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OS 217 Infectious Diseases > Lec 20 Arthropod-Borne Infections > Flashcards

Lec 20 Arthropod-Borne Infections Flashcards

1
Q

True of dengue virus EXCEPT

A. spherical particle with single-stranded DNA
B. has 7 non-structural proteins
C. most infections are asymptomatic
D. short-term cross protection against other serotypes

A

A

It is an RNA virus.

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2
Q

ID: Mosquito vectors of dengue.

A

Aedes aegypti

Aedes albopictus

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3
Q

Found in temperate regions

A. Aedes aegypti
B. Aedes albopictus
C. both
D. none

A

B

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4
Q

Typically feeds and rests indoors

A. Aedes aegypti
B. Aedes albopictus
C. both
D. none

A

A

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5
Q

Found in the tropics and subtropics

A. Aedes aegypti
B. Aedes albopictus
C. both
D. none

A

C

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6
Q

What is the intrinsic incubation period of dengue?

A

4-13 days

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7
Q

Primary dengue infection may result in the following EXCEPT

A. dengue fever
B. subclinical infection
C. undifferentiated febrile syndrome
D. dengue shock syndrome
E. AOTA
A

D

DSS happens after the 2nd dengue infection

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8
Q

What cells do dengue viruses infect first?

A

immature dendritic cells in the skin

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9
Q

What is the first noticeable laboratory finding in a person infected with dengue?

A

low WBC count

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10
Q

Enumerate the clinical manifestations of dengue fever.

A 
fever
retro-orbital pain
headache
muscle and joint pain
anorexia
rash
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11
Q

True of the torniquet test EXCEPT

A. Torniquet is tied midway through the arm.
B. Test is done for 5 minutes
C. Counting is done on an area of 1 square inch.
D. Positive test is 20 or more petechiae per square inch.
E. NOTA

A

A

Torniquet is not used in the torniquet test.
You use BP cuff and inflate midway between the systolic and diastolic pressures.

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12
Q

T/F: The patient is viremic during the critical phase.

A

F

The patient is viremic only during the febrile phase.

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13
Q

During the critical phase, which occurs first?

A. leukopenia
B. thrombocytopenia
C. hemoconcentration
D. anemia
E. NOTA
A

A

leukopenia

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14
Q

What is the main underlying cause of the warning signs seen in the critical phase?

A

plasma leakage due to increased capillary permeability

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15
Q

Severe dengue is characterized by the following EXCEPT

A. severe plasma leakage
B. severe bleeding
C. severe organ impairment
D. severe anemia
E. NOTA
A

D

The patient is polycythemic NOT anemic.

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16
Q

The critical phase of dengue lasts for how long?

A

24-48 hours

17
Q

Which of happens first during the recovery phase?

A. defervescence
B. WBC rise
C. platelet count rise
D. hemodilution

A

A

defervescence - WBC rise - hemodilution - platelet count rise

18
Q

What is the main differential of dengue fever?

A

chikungunya

19
Q

Which rises faster and higher during a secondary dengue infection?

A. IgM
B. IgG
C. both
D. secondary infection does not involve antibodies

A

B

IgG - rapid and higher increase

20
Q

WHO 1997 Criteria for dengue fever include the ff EXCEPT

A. leukopenia (

A

D

20% increase is already a sign of plasma leakage therefor it is already dengue HEMORRHAGIC fever

5-10% Hct increase only for uncomplicated dengue fever

21
Q

DHF patient presenting with platelet count 57,000, spontaneous bleeding, weak pulse, and 15 mmHg pulse pressure. The patient has DHF grade

A. Grade I
B. Grade II
C. Grade III
D. Grade IV

A

C

22
Q

What sign, apart from those in Grades 1-3, must be present to be classified DHF as Grade IV?

A

profound shock

- undetectable BP and pulse

23
Q

T/F: The 1997 criteria has high sensitivity.

A

F

24
Q

DHF Grades III and IV are collectively termed as what?

A

dengue shock syndrome

25
Q

Patient has 2 day history of fever, myalgia, retro-orbital pain, and nausea. Laboratory test showed leukopenia and (+) dengue IgM antibody. Based on the 2011 DOH revised classification, the patient has

A. probable dengue fever
B. confirmed dengue fever
C. dengue fever with warning signs
D. severe dengue
E. a condition other than dengue
A

A

probable dengue fever only

A confirmed dengue fever should have (+) viral isolation or (+) PCR

26
Q

Which is can be used for rehydration?

A. reduced osmolarity ORS
B. high sodium, high glucose ORS
C. gatorade or similar sports drink
D. plain water
E. AOTA
A 
A
reduced osmolarity (Na: 50-70 mmol/L)
27
Q

First line IV fluid for dengue shock

A. crystalloids
B. colloids
C. NOTA
D. AOTA

A

A

28
Q

Which is not recommended for transfusion?

A. packed RBC
B. fresh whole blood
C. platelet concentrate
D. NOTA

A

C

platelet concentrate - may exacerbate fluid overload

29
Q

ID: Vector of chikungunya.

A

Aedes aegypti
Aedes albopictus

same as dengue

30
Q

ID: hallmark of chikungunya

A

severe and often debilitating joint pains

31
Q

The following are true in the recent (ca. 2005-2008) chikungunya pandemic EXCEPT

A. more efficient viral replication in Ae. aegypti
B. spread in temperate countries
C. unusual clinicopathologic complications
D. high morbidity

A

A

Aedes albopictus

32
Q

T/F: Co-infection of dengue and chikungunya results in more severe or additive symptoms.

A

F

33
Q

3-day fever with myalgia and mild arthralgia. Which can you prescribe?

A. paracetamol
B. ibuprofen
C. aspirin
D. celecoxib
E. AOTA
A

A

Do not prescribe NSAIDs or aspirin. Case may be a possible dengue and these drugs are contraindicated.

34
Q

More headache, body ache, and abdominal pain.

A. dengue
B. chikungunya

A

A

OS 217 Infectious Diseases (22 decks)

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