neuro quick memo Flashcards
acute treatment of migraines?
NSAIDS, triptans, dihydroergotamine
3 things adenovirus cause?
Tonsillitis, hemorrhagic cystitis, viral conjunctivitis
Distinguish rash of measles, parvo and roseola?
roseola is post fever and spares face, measles is with fever and on face, parvo is on face
where does EBV lay latent?
B cells
Tx for cluster HA
acutely - sumatriptan, O2
prophylaxis - verapamil
prophylactic treatment of migraines?
b-blockers (propanolol), Ca-channel blockers (verapamil), anti-epileptic drugs (topiramate, valproate), and tri-cyclic antidepressants (amitryptaline)
congenital rubella and CMV present with what rash?
blueberry muffin -
What type of virus is polyoma?
naked, round, double-stranded DNA
Describe the classic appearance of CMV on histo?
Owl Eyes
name two brain tumors with elevated GFAP
Pilocytic Astrocytoma and GBM - both tumors of astrocytes
How does HPV work?
disrupts regulation of cell cycle with proteins E6 and E7 which promote proteolysis of p53 and Rb, respectively
Tell me about HPV 6, 11
Laryngeo papillomatosis (tumors develop in airway), acquired in birth; ano-genital warts “condyloma accuminata”, sexual transmission
how do you differentiate esophagitis due to CMV vs herpes?
CMV = singular, deep; HSV= multiple and shallow
what does HPV look like?
naked double stranded DNA virus
describe molluscum contagiosum
flesh-colored, dome-shaped, umbilicate lesions
What can EBV cause in HIV patients?
Oral hairy leukoplakia
Tell me about HPV 1-4
verruca vulgaris = general warts through physical contact
Tell me about HPV 16, 18, and 31, 33 (add 15 to previous pair)
anogenital CA (anal, vulvar, vaginal, penile, cervix)
VZV in kids?
chicken pox - vesicular lesion with surrounding erythema (like HSV) in different stages
HIV patients at risk of CMV when?
CD4 <50
Person comes in with post-coital bleeding, what are you concerned about?
cervical CA due to HPV 16, 18
What type of B cell lymphoma can HHV8 cause?
primary effusion lymphoma
What type of cells are bad on a pap smear?
Koliocytes - squamous cells w/morphological changes due to HPV “blue sunny side up eggs”
populations susceptible to HHV8?
AIDS/immunocompromised, elderly russian men, endemic in africa
What two viruses can cause hemorrhagic cystitis?
Adenovirus (young boys, go to swimming pools) and BK polyoma virus (transplant patients)
which two viruses can lead to intracranial calcifications in a baby?
CMV and toxoplasmosis
types of pox infections?
smallpox, cowpox, molluscum contagiosum
how do you differentiate herpes vs smallpox rash?
smallpox all at same stage, whereas herpes will have some vesicles and some blisters
is CMV the most common fetal viral infection and cause of sensorineural hearing loss in infants?
YES
Roseola vs measles
measles = fever and rash at same time, rash on face
Which disease is associated with condyloma lata?
Syphilis
What may PML look like on MRI?
MS b/c multifocal demyelinating
what do they look like and where are the lesions of kaposi sarcoma?
violet due to angiogenesis - (dysregulation of VEGF); nose, extremities, mucous membranes (GI tract, gingiva, hard pallet)
which two viruses are multi-nucleate gian cells on tzanck smear?
HSV and VZV
whats on DDx for Kaposi Sarcoma?
bacillary angiomatosis (neutrophilic infiltrate rather than lymphocytic, b/c bacteria)
Who is likely to get adenovirus?
droplet and fecal-oral spread: kids, military recruits, public-pool users
EBV associated with what 3 types of CA?
HL (reed steinbergy owl eyes), Burkitt Lymphoma, nasophayngeal carcinoma (asian ancestry)
What does monospot look for?
agglutination of ab in presence of sheep or horse red blood cells
What causes progressive multifocal leukoencephalopathy (PML-demyelinating disease of CNS)
JC virus, affects those with CD4 <200
What is the most common infection in adenoids and tonsils?
Adenovirus
Which virus in the herpes family causes Kaposi Sarcoma?
HHV8
Where can CMV hide latent?
B and T lymphocytes and macrophages
EBV vs CMV mono-nucleosis?
Monospot!
EBV incites what type of response?
CD8 T cells, can see downey cells on histo
how do you describe the parvovirus rash?
slapped-cheek rash
Other names for parvo?
Fifths disease, slapped-cheek fever, erythema infectiosum
how can HHV6 (roseola) cause immunosuppression?
Infecting CD4 cells, killing them off and thereby weakening immune system
Roseola - when does rash start and what does it look like?
Once fever goes down after 4 days, and diffuse body sparing the face
Tx for CMV
Ganciclovir, then Foscarnet
list the DNA viruses
HSV1&2, EBV, VZV, adenovirus, parvovirus, HHV8, HPV, poxvirus, polyomavirus, HHV6/roseola virus, EBV, CMV, Hepatitis B
where does VZV remain latent?
dorsal root ganglia
What’s unique about pox virus?
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
Which viruses does guardasil vaccinate against?
6, 11, 16, 18
