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Elliot > RNA virus 3.17.14 > Flashcards

RNA virus 3.17.14 Flashcards

1
Q

Double Stranded, Segmented, Non envoloped RNA Viruses (2)

A

Reoviridae

1) Rotavirus
2) Coltivirus

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2
Q

Picornaviruses: envelope? Structure? Capsid? Viruses? Clinically?

A

1) No envelope
2) RNA SS+ linear
3) Icosohedral
4) PERCH

Polio; Echo; Rhino; Coxsackie; HAV

5) Asceptic meningitis (except rhino); Fecal-oral route (except rhino)

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3
Q

Polio Virus: Virus family? RNA structure? Clinical

A

1) Picornavirus
2) RNA SS+ linear
3) flaccid paralysis of lower limbs and trunk; troubled breathing; lymphocytosis on CSF; normal glucose and protein

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4
Q

Coxsackie A,B: Family? Structure? Clinical?

A

1) Picornavirus
2) RNA SS+linear
3a) Herpangina: sore throat and fever; vesicles in oral cavity (hand foot and mouth disease)
b) Pleurodynia: myocarditis; pericarditis

A/B Asceptic meningitis; paralysis; URT infection

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5
Q

1) Picornavirus
2) RNA SS+ linear
3) flaccid paralysis of lower limbs and trunk; troubled breathing; lymphocytosis on CSF; normal glucose and protein

A

Polio Virus: Virus family? RNA structure? Clinical

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6
Q

1) Picornavirus
2) RNA SS+linear
3a) Herpangina: sore throat and fever; vesicles in oral cavity (hand foot and mouth disease)
b) Pleurodynia: myocarditis; pericarditis

A/B Asceptic meningitis; paralysis; URT infection

A

Coxsackie A,B: Family? Structure? Clinical?

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7
Q

Most common causes of asceptic meningitis? 3

A

Coxsackie (Picorna)

Echo (Picorna)

Mumps

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8
Q

Causes of Palm and sole rash (3)

A

1) Syph
2) Rocky Mountain Spotted Fever
3) Coxsackie

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9
Q

Hep A: Family? Structure? Capsid? Transmission?Clinical

A

1) Picorna
2) RNA SS+
3) Icosohedral
4) Fecal oral
5) Jaundice; elevated liver enzymes; (A and E are the less toxic forms of Hep); will see IgM in serum; IgG indicative of past infection

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10
Q

5 out of 10 children in a fourth grade class present with nausea, vomiting, loss of appetite and appear yellow. What is the virus? Family? Structure? Capsid?

A

1) Hep A
2) Picorna
3) SS+
4) Icosohedral

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11
Q

Rhino: Family? Structure? Capsid? Clinical?

A

1) Picorna
2) RNA SS+
3) Icosohedral
4) Common cold; replicates in the cooler nose and the warmer lungs

rhino has a runny nose

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12
Q

Norwalk: Family? Structure? Capsid? Clinical?

A

1) Calici
2) RNA SS+
3) Icosohedral
4) Gastroenteritis; contaminated water/food; major cause of group related diarrhea

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13
Q

Family goes out to dinner and develops bout of diarrhea. Organism? Family? Structure?

A

1) Norwalk
2) Calici
3) SS+

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14
Q

Hep E: Family? Structure? Capsid? Clinical?

A

1) Calici
2) RNA SS+
3) Icosahedral
4) Jaundice and hepatomegaly; must rule out HAV; high mortality in pregnant women;

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15
Q

1 cause of fatal diarrhea in children? Family? Structure?

A

Rotavirus; RNA Double stranded (only double stranded RNA virus)

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16
Q

Colorado Tick Virus: Envelope? Structure? Capsid? Clinical? Transmission?

A

1) No envelope
2) DS linear RNA 10-12 segments (only double stranded RNA Virus)
3) Icosahedral
4) Fever; myalgias; ocular pain; headache

SHOULD AVOID ASPIRIN FOR FEAR OF HEMORRHAGE

5) Rodents

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17
Q

Rockey Mountain hicker begins to feel fever and muscle aches. Bit by ticks. Diagnosis? Type of bug? What should patient avoid?

A

1) Colorado Tick Virus
2) Reoviridae Coltivirus (RNA double stranded)
3) Avoid Aspirin and any contact to prevent hemorrhage

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18
Q

Rotavirus: Envelope? Structure? Capsid? Clinical? Transmission? Diagnostic test?

A

1) No envelope
2) RNA DS linear; segmented
3) Icosahedral
4) Watery diarrhea (Gastroenteritis)– make sure to rehydrate
5) Fecal oral
6) ELISA

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19
Q

3yo presents with severe bouts of vomiting and watery diarrhea for past two days. No blood in diarrhea. Diagnosis? Lab?

A

1) Rotavirus (RNA DS linear)
2) ELISA

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20
Q

EEE/VEE/WEE: Envelope? Structure? Capsid? Clinical? Transmission?

A

1) Togaviruses have an envelope (need an invitation to the toga party)
2) RNA SS+
3) Icosahedral
4) Photophobic; head/neck pain; hemiparesis
5) Carried in birds or horses and transferred to humans via mosquitos

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21
Q

8yo girl presents to ED with head and neck pain; photophobia; heiparesis and CN deficits. Bitten by mosquitos recently. Bug? Transmission?

A

1) EEE/WEE/VEE
2) Carried in birds and horses; transmitted to humans via mosquitos

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22
Q

Rubella: Envelope? Structure? Capsid? Clinical? Transmission?

A

1) Togavirus has an envelope (need invitation to toga party) (but NOT transmitted by arthropod!)
2) RNA SS+
3) Icosahedral
4) Fever followed by descending rash
5) Transmitted by aerosol

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23
Q

33yo woman presents with rash on her face that traveled to her arms in recent days. Before rash, pt. had a fever for a couple of days that resolved. Pt. is unsure of her vaccinatio history. Diagnosis? Transmission?

A

1) Rubella (Togavirus= SS+ RNA virus)
2) Aerosol (unlike the other togaviruses which are transmitted via aerosol)

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24
Q

West Nile Virus: Family? Envelope? Structure? Capsid? Clinical? Transmission?

A

1) Flavivirus
2) Yes envelope–Flaviflav sends out envelops for his parties
3) RNA SS+ linear
4) Non specific sx or encephalitis (hx is impt)
5) Virus cycle between birds and mosquitoes; clusters of dead crows herald human cases

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25
Q

75yo man from NY brough to ED with fever, ehadache, nasua and muscle ache; confused and tremor in hands. CT and MRI are unrevealing. CSF shows elevated protein, normal glucose and lymphocytosis. Have seen lots of dead cows in town recently. Bug? Transmission?

A

1) West nile virus ( Flavivirus– SS+RNA)
2) Usually between birds and mosquitos; humans are incidental hosts

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26
Q

Patient from South America presents with hepatitis and jaundice; black vomit. Recently bitten by a mosquito. Possible diagnosis? Family? What kind of mosquito?

A

1) Yellow Fever
2) Flavivirus (RNA SS+)
3) Aedes

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27
Q

Patient from tropical area with flu-like sx and SEVERE joint/muscle pain. Recently bitten by a mosquito. Possible diagnosis? Family? Complications?

A

1) Dengue Fever
2) Flavivirus (RNA SS+)
3) If pt. becomes infected with a different serotype, the antibodies from the first rxn can cross link–>immune complexes–>hemorrhage and shock

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28
Q

Major mosquito vector for Yellow Fever and Dengue Fever

A

Aedes Aegypti

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29
Q

Hep C: Family? Envelope? Structure? Capsid? Presentation? Treatment?

A

1) Flavivirdae
2) Yes
3) RNA SS+
4) Icosahedral
5) Jaundice acutely; cirrhosis long term
6) Pegylated alpha interferon; ribavirin

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30
Q

Pt presents with fatigue. Received blood transfusion a few years ago and had an episode of jaundice. After confirmation of the likely disease, 1) what drug would you use to treat this man? 2) MOA of drug?

A

Ribivarin (inhibits IMP dehydrogenase)

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31
Q

Retroviridae: Envelope? Structure? Capsid?

A

1) Yes ( need an invitation to the retro party)
2) SS+ linear
3) Icosahedral

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32
Q

HTLV: Family? Envelope? Structure? Capsid? Presentation?

A

1) Retroviridae
2) Yes (invitation to retro party)
3) SS+ RNA
4) Icosahedral
5) White matter lesions on brain and paraventricular gray matter; sensory loss; T-cell leukemia/lymphoma

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33
Q

Where is HTLV 1 endemic to? HTLV2 endemic?

A

1) Japan and Caribbean
2) Native American

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34
Q

Japanese woman presents with stiffness in her legs. Lesions of white matter and paraventricular gray matter on MRI. Diagnosis? Family?

A

1) HTLV 1 (probably not 2– 2 is endemic to native america)
2) Retroviridae

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35
Q

Delta Virus (Hep D): Envelope? Structure? Capsid? Presentation? Diagnosis? Treatment?

A

1) YES
2) RNA SS- circular
3) Uncertain
4) Hepatitis
5) delta antigen detection
6) Alpha IFN

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36
Q

Patient, chronic drug user, with hx of HBV presents with severe signs of chronic hepatitis. What other condition may this patient have? Treatment?

A

1) Hep D (SS- circular; delta)
2) Alpha IFN

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37
Q

Coronavirus: Envelope? Structure? Capsid? Presentation? Why called corona?

A

1) Yes (need invitation to party with corona)
2) SS+ linear
3) Icosahedral
4) common cold
5) Club shaped projections on envelope (glycoprotein spikes)

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38
Q

Child presents with runny nose and common cold. It is not a rhinovirus. What is the second most common cause of cold?

A

1) Corona

Yes envelope, SS+ linear RNA virus

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39
Q

Bunyavirus: Envelope? Structure? Capsid? Transmission?

A

1) Yes envelope (bunnies send messages)
2) SS- Circular RNA
3) UNCERTAIN
4) Rodents to mosquitos

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40
Q

4 types of Bunyavirus? Structure?

A

1) California encephalitis
2) Sandfly/Rift Valley fevers
3) Crimean-congo hemorrhagic fever
4) Hantavirus
5) SS- circular RNA

41
Q

California encephalitis Virus: Family? Envelope? Structure? Capsid? Clinical? Transmission?

A

1) Bunya
2) Yes (bunnies send letters)
3) SS- Circular RNA
4) Encephalitis
5) Forest rodents–>humans via mosquitos–>direct damage to neurons

Higher risk in Midwest Forests

42
Q

10yo pt. presents with severe headache, + babinski, tremors, confusion. Nroaml glucose and protein but PMN and Mononuclear cells on CSF. Illness acquired fro mosquitos near Michigan forest. Bug? Transmission?

A

1) California Encephalitis Virus (RNA SS- circular)
2) Rodents to mosquitos to humans

43
Q

Hantavirus: Family? Envelope? Structure? Capsid? Clinical? Transmission?

A

1) Bunya
2) Yes envelope (bunnies send letters)
3) unclear
4) Deer mice; fever; vomiting; cyanotic; tachypneic; respiratory failure; interstitial pulmonary edema
5) NO ARTHROPOD

44
Q

23yo M, from arizona, presents with cyanosis, hypotension, tachypnia. Interstitial edema is evident on CXR. Pt. develops respiratory failure and dies the next day. Bug? Class? Transmission?

A

1) Hantavirus
2) Bunya (SS- circular)
3) Rodents (no arthropods)!

45
Q

Arenaviruses: Envelope? Structure? Capsid?

A

1) Yes
2) SS- Circular
3) helical

46
Q

Lassa Virus: Family? Envelope? Structure? Capsid? Clinical? Transmission?

A

1) Arenavirus
2) Yes envelope (send messages to “Las” Vegas)
3) SS- circular RNA
4) Helical
5) hemorrhagic fever
6) WEST AFRICA; Rodents

47
Q

34yo woman, visit to Nigeria, fever, headache, nausea, diarrhea. Pericardial effusion; GI bleed. Possible disease? transmission?

A

Lassa Virus (RNA SS-; Arenavirus)

Rodents

Presents with hemorrhagic fever

48
Q

Orthomyxovirdae influ: Envelope? Structure? Capsid? Clinical? Transmission? Associated syndrome when treated with aspirin?

A

1) Yes
2) SS- linear (8 segments– MYX up the types of flus)
3) Helical
4) Altered mental status and seizures; RLQ pain; epistaxis; family member with similar
5) Aerosol
6) Reyes syndrome

49
Q

10yo presents with altered mental status and seizures. He has fever, myalgia, and cough. His mother said she had the same thing last week. She gave her son aspirin for his condition. Bug? Family? other?

A

1) Flu
2) Orthomix ss- segmented
3) Reye’s syndrome! Aspirin caused this syndrome

50
Q

Paramyxovirus: Envelope? Structure? Capsid? Bugs (4)

A

1) Yes
2) SS- linear
3) helical
4) Parainfluenza; RSV; measles; Mumps

51
Q

Baby girl brought to ED with high fever, nasal discharge, and barking cough. Cough disappeared when pt went outside in the cold. Dx?

A

Croup (Parainfluenza)

52
Q

Baby with previous illness returns to hospital 2 days later with cough fever and wheezing. CXR reveals hyperinflated lungs with infiltrates. Possible dx? Treatment? Characteristic cells? Why?

A

RSV

Ribavirin

Syncytial cells dt viral fusion F surface proteins

53
Q

16yo testicular pain. Tender and enlarged over last day. Swollen parotid glands. Muscle aches. Dx? Labs?

A

1) Mumps (URT)
2) Elevated serum amylase generally

54
Q

11month old presents with rash, fever, conjunctivitis and runny nose. Rashes spread from hairline to trunk and then to extremities; bright red and raised. Dx? Other sx? complications?

A

Measles

Koplik spots followed by rash; encephalitis

3) Can lead to subacute sclerosing panencephalitis (neuro sx of measles)

55
Q

Protein common to all Paramyxoviridae?

A

Viral Fusion (F) protein–>causes infected cells to produce multinucleated giant cells

56
Q

Rabies: Envelope? Structure? Capsid? Pathobio?clinical? Histology?

A

1) Yes
2) RNA SS-
3) helical
4) Glycoprotein spikes bind to ACh receptors and are vital for rabies virulence
5) Negri bodies

57
Q

Graduate student bitten by wild dog. Few months later begins to have trouble swallowing; hallucinations; sensitivity to bright light. Dies. DX? Pathobio? Histology?

A

1) Rabies duh
2) Glycoprotein spikes bind to ACh receptors– vital for virulence of rabies
3) NEGRI BODIES

58
Q

Filovirus (Ebola, Marburg): Envelope? Structure? Capsid? Clinical? resevoir?

A

1) yes
2) SS- linear
3) helical
4) hemorrhagic fever
5) In marburg is monkeys; unknown in ebola (Subsaharian Africa)

59
Q

Negative Strand RNA viruses

A

Always Bring Polymerase Or Fail Replication

Arenavirus

Bunyavirus

Paramyxovirus

Orthomyxovirus

Filoviruses

Rhabdovirus

60
Q

Segmented RNA viruses

A

BOAR

Bunyavirus

Orthomyxovirus

Arenavirus

Reoviruses

61
Q

Most important cause of infantile gastroenteritis?

A

Rotavirus

62
Q
A
63
Q

Medication against the F protein?

A

Palivizumab

paramyxovirus…

64
Q

What does a high HBeAg tell us?

A

Indicative of ACTIVE viral replication– highly transmissible

65
Q

Catalase positive Coagulase positive? Complication?

A

S. Aureus can cause toxis SS

66
Q

Beta hemolytics: Group A?

Group B?

Sensitive or resistent to?

A

A=S. pyogenes; bacitracin sensitive

B= S. agalactiae; bacitracin resistant

67
Q

Catalase positive; coag negative (2)– what are they resistant or sensitive to?

A

1) Staph epi; novobiocin sensitive
2) S. saprophyticus; novobiocin resistant

68
Q

Alpha hemolytics? (2) Sensitivity or resistance?

A

1) S. pneumonia; optochin sensitive; capsule
2) S. viridans; optochin resistant; no capsule

69
Q

Gamma hemolytics: group D? Nonenterococcus?

A

1a) E. faecalis; growth in bile and NaCl
2) Nonenteroccus; growth in bile but NOT nacl

70
Q

5 gram positive rods

A

1) Clostridium (anaerobic)
2) Cornebacterium
3) Listeria
4) Bacillus
5) mycobacterium

71
Q

Important surface antigen in gram positive bacteria?

A

Techoic acid

72
Q

Quellung reaction? (2 examples)

A

diagnositc test in which specific antiserum causes the capsule to swell (s pneumoniae; h flu)

73
Q

Componenets of LPS

A

Lipid A= endotoxin component of gm- that causes fever and shock

Polysaccharide= important surafce antigen

74
Q

Stap Aureus: Virulence factor? Clinical presentations (3)?

A

1) Protein A binds Fc-IgG region inhibiting complement fixation and phagocytosis
2) a) Skin infections (scalded skin syndrome)
b) Food poisoning– heat stabile toxin
c) TSS= TSST- 1 is a superantigen which promotes excess release of cytokins–>hypotensive shock

75
Q

Young women develops high fever 2 days after menses. She used tampons. Dizziness, hypotension, myalgias, and diffuse chest rash ensue. Desquamation of palms is observed. Describe pathophys of this bug? Class of drugs to treat?

A

1) S. aureus–> TSS
2) Superantigen binds to MHCII and TCR resulting in polyclonal Tcell activation
3) block IL-1 and TNF

76
Q

Virulence factor of S. aureus?

A

Protein A which binds up Fc portion of IgG–>blocks complement fixation

77
Q

IV drug user presens with fever and signs of heart failure. Echo reveals tricuspid vegetations. Patient put on penicillinase resistant penicillin and improves. Bug? pathophys? Who else is susceptible to this?

A

1) S. aureus infection–> acute endocarditis on tricuspid valve particularly
2) Protein A binds Fc portion of IgG
3) CGD patients (impaired neutrophil function)

78
Q

What is the leading cause of osteomyelitis in children and adults?

A

S. aureus

79
Q

What class of drugs is MRSA resistant to?

A

Beta lactams

80
Q

S. epidermitis: Cat? Coag? clinical? Virulence?

A

1) Gm+ cat+ coag-
2) infects prosthetic devices and IV catheters
3) Produces ADHERENT BIOFILMS

81
Q

Patient recently in hospital for chemo. Has an IV catheter. Develops fever; erythema and tenderness at IV site. Pathophys of organism?

A

1) Staph Epi
2) Produces adherent biofilms

82
Q

Strep pneumo: Describe? Clinical? Virulence?

A

1) Gm+; cat-; alpha hemolytic; optochin sensitive
2) Lobar pneumonia
3) No virulence without capsule; also have IgA PROTEASE

83
Q

S. saprophyticus: Description? Clinical? Virulence?

A

1) Cat+, coag-
2) UTI; cystitis
3) nothing important

84
Q

Sexually active woman develops dysuria, pyuria and fever. Cultures show gm+, cat+ coag-. What should patient be put on? what does patient have?

A

1) Staph saprophyticus
2) TMP-SMX

85
Q

Strep pyogenes: Description? Clinical? Virulence?

A

1) Group A beta hemolytic; bacitracin sensitive
2) Pyogenic= pharyngitis

Toxigenic= scarlet fever, TSS

Immunologic= rheumatic fever

3) M protein resists phagocytosis

86
Q

Jones criteria for Rheumatic Fever

A

1) Joints
2) O (heart) carditis
3) Nodules
4) Erythema marginatum
5) Syndenhams chorea= jerky movement of hands and feet

87
Q

8yo with fever and skin rash around lips and arms. Rash appears pustular with yellow crusts. Cultures from impetigo show gm+ cocci; beta hemolytic. Virulence?

A

M protein resists phagocytosis–> can give rise to rheumatic fever

88
Q

Young girl has rough appearing rash on trunk and neck that has spread to arms. Palms and soles are spared. Fever and sore throat. ASO+. Bug? Condition?

A

1) Strep pyogenes; gm+ group A beta hemolytic; bacitracin sensitive
2) Scarlet fever– rash starts at trunk and moves outward; desquamation of hands and soles after rash subsides

89
Q

Adolescent presents complaining of brownish urine. Two weeks earlier had sore throat that resolved. High BP and slight swelling around eyes. Elevated Bun and Creatinin, ASO+; What would you expect to see in complement? Urinalysis? EM? Virulence factor?

A

1) decreased C3 levels
2) RBC casts and protein; hematuria;
3) Subepithelialm humps

90
Q

Possible endocarditis pathophys?

A

Valves damaged by rheumatic fever (strep pyogenes) makes the valves susceptible to enterococci or Viridans–>endocarditis

91
Q

Strep Agalactiae: Description? Clinical? Virulence?

A

1) Gm+, Group B beta hemolytic; bacitracin resistant
2) Baby develops seizures, poor feeding and fever; most common cause of meningitis in newborn
3) Produces CAMP factor which

92
Q

Baby develops seizure; poor feeding; fever. Prolonged labor. Bug? Virulence factor?

A

1) Strep agalactiae; Gm+ group B beta hemolytics; bacitracin resistant
2) CAMP which enlarges area of hemolysis by S. aureus

93
Q

Most common cause of neonatal meningitis?

A

Strep Agalactiae

94
Q

Top 3 causes of neonatal meningitis?

A

1) Strep agalactiae
2) Ecoli
3) Listeria

95
Q

Enterococcus Faecalis: Description? Clinical? Resistant to what drug? Treatment?

A

1) Gm+; can be any of the hemolytics; grows in Bile AND NaCL
2) UTI; biliary tract infection
3) RESISTANT TO CEPHALOSPORINS (coccus are cocks bec they are resistant to vanco)

** **4) Vancomycin (d-ala d-ala)

96
Q

Old man develops UTI after admission to hospital. Receiving cephalosporin for unrelated infection. Bug?

A

Enterococcus faecelis– second most common cause of nosocomial infection and RESISTANT TO CEPAHLOSPORIN

97
Q

Strep Bovis: Description? Clinical? Virulence?

A

1) Gm+; nonenterococus; alpha beta or gamma; grows in BILE only
2) Subacute bacterial endocarditis in colon cancer patients; bacteremia (Bovis in blood= cancer in colon)
3) Invades through GI lesions; may signal COLONIC CARCINOMA OR IBD

98
Q

Elderly man develops low grade fever and signs of endocarditis over 2 weeks. Bug grows on Bile but not NaCl. Bug? What should doctor be concerned about?

A

1) Strep bovis
2) Colon cancer– bug travels through lesions in the GI tract

Elliot (11 decks)

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