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Non Hep Viruses Flashcards

1
Q

Varicella condition name?

A

Chickenpox

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2
Q

Primary signs of Varicella?

A

Fever
Crops of vesicles in waves and more on trunk than extremeties

VZV should recover in 7-10 days

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3
Q

Spread of Varicella?

A

Contact with skin lesions of Varicella
Droplet infection from saliva

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4
Q

Complications of Varicella?

A

Haemorrhage
Aseptic arthritis
Pneumonia
Post-infectious encephalomyelitis
Congenital Varicella
Neurological syndrome
Skin superinfection
Keratitis - vesicles, epistaxis
Corneal ulcers - blindness

HAPE CNS

Uncomplicated VZV should recover in 7-10 days

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5
Q

In varicella, Pain can come before rash. No rash yet, but got unexplained pain. Correct?

A

Yes. Must suspect when pain is vague and unexplained. Send pt home and observe closely.

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6
Q

Important complication for VZV?

A

Post-herpetic neuralgia. 20% of VZV pts can have.
Treat with analgesia - gabapentin

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7
Q

Previous infections with varicella confer life-long immunity to varicella but not zoster?

A

Yes

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8
Q

Treatment and Vaccine for Varicella?

A

Acyclovir
Live attenuated vaccines

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9
Q

Zoster signs?

A

Vesicles - recurrent infection

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10
Q

Why does Zoster occur

A

Occur in dermatome of sensory nerve ganglion due to reactivation of latent VZV.
Usually long after childhood Varicella.

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11
Q

Signs of Zoster?

A

Painful vesicular eruption similar to Varicella

Thoracic root ganglia has 50% - Belt of Roses

If geniculate ganglion affected then Ramsay-Hunt Syndrome -> Facial nerve palsy

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12
Q

How to know VZV is not infectious anymore?

A

No new lesions means no longer infectious

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13
Q

Complications of Zoster?

A

Encephalomyelitis
Post-herpetic neuralgia
Disseminated zoster, vesicles outside involved dermatomes.

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14
Q

CMV symptoms

A

Guillaine-Barre Syndrome
Cytomegalic inclusion disease - every single organ affected in every way.
Affected organs show enlarged cells with large intranuclear “Owl’s eye” inclusions
Postnatal hepatitis - hepatomegaly
Infectious mononucleosis
Immunocompromised infection -> fever, leukopenia, hepatitis, pneumonitis
Congenital CMV infection

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15
Q

CMV transmission?

A

Close contact e.g. sex, urine-hand-mouth
Blood transfusion
Transplacental

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16
Q

CMV treatment?

A

Gancyclovir or Valgancyclovir

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17
Q

Measles symptoms?

A

Koplik’s spots around parotid duct
Maculopapular rash from face and spreads to whole body
Fever, conjunctivitis, rhinorrhea, cough

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18
Q

Mumps symptoms?

A

Salivary gland enlargement, pain aggravated by eating. Especially parotid gland
Tender cervical lymphadenopathy
Orchitis
Aseptic meningitis

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19
Q

Rubella symptoms?

A

Forschheimer’s spots - discrete spots on palate
Rubella rash - small maculopapular lesions from face to trunk and extremities. Lasts abt 3 days
TEnder lymphadenopathy
Often subclinical esp in kids

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20
Q

HIV characteristics

A

Human retrovirus, cause immunodeficiency.
Enveloped
2 copies of positive ssRNA

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21
Q

Important stuff in HIV?

A

gp120
gp41
Reverse Transcriptase

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22
Q

HIV pathogenesis

A
  1. Primary infection -> burst of viremia, transient decline in CD4 cells
  2. Latency -> Immune system fights off virus, low level viremia
  3. Progression to AIDS -> CD4 cell loss outweighs production
23
Q

HIV antibodies only appear after 3-6 months

A

Yes

24
Q

Test for HIV?

A

PCR detect HIV DNA.
ELISA detect HIV antibody.

MUST confirm with Western blot - Ab reaction against viral components

25
Q

Complications of Measles?

A

Conjunctivitis
Otitis media
Bronchopneumonia
Giant cell pneumonia
Encephalitis

26
Q

Mumps complications?

A

Orchitis
Aseptic meningitis

27
Q

Common opportunistic infections in HIV?

A

Pneumocystis Jirovecii
Tuberculosis
Toxoplasmosis
CMV infection
Cryptococcus

28
Q

Commonest cause of common cold?

A

Rhinoviruses

29
Q

Commonest cause of bronchiolitis in kids?

A

Respiratory syncytial virus

30
Q

What virus serotype causes croup in infants?

A

Parainfluenza Type 1

31
Q

What virus serotype for bronchiolitis and bronchopneumonia in young?

A

Parainfluenza Type 3

32
Q

Lab diagnosis of Measles?

A

IgM assay for recent infection
IgG for retrospective diagnosis

33
Q

Immunization for MMR?

A

Live attenuated vax.
1st dose at 12 months,
2nd dose at 15-18 months
Effective lifelong immunity
Contraindicated in immunocompromised children and pregnants.

34
Q

Incubation period for MMR?

A

MEasles 10-14 days
Mumps 2-3 weeks
Rubella 2-3 weeks

35
Q

Presentation of Infectious Mononucleosis?

A

Glandular fever
Pharyngitis, exudative tonsilitis
Lymphadenopathy
Hepatosplenomegaly
Rash worsened by ampicillin

36
Q

Rubella complications?

A

Arthralgia, arthritis. Affects multiple joints when rash subsides.
Encephalitis
Purpura
Congenital Rubella syndrome - teratogenic to fetus esp if intrauterine infection of mother during 1st trimester. Can have stillbirth or birth defects

37
Q

Incubation period of EBV in Infectious Mononucleosis?
EBV transmission?

A

4-7 weeks
Transmitted via close contact - kissing disease

38
Q

Complications of infectious mononucleosis?

A

Hepatitis - transaminitis
Pneumonitis
Neurological symptoms = e.g. encephalitis, GBS, Bell’s palsy
Haemolytic anemia, thrombocytopenia
Myopericarditis

39
Q

Epidemiology of Dengue in SG?

A

Aedes aegypti mosquito is the main vector which is endemic in SG.
4 serotypes/subgroups (DENV-1 to 4): DENV-1 & DENV-2 are the most common in SG

40
Q

Pathophysiology of Dengue?

A

Virus replicates at site of bite and in local lymphatic tissue. Viraemia occurs in a few days

3 phases of dengue
Febrile phase lasting 2-7 days = symptoms start
Critical phase lasting 1-2 days = plasma leakage starts. Pt either gets worse or improves clinically
Convalescent phase lasting 2-4 days = plasma leakage subsides

41
Q

Post-recovery immunity of dengue?

A

For mild dengue:
- Lifelong immunity to specific serotype
- Partial protection from other serotypes for 3-6 weeks. Is then subsequently infection enhancing towards other serotypes
- For DHF: Protected from subsequent 3rd or 4th infections

42
Q

How does Dengue Haemorrhagic Fever / DSS come about in infants?

Infants btw 6 months - 1 yr

A

In primary dengue infection regardless of serotype, Maternal IgG in high lvls protect infants against all serotypes for first 6mths. As maternal IgG degrades, it becomes infection-enhancing for other serotypes.

43
Q

How does DHF or DSS come for patients above 1yo?

A

For pts having second dengue infection with different serotype more than 3-6 weeks after first infection resolves

Ab-dependent enhancement of infectivity mediated by cross-reactive but non-neutralizing dengue viral Abs (formed during primary infection)

44
Q

Diagnostics for Dengue?

A

Dengue duo test!!!
NS1 Antigen, IgM, IgG
Only NS1 +ve means NEW 1st infection
NS1 and IgM +ve means 1st infection, usu within 7 days of symptom onset
All 3 +ve means this is not first dengue infection

Others = LFT showing mild transaminitis,
FBC = platelets, TW

45
Q

Presentation of Dengue haemorrhagic fever?

A

Acute onset high fever lasting 2-7 days
Haemorrhagic manifestations:
- Petechiae, purpura, ecchymosis.
- Epistaxis, gum bleeding
- Haematemesis and/or melena

Hepatomegaly with/wo transaminitis

46
Q

Lab criteria for Dengue haemorrhagic feveR?

A

Thrombocytopenia <100k/mm3
Haematocrit raised by >20% of recovery value

47
Q

Presentation of Dengue shock syndrome?

A

Occurs at time of, or shortly after, fall in temperature, between day 3 and 7 of disease.
Acute abdo pain shortly before shock onset.
Duration of shock is short, and pt can die within 24 hrs or recover.

48
Q

What groups of patients show DSS?

2 groups!

A
  • infants before 1 yo during primary dengue infection
  • Children above 1yo (Even adults) while having 2nd dengue infection
49
Q

Treatment for Zoster?

A

Acyclovir 800mg 5x daily for 7 days.
Most useful if started within 3 days symptom onset.

50
Q

Spread of VZV?

A

Airborne and droplets

51
Q

Vaccine for dengue is what type? How many injections? Contraindicated in?

A

Live attenuated virus vax.
3 injections at 6 month intervals.
Contraindicated in pregnancy, breastfeeding, immunocompromised

52
Q

3Cs + rash of Measles?

A

Corynza
Conjunctivitis
Cough
Morbiliform rash (non-blanchable)

53
Q

Herpangina vs HFMD?

A

Usu due to Coxsackie A.
Herpangina only causes mouth ulcers.
Solves in 7-10 days.
Transmitted fecal-orally or airborne.

54
Q
A

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