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1
Q

What is the other name for HHV-1?

A

Herpes Simplex Virus - 1 ‘predominantly orofacial’

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2
Q

What is the other name for HHV-2?

A

Herpes simplex virus-2 ‘predominantly genital’

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3
Q

What is the other name for HHV-3?

A

Varicella zoster virus

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4
Q

What is the other name for HHV-4?

A

Epstein-Barr virus

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5
Q

What is the other name for HHV-5?

A

Cytomegalovirus

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6
Q

What is the other name for HHV-6a

A

Roseolovirus

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7
Q

What is the other name for HHV-6b

A

Herpes lymphotropic virus

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8
Q

What is the other name for HHV-8?

A

Kaposi’s sarcoma-associated herpesvirus

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9
Q

How is HHV-1 transmitted?

A

Muco-cutaneous contact

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10
Q

How is HHV-2 transmitted?

A

Muco-cutaneous contact

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11
Q

Where does persistent latent HHV1/2 reside?

A

Neural ganglia

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12
Q

What is a herpetic whitlow?

A

Lesion on fingers/hands caused by HSV

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13
Q

What are the signs/symptoms of herpes genitalis?

A

clusters of inflamed papules and vesicles

outer surface of genitals

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14
Q

When are you worried about a HSV infection during pregnancy?

A

A primary outbreak in the 3rd trimester

mother unlikely to have developed protective maternal antibodies to pass onto child in time

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15
Q

What is the treatment for primary HSV infection during pregnancy?

A

1st and 2nd trimester = oral/IV aciclovir for 5 days/until lesions stop forming
Last 4 weeks of pregnancy offer antiviral therapy.

Usually want to deliver by cesarean.

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16
Q

What is Mollaret’s meningitis?

A

A benign recurrent lymphocytic meningitis associated with HSV infection

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17
Q

Skin scrapings demonstrate multinucleated giant cells. What could the condition be?

A

HSV
VZV or HZV
Pemphigus vulgaris
CMV

This is known as the Tzanck test and the multinucleated giant cells are Tzanck cells

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18
Q

When is the fetus at greatest risk of developing neonatal varicella?

A

Exposure to infection 7 days before delivery

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19
Q

If a pregnant woman who is not immune to VZV and she has had a significant exposure, what should be the managment?

A

Offer varicella-zoster immunoglobulin as soon as possible

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20
Q

When is varicella-zoster immunoglobulin most effective?

A

Within 10 days of exposure

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21
Q

When should you not use varicella-zoster immunoglobulin?

A

Once a chickenpox rash has developed in a pregnant woman.

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22
Q

What treatment could you use for a pregnant woman who has developed chickenpox and what are the requirements in terms of presentation and gestation?

A

Oral aciclovir

if present within 24 hours of rash onset, ideally 20 weeks or more but can use it whenever.

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23
Q

What should a new mother with chickenpox be advised regarding breastfeeding her newborn?

A

She can breastfeed if she wishes to and is well enough to do so.

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24
Q

What are the signs/symptoms of Reye’s syndrome and what causes it?

A

Rash, vomiting, liver damage.

Post-viral, aspirin use in children.

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25
Q

What causes Ramsay Hunt syndrome type 2 and what are the signs/symptoms?

A

Reactivation of herpes zoster in the geniculate ganglion.

Triad: ipsilateral facial paralysis, ear pain and vesicles in the auditory canal/auricle

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26
Q

A 1 year old child develops a sudden high fever which lasts for a few days. A few days after the fever subsides a red rash appears - blanching rose-pink spots affecting the trunk, non-itchy/tender or blistering.

A

Roseola

  • High fever for 3-5 days
  • URTI
  • Irritability and tiredness
  • Rash around day 3-5 as fever subsides (small reddish spots that blanch, mainly trunk, fade away shortly)
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27
Q

What is the treatment for roseola?

A

Rest
maintain fluid intake
paracetamol for fever

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28
Q

14-3-3 protein is found on CSF analysis, what condition does this indicate?

A

CJD

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29
Q

MRI shows high signal intensity in the posterior thalamus on T2 weighted images, the radiologist murmurs something about the pulvinar sign. What condition does this indicate?

A

CJD - a/w pulvinar sign

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30
Q

What is the normal appearance of CSF?

A

Clear and colourless

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31
Q

What is the normal WCC of CSF?

A

0-5 - all lymphocytes, no neutrophils

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32
Q

What is the normal protein level in CSF?

A

0.2 - 0.4 or less than 1% of the serum protein concentration

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33
Q

What is the normal glucose level of CSF?

A

3.3 - 4.4 or greater than 60% of

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34
Q

What’s a normal opening pressure of CSF?

A

70 - 180 mmH20

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35
Q

The following CSF results come back:

  • Cloudy
  • Raised lymphocytes with polymorphs
  • Very high protein
  • Low glucose
A

Bacterial meningitis

will show WCC with neutrophils/polymorphs

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36
Q

The following CSF results come back:

  • Normal appearance
  • Raised lymphocytes
  • Mildly raised protein
  • Normal glucose
A

Viral meningitis

protein can be normal/raised. Glucose can be normal/low

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37
Q

The following CSF results come back:

  • Slightly cloudy
  • Raised lymphocytes
  • Very high protein
  • Very low glucose
A

Tuberculous meningitis

appears normal/cloudy, protein high/very high

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38
Q

The following CSF results come back:

  • blood-stained
  • normal WCC
  • normal protein
  • normal glucose
A

Subarachnoid Haemorrhage

Protein can be normal/high. Glucose can be normal/low.

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39
Q

The following CSF results come back:

  • Normal appearance
  • Noraml WCC
  • Normal protein which rises over the next 7 days
  • Normal glucose
A

Guillan-Barre Syndrome

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40
Q

The following CSF results come back:

  • Normal appearance
  • Raised lymphocytes
  • High protein
  • Normal glucose
  • Oligoclonal bands and IgG
A

Multiple Sclerosis

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41
Q

The antiviral which is given to untreated pregnant women with HIV to prevent vertical transmission of the virus during childbirth.

A

Nevirapine ( a non-nucleoside RTI)

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42
Q

How is Oseltamivir administered and what strains of influenza does it treat?

A

influenza A and B

Oral

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43
Q

What is Ribavirin used to treat?

A

RSV infection

Hepatitis C infection

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44
Q

What is aciclovir’s mechanism of action?

A

Viral thymidine converts aciclovir to aciclovir monophosphate.

Host cells convert ACV-MP to ACV triphosphate.

ACV-triphosphate competitively inhibits and inactivates HSV-specified DNA polymerases

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45
Q

What is zidovudine used for?

A

HAART and PEP

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46
Q

What is Entecavir used in the treatment of?

A

Hepatitis B

47
Q

Uses of nevirapine?

A

HIV - mother-to-child transmission

48
Q

Uses of foscarnet?

A

HSV 1 + 2, drug-resistant CMV (and CMV retinitis)

49
Q

Use of cidofovir?

A

CMV retinits

50
Q

Paul Bunnell

A

Glandular Fever

51
Q

Primary stomatitis

52
Q

A herpes virus causing pneumonitis

53
Q

Cause of herpes gladiatorum

54
Q

Other name for exanthem subitum?

55
Q

Acute necrotising viral encephalitis

56
Q

Cause of mollaret’s meningitis?

57
Q

Alpha herpes virus

A

Neurotropic

58
Q

beta herpes virus

A

Epiethliotropic

59
Q

Gamma herpes virus

A

Lymphotropic

60
Q

Alternative if penicillin allergic?

A

Erythromycin

61
Q

long term prophylaxis for post-splenectomy patients?

A

Penicillin V

62
Q

Pregnant or breastfeeding with active TB

63
Q

Contacts of people with TB

64
Q

Ghon focus

65
Q

Rich focus

66
Q

Auramine-rhodamine stain is reddish-yellow fluorescence

A

Acid-fast

mycobacterium usually, like TB

67
Q

TB treatment

Side effect: Raised transaminase, CP450, orange secretions

A

Rifampacin

68
Q

TB treatment

Side effect: peripheral neuropathy and hepatotoxicity

69
Q

TB treatment

Side effect: hyperuricaemia and hepatotoxicity

A

Pyrazinamide

70
Q

Tb treatment

Side effect: optic neuritis, visual disturbances

A

Ethambutol (E for eye!)

71
Q

Treatment multibacillary leprosy

A

Dapsone
Cofazimine
Rifampicin

72
Q

Ziehl-neelson = blue

positive or negative?

73
Q

Ziehl-neelson = red

positive or negative?

74
Q

Rusty sputum
Lobar consolidation cxr
Gram positive diplococcous

A

S. pneumonia

75
Q

Smoker
COPD
pnemonia
Gram negative cocco-bacilli

A

H. influenza

76
Q

Smoker
Pneumonia
Gram negative coccus

A

M. catarrhalis

77
Q

Post-influenza
cavitation on CXR
gram positive in clusters

78
Q 
Alcoholism
elderly
pneumonia
haemoptysis
gram negative rod enterobacter
A

K. pneumonia

79
Q 
Travel
pneumonia
Air con
Water towers
hepatitis
low sodium
A

Legionella pneumophilia

80
Q 
Systemic symptoms
pneumonia
joint pain
cold agllutinin
erythema multiforme
A

Mycoplasma pneumonia

81
Q

whooping cough

travelling community

A

bordatella pertussis

82
Q

Streptococcus
Dark green agar under colony
“green haemolysis”

A

Alpha-haemolytic

  • S. pneumoniae
  • viridans streptococci
83
Q

Streptococcus
complete haemolysis
agar appears lightened yellow and transparent

A

Beta-haemolytic
Group A strep (aka pyogenes)
Group B strep

84
Q

Alpha haemolytic strep that is optochin sensitive

A

S. pneumoniae

85
Q

Alpha haemolytic strep that is optochin resistant

A

S. viridans

86
Q

Organisms that post-splenectomy patients are at risk of?

A

H. influenza
S. pneumonia
N. meningitidis

87
Q

Mild-moderate community acquired classical pneumonia treatment

A

Amoxicillin or a macrolide if resistant

88
Q

moderate-severe community acquired classical pneumonia

A

Clarithromycin + co-amoxiclav/cefuroxime

89
Q

Treatment of atypical community acquired pneumonia

A

macrolide/tetracycline

90
Q

Community acquired legionella pneumonia treatment

A

Macrolide and rifampicin

91
Q

Community acquired staph aureus pneumonia treatment

A

Flucloxacillin

92
Q

Hospital acquired MRSA pneumonia treatment

A

Vancomycin

93
Q

Hospital acquired Pseudomonas pneumonia treatment

A

Piperacillin and tazobactam

94
Q 
Snail track oral ulcers 
Uveitis
Alopecia 
Low grade fever
Maculo-papular rash on palms and soles 
A cranial nerve palsy
A

Secondary syphilis

95
Q

bilateral small pupils that reduce in size to near objects and that do not constrict when exposed to bright light

A

Argyll-Robertson pupil

96
Q

Treatment for syphillis

A

IM Benzathine Penicillin

97
Q

Jarisch-Herxheimer reaction

A

reaction to endotoxin-like products released by the death of harmful microorganisms within the body during antibiotic treatment

usually associated with penicillin treatment of syphillis

98
Q

Temperature greater than 38.3C on several occasions
More than 3 weeks illness
failure to reach a diagnosis after one week of inpatient investigation

A

Pyrexia of Unknown origin

99
Q

Accumulation of mutations within the genes that code for antibody-binding sites in viruses. Results in new strain of virus

A

Antigenic drift

100
Q

Two or more different strains of virus combine to form a new subtype.

A

Antigenic shift

101
Q

Influenza:

Catalyses sialic acid residues exposing host cell receptors and disrupting mucin barrier

A

Neuraminidase

102
Q

Influenza:

Facilitates entry of the viral genome into the target cells by causing the fusion of host endosomal membrane with the viral membrane .

A

Haemagglutinin

103
Q 
Retinitis
Colitis
Hepatitis
Encephalitis
Pneumonitis
A

CMV effects ‘RCHEP’

104
Q

Pyrophosphate analogue

Used to treat HSV or CMV that is drug resistant

105
Q

Treatment for CMV retinitis!

106
Q

Treatment for Hep B Virus

A

PegINF alpha 2a
Entecavir
Tenofovir

107
Q

Mechanism of action of zanamivir

A

Neuraminidase inhibitor - influenza

108
Q

Mechanism of action of oseltamivir

A

Neuraminidase inhibitor

109
Q

Influenza mechanism of amantadine?

A

M2 proton channel interference

110
Q

This guanosine analogue is used in treatment of severe RSV infection and often in combo with pegIFN alfa2a.

111
Q

Cause of hairy leukoplakia in HIV patients

A

Epstein-Barr virus

112
Q

Virus associated with causing castleman’s diseaes

113
Q

Uncontrolled proliferation of B cell lymphocytes latently infected with EBV

A

Post-transplant lymphoproliferative disease

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