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Tropical Medicine > Viral > Flashcards

Viral Flashcards

1
Q

3TC- chemical, class

A

lamivudine

NRTI

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2
Q

ABC- class, name, SE

A

NRTI

abacavir

hypersensitivity with HLA-B5701

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3
Q

ABC- class, name, SE

A

abacavir

NRTI

hypersensitivity, esp HLA-B5701

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4
Q

Aedes aegypti- appearance, transmits 3

A

dark body with white stripes

DEN, CHIK, YF

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5
Q

Anopheles transmits which viruses/parasites (2)

A

ONY, malaria

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6
Q

ARBOvirus transmission: no vector (4), blood exposure (2), ribavarin use (

A

Ebola, Marburg, Lassa, Hanta

RVF, CCHF

Ribavirin use: Lassa, CCHF, Hanta, RVF

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7
Q

Arenaviridae- 2

A

Lassa, lymphocytic choriomeningitis

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8
Q

ART has NOT led to reduction in which CA

A

cervical

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9
Q

at what prevalence need HIV and Hep B screening

A

> 0.1% HIV

> 2% Hep B

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10
Q

AZT- chemical, class, SE

A

zidovidine

NRTI

macrocytic anemia

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11
Q

B virus- agent, host, Sx

A

DNA Herpesviridae

macaque bite

localized neuro to CNS (fatal)

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12
Q

Bacillary angiomatosis- agents, Dx, Tx

A

B. henslae and B. quintana

silver stain

macrolide or doxy

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13
Q

Bunyaviridae (3)

A

CCHF, RVF, Hantavirus

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14
Q

CCHF family, geo, vector, classic Sx, mortlaity, Tx

A

bunya

Eastern Europe, Africa, Asia, Middle East

tick

extensive prupura

25%

ribavarin

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15
Q

CCHF- family, vector, reservior, geo, characteristic Sx

A

Bunyaviridae (nairovirus)

transmitted by the hard (Ixodid) Hyalomma ticks

herd animals

Eastern Europe, Africa, Indian subcontinent, and Middle East

extensive purpura

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16
Q

Chik vs dengue clinically

A

arthralgia vs myalgia

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17
Q

Chik- family, vector, Sx (3), sequalae (3)

A

toga/alpha

Aedes (aegypti and albopictus)

fever, rash, arthralgia

tenosynovitis for years, Raynauds, cryoglobulinemai

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18
Q

Chikungunya- family, vector, geo, classic

A

RNA togo/alpha

Aedes

Asia, Africa, Europe

fever, joint pain esp hands and feet

half may have pain mos to yrs

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19
Q

Contraindications to AZT

A

bone marrow suppression, myopathy, lactic acidosis (rare), and hepatic

Also antogonistic with d4T (stavudine)

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20
Q

cryptococcus maintenance in HIV

A

fluconazole 200 QD for life (NOT proph)

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21
Q

cryptococcus prophylaxis with HIV- when, what

A

CD4< 200

fluconazole

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22
Q

Culex transmits which viruses (2)

A

JE, WNV, equines

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23
Q

CXR typical HIV with TB

A

hilar and mediastinal adenopathy

lower non-cavitating infiltrate

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24
Q

d4T- chemical, class, SE

A

staduvidine

NRTI

neuropathy, pancreatitis,hepatitis

Antaginistic with AZT

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25
Q

ddC- class

A

NRTI

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26
Q

ddI- class, name, SE

A

NRTI

didanosine

pancreatitis, peripheral neuropathy

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27
Q

Dengue Sx, course, mortality

A

DF- breakbone fever with retro-orbital HA, rash, tourniquet test, white islands on red sea rash in recovery

resolves by day 7 unless DHF develops; avoid fluid overload

mortality: 12% DHF, 50% DSS

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28
Q

Dengue- class, cases, deaths, vector

A

flavivirus

75 million (but > 50% ASx), 25K deaths

Aedes

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29
Q

Dengue- family, vector, geo, Sx

A

RNA flavivirus

Aedes

Latin and S. America, Asia, Africa

75% ASx

retro-oribital pain, rose spots, bradycardia, petechiae, V, abd pain, low PLT, shock if goes hemorrhagic

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30
Q

Ebola/Marburg Sx

A

severe headache, arthralgias or myalgias, anorexia, asthenia, GI Sx

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31
Q

EFV- chemical, class, SE

A

efavirenz

NNRTI

teratogenic, interact rifampin

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32
Q

Esophageal candidiasis is which WHO HIV stage

A

4

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33
Q

Faget’s sign

A

relative brady despite fever

seen YF and DEN

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34
Q

Filovirus- agents, reservior, Sx

A

Ebola, Marburg

fruit bat reservior, unknown host

capillary leak, DIC, asthenia, diarrhea, abd pain, conjunctival, rash

high fatality- 25% Marburg

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35
Q

Flaviviridae

A

Hep C

Mosq: DEN, WNV, JE, YF, Zika

Tick: Powassan, Kysanar Forest dz, Omsk hem fever, tick-borne enceph (POW, TBE, OMS, KFD)

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36
Q

Hantavirus- family, source, geo, incubation, Sx

A

bunya

inhalation urine, droppings, or saliva of the deer mouse

central and western US and Canada, also Korea

incubation 3-4 wks

Hantavirus pulmonary syndrome (HPS)- 38% mortality Sin Nombre virus

ALSO, hemorrhagic fever renal syndrome in Korea

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37
Q

Hep A shedding duration

A

2 wks before

kids up to 6 mo

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38
Q

Hep A vaccine contraindications

A

allergy- neomycin, yeast, latex

age < 12 mo

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39
Q

Hep A vaccine effectiveness after 1 and 2

A

94% after 1 mo

99% after 2 shots

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40
Q

Hep B acute Sx- infants and older than 5 YO

A

infant 1%, older 40%

BUT more kids get chronic

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41
Q

Hep B chronic % in infants, > 5 YO

A

90% infants

10% > 5 YO

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42
Q

Hep B highly endemic in

A

Southeast Asia, Sub-Saharan Africa, Amazon basin in South America, Greenland, Northern Canada

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43
Q

Hep B overall mortality

A

0.75%

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44
Q

Hep B prevalence

A

2 billion, 1/3 of world

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45
Q

Hep C % chronic, % cirrhoisis

A

80% chronic

20% cirrhosis

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46
Q

Hep C acute %

A

20%

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47
Q

Hep C and cancer

A

NHL lymphoma > liver CA

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48
Q

Hep C- family, transmission, incubation, Tx

A

RNA

fluids, perinatal 5% risk

6 wk

interferon and ribavarin

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49
Q

Hep E and pregancy

A

10% mortality

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50
Q

Hep E- family, tansmission, incubation, geo, severity

A

RNA hepevirdae

FO>>P2P, swine workers

6 wks

India, Africa, ME…

15% pregnant mortality

worse in older

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51
Q

HepA- family, transmission, age, incubation

A

RNA flavivirus

FO, P2P

more severe > 50 YO

4 wk

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52
Q

Hepatitis B endemic in

A

Southeast Asia Sub-Saharan Africa Amazon basin in South America Greenland Northern Canada

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53
Q

Hepatocellular CA assoc

A

B > C

B- 40% no cirrhosis first

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54
Q

HepB- family, transmission, geo, incubation

A

DNA hepadnaviridae

body fluds (90% perinatal)

Asia, Africa

6 wks

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55
Q

high nosocomial spread

A

CCHF, filovirus, MERS

56
Q

HIV and HBV co-infection Tx

A

NRTI: tenovir (TDF), lamivudine (3TC), emtricitabine (FTC)

less liver

57
Q

HIV breast feeding transmission rate

A

15%

58
Q

HIV drug teratogenic 1st trimester

A

EFV

59
Q

HIV med causing cytopenia

A

AZT

60
Q

HIV med commonly causing drug eruption

A

NVP, worse higher CD4

61
Q

HIV med nephrotoxic

A

TDF (tenovir)

62
Q

HIV meds causing dyslipidemia

A

PI

63
Q

HIV meds causing hepatitis

A

all, esp NVP

64
Q

HIV meds causing neuropathy and pancreatitis

A

d4T (staduvidine), ddI (didanosine)

65
Q

HIV meds causing pancreatitis (2)

A

d4T, ddI

66
Q

HIV second line Tx in Africa

A

Ritonavir protease inhibitier + 2 NRTI (at least 1 new)

67
Q

HIV Tx firstline in Africa

A

2 NRTI + 1 NNRTI (usually EFV)

68
Q

HIV with fever and HA- Asia, Africa

A

Penicillinosis in Asia

Cryptococcus in Africa

69
Q

HIV-2- number, resistance

A

< 500K

NNRTI resistant

70
Q

How effective is Hep B vaccine

A

90%

71
Q

How many in world infected with Hep B

A

2 billion

72
Q

HTLV-1- assoc dz (3), transmission (3), geo

A

adult T-cell (in 4%), tropical spastic paresis, worse strongy

STD, iatrogenic, BF

Japan, Carribean, New Guinea, S. Am

73
Q

Incubation for hemorrhagic fevers

A

< 21 d

74
Q

Infections resembling moluscum contagiousum (2)

A

Penicillinosis

cutaneous cryptococcus

75
Q

Japanese encepahalitis- family, vector, mortality

A

flavi

Culex

if Sx, 25% fatal, 40% morbidity

76
Q

Kyasanur Forest Disease- family, geo

A

flavi

India

77
Q

Lassa treatment

A

ribavarin

78
Q

Lassa- genus, geo, reservior, Sx (big 3), sequelae, perinatal, Tx

A

arenovirus

Africa

mastomys rats inhaled or ingested

fever, retrosternal pain, pharyngitis…GI, proteinuria, and mucosal bleeding, possible neuro

Deafness sequelae in 30%

Mortality 30% pregnant, 85% infants (“swollen baby syndrome”- anasarca and bleeding

Tx- early ribavirin can reduce mortality

79
Q

Lymphocytic Choriomeningitis Virus (LCMV)- family, vector

A

arena

mouse

80
Q

MAC prophylaxis at

A

CD4 50

macrolide- Zithromax/biaxin,

81
Q

maternal HIV transmission rate

A

30%

(8% with AZT)

1% with infant triple drug and exclusive BF

82
Q

measles clinical triad

A

cough, coryza, conjunctivitis

83
Q

Measles complication 1:10,000

A

subacute sclerosing panencephalitis

5-10 yrs later

84
Q

Measles- % exposed who become ill

A

90%

85
Q

Measles- timing, Sx, contagious, complications (3)

A

incubation 7-14 d, 90% exposed get infected

prodrome-cough, conjunctivitis, and coryza

Koplik spots

rash (9-19 d from exposure), 2-5 days after prodrome

Head -> body fades in 3-5 days.

Contagious 4 days before to 4 d after rash

Pneumonia (giant cell and secondary bacterial)

Encephalitis (1/1000)

Sub-acute sclerosing panencephalitis (1/100,000) yrs later

86
Q

Meds associated with lactic acidosis

A

Didanosine (ddI), stavidine (d4T) and zidovudine (AZT)

87
Q

MERS- family, geo, host, mortality

A

betacoronovirus

Saudi Arabia

camels

40%

88
Q

monkeypox geo

A

Africa

89
Q

mosquito borne viruses

A

Aedes- DEN, CHIK, YF, RVF

Anopheles- ONY

Culex- JE, WNV, VEE, WEE, EEE

multiple: RR, SEM, lymphatic filariasis

90
Q

most common 1st line HAART Tx in developing

A

Tenofovir (TDF) + lamivudine (3TC) + efavirenz (EFV)

91
Q

mumps- family, transmission, complication

A

paramyxovirus

droplet, saliva, fomite

5-10% meningitis, orchitis

92
Q

needlestick risk- B, C, HIV

A

30% B

3% C

0.3% HIV

93
Q

NRTI assoc with lactic acidosis (3)

A

didanosine (ddI), stavidine (d4T) and zidovudine (AZT)

94
Q

number infected with HIV

A

33 million, 2/3 in Africa

95
Q

NVP- chemical, class, SE

A

nevirapine

NNRTI

dermatitis, hepatitis

more toxic M CD4>400, F CD4>250

96
Q

OMSK- family, vector (2)

A

flavi

rodent, sheep/goat milk

97
Q

Perinatal Hep B transmission

A

90%

98
Q

PJP prophylaxis- when, what

A

CD4 <200

Bactrim SS sufficient

99
Q

Polio Sx

A

most Asx, many mild GI, severe with meningismus

100
Q

Polio- family, host, endemic (2), % post polio

A

RNA enterovirus, 3 serotypes

human

Pakistan, AFG

post polio in 25%

101
Q

Polio- Sx %

A

0.5% of infected get paralytic polio

5-10% of paralytic will die so 0.05% of infected will die

0.05% will have irreversible paralysis

102
Q

Prion- agent, Sx, Dx

A

protein

dementia, neuro

tonsil Bx

103
Q

Progressive Multifocal Leukoencephalopathy- agent, assoc

A

Polyomavirus JC

IRIS in HIV

104
Q

Proph for HIV- 50, 100, 200

A

50- MAC; macrolide

100- toxo; Bactrim DS, Fandisar

200- PJP and crypto- Bactrim SS and fluconazole

105
Q

Rabies post exposure both unimmun and immunized in USA

A

Unimmun: RIG 100% into wound, vaccine 0, 3, 7, 14

Immun: No HRIG, vaccine 0, 3

Extra at 28 for immunocompromised

106
Q

Rabies PrEP- schedule

A

0, 7, 21/28

do NOT start if cannot finish

107
Q

Rabies US PEP- exposure, how fast start

A

for any exposure- touch, bat in same room while asleep

RIG at site within 24 hours

4 doses vaccine within 24 hours (0, 3, 7, 14)

IF IMMUNIZED- 2 doses within 48 h (0, 3)

108
Q

Rabies- 2 forms, mortality

A

furious (most)- 80%

paralytic (dumb)- 20%

100% fatal, 55K/yr (1/3 India)

109
Q

Reoviridae (1)

A

Colorado Tick Fever

110
Q

Rift Valley Fever- family, reservior, vector, geo

A

Bunya

sheep, cattle- abortions

Aedes mosquito

Africa, Mid East

111
Q

Ross River virus- family, vector, geo, Sx

A

Togavirus

“endemic polyarthritis”

mosquitoes

Australia and Asia

112
Q

Rubella- family, incubation, contagious time, complication

A

togavirus

2-3 wks

2 wks before rash; congenital for 1 yr

congenital with PA stenosis, deaf, cataract, microcephaly

113
Q

Salk vs Sabin

A

oral vaccine (Sabin) 1 dose -> 50% immunity; 3 doses -> 95% immunity, also IgA, shedding may immunize others, better for wild type polio

Salk (injected/inactivated) vaccine 2 doses -> 90% immunity in 90%

114
Q

sheep/goat milk possible source of which viruses (2), bacteria (4)

A

TBE, OMSK

M. bovis, Coxiella, EHEC, Yersinia

115
Q

Smallpox vaccine post-exposure prophylaxis within…

A

4 days

116
Q

Smallpox- incubation, Sx

A

incubation 10-12 days

fever, headache, and severe backache

centrifugal rash in 2-4 days

vesicles, pustules, scabs that desquamate end of the third or fourth week- SAME STAGE

more lesions on the arms and legs than on the trunk

117
Q

TDF- chemical, class, SE

A

tenovir

NRTI

nephrotoxic

118
Q

Tick borne encephalitis- family, host, vector, geo, prevention

A

Flavivirus

Rodents

Tick- 30% not recall AND sheep/goat milk

Europe, Russia, Siberia

vaccine in other countries

119
Q

Tick borne viruses (6) P. TOCCK

A

CCHF, TBE, KFD, OMSK, POW, CTF

120
Q

Togoviridae (4 types)

A

CHIK, EEE, VEE, WEE, RF (Ross), ONY, SEM

(CHIK, equine, Ross, rubella and odd)

121
Q

toxoplama prophylaxis in HIV- when, what

A

CD4< 100

Bactrim DS or Fandisar

122
Q

Toxoplasma maintenance of______ until CD4______

A

Pyrimethamine and sulfdiazine (fandisar) OR Bactrim DS

CD4 >100

123
Q

Tx for infants of HIV pos mom

A

NVP for 1 year

Bactrim PJP proph

INH if TB exposed

124
Q

Tx HIV with TB

A

rifampin and clarithromycin

drug interaction with EFV (use NVP or 3 NRTI)

start ART < 8 wks after start TB Tx

125
Q

Varicella endemic

A

temperate

people in tropics may not be immune

126
Q

Infections leading to hearing loss

A

Borrelia, Lassa, rickettsia

127
Q

Where is HTLV-1 endemic

A

Japan, Carribean

128
Q

WHO HIV stage 1

A

ASx to LAD

129
Q

WHO HIV stage 2

A

minor rashes, zoster, URI

130
Q

WHO HIV stage 3

A

weight loss

unexplained fever, diarrhea, or anemia

oral lesions/thrush

active TB

131
Q

WHO HIV stage 4

A

HIV wasting

extrapulmonary TB

esophageal candidiasis

AIDS defining infections

132
Q

WHO rabies PEP

A

lick, touch -> 0

minor scratch/no bleed -> vaccine

bite -> RIG and vaccine

133
Q

Yellow fever- family, annually, geo, mortality, Sx

A

flavi

200K cases, 30K deaths

90% Africa (mortality 25%), 10% Americas (mort 55%)

15% acute go toxic

Jaundice, Abd pain, Diarrhea, ARF, Bleeding

134
Q

YF Sx

A

3-4 d HA, photophobia, conjunctival injection, bradycardia

remission 1-2 d

15% get biphasic with mild jaundice, bleeding, hemetemsis, proteinura, EKG changes, nuero, secondary pneumonia

135
Q

Zika- family, vector, Sx (4)

A

flavi

Aedes

rash, fever, joints, conjunctivitis

136
Q

Hep B serotypes

A

A- more resistant to lamuvidine

B- respond better to inteferon

C- higher risk HCC

137
Q

Rotovirus vaccine

A

killed, oral

Tropical Medicine (7 decks)

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