X · Day 2 · Renal failure Severe Falciparum Malaria11 / 18
Creatinine µmol/LCRRT commenced Day 2
Examiner traps⚠ Trap 1 — Exchange transfusion
No routine role. WHO and CDC do not recommend it. Riddle 2002 meta-analysis: no mortality benefit. Candidates who advocate it lose marks.
⚠ Trap 2 — Recurrent hypoglycaemia
Parasites consume glucose · reduced gluconeogenesis · quinine stimulates insulin. Hourly glucose is mandatory.
⚠ Trap 3 — Steroids in cerebral malaria
SNAP trial (1982): dexamethasone increased coma duration and GI complications. Never use.
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