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Virology 2 > Questions from S 24 > Flashcards

Questions from S 24 Flashcards

1
Q

I161I
T184L

Entecavir mutations HBV
Does this confer resistance to tenfovir?

A

No

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2
Q

Cowpox

What type of virus is it?

A

dsDNA virus

Orthopox

Edward Jenner used Cowpox as vaccine against smallpox

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3
Q

Cowpox

What does rash look like?

A

Usually singular localised lesion

same as Mpox

maculopapular then
vesicular then
pustular then
crust

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4
Q

Cowpox

Which countries have it>

A

Europe
East Asia

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5
Q

Cowpox what are hosts?

A

rodents are actually the main reservoirs

Cow/ Humans/ cats are incidental host

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6
Q

Cowpox

What is treatment?

A

Usually resolves in 4-6 weeks spotnaneously

Can trial cidofovir IV or intra-lesional

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7
Q

Want to perform a test on a sample you dont usually perform testing on

What needs to be done before issuing reports?

A

Confirm validation by sending results to reference lab

New SOP
Staff training

change IT ordering system

communicate to end user - report comment - testing has not be validated

communicate to UKAS - increased scope of testing

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8
Q

Antenatal HSV infection, suspect infection in neonate

When does mucocutaneous/ disseminated/ CNS infection appear?
What is mortality rate?

A

Mucocutaneous 5-14 days after birth
1% mortality

Disseminated 5-10 days after birth
30-50% mortality

CNS 4-14 days after birth
15% mortality

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9
Q

How does HSV infection present in neonate?

A

fever
Poor feeding
lethargy
Hepatitis
thrombocytopenia
pneumonitis
rash
convulsions

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10
Q

Neonatal HSV infection

What is treatment?

A

Aciclovir 20mg/kg TDS

14 days for mucocutaneous infection
21 days for disseminated/ CNS

CNS needs follow on oral aciclovir for 12 months - 300mg/square metre

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11
Q

Antenatal CMV infection

What treatment is available for mother?

A

Oral valaciclovir

CMV hyper immunoglobulin

both have weak evidence and aren’t standard practice

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12
Q

Neonate confirm CMV infection

What is most common presentation?

A

10% will have sensorineuraal hearing loss

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13
Q

Antenatal CMV infection
Amniocentesis performed

What is sensitivity?

A

90% sensitivity if performed after week 21

and 6 weeks after suspected infection

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14
Q

Baby born unwell

Treated with aciclovir

CSF pos for HSV2

clinical team baby is fine and dont suspect HSV

What do you do?

A

Risk factors -
check does mother have lesions at birth or during pregnancy

Why was LP performed

any skin lesions

any hepatitis/ thrombocytopenia/ pneumonitis

Consider switched samples or contamination on PCR run

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15
Q

Baby born unwell

Treated with aciclovir

CSF pos for HSV2

clinical team baby is fine and dont suspect HSV

CSF result was next to a strongly positive genital HSV2 swab

Waht do you do?

A

Continue treatment until situation clarified

check PCR paperwork - did all pos/ neg controls work. Any signs of contamination - check CT values

Repeat in parallel - re-extract and PCR from original sample

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16
Q

Baby born unwell

Treated with aciclovir

CSF pos for HSV2

clinical team baby is fine and dont suspect HSV

CSF result was next to a strongly positive genital HSV2 swab

You repeat the CSF, and it is negative

What do you do?

A

Inform consultant of clinical team - apologise and explain issue

Datix - learning event

Re-issue amended report

Duty of Candour

Investigate
- training
SOP
Air flow
unidirectional workflow
disposable pipettes
controls/ reagents correctly stored temp/ humidity
negative controls
waste disposal
environmental cleaning

Make an improvement plan to prevent in future

17
Q

What is duty of candour?

A

Every healthcare professional must be open and honest with patients when something that goes wrong with their treatment or care causes, or has the potential to cause, harm or distress.

If test has amended report, may need to speak to patient or write letter

18
Q

What is unidirectional work flow

A

nothing to be brought back from amp to pre-amp

Amplification section has high concentration of products which can easily contaminate

this includes pens, books, lab coats, pippettes etc

19
Q

Woman with HIV presenting in labour

what is management

A

Urgent HIV test/ VL, HBV/ HCV/ Syphilis

IV zidovudine if presenting in labour

C-section if VL likely >1000

Baby - 4 weeks of lam/ zido/ nev

20
Q

What is ibalizumab

A

Ibalizumab, a long-acting monoclonal antibody, is a CD4-directed post-attachment inhibitor approved for the treatment of infection with multidrug-resistant HIV-1 strains

Entry inhibitors
Enfuvirtide gp41
Maraviroc CCR5
Ibalizumab

21
Q

Which drugs are active against HIV2?

A

NRTI
INSTI
PI

Entry inhibitor - ibalizumab - in vitro datra only
Capsid assembly inhibitor - lenacapavir - in vitro data only

Virology 2 (57 decks)

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