A patient with severe cerebral malaria is found to have Plasmodium falciparum that is resistant to chloroquine. This resistance is primarily mediated by mutations in which gene encoding a transporter in the digestive vacuole membrane?
- A pfmdr1
- B pfdhfr
- C pfcrt (P. falciparum chloroquine resistance transporter) ✓
- D pfatp6
Correct answer: C. pfcrt (P. falciparum chloroquine resistance transporter)
Explanation
Chloroquine resistance in P. falciparum is primarily mediated by mutations in the pfcrt gene (particularly K76T), which encodes a transporter in the parasite's digestive vacuole membrane. This reduces chloroquine accumulation in the vacuole. pfmdr1 amplification confers multidrug resistance; pfdhfr mutations cause pyrimethamine resistance; pfatp6 was investigated for artemisinin resistance but not confirmed.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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