Infectious diseases

Question 1

What is the pathogenesis of HSV infection?

Answer 1

Question 2

What are the clinical manifestations of HSV?

Answer 2

Oral facial infection: gingivostomatitis and pharyngitis (most common clinical manifestation of HSV1 infection), herpes labialis (most common clinical manifestation of reactivation of HSV 1 infection): vesicular lesions on an erythematous base of oral mucosa commonly referred to as cold sores
Genital herpes: recurrence of genital herpes common but less severe and shorter duration
CNS infection: HSV encephalitis (neonates: HSV1/HSV2, in adults –> nearly all causes are HSV1), HSV meningitis (HSV2), Bells palsy
Ocular infection: HSV keratitis (chemosis, conjunctivitis and characteristic dendritic lesions of cornea), chorioretinitis, acute retinal necrosis
Cutaneous manifestation: herpetic whitlow (HSV infection of the finger –> complication of primary oral or genital herpes by inoculation of virus through a break in skin barrier), herpes gladiatorum (face, neck and arms), eczema herpeticum (atopic dermatitis patients are at risk), erythema multiforme
Visceral infections: HSV proctitis, HSV esophagitis, HSV hepatitis (both HSV1 and HSV2. Lab findings: leukopenia, coagulopathy, elevated serum aminotransferase level and bilirubin), HSV pneumonitis (uncommon except in immunocompromised patients): results from direct extension of herpetic tracheobronchitis into lung parenchyma

Question 3

What are the biochemical tests for HSV?

Answer 3

Question 4

What is medical treatment for HSV infection?

Answer 4

Question 5

What are the general features of varicella zoster virus?

Answer 5

Question 6

What is the pathogenesis of VZV?
Primary and reactivation

Answer 6

Question 7

What are the SS of chickenpox?

Answer 7

Question 8

What are the SS of shingles?

Answer 8

Question 9

What is the biochemical tests for VZV?

Answer 9

Question 10

What is treatment for varicella and herpes zoster (shingles)

Answer 10

Question 11

What is the treatment for complicated VZV infection?

Answer 11

Question 12

What are the complications of chickenpox?

Answer 12

Question 13

What are the complications of shingles?

Answer 13

Question 14

What is the prevention of VZV?

Answer 14

Question 15

What is the triad of infectious mononucleosis, route of transmission?

Answer 15

Question 16

what is the ddx of infectious mononucleosis

Answer 16

Question 17

What is the pathogenesis of infectious mononucleosis?

Answer 17

Question 18

What general features and PE for infectious mononucleosis?

Answer 18

Question 19

What biochemical tests for infectious mononucleosis and results

Answer 19

CBC with DC: leukocytosis with lymphocyte predominance
Peripheral blood smear: lymphocytosis, atypical lymphocytosis (defined as atypical lymphocyte >10% of total lymphocytes. Atypical cells are primarily mature CD8+ CTL that have been antigenically activated
LFT: may show hepatitis pattern
Heterophile antibodies (monospot test): latex agglutination assay using horse RBC as substrate for heterophile antibodies to agglutinate
EBV specific antibodies: EBV VCA IgM (most valuable), EBNA (nuclear antigen)
EBV DNA PCR

Question 20

What is the general management of infectious mononucleosis?

Answer 20

Question 21

What are the complications of infectious mononucleosis?

Answer 21

Question 22

What is the pathogenesis of mumps?

Answer 22

Question 23

What specific symptom of mumps?

Answer 23

Question 24

What biochemical test for mumos:

Answer 24

CBC with DC
Serology: IgM in serum confirms acute infection
RT-PCR
Viral culture

Question 25

What is complications of mumps infection?

Answer 25

Question 26

What is prevention of mumps?

Answer 26

Question 27

What is mode of transmission, incubation period and infectious period of measles?

Answer 27

Question 28

What are the RF of measles infection?

Answer 28

* Children too young to be vaccinated * Individuals without vaccination * Individuals without a 2nd dose of vaccination * Individuals with vaccination but failed to elicit a protective immune response (very small fraction of those immunized) * Travelers to areas where measles is endemic or contact with ill person arriving from those countries

Question 29

What is the pathogenesis of infection of measles?

Answer 29

 Infection occurs in upper respiratory tract epithelium  Viral replication in upper respiratory tract epithelial cells and LNs leads to primary viremia in around 2 – 3 days  Subsequent dissemination to distal reticuloendothelial sites such as spleen leads to secondary viremia in around 5 – 7 days * Secondary viremia leads to spread to respiratory tract and other organs

Question 30

What is clinical course of measles?

Answer 30

Question 31

What Ix for measles?

Answer 31

Question 32

What treatment for measles?

Answer 32

Question 33

What are the complications of measles?

Answer 33

Question 34

When is vaccination for measles done?

Answer 34

Question 35

What is the general features of rubella mode of transmission incubation period and infecitous period

Answer 35

Question 36

What are the SS for rubella?

Answer 36

Question 37

What Ix and tx for rubella?

Answer 37

Question 38

What are the complications of rubella>

Answer 38

Question 39

How to diagnose maternal rubella Management of women with possible exposure to rubella virus dx of congenital rubella infection after delivery

Answer 39

Question 40

How to prevent rubella?

Answer 40

Question 41

What are the regions affected by enteric fever What transmission and reservoir?

Answer 41

Question 42

What bacteria causes enteric fever?

Answer 42

Question 43

What is the clinical course of enteric fever What SS? Complications

Answer 43

Question 44

What tests for suspicion of enteric fever?

Answer 44

Question 45

What is management of enteric fever?

Answer 45

Question 46

What is the prevention of typhoid/paratyphoid fever?

Answer 46

Question 47

What is ricketssia what mode of transmission and incubation period?

Answer 47

Question 48

What is the geographical distribution of rickettsial illness?

Answer 48

Question 49

What is the rickettsia and orientia species categorized into?

Answer 49

Question 50

What is the pathogenesis of rickettsial illness?

Answer 50

Bacteria are transmitted via arthropod saliva during bite * Bacteria multiply and penetrate skin at site of arthropod bite * Primary target cells are vascular endothelial cells except for Orientia tsutsugamushi and Rickettsia akari which infects monocytes * Replication in endothelial cells of small blood vessels causes vasculitis and local hemorrhage and certain species cause local skin necrosis (eschar) at exposure site * Regional lymphadenopathy is common in infection with Orientia tsutsugamushi and some members of spotted fever group

Question 51

What is SS of ricketssial illness?

Answer 51

Question 52

What is SS of rocky mountain spotted fever (rickettsial)?

Answer 52

Question 53

What is SS of Meditteranean spotted fever (rickettsial)?

Answer 53

* Classic triad variably present * Presents with rash that may be macular, maculopapular or purpuric * Presence of inoculation eschar at tick bite sites * Associated laboratory features include thrombocytopenia, hyponatremia and abnormal LFT

Question 54

What is SS of epidemic typhus (rickettsial)?

Answer 54

* Classic triad variably present * Presents with macular or petechial rash that spread centrifugally o Centrifugal spread meaning lesions first arise on trunk and spread gradually towards the wrist and ankles * Neurological symptoms are common and range from confusion, seizure to coma * Inoculation eschar is typically NOT present at sites * Associated laboratory features include thrombocytopenia and abnormal LFT

Question 55

What is SS of murine typhus (rickettsial)?

Answer 55

* Classic triad occurs in 15% of cases * Presents with macular or petechial rash that spread centrifugally o Centrifugal spread meaning lesions first arise on trunk and spread gradually towards the wrist and ankles * Inoculation eschar is typically NOT present at sites * Associated laboratory features include anemia, thrombocytopenia, hyponatremia and abnormal LFT

Question 56

What is SS of scrub typhus (rickettsial)?

Answer 56

* Classic triad variably present * Presents with rash in 30% of cases and is macular, transient and pale * Distinct feature includes eschar in 50% of cases and may be multiple and associated localized lymphadenopathy * Neurological symptoms may be present ranging from slight intellectual blunting to delirium and coma * Associated laboratory features include anemia, thrombocytopenia, hyponatremia and abnormal LFT

Question 57

What tests for rickettsia?

Answer 57

Question 58

What treatment for rickettsia?

Answer 58

Question 59

What is the micbio of dengue virus?

Answer 59

Question 60

What is the pathogenesis of dengue fever?

Answer 60

Question 61

What is the clinical manifestation of dengue fever?

Answer 61

Question 62

What are the 3 categories of symptomatic dengue virus infection and description based on WHO 1997 (outdated)?

Answer 62

Question 63

What are the 3 categories of symptomatic dengue virus infection and description based on WHO 2009 ?

Answer 63

Question 64

How to confirm dx of dengue fever?

Answer 64

 Early phase of illness * Detection of virus by cell culture * Detection of viral nucleic acid by nucleic acid amplification tests * Detection of viral antigens by ELISA  End of acute phase of illness * Detection of antibodies by serology

Question 65

What biochemical tests done for dengue fever?

Answer 65

Question 66

What are the virus types causing malaria? What conditions protect against malaria?

Answer 66

 5 Different types of plasmodium species * Plasmodium falciparum (most common and severe) o Most prevalent malaria parasite on the African continent and responsible for most malaria-related deaths globally * Plasmodium vivax o Dominant malaria parasite in most countries outside of sub-Saharan Africa * Plasmodium malariae * Plasmodium ovale * Plasmodium knowlesi  Conditions that protects against malaria * G6PD deficiency * Thalassemia * Hemoglobinopathies (Hb S/C/SC/E/F)

Question 67

What is the region, transmission and incubation period for malaria?

Answer 67

Question 68

What is the life cycle of plasmodium species in human hosts?

Answer 68

Question 69

What is the classical SS for malaria?

Answer 69

Question 70

What are the SS of severe malaria?

Answer 70

Question 71

What biochemical tests for malaria?

Answer 71

Question 72

What is the treatment of uncomplicated malaria?

Answer 72

Question 73

What is the treatment for complicated malaria?

Answer 73

Question 74

What is done for prevention of malaria?

Answer 74