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Microbiology > Clinical features of different viruses > Flashcards

Clinical features of different viruses Flashcards

1
Q

What type of virus is varicella zoster?

A

Herpes virus, DNA virus

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2
Q

How is varicella zoster spread?

A

By close contact and droplets

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3
Q

How is varicella zoster virus transmitted in pregnancy

A

Maternal infection> maternal viraemia> virus transferred across the placenta> fetus recovers from initial infection> virus reactivates and acts like Zoster attacking the dermatomes

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4
Q

What are the physical consequences of varicella embryopathy?

A

Skin - scarring, hypopigmentation, hyperpigmentation
Limbs - hypoplasia and rudimentary digits
eyes - chorioretinitis, eye defects, cataracts
brain - cortical atrophy
Head - microcephaly

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5
Q

When should the varicella vaccination be given?

A

Pre natally or postpartum not antenatally as it is a live attenuated vaccination

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6
Q

What type of vaccination is the varicella zoster vaccine?

A

Live attenuated

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7
Q

When should VZIG be given?

A

Within 10 days of significant exposure in a patient that has not had chickenpox

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8
Q

When should VZIG not be given?

A

When a chickenpox rash is present

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9
Q

When should acyclovir be given to treat chickenpox in pregnancy?

A

Within 24 hours of a rash and after 20 weeks gestation

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10
Q

How long is a pregnant patient with chickenpox infectious for?

A

8-28 days (if they received VZIG)

8-21 days (if they did not receive VZIG)

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11
Q

What is the incubation period for Varicella Zoster?

A

14 days (10-21)

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12
Q

Which viruses are part of the herpes family?

A

Varicella zoster, herpes simplex, cytomegalovirus

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13
Q

What is the rate of fetal transmission of VZV in the first trimester?

A

0.4%

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14
Q

What is the rate of fetal transmission of VSV in the second trimester?

A

2%

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15
Q

What is the rate of transmission after 20 weeks?

A

0%

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16
Q

What are the maternal consequences of varicella zoster infection?

A

High risk of pneumonitis (10%)

Hepatitis, encephalitis

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17
Q

How do fetal transmission rates for CMV throughout pregnancy?

A

Fetal transmission rates increase

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18
Q

How does gestation affect the risk of CMV infection affecting the neonate?

A

The risk of a fetus being affected decreases with gestation

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19
Q

What are the ultrasound findings of a CMV infected fetus?

A

IUGR, microcephaly, ventriculomegaly, ascites, hydrops, intracerebral calcifications, echogenic bowel

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20
Q

How many affected babies with CMV will be symptomatic at birth?

A

7-10%

21
Q

What are the clinical features of congenital CMV at birth?

A

Microcephaly, jaundice, SGA, petechiae, hepatosplenomegaly, jaundice, seizures, visual impairment, cerebral palsy

22
Q

What proportion of babies with congenital CMV are asymptomatic at birth?

A

approximately 90% (approx. 10% will develop symptoms in later life)

23
Q

What are the clinical features of late stage congenital CMV?

A

Sensorineural deafness and mental retardation (10%), failure to thrive, failure to reach milestones

24
Q

How is CMV transmitted?

A

Body fluids (including breast milk)

25
Q

Who is most at risk of developing a CMV infection?

A

Nursery workers, pregnancy women with nursery age children, teenage pregnant women

26
Q

Can you develop immunity to CMV

A

No

27
Q

What types of CMV infections are there?

A

Primary (first infection) vs. non-primary (reactivation or new infection on previously infected)

28
Q

What is the risk of fetal transmission in a primary infection?

A

40%

29
Q

What is the risk of fetal transmission in a secondary infection?

A

1%

30
Q

Why is IgG avidity used in CMV testing in pregnancy?

A

It tells how tightly the IgG binds to the antigen, higher avidity increases the likelihood that the infection is a non-primary infection and therefore is at lower risk of being transmitted to fetus

31
Q

What does negative IgM and IgG for CMV mean?

A

No active or previous CMV infection

32
Q

What does positive IgM and IgG for CMV mean?

A

May be either a primary or non-primary infection therefore IgG avidity needs to be performed.

33
Q

What is the incubation period for CMV?

A

3-12 weeks

34
Q

What are the maternal symptoms of CMV in pregnancy?

A

Most women are asymptomatic. May be flu like symptoms, general malaise or lethargy

35
Q

When should amniocentesis be performed for CMV?

A

At least 6 weeks after maternal infection, more than 21 weeks (baby needs to be producing urine)

36
Q

Is there a treatment for CMV?

A

No

37
Q

What is a retrovirus (+example)?

A

HIV - RNA virus that uses host DNA for replication

38
Q

What type of virus is rubella?

A

A togavirus, single stranded RNA. Family = rubibvirus

39
Q

What kind of vaccine is the rubella vaccine?

A

Live attenuated

40
Q

Incubation period for Rubella

A

12-23days

41
Q

What are the symptoms of rubella?

A

25% asymptomatic
Joint pain
Fever, malaise coryzal symptoms
Maculopapular all body rash

42
Q

What are the features of congenital rubella syndrome

A

80% sensorineural deafness
60% neurological deficit (neurodevelopmental delay, microcephaly)
60% cardiac defect
30% eye defect - cataracts, glaucoma

43
Q

What is the significance of gestation with rubella syndrome infection?

A

In first trimester - High risk of mortality and morbidity
20% miscarry, 80% affected by the disease
In second trimester - 15-20% sensorineural deafness
In third trimester - low risk of impact to baby

44
Q

What does Gardasil vaccinate against?

A

4 Human Papilloma viruses
16 and 18 - responsible for 70% of cervical cancer
6 and 11 - cause anogenital warts

45
Q

What type of virus is HIV?

A

A retrovirus, Family = lentivirus, single stranded RNA

46
Q

What type of virus is polio

A

Enterovirus, single stranded RNA virus

47
Q

What type of virus is the zika virus?

A

Flavirus, single stranded RNA virus

48
Q

Which organism causes scarlet fever?

A

Streptococcus pyogenes

49
Q

What percentage of women develop antibodies to HPV infection?

A

50-60%

Microbiology (12 decks)

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