3.1 Micro 1 Flashcards
for viral CNS inx: WBC in CSF
increased (mostly lymphocytes). in bacterial, mostly PMN
for viral CNS inx: culture gram stain in CSF
no organisms
for viral CNS inx: glucose in CSF
normal (~65mg/dL). In bacteria, decreased
for viral CNS inx: protein in CSF
mildly elevated vs bacteria which is sharply elevated
best way to test for enterovirus
Quickest & most sensitive method is RT-PCR using CSF or throat swab (directly testing for viral RNA).
- best treatment for enteroviral diseases:
2. best prevention against enterovirus:
- NO antiviral treatment available dummy.
2. no vaccine. only prevention is hand-washing (alcohol gel must be above 70%)
Picornaviridae (family of enerovirus species): +/- sense? DNA or RNA? naked/non-enveloped? Shape? replication?
naked, SS, + sense RNA virus. icosahedral. replicates in cyoplasm
there can be some deviation from this, but If i have herpes lesions on my junk, it’s HSV ____. if on my upper lip, it’s HSV____
- above the waist= HSV 1 usually
2. below the waist = HSV 2 (sexually transmitted)
How does the herpes virus evade host immunity? most obvious way
- LATENCY with latency-associated transcripts (LATs) & microRNAs = noncoding, regulatory RNAs. a. Silencing lytic gene expression
b. Blocking apoptosis & innate immune responses
c. Evading acquired immune response
3 major (red) methods to diagnose HSV
Cowdry type A inclusions, Tzanck smear, PCR using CSF
How to treat HSV?
prevention?
- acycolovir for treatment
2. no vaccine. safe sex, gloves, c-sections for + mother
location of HSV 1, 2, 3 (VZV) latency?
sensory ganglia. Flare only affects dermatome corresponding to affected (infected) ganglia
varicella particularly rough for immunocompromized patients. how so?
infx can lead to dissemination leading to pneumonia, hepatitis, encephalitis & disseminated intravascular coagulopathy
how is VZV encephalitis diagnosed
PCR of CSF
VZV treatment? prevention?
- Acyclovir treatment for severe infx or those at risk for severe infx
- a. Post-exposure prophylaxis using varicella IG for immunocompromised/newborn b. Varicella vaccine for children & non-immune adults (two doses)
c. Zoster vaccine for adults over 60 years
newborn with petechial rash, microcephaly & jaundice. CSF glucose normal. what’s probable diagnosis?
CMV.
HIV patient has CMV. How do you diagnose it?
treat it? what’s the name of the vaccine to prevent it?
- CMV DNA PCR is best 2. can treat with gancivlovir, cidofovir, foscarnet 3. no vaccine available
What is the timeframe of the illness after infection by enterovirus, including symptomatic state and immune system?
Incubation, then illness, then as soon as immune system begins to work disease diminishes.
Herpes virus: shape? Envelope status? size? genetic info? replication?
Icosahedral, enveloped, large, dsDNA linear, replicates in nucleus.
What is the pathogenesis of enterovirus? (replicates where, how can it cause encephalitis/ meningitis, what time of year is it most prevalent?).
Replicates in oropharynx and intestines (found in fecal matter).
Replicates in lymphoid tissue => viremia => spread to brain/ meninges.
Common in summer/ early fall.
5yr old pt presents with delirium, fever, and severe pain in head. Travel history = none, no recent cuts/injuries. Pts mother says they recently went to a new park, has not seen a mosquito since its below freezing every night even though its only september, she also states ashamed that her son usually picks his butthole and licks his fingers all the time. You take a mouth swab sample and after rt-pcr find it to be a single stranded +sense RNA virus. What is the likely shape of this organism, would it have an envelope? What is the treatment for this young punk kid? What suggestions would you give to the mother?
- Icosahedral
- Naked
- No treatment (supportive)
- Tell the mom to use 70%+ ethanol hand sanitizer for this young butt-licking punk.
A 17yr male presents to your clinic, the boys mother is concerned because her son “just hasn’t been himself today”, he complains of a massive H/A and is even feeling numbness in his limbs. After collecting the history you find out that this boy just recently tried oral sex with his GF for the first time 2 days prior and still has a mouth sore from it. He states his GF has been sexually active in the past but he has not. You get a CSF sample and use PCR to find a dsDNA virus. What is the most likely shape of this culprit? Enveloped? Where does this virus replicate? What virulence factors does this culprit use in this kids GF to keep her outbreaks hidden? What other tests could be used for diagnosis (what would have been seen)? Who is the MOST LIKELY culprit? How do you treat this young horny little punk? How do you educate this little dude?
- Icosahedral
- Enveloped
- Nucleus
- LATs and microRNAs to keep immune response down.
- Cowdry (type A inclusions), Tzanck smear (giant multinucleate bodies)
- HSV-2, GF had it on her genitalia, dude licked it off onto his mouth.
- Acyclovir
- Tell him to wrap up his junk if he starts banging this girl and probably not try anymore oral sex with her.
A 85yo HIV+ pt presents to your hospital with diagnosed encephalitis, time is brain so you are running diagnostic tests to determine what you are competing with. The pts son who brought him in states the pt was playing with his grandchild 2wks ago. You ask the son, “was your child ill?” the son says “no he is healthy…. well he did just get over the chickenpox but that was before he had them so there is no way it could have been that!” You look at the dude and say______? and it spreads by way of? To make sure you have the dx right you run what test(s)? You treat with what? This organism must have stayed dormant in this pts _______ for the past two weeks.
- It could be varicella due to the fact that the infectious stage occurs prior to breakout of rash.
- Droplets.
- CSF-PCR, Tzanck, immunoflourescence of antigen.
- Acyclovir.
- Dorsal root ganglion.
You are volunteering in rural Giny, where anything goes. You deliver a kid and the child has a petechial rash, jaundice, and microcephaly. You are thinking one thing. How do you substantiate your claim, what tests? What do you see in one of your tests? Where does this virus go latent, how is it activated? The husband was recently diagnosed with mono, at the clinic today he is feeling worse than ever and can barely enjoy his child’s birth, how do you treat this dude if he isn’t already being treated?
- DNA-PCR
- Owl’s eye - in cell observation
- Monocytes, activated by differentiation into macrophages
- -clovir type drugs.
