9

Question 1

Glandular Enlargement
Childhood disease; bilateral inflammation of parotid glands; many inapparent infections

Answer 1

mumps

Question 2

complication of mumps

Answer 2

Oophoritis (5% in women)

Orchitis (20% inflammation of testes)

meningitis

Question 3

incubation period and transmission of mumps

Answer 3

saliva and respiratory glands. 18-21 days

Question 4

prevention of mumps

Answer 4

live attenuated virus

Question 5

kissing disease

mild disease, most often in children or young adults

prolonged and debilitating

Lymphadenopathy, fever, sore throat, lymphocytosis with atypical lymphocytes, often enlargement of
liver and spleen.

HERPES FAMILY

Answer 5

infectious mononucleosis

Question 6

how to diagnose infectious mononucleosis? vaccine?

Answer 6

1. Blood picture (increase in atypical lymphocytes)
2. Monospot test, detects RBC agglutination, based on heterophile antibody response in which EBV induces the production of a wide range of antibodies, including one that acts as a hemagglutinin
3. Demonstration of the presence of EBV antigens as confirmation

NO VACCINE

Question 7

what family is Cytomegalovirus infections (CMV)

Answer 7

Herpes family

Question 8

who is Cytomegalovirus dangerous for?

Answer 8

pregnant women: neonatal infection, enlarge liver and spleen, mental delay

transplant patient: infection can cause rejection

AIDS and other immunocompromised patient: frequent infection, gi tract ulceration and retinitis

Question 9

how to diagnose infectious cytomegalovirus

Answer 9

1. isolation of blood, urine, organ biopsie (SLOW unless immunocompromised with high amount of virus present
2. CMV antigen detection, DNA hybridization

3.serology screening for donors and recipients

Question 10

treatment for infectious cytomegalovirus

Answer 10

antivirals

Question 11

prevention of cytomegalovirus

Answer 11

– Match CMV immune status between donor and
recipient in transplants
– Preventative administration of antivirals
– Universal precautions to prevent transmission
– NO VACCINE

Question 12

what is hepatitis

Answer 12

Inflammation of the liver
– Malaise, fatigue, nausea, loss of appetite and jaundice

Question 13

most common hepatitis

Answer 13

A and B

Question 14

how to get diagnoses of hepatitis

Answer 14

serology

Question 15

mainly effects children and young adults

sporadic cases and small epidemics

Transmission by fecal-oral route

– Incubation 15-50 days

– Stools infectious 2-3 weeks before onset

– Mild or inapparent infection in children

– No chronic hepatitis

– Life-long immunity

Answer 15

Hepatitis A

Question 16

how to diagnose hepatitis A? immunity

Answer 16

check IgM

check IgG

Question 17

prevention of hepatitis A

Answer 17

Vaccine for high risk
populations
– Commercial γ-globulin for
prevention after exposure

Question 18

sporadic cases; all ages

– Contaminated blood/blood products; saliva, urine, semen

– Avg. incubation 90 days

– Infective serum 30-60 days before onset of
symptoms

– Carriers

Answer 18

Hepatitis B

Question 19

diagnoses of Hepatitis B

Answer 19

HbSAg

anitbodies produced months later mark ofimmunity and infection

Question 20

prevention of Hep B

Answer 20

– Universal precautions for blood and
body fluids
– Proper handling of needles
– Screening
– Vaccination
– Hep B immunoglobulins after exposure
– Hep B carriers

Question 21

Blood and sexual transmission

Initially mild disease but can cause chronic
hepatitis

Answer 21

hep c

Question 22

prevention of Hep C

Answer 22

SAME AS HEP B

univeral precaution for blood and fluids

proper handling of needles

screening

no vaccine

Hep C carriers

Question 23

Blood and sexual transmission
– “Viroid”-relies on HepB presence for
replication in cells
– Increases severity of HepB infection

Answer 23

Hep Delta Agent

Question 24

Transmission via fecal-oral route
* Incubation 15-50 days
* Symptoms similar to HepA BUT 20%
mortality in pregnant women
* Endemic in India, Pakistan, Nepal, Burma,
North Africa and Mexico

Answer 24

Hep E

Question 25

how to diagnose Hep G

Answer 25

Detection of viral DNA by PCR or other molecular methods

Question 26

Blood and sexual transmission – Incubation 14-180 days – Initially mild and no jaundice, can cause chronic hepatitis NO VACCINE

Answer 26

Hep G

Question 27

Haemorrhagic fever with hepatitis * Endemic in Africa, South America and Caribbean * Mortality rates as high as 50% * Transmitted by mosquito * Travellers to endemic countries receive live attenuated vaccine

Answer 27

Yellow Fever Virus

Question 28

Viruses affecting the CNS * Clinical Manifestations

Answer 28

Aseptic meningitis – Encephalitis – Meningo-encephalitis – Poliomyelitis – Slow progressive, persistent infections

Question 29

diagnostic procedure

Answer 29

*Always first exclude possibility of bacterial or fungal infection 1.CFS CSF biochemistry (cells, proteins and glucose) - CSF direct Gram stain and cultures for bacteria and fungi - CSF detection of bacterial and fungal antigens - CSF for viral cultures blood for blood cultures, urines for antigen detection, naso-pharyngeal aspirates, throat swabs, stools or rectal swabs for viral cultures, acute and convalescent sera for viral serology.

Question 30

CNS Viruses with a Human Resevoir

Answer 30

Usually an extension of a primary infection in another part of the body – Mumps-aseptic meningitis in children – Enteroviruses-aseptic meningitis in infants and children – HSV1-RARE cause of herpetic encephalitis in young adults – HSV 1 or 2-RARE cause of meningo-encephalitis in neonate or young adult – Vaccination for mumps, measles and polio (entero)

Question 31

CNS Viruses with an Animal Reservoir

Answer 31

RARE: Humans are accidental or dead-end hosts – Arbovirus: * over 200 different types * Tropical rainforest areas * Encephalitis * Eg. West Nile – Rabies virus * Fatal, acute encephalitis * Infects mammals, transmitted via saliva * Long incubation (30-60 days) * Combined active and passive immunization * Prevention by vaccination of wildlife and pets

Question 32

Severe immunosuppressive condition; often fatal; predisposition to opportunistic infections and cancers causes depletion in helper T-cells making the host very susceptible to other infections * Frequent antigenic changes

Answer 32

HIV AND AIDS

Question 33

Transmission of HIV

Answer 33

-Sexual, blood/blood products, congenital, organ transplants, sperm donation

Question 34

HIV is cytocidal for T4 helper lymphocytes; neural cells also may be infected. Development of AIDS due to progressive impairment of immunological competence.

Answer 34

HIV is cytocidal for T4 helper lymphocytes; neural cells also may be infected. Development of AIDS due to progressive impairment of immunological competence.

Question 35

incubation period of HIV before clinical symptoms are shown

Answer 35

Incubation 6 months-several yrs

Question 36

Lab Diagnosis (HIV)

Answer 36

serology + may take months to occur isolation of virus from blood, plasma, semen, cervical,vaginal secretions

Question 37

HIV Prevention

Answer 37

Universal precautions for healthcare personnel – Screen blood, organ and semen donors – Heat inactivation of plasma for haemophilia patients – Sexual education – Education of drug users – Testing pregnant women at risk – NO VACCINE yet, but is a key focus of current resear

Question 38

HIV treatment

Answer 38

– MANY forms of treatment – Most effective is cocktail of treatments * HAART – Protease inhibitor (stops viral maturation) – Reverse transcriptase (stops viral replication

Question 39

Bad side-effects

Answer 39

– Expensive – Treatment and Prevention in developing countries very difficult

Question 40

What happens if HIV has a long asymptomatic period

Answer 40

– Lengthy asymptomatic period increases spread of disease