Picornaviruses Flashcards

1
Q

Which Enterovirus(es) cause: Poliomyelitis?

A

Poliovirus, EV-71

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2
Q

Which Enterovirus(es) cause Meningitis/Encephalitis:

A

Coxsackie A&B; Echovirus

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3
Q

Which Enterovirus(es) cause: Myocarditis/Pericarditis

A

Coxsackie B

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4
Q

Which Enterovirus(es) cause:Pleurodynia

A

Coxsackie B

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5
Q

Which Enterovirus(es) cause:Hand Foot and Mouth dz

A

Coxsackie A, EV-71

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6
Q

Which Enterovirus(es) cause Herpangia:

A

Coxsackie A

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7
Q

Which Enterovirus(es) cause Respiratory Infections:

A

EV-68

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8
Q

Which Enterovirus(es) cause Acute Hemorrhagic Conjunctivitis:

A

EV-70, Coxsackie A

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9
Q

Which Enterovirus(es) cause Generalized infx of newborn:

A

Echo, Coxsackie B

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10
Q

what immune cells are important in fighting enterovirus infections

A

B cells

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11
Q

at what point in a picornavirus/enterovirus infx are neutralizing antibodies useful?

A

After spread from pharynx to intestinesthey invade the regional LNs. At this point the virus is usually cleared (i.e., the virus establishes minor viremia, but not major viremia)

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12
Q

What are the 4 main outcomes of poliovirus infections?

A

Asymptomatic infection (MC)
Abortive poliomyelitis (fever less than week)
Non-paralytic poliomyelitis (meningitis, no paralysis, full recovery)
Paralytic poliomyelitis

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13
Q

where does poliovirus replicate

A

motor neurons (lytic infection) of the anterior horn

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14
Q

How to differentiate between poliovirus and Guillane Barre

A

Guillane-Barre has sensory loss)

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15
Q

3 types of paralytic poliomyelitis

A

Spinal
Bulbar
combined

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16
Q

How does Spinal poliomyeltis present

A

flaccid paralysis, atrophy, Usually asymmetric in lower limbs, with sensory perception intact (vs Guillane-Barre)

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17
Q

How does bulbar poliomyelitis present?

A

paralysis of the pharyngeal and laryngeal muscles, facial muscles, and/or tongue.

paralysis of diaphragm and intercostal muscles requiring mechanical ventilation.

18
Q

What is Post-Polio Syndrome and how does it present

A

§ Weakness in muscles that were affected and then recovered
§ Can affect muscles unaffected by the initial, acute polio attack
-Occurs many years later, usually (36 years)

19
Q

2 polio vaccines, route of administration, and what type they are

A

Salk - IM shot, killed/inactivated

Sabin- Oral, live attenuated

20
Q

what is one advantage and one drawback of the (OPV) Sabin vaccine?

A
  • Secretion of vaccine virus could spread immunization to unvaccinated.
  • can cause vaccine-associated paralytic poliomyelitis (VAPP).
21
Q

What is only vaccine given in US

A

Salk (IVP)

22
Q

What is the #1 cause of viral meningitis? (genus and 3 species)

A

1 cause = Enteroviruses: Coxsackievirus A and B, echovirus

23
Q

What age group is most affected with viral meningitis

A

young kids

24
Q

What enteroviruses cause encephalitis

A

the same ones that cause meningitis: Coxsackievirus A and B, echovirus

25
Q

What occurs in WBC (composition and # of cells) in enterovirus meningitis?

A

Cell count = 10 to 500

-neutrophils predominate in first 1 to 2 days then shifts to leukocytes

26
Q

What is best method to dx enterovirus meningits?

A

virus in CSF by nucleic acid amplification tests (NAAT) like RT-PCR

27
Q

what pop is at risk of chronic meningoencephalitis caused by enteroviruses?

A

people (children) with B cell deficiencies: X-linked agammaglobulinemia, severe combined immunodeficiency syndrome

28
Q

What is the main enterovirus that causes myocarditis/pericarditis?

A

Coxsackie B

29
Q

How is coxsackie B myocarditis/pericarditis diagnosed? (3 ways)

A
  • Viral RNA present in endomyocardial bx
  • RT-PCR positive serum, stool, throat swab
  • 4 fold increase in antibody titer over several week
30
Q

What is the major sequelae of coxsackie B myocarditis/pericarditis?

A

dilated cardiomyopathy.

31
Q

What viruses causes epidemic pleurodynia? by infecting what cells? outocme?

A

Coxsakievirus B infects skeletal muscle cells (intercostals)

complete recovery usually

32
Q

What 2 viruses cause HFMD

A

Coxsackie A and EV-A71

33
Q

What virus is causing large outbreaks of HFMD in the Asia-Pacific region and the serious complication?

A

EV-A71: Brainstem Encephalitis (rhombencephalitis) predominantly affects gray matter

34
Q

what virus cause herpangina

A

coxsackie A

35
Q

What 2 viruses that cause acute hemorrhagic conjunctivitis

A

EV-70 and Coxsackievirus A

36
Q

2 Sx of acute hemorrhagic conjunctivitis

A

Watery discharge that begins in one eye and progresses to the other eye
Subconjunctival hemorrhage seen in most cases

37
Q

What 2 viruses cause Generalized infection of Newborns?

A

Echovirus, Coxsackie B

38
Q

What are the ○ Two Main manifestations of generalized infection of newborns?

A
§ Myocarditis (CV-B) CFR 30-50%
Fulminant Hepatitis (Echovirus), CFR >50%
39
Q

What is the name of the virus that caused an outbreak of serious respiratory infections in children in 2014

A

EV-68

40
Q

What serious side effect is associated with the virus that caused serious respiratory infections in children in 2014?

A

acute flaccid paralysis