Exam #7: Viral Infections of Circulatory, RES, & Lymphatic System II Flashcards
What is viral myocarditis?
Inflammation of the middle musclar layer of the heart wall leading to ventricular dysfunction
- Most prevalent in adult men
What is the typical presentation of viral myocarditis?
Dyspnea
Exercise intolerance
Fatigue
What are most US myocarditis cases associated with?
Viral infection
What viruses most commonly cause myocarditis?
Historically:
- Adenovirus (Type 2&5)
- Enterovirus (Coxsackievirus B)
Currently:
- B19 Parvovirus
- HHV-6
How is viral myocarditis diagnosed?
- A high index of suspicion in patient’s with “CHF of unknown origin”
- CXR, ECG, & endomyocardial biopsy
- Nucleic acid test of biopsied material
How is viral myocarditis treated?
1) Manage CHF & arrhythmia
2) Bed rest & observation if only mild disease
What is the prognosis of viral myocarditis?
50% have full cardiac function restored
What are the symptoms of mumps? What is the typical age of onset?
5-14 year old with:
- Swollen, tender parotid glands
- Sometimes accompanied by submandibular gland swelling
*Prodrome of malaise & anorexia for 1-2 days
List the characteristics of the mumps virus.
- Paramyoxviridiae family
- ssRNA
- One serotype
What are the complications of Mumps?
Meningitis
Orchitis (testicular inflammation)
Deafness
Myocarditis (rare, but often fatal)
How is mumps diagnosed?
- Clinically, acute onset of parotid gland swelling lasting more than 2 days without any other apparent cause
- Lab assays to detect viral genomes
How is Mumps treated?
Uncomplicated cases resolve without intervention within ~10 days
How is Mumps transmitted?
Direct contact with:
- Respiratory droplets
- Saliva
- Contaminated fomites
How is Mumps prevented?
IM live attenuated vaccine that is part of the MMR & MMRV (Mumps, Measles, Rubella, & Varicella) vaccine combinations
- 1 dose 12-15 months
- Another before Kindergarden
- One dose for adults
- *Note that 1 dose is ~78% effective & 2x is ~88% effective
Who is at increased risk for Mumps?
- Healthcare workers
- International travelers
- Students at post high-school educational institutions
What is Kaposi’s Sarcoma (KS)?
Multicentric tumor associated with hyperproliferation of endothelial cells
Describe the presentation of KS.
- Initially, flat or slight raised spots on the skin that can range from light pink to purple
- Progressively become larger nontender nodules
- Can become confluent or clump together
How are KS cells histologically identified?
Spindle morphology (elongated) of cells vs. cuboid or round morphology
What is KS associated with?
Immunosuppression
*There was a sharp increase in the number of cases during the AIDS epidemic
What are the different types of KS?
- Classic
- Endemic
- Transplant-related
- AIDS-related
Describe Classic KS.
- Rare
- Found in those with middle eastern or mediterranean descent
- Few lesions
- Rarely life-threatening
Describe Endemic KS.
- Most common in Africa
- Two forms: 1 is identical to classic, other is more aggressive & seen in prepubescent children (fatal in 3 years of onset)
Describe Transplant-related KS.
KS seen in post-transplant immunosuppression
Describe AIDS-related KS.
KS seen in AIDS patients
- More lesions that involve multiple organ systems
- Lung involvement is fatal
