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Senior - ID 2 > 12 - Common Virals > Flashcards

12 - Common Virals Flashcards

1
Q

Measles is aka?

A

Rubeola

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2
Q

Spread of rubeola?

A

Droplet contact

  • highly communicable viral disease
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3
Q

Prodromal symptoms for measles/rubeola?

A

Fever
Conjunctivitis
Coryza
Cough

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4
Q

Pathognomonic form measles?

A

Koplik spots

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5
Q

S/s of measles?

A

Red blotchy rash
- appears day 3-7

Begins on face -> trunk -> extremeties

Lasts 4-7 days

Sometimes desquamanated

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6
Q

Labs for measles?

A

Leukopenia is common

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7
Q

Who gets measles?

A

Antivaxers
Shit-hole countries
Kids who dont sero-convert

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8
Q

Deficiency that puts pts at a high risk for measules?

A

Vitamin A deficiency

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9
Q

Fatality rate for rubeola?

A

10% globally

Up to 10-30% in some locations

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10
Q

Complications of rubeola?

A 
Otitis media
Croup
Encephalitis
Pneumonia
Diarrhea
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11
Q

Rubeola is more sever in?

A

Infants and adults

So people? Dont blame me its on the slides page 17

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12
Q

US death rate for rubeola?

A

2-3/1000 cases

Mostly <5 y/o

Pneumonia or encephalitis

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13
Q

Diagnosis for rubeola?

A

Clinical or epidemioligic grounds

Measles specific IgM

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14
Q

When are the measles pax communicable?

A

Just before the prodromal period

4 days after the appearance of the rash

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15
Q

Measles immunity?

A

Acquired immunity after the illness is permanent

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16
Q

Maternal antibody?

A

Protects the kid till they get the vaccine at 15 mo

Also makes the vaccine not work on younger kids

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17
Q

Who gets the immune globulin?

A

Persons not immunized

  • best - 72hrs after exposure
  • up to 6 days of expsure
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18
Q

Exposed pax also need?

A

Vitamin A

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19
Q

Rubella is not?

A

Measles

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20
Q

identification of rubella

A

Mild febrile diseasea

Diffuse punctate, maculo-papular rash

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21
Q

Rubella resembles?

A

Scarlet fever
Coxsackie virus
Mono rash

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22
Q

S/s for rubella (kids)

A

Few or no constitutional symptoms

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23
Q

Adult rubella presentation?

A 
Low grade fever
Mild coryza
HA
Conjunctivitis
Malaise
Lymphadenopathy
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24
Q

Lymphadenopathy for rubella?

A

Postauricular, occipital and post cervical

Most characteristic clinical feature

Precedes rash by 5-10 days

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25
Q

Pathognomonic for rubella?

A

Forscheimer spots

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26
Q

Complications for rubella?

A

Arthralgia
Arthritis (less common)
Encephalitis (rare in kids)

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27
Q

Arthralgia and arthritis from rubella is especially common in?

A

Young adult females

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28
Q

Labs for rubella?

A

Non-diagnositic

  • leukopenia
  • thrombocytopenia
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29
Q

Why do we care about rubella?

A 
Potential fetal anomalies
Risk of fetal defects
Maternal infection (early)
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30
Q

CRS?

A

Congenital rubella syndrome

  • 1st 16 weeks is highest risk
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31
Q

If rubella is acquired in 1st trimester?

A

80% get CRS

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32
Q

Early fetal infection causes?

A

Intra-uterine death
Spontaneous abortion
Congenital malformation

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33
Q

Major organ systems affected in babies:?

A

Deafness
Cataracts
Microphthalmia
Glaucoma

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34
Q

Other concerns for preggos?

A 
Microcephaly
MR
Hepatosplenomegaly
Bone disease
Meningo-encephalitis
Varied cardiac anomalies
Icterus
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35
Q

Milder cases of CRS?

A

May be unrecognized for years

Linked to DM1

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36
Q

Labs for rubella?

A

Rubella-specific IgM on ELISA

4 fold rise in specific antibody titer

CSF of newborn

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37
Q

Occurrence for rubella?

A

World-wide
Winter/spring
Children

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38
Q

Only reservoir of rubella?

A

Humans

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39
Q

Rubella transmission?

A

Infected nasopharyngeal secretions

CRS kids

  • spread large quantities
  • secretions in urine
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40
Q

Infants communicability for rubella?

A

From 1 week before onset
To 4 days after onset of rash

Highly communicable

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41
Q

Susceptible adults in the US?

A

10-20% are still susceptible

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42
Q

With preggos never

A

Immunize w rubella

43
Q

CMV is?

A

Very common

Rarely symptomatic

44
Q

The most sever form of cmv

A

Occurs in 5-10% of infants

  • infected in perinatal period
  • following intrauterine infection
  • blood transfusions
45
Q

Severe cmv affects?

A

CNS

Liver

46
Q

Symptoms of severe CMV?

A 
Lethargy
Icterus
Purpura
Chorioretinitis
Pulmonary infiltrates 
Convulsions
Petechiae
Hepatosplenomegaly
Intra-cerebral calcifications
47
Q

Survivors of CMV can exhibit?

A 
MR
Microcephaly
Motor disabilities
Hearing loss
Chronic liver disease 
Death - in utero infection
48
Q

Cmv is a big deal when?

A 
HIV
Disseminated pneumonia
Retinitis
GI tract disorders
Hepatitis
49
Q

MC cause of CMV problems?

A

Post transplant infections

50
Q

Diagnosis of CMV?

A

Newborns - urine
Adults - not as easy

Viral isolation
CMV antigen
CMV DNA detection

51
Q

CMV transmission?

A 
urine
Semen
Saliva
Cervical secretions 
Breast milk

Day care

52
Q

What is the reservoir for CMV?

A

Humans

53
Q

Communicability for CMV?

A

Excreted for months
(Maybe years)

Longer for neonates

54
Q

Tx for CMV?

A

Antivirals

  • valganciclovir
  • gancicolvir
  • foscarnet
55
Q

Definition of mononeculosis

A

Acute viral syndrome characterized clinically by:

  • fever
  • sore throat (exudative)
  • cervical lymphadenopathy
  • splenomegaly
56
Q

What differentiates Mono from strep?

A

Lymphocytosis

Splenomegaly

Extreme fatigue

57
Q

S/s of mono?

A 
Fever (7-10 days)
Chills
Malaise
Fatigue 
Myalgia
Sever sore throat
Prolonged recovery
Jaundice 
Splenomegaly
58
Q

Causative agent for mono? (Possible connection)

A

Burkitt lymphoma

Nasopharyngeal cancer

59
Q

Labs for mono?

A

Lymphocytosis (>50%)
Abnormal LFT (AST)
Mono-spot test

60
Q

Infectious agent for mono?

A

EBV (HHV4)

61
Q

How is mono spread?

A

Humans are the reservoir

Person to person transmission via oropharyngeal route (kissing)

62
Q

Incubation period for mono?

A

4-6 weeks

63
Q

How communicable is mono?

A

Prolonged

Pharyngeal virus exertion up to 1 yr after infection

64
Q

Immunity for mono?

A

Infection gives a high degree of resistance NOT IMMUNITY

65
Q

Tx for mono?

A

Symptomatic

Rest

66
Q

What is mumps?

A

Acute viral disease with fever, swelling/tenderness of 1 or more salivary glands

  • usually the parotid
  • sometimes the sulingual/submaxillary
67
Q

S/s of mumps?

A 
Orchitis (unilateral)
Oophoritis 
Sterility (uncommon)
Encephalitis (uncommon)
Pancreatitis (mild)
Mortality (rare)
Neurologic involvment
Deafness (rare, unilateral)
Spontaneous abortion (1st trimester)
68
Q

Diagnosis for mumps?

A

Viral isolation
- ELISA IgM

Skin test - unreliable

69
Q

1/3 of mumps infections are?

A

Subacute infections

Especially <2yrs old

70
Q

How is mumps spread?

A

Droplet spread
Saliva

Humans are the reservoir

71
Q

When is mumps contagious?

A

In saliva

  • 6-7 days before parotitis
  • 5 days after onset

Max 48hrs before onset

72
Q

Mumps will be in the urine?

A

Up to 14 days after illness onset

73
Q

Immunity to mumps?

A

Usually a lifelong immunity after infection

74
Q

Acute poliomyelitis?

A

Viral infection - acute onset of flaccid paralysis

75
Q

Poliomyelitis infection starts?

A

In the GI tract

  • flacid paralysis occurs
  • 90% are subacute

(Fecal oral)

76
Q

Common s/s of polio?

A

Usually its minor

  • fever
  • malaise
  • HA
  • N/V
77
Q

Major illness polio s/s?

A

Severe muscle pain
Neck/back stiffness
- w or w/o flaccid paralysis

78
Q

Describe the paralysis of polio

A

Asymmetric
Fever
w/o sensory loss

Legs>arms

79
Q

Categories of poliomyelitis?

A
  • Abortive poliomyelitis (mild)
  • Non-paralytic poliomyelitis (meningeal and muscle spasms)
  • paralytic poliomyelitis
80
Q

Paralytic polio includes?

A

Spinal : innervated by spinal nerves

Bulbar : CN-respiratory/vasomotor

81
Q

Complications of polio?

A

Life-threatening paralysis

Destruction of the spinal cord nerve cells

82
Q

Lab and diagnosis for polio?

A

Labs isolate polio in

  • stool
  • CSF
  • oral pharyngeal secretions

Fourfold + rise in antibody levels

83
Q

Occurrence of polio?

A

Rare in developed countries

Sporadic appearance/occasional epidemics

Primary kids

84
Q

Differentiating between GBS and polio?

A

GBS is:

  • typically symmetric
  • High protein in CSF
  • Fever, HA, N/V absent
85
Q

Transmission of polio

A

Person to person
Fecal oral
Pharyngeal spread

86
Q

Types of polio vaccines?

A

OPV
- live trivalent

IPV

  • inactivated
  • higher GI excretion
87
Q

Varicella is?

A

Chickenpox

An acute generalized viral disease w

  • sudden onset low grade fever,
  • mild constitutional symptoms
  • skin eruptions (quickly evolving)
88
Q

Skin eruptions of varicella?

A

Progression

  1. Maculopapular rash
  2. Vesicular rash
  3. Granular scab

Vesicles are monocular
Collapse on puncture

89
Q

Varicella rash has?

A

Multiple stages of maturity

90
Q

Atypical locations for varicella rash?

A 
Scalp
High on axilla
Mucous membranes of mouth
URT
Conjunctiva
91
Q

With varicella adults typically have?

A

Severe fever/constitutional symptoms

Death:
Kids 2/1000
Adults 30/1000

92
Q

With varicella what are common causes of death?

A

Primay viral pneumonia (adults)
Sepsis (kids)
Encephalitis (kids)
Congenital malformations (early pregnancy)

93
Q

Complications of varicella?

A

Reyes syndrome

Herpes zoster

94
Q

S/s of herpes zoster?

A
  • Vesicles on an erythematous base
  • restricted to dermatomes
  • irregular crops of lesions
  • unilateral
  • more closely aggregated than varicella
95
Q

Diagnosis of varicella and zoster?

A

PCR
EM visualation of virus
FA Viral antigen in spears
Cell culture

96
Q

Infectious agent or varicella and zoster?

A

Human alpha herpesvirus 3

97
Q

Varicella transmission?

A

Person to person direct contact

Droplet/airborne spread of vesicle fluid

Respiratory tract secretion

98
Q

Zoster transmission?

A

Reactivation of dormant varicella from a dorsal root ganglia

99
Q

When are you contagious with varicella?

A
  • 1-2 days before rash
  • 5 days after 1st crop of vesicles

Scabs are not infectious

100
Q

When is zoster infectious?

A

1 week after appearance

101
Q

Resistance for varicella?

A

You never get chicken pox again
But…
Welcome to the risk of zoster

102
Q

Prevention/tx of varicella and herpes?

A

VZIG w/in 96hrs of exposure

Varicella virus vaccine

Acyclovir

103
Q

Polio builds character

A

Vaccine free is the way to be

Senior - ID 2 (6 decks)

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