"Signs and symptoms of malaria."},"library":"H5P.Image 1.1","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"ac2371ff-dbd4-4556-890d-88ce7216d296"},"useSeparator":"auto"},{"content":{"params":{"text":"
Figure 2. Signs and symptoms of malaria.(credit: modification of work from Wikipedia Commons)<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"495e0f90-d429-46d2-bda4-423f473ac40d"},"useSeparator":"auto"},{"content":{"params":{"text":"
Severe malaria occurs when infections are complicated by serious organ failures or abnormalities in the patient's blood or metabolism. The manifestations of severe malaria include the following:<\/p>\n\n
\n\t
Cerebral malaria, with abnormal behavior, impairment of consciousness, seizures, coma, or other neurologic abnormalities<\/li>\n\t
Severe anemia due to hemolysis (destruction of the red blood cells)<\/li>\n\t
Hemoglobinuria (hemoglobin in the urine) due to hemolysis<\/li>\n\t
Acute respiratory distress syndrome (ARDS), an inflammatory reaction in the lungs that inhibits oxygen exchange, which may occur even after the parasite counts have decreased in response to treatment<\/li>\n\t
Abnormalities in blood coagulation<\/li>\n\t
Low blood pressure caused by cardiovascular collapse<\/li>\n\t
Acute kidney injury<\/li>\n\t
Hyperparasitemia, where more than 5% of the red blood cells are infected by malaria parasites<\/li>\n\t
Metabolic acidosis (excessive acidity in the blood and tissue fluids), often in association with hypoglycemia<\/li>\n<\/ul>\n\n
Severe malaria is a medical emergency and should be treated urgently and aggressively.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"300c5cbb-bf04-418b-acf1-7dbea0c2f5da"},"useSeparator":"auto"},{"content":{"params":{"media":{"disableImageZooming":false},"answers":[{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Fever and chills<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Headache<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Nausea and vomiting<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Muscle pain<\/div>\n"}],"overallFeedback":[{"from":0,"to":99,"feedback":"Not quite!"},{"from":100,"to":100,"feedback":"Correct! All of the above are common symptoms of malaria."}],"behaviour":{"enableRetry":true,"enableSolutionsButton":true,"enableCheckButton":true,"type":"auto","singlePoint":false,"randomAnswers":true,"showSolutionsRequiresInput":true,"confirmCheckDialog":false,"confirmRetryDialog":false,"autoCheck":false,"passPercentage":100,"showScorePoints":true},"UI":{"checkAnswerButton":"Check","submitAnswerButton":"Submit","showSolutionButton":"Show solution","tryAgainButton":"Retry","tipsLabel":"Show tip","scoreBarLabel":"You got :num out of :total points","tipAvailable":"Tip available","feedbackAvailable":"Feedback available","readFeedback":"Read feedback","wrongAnswer":"Wrong answer","correctAnswer":"Correct answer","shouldCheck":"Should have been checked","shouldNotCheck":"Should not have been checked","noInput":"Please answer before viewing the solution","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yShowSolution":"Show the solution. The task will be marked with its correct solution.","a11yRetry":"Retry the task. Reset all responses and start the task over again."},"confirmCheck":{"header":"Finish ?","body":"Are you sure you wish to finish ?","cancelLabel":"Cancel","confirmLabel":"Finish"},"confirmRetry":{"header":"Retry ?","body":"Are you sure you wish to retry ?","cancelLabel":"Cancel","confirmLabel":"Confirm"},"question":"
Which of the following are common signs and symptoms of malaria? Check all that apply.<\/p>\n"},"library":"H5P.MultiChoice 1.16","metadata":{"contentType":"Multiple Choice","license":"U","title":"Common Signs of Malaria"},"subContentId":"80bae1ba-a21b-4469-bebd-a970327cb045"},"useSeparator":"auto"}]},"library":"H5P.Column 1.18","subContentId":"f375f53b-2dd5-45cc-81b9-8695c2634efc","metadata":{"contentType":"Column","license":"U","title":"Signs and Symptoms"}},{"params":{"content":[{"content":{"params":{"text":"
Causative Agent<\/span><\/strong><\/p>\n\n
Malaria is caused by several protozoan parasites in the genus Plasmodium<\/em>: P. falciparum, P. knowlesi, P. malariae, P. ovale,<\/em> and P. vivax<\/em>. Plasmodium<\/em> primarily infect red blood cells and are transmitted through the bite of Anopheles<\/em> mosquitoes.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"063618a3-c1cb-4cae-8869-649a11a91a05"},"useSeparator":"auto"},{"content":{"params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-67941926af2fb.png","mime":"image\/png","copyright":{"license":"U"},"width":892,"height":528},"alt":"Apicomplexan protist."},"library":"H5P.Image 1.1","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"1260792b-f9aa-4471-9dda-6ca26b7d3c98"},"useSeparator":"auto"},{"content":{"params":{"text":"
Figure 5.12<\/strong> (a) Apicomplexans are parasitic protists. They have a characteristic apical complex that enables them to infect host cells. (b) A colorized electron microscope image of a Plasmodium sporozoite. (credit b: modification of work by Ute Frevert)<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"d21ccff4-184d-4af0-acc6-58efef4817c4"},"useSeparator":"auto"},{"content":{"params":{"text":"
Plasmodium<\/em> belongs to a group of unicellular eukaryotic parasites called the apicomplexans. The apicomplexans are intra- or extracellular parasites that have an apical complex at one end of the cell. The apical complex is a concentration of organelles, vacuoles, and microtubules that allows the parasite to enter host cells (Figure 5.12<\/a>).<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"d2cd906b-6c93-49f7-90e1-9edc255241b2"},"useSeparator":"auto"},{"content":{"params":{"scoreShow":"Check","submit":"Submit","tryAgain":"Retry","scoreExplanation":"Correct answers give +1 point. Incorrect answers give -1 point. The lowest possible score is 0.","question":{"settings":{"size":{"width":370,"height":310},"background":{"path":"images\/background-67941e42a5a2e.png","mime":"image\/png","copyright":{"license":"U"},"width":707,"height":597}},"task":{"elements":[{"x":3.0191211023274884,"y":64.92985977148686,"width":7.6594835989425984,"height":1.4415832968277944,"dropZones":["0","1","2","3","4","5","6"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Apical complex<\/p>\n"},"subContentId":"64bf9eaf-649b-43f1-b940-181a4ae8c844","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":3.0191211023274884,"y":79.35871749848395,"width":5.0046497620845924,"height":1.446429273537823,"dropZones":["0","1","2","3","4","5","6"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Apical end<\/p>\n"},"subContentId":"829bac10-b72f-4422-9d28-449149cf161b","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":42.26769543258484,"y":64.92985977148686,"width":6.960843115558913,"height":1.4415832968277944,"dropZones":["0","1","2","3","4","5","6"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Mitochondrion<\/p>\n"},"subContentId":"c39a1704-9ddf-4f4b-85d0-9255f89bc38e","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":78.4971486605147,"y":64.92985977148686,"width":2.7690002152567974,"height":1.453217821203514,"dropZones":["0","1","2","3","4","5","6"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Golgi<\/p>\n"},"subContentId":"62dfd72f-18e4-4bfa-8644-bd277fafd74a","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":30.191211023274885,"y":79.35871749848395,"width":4.166281182024169,"height":1.453217821203514,"dropZones":["0","1","2","3","4","5","6"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Nucleus<\/p>\n"},"subContentId":"3ad3882f-4db7-48c0-b54e-878579c097b8","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":54.34417984189479,"y":79.35871749848395,"width":5.0046497620845924,"height":1.4512904194793355,"dropZones":["0","1","2","3","4","5","6"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Nucleolus<\/p>\n"},"subContentId":"28369ed5-2200-44f4-8ea1-0c725ed41118","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":81.51626976284219,"y":79.35871749848395,"width":2.0703597318731117,"height":1.4415832968277944,"dropZones":["0","1","2","3","4","5","6"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"
ER<\/p>\n"},"subContentId":"044d579f-181c-46db-beae-d08df983ed6b","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false}],"dropZones":[{"x":48.305937637239815,"y":3.6072144317492705,"width":9.222054380664654,"height":1.8164671442185256,"correctElements":["1"],"showLabel":false,"backgroundOpacity":100,"tipsAndFeedback":{"tip":""},"single":true,"autoAlign":true,"label":"
Apical end<\/div>\n"},{"x":3.012747729418427,"y":3.6059653379772625,"width":6.287764350453172,"height":1.676737160120846,"correctElements":["0"],"showLabel":false,"backgroundOpacity":100,"tipsAndFeedback":{"tip":""},"single":true,"autoAlign":true,"label":"
Apical complex<\/div>\n"},{"x":63.35178972455627,"y":28.857602582675607,"width":8.38368580060423,"height":1.8164652567975832,"correctElements":["2"],"showLabel":false,"backgroundOpacity":100,"tipsAndFeedback":{"tip":""},"single":true,"autoAlign":true,"label":"
Mitochondrion<\/div>\n"},{"x":72.35649441028606,"y":39.69554158523223,"width":6.287764350453172,"height":2.0959214501510575,"correctElements":["5"],"showLabel":false,"backgroundOpacity":100,"tipsAndFeedback":{"tip":""},"single":true,"autoAlign":true,"label":"
Nucleolus<\/div>\n"},{"x":3.0191211023274884,"y":50.50100204448979,"width":8.663141993957705,"height":2.0959214501510575,"correctElements":["4"],"showLabel":false,"backgroundOpacity":100,"tipsAndFeedback":{"tip":""},"single":true,"autoAlign":true,"label":"
Nucleus<\/div>\n"},{"x":3.0191211023274884,"y":39.67935874924198,"width":6.287764350453172,"height":1.8183945459427042,"correctElements":["6"],"showLabel":false,"backgroundOpacity":100,"tipsAndFeedback":{"tip":""},"single":true,"autoAlign":true,"label":"
ER<\/div>\n"},{"x":3.0211480362537766,"y":28.857602582675607,"width":6.2867940086858,"height":1.8164652567975832,"correctElements":["3"],"showLabel":false,"backgroundOpacity":100,"tipsAndFeedback":{"tip":""},"single":true,"autoAlign":true,"label":"
Golgi<\/div>\n"}]}},"overallFeedback":[{"from":0,"to":99,"feedback":"Give it another go."},{"from":100,"to":100,"feedback":"Correct! You have accurately labelled the apicomplexan."}],"behaviour":{"enableRetry":true,"enableCheckButton":true,"singlePoint":false,"applyPenalties":true,"enableScoreExplanation":true,"dropZoneHighlighting":"dragging","autoAlignSpacing":2,"enableFullScreen":false,"showScorePoints":true,"showTitle":true},"grabbablePrefix":"Grabbable {num} of {total}.","grabbableSuffix":"Placed in dropzone {num}.","dropzonePrefix":"Dropzone {num} of {total}.","noDropzone":"No dropzone.","tipLabel":"Show tip.","tipAvailable":"Tip available","correctAnswer":"Correct answer","wrongAnswer":"Wrong answer","feedbackHeader":"Feedback","scoreBarLabel":"You got :num out of :total points","scoreExplanationButtonLabel":"Show score explanation","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yRetry":"Retry the task. Reset all responses and start the task over again.","localize":{"fullscreen":"Fullscreen","exitFullscreen":"Exit fullscreen"}},"library":"H5P.DragQuestion 1.14","metadata":{"contentType":"Drag and Drop","license":"U","title":"Label the Apicomplexans"},"subContentId":"0631ca9c-9548-45ab-8b4e-64090b201ee8"},"useSeparator":"auto"}]},"library":"H5P.Column 1.18","subContentId":"9de41b89-bfa0-4cda-9319-46fad5a791c8","metadata":{"contentType":"Column","license":"U","title":"Causative Agent"}},{"params":{"content":[{"content":{"params":{"text":"
Life Cycle and Pathogenesis<\/span><\/strong><\/p>\n\n
Access for free in CDC Malaria<\/a>.<\/p>\n\n
The natural history of malaria involves cyclical infection of humans and female Anopheles<\/em> mosquitoes. In humans, the parasites grow and multiply first in the liver cells and then in the red cells of the blood. In the blood, successive broods of parasites grow inside the red cells and destroy them, releasing daughter parasites (\"merozoites\") that continue the cycle by invading other red cells.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"7d740214-b14d-42b5-9d24-f4711df8b7ce"},"useSeparator":"auto"},{"content":{"params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-679c9db4c9454.png","mime":"image\/png","copyright":{"license":"U"},"width":787,"height":632},"alt":"Malaria life cycle."},"library":"H5P.Image 1.1","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"2e95a70c-040e-47a5-8b55-f51ec1e610bd"},"useSeparator":"auto"},{"content":{"params":{"text":"
Figure 3<\/strong>. Malaria life cycle. (credit: modification of work by CDC)<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"b04cccc0-fcbe-4d1b-813e-a5d71d878feb"},"useSeparator":"auto"},{"content":{"params":{"text":"
The malaria parasite life cycle involves two hosts.<\/p>\n\n
During a blood meal, a malaria-infected female Anopheles<\/em> mosquito inoculates sporozoites into the human host (1) . Sporozoites infect liver cells (2) and mature into schizonts (3), which rupture and release merozoites (4). (Of note, in P. vivax <\/em>and P. ovale<\/em> a dormant stage [hypnozoites] can persist in the liver (if untreated) and cause relapses by invading the bloodstream weeks, or even years later.) After this initial replication in the liver (exo-erythrocytic schizogony [A]), the parasites undergo asexual multiplication in the erythrocytes (erythrocytic schizogony [B]). Merozoites infect red blood cells (5). The ring stage trophozoites mature into schizonts, which rupture releasing merozoites (6). Some parasites differentiate into sexual erythrocytic stages (gametocytes) (7). Blood stage parasites are responsible for the clinical manifestations of the disease. The gametocytes, male (microgametocytes) and female (macrogametocytes), are ingested by an Anopheles<\/em> mosquito during a blood meal (8).<\/p>\n\n
The parasites' multiplication in the mosquito is known as the sporogonic cycle [C]. While in the mosquito's stomach, the microgametes penetrate the macrogametes generating zygotes (9). The zygotes in turn become motile and elongated (ookinetes) (10) which invade the midgut wall of the mosquito where they develop into oocysts (11). The oocysts grow, rupture, and release sporozoites (12), which make their way to the mosquito's salivary glands. Inoculation of the sporozoites (1) into a new human host perpetuates the malaria life cycle.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"cc2a06b9-1fe7-4d47-a0cf-b074ea10cea0"},"useSeparator":"auto"},{"content":{"params":{"visuals":{"fit":true,"controls":true},"playback":{"autoplay":false,"loop":false},"l10n":{"name":"Video","loading":"Video player loading...","noPlayers":"Found no video players that supports the given video format.","noSources":"Video is missing sources.","aborted":"Media playback has been aborted.","networkFailure":"Network failure.","cannotDecode":"Unable to decode media.","formatNotSupported":"Video format not supported.","mediaEncrypted":"Media encrypted.","unknownError":"Unknown error.","invalidYtId":"Invalid YouTube ID.","unknownYtId":"Unable to find video with the given YouTube ID.","restrictedYt":"The owner of this video does not allow it to be embedded."},"sources":[{"path":"https:\/\/youtu.be\/Xaxjg9JOxug","mime":"video\/YouTube","copyright":{"license":"U"}}]},"library":"H5P.Video 1.6","metadata":{"contentType":"Video","license":"U","title":"Malaria Life Cycle Animation: Human Host - HHMI BioInteractive Video"},"subContentId":"d09ae0a3-27ce-4afb-a962-fd739ff4a059"},"useSeparator":"auto"},{"content":{"params":{"media":{"disableImageZooming":false},"taskDescription":"
Drag the steps into the correct order of a Plasmodium infection from the patient being bitten by a mosquito.<\/p>\n","overallFeedback":[{"from":0,"to":99,"feedback":"Not quite."},{"from":100,"to":100,"feedback":"That's right! This is the correct order of a Plasmodium infection progressing in a patient bitten by a mosquito."}],"checkAnswer":"Check","submitAnswer":"Submit","tryAgain":"Retry","showSolution":"Show solution","dropZoneIndex":"Drop Zone @index.","empty":"Drop Zone @index is empty.","contains":"Drop Zone @index contains draggable @draggable.","ariaDraggableIndex":"@index of @count draggables.","tipLabel":"Show tip","correctText":"Correct!","incorrectText":"Incorrect!","resetDropTitle":"Reset drop","resetDropDescription":"Are you sure you want to reset this drop zone?","grabbed":"Draggable is grabbed.","cancelledDragging":"Cancelled dragging.","correctAnswer":"Correct answer:","feedbackHeader":"Feedback","behaviour":{"enableRetry":true,"enableSolutionsButton":true,"enableCheckButton":true,"instantFeedback":false},"scoreBarLabel":"You got :num out of :total points","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yShowSolution":"Show the solution. The task will be marked with its correct solution.","a11yRetry":"Retry the task. Reset all responses and start the task over again.","textField":"1. *Sporozoites infect liver cells.*\n2. *Merozoites released from liver cells.*\n3. *Merozoites infect RBCs.*\n4. *Trophozoites in RBCs grow.*\n5. *Release of parasites lysing RBC causing clinical manifestation.*"},"library":"H5P.DragText 1.10","metadata":{"contentType":"Drag the Words","license":"U","title":"Human Plasmodium Infections"},"subContentId":"f019923a-0a17-4a91-a11d-a87e7989077b"},"useSeparator":"auto"},{"content":{"params":{"visuals":{"fit":true,"controls":true},"playback":{"autoplay":false,"loop":false},"l10n":{"name":"Video","loading":"Video player loading...","noPlayers":"Found no video players that supports the given video format.","noSources":"Video is missing sources.","aborted":"Media playback has been aborted.","networkFailure":"Network failure.","cannotDecode":"Unable to decode media.","formatNotSupported":"Video format not supported.","mediaEncrypted":"Media encrypted.","unknownError":"Unknown error.","invalidYtId":"Invalid YouTube ID.","unknownYtId":"Unable to find video with the given YouTube ID.","restrictedYt":"The owner of this video does not allow it to be embedded."},"sources":[{"path":"https:\/\/youtu.be\/0uyE046It3o","mime":"video\/YouTube","copyright":{"license":"U"}}]},"library":"H5P.Video 1.6","metadata":{"contentType":"Video","license":"U","title":"Malaria Life Cycle Animation: Mosquito Host \u2014 HHMI BioInteractive Video"},"subContentId":"1e58d4bc-1db1-4b8d-bbc0-e3c565a11ead"},"useSeparator":"auto"},{"content":{"params":{"media":{"disableImageZooming":false},"taskDescription":"
Drag the steps into the correct order of a Plasmodium life cycle in a mosquito host.<\/p>\n","overallFeedback":[{"from":0,"to":99,"feedback":"Try again."},{"from":100,"to":100,"feedback":"Correct! This is the right order of Plasmodium life cycle in a mosquito host!"}],"checkAnswer":"Check","submitAnswer":"Submit","tryAgain":"Retry","showSolution":"Show solution","dropZoneIndex":"Drop Zone @index.","empty":"Drop Zone @index is empty.","contains":"Drop Zone @index contains draggable @draggable.","ariaDraggableIndex":"@index of @count draggables.","tipLabel":"Show tip","correctText":"Correct!","incorrectText":"Incorrect!","resetDropTitle":"Reset drop","resetDropDescription":"Are you sure you want to reset this drop zone?","grabbed":"Draggable is grabbed.","cancelledDragging":"Cancelled dragging.","correctAnswer":"Correct answer:","feedbackHeader":"Feedback","behaviour":{"enableRetry":true,"enableSolutionsButton":true,"enableCheckButton":true,"instantFeedback":false},"scoreBarLabel":"You got :num out of :total points","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yShowSolution":"Show the solution. The task will be marked with its correct solution.","a11yRetry":"Retry the task. Reset all responses and start the task over again.","textField":"1. *Gametocytes ingested by a mosquito taking a blood meal.*\n2. *Sexual reproduction in mosquito gut.*\n3. *Sporozoites migrate to the mosquito salivary glands.*"},"library":"H5P.DragText 1.10","metadata":{"contentType":"Drag the Words","license":"U","title":"Mosquito Plasmodium Infections"},"subContentId":"8889c46f-7c3a-4e6b-8b34-f8148adccae4"},"useSeparator":"auto"}]},"library":"H5P.Column 1.18","subContentId":"b9c346c6-4041-4587-be48-1ee27e6929f8","metadata":{"contentType":"Column","license":"U","title":"Life Cycle and Pathogenesis"}},{"params":{"content":[{"content":{"params":{"text":"
Genetic Factors<\/span><\/strong><\/p>\n\n
Biologic characteristics present from birth can protect against certain types of malaria. Persons who have the sickle cell trait (heterozygotes for the abnormal hemoglobin gene HbS) are relatively protected against P. falciparum<\/em> malaria and thus enjoy a biologic advantage. Because P. falciparum<\/em> malaria has been a leading cause of death in Africa since remote times, the sickle cell trait is now more frequently found in Africa and in persons of African ancestry than in other population groups. In general, the prevalence of hemoglobin-related disorders, such as Hemoglobin C, the thalassemias and G6PD deficiency, are more prevalent in malaria endemic areas and are thought to provide protection from malarial disease.<\/p>\n\n
Other genetic factors related to red blood cells also influence malaria, but to a lesser extent. Various genetic determinants (such as the \"HLA complex,\" which plays a role in control of immune responses) may equally influence an individual's risk of developing severe malaria.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"9cd55964-fbdb-4d5d-aa6d-24cd2fea1f7f"},"useSeparator":"auto"},{"content":{"params":{"scoreShow":"Check","submit":"Submit","tryAgain":"Retry","scoreExplanation":"Correct answers give +1 point. Incorrect answers give -1 point. The lowest possible score is 0.","question":{"settings":{"size":{"width":840,"height":620},"background":{"path":"images\/background-679ca6441e6c8.png","mime":"image\/png","copyright":{"license":"U"},"width":907,"height":645}},"task":{"elements":[{"x":3.228846216025709,"y":56.94551528055231,"width":12.678238203169963,"height":4.142379994697327,"dropZones":["1","0","2"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Have only abnormal S form, defective in carrying oxygen<\/span><\/p>\n"},"subContentId":"97f7c9fb-3264-4212-94c0-78d2eecff05f","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":51.733391964510886,"y":74.47516910244278,"width":5.888230507827908,"height":4.189536598141477,"dropZones":["0","1","2"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"
High risk of malaria<\/span><\/p>\n"},"subContentId":"9f0b06cd-21f0-4ad4-9026-2e70d89dc15d","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":67.89558617166432,"y":74.46908448112708,"width":14.374548141154559,"height":4.190728583992395,"dropZones":["0","1","2"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Have only normal A form, and no problem carrying oxygen<\/span><\/p>\n"},"subContentId":"d857c9e0-7de8-459a-b534-f16e650f6cb8","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":64.6667399556386,"y":56.95159990186801,"width":12.677046217319045,"height":4.190728583992395,"dropZones":["1","0","2"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Low risk of malaria but has a painful disease<\/span><\/p>\n"},"subContentId":"bb5676c6-6629-4579-a90b-bac1bf877d56","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":29.100032980037376,"y":74.47516910244278,"width":9.283234355498935,"height":4.189536598141477,"dropZones":["2","0","1"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Have some A form and some S form<\/span><\/p>\n"},"subContentId":"b961710f-ce5e-4413-82f1-3c5a48628dda","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":32.3333699778193,"y":56.95159990186801,"width":15.176141648224855,"height":4.189536598141477,"dropZones":["2","0","1"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"
No problem with oxygen carrying except in low oxygen areas<\/span><\/p>\n"},"subContentId":"c2710e27-a4ab-46e9-bce8-49f139e0a58c","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false},{"x":3.2333369977819304,"y":74.47516910244278,"width":10.980736279334451,"height":4.189536598141477,"dropZones":["2","0","1"],"type":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Low risk of malaria and no disease<\/span><\/p>\n"},"subContentId":"3c579aa9-78fc-4fca-b6eb-b920b02aa9ae","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"backgroundOpacity":100,"multiple":false}],"dropZones":[{"x":3.228846216025709,"y":1.183525432706041e-5,"width":15.277517314519622,"height":20.370023086026162,"correctElements":["1","2"],"showLabel":false,"backgroundOpacity":0,"tipsAndFeedback":{"tip":""},"single":false,"autoAlign":false,"label":"
Wild Type<\/div>\n"},{"x":35.55322702757005,"y":1.183525432706041e-5,"width":15.277517314519622,"height":20.370023086026162,"correctElements":["0","3"],"showLabel":false,"backgroundOpacity":0,"tipsAndFeedback":{"tip":""},"single":false,"autoAlign":false,"label":"
Sickle cell patients<\/div>\n"},{"x":67.88659700538936,"y":1.183525432706041e-5,"width":15.277517314519622,"height":20.370023086026162,"correctElements":["4","5","6"],"showLabel":false,"backgroundOpacity":0,"tipsAndFeedback":{"tip":""},"single":false,"autoAlign":false,"label":"
Carriers<\/div>\n"}]}},"overallFeedback":[{"from":0,"to":99,"feedback":"Not quite. Give it another go!"},{"from":100,"to":100,"feedback":"Perfect! You have correctly matched the descriptions to their corresponding genotypes."}],"behaviour":{"enableRetry":true,"enableCheckButton":true,"singlePoint":false,"applyPenalties":true,"enableScoreExplanation":true,"dropZoneHighlighting":"dragging","autoAlignSpacing":2,"enableFullScreen":false,"showScorePoints":true,"showTitle":true},"grabbablePrefix":"Grabbable {num} of {total}.","grabbableSuffix":"Placed in dropzone {num}.","dropzonePrefix":"Dropzone {num} of {total}.","noDropzone":"No dropzone.","tipLabel":"Show tip.","tipAvailable":"Tip available","correctAnswer":"Correct answer","wrongAnswer":"Wrong answer","feedbackHeader":"Feedback","scoreBarLabel":"You got :num out of :total points","scoreExplanationButtonLabel":"Show score explanation","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yRetry":"Retry the task. Reset all responses and start the task over again.","localize":{"fullscreen":"Fullscreen","exitFullscreen":"Exit fullscreen"}},"library":"H5P.DragQuestion 1.14","metadata":{"contentType":"Drag and Drop","license":"U","title":"Match the description with the individual's geneotype."},"subContentId":"d60e923e-3330-4140-b8c4-216eadfe2136"},"useSeparator":"auto"}]},"library":"H5P.Column 1.18","subContentId":"87b6a59a-310e-4ca5-bb06-ba4649b5a2a0","metadata":{"contentType":"Column","license":"U","title":"Genetic Factors"}},{"params":{"content":[{"content":{"params":{"text":"
Disease Transmission and Epidemiology<\/strong><\/span><\/p>\n\n
Despite more than a century of intense research and clinical advancements, malaria remains one of the most important infectious diseases in the world today. Its widespread distribution places more than half of the world's population in jeopardy. In 2015, the WHO estimated there were about 214 million cases of malaria worldwide, resulting in about 438,000 deaths; about 88% of cases and 91% of deaths occurred in Africa. In 2017, an estimated 219 million cases of malaria occurred worldwide (435,000 people died). These deaths were mostly children in Africa. Approximately 1,500 case are reported in the U.S., with nearly all of the infections originating in other countries and diagnosed in returning travelers.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"8495a423-dcc5-46cf-b90a-42539ee45993"},"useSeparator":"auto"},{"content":{"params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-679cabe0d1df2.png","mime":"image\/png","copyright":{"license":"U"},"width":825,"height":500},"alt":"This map shows an approximation of the parts of the world where malaria transmission occurs."},"library":"H5P.Image 1.1","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"3ee43c7a-652f-4370-a801-21de8bc1e0ef"},"useSeparator":"auto"},{"content":{"params":{"text":"
Figure 5. <\/strong>This map shows an approximation of the parts of the world where malaria transmission occurs. (credit: modification of work by CDC)<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"1a1821b1-36af-4d78-a80e-6dd20a2ea8b1"},"useSeparator":"auto"},{"content":{"params":{"text":"
Where malaria is found depends mainly on climatic factors such as temperature, humidity, and rainfall. Malaria is transmitted in tropical and subtropical areas (Figure 5), where<\/p>\n\n
\n\t
Anopheles<\/em> mosquitoes can survive and multiply, and<\/li>\n\t
Malaria parasites can complete their growth cycle in the mosquitoes (\"extrinsic incubation period\").<\/li>\n<\/ul>\n\n
Temperature is particularly critical. For example, at temperatures below 20\u00b0C (68\u00b0F), Plasmodium falciparum<\/em> (which causes severe malaria) cannot complete its growth cycle in the Anopheles<\/em> mosquito, and thus cannot be transmitted.<\/p>\n\n
The highest transmission is found in Sub-Saharan Africa, Central and South America and some regions of Southeast Asia, collectively called the \"malaria belt\".<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"95e492df-4017-4428-ade5-e916343e6eb5"},"useSeparator":"auto"},{"content":{"params":{"media":{"disableImageZooming":false},"answers":[{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Deaths occur mostly in African children<\/div>\n"},{"correct":false,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Transmission is through vehicle<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Transmission is through vector<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Most cases are in tropical and subtropical areas<\/div>\n"}],"overallFeedback":[{"from":0,"to":99,"feedback":"Not quite. Remember there can be more than one answer."},{"from":100,"to":100,"feedback":"Correct! You have identified the true statements about the malaria epidemic."}],"behaviour":{"enableRetry":true,"enableSolutionsButton":true,"enableCheckButton":true,"type":"auto","singlePoint":false,"randomAnswers":true,"showSolutionsRequiresInput":true,"confirmCheckDialog":false,"confirmRetryDialog":false,"autoCheck":false,"passPercentage":100,"showScorePoints":true},"UI":{"checkAnswerButton":"Check","submitAnswerButton":"Submit","showSolutionButton":"Show solution","tryAgainButton":"Retry","tipsLabel":"Show tip","scoreBarLabel":"You got :num out of :total points","tipAvailable":"Tip available","feedbackAvailable":"Feedback available","readFeedback":"Read feedback","wrongAnswer":"Wrong answer","correctAnswer":"Correct answer","shouldCheck":"Should have been checked","shouldNotCheck":"Should not have been checked","noInput":"Please answer before viewing the solution","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yShowSolution":"Show the solution. The task will be marked with its correct solution.","a11yRetry":"Retry the task. Reset all responses and start the task over again."},"confirmCheck":{"header":"Finish ?","body":"Are you sure you wish to finish ?","cancelLabel":"Cancel","confirmLabel":"Finish"},"confirmRetry":{"header":"Retry ?","body":"Are you sure you wish to retry ?","cancelLabel":"Cancel","confirmLabel":"Confirm"},"question":"
Which of the following is true about malaria epidemic? Check all that apply.<\/p>\n"},"library":"H5P.MultiChoice 1.16","metadata":{"contentType":"Multiple Choice","license":"U","title":"Malaria Epidemic"},"subContentId":"c2b3267f-a2f2-4971-841b-36c7352b7f0f"},"useSeparator":"auto"}]},"library":"H5P.Column 1.18","subContentId":"f1a21e28-8888-413d-88e4-d5b6fbdb6ac1","metadata":{"contentType":"Column","license":"U","title":"Disease Transmission and Epidemiology"}},{"params":{"content":[{"content":{"params":{"text":"
Culture and Diagnosis<\/span><\/strong><\/p>\n\n
Healthcare providers should always obtain a travel history from febrile patients. Fever in a person who has recently traveled in a malaria-endemic area should always be immediately evaluated using the appropriate diagnostic tests for malaria.<\/p>\n\n
Diagnosis of malaria is by microscopic observation of developmental forms of Plasmodium<\/em> in blood smears (Figure 25.28). \"Rapid Diagnostic Tests\" (RDTs) (Enzyme immune assays \/ EIAs based on antigen-antibody interaction) that detect Plasmodium antigens or enzymes are also used.<\/p>\n\n
Parasite nucleic acids are detected using polymerase chain reaction (PCR). Although this technique may be slightly more sensitive than smear microscopy, it is of limited utility for the diagnosis of acutely ill patients in the standard healthcare setting. PCR results are often not available quickly enough to be of value in establishing the diagnosis of malaria infection.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"7fbf30a0-acb0-4bb0-a13c-f8340f52cb12"},"useSeparator":"auto"},{"content":{"params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-679caebc247cc.png","mime":"image\/png","copyright":{"license":"U"},"width":527,"height":346},"alt":"A blood smear of a patient with malaria."},"library":"H5P.Image 1.1","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"7bff4b31-bff1-4b32-95ec-856cf8a1c8fa"},"useSeparator":"auto"},{"content":{"params":{"text":"
Figure 25.28<\/strong> A blood smear (human blood stage) shows an early trophozoite in a delicate ring form (upper left) and an early stage schizont form (center) of Plasmodium falciparum from a patient with malaria. (credit: modification of work by Centers for Disease Control and Prevention)<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"5fe4911b-3536-41a2-a5b5-1c7406a0113f"},"useSeparator":"auto"},{"content":{"params":{"media":{"disableImageZooming":false},"answers":[{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Blood smear<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Clinical signs and symptoms<\/div>\n"},{"correct":false,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
PCR (genetic)<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
RDT\/EIA (serological)<\/div>\n"}],"overallFeedback":[{"from":0,"to":99,"feedback":"Not quite. Remember you can choose more than one answer."},{"from":100,"to":100,"feedback":"Correct! The only diagnostic test listed above that is not used for malaria, is the PCR."}],"behaviour":{"enableRetry":true,"enableSolutionsButton":true,"enableCheckButton":true,"type":"auto","singlePoint":false,"randomAnswers":true,"showSolutionsRequiresInput":true,"confirmCheckDialog":false,"confirmRetryDialog":false,"autoCheck":false,"passPercentage":100,"showScorePoints":true},"UI":{"checkAnswerButton":"Check","submitAnswerButton":"Submit","showSolutionButton":"Show solution","tryAgainButton":"Retry","tipsLabel":"Show tip","scoreBarLabel":"You got :num out of :total points","tipAvailable":"Tip available","feedbackAvailable":"Feedback available","readFeedback":"Read feedback","wrongAnswer":"Wrong answer","correctAnswer":"Correct answer","shouldCheck":"Should have been checked","shouldNotCheck":"Should not have been checked","noInput":"Please answer before viewing the solution","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yShowSolution":"Show the solution. The task will be marked with its correct solution.","a11yRetry":"Retry the task. Reset all responses and start the task over again."},"confirmCheck":{"header":"Finish ?","body":"Are you sure you wish to finish ?","cancelLabel":"Cancel","confirmLabel":"Finish"},"confirmRetry":{"header":"Retry ?","body":"Are you sure you wish to retry ?","cancelLabel":"Cancel","confirmLabel":"Confirm"},"question":"
<\/p>\n\n
Which of the following is frequently used for malaria diagnosis? Check all that apply.<\/p>\n"},"library":"H5P.MultiChoice 1.16","metadata":{"contentType":"Multiple Choice","license":"U","title":"Diagnosing Malaria"},"subContentId":"409ffb22-aa24-4834-a2b6-d95367535e52"},"useSeparator":"auto"}]},"library":"H5P.Column 1.18","subContentId":"6695285e-722a-421a-8e78-545d84806ae6","metadata":{"contentType":"Column","license":"U","title":"Culture and Diagnosis"}},{"params":{"content":[{"content":{"params":{"text":"
Prevention<\/span><\/strong><\/p>\n\n
Malaria prevention consists of a combination of mosquito avoidance measures and chemoprophylaxis. Mosquito control methods (Figure 6) include using mosquito net and insect repellents, closing windows, eliminating standing water, etc.<\/p>\n\n
All recommended primary prophylaxis regimens involve taking a medicine before, during, and after travel to an area with malaria. Beginning the drug before travel allows the antimalarial agent to be in the blood before the traveler is exposed to malaria parasites. Drugs for prophylaxis chloroquine and hydroxychloroquine, doxycycline, mefloquine, etc.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"d56b19c2-793a-4170-acdb-1f81eb2c64fc"},"useSeparator":"auto"},{"content":{"params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-679cb0197e7ef.png","mime":"image\/png","copyright":{"license":"U"},"width":283,"height":264,"originalImage":{"path":"images\/file-679cb00cbd3a2.png#tmp","mime":"image\/png","height":281,"width":898}},"alt":"The primary defence against mosquito-born diseases such as malaria - mosquito nets."},"library":"H5P.Image 1.1","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"af309699-75f2-4e91-b1f8-e07d178f2081"},"useSeparator":"auto"},{"content":{"params":{"text":"
Figure 6<\/strong>. A primary defense against mosquito-borne illnesses like malaria\u2014mosquito netting. (credit: modification of work by Tjeerd Wiersma)<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"3f063077-785a-4372-8e1a-a7a49dbb3b33"},"useSeparator":"auto"},{"content":{"params":{"text":"
Developing a vaccine against malaria has been a priority for decades because it is considered the most devastating neglected tropical diseases economically speaking. One challenge for malaria vaccine development is antigenic variation of the surface proteins of Plasmodium. The first malaria vaccine that meets the WHO's goal of having > 75% efficacy was approved by the WHO in 2021. The vaccine has been distributed in several African countries and administered to millions of children. Other vaccines continue to be developed.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"3a09c9e5-ce4f-419f-af69-1eb641eff54e"},"useSeparator":"auto"},{"content":{"params":{"text":"
Treatment<\/span><\/strong><\/p>\n\n
Treatment of malaria depends on many factors including disease severity, the species of malaria parasite causing the infection, and the part of the world in which the infection was acquired. The latter two characteristics help determine the probability that the organism is resistant to certain antimalarial drugs. Additional factors such as age, weight, and pregnancy status may limit the available options for malaria treatment.<\/p>\n\n
Drugs such as chloroquine, atovaquone , artemether, and lumefantrine may be prescribed for both acute and prophylactic therapy, although some Plasmodium<\/em> spp. have shown resistance to antimalarial drugs.<\/p>\n\n
One of the challenges for developing drugs to treat protozoa infections is that the infectious cells are eukaryotes, and they are structurally very similar to our (animal) cells. Therefore, it is hard to develop drugs that can target infectious agents specifically, without causing side effects in our body. Antibiotics, on the other hand, target bacterial (prokaryotic) cells; and there are many differences between how prokaryotic and eukaryotic cells function that can be explored in developing drugs.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"8e54f5e9-87bd-49df-9444-2176cfe1d91f"},"useSeparator":"auto"},{"content":{"params":{"media":{"disableImageZooming":false},"answers":[{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Protozoan cells are similar to human cells<\/div>\n"},{"correct":false,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Bacterial cells are similar to human cells<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Drugs that target protozoan cell structures may cause side effects<\/div>\n"},{"correct":false,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Drugs that target bacterial cell structures may cause side effects<\/div>\n"}],"overallFeedback":[{"from":0,"to":50,"feedback":"Try again!"},{"from":51,"to":100,"feedback":"Correct! Protozoan cells are similar to human cells, and so drugs that target protozoan cell structures may cause side effects."}],"behaviour":{"enableRetry":true,"enableSolutionsButton":true,"enableCheckButton":true,"type":"auto","singlePoint":false,"randomAnswers":true,"showSolutionsRequiresInput":true,"confirmCheckDialog":false,"confirmRetryDialog":false,"autoCheck":false,"passPercentage":100,"showScorePoints":true},"UI":{"checkAnswerButton":"Check","submitAnswerButton":"Submit","showSolutionButton":"Show solution","tryAgainButton":"Retry","tipsLabel":"Show tip","scoreBarLabel":"You got :num out of :total points","tipAvailable":"Tip available","feedbackAvailable":"Feedback available","readFeedback":"Read feedback","wrongAnswer":"Wrong answer","correctAnswer":"Correct answer","shouldCheck":"Should have been checked","shouldNotCheck":"Should not have been checked","noInput":"Please answer before viewing the solution","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yShowSolution":"Show the solution. The task will be marked with its correct solution.","a11yRetry":"Retry the task. Reset all responses and start the task over again."},"confirmCheck":{"header":"Finish ?","body":"Are you sure you wish to finish ?","cancelLabel":"Cancel","confirmLabel":"Finish"},"confirmRetry":{"header":"Retry ?","body":"Are you sure you wish to retry ?","cancelLabel":"Cancel","confirmLabel":"Confirm"},"question":"
The main reasons that protozoan diseases are harder to treat than bacterial infections are: Check all that apply.<\/p>\n"},"library":"H5P.MultiChoice 1.16","metadata":{"contentType":"Multiple Choice","license":"U","title":"Treating Protozoan Diseases"},"subContentId":"a650f22b-2abc-4fed-b0c9-64aa1f9271e7"},"useSeparator":"auto"}]},"library":"H5P.Column 1.18","subContentId":"54a80da3-e276-4fd3-868c-ebc2d31424b8","metadata":{"contentType":"Column","license":"U","title":"Prevention and Treatment"}},{"params":{"content":[{"content":{"params":{"text":"
<\/p>\n\n
Patient Information<\/strong><\/span><\/p>\n\n
A 29-month-old female from Togo, a small country on the west coast of Africa, came to the Emergency Department with a fever after having emigrated to the United States approximately 2 weeks prior. The patient had been on anti-malarial treatment approximately 3 months prior to the emergency department visit.<\/p>\n\n
Fever in a returning traveler from Africa can be caused by bacteria such as Salmonella typhi<\/em>, Rickettsia<\/em>; or viruses including Dengue fever and yellow fever; or protozoa such as Plasmodium<\/em> which causes malaria.<\/p>\n\n
<\/p>\n\n
Adapted from American Society for Microbiology Case Studies<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"851b56b1-f3a2-4ae8-96ef-46e1f9c22c61"},"useSeparator":"auto"},{"content":{"params":{"media":{"disableImageZooming":false},"answers":[{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Salmonella typhi<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Rickettsia spp.<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Dengue fever virus<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Yellow fever virus<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Plasmodium spp.<\/div>\n"}],"overallFeedback":[{"from":0,"to":99,"feedback":"Not quite."},{"from":100,"to":100,"feedback":"Correct! All of the examples listed above could be the cause of the toddler's fever."}],"behaviour":{"enableRetry":true,"enableSolutionsButton":true,"enableCheckButton":true,"type":"auto","singlePoint":false,"randomAnswers":true,"showSolutionsRequiresInput":true,"confirmCheckDialog":false,"confirmRetryDialog":false,"autoCheck":false,"passPercentage":100,"showScorePoints":true},"UI":{"checkAnswerButton":"Check","submitAnswerButton":"Submit","showSolutionButton":"Show solution","tryAgainButton":"Retry","tipsLabel":"Show tip","scoreBarLabel":"You got :num out of :total points","tipAvailable":"Tip available","feedbackAvailable":"Feedback available","readFeedback":"Read feedback","wrongAnswer":"Wrong answer","correctAnswer":"Correct answer","shouldCheck":"Should have been checked","shouldNotCheck":"Should not have been checked","noInput":"Please answer before viewing the solution","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yShowSolution":"Show the solution. The task will be marked with its correct solution.","a11yRetry":"Retry the task. Reset all responses and start the task over again."},"confirmCheck":{"header":"Finish ?","body":"Are you sure you wish to finish ?","cancelLabel":"Cancel","confirmLabel":"Finish"},"confirmRetry":{"header":"Retry ?","body":"Are you sure you wish to retry ?","cancelLabel":"Cancel","confirmLabel":"Confirm"},"question":"
Which of the following can be the cause of the travelling toddler's fever? Check all that apply.<\/p>\n"},"library":"H5P.MultiChoice 1.16","metadata":{"contentType":"Multiple Choice","license":"U","title":"Causes of Fever"},"subContentId":"09b7daa0-f151-400b-b173-52a25ac1a502"},"useSeparator":"auto"}]},"library":"H5P.Column 1.18","subContentId":"5855d678-74ad-4734-bc82-c94e338a3c6f","metadata":{"contentType":"Column","license":"U","title":"Patient Information"}},{"params":{"content":[{"content":{"params":{"text":"
Lab Tests and Resolution<\/strong><\/span><\/p>\n\n
Based on the clinical presentation of the patient and the travel history (Togo, West Africa), serologies for various pathogens (Dengue, Yellow Fever, Rickettsia<\/em>), blood cultures and malaria smears were ordered. Light microscopy of thick and thin Giemsa-stained blood smears remains the standard method for diagnosing malaria.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"2935607a-81f5-4df4-b466-41767ca1e8a8"},"useSeparator":"auto"},{"content":{"params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-678d1a6f8cc14.png","mime":"image\/png","copyright":{"license":"U"},"width":771,"height":513},"alt":"A blood smear of a malaria patient."},"library":"H5P.Image 1.1","metadata":{"contentType":"Image","license":"U","title":"Untitled Image"},"subContentId":"28d16467-21fa-4705-92a2-8727680b4166"},"useSeparator":"auto"},{"content":{"params":{"text":"
Figure 1 <\/strong>A blood smear of a malaria patient. (credit: modification of work by Flickr)<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"6d4ef607-862e-4b56-acaf-d024bb4f1a86"},"useSeparator":"auto"},{"content":{"params":{"text":"
Even though this patient had been on prior prophylaxis for malaria, her smears showed the presence of Plasmodium<\/em> sp., the causative agent of malaria (Figure 1). Most clinical laboratories attempt to speciate the Plasmodia<\/em> based on the life cycle stages presents on the smear in the microbiology laboratory.<\/p>\n\n
The parasite replicates within the red blood cell of the infected host. However, no species identification was given in this particular case. If speciation is difficult, public health is contacted for assistance in identification of the parasite in the United States. <\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"7f791b1b-7a89-4101-99db-7a6c63dca6a6"},"useSeparator":"auto"},{"content":{"params":{"media":{"disableImageZooming":false},"answers":[{"correct":true,"tipsAndFeedback":{"chosenFeedback":"
Correct! Blood samples are the most efficient way to identify Plasmodium sp. in a patient with malaria.<\/div>\n","tip":"","notChosenFeedback":""},"text":"
Blood<\/div>\n"},{"correct":false,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Urine<\/div>\n"},{"correct":false,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Stool<\/div>\n"},{"correct":false,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Throat swab<\/div>\n"}],"overallFeedback":[{"from":0,"to":100}],"behaviour":{"enableRetry":true,"enableSolutionsButton":true,"enableCheckButton":true,"type":"auto","singlePoint":false,"randomAnswers":true,"showSolutionsRequiresInput":true,"confirmCheckDialog":false,"confirmRetryDialog":false,"autoCheck":false,"passPercentage":100,"showScorePoints":true},"UI":{"checkAnswerButton":"Check","submitAnswerButton":"Submit","showSolutionButton":"Show solution","tryAgainButton":"Retry","tipsLabel":"Show tip","scoreBarLabel":"You got :num out of :total points","tipAvailable":"Tip available","feedbackAvailable":"Feedback available","readFeedback":"Read feedback","wrongAnswer":"Wrong answer","correctAnswer":"Correct answer","shouldCheck":"Should have been checked","shouldNotCheck":"Should not have been checked","noInput":"Please answer before viewing the solution","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yShowSolution":"Show the solution. The task will be marked with its correct solution.","a11yRetry":"Retry the task. Reset all responses and start the task over again."},"confirmCheck":{"header":"Finish ?","body":"Are you sure you wish to finish ?","cancelLabel":"Cancel","confirmLabel":"Finish"},"confirmRetry":{"header":"Retry ?","body":"Are you sure you wish to retry ?","cancelLabel":"Cancel","confirmLabel":"Confirm"},"question":"
What is the appropriate sample to take for malaria?<\/p>\n"},"library":"H5P.MultiChoice 1.16","metadata":{"contentType":"Multiple Choice","license":"U","title":"Sampling for Malaria"},"subContentId":"d2366f00-cbf9-4c07-a458-4a0a8b5d6586"},"useSeparator":"auto"},{"content":{"params":{"media":{"disableImageZooming":false},"answers":[{"correct":false,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Affect people with a healthy immune system<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Affect people who are immunocompromised or with a partially developed immune system<\/div>\n"},{"correct":false,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Affect people in developed countries<\/div>\n"},{"correct":true,"tipsAndFeedback":{"tip":"","chosenFeedback":"","notChosenFeedback":""},"text":"
Affect people in developing countries<\/div>\n"}],"overallFeedback":[{"from":0,"to":50,"feedback":"Try again!"},{"from":51,"to":100,"feedback":"Correct. Fatal cases of malaria most commonly occur in immunocompromised patients and patients in developing countries."}],"behaviour":{"enableRetry":true,"enableSolutionsButton":true,"enableCheckButton":true,"type":"auto","singlePoint":false,"randomAnswers":true,"showSolutionsRequiresInput":true,"confirmCheckDialog":false,"confirmRetryDialog":false,"autoCheck":false,"passPercentage":100,"showScorePoints":true},"UI":{"checkAnswerButton":"Check","submitAnswerButton":"Submit","showSolutionButton":"Show solution","tryAgainButton":"Retry","tipsLabel":"Show tip","scoreBarLabel":"You got :num out of :total points","tipAvailable":"Tip available","feedbackAvailable":"Feedback available","readFeedback":"Read feedback","wrongAnswer":"Wrong answer","correctAnswer":"Correct answer","shouldCheck":"Should have been checked","shouldNotCheck":"Should not have been checked","noInput":"Please answer before viewing the solution","a11yCheck":"Check the answers. The responses will be marked as correct, incorrect, or unanswered.","a11yShowSolution":"Show the solution. The task will be marked with its correct solution.","a11yRetry":"Retry the task. Reset all responses and start the task over again."},"confirmCheck":{"header":"Finish ?","body":"Are you sure you wish to finish ?","cancelLabel":"Cancel","confirmLabel":"Finish"},"confirmRetry":{"header":"Retry ?","body":"Are you sure you wish to retry ?","cancelLabel":"Cancel","confirmLabel":"Confirm"},"question":"
Which of the following is true about malaria fatal cases? Check all that apply.<\/p>\n"},"library":"H5P.MultiChoice 1.16","metadata":{"contentType":"Multiple Choice","license":"U","title":"Fatal Cases"},"subContentId":"adf4cdfa-aa1c-40dc-8d2d-5368d098b299"},"useSeparator":"auto"},{"content":{"params":{"text":"
The patient was treated with quinidine and clindamycin for 2 days followed by malarone for 3 days. The treatment was successful, and the patient recovered.<\/p>\n"},"library":"H5P.AdvancedText 1.1","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"},"subContentId":"534be03d-e4c1-435e-a024-fa59801e5d16"},"useSeparator":"auto"}]},"library":"H5P.Column 1.18","subContentId":"e98e2c2b-5868-4a94-91d6-a7892acee70c","metadata":{"contentType":"Column","license":"U","title":"Lab Test and Resolution"}}],"behaviour":{"baseColor":"#1768c4","defaultTableOfContents":true,"progressIndicators":true,"progressAuto":true,"displaySummary":true,"enableRetry":true},"read":"Read","displayTOC":"Display 'Table of contents'","hideTOC":"Hide 'Table of contents'","nextPage":"Next page","previousPage":"Previous page","chapterCompleted":"Page completed!","partCompleted":"@pages of @total completed","incompleteChapter":"Incomplete page","navigateToTop":"Navigate to the top","markAsFinished":"I have finished this page","fullscreen":"Fullscreen","exitFullscreen":"Exit fullscreen","bookProgressSubtext":"@count of @total pages","interactionsProgressSubtext":"@count of @total interactions","submitReport":"Submit Report","restartLabel":"Restart","summaryHeader":"Summary","allInteractions":"All interactions","unansweredInteractions":"Unanswered interactions","scoreText":"@score \/ @maxscore","leftOutOfTotalCompleted":"@left of @max interactions completed","noInteractions":"No interactions","score":"Score","summaryAndSubmit":"Summary & submit","noChapterInteractionBoldText":"You have not interacted with any pages.","noChapterInteractionText":"You have to interact with at least one page before you can see the summary.","yourAnswersAreSubmittedForReview":"Your answers are submitted for review!","bookProgress":"Book progress","interactionsProgress":"Interactions progress","totalScoreLabel":"Total score","a11y":{"progress":"Page @page of @total.","menu":"Toggle navigation menu"}}

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