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micro unit 6 > enteric viruses 1 and 2 > Flashcards

enteric viruses 1 and 2 Flashcards

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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
what are the two kinds of picornavirus
rhinovirus and enterovirus.
26
what kind of infection do enteroviruses have
biphasic with dual tropisms
27
where is the normal primary replication for picornavirus
in the gut
28
where is the normal secondary replication for picornavirus
viremia. in the blood. then spread to lymph nodes.
29
what is the normal progression of picornavirus
immune response clears the virus, full recovery with lifelong immunity
30
what is the rare progression of picornavirus
during the viremia the virus infects the CNS
31
what are the different picornavirus
poliovirus, coxsackie A/B and hep A
32
poliovirus percentage and complications
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.
33
what is the common receptor for gut and gray matter?
CD155
34
how can poliovirus enter the CNS
by BBB or by retrograde axonal transport from periphery
35
is there lifelong immunity to polio?
yes IgG. vaccines work
36
what does the exam look like for non/preparalytic polio
HA, fever, sore throat, gastroenteritis.
37
what does the CNS progression look like for polio
new round of headache and fever, irritability, restlessness, apprehensiveness, stiff neck and back muscle pain, spasms, weakness, paresthesias
38
what are the risks for polio CNS
young age, advanced age, recent hard exercise, tonsillectomy, pregnancy, immunosuppression. unvaccinated
39
what labs for polio
spinal tap -pressure, protein, pleocytosis, viral culture. CBC for leukocytosis, viral recovery, MRI, electromyograph, biopsy gray matter.
40
what can we do for viral recovery of polio
throat washing, stool culture, blood culture, CSF
41
treatment for polio
supportive, isolation, bed rest, monitoring, physical therapy and speech therapy.
42
polio prevention
inactivated salk vaccine, attenuated sabin vaccine, passive immunization, handwashing
43
what does coxsackie A cause=
herpangina
44
what is herpangina
acute febrile illness, small vesicular or ulcerative lesions of posterior oropharyngeal structures.
45
who usually gets herpangina
pediatric
46
what is the course of herpagina
usually self-limited and mild.
47
are there other viruses, other than coxsackie A, that cause herpangina
yes, B and other enterics.
48
hand foot and mouth disease
coxsackie A. acute febrile illness, vesicular eruptions in the mouth, hands, feet, buttocks, genitalia
49
who gets hand-foot and mouth
peds
50
what is the course of hand foot and mouth
mild, self-limiting
51
what complications can occur from hand foot mouth
dehydration from refusal to eat or drink from sores in the mouth
52
any other causes of hand foot mouth
yes B and other
53
acute hemorrhagic conjuctivitis
rapid onset, painful conjuctivitis that occurs in teens. unpleasant but short in duration. cuased by coxsackie A
54
coxsackie A exam
look for fever, sore throat, anorexia and lesions to specific sites. lab work is seldom although PCR is avail.
55
what to counsel parents for with coxsackie A
watch for rare complications such as aseptic meningitis, myocarditis, guillain-barre
56
treatment for coxsackie A
supportive care with rehydration and tylenol (NO ASPIRIN FOR KIDS). topical analgesics if needed. no steroids,
57
how to prevent coxsackie A
handwashing
58
coxsackie B diseases
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
who is at higher risk for coxsackie B myocarditis
pregnant infants, immunocompromised.
60
viral myocarditis exam
HF, chest pain, dysrrhythmia, recent history of nonspecific flu-like illness.
61
what tests to order for viral myocarditis
ECHO, chest X, myocyte biopsy
62
what for labs on viral myocarditis
CBC shows anemia, lymphcytosis, neutropenia. blood cultures rule out bacteria, sed rate and CRP. viral cultures, CK and troponin I
63
treatment for viral myocarditis
admit. rest, O2, steroids (controversial), IgG optional, plecornaril.
64
pleurodynia
infection of the striated muscle of the chest. COX B.
65
what is the presentation of pleurodynia
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
pleurodynia lab work
vrial cultures, ELISA, RT-PCR. serum creatine kinase.
67
treatment for pleurodynia
supportive, follow up for sequelae
68
COX B neonatal mortality
occurs when there is inadequate immune response to contain infection. first 4 weeks of life. usualy from cardiac involvement.
69
what to watch for with coxsackie B neonatal
recent maternal GI illness that was febrile, poor feeding, lethargy, fever, irritability, hyperperfusion, jaundice.
70
what can occur with COX B neonatal
fulminant liver, sepsis, meningioencephalitis, cardiac failure from biopsy.
71
treatment for COX B neonatal
supportive
72
prevention of COX B
hand-washing
73
enterovirus aseptic meningitis
breaches the CNS infects the leptomeninges. the immune response creates inflammation.
74
enterovirus aseptic meningitis natural course
self-limited most recover completely 7-10 can be lethal in neonates
75
hat to find on exam for enterovirus aseptic meningitis
fever, meningisumus, irritability, photophobia, severe HA, N/V, rash.
76
what must be ruled out in enterovirus aseptic meningitis
drug OD or RXN, lupus, bacterial and fungal infections
77
what tests to order in enterovirus aseptic meningitis
tap, MRI, CT EEG. admit for observation and supportive.
78
lab work in enterovirus aseptic meningitis
CSF culture, gram, acid-fast, PCR for virusWBC, protein, glucose.
79
treatment for enterovirus aseptic meningitis
rest, rehydration, analgesics, anti-inflammatories. ICU maybe. plecornaril (phase III trials).
80
what do we monitor children for with enterovirus aseptic meningitis
learning disabilities.

micro unit 6 (7 decks)

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