Which one of the following organ is enlarge due to malarial infection?

NVS Staff Nurse - 2022

Medical Surgical Nursing

Easy

Appeared in: NVS Staff Nurse - 2022

Explanation

The spleen is the organ that most characteristically enlarges in malaria, a condition called splenomegaly.
This occurs because the spleen is the primary site for filtering the blood and removing red blood cells infected and destroyed by the Plasmodium parasite.
The increased workload causes congestion and hyperplasia (overgrowth) of the splenic tissue, leading to its enlargement.
In chronic infections, the spleen can become massively enlarged, sometimes weighing over 1000 grams.

Option A: While the liver does enlarge in malaria (hepatomegaly) due to its role in the parasite's life cycle and clearing debris, the enlargement of the spleen is a more prominent and characteristic feature of the disease.
Option C: The stomach is part of the digestive system and is not directly involved in the filtration of blood or the life cycle of the malaria parasite. Therefore, it does not typically enlarge due to malaria.
Option D: The pancreas is primarily involved in producing digestive enzymes and hormones like insulin. It is not a site of malaria parasite activity or blood filtration, and its enlargement is not a feature of malarial infection.

Clinical Relevance

Nursing practice connection: Knowing Pathophysiology of Malaria helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
In areas where malaria is endemic, an enlarged spleen (splenomegaly) is a key clinical sign that should raise suspicion for the disease, especially in a patient with fever.
A crucial nursing consideration is to palpate the abdomen gently in suspected malaria cases. An enlarged, fragile spleen is at risk of rupture, which is a medical emergency.
What if? If a patient presents with massive splenomegaly but no acute fever, it could indicate chronic or repeated malarial infections, and the patient may have developed partial immunity.

How to Approach the Question

First, identify the key terms in the question: 'organ enlarge' and 'malarial infection'.
Recall the basic pathophysiology of malaria. The parasite infects and destroys red blood cells.
Consider the function of each organ listed. The spleen's primary role is to filter blood and remove old or damaged cells.
Connect the disease process to organ function. The destruction of red blood cells places a massive workload on the spleen, causing it to enlarge ('work hypertrophy').
Evaluate the other options. The liver is also involved, but the spleen's role in blood filtration makes its enlargement the most significant finding. The stomach and pancreas are not directly involved in this process.
Conclude that the spleen is the organ most characteristically enlarged in malaria.

Concept Tested & Keywords

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E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 397-399

E6 Medicine Harrison 22e Part 1 p. 521-523