ID 1 Flashcards
what are 2 common causes of acute viral rhinosinusitis
rhinovirus
parainfluenza virus
coronavirus
some bacterial
tx of acute viral rhinosinusitis
supportive: NSAIDs, saline washes, fluids, decongestants
*s/s>10 days, abx indicated
spread and incubation of influenza
spread- droplet
incubation- 1-4 days
influenza s/s include…
fever, chills, malaise, myalgia, URI s/s, non-productive cough
GI symtoms- influenza B
influenza dx
rapid tests
PCR- most sensitive
CBC
low O2
influenza tx
supportive
antivirals within 48 hrs
neuraminidase inhibitors (A&B)
if exposed to influenza, may tx with this within 48 hrs of exposure
chemoprophylaxis: oseltamivir or baloxavir
this syndrome is associated with giving aspirin with acute viral illnesses and may lead to progressive liver failure and encephalopathy
reye syndrome
s/s of this disease include grouped vesicles on erythematous base
HSV-1 and HSV-2
primary infection of HSV-1
Adults-tonsillopharyngitis
Children- gingivostomatitis
most asymtpomatic
HSV-2 primary infection s/s
dysuria
tender lymphadenopathy
systemic symptoms- fever, HA
Dx of HSV 1 and 2
PCR
serology
Tzanck smear
clinical
tx of HSV-1 and HSV-2
oral antivirals- valacylovir, acyclovir, famicilovir
varicella zoster transmission and incubation
transmission- contact, droplet, airborne
incubation- 10-21 days
when is chickenpox contagious
48 hrs before rash onset–> crusting of lesions
s/s of varicella zoster
fever, malaise, headache
rash:
- pruritic
- face–> trunk
- variable stages at once
- dew drop on rose petal
dx of varicella
clinical
PCR
serology
Tzanck smear
tx of varicella zoster
<12- supportive
>12- acyclovir
herpes zoster s/s
rash- unilateral vesicular dermatomal
erythematous papules–> grouped vesicles/ bullae–> pustular
this complication of shingles affects the facial nerve and leads to:
auditory and oral lesions
loss of taste
ipsilateral facial palsy
HL, tinnitus, vertigo
Ramsey Hunt syndrome
tx of ramsey hunt syndrome
antivirals and prednison
tx of herpes zoster
antivirals
analgesics
corticosteroids
tx of PHN
gabapentin
lidocaine
tricyclic antidepressants
capsaicin cream
HPV transmission and incubation
transmission- direct contact
incubation- 2-18 mo
what are 3 presentations of HPV
common wart (verruca vulgaris)
genital wart (condyloma)
plantar wart (verruca plantaris)
tx of HPV
common and plantar- cryotherapy, salicylic acid
genital- podophyllum resin, imiquimod, sinecatechins, cryotherapy, removal
Epstein-Barr virus (HHV-4) transmission and incubation
transmission- saliva, genital secretions
incubation- 30-50 days
s/s of epstein-barr (HHV-4)
- enlarged tonsils and exudates
- pharyngeal petechiae
- lymphadenopathy (cervical)
- Hoagand sign- transient upper lid edema
- splenomeagly and hepatomeagly
- maculopapular rash
dx of epstein barr virus (HHV-4)
heterophile antibody
EBV specific antibodies (IgM and IgG)
periopheral smear–> downey cells
tx of epstein-barr (HHV-4)
supportive- steroids for airway, fluid, analgesics
erythema infectiosum (5th disease) cause
parovirus B19
erythema infectiosum (5th disease) transmission and incubation
transmission- respiratory secretions and blood transfusions
incubation- 4-14 days
s/s of erythema infectiosum
prodrome- pharyngitis, conjunctivitis, fever, myalgias
rash- 2-5 later
* “slapped cheek” appearance
* symmetric maculopapular rash
* lacy reticulated rash
tx of erythema infectiosum
supportive- antipyretics, hydration
mumps cause
paramyxovirus
spread and incubation of mumps
transmission- repiratory secretions, droplets, saliva
incubation- 12-25 days
s/s of this disease includes:
* parotid tenderness/ facial edema
* orchitis- testicular swelling
* oophrotitis- lower abd pain
* pacreatitis- esp in children
mumps
mumps dx
leukopenia
lymphocytosis
elevated serum amylase
elevated IgM
tx of mumps
supportive- cold compress, analgesics, BR
what is the cause of rubeola (measles)
paramyxovirus
what is the transmission and incubation of rubeola (measles)
transmission- droplet and airborne
* contagious: 5 days before s/s- 4 days after rash
incubation- 6-21 days
s/s of rubeola
prodrome- 3 Cs: cough, coryza, conjunctivitis
enanthem- Koplik spots
exanthem- brick red starts at neckline and moves down and out
tx of rubeola
supportive- antipyretics, hydration, vit A, isolation
cause of rubella
togavirus
rubella incubation time
14-21 days
* contagious- 1 wk before rash–> 15 days after rash
rubella s/s
prodrome
* lymphadenopathy, fever, malaise
enanthem
* forchheimer spots
exanthem
* pink rash starts on face and spreads to trunk and extremities
rubella tx
supportive- anitpyretics, hydration
roseola (6th disease) cause
HHV-6 or HHV-7
s/s of roseola (6th disease)
prodrome
* high fever, OM, conjunctivitis
enanthem
* nagayama spots
exanthem
* rose colored rash starts on tunk and spreads toward face
tx of roseola
supportive- antipyretics, hydration
this is common s/s of primary infection of what disease?
mononucleosis- exudative tonsillopharyngitis and cervical lymphadenopathy
CMV (HHV-5)
CMV (HHV-5) secondary s/s
colitis
* diarrhea, n/v, abd pain
retinitis
* fluffy, yellow/ white retinal lesions, granular appearance, intraretinal hemorrhage
esophagitis
* odynophagia, dysphagia, large superifical ulcers
pneumonitis
* common post transplant
dx of CMV
tissue biopsy
serology (IgM, IgG)
CMV (HHV-5) tx
primary- supportive
* pregnancy- high dose valacylovir
severe or reactivation- antiviral therapy (ganciclovir)
s/s of congenital CMV
SNHL
eye involvement- cataracts, glaucoma
heart defects
blueberry muffin like hemorrhagic purpuric eruptions
dx of congenital CMV
PCR
tx of congenital CMV
life threatening- IV ganciclovir
non-life threatening- valganciclovir
rabies cause
rhabdovirus–> encephalitis of gray matter
s/s of this disease includes:
* prodrome- aerophobia, hydrophobia, pain, fever, n/v
* CNS stage- encephalitic or paralytic
* coma, ANS dysfunction, death
rabies
dx of rabies
PCR
skin biopsy
after death–> negri bodies
rabies tx
wound care
post exposure prophylaxis- HDCV on days 0, 3, 7, and 14 + immune globulin day 0
west nile virus cause and incubation
arbovirus/ flavivirus
arthropod borne
2-14 days
s/s of this viral illness include:
* fever and flu like s/s
* meningitis
* encephalitis: AMS, tremor, seizure, CN palsy
west nile virus
dx of west nile virus
serology- IgM ELISA in serum or CSF
west nile virus tx
supportive
if severe–> hospitalize
ebola cause
filoviridae
transmission and incubation of ebola
transmission- contact with bodily fluids and skin
incubation- 2-21 days
these s/s describe what disease?
stage 1/ nonspecific febrile illness
* HA
* weakness, dizziness
* fatigue
* myalgia or arthralgia
stage 2
* abd pain, n/v, diarrhea
* ecephalitis
* hypovolemic shock
* hemorrhagic symptoms
ebola