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MICI Module 2 > Resp Virus, Childhood Viruses, HPV And Gastroenteritis > Flashcards

Resp Virus, Childhood Viruses, HPV And Gastroenteritis Flashcards

1
Q

Describe Influenza

A

Single stranded RNA virus, ENVELOPED, SEGMENTED GENOME

Actually 3 viruses

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2
Q

How is influenza spread

A

RESPIRATORY DROPLETS ON SOILED HANDS

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3
Q

Why is influenza A more important?

A

Pandemic potential and usually more severe

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4
Q

Describe Influenza A

A

Humans AND animals infected
Outbreaks, epidemics and pandemics
Yearly antigen DRIFT
Liable for antigenic SHIFT

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5
Q

Describe influenza B

A 
Usually less severe
Humans only 
Outbreaks and epidemics 
Yearly antigenic drift
Not liable to shift
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6
Q

What js the difference between colds and flu

A

Cold: gradual (slow) onset, little or no fever, coryza; no vaccine or treatment

Flu: rapid onset, fever, fatigue; vaccine and treatment available

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7
Q

What proteins are present on the surface of the influenza virus

A

HEMAGGLUTININ (the H in H1N1) which attaches to cell receptors

NEURAMINIDASE (N in H1N1) which frees the virus to infect other cells

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8
Q

What are drifts

A

Small changes or mutations are called drifts, these are present in both influenza A&B
Drifted viruses contribute to epidemics and deaths in vulnerable

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9
Q

What are shifts

A

Larger changes or mutations only present jn influenza A
Shifted viruses cause pandemics
Shifts are reassortments of avian and human viruses; new viruses emerge

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10
Q

Describe how a shift occurs

A

Pigs!
Pigs have receptors for both avian and human strains of influenza, pig acts as mixing vessel and shifts segments to pop out a new virus

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11
Q

What are potential complications of influenza

A

Lower respirstory tract (direct viral effect): croup, bronchiolitis(kids), primary pneumonia

Secondary bacterial infection:
Pneumonia or otitis media

And heart failure

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12
Q

Describe seasonal influenza vaccine

A

Quadrivalent- 2 type A and 2 type B

60-80% effective in healthy young adults
20-30% effective in elderly
50-60% effective in preventing hospitalization

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13
Q

How is influenza treated

A

Neuraminidase inhibitors
Osteltamivir (tami flu) h1n1 resistant
Zamamivir (inhaler) not convinient

MUST BE TREATED within 72 HOURS preferably 24 hours post infection for it to be effective

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14
Q

Describe respiratory syncytial virus (RSV)

A

A paramyxovirus
Most common cause of bronchiolitis in children
Manifests as common cold in older kids and adults
Almost all kids infected by age 4; maybbe fatal if heart and lung disease

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15
Q

How is RSV transmitted

A

Hand contact and respirstory route occasionally

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16
Q

How is RSV treated?

A

Ribavirin, requires hospitalization and is reserved for severe infection

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17
Q

Describe parainfluenza viruses

A

Pretty common; bad cold with persistent cough? Probably parainfluenza
Infection limited to nasopharynx
Approximately 2% get croup

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18
Q

Describe rhinovirus

A

A picornavirus positive strand RNA virus

Infects upper airway (common cold, sinitus, sore ear)

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19
Q

How are respiratory viral infections diagnosed?

A 
Symptoms 
Time of year
Whats in community
Virus antigen detection (not rhinovirus)
Molecular methods (pcr)
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20
Q

Describe measles

A

Paramyxovirus (related to mumps and rsv)
World wide occurence
Vaccine available

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21
Q

How is measles transmitted

A

AIRBORNE

After initial replication it disseminates (viremia)

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22
Q

What are symptoms of measles

A

Takes 2 weeks for rash to develop
Maculopapular rash evolves from face to trunk to extremities INCLUDING PALMS AND SOLES
FEVER AND 3 Cs: cough coryza and conjunctivitis
KOPLIK SPOTS (sugary spots near molar teeth)

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23
Q

What are some complications of measles

A 
Thousands of 3rd workd kids die yearly 
Otitis media
Pneumonia 
Encephalitis 
Death
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24
Q

When is measles communicative

A

Communicable 4 days before and 4 dats after development of rash

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25
Q

How is measles diagnosed

A

Not easy to diagnose IgM antibody levels the best option

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26
Q

Describe the measles vaccine

A

A live vaccine administered with mumps and rubella as MMR or with mumps and rubella and varicella as MMRV
Given in 2 doses now

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27
Q

Describe rubella

A

RNA togavirus
Spread by respiratory droplets or vertically (mum to baby)
Rash develops after 2-3 weeks
May be infected and not know esp young kids

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28
Q

What are some symptoms of rubella

A

Rash
Adenopathy (swollen lymph nodes)
Adults may get mild arthritis

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29
Q

What are some complications of rubella

A 
Congenital rubella most severe:
Cardiac abnormalities 
Cataracts
Deafness
Brain, liver, organ damage
30
Q

How is rubella diagnosed

A

IgM antibodies

31
Q

Describe erythema infectiosum

A

Fifth disease
Caused by PARVOVIRUS B19 INFECTION
Worldwide, common in early childhood

32
Q

How is fifth disease transmitted

A

Respiratory droplets

Vertical (biggest worry)

33
Q

What are complications of fifth disease

A

Slapped cheek rash sparing mouth
Lacy pink rash in extremities
May cause miscarriage or fetal abnormalities

34
Q

How is fifth disease disgnosed

A 
Antibody detection (IgM)
No vaccine
35
Q

Describe Mumps

A

A paramyxovirus
Worldwide
Uncommon thanks to vaccine
Incubation period 2-3 weeks

36
Q

How is mumps spread

A

Droplets and fomites contaminated by saliva

37
Q

What are some complications of mumps

A

Parotid gland swelling (95%)
Orchitis (young men may cause sterility)
Meningitis (15%)
Encephalitis and pancreatitis

38
Q

How is mumps diagnosed

A

Looking for viral RNA in saliva or urine (PCR)

39
Q

Describe chicken pox

A

A member of herpes viridae family
Very very infectious
Unlike other herpes virus almost all infections are symptomatic

40
Q

How is chicken pox transmitted

A

Airborne

41
Q

How is chicken pox characterized

A

Fever, generalized vesicular erruption

42
Q

What js the incubation period of chickenpox

A

11-13 days

Virus replicates in throat and spreads during secondary viremia to skin, tissue, rarely to lungs and brain

43
Q

What is the typical progression of chicken pox

A

Macule -> papule -> vesicle -> pustule -> ulcer -> crust

44
Q

What are complications of chicken pox

A

Pneumonia (very serious)
Disseminated infections in immuno compromised
Severe infections in newborns
CNS involvement (rare)
Bacterial superinfection from kids scratching or picking (S.Aureus/S.Pyrogenes)

45
Q

How is varicella zoster infections (shingles/chickenpox) diagnosed

A

Clinical syndrome recognition

PCR if immuno compromised

46
Q

How are varicella zoster jnfections prevented

A

Chicken pox vaccine (live vaccine)
Shingles vaccine: 2
Shingrex the best (2 shots)
VZ immunoglobulin: post exposure prophylaxis for congenital or immunodeficincy; given to newborns

Newborns may be given immunoglobulin and Acylovir

47
Q

How are varicella zoster infections treated?

A

Airborne precautions in hospital (negatuve pressure room)

Acyclovir: immune compromised, varicella pneumonia or CNS infections

48
Q

Describe coxsackie virus and echoviruses

A

Picornaviruses
Mostly summer/fall infection
Fecal oral transmission
50-80% asymptomatic

49
Q

What are complications of coxsackie and echoviruses

A

Meningitis, myocarditis, handfoot and mouth

50
Q

Describe hand foot and mouth disease

A

Mostly kids
Coxsackie A16
Sore throat, vesicles, fever, lesions including hand and feer

51
Q

Describe human papilloma viruses

A

Small non enveloped icosahedral viruses
Circular doubke stranded viral DNA
More than 100 different types

52
Q

How is HPV transmitted

A

Virus shed in cells from warty lesions on skin/mucous membranes
Infected cells multiply and form new lesions

53
Q

Does HPV have viremia

A

No infection is limited to superficial tissue

54
Q

What is skin to skin hpv

A

Platar warts or common warts caused by 1,2,3 and other types

55
Q

What are low risk mucosal HPV infections

A

Low risk of cancer
HPV 6,11
Primarily associated with genital warts

56
Q

What are high risk mucosal HPV infections

A

High risk of invasive cancer

HPV 16, 18 and others

57
Q

What makes HPV potentially cancerous

A

Integrated gene gives rise to genomic instability causes growth of cells to become unrestricted

58
Q

What cancers can be prevented by HPV vaccine

A 
Cervical
Oropharynx
Anus
Oral cavity
Vulva
Penile
59
Q

How do we test for HPV?

A

In NS pap smear

60
Q

Describe the HPV vaccine

A

Prevents virus replication by using virus outside and not the inside

61
Q

What HPV types does the vaccine protect against

A

16, 18 (highest risk), 6,11 (low risk) and 5 other types

Can be given in 2 or 3 doses

62
Q

Who should get the HPV vaccine

A

Males and females 9-26
MSM
Immunosuppressed
NOT RECCOMENDED FOR UNDER 9 AND PREGNANT MOTHERS

63
Q

What are common gastroenteritis viruses

A

Noroviruses (MOST COMMON)
Rotaviruses
Enteric adenoviruses
Astrovirus

64
Q

Describe noroviruses

A

Winter vomiting disease
Small RNA viruses, multiple serotypes
Adults more commonly affected
Very infectious

65
Q

How are noroviruses transmitted

A

Fecal oral and aerosol spread

66
Q

Describe rota viruses

A

Naked doubke stranded RNA viruses
Look like a wheel
Usually endemic, reduced with vaccine
Most severe in neonates and kids

67
Q

Describe the pathogenisis of gastroenteritis viruses

A

Replicate in mucosal cells of the small intestine
Damage transport mechanisms
Loss of fluids and electrolytes
Little inflammation

68
Q

How are enteric viruses spread

A 
Poor hygiene and sanitation 
Fecal oral
Contaminated water 
Food (filtering fish)
Fomites
69
Q

Desrcibe the transmission of gastroenteritis viruses

A

Highly trasmissible especially by convalescents; may be symptom free bht high numbers in stool for 48 hours and may shed for weeks

70
Q

What are some symptoms of gastroenteritis viruses

A 
Vomiting (esp norovirus)
Occasionally fever
Diarrhea 
Dehydration 
Electrolyte imbalance
71
Q

Hiw are enteric viral infections diagnosed

A

Clinical syndrome
PCR for outbreaks
Antigen in stool (not as common)

72
Q

How is viral gastroenteritis treated

A

Rehydration (IV elderly)
Anti motility agents
Pepto bismol

MICI Module 2 (3 decks)

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