Which of the following organs is affected by malaria?

IGIMS Staff Nurse - 2018

Pathology & Genetics (E5)

Easy

Appeared in: IGIMS Staff Nurse - 2018

Explanation

The spleen is a key organ affected by malaria as it is responsible for filtering the blood of infected red blood cells (RBCs).
During a malaria infection, the spleen works to remove and destroy RBCs parasitized by Plasmodium, as well as normal RBCs, leading to anemia.
This constant and high-demand filtering activity causes the spleen to become congested and significantly enlarged, a condition known as splenomegaly.
Splenomegaly is a hallmark clinical sign of both acute and chronic malaria and is often used as an epidemiological marker (spleen rate) in endemic areas.

Option B: White Blood Cells (WBCs) are individual cells of the immune system, not a collective organ. While their numbers can fluctuate in response to infection, they are not an 'organ' affected by malaria.
Option C: The thyroid gland is part of the endocrine system and is not directly involved in the life cycle or pathophysiology of the malaria parasite.
Option D: While the liver is a critical organ in the malaria life cycle, it is the site of the initial, asymptomatic pre-erythrocytic stage where sporozoites mature. The most prominent clinical pathology and signs during the symptomatic phase are related to the spleen's function.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Organ-specific pathophysiology of malaria as background academic context rather than a clinical decision trigger.
For a nurse, palpating for an enlarged spleen is a crucial physical assessment skill when evaluating a patient with fever who has traveled to a malaria-endemic area.
The 'spleen rate,' which is the percentage of children in a community with a palpable spleen, is a key epidemiological tool used to measure the intensity of malaria transmission and the impact of control interventions.
A patient with massive splenomegaly from chronic malaria is at risk for splenic rupture, a life-threatening emergency. Nurses should be aware of this risk and monitor for signs of sudden abdominal pain and hemodynamic instability.

How to Approach the Question

First, identify the core of the question: it asks which organ is affected by malaria. This is a factual recall question based on pathophysiology.
Next, evaluate each option. Recognize that 'WBC' is a cell type, not an organ, and can be eliminated immediately.
Eliminate 'Thyroid' as it has no known direct role in malaria pathology.
You are left with 'Spleen' and 'Liver'. Both are known to be involved in malaria. Recall the specific role of each.
The liver is the site of the initial, asymptomatic parasite multiplication (pre-erythrocytic stage).
The spleen is involved in the symptomatic phase (erythrocytic stage), where it clears infected red blood cells, leading to the classic clinical sign of splenomegaly.

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