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Pathology > Mi - Opportunistic Viral Infections > Flashcards

Mi - Opportunistic Viral Infections Flashcards

1
Q

Egs of AIDs defining illnesses

A

CMV retiinitis
HSV oesophagi’s/bronchitis/pneumonitis
Kaposi’s
Burkitt’s lymphoma
Progressive multifocal leukoencephalopathy

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2
Q

JC virus in an immunocompromised patient –>

A

Progressive multifocal leukoencephalopathy

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3
Q

In BMT patients, why are they so immunocompromised?

A

Continuous immunosuppression to prevent GvHD

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4
Q

Immunosuppressive treatments:
Depleting antibody treatment?
Non-depleting antibody treatment?

A

Depleting: Rituximab (antiCD20)
Non-depleting: Basiliximab (antiCD25)

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5
Q

In a patient who is post-BMT, which lab investigation result would make you suspicious of an opportunistic infection?

A

Raised transaminases (AST/ALT)

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6
Q

Which lab investigation is pointless in identifying presence of opportunistic infection in a post-BMT patient? therefore which investigation should you request?

A

Serology (pt can’t yet amount an immune response)

  • viral PCR or rapid Ag test
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7
Q

3 routes of viral infection in transplant patients

A

1) From the GRAFT
2) immunosuppression –> REACTIVATION
3) immunosuppression –> INFECTION from outside

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8
Q

Name 2 herpes viruses which reside in WBCs?

A

EBV
CMV

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9
Q

When does HSV tend to affect transplant patients?

A

<1 month Post-transplant

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10
Q

How can HSV reactivation be prevented in transplant patients?

A

Acyclovir prophylaxis

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11
Q

In solid organ transplantation, what kind of CMV serology is at highest risk of CMV infection in recipient

A

Donor +
Recipient -

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12
Q

In bone marrow transplantation, what kinda serology is at highest risk of CMV infection

A

Donor -
Recipient + (as chemo/radio wipes out the recipient’s antibodies)

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13
Q

CMV prophylaxis in solid organ transplant patients?

A

Valganciclovir for 10 days

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14
Q

How is potential CMV infection monitored in bone marrow transplantation patients?

A

CMV viral load monitoring and treated when it rises

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15
Q

1st line tx of CMV infection

A

Vancyclovir

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16
Q

2nd line tx of CMV infection

A

Foscarnet

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17
Q

which Ix confirms post transplant lymphoproliferative disease

A

Lymph node biopsy (+ viral load)

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18
Q

Post-transplant lymphoproliferative disease - responsible virus?

A

EBV

19
Q

Progressive multifocal leukoencephalopathy
- Cause?
- Pathology?

A

JC virus
Demyelination of white matter

20
Q

Haemorrhagic cystitis in a post-transplant patient : potential causative organism?

A

BK virus

21
Q

Transmission of Hepatitis E

A

Undercooked meat (+blood transfusion??)

22
Q

Viral classification system? What is it based on?

A

Baltimore - how viruses replicate, whether DNA or RNA

23
Q

Definition of opportunistic virus

A

Doesn’t affect an immunocompetent person, but will to an immunocompromised person

24
Q

What does IgM presence mean?

A

Active infection

25
Q

What does IgG presence mean?

A

Previous infection in last 6 weeks

26
Q

How do you directly detect a virus?

A

PCR

27
Q

Which HIV patients are most at risk of bad CMV?

A

If CD4 <200

28
Q

Tx of HSV in immunocompromised pt?

A

Prophylaxis - HSV Ig test

29
Q

Tx of VZV in immunocompromised patients?

A

7-10 days antivirals if chicken pox
Antiviral IV if disseminated +/- steroids

30
Q

Complications of EBV

A

Oncogenic - PTLD or B cell lymphoma

31
Q

Dx of EBV?

A

biopsy lymph nodes

32
Q

What drug may work for EBV?

A

Rituximab

33
Q

CMV Sx

A

Retinitis, polyradiculopathy, pneumonitis, encephalitis, GI disease

34
Q

Which HIV pts get CMV?

A

If CD4 <50 (very low)

35
Q

Which hepatitis virus is this: severe, vaccinate against?

A

A

36
Q

Which hepatitis virus is this: reactivation, only occurs in presence of hep D, vaccinate or prophylaxis against?

A

B

37
Q

Which hepatitis virus is this: causes fibrosis. Can give antivirals for a potential cure?

A

C

38
Q

Which hepatitis virus is this: chronic infection, need to reduce immunosuppression as no cure?

A

E

39
Q

What is this persons hepatitis status: sAg+ eAg+ IgM+?

A

Current infection

40
Q

What is this persons hepatitis status: sAb+ eAB+?

A

Prior infection & immune

41
Q

What is this persons hepatitis status: sAb+ eAb-?

A

Vaccinated

42
Q

Mx of monkey pox?

A

Isolation
Small pox vaccine (low stock)
Tecovirimat if very severe (££££)
Screen for STDs inc HIV
Inform UKHSA

43
Q

Sx of monkeypox

A

Systemic illness eg fever
Atypical rash on genitals

Pathology (87 decks)

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