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micro unit 6 > enteric viruses 1 and 2 > Flashcards

enteric viruses 1 and 2 Flashcards

1
Q

rotavirus capsid

A

double-layered, naked icosahedral

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2
Q

rotavirus genome

A

segmented RNA

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3
Q

where do we find rotavirus

A

environmentally rugged and ubiquitous reinfection is common.

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4
Q

why is reinfection with rotavirus common

A

because there are many slightly different tyoes

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5
Q

how is rotavirus transmitted

A

fecal-oral, fomites.

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6
Q

what is the natural progression of rotavirus

A

self-limited of small intestinal villi lasts about 5 days. the impaired villus function leads to excessive fluid loss dehydration.

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7
Q

what will the exam show for rotavirus

A

history of exposure, vomit, anorexia, low fever, cramps. dehydration.

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8
Q

treatment for rotavirus

A

rehydrate. IV if necessary, excellent prognosis, no sequelae. no antidiarrheal meds for children.

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9
Q

prevention for rotavirus

A

handwashing and vaccine

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10
Q

what vaccines are available for rotavirus

A

rotateq and rotarix

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11
Q

norovirus genome

A

single-stranded RNA

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12
Q

norovirus capsid

A

naked icosahedral

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13
Q

where do we find norovirus

A

environmentally rugged. reinfection common.

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14
Q

compare the patients for norovirus and rotavirus?

A

norovirus has an older cohort.

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15
Q

ow is norovirus transmitted

A

fecal-oral, contaminated food, fomites.

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16
Q

what does norovirus infection cause

A

gastroenteritis, small intestinal villi infection with delayed gastric emptying. more severe vomiting then rotavirus

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17
Q

what is the course of norovirus

A

shorter course than rota 48hrs.

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18
Q

what are the consequences of norovirus time line for the illness>

A

shorter course and older patients means less dehydration.

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19
Q

ow do we diagnose norovirus

A

24-48 incubation and course, profuse nonbloody vomiting, nausea, cramping, HA, fever, muscle aches. may be dehydrated

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20
Q

treatment for norovirus

A

rest, rehydration. antidiarrheals sparingly in adults. reportable.

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21
Q

prevention of norovirus

A

handwashing

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22
Q

picornavirus genome

A

ssRNA (+) sense

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23
Q

picornavirus capsid

A

naked icosahedral. a

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24
Q

are picornavirus environmentally rugged

A

yes

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25
Q

what are the two kinds of picornavirus

A

rhinovirus and enterovirus.

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26
Q

what kind of infection do enteroviruses have

A

biphasic with dual tropisms

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27
Q

where is the normal primary replication for picornavirus

A

in the gut

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28
Q

where is the normal secondary replication for picornavirus

A

viremia. in the blood. then spread to lymph nodes.

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29
Q

what is the normal progression of picornavirus

A

immune response clears the virus, full recovery with lifelong immunity

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30
Q

what is the rare progression of picornavirus

A

during the viremia the virus infects the CNS

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31
Q

what are the different picornavirus

A

poliovirus, coxsackie A/B and hep A

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32
Q

poliovirus percentage and complications

A

usually follows normal course. 1-2% have neurological symptoms. infection of the anterior horn motor neurons and/or brainstem. causing flacccid paralysis asymmetric weakness. and or respiratory failure.

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33
Q

what is the common receptor for gut and gray matter?

A

CD155

34
Q

how can poliovirus enter the CNS

A

by BBB or by retrograde axonal transport from periphery

35
Q

is there lifelong immunity to polio?

A

yes IgG. vaccines work

36
Q

what does the exam look like for non/preparalytic polio

A

HA, fever, sore throat, gastroenteritis.

37
Q

what does the CNS progression look like for polio

A

new round of headache and fever, irritability, restlessness, apprehensiveness, stiff neck and back muscle pain, spasms, weakness, paresthesias

38
Q

what are the risks for polio CNS

A

young age, advanced age, recent hard exercise, tonsillectomy, pregnancy, immunosuppression. unvaccinated

39
Q

what labs for polio

A

spinal tap -pressure, protein, pleocytosis, viral culture. CBC for leukocytosis, viral recovery, MRI, electromyograph, biopsy gray matter.

40
Q

what can we do for viral recovery of polio

A

throat washing, stool culture, blood culture, CSF

41
Q

treatment for polio

A

supportive, isolation, bed rest, monitoring, physical therapy and speech therapy.

42
Q

polio prevention

A

inactivated salk vaccine, attenuated sabin vaccine, passive immunization, handwashing

43
Q

what does coxsackie A cause=

A

herpangina

44
Q

what is herpangina

A

acute febrile illness, small vesicular or ulcerative lesions of posterior oropharyngeal structures.

45
Q

who usually gets herpangina

A

pediatric

46
Q

what is the course of herpagina

A

usually self-limited and mild.

47
Q

are there other viruses, other than coxsackie A, that cause herpangina

A

yes, B and other enterics.

48
Q

hand foot and mouth disease

A

coxsackie A. acute febrile illness, vesicular eruptions in the mouth, hands, feet, buttocks, genitalia

49
Q

who gets hand-foot and mouth

A

peds

50
Q

what is the course of hand foot and mouth

A

mild, self-limiting

51
Q

what complications can occur from hand foot mouth

A

dehydration from refusal to eat or drink from sores in the mouth

52
Q

any other causes of hand foot mouth

A

yes B and other

53
Q

acute hemorrhagic conjuctivitis

A

rapid onset, painful conjuctivitis that occurs in teens. unpleasant but short in duration. cuased by coxsackie A

54
Q

coxsackie A exam

A

look for fever, sore throat, anorexia and lesions to specific sites. lab work is seldom although PCR is avail.

55
Q

what to counsel parents for with coxsackie A

A

watch for rare complications such as aseptic meningitis, myocarditis, guillain-barre

56
Q

treatment for coxsackie A

A

supportive care with rehydration and tylenol (NO ASPIRIN FOR KIDS). topical analgesics if needed. no steroids,

57
Q

how to prevent coxsackie A

A

handwashing

58
Q

coxsackie B diseases

A

causes a viral myocarditis sequel in 1-4% of B gastroenteritis. necrosis of myocytes with inflammatory infiltrate that effects the hearts function. may progress to CHF

59
Q

who is at higher risk for coxsackie B myocarditis

A

pregnant infants, immunocompromised.

60
Q

viral myocarditis exam

A

HF, chest pain, dysrrhythmia, recent history of nonspecific flu-like illness.

61
Q

what tests to order for viral myocarditis

A

ECHO, chest X, myocyte biopsy

62
Q

what for labs on viral myocarditis

A

CBC shows anemia, lymphcytosis, neutropenia. blood cultures rule out bacteria, sed rate and CRP. viral cultures, CK and troponin I

63
Q

treatment for viral myocarditis

A

admit. rest, O2, steroids (controversial), IgG optional, plecornaril.

64
Q

pleurodynia

A

infection of the striated muscle of the chest. COX B.

65
Q

what is the presentation of pleurodynia

A

sudden onset lancinating chest pain attacks. there will be fever, malaise, HA, 3-5 days of attacks of the chest sore throat, cough rhinitis,dry cough. N/V diarrhea. pleural friction rub. can also be herpangina or other coxsackie virus associations.

66
Q

pleurodynia lab work

A

vrial cultures, ELISA, RT-PCR. serum creatine kinase.

67
Q

treatment for pleurodynia

A

supportive, follow up for sequelae

68
Q

COX B neonatal mortality

A

occurs when there is inadequate immune response to contain infection. first 4 weeks of life. usualy from cardiac involvement.

69
Q

what to watch for with coxsackie B neonatal

A

recent maternal GI illness that was febrile, poor feeding, lethargy, fever, irritability, hyperperfusion, jaundice.

70
Q

what can occur with COX B neonatal

A

fulminant liver, sepsis, meningioencephalitis, cardiac failure from biopsy.

71
Q

treatment for COX B neonatal

A

supportive

72
Q

prevention of COX B

A

hand-washing

73
Q

enterovirus aseptic meningitis

A

breaches the CNS infects the leptomeninges. the immune response creates inflammation.

74
Q

enterovirus aseptic meningitis natural course

A

self-limited most recover completely 7-10 can be lethal in neonates

75
Q

hat to find on exam for enterovirus aseptic meningitis

A

fever, meningisumus, irritability, photophobia, severe HA, N/V, rash.

76
Q

what must be ruled out in enterovirus aseptic meningitis

A

drug OD or RXN, lupus, bacterial and fungal infections

77
Q

what tests to order in enterovirus aseptic meningitis

A

tap, MRI, CT EEG. admit for observation and supportive.

78
Q

lab work in enterovirus aseptic meningitis

A

CSF culture, gram, acid-fast, PCR for virusWBC, protein, glucose.

79
Q

treatment for enterovirus aseptic meningitis

A

rest, rehydration, analgesics, anti-inflammatories. ICU maybe. plecornaril (phase III trials).

80
Q

what do we monitor children for with enterovirus aseptic meningitis

A

learning disabilities.

micro unit 6 (7 decks)

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