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ID Boards > General Virology (and other slow viruses) > Flashcards

General Virology (and other slow viruses) Flashcards

1
Q

Illnesses and serotypes a/w Coxsackie A Viruses

A
  • herpangina
  • HFM (CV A6 and A16 = MC in US)
  • hemorrhagic conjunctivitis (CV A24)
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2
Q

Illnesses and serotypes a/w Enterovirus

A
  • acute flaccid paralysis (polio)
  • respiratory (EV-D68)
  • hemorrhagic conjunctivitis (ED-70)
  • HFM (EV-71)
  • encephalitis
  • aseptic meningitis
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3
Q

Illnesses and serotypes a/w Echovirus

A
  • meningitis (EV-13, 18, 30)
  • respiratory illness
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4
Q

Tzank smear - multinucleated giant cells

A

VZV

HSV

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5
Q

CMV IgM False Positives

A

RF

cross-reactivity w/ EBV VCA

other non-specific immune complexes

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6
Q

Drug Resistance in CMV

A
  • UL97 (thymidine kinase): ganciclovir
  • UL54 (DNA polymerase): cidofovir, foscarnet, ganciclovir - usually follows UL97 mutation, rarely occurs without
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7
Q

rash that starts at head and spreads caudally

followed 2-3 days later by lesions on the oral mucosa

A

think measles

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8
Q

Spectrum and MOA for acyclovir/valacyclovir

A

HSV, VZV via competition w/ deoxyquanosine triphosphate (inhibits viral DNA polymerase and blocks viral DNA synthesis)

**oral acyclovir has crummy oral absorption - valacyclovir preferred formulation

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9
Q

AEs of acyclovir (IV)

A
  • phlebitis/inflammation during infusion (d/t alkaline soln)
  • neurotox: lethargy, confusion, tremor/myoclonus, hallucinations, EPS
  • crystalline nephropathy
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10
Q

Ganciclovir/Valganciclovir Spectrum and MOA

A

HSV, VZV, primarily used for CMV - via competition of deoxyguanosine triphosphate (blocks viral DNA synthesis)

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11
Q

zoonotic transmission of CJD

A

ONLY BEEF

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12
Q

Definite causes of iatrogenic CJD

A
  • pituitary extracts
  • dura mater grafts
  • transplants (corneal, pericardium, liver linked)
  • neurosurgical instrumentation
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13
Q
A

vCJD

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14
Q
A

sCJD

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15
Q

vCJD vs sCJD

  • source -
  • distribution -
  • median age -
  • progression -
  • EEG -
  • MRI basal ganglia -
  • Pathology -
A
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16
Q

Which countries have the highest risk for vCJD

A

1 UK, #2 France

17
Q

rapid progression of dementia, myoclonus

EEG: periodic sharp waves

A

spontaneous CJD

18
Q

what CSF result is most consistent with CJD?

A

RT-QuIC

(traditionally, 14-3-3 protein, but not very specific)

19
Q

Dementia Comparison

  • myoclonus; course <2yrs; MRI: caudate, striatum, thalamus
  • memory, language; course >4yrs; MRI: hippocampus, white matter
  • parkinsonian, visual hallucination; course >4yrs; MRI: lesions uncommon
  • focal deficits; incremental course; MRI: caudate, pons, thalamus
A
  • sCJD (prion)
  • alzheimer (apo E4, Tau)
  • Lewy body (a-synuclein)
  • multi-infarct (atheroma)
20
Q

Transmissible Spongiform Encephalopathies

A
  • spontaneous (MCC in US)
  • associated w/ ingestion: beef = variant CJD; human brains = kuru
  • associated w/ medical procedure
  • hereditary: fCJD, Gerstmann-Straussler-Sheinker, Fatal Familial Insomnia, Fatal Sporadic Insomnia
21
Q

MCC of CJD in the US

A

sporadic!

no domestic cases of animal transmission

22
Q

Presentation of HTLV-1 TSP/HAM

A
  • spastic paraparesis (lower>upper, proximal>distal)
  • bladder disturbance
  • hyperreflexia
  • +babinski
23
Q

Second most common neurologic syndrome in Jamaica (after stroke)

A

HTLV-1 tropical spastic paraparesis/associated myelopathy

(<1% of HTLV-1+ pts develop this)

24
Q

2 manifestations of HTLV-1

A
  1. acute T cell leukemia
  2. HTLV-1 tropical spastic paraparesis/HTLV-1 assoc myelopathy
25
Q

Main associated syndromes with HTLV-1 acute T cell leukemia

(seen in 1% of HTLV-1 infected adults)

A
  • Infectious: TB, MAC, leprosy, PCP, recurrent strongy, scabies (esp Norwegian scabies)
  • Non-infectious: hyperCa + lytic bone lesions
26
Q

transmission of HTLV-1

A
  • sexual
  • transfusion (40-60% risk of seroconversion)
  • breastfeeding (prolonged) - 20-30% seroconvert if BF >12mos or if high maternal viral load. Can significantly decrease risk of transmission by dc breastfeeding
27
Q

distribution of HTLV

A
  • most commonly in E Asia (S Japan)
  • Caribbean
  • S America
28
Q

HIV+ person w/ high viral load but with high ALC and CD4

+ lymphocytes = “flower cells”

A

HTLV-1 co-infection

w/ HIV + HTLV-1 - CD4 unreliable, as HTLV infects CD4 cells and causes clonal expansion (though these remain non-functional)

29
Q

What class of ART is HIV-2 naturally resistant to?

A

NNRTI

30
Q
A

ID Boards (24 decks)

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