Ch. 122 Viruses

Question 1

What are the viral diseases that can be prevented by routine vaccinations of all healthy children?

Answer 1

MMR
Varicella
Hep B
Rotavirus
Polio
Influenza

Question 2

What is the hallmark of mumps?

What is another well-known symptom besides fever, malaise and headache?

Answer 2

Parotiits unilateral or bilateral

Orchitis: usually older patients, usually unilateral but can be both

Question 3

Why is mumps a big deal?

Answer 3

It usually isn’t, but in rare cases can cause meningitis and encephalitis

Question 4

Unvaccinated patient presents with swollen parotid gland. What is the likely diagnosis and what other viruses can cause this presentation?

Answer 4

Mumps (mumps gives you bumps)

Also caused by EBV, parainfluenza, flu A, coxsackievirus, adenovirus, parvovirus B19, and HIV

Question 5

What virus is the most contagious known to humans?

Answer 5

Measles

Question 6

What are the classic features of measles?

Answer 6

Cough, coryza, conjunctivits, and Koplik spots that happen first then followed by the rash which is maculopapular, non-pruritic, starts on the head and spreads down entire body

Question 7

What disease is known for the three C’s? What is the pathognomonic sign of this desease?

Answer 7

Measles

Koplik spots

Question 8

What are the more common and usually not life-threatening complications of measles?

Answer 8

otitis media, laryngitis, bronchiolitis, pneumonitis, pneumonia, diarrhea, encephalitis

Question 9

What is the serious complication of measles?

Answer 9

Subacute sclerosing panencephalitis SSPE
Rare but deadly, slow progressive infection of the CNS with onset ~7 years after measles infection
Symptoms: behavior change, decreased intellect, ataxia, seizures, neuro deterioration and death

Question 10

What disease causes SSPE (subacute sclerosising panencephalitis) 7 years after infection?

Answer 10

Measles

Question 11

Does mumps orchitis cause infertility?

Answer 11

Can cause decrease sperm count leading to subfertility but rarely ever causes infertility

Question 12

Postexposure PPx recommendations for the measles?

Answer 12

MMR vaccine in 72 hours, or immune globulin within 6 days

Infants and immune suppressed kids should have IM IG

Question 13

Kids and malnourished admitted for severe measles infection may benefit from what specific supplement?

Answer 13

Vitamin A

Question 14

How are mumps and measles spread?

Answer 14

Respiratory droplets

Question 15

What is the other name for German Measles?

Answer 15

Rubella

Question 16

How is rubella spread?

Answer 16

Respiratory

Question 17

What are the clinical features of rubella?

Answer 17

Viral syndrome, measles-like rash, and arthritis

Almost always a mild disease if acquired

Question 18

What is the big deal with rubella?

Answer 18

Consequences in pregnant patients can be devastating

Can cause miscarriage, intrauterine death, premature delivery, or congenital rubella syndrome

Question 19

Describe congenital rubella syndrome

Answer 19

Severe birth defects
Hearing impairment
Cataracts
Retinopathy
Mental Retardation
Microcephaly
Congenital heart defects

Question 20

What vaccine preventable virus, when congenital, can cause heart defects, cataracts, MR, microcephaly, hearing impairment, and retinopathy?

Answer 20

Rubella (rubella affects the baby in the bella)

Question 21

Herpes stays latent in sensory nerves. What triggers reactivation of the virus?

Answer 21

Emotional stress
trauma
Intense sunlight
Fever

Question 22

How does genital herpes usually present the first time?

Answer 22

Fever, headache, malaise, myalgias, painful vesicles and ulcers on genitalia, and tender inguinal lymphadenopathy

Question 23

What are the features of HSV encephalitis?

Answer 23

Fever
Headache
AMS
Seizures
Focal Nerve Deficits

Question 24

What type of encephalitis is caused by HSV? What part of the brain is usually involved?

Answer 24

Necrotizing Hemorrhagic Encephalitis

Involves the temporal lobes most commonly

Question 25

What is the difference between HSV encephalitis and meningitis?

Answer 25

Encephalitis mortality is 70%

Meningitis has a benign course

Question 26

HSV-2 causes meningitis is what patients?

Answer 26

Neonatal and women