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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
What causes Ramsay Hunt syndrome type 2 and what are the signs/symptoms?
Reactivation of herpes zoster in the geniculate ganglion. Triad: ipsilateral facial paralysis, ear pain and vesicles in the auditory canal/auricle
26
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.
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)
27
What is the treatment for roseola?
Rest maintain fluid intake paracetamol for fever
28
14-3-3 protein is found on CSF analysis, what condition does this indicate?
CJD
29
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?
CJD - a/w pulvinar sign
30
What is the normal appearance of CSF?
Clear and colourless
31
What is the normal WCC of CSF?
0-5 - all lymphocytes, no neutrophils
32
What is the normal protein level in CSF?
0.2 - 0.4 or less than 1% of the serum protein concentration
33
What is the normal glucose level of CSF?
3.3 - 4.4 or greater than 60% of
34
What's a normal opening pressure of CSF?
70 - 180 mmH20
35
The following CSF results come back: - Cloudy - Raised lymphocytes with polymorphs - Very high protein - Low glucose
Bacterial meningitis | will show WCC with neutrophils/polymorphs
36
The following CSF results come back: - Normal appearance - Raised lymphocytes - Mildly raised protein - Normal glucose
Viral meningitis | protein can be normal/raised. Glucose can be normal/low
37
The following CSF results come back: - Slightly cloudy - Raised lymphocytes - Very high protein - Very low glucose
Tuberculous meningitis | appears normal/cloudy, protein high/very high
38
The following CSF results come back: - blood-stained - normal WCC - normal protein - normal glucose
Subarachnoid Haemorrhage Protein can be normal/high. Glucose can be normal/low.
39
The following CSF results come back: - Normal appearance - Noraml WCC - Normal protein which rises over the next 7 days - Normal glucose
Guillan-Barre Syndrome
40
The following CSF results come back: - Normal appearance - Raised lymphocytes - High protein - Normal glucose - Oligoclonal bands and IgG
Multiple Sclerosis
41
The antiviral which is given to untreated pregnant women with HIV to prevent vertical transmission of the virus during childbirth.
Nevirapine ( a non-nucleoside RTI)
42
How is Oseltamivir administered and what strains of influenza does it treat?
influenza A and B | Oral
43
What is Ribavirin used to treat?
RSV infection | Hepatitis C infection
44
What is aciclovir's mechanism of action?
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
45
What is zidovudine used for?
HAART and PEP
46
What is Entecavir used in the treatment of?
Hepatitis B
47
Uses of nevirapine?
HIV - mother-to-child transmission
48
Uses of foscarnet?
HSV 1 + 2, drug-resistant CMV (and CMV retinitis)
49
Use of cidofovir?
CMV retinits
50
Paul Bunnell
Glandular Fever
51
Primary stomatitis
HSV-1
52
A herpes virus causing pneumonitis
CMV
53
Cause of herpes gladiatorum
HSV-1
54
Other name for exanthem subitum?
Roseola
55
Acute necrotising viral encephalitis
HSV 1
56
Cause of mollaret's meningitis?
HSV 2
57
Alpha herpes virus
Neurotropic
58
beta herpes virus
Epiethliotropic
59
Gamma herpes virus
Lymphotropic
60
Alternative if penicillin allergic?
Erythromycin
61
long term prophylaxis for post-splenectomy patients?
Penicillin V
62
Pregnant or breastfeeding with active TB
Isoniazid
63
Contacts of people with TB
Isoniazid
64
Ghon focus
TB
65
Rich focus
TB
66
Auramine-rhodamine stain is reddish-yellow fluorescence
Acid-fast | mycobacterium usually, like TB
67
TB treatment | Side effect: Raised transaminase, CP450, orange secretions
Rifampacin
68
TB treatment | Side effect: peripheral neuropathy and hepatotoxicity
Isoniazid
69
TB treatment | Side effect: hyperuricaemia and hepatotoxicity
Pyrazinamide
70
Tb treatment | Side effect: optic neuritis, visual disturbances
Ethambutol (E for eye!)
71
Treatment multibacillary leprosy
Dapsone Cofazimine Rifampicin
72
Ziehl-neelson = blue positive or negative?
negative
73
Ziehl-neelson = red positive or negative?
positive
74
Rusty sputum Lobar consolidation cxr Gram positive diplococcous
S. pneumonia
75
Smoker COPD pnemonia Gram negative cocco-bacilli
H. influenza
76
Smoker Pneumonia Gram negative coccus
M. catarrhalis
77
Post-influenza cavitation on CXR gram positive in clusters
S. aureus
78
``` Alcoholism elderly pneumonia haemoptysis gram negative rod enterobacter ```
K. pneumonia
79
``` Travel pneumonia Air con Water towers hepatitis low sodium ```
Legionella pneumophilia
80
``` Systemic symptoms pneumonia joint pain cold agllutinin erythema multiforme ```
Mycoplasma pneumonia
81
whooping cough | travelling community
bordatella pertussis
82
Streptococcus Dark green agar under colony "green haemolysis"
Alpha-haemolytic - S. pneumoniae - viridans streptococci
83
Streptococcus complete haemolysis agar appears lightened yellow and transparent
Beta-haemolytic Group A strep (aka pyogenes) Group B strep
84
Alpha haemolytic strep that is optochin sensitive
S. pneumoniae
85
Alpha haemolytic strep that is optochin resistant
S. viridans
86
Organisms that post-splenectomy patients are at risk of?
H. influenza S. pneumonia N. meningitidis
87
Mild-moderate community acquired classical pneumonia treatment
Amoxicillin or a macrolide if resistant
88
moderate-severe community acquired classical pneumonia
Clarithromycin + co-amoxiclav/cefuroxime
89
Treatment of atypical community acquired pneumonia
macrolide/tetracycline
90
Community acquired legionella pneumonia treatment
Macrolide and rifampicin
91
Community acquired staph aureus pneumonia treatment
Flucloxacillin
92
Hospital acquired MRSA pneumonia treatment
Vancomycin
93
Hospital acquired Pseudomonas pneumonia treatment
Piperacillin and tazobactam
94
``` Snail track oral ulcers Uveitis Alopecia Low grade fever Maculo-papular rash on palms and soles A cranial nerve palsy ```
Secondary syphilis
95
bilateral small pupils that reduce in size to near objects and that do not constrict when exposed to bright light
Argyll-Robertson pupil
96
Treatment for syphillis
IM Benzathine Penicillin
97
Jarisch-Herxheimer reaction
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
Temperature greater than 38.3C on several occasions More than 3 weeks illness failure to reach a diagnosis after one week of inpatient investigation
Pyrexia of Unknown origin
99
Accumulation of mutations within the genes that code for antibody-binding sites in viruses. Results in new strain of virus
Antigenic drift
100
Two or more different strains of virus combine to form a new subtype.
Antigenic shift
101
Influenza: Catalyses sialic acid residues exposing host cell receptors and disrupting mucin barrier
Neuraminidase
102
Influenza: Facilitates entry of the viral genome into the target cells by causing the fusion of host endosomal membrane with the viral membrane .
Haemagglutinin
103
``` Retinitis Colitis Hepatitis Encephalitis Pneumonitis ```
CMV effects 'RCHEP'
104
Pyrophosphate analogue | Used to treat HSV or CMV that is drug resistant
Foscarnet
105
Treatment for CMV retinitis!
Cidofovir
106
Treatment for Hep B Virus
PegINF alpha 2a Entecavir Tenofovir
107
Mechanism of action of zanamivir
Neuraminidase inhibitor - influenza
108
Mechanism of action of oseltamivir
Neuraminidase inhibitor
109
Influenza mechanism of amantadine?
M2 proton channel interference
110
This guanosine analogue is used in treatment of severe RSV infection and often in combo with pegIFN alfa2a.
Ribavirin
111
Cause of hairy leukoplakia in HIV patients
Epstein-Barr virus
112
Virus associated with causing castleman's diseaes
HHV8
113
Uncontrolled proliferation of B cell lymphocytes latently infected with EBV
Post-transplant lymphoproliferative disease

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