Typical exam stem
A febrile patient in a malaria-endemic setting presents with confusion, jaundice and acute kidney injury. How would you assess and manage suspected severe malaria?
Active exam mode
Plan the case before reading, then mark sections, reveal pearls and self-rate the viva.
1. Sixty-second answer plan
1:00Before reading the notes, say or write your assessment, investigations and management structure.
2. Section checklist
Mark each section only after you can explain its main decision points without reading.
3. Exam-pearl flashcards
Try to predict the pearl before revealing it.
4. Viva drill
Answer aloud before rating yourself. Anything marked “review” stays visible in your progress.
Which features define severe malaria?
Progress is saved on this device. Use “Reset session” when you want a fresh attempt.
Recognise severe disease early
Severe malaria is a medical emergency. Features include impaired consciousness, repeated seizures, severe anaemia, hypoglycaemia, acidosis, acute kidney injury, jaundice with other organ dysfunction, shock, pulmonary oedema or significant bleeding. Parasite density can contribute to severity assessment but organ dysfunction is central.
Confirm malaria without delaying treatment
- Use microscopy or a quality-assured rapid diagnostic test according to local availability.
- Repeat or obtain expert testing when clinical suspicion remains high despite an initial negative result.
- Measure glucose urgently and repeatedly in severe disease.
- Check full blood count, renal function, electrolytes, acid-base status and other tests guided by organ dysfunction.
Emergency management
Parenteral artesunate is the preferred treatment for severe malaria where available, followed by a complete oral antimalarial course once the patient can tolerate oral medication. Supportive care is equally important: treat hypoglycaemia, seizures, severe anaemia, renal failure, shock and respiratory complications using careful fluid management.
Avoid unnecessary fluid loading because pulmonary oedema and renal dysfunction may coexist. Reassess frequently and involve critical care or renal services when organ failure is present.
Guideline source for further reading
This page is an original exam-revision summary. For clinical decisions, use current local protocols and the primary guidance below.