neuro quick memo

Question 1

acute treatment of migraines?

Answer 1

NSAIDS, triptans, dihydroergotamine

Question 2

3 things adenovirus cause?

Answer 2

Tonsillitis, hemorrhagic cystitis, viral conjunctivitis

Question 3

Distinguish rash of measles, parvo and roseola?

Answer 3

roseola is post fever and spares face, measles is with fever and on face, parvo is on face

Question 4

where does EBV lay latent?

Answer 4

B cells

Question 5

Tx for cluster HA

Answer 5

acutely - sumatriptan, O2

prophylaxis - verapamil

Question 6

prophylactic treatment of migraines?

Answer 6

b-blockers (propanolol), Ca-channel blockers (verapamil), anti-epileptic drugs (topiramate, valproate), and tri-cyclic antidepressants (amitryptaline)

Question 7

congenital rubella and CMV present with what rash?

Answer 7

blueberry muffin -

Question 8

What type of virus is polyoma?

Answer 8

naked, round, double-stranded DNA

Question 9

Describe the classic appearance of CMV on histo?

Answer 9

Owl Eyes

Question 10

name two brain tumors with elevated GFAP

Answer 10

Pilocytic Astrocytoma and GBM - both tumors of astrocytes

Question 11

How does HPV work?

Answer 11

disrupts regulation of cell cycle with proteins E6 and E7 which promote proteolysis of p53 and Rb, respectively

Question 12

Tell me about HPV 6, 11

Answer 12

Laryngeo papillomatosis (tumors develop in airway), acquired in birth; ano-genital warts “condyloma accuminata”, sexual transmission

Question 13

how do you differentiate esophagitis due to CMV vs herpes?

Answer 13

CMV = singular, deep; HSV= multiple and shallow

Question 14

what does HPV look like?

Answer 14

naked double stranded DNA virus

Question 15

describe molluscum contagiosum

Answer 15

flesh-colored, dome-shaped, umbilicate lesions

Question 16

What can EBV cause in HIV patients?

Answer 16

Oral hairy leukoplakia

Question 17

Tell me about HPV 1-4

Answer 17

verruca vulgaris = general warts through physical contact

Question 18

Tell me about HPV 16, 18, and 31, 33 (add 15 to previous pair)

Answer 18

anogenital CA (anal, vulvar, vaginal, penile, cervix)

Question 19

VZV in kids?

Answer 19

chicken pox - vesicular lesion with surrounding erythema (like HSV) in different stages

Question 20

HIV patients at risk of CMV when?

Answer 20

CD4 <50

Question 21

Person comes in with post-coital bleeding, what are you concerned about?

Answer 21

cervical CA due to HPV 16, 18

Question 22

What type of B cell lymphoma can HHV8 cause?

Answer 22

primary effusion lymphoma

Question 23

What type of cells are bad on a pap smear?

Answer 23

Koliocytes - squamous cells w/morphological changes due to HPV “blue sunny side up eggs”

Question 24

populations susceptible to HHV8?

Answer 24

AIDS/immunocompromised, elderly russian men, endemic in africa

Question 25

What two viruses can cause hemorrhagic cystitis?

Answer 25

Adenovirus (young boys, go to swimming pools) and BK polyoma virus (transplant patients)

Question 26

which two viruses can lead to intracranial calcifications in a baby?

Answer 26

CMV and toxoplasmosis

Question 27

types of pox infections?

Answer 27

smallpox, cowpox, molluscum contagiosum

Question 28

how do you differentiate herpes vs smallpox rash?

Answer 28

smallpox all at same stage, whereas herpes will have some vesicles and some blisters

Question 29

is CMV the most common fetal viral infection and cause of sensorineural hearing loss in infants?

Answer 29

YES

Question 30

Roseola vs measles

Answer 30

measles = fever and rash at same time, rash on face

Question 31

Which disease is associated with condyloma lata?

Answer 31

Syphilis

Question 32

What may PML look like on MRI?

Answer 32

MS b/c multifocal demyelinating

Question 33

what do they look like and where are the lesions of kaposi sarcoma?

Answer 33

violet due to angiogenesis - (dysregulation of VEGF); nose, extremities, mucous membranes (GI tract, gingiva, hard pallet)

Question 34

which two viruses are multi-nucleate gian cells on tzanck smear?

Answer 34

HSV and VZV

Question 35

whats on DDx for Kaposi Sarcoma?

Answer 35

bacillary angiomatosis (neutrophilic infiltrate rather than lymphocytic, b/c bacteria)

Question 36

Who is likely to get adenovirus?

Answer 36

droplet and fecal-oral spread: kids, military recruits, public-pool users

Question 37

EBV associated with what 3 types of CA?

Answer 37

HL (reed steinbergy owl eyes), Burkitt Lymphoma, nasophayngeal carcinoma (asian ancestry)

Question 38

What does monospot look for?

Answer 38

agglutination of ab in presence of sheep or horse red blood cells

Question 39

What causes progressive multifocal leukoencephalopathy (PML-demyelinating disease of CNS)

Answer 39

JC virus, affects those with CD4 <200

Question 40

What is the most common infection in adenoids and tonsils?

Answer 40

Adenovirus

Question 41

Which virus in the herpes family causes Kaposi Sarcoma?

Answer 41

HHV8

Question 42

Where can CMV hide latent?

Answer 42

B and T lymphocytes and macrophages

Question 43

EBV vs CMV mono-nucleosis?

Answer 43

Monospot!

Question 44

EBV incites what type of response?

Answer 44

CD8 T cells, can see downey cells on histo

Question 45

how do you describe the parvovirus rash?

Answer 45

slapped-cheek rash

Question 46

Other names for parvo?

Answer 46

Fifths disease, slapped-cheek fever, erythema infectiosum

Question 47

how can HHV6 (roseola) cause immunosuppression?

Answer 47

Infecting CD4 cells, killing them off and thereby weakening immune system

Question 48

Roseola - when does rash start and what does it look like?

Answer 48

Once fever goes down after 4 days, and diffuse body sparing the face

Question 49

Tx for CMV

Answer 49

Ganciclovir, then Foscarnet

Question 50

list the DNA viruses

Answer 50

HSV1&2, EBV, VZV, adenovirus, parvovirus, HHV8, HPV, poxvirus, polyomavirus, HHV6/roseola virus, EBV, CMV, Hepatitis B

Question 51

where does VZV remain latent?

Answer 51

dorsal root ganglia

Question 52

What's unique about pox virus?

Answer 52

makes own envelopes, completely replicates in cytoplasm b/c has own DNA-dependent RNA polymerase, Guarnerni bodies (inclusion bodies in cytoplasm, site of viral replication), dumbbell shaped core, largest known DNA virus

Question 53

Which viruses does guardasil vaccinate against?

Answer 53

6, 11, 16, 18