General Virology (and other slow viruses) Flashcards
Illnesses and serotypes a/w Coxsackie A Viruses
- herpangina
- HFM (CV A6 and A16 = MC in US)
- hemorrhagic conjunctivitis (CV A24)
Illnesses and serotypes a/w Enterovirus
- acute flaccid paralysis (polio)
- respiratory (EV-D68)
- hemorrhagic conjunctivitis (ED-70)
- HFM (EV-71)
- encephalitis
- aseptic meningitis
Illnesses and serotypes a/w Echovirus
- meningitis (EV-13, 18, 30)
- respiratory illness
Tzank smear - multinucleated giant cells
VZV
HSV
CMV IgM False Positives
RF
cross-reactivity w/ EBV VCA
other non-specific immune complexes
Drug Resistance in CMV
- UL97 (thymidine kinase): ganciclovir
- UL54 (DNA polymerase): cidofovir, foscarnet, ganciclovir - usually follows UL97 mutation, rarely occurs without
rash that starts at head and spreads caudally
followed 2-3 days later by lesions on the oral mucosa
think measles
Spectrum and MOA for acyclovir/valacyclovir
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
AEs of acyclovir (IV)
- phlebitis/inflammation during infusion (d/t alkaline soln)
- neurotox: lethargy, confusion, tremor/myoclonus, hallucinations, EPS
- crystalline nephropathy
Ganciclovir/Valganciclovir Spectrum and MOA
HSV, VZV, primarily used for CMV - via competition of deoxyguanosine triphosphate (blocks viral DNA synthesis)
zoonotic transmission of CJD
ONLY BEEF
Definite causes of iatrogenic CJD
- pituitary extracts
- dura mater grafts
- transplants (corneal, pericardium, liver linked)
- neurosurgical instrumentation
vCJD
sCJD
vCJD vs sCJD
- source -
- distribution -
- median age -
- progression -
- EEG -
- MRI basal ganglia -
- Pathology -
Which countries have the highest risk for vCJD
1 UK, #2 France
rapid progression of dementia, myoclonus
EEG: periodic sharp waves
spontaneous CJD
what CSF result is most consistent with CJD?
RT-QuIC
(traditionally, 14-3-3 protein, but not very specific)
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
- sCJD (prion)
- alzheimer (apo E4, Tau)
- Lewy body (a-synuclein)
- multi-infarct (atheroma)
Transmissible Spongiform Encephalopathies
- 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
MCC of CJD in the US
sporadic!
no domestic cases of animal transmission
Presentation of HTLV-1 TSP/HAM
- spastic paraparesis (lower>upper, proximal>distal)
- bladder disturbance
- hyperreflexia
- +babinski
Second most common neurologic syndrome in Jamaica (after stroke)
HTLV-1 tropical spastic paraparesis/associated myelopathy
(<1% of HTLV-1+ pts develop this)
2 manifestations of HTLV-1
- acute T cell leukemia
- HTLV-1 tropical spastic paraparesis/HTLV-1 assoc myelopathy
