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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

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
Complications of Measles?
Conjunctivitis Otitis media Bronchopneumonia Giant cell pneumonia Encephalitis
26
Mumps complications?
Orchitis Aseptic meningitis
27
Common opportunistic infections in HIV?
**Pneumocystis Jirovecii** Tuberculosis Toxoplasmosis CMV infection Cryptococcus
28
Commonest cause of common cold?
Rhinoviruses
29
Commonest cause of bronchiolitis in kids?
Respiratory syncytial virus
30
What virus serotype causes croup in infants?
Parainfluenza Type 1
31
What virus serotype for bronchiolitis and bronchopneumonia in young?
Parainfluenza Type 3
32
Lab diagnosis of Measles?
IgM assay for recent infection IgG for retrospective diagnosis
33
Immunization for MMR?
Live attenuated vax. 1st dose at 12 months, 2nd dose at 15-18 months Effective lifelong immunity Contraindicated in immunocompromised children and pregnants.
34
Incubation period for MMR?
MEasles 10-14 days Mumps 2-3 weeks Rubella 2-3 weeks
35
Presentation of Infectious Mononucleosis?
Glandular fever Pharyngitis, exudative tonsilitis Lymphadenopathy Hepatosplenomegaly Rash worsened by ampicillin
36
Rubella complications?
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
Incubation period of EBV in Infectious Mononucleosis? EBV transmission?
4-7 weeks Transmitted via close contact - kissing disease
38
Complications of infectious mononucleosis?
Hepatitis - transaminitis Pneumonitis Neurological symptoms = e.g. encephalitis, GBS, Bell's palsy Haemolytic anemia, thrombocytopenia Myopericarditis
39
Epidemiology of Dengue in SG?
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
Pathophysiology of Dengue?
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
Post-recovery immunity of dengue?
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
How does Dengue Haemorrhagic Fever / DSS come about in infants? | Infants btw 6 months - 1 yr
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
How does DHF or DSS come for patients above 1yo?
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
Diagnostics for Dengue?
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
Presentation of Dengue haemorrhagic fever?
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
Lab criteria for Dengue haemorrhagic feveR?
Thrombocytopenia <100k/mm3 Haematocrit raised by >20% of recovery value
47
Presentation of Dengue shock syndrome?
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
What groups of patients show DSS? | 2 groups!
- infants before 1 yo during primary dengue infection - Children above 1yo (Even adults) while having 2nd dengue infection
49
Treatment for Zoster?
Acyclovir 800mg 5x daily for 7 days. Most useful if started within 3 days symptom onset.
50
Spread of VZV?
Airborne and droplets
51
Vaccine for dengue is what type? How many injections? Contraindicated in?
Live attenuated virus vax. 3 injections at 6 month intervals. Contraindicated in pregnancy, breastfeeding, immunocompromised
52
3Cs + rash of Measles?
Corynza Conjunctivitis Cough Morbiliform rash (non-blanchable)
53
Herpangina vs HFMD?
Usu due to Coxsackie A. Herpangina only causes mouth ulcers. Solves in 7-10 days. Transmitted fecal-orally or airborne.
54

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