402. Viruses

Question 1

Provide examples of the different types of herpes viruses.

Answer 1

Herpes labialis- cold sores hepres 1

Genital herpes- erpes 2

Keratoconjuctivitis- avoid steroids

Herpetic encephalitis

Question 2

How are herpes viruses treated?

Answer 2

Confirmation with viral PCR of CSF, swab or vesicle scraping

Aciclovir, especially important to give empirically in suspected HSV encephalitits

Question 3

What virus is responsibel for shingles

What are the symptoms and complications

How is it terated?

Answer 3

Latent Varicella zoster infection

Painful hyperaesthetic area. Post hepatic neuralgia, ramsay hunt syndrome

Oral aciclovir

Question 4

How is shingles prevented

Answer 4

Vaccination at age70

Question 5

What serious diseases may chickenpox warrant

Answer 5

In immunosuppressed may lead to Ecephalitis, VZV pneumonia, transverse myelitis, pericarditits

Question 6

What are the presenting features of EBV?

Answer 6

Sore throat, lymphadenopathy, fever, anorexia, palatal petichae, splenomegaly

Question 7

What viruses are associated with cancer?

Answer 7

EBV- Burkitt’s lymphoma, Hodgkin’s lymphoma, B cell, gastric cacner, oropharyngeal cancer, nasopharrngeal

HHV8- kaposai’s

HPV- Cervix, anus, vulva and penis

Hep B and C- hepatocellular carncinoma

HTLV-1 and MCV

Question 8

Describe the various Human papilloma viruses and what diseases they cause?

Answer 8

Skin warts, verucas- 1&2

Anogenital warts- HPV 6&11

Cervical cancer- HPV 16 and 18

Question 9

What does a measles infection look like?

Answer 9

Fever, conjunctivitis, coryza, diarrhoea, koplik spots (buccal mucosa spots)

Generalised maculopapular rash

Question 10

Discuss the complications of a measles infection?

Answer 10

Secondary infection- bacterial pneumonitits, otitis media, occula rherpes simplex, Oral/GI candidiasis

Acute demyelinating encephalitits- Seizures, fever, irritability, rash

Subacute sclerosing panencepalitis- 5-10yr infection, changes in intellect and personality

Question 11

Discuss the presentation of mumps?

Answer 11

Fever, myalgia, headache

Infection and tender swellign of salivary glands

Question 12

What are the complications of a measles infection?

Answer 12

Meningoencephalitis, epidydimo-orchitis

Swollen, tender testicles, subfertility

oophritis, pancreatitis, deafness

Question 13

Describe a rubella infection?

Answer 13

Fever, conjunctiviits, rhinorrhea

Generalised pink maculopapular rash

Lymphadenopathy

Question 14

What vaccines are live vaccines?

Answer 14

BCg

Rotavirus

Rubella

Varicella zoster

Question 15

What diseases are caused by malaezzi fungi?

Answer 15

Pityriasis versicolor- scaly pigmented rash

Seborrhoeic dermatitis

Malassezia follicultits

Question 16

How do you treat fungal infections?

Answer 16

-azole antifungal, or terbinafine 1-4 weeks

Question 17

What fungal infection may mimic TB or sarcoidosis

Answer 17

Histoplasmosis

Question 18

What risk factors increase the risk of a fungal infection?

Answer 18

Infection

Malignancy

Critical illness

Catheter

Transplantation

Genetic

Surgical

Question 19

How to reduce incidence of catheter related infection?

Answer 19

Good catheter insertion

Reduce duration of catheter

Quality of catheter care

IS it necccesary? Is there obstruction?

Question 20

What organsisms typically cause catheter related infections?

Answer 20

Staph. epidermis,

Staph. aureus

Candida

Enterococci

Question 21

What organsism typically cause ventilator associated pneumonia?

What would make you suspect someone has a ventilator acquired pneumoniae?

Answer 21

Pseudamona aeruginosa

Enterobacteriaceae

Staph Aureus

Not so many clinical signs, suspect if new or persistnat infiltrates on CXR or sputumn, leucocytosis, luecopenia or increased temperature

Question 22

How do you prevent a ventilator associated pneumonia?

Answer 22

Nurse at 45 degreees

Mouthwash, silver coated tubes

Wean off venilation as soon as possible

Question 23

How do you manage a c.diff infection?

Answer 23

Isolate, use gloves, wash hands

Mild/moderate- metronidazole
Severe- Vancomycin

Non responding Vanc and IV met

Feacal transplant