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Infectious Disease > Viral > Flashcards

Viral Flashcards

1
Q

Mechanism of acyclovir?

A

nucleoside analogue which inhibits viral DNA polymerase

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2
Q

Indications for acyclovir?

A

HSV type 1 and type 2
VSV
occasional EBV

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3
Q

Precautions in prescribing acyclovir?

A

Reduce dose in renal impariment as crystalises in the tubules
Rare - neurologic toxicity

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4
Q

Mechanism of gancylcovir?

A

nucleoside analogue which inhibits viral DNA polymerase

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5
Q

Indications for Gancyclovir?

A

CMV

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6
Q

Side effects of gancyclovir?

A

Resistance can develop through target site mutations (ie. DNA polymerase)
Myelosuppression
Renal impairment

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7
Q

Mechanism of action of Ostelmavir?

A

Neramindase inhibitor

- prevents budding of virus from host cell

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8
Q

Indications for Ostelmavir?

A

Influenza A and B

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9
Q

Side effects of Foscarnet?

A

Renal insufficiency

Electrolyte wasting - low K, MG, phos, Ca

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10
Q

Clinical features of CMV infection?

A

Prolonged fever, night sweats, malaise, anorexia, fatigue, arthralgias
Deranged LFTs, leucopenia, thrombocytopenia, and atypical lymphocytes
Lung involvement: SOB, hypoxia, non productive cough with bilateral interstitial infiltrates that begin in the periphery of lower lobes and spread upwards
GI involvement: oesophageal ulcers, stomach, small intestine or colon, hepatitis (particularly after liver transplant)

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11
Q

What complications of CMV occur more frequently in HIV patients?

A

Meningioencephalitis and retinitis particularly in HIV patients

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12
Q

Highest risk time period for CMV after transplant??

A

1-4 months following transplant

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13
Q

Possible treatment options for CMV?

A

Valgancyclovir
Gancyclovir
Foscarnet
Cidofovir

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14
Q

Complications of EBV in the immunocompromised?

A

EBV lymphoproliferative disorder

Oral hairy leukoplakia in HIV patients

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15
Q

Manifestations of HHV-6 in immunocompromised?

A

Cytopenias
Limbic encephalitis
Hepatitis
Pneumonitis

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16
Q

Manifestations of HHV-8 in immunocompromised?

A

Kaposis sarcoma
Castlemans disease
Primary effusion lymphoma

17
Q

How does ebola virus enter the cell?

A

glycoprotein 1 and 2 on the surface of virus bind to cell surface markers

18
Q

How does MERs-Cov enter the cell?

A

Enters via DPP-4 on non ciliated bronchial cells

19
Q

What type of virus is the ebola virus?

A

Filovirus

20
Q

What type of virus is dengue?

A

Flavivirus

21
Q

What are the phases of infection with dengue?

A

inital: fever, retroorbital pain, rash, arthralgia, headache, back pain
defeverescence: occurs around 3-7 days (at risk for getting critical disease - haemorrhagic fever/shock syndrome)
recrudescence: rash, skin desquamation and fever
recovery

22
Q

Complications of Dengue?

A

Dengue shock syndrome = haemorrhagic dengue + shock
Increased vascular permeability
Marked thrombocytopenia
Torniquet test - petichiae

23
Q

Diagnosis of dengue?

A

serology - arbovirus Igm/IgG
NS1 antigen can be tested early and is specific
Bloods - plts less than 100 and raised LFts = severe disease

24
Q

Vector of dengue?

A

Aedes aegyptii

25
Q

Countries that have dengue?

A

Across equatorial band

- occurs in northern queensland

26
Q

What is the incubation period?

A

3-10 days

Greater then 14 days - excludes diagnosis

27
Q

Tests for EBV?

A 
Blood film - atypical lymphocytes
Heterophile antibodies (aka Paul Bunnell/Monospot - not sensitive or specific
EBV serology more specific
 - VCA IgM/IgG and EBNA
 - last for life
28
Q

Causes of infectious mono

A

EBV most common - 90%
CMV
Toxoplasmosis
HIV

29
Q

What infections do you get with HSV-1?

A

Oral ulcers

Meningoencephalitis

30
Q

What infections do you get with HSV-2?

A

Genital ulcers - painful lesions

Meningitis

31
Q

What does antigen shift mean (in context of influenza)

A

Major genetic reassortment of surface proteins (Haemagglutinin & Neuraminidase)
Cause pandemics as population has not previously been exposed

32
Q

What does antigenic drift mean (in context of influenza)

A

Point mutations in surface proteins resulting in small change
Cause epidemics/local outbreak as population has seen part of virus before

33
Q

Complications of influenza

A

Pneumonia - viral and secondary bacterial
Myositis
Rhabdomyelitis
CNS involvement - transverse myelitis, GBS, aseptic meningitis
Myocarditis/pericarditis

34
Q

Groups at high risk for severe influenza

A 
Children 65
Chronic illness
Pregnant
Obesity
Immunocompromised - particularly IgG2
Asthma
35
Q

5 types of illness from Parvovirus B19

A 
Slapped cheek - erythema infectiosum
Polyarthropathy syndrome
Transient aplastic crisis
Fetal infection
Chronic infection in immunosuppressed host

Infectious Disease (8 decks)

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