Circulatory, RES & Lymphatics-Viral II

Question 1

inflammation of the middle muscular layer of the heart wall leading to ventricular dysfunction

Answer 1

myocarditis

Question 2

myocarditis is more prevalent in

Answer 2

men

Question 3

symptoms of myocarditis

Answer 3

shortness of breath, excercise intolerance, fatigue (also chest pain, abdominal pain, palpitations, syncope)

Question 4

may mimic myocardial infection

Answer 4

myocarditis

Question 5

most US myocarditis cases are associated with

Answer 5

viral infection

Question 6

Most recently, myocarditis is associated with

Answer 6

B19 parvovirus, HHV-6

Question 7

Echovirus, influenza virus, mumps virus, adenoviruses (2/5), and enteroviruses (especially coxsackie B) are associated with

Answer 7

myocarditis

Question 8

Dx: of myocarditis

Answer 8

chest cardiograph, electrocardiogram, endomyocardial biopsy, nucleic acid based test

Question 9

Tx: myocarditis

Answer 9

manage symptoms of CHF and arrhytmias (if mild, bed rest and observation)

Question 10

swollen, tender parotid glands, sometimes accompanied by submandibular gland swelling with a prodrome of malaise and anorexia (1-2 days)

Answer 10

Mumps

Question 11

-ssRNA genome, one serotype, incubation period is 14-18 days, paramyxoviridae family

Answer 11

Mumps virus

Question 12

Age of onset of mumps

Answer 12

5-14 yrs (pre-vaccine era)

Question 13

% of mumps infections that are asymptomatic

Answer 13

20%

Question 14

Complications of mumps

Answer 14

meningitis, orchitis, deafness, myocarditis (very rare, often fatal)

Question 15

how is mumps spread?

Answer 15

respiratory secretions, saliva, contaminated fomites

Question 16

where is mumps spread to after primary viremia

Answer 16

salivary glands, testes, ovaries, pancreas, CNS

Question 17

where is mumps spread to after secondary viremia

Answer 17

generalized spread to salivary and other glands and other body sites including the kidneys

Question 18

Dx:

Answer 18

assay to detect viral genomes or serology

Question 19

Tx: mumps

Answer 19

uncomplicated cases resolve on their own

Question 20

Prevention of mumps

Answer 20

live attenuated vaccine (MMR/MMRV vaccine) intramuscular injection

Question 21

MMRV stands for

Answer 21

mumps, measles, rubella, varicella

Question 22

1st dose of MMRV

Answer 22

MMR + varicella for 12-15 month olds

Question 23

2nd dose of MMRV

Answer 23

MMRV 4-6 yrs of age

Question 24

Give 2 doses of mumps vaccination for adults who are at high risk which include

Answer 24

health-care workers, international travelers, students at post–high school educational institutions

Question 25

cases of mumps are highest in which age group (even amongst vaccinated individuals)

Answer 25

18-24

Question 26

patients exhibit cutaneous lesions that are pink, purple, or brown in color, are non-painful, and can become confluent

Answer 26

Kaposi's Sarcoma

Question 27

Cases with visceral lesions present with

Answer 27

weight loss or fever

Question 28

kaposi's sarcoma lesions are caused by

Answer 28

increased proliferation of endothelial cells

Question 29

kaposi's sarcoma histology

Answer 29

spindle cell morphology

Question 30

how many types of karposi's sarcoma are there

Answer 30

4

Question 31

rare disease, middle eastern or mediterranean descent, few lesions, rarely life threatening

Answer 31

Classic KS

Question 32

equatorial africa, two forms-1 presents like classic KS, 2-aggressive form in pre-pubrescent children, often fatal within 3 years

Answer 32

Endemic KS

Question 33

occurs in individuals with immune system suppression after organ transplant, KS regresses after immunosuppressive therapy is discontinued

Answer 33

transplant-related KS

Question 34

more widespread lesions than other KS forms, may include other symptoms such as lymph node swelling, fever, weight loss, often fatal when lung involvement occurs

Answer 34

AIDS-related KS

Question 35

KS is caused by?

Answer 35

Human Herpes Virus 8 (Kaposi's associated herpesvirus (KSHV))

Question 36

enveloped, dsDNA genome, latent state in KS lesions, contains several homologues of cellular genes (turn on proliferation)

Answer 36

human herpes virus 8 (causes kaposi's sarcoma)

Question 37

KS leads to over proliferation due to

Answer 37

cellular homologues

Question 38

transmission of HHV-8/KS

Answer 38

blood borne, sexual and needle sharing

Question 39

other HHV-8 associated diseases

Answer 39

castleman's disease, primary effusion lymphomas

Question 40

Tx: KS

Answer 40

control immune deficiency

Question 41

Why won't antivirals have any affect on KS?

Answer 41

virus is in latent state in lesions

Question 42

Visceral lesions of KS Tx

Answer 42

chemotherapy, radiation, or surgery

Question 43

T-cell origin, presents with lymphadenopathy, hepatosplenomegaly, hypercalcemia, skininfiltration of tumor cells (papules, plaques, tumors, ulcers)

Answer 43

Adult T-cell Lymphoma

Question 44

flower cells are identifying for

Answer 44

ATL (T-cells)

Question 45

ATL is most common in

Answer 45

southern Japan, the Caribbean, and Central Africa

Question 46

median age of onset for ATL

Answer 46

55 years

Question 47

median survival time post diagnosis of ATL

Answer 47

7 months

Question 48

Dx of ATL

Answer 48

detection of antibodies to HUman T-cell leukemia virus 1 (HTLV-1)

Question 49

HAM/Tropic Spastic Paraparesis

Answer 49

HTLV-1 associated myelopathy

Question 50

Demyelination of neurons within the spinal cord-likely autoimmune

Answer 50

HAM

Question 51

HAM highest incidence in

Answer 51

adult women infected by HTLV-1

Question 52

stiff gait, lower extremity weakness, back pain, incontinence are symptoms of

Answer 52

HAM

Question 53

infects CD4/CD8 positive T cells

Answer 53

HTLV-1 (Human T-cell leukemia virus I)

Question 54

+ssRNA, reverse transcription, retrovirus, enveloped

Answer 54

HTLV-1

Question 55

HTLV-1 gets into cell via the

Answer 55

GLUT1 receptor

Question 56

has a similar life cycle to HIV

Answer 56

HTLV-1

Question 57

Time between infection with HTLV-1 and ATL development

Answer 57

30 years

Question 58

greastest risk of ATL

Answer 58

childhood transmission

Question 59

Transmission of HTLV-1

Answer 59

nursing, blood transfusion, sexual transmission (male to female more efficient)

Question 60

cell-associated virus

Answer 60

HTLV-1

Question 61

Tx: of ATL

Answer 61

combined chemotherapy (limited effectiveness)

Question 62

prevention of ATL

Answer 62

avoid nursing in endemic areas, screen blood supply, reduce unprotected sex