Rabies Flashcards
family of rabies virus
Rhabdoviridae
genus of rabies virus
Lyssavirus
false about rabies virus
A.75 nm to 180 nm, bullet shaped
B.May only be seen via electron microscope
C.Single-stranded, negative-sense DNA virus
C
RNA, not DNA
Enumerate main parts of the rabies virus structure
envelope, peplomers, ribonucleocapsid
false about rabies virus
A.Survives storage at 4 ̊C for weeks and -70 ̊C for years B.Activated by carbon dioxide, extremes of pH, detergent
C.Inactivated by UV radiation,sunlight, trypsin, heat, lipid solvent
B
inactivated dapat
false about rabies virus
A.Has two serotypes
B.Purified spikes with viral glycoprotein elicit neutralizing
antibody in animals
C.Antiserum prepared against the purified nucleocapsid is
used in diagnostic immunofluorescence for rabies
A
one serotype only
Strain differences can be distinguished by three factors. Enumerate the three factors.
Epitopes in nucleoprotein
specific nucleotide sequences
glycoprotein
What mutation results in loss of virulence for the rabies virus?
substitution at amino acid position 333
What mediates attachment of rabies virus to host cell?
glycoprotein spikes
host cell receptor of rabies virus (attachment)
nicotinic acetylcholine
enzyme in-charge of transcription for rabies virus
virion-assoc RNA polymerase
transcription template for rabies virus
ribonucleoprotein
product of transcription, rabies virus
5 mRNA species
enumerate the three substances involved in RNP Core Formation
viral transcriptase
nucleoprotein
newly rep viral RNA
true about outer covering formation of rabies virus
A.Envelope gained via budding through plasma membrane
B.Viral matrix protein forms a layer on the outer side of the envelope
C.Viral glycoprotein – inner layer, c/o spike formation
A
Baliktad ang B at C. switch the words inner and outer!
False about viral RNA Replication for rabies
A. complementary negative sense RNA formed from genome RNP
B. the (-)sense RNA is used to code for negative-sense progeny RNA
C. both are false
D. both are true
C
change negative to positive
incubation period for Rabies
2 weeks to 6 months
In pathogenesis of rabies, which does not happen? A. it goes straight to CNS B. multiplication in skin C. entry into peripheral nerves at neuromuscular junctions D. travels at axoplasm, rate is 10 mm/hr
B
Muscle or connective tissue dapat
Once rabies has entered the CNS, what occurs?
progressive encephalitis
__ is the organ with highest titers
of virus
Submaxillary salivary gland:
A brain infected with rabies is not/does not have:
A.edematous
B.perivascular cuffing
C.gliosis with maximal neuronal damage
C
minimal dapat
Specific eosinophilic cytoplasmic inclusions formed by rabies virus in nerve cells
o Filled with viral neurocapsids
o Absent in at least 20%(may reach until 50%) of cases
identify
Negri bodies
1 rabies infected country
India
Which is not a usual reservoir host of rabies? A. dogs B. zebras C. vampire bats D. raccoons
B
Which is not a frequent mode of transmission of rabies?
A. Contact with saliva, milk or urine of animal suffering from rabies
B. Licks on wounds
C. Scratches/bites of animals
D. Aerosol
D
Which is false?
A. Rabies has no cure.
B. Rabies has no vaccine.
C. The saliva is infective 2-3 days before signs of rabies manifest in the infective animal.
b
enumerate two types of rabies
furious rabies
paralytic rabies
first phase of furious rabies, Tingling and numbness at the site of bite 2-3 days
before clinical symptoms appear
prodromal phase
Which does not happen in a person with furious rabies?
A.Low grade fever, headache, body ache
B.Painful spasms of the muscles that control
breathing and swallowing
C. Pupils are dilated
D. Tears, blood pressure and perspiration increase
D
blood pressure decreases
T or F
Furious and paralytic rabies have the same prodromal phase
T
Which is false?
A.The patient may experience constipation, urinary retention, and incontinence
B.Hydrophobia is usually present
C.Seen usually in patients who have taken some anti-rabies vaccination in the past
B
absent dapat
[LAB DIAGNOSIS]
where the brain is preserved when there’s a delay
50% glycerol saline
False about antemortem rabies diagnosis
A.Saliva samples – virus isolation and antigen detection
B.Skin samples (sent on dry ice) – antigen detection
C.CSF sample – virus isolation and antigen detection
D.No single test is 100% positive and a negative test does not rule out the possibility of rabies
A
RNA detection dapat
In postmortem rabies diagnosis, what stain is used to detect Negri bodies?
Seller’s stain
most widely used method for detecting rabies post-mortem
fluorescent antibody test
false about Category I exposure
A.pet owners can be advised to have a pre-exposure vaccination
B.Touching and feeding of animals
C.Licks on skin abrasions
C
intact skin dapat
Which is/are not part of Category II exposure?
A.Minor risk: local treatment of wounds and
anti-rabies vaccination
B.Minor scratches or abrasions with superficial nibbling of
skin not associated with bleeding
C.Bites from bats and wild animals
D.Administration of rabies immunoglobulin & rabies vaccine
C and D
not part of Category III exposure
A.local treatment of wounds,
B.administration of rabies immunoglobulin, and a complete course of anti-rabies vaccine
C.Single or multiple wounds with breach in the skin and
bleeding (transdermal bites)
D.Licks on intact skin and mucus membranes
D
broken dap at
Which is false?
A.Animal bite wounds must be bandaged.
B.Animal bite wounds are not sutured unless anti-rabies serum or Ig is given.
C.Local applicants like plant juices and coffee shouldn’t be applied.
A
enumerate types of rabies vaccine (kahit wag na yung brand)
- Human diploid cell vaccine (HDCV) - Imovax
- Purified chick embryo cell vaccine (PCEC) - Rabipur
- Purified vero cell rabies vaccine (PVRV) – Verorab
- Purified duck embryo vaccine (PDEV) – Lyssavac
Enumerate intramuscular vaccine admin methods
Five-dose intramuscular regimen
Abbreviated multisite intramuscular regimen
five dose IM regimen is also known as __
Essen regimen
abbrev multisite IM regimen is also known as
Zagreb regimen
for Zagreb regimen, where exactly is the vaccine injected?
left and right of upper arm deltoid
for Essen regimen, where is it injected @ kids?
anterolateral thigh region
for Essen regimen, where is it injected @ adults?
deltoid muscle of upper arm
Rabies vaccines formulated with adjuvant should be administered intradermally. true or false?
false
two methods for intradermal vaccine admin: enumerate
updated Thai Red Cross intradermal regimen
eight site intradermal regimen
Which are administered via 8 site ID reg?
A)Human diploid cell vaccine (HDCV) - Imovax
B)Purified chick embryo cell vaccine (PCEC) - Rabipur
C)Purified vero cell rabies vaccine (PVRV) – Verorab
D)Purified duck embryo vaccine (PDEV) – Lyssavac
A and B
Which are administered via updated Thai Red Cross ID reg?
A)Human diploid cell vaccine (HDCV) - Imovax
B)Purified chick embryo cell vaccine (PCEC) - Rabipur
C)Purified vero cell rabies vaccine (PVRV) – Verorab
D)Purified duck embryo vaccine (PDEV) – Lyssavac
B & C
false about Anti Rabies Serum/ Rabies Ig
A.provides active immunity + protection @ window pd
B.neutralize the virus present in the wound and provide
ready-made rabies antibody before active response to
rabies vaccine
C.always given along with vaccines
D.vaccines should be given at a site away from the site of
RIG infiltration
A
passive dapat
enumerate the types of Rabies Ig
Equine Rabies Ig
Human Rabies Ig
Where is Equine Rabies Ig injected for test dose?
flexor aspect of forearm
False about HRIG
A.No need for skin sensitivity test
B.Required dose of RIGs is the same regardless of body weight
C.Any remaining RIGs should be injected intramuscularly in the thigh region or any site away from the vaccine
administration
B
it is computed accdg to body wt
false about re-exposure vaccination
A.Only 2 doses of vaccine on days 0 and 3
B.There is a need for RIGs
C.Patients with history of nerve tissue vaccines are treated as fresh cases
B
NO NEED!
Double the first dose of vaccines for all except
A.Patients who seek treatment after a delay of 48 hours or more
B. People with high risk exposure or extensive wounds on
head, neck, face, hands, and genitalia
C. Patients where RIG is indicated but is unavailable
D. All children less than 5 y/o
D
Persons exposed to rabies after drinking milk of rabid animal need for PEP regardless of milk type. t/f?
F
pasteurized: no need
Which is false?
A.Rabies patients cannot eat red meat.
B.The carrier state of rabies in dogs is reported in experimental conditions and is considered to be afraid of nature.
A
According to the WHO, an anti-rabies antibody titer of greater than or equal to __ IU in the vaccinated individual is considered as protective.
0.5
