skip to main content

Severe falciparum malaria — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardSepsis and Infectious EmergenciesSevere falciparum malariaSCE Acute Medicine

A 41-year-old woman is assessed on the acute medical unit. She has falciparum parasitaemia of 8%, confusion and acute kidney injury after travel to Ghana. Platelets are low and lactate is raised. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Start intravenous artesunate urgently

Start intravenous artesunate urgently is the best answer because severe falciparum malaria requires urgent parenteral artesunate and critical care involvement. Insert a large-bore chest drain using image guidance is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: High parasitaemia, organ dysfunction or impaired consciousness define severe disease.

Reference: UK malaria treatment guidelines