Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Virology 2 > Past Papers 4 > Flashcards

Past Papers 4 Flashcards

1
Q

What are clinical features of HHV8 infection?

A

Immunocompetent -
asymptomatic
flu-like illness with maculopapular rash
acute hepatitis
Multicentric Castleman Disease

Immunocompromised -
Kaposi sarcoma
Primary effusion lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is HHV8 transmitted?

A

unclear

saliva likely most common transmission method

also detected in genital secretions

potentially through blood transfusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Patient with HHV8 infection

What infection control measures need to be inplacE?

A

Recommendations do not exist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is vaccine effectiveness?

A

Measure of how much it protects against:

severe disease/ hospital admission/mortality
reducing rate of infection in population
reducing transmission and spread of virus
duration of protection

Can measure in trials by comparing those vaccinated/ not vaccinated
or in real world data following vaccine administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Vaccine effectiveness

What is definition of herd immunity?

A

When a significant portion of a population are immune to an infection. Either by immunisation or prior infection

Once this level of herd immunity is reached, it restricts viral spread through a population, and thereby reduces the risk of a non-immune person developing infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Vaccinating populations

What is the “free riding” problem?

A

Herd immunity should protect those who are vulnerable

however some people decide not to get vaccinated due to various beliefs:
belief vaccines are ineffective
mistrust of healthcare
peer pressure
bandwaggoning
religious beliefs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the components of the innate immune system?

A

Physical barrier - skin, mucusa

Chemical barrier - saliva, tears, stomach acid

Cells -
phagocytic cells - macrophages/ neutrophils
NK cells
lymphoid cells

Complement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Long essay

Compare and contrast the strategies of prophylactic and pre-emptive therapy for CMV infection in solid organ transplant
recipients

A

CMV-seronegative recipients who receive a solid organ transplant from a donor who is seropositive, should be offered prophylaxis against primary infection, using oral valganciclovir, oral valaciclovir or intravenous ganciclovir.

The same should apply where either the donor or recipient is seropositive if the patient is treated with T-cell depleting therapies.

Continue prophylaxis for 3-6 months

If donor and recipient are both seropositive, and patient is not treated with T-cell therapy:

For renal/ liver/ cardiac transplant recipients: no prophylaxis is recommended.
For lung transplant recipients: the recommended prophylactic strategy is oral valganciclovir or oral valaciclovir.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Short answer questions

A 37 year old woman presents to the Accident and Emergency Department with severe respiratory symptoms. She returned two days previously from Viet Nam.

What advice would you give about her management

A

DDx - Avian influenza, COVID, Melioidosis

Patient History - travel, layovers, unwell contacts, activities e.g caves, animals. Check PROMED

IPC - side room with respiratory precautions. FFP3 if avian influenza suspected or aerosol generating procedures. Until diagnosis is understood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Short answer questions

Write short notes on the epidemiology, symptoms, diagnosis and treatment of chikungunya virus

A

Epidemiology - Africa, Asia, Carribbean, South America. Rare cases in south of France

incubation 4-8 days

Symptoms -
fever
polyarticular arthritis - ankles/ wrists most common
maculopapular rash
Aged >65 - more likely to have severe disease, and potentially death

diagnosis - serology/ PCR

management - analgesia

prevention - mosquito avoidance

complications - chronic arthralgia. If severe, can have meningoencephalitis, cardiac failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Short answer questions

Write short notes on the epidemiology, symptoms, diagnosis and treatment of chikungunya virus

  1. What are important differentials to consider?
A

Fever/ arthralgia/ rash

Chikungunya
Dengue
Zika
O’Nyong’Nyong

Malaria
Leptospirosis
Rheumatic fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Short answer questions

Write short notes on the epidemiology, symptoms, diagnosis and treatment of chikungunya virus

  1. Which species of mosquito transmit this?
A

Aedes aegypti

Aedes albopictus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Short answer questions

Discuss the laboratory investigation of immunity to measles, mumps and rubella virus

A

History taking - if history of infection, or appropriate immunisation, then no investigation necessary

Usually scree occupational health, especially from tropics

IgG testing for immunity - Measles/ Rubella - if immune, can assume Mumps immunity

If negative results - susceptible

Equivocal results without history of infection or immunisation, would consider non-immune

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

short answer questions

Discuss the management of a 12 week pregnant woman in contact with her young son who developed a maculopapular rash two days ago

A

History of previous MMR immunisation

does pregnant patient have rash/ fever

any contacts with rash - may have a shared exposure

DDx - parvo virus, measles/ rubella

Parvo - test bloods for IgG/ IgM. If neg, follow up bloods in 4 weeks

Measles/ Rubella - if vaccinated, do not test. If negative, then follow up bloods in 4 weeks to assess if acquired infection

ask

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

short answer questions

Discuss the management of a 12 week pregnant woman in contact with her young son who developed a maculopapular rash two days ago

DDX - Parvo, Rubella, Measles

How long is her son infectious for?

A

Infectious periods

Parvo - 10 days before rash, to day of onset

Rubella - 7 days before rash, to 10 days after onset

Measles - 4 days before rash, to 4 days after onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

short answer questions

A 57 year old man is admitted to hospital with severe headache, fever, confusion, becoming unconscious. Discuss the virological diagnosis and treatment you would recommend

A

History taking - timing of symptoms, travel history, animal exposure, sexual, unwell contacts

CTB

Bloods - including HIV test

Blood culture

Respiratory swab e.g covid/ influenza

Rash - swab e.g VZV

Stool PCR - enterovirus

CSF - HSV/ VZV/ Adeno/ Entero

Travel - JEV, WNV, Dengue, Nipah, Malaria

Immunosuppressed - JC, CMV, HHV6/7, HIV
STI- Syphilis

Animals- rats LCMV, Leptospirosis
Animal bites - rabies
Tick bites - TBEV, Lyme
Macaque - Herpes B virus

17
Q

short answer questions

A 24 week pregnant woman presents to her GP with a two day history of severe chickenpox.

What would you suggest for the management of this patient?

A

Confirm diagnosis - swab

VZV IgG - check not disseminated reactivation

LP if encepahlitis suspected

Bloods to look for hepatitis

CXR to look for pneumonitis

Admit - IV aciclovir, 10mg/kg IV TDS. Once improving/ no new lesions, then switch to oral

Treat any secondary bacterial infections

IPC - side room, respiratory precautions until lesions crusted

Public health - check for other contacts

Neonate - risk of FVS

18
Q

short answer questions

A 24 week pregnant woman presents to her GP with a two day history of severe chickenpox.

What is the risk of foetal varicella syndrome?

A

<13 weeks 0.4%

13-20 weeks 2%

> 20 weeks minimal risk

19
Q

short answer questions

What are the signs of foetal varicella syndrome?

A

LBW

eye lesions

skin scarring

limb hypoplasia

neurologic involvement

20
Q

short answer questions

A 39 year old man who had a living unrelated bone marrow transplant 4 weeks ago is admitted to hospital with severe respiratory symptoms. Adenovirus DNA is detected by PCR in a BAL.

What advice would you give on the management of the patient?

A

Assess which organs are involved
- LP for meningitis if indicated
- bloods look for hepatitis

viral load - confirm systemic involvement, and for monitoring treatment

Cidofovir treatment

Needs fluids + probenicid

Look for other diagnoses - e.g covid/ influenza/ PCP/ bacterial/ fungal

21
Q

short answer questions

A term baby is born with cerebral calcifications and chorioretinitis. His CMV IgM and Toxoplasma gondii IgM results on a clotted blood taken two days after birth are negative.

Does this exclude infection with these two organisms and what management would you recommend?

A

Does not exclude CMV or Toxoplasma

Check mothers samples for evidence of CMV or Toxoplasma in pregnancy

Check urine/ Saliva for CMV within first 3 weeks

Send baby blood for Toxoplasma IgM/IgG/ Dye test

22
Q

short answer questions

A 44 year old CMV antibody negative man is given a lung transplant from a CMV antibody positive donor.

Discuss the ideal management of this case, and the likely outcome with and without interventive management

A

Likely to develop a primary CMV infection - could have severe hepatitis/ pneumonitis/ colitis

cannot reduce immunosupression. So give pre-emptive ganciclovir for 100 days following transplant

Virology 2 (57 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions