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microbiology 3 > viral arthropathies > Flashcards

viral arthropathies Flashcards

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1
Q

arthralgia

A

pain in the joints

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2
Q

arthritis

A

inflammation of the joint with the presence of inflammatory cells

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3
Q

arthropathy

A

something wrong with the joint that may or may not be arthritis

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4
Q

arthritogenic

A

something that tends to cause arthritis

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5
Q

monoarthritis

A

a single joint infected

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6
Q

oligoarthritis

A

2 or 3 joints affected

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7
Q

polyarthritis

A

lots of joints affected

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8
Q

migratory arthritis

A

one joint is affected and then resolves, pain moves onto another joint

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9
Q

differential diagnosis of joint pain

A

bacterial, viral, postinfectious, crystal arthropathy, rheumatological diseases, osteoarthritis, trauma

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10
Q

viruses commonly causing arthropathy

A

arboviruses
rubella virus
parvovirus

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11
Q

viruses that rarely cause arthropathy

A

hepatitis viruses and HIV
herpesvirus
enteroviruses
adenoviruses

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12
Q

arboviruses

A

arthropod borne viruses
transmitted via arthropod vector, usually mosquito
- flavivirus (RNA)
- alphavirus (RNA)

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13
Q

flavivirus

A

yellow fever virus (viscerotropic)

eg. dengue, zika, neuurotopric (encephalic) viruses

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14
Q

dengue

A

most common flavivirus infection worldwide

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15
Q

zika

A

caused an epidemic in south and central america

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16
Q

neurotropic flavivirus

A

tend to cause infection of the CNS

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17
Q

australia neurotropic viruses

A

murray valley encephalitis

kunjin virus

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18
Q

non australian flaviviruses

A

japanese encephalitis virus
west nile virus
st louis encephalitis virus

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19
Q

alphaviruses

A 
arthritogenic 
- ross river 
- barmah forest virus 
- chikungunya 
neurotropic 
- western equine encephalitis virus 
- eastern equine encephalitis virus 
- venezuelan equine encephalitis virus 
- mayaro (arthritogenic)
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20
Q

dengue virus transmitted by

A

aedes aegypti

also aedes albopictus

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21
Q

dengue infects

A

maintained in human populations

can infect non human primates

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22
Q

dengue seotypes

A

4 serotypes which co circulate

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23
Q

dengue incubation period

A

3-14 days after mosquito bite

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24
Q

clincal manifestations of dengue

A

fever
headache, eye pain, myalgia, arthralgia
rash, usually 2-5 days after symptom onset
GI symptoms

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25
Q

dengue lab resullts

A

abnormal LFTs, low platelets
serology for diagnosis - NS1 antigen and IgM and IgG antibodies
nucleic acid testing (PCR) also works for diagnosis

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26
Q

severe dengue

A

formerly dengue haemorrhagic fever and dengue shock syndrome
more common in secondary than primary dengue infection
plasma leakage, heamorrhage, shock
critical period 3-7 days after symptom onset

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27
Q

dengue treatment

A

supportive care only
careful fluid management in severe dengue
vaccine development hampered by antibody dependant enhancement

28
Q

Zika transmitted by

A

Ae. aegypti, Ae. albopictus

29
Q

Zika incubation period

A

2 - 14 days

30
Q

clinical manifestations of Zika

A

similar to dengue but milder
50-75% of infections are asymptomatic
conjunctivitus is common in symptomatic infection

31
Q

lab diagnosis of zika

A

serology for igM and IgG antibodies
definitive diagnosis can be difficult due to cross reactivity with other flaviviruses
nucleic acid testing

32
Q

treatment of zika

A

supportive care only

33
Q

person to person transmission in Zika

A

sexual and vertical transmission possible

34
Q

neurotropism of zika

A

microcephaly and other neurological abnormalities from intrauterine infection
causes guillain barre syndrome

35
Q

ross river and barmah forest viruses

A

most common causes of viral polyarthritis in australia
regular epidemics with a geographical focus
distributed throughout australia, also found in melanesia
multiple mosquito vectors
infection is enzootic in native macropods (kangaroos, wallabies), can also infect horses, livestock, other wild animals

36
Q

incubation period for ross river and barmah forest

A

3-21 days

37
Q

clinical manifestationss of ross river and barmah forest viruses

A

arthralgia
fatigue
rash
fever and myalgia

38
Q

arthralgia in ross river and barmah forest viruses

A

athralgia is usually symmetrical, affects wrists, knees, ankles, MCP/IP joints of the hands
may persist for 3-6 months

39
Q

lab diagnosis for ross river and barmah forest

A

serology for IgM and IgG

nucleic acid testing

40
Q

treatment for ross rver and barmah frest

A

supportive care only

41
Q

chikungunya virus vectors

A

prmary vectors are Ae. aegypti and Ae. albopictus

42
Q

chikungunya virus incubation period

A

incubation period 1-14

43
Q

chikungunya virus clinical manifestations

A

fever
arthralga
rash
headache, myagla, GI symptoms

44
Q

althralgia in chickungunya vrus

A

usually 2-3 days after fever onset, similar distribution to other alphaviruses
can be debilitating, gradually mproves over 3-18 months

45
Q

lab diagnosis of chikungunya

A

serology for IgM and IgG

nucleic acd testing

46
Q

treatment for chikungunya

A

supportive care only

47
Q

rubella caussed by

A

rubella virus (RNA)

48
Q

rubella incubation period

A

14-18 days

49
Q

rubella tranmission

A

person to person via large respiratory droplets

50
Q

clinical manifestations in children of rubella

A

often mild or asymptomatic
distinctive rash spreads from face to trunk and extremities within 24 hours, lasts 3-8 days
low grade fever and lymphadenopathy pay precede the rash

51
Q

clinical manifestations of rubella in adults

A

rarely asymptomatic
prodrome with fever and lymphadenopathy more pronounced, followed by rash
arthralgia reported in 70% of adult women, concurrent with rash
- may persist for 1-2 months
- knees, wrists, fingers most frequently involved

52
Q

lab diagnosis of rubella

A

serology IgM and IgG anitbodies

nucleic acid testing (PCR)

53
Q

treatment for rubella

A

supportive care only

54
Q

rubella in pregnancy

A

transplacental infection may occur
greatest risk in first trimester, minimal after 20 weeks gestation
intrauterine infection may lead to fetal loss or congental rubella syndrome

55
Q

congenital rubella syndrome

A

hearing loss
intellectual impairment
cardiac abnormalities
cataracts

56
Q

rubella precautions in pregnancy

A

testing for rubella immunity routinely recommended in pregnancy; post-pregnancy booster if IgG is low
post exposure prophylaxis in pregnancy has not been shown to be beneficial
confirmed cases managed by maternal-fetal medicine

57
Q

parvovirus

A

parvovirus B19
small DNA virus with global dictribution, first isolated in australia
causes another childhood exanthem ‘fifth disease’
50% infected by age 15
transmission person to person by large respiratory droplets
incubation period 1-2 weeks

58
Q

clinical manifestations of parvovirus

A

25% asymptomatic
50% have mild, non-specific illness (fever, myalgia, coryza, headache)
25% present with erythema infectiosum or arthralgia

59
Q

erythema infectosum

A

usually seen in children
erythematous malar rash with circumoral pallor (slapped cheek syndrome) follows 2-5 days after prodrome
generalised rash follows

60
Q

athralgia in parvovirus

A

mainly adults, especially women
affects hands, wrists, knees, feet symmetrically
usually lasts three weeks
generalised rash in 75% of cases

61
Q

other manifestations of parvovirus

A

aplastic crisis in haematological disorders

chronic haemolysis in immunocompromised patients

62
Q

lab diagnosis of parvovirus

A

serology for IgM and IgG antibodies

nucleic acid testing (PCR)

63
Q

parvovirus treatment

A

supportive care only

no vaccine or post exposure prophylaxis exists

64
Q

parvovirus in pregnancy

A

transplacental infection may occur
may lead to fetal loss or fetal hydrops
- parvovirus is cytotoxic too fetal red blood cell precursors
greatest risk prior to 20 weeks
confirmed infection in pregnancy managed by maternal-fetal medicine
- fetal blood transfusion may be used to treat fetal hydrops

65
Q

pathogenesis of viral arthropathy

A

not well understood
not simply viral replication in the joints
at least partially immune mediated
virus has occasionally been cultured from joint aspirates
- viral antigens and nucleic acid detected more commonly
- viral inclusions have been seen in joint macrophages
immune complex deposition thought to contribute to joint symptoms and rash

66
Q

qualities of viral anthropathies

A

usually symmetrical
affect wrists, knees, hands, feet,
often accompanies by rash and/or fever

microbiology 3 (10 decks)

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