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VIRAL Flashcards

1
Q

How is herpes zoster can be separated from anterior poliomyelitis

A

unilateral , segmental localization and greater involvement of dorsal root ganglion

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2
Q

Histologic hallmark of SSPE

A

Eosinophilic inclusion in cytoplasm and nuclei of glia cells

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3
Q

Differential Diagnosis of SSPE:

A

Lipid storage disease
CJD
Schilder type demyelinating disease

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4
Q

Treatment of Toxoplasmosis

A

Pyrimetamine (100 mg then 25mg daily)

Sulfonamide

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5
Q

Pathology of Herpes occipitocollaris

A

necrotizing inflammatory myelopathy and vasculitis

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6
Q

2 forms of Neurosyphilis

A

Syphilitic Menigitis

Meningovascular syphilis

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7
Q

Test culture of Cryptococcal Meningitis

A

India Ink

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8
Q

Conversion of normal cellular protein involves conversiopn of Prp to

A

PrPsc

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9
Q

PCR in HSV:

  1. False negative?
  2. False positive
  3. Sensitivity
A
  1. first 48 hours of fever
  2. first 3 weeks of illness
  3. 95%
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10
Q

Treatment pf PML

A

Non-AIDS: non-treatable

AIDS: aggressive ARV with protease inhibitor (slows the progression)

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11
Q

Fatality rate of HSC

A

30-70%

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12
Q

This condition is has a histopathologic findings of gliosis mainly in the MEDIAL THALAMIC NUCLEI

A

Famililal Fatal insomnia (FFI)

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13
Q

How many cases of PML has AIDS?

A

75%

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14
Q

Quertet of Human Disease (Prion)

A

a. CJD
b. Gertesmann Straussler Scheiker
c. Kuru
d. Fatal insomnia

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15
Q

Death occurrence in patients with PML

A

3-6months

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16
Q

non-progressive in nature occurring 2-3 years of life characterized by clumsiness with frank ataxia

A

Progressive Rubella Panencephalitis

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17
Q

How is post-exposure prophylaxis given in rabies

A

a. HRIG at 20u/kg (1/2 IM and 1/2 wound)

b. human diploid cell vaccine - given 1ml day 0-3-7-14-28

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18
Q

Pattern of deterioration of SSPE

A

a. deterioration in proficiency at school
b. progressive intellectual deterioration(seizure and myoclonus)
c. Hyperactive DTR
d. Decorticate

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19
Q

Most common cause of Aseptic Meningitis

A
  1. Entero virus (1st)
  2. HSV2 -2nd common
  3. EBV CMV Leptospira , HSV2 and mycoplasma (3rd)
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20
Q

What is involved if deglutition is affected in poliomyelitis

A

Nucleus ambiguus

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21
Q

Lentivirus causes?

A

HIV

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22
Q

Incubation period of poliomyelitis

A

1-3 weeks

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23
Q

2 TB infection to complicate AIDS

A

M. Tuberculosis

M. Avium intracellulare

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24
Q

What is the other name of Somnolent-ophthalmoplegic encephalitis

A

von Economo Disease, Sleeping Sickness

ENCEPHALITIS LETHARGICS

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25
Q

Most common site of Herpes Zoster

A

T5-T10

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26
Q

Epidemiology of HIV (4)

A
  1. 9% of population
  2. 2% hemophiliacs
  3. 80% of african: heterosexual contact
  4. 2/3 homosexual and bisexual men
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27
Q

treatment, dose and duration of HSV

A
  1. Acyclovir at 30mg/kg 10-14 days
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28
Q

What strain of Parvovirus causes encephalitis and meningitis

A

B-19

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29
Q

Viral infection associated with cauda equina neuritis (2)

A

HIV and HSV

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30
Q

What differentiate cerebral lipidosis from CJD?

A

Retinal changes and chronicity

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31
Q

What is the reason for myoclonus in CJD?

A

loss of inhibitory neurons in thalamic reticular neurons that corresponds with positive sharp waves

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32
Q

Evidences that viral infection leads to chronic disease:

A

a. Demonstration of degeneration of nigral neurons (encephalitis lethargica)
b. Presence of inclusion bodies ( SSPE)
c. slow viral infection with long incubation period (VISNA)
d. EM of viral particles (PML)

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33
Q

Earliest pathologic findings in poliomyelitis

A

central chromatolysis of Anterior horn cells

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34
Q

Herpes Zoster associated with malignancy that tends to be generalized?

A

Herpes Zine Herpete

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35
Q

Measles or exposure to measles precedes encephalitis by 1-6 months that occurs in children and adult secondary to cell mediated immune response?

A

Subactute Measles encephalitis with Immunosupression

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36
Q

Mortality rate of poliomyelitis

A

5-10%

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37
Q

Prognosis of poliomyelitis

A

if survive the acute stage - recovers completely

Muscle recovery at 3-4 months

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38
Q

Treatment of CMV

A

Foscarnet and Ganciclovir

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39
Q

Etiology of Acute ANterior Poliomyelitis

A

Entero virus
Coxsackie A and B
Japanese Encephalitis (west nile)

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40
Q

How many percent occurrence of ophthalmic zoster

A

15%

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41
Q

Viral organism associated with encephalitis in Stem Cell transplant

A

Roseola (exanthem subitum)

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42
Q

Causes of Non-poliovirus myelitis

A

Echo Virus:
70 (residual paralysis and hemorrhagic conjunctivitis)
71 ( Hand and foot and mouth disease)
West nile virus

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43
Q

In viral infection glucose is always normal, if the level is decreased suspect for the following condition:

A
  1. Mumps
  2. HSV 2
  3. LCM
  4. VZV
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44
Q

Reason for tingling sensation at bite site of rabies

A

inflammatory response when virus reaches the sensory ganglia

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45
Q

2 forms of Cranial Herpes Syndromes

A
  1. Ophthalmic - Gasserian

2. Geniculate- Ramsay Hunt ganglion

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46
Q

prognosis of patients with HSV? (3)

A
  1. if unconscious - poor
  2. if treatment begun 4 days and awake - good
  3. residual symptoms - Korsakoff amnesic defect , seizure and dementia
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47
Q

Mode of transmission of HTL-1

A

mother to child
Across placenta
IV drug
Blood Transfusion

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48
Q

Death rate of SSPE

A

1-3 years

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49
Q

AIDS Dementia Complex is how many percent among AIDS patients

A

3%

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50
Q

When does VZV set in HIV

A

when CD4 is below 500

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51
Q

SSPE: Age of onset

A

Rarely beyond 10 years old

Almost 2 years old

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52
Q

MRI findings of CJD

A

hyperintensity of lenticular nuclei (T2 and BWI) in basal ganglia and cortex

Long contiguous segment of cortex (90%)

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53
Q

EEG findings of SSPE

A

Burst suppression 2-3 high voltage

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54
Q

What condition has a histopathologic findigs of:

Widepsread neuronal loss and gluosis by vacuolation and accumulation of specific protein (amyloid, tau, synucleun and ubiquitin)

A

CJD

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55
Q

3 Groups of Von Economo Disease

A

a. Ophthalmoplegia and somnolence
b. Overly acitive
c. Bradykinesia, catalepsy, mutism and chorea

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56
Q

EEG findings of HSV

A

PLEDS

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57
Q

Kuru plaques are characterized by:

A

non-inflammatory neurons and spongiform changes throughout cerebellar cortex and Stellate plaques of amyloid like material

58
Q

Virus that resides latent in tissue (kidney and BM)

A

JC virus

59
Q

Other term of SSPE

A

inclusion body encephalitis

Result from chronic measles virus infection

60
Q

Quartet of Vogt Koyagan Harada Syndrome

A
  1. Iridocyclitis
  2. Depigmentation of hair
  3. Loss of eyelashes
  4. Deafness
61
Q

2 forms of acute encephalitis

A
  1. Direct invasion

2. Postinfectious encephalomyelitis

62
Q

treatment of ophthalmic zoster

A

Acyclovir every hour 0.1 or 0.5 ointment 4-5 days

63
Q

3 forms of poliomyelitis

A
  1. Inapparent - mild symptoms (abortive)
  2. Non-paralytic
  3. Paralytic
64
Q

PrP is encoded with what gene

A

Short arm of Chr. 20

65
Q

Patient who develop this condition has a preceding pharyngitis with elevated ASO and oligoclonal bands

A

Von economo disease

66
Q

DIagnostic criteria for SSPE (3)

A

Periodic complexes in EEG
Elevated Oligoclonal bands
Elevated IgG and Measles AB titer

67
Q

Pathologic findings in JCL

A

Inclusion bearing oligodendrocytes

JC VIRUS

68
Q

Limbic encephalitis and brainstem encephalitis is associated with what malignancy?

A

Distant lung cance

69
Q

MRI findings of acute cerebellitis

A

normal or with enhancement of cerebellar cortical ribbon

70
Q

inclusion body found in Herpes Zoster Virus

A

Lipshütz Inclusion Body

71
Q

Histologic findings of SSPE

A

degeneration of medullated fibers with perivascular cuffing and fibrous gliosis (sclerosing encephalitis_

72
Q

Characterized by intractable seizure and progressive hemiparesis?

A

Rasmussen’s encephalitis

73
Q

What condition where there is acute inflammatory reaction in isolated spinal, cranial sensory ganglia lesser in posterior and anterior roots and posterior grey matter

A

Herpes Zoster Virus

74
Q

Molecular abnormalities of Familial Fatal insomnia

A

mutation at codon 178 with methionine at codon 129 om chr 20 (sporadic)

75
Q

What condition will you see a viral infection localized to midbrain, subthalamus and hypothalamus with depigmentation of substantia nigra

A

Von economo disease

76
Q

Slow infection caused by unconventional transmissible agents to be documented in human beings?

A

Kuru

77
Q

Pattern of symptoms of CJD

A

Changes in behavior –> intellectual function –> ataxia –> visual abnotmalitis (BIAV)

78
Q

Prevalence of Toxoplasmosis in AIDS

A

13%

79
Q

Causes ependymal and acqueductal stenosis

A

Mumps

80
Q

Neuroaxis affected by HSV (3)

A
  1. inferomedial or lateral frontal
  2. temporal lobes
  3. insula
81
Q

What condition you can see intense hemorrhagic necrosis:

A

HSV

82
Q

Transmission of Fatal insomnia

A

inoculation

83
Q

What type of HSV causes encephalitis?

A

HSV-1

84
Q

CSF picture of abortive poliomyelitis

A

aseptic meningitis

85
Q

First slow virus in human

A

von economo disease

86
Q

When is atrophy detected in paralytic poliomyeltis

A

3 weeks of onset (maximal 12-15 weeks)

87
Q

MRI of CMV

A

concentrated on ventricular borders with meningeal enchancement

88
Q

Biogenic amines implicated for this virus for entry to oligodendrocytes

A

Serotonin

89
Q

What condition is characterized by progressive and profound dementia with diffuse myoclonic jerks

A

Creutzfeldt-Jakob Disease

90
Q

Condition associated with PML (6)

A 
CLL
Hodgkins
Lymphosarcoma
Myeloproliferative disease
TB
Sarcoidosis
91
Q

Immune reponses assocated with Rasmussen Encephalitis

A

(+) Glutamate receptor

92
Q

Among the organism associated with aacute poliomyeltis, what causes severe and persistent asymmetrical paralysis?

A

WESL NILE

93
Q

Classification of CJ based on Genotypes:

  1. Least common
  2. Most common
  3. EEG findings seen in what type?
  4. What codon are methionine and valine found:
A
  1. MM
  2. MM2
  3. Type 1
  4. Codon 129
94
Q

Immunoassay in CJD

A

brain fragments of 14-3-3

95
Q

MRI findings of HSV

A

high intensity T2 and low intensity T1 and always enhancing

96
Q

Imaging findings of AIDS Dementia Complex

A

CT: widening of sulci

MRIL patchy but confluence, diffuse white matter changes

97
Q

Acute cerebellitis is secondary from what infections? (2)

A

Small pox and typhoid

98
Q

Lab test and CSF findings of CJD

A

Normal

99
Q

Presence of this will yield false positive for syphilis

A

HIV

100
Q

EEG findings of CJD

A

diffuse and non-specific slowing of stereotyped high voltage slowing and sharp wzve complexes (pseudoperiodic and synchronous myoclonus)

101
Q

Clinical manifestation of CMV (3)

A

Acute confusional state), delirium, CN ophthalmoparesis)

102
Q

Iron lung is seen in what condition?

A

Acute poliomyelitis

103
Q

Mollaret recurrent meningits is associated with what infection:

A

HSV-1 (steel) and HSV-2

104
Q

Prognosis of Encephalitis lethargica

A

20% dies within weeks

If survives, with neurologic deficits

105
Q

Associated with acute confusional dementia

A

HIV-type 2

106
Q

brain fragments of 14-3-3:

  1. What is the use?
  2. Sensitivity?
  3. Specificity?
A
  1. separates CJD from other chronic inflammatory cause of Dementia
  2. 92%
  3. 80%
107
Q

Incubation period of Rabies

A

20-60 days (as early as 14 days - neck and face)

108
Q

How many percent develop myelopathy in HTLV-1

HTLV associated myelopathy

A

2%

109
Q

Treatment of SSPE

A

Amantadinr and inosine Pranobex

110
Q

Transmitted in proteinacious infectious particles that is devoid of nuclei acid

A

Prion Disease

111
Q

How many percent of CJD will present with stroke-like suddenness

A

10%

112
Q

inorder for a virus to cause infection host must have this for attachement of virus

A

Cytoplasmic membrane

113
Q

What lobe is affected by HHV encephalitis- associated stem cell transplant

A

Medial temporal lobe (llimbic encephalitis)

114
Q

What family of virus causes anterior poliomyelitis

A

Picornavirus (RNA)

115
Q

Condition characterized by hemiparesis, hemianesthesia, aphasia and retinal defects that complicates VZV infection

A

Zoster angitis

116
Q

Features of MadCow disease vs CJD (3)

A
  1. young onset
  2. no typical eeg findings
  3. variant of CJD
117
Q

Treatment for post herpetic neuralgua

A

Amitryptilline

Others CBZ, gabapentin, pregabalin, valprotte

118
Q

What is the TREATMENT and CONDITION associated with initial treatment of ARV?

A

CONDITION: PML
TREATMENT: Corticosteroids

119
Q

Variant of CJD where ataxia is prominent?

A

Brownell-oppenheimer variant

120
Q

Most common non focal neurologic complication of AIDS

A

CMV

121
Q

Clinical manifestation of FFI

A

intractable insomnia, symathetic overactivity and dementia

122
Q

Diagnosis of Herpes Zoster

A

Membrane antigen (VAMA) found in CSF and serum

123
Q

Meningeal infections that are difficult to isolate? (3)

A

TB fungal and syphilis

124
Q

Imaging findings of PML

A

Non-enhancing lesion with variable size and location

125
Q

What inclusion bodies seen in rabies and describe? (2)

A

a. negri bodies - cytoplasmic eosinophilic inclusion

b. babes nodule - focal collection of microglia

126
Q

Cognitive domain affected in AIDS dementia complex?

A

loss of retentive memory

127
Q

Most gravest and common viral infection?

A

HSV

128
Q

Variant of CJD where visual disturbance is prominent?

A

Hedeinhain variant

129
Q

Where is JC virus Dormant?

A

Kidney

130
Q

Complication of HIV treatment

A

Immune Reconstitution of Syndrome (PML)

131
Q

Prevention of Poliomyelitis

A

Salk Vaccine

oral dose two dose 8 weeks apart

132
Q

HIV myelopathy pathophysoiology

A

Vacuolar degeneration (resemble to SCD B12)

133
Q

Rule of paralysis in paralytic poliomyelitis

A

weakness while fever is at its height

No progression of weakness once temperature is normal within 48 hours

134
Q

First viral polyneuropathy in human

A

zoster - ganglionopathy

135
Q

Massive multifocal zone of destruction of both myelin and axon mainly of cerebral hemisphere

A

Progressive Multifocal Leukoencephalopathy (PML)

136
Q

At what temperature CJD can be deactivated

A

132C in 1 hour

137
Q

What condition characterized by ataxia, dysarthria and mild dementia occuring in midlife and runs a chronic course where dysesthesia in proximal leg is prominent?

A

Gerstsmann-Sträussler-Scheinker Syndrome

138
Q

Mechanism of spread of CJD

A

Iatrogenic (tonsils and nasophayrnx)

139
Q

Herpes zoster in palate, pharymx, and retroauricular area

A

Herpes occipitocollaris

140
Q

What markers are elevated in CSF of patients with CJD

A

Neopterin and enolase

CNS infection (1 decks)

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