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Multisystem Micro > Viral disease of childhood > Flashcards

Viral disease of childhood Flashcards

1
Q

Childhood Exanthema

A

1st disease: measles
2nd disease: scarlet fever
3rd disease: german measles (rubella)
4th disease: filatow-dukes disease..don’t know if this is really a thing
5th disease: erythema infectiosum due to parvo b19
6th disease: roseola infantum (aka exanthema subitum due to HHV 6/7)

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2
Q

Paramyxovirus. Tell me about it

A
  1. Large, enveloped
  2. ssRNA- (has RNA dependent RNA polymerase)
  3. Non-segmented genome so doesn’t rearrange like orthomyxovirus (the flu) does
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3
Q

Viruses in Paramyxoviridae family?

A
  1. Parainfluenza virus
  2. Measles
  3. Mumps
  4. RSV
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4
Q

What part of the paramyxovirus do we make antibodies to initially?

A

The surface glycoproteins

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5
Q

What viruses cause a maculoarpapular rash (one of the objectives….)

A
  1. Measles
  2. Rubella
  3. Echoviruses 4, 9, 16
    4, Coxsackievirus A9, 16, B5
  4. Adenovirus
  5. Parvovirus B19
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6
Q

What viruses cause a vesicular/papular rash (one of the objectives….)

A
  1. Varicella
  2. Smallpox
  3. Molluscum contagiosum
  4. HSV
  5. Cosackievirus Group A
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7
Q

What viruses can petechial or purpuric rash (one of the objectives….)

A
  1. Coxsackievirus Group A

2. Echovirus

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8
Q

What vaccine works against measles and mumps?

A

MMR: live attenuated virus

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9
Q

Measles. Tell me about it’s presentation.

A

Initially, think 4 C’s:

  1. Conjunctivitis
  2. Cough
  3. Coryza
  4. Koplik spots (blue/white spots on red background in the oral mucosa) (pathonemonic for Measles)

Then you get really high fever (40C) and descending, confluent rash (which is a cell mediated, T-cell response. If pt has reduced cell mediated immunity there will be no rash).

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10
Q

What are the complications of measles?

A
  1. Pneumonia
  2. ADEM: acute disseminate encephalomyelitis (days after)
  3. MIBE: measles inclusion body encephalitis (months after)
    * 4. SSPE: Subacute sclerosing, pan-encephalitis (years after)
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11
Q

Virulence factors for measles?

A
  1. HA: hemagluttinin which makes RBC stick together
  2. Fusion protein: makes multinucleate giant cells usually in lymphoid tissue. May also see cytoplasmic and intranuclear inclusion bodies.
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12
Q

What vitamin reduces the morbidity and mortality of measles?

A

Vitamin A

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13
Q

What clinical manifestations are associated with mumps?

A
  1. Parotitis (virus replicates in the salivary and parotid gland)
  2. Unilateral orchitis (impaired fertility)
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14
Q

Complications of mumps?

A
  1. Meningitis

2. Post- infectious Encephalitis

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15
Q

Virulence factors of mumps

A
  1. HA
  2. Fusion proteins
  3. Neuraminidase (NA): catalyzes hydrolysis of sialic acid off infected cell so that when the new virus is released it doesn’t just stick to the cell its coming from, but can infect new cells.
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16
Q

RSV clinical manifestations?

A
  1. Seen in infants
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17
Q

RSV is the #1 cause of _________ and ________ in infants

A
  1. Pneumonia

2. Brochiolitis

18
Q

Virulence factors of RSV

A
  1. Fusion proteins
19
Q

Treatment for RSV?

A

Ribavirin (not for kids)

*Palivizumab: for kids that are at risk (preterm)

20
Q

Parainfluenza virus (PIV). What does this cause?

A
  1. *Croup (aka laryngotracheobronchitis): Seal bark cough and inspiratory stridor (type 1 and 2)
  2. Bronchitis (type 4)
  3. Bronchiolitis (type 3–children
21
Q

Virulence factors for PIV?

A
  1. HA
  2. NA
  3. Fusion protein
22
Q

Characteristic X-ray finding with croup?

A

Steeple sign (narrowed subglotic region)

23
Q

What happens in a neutralization assay?

A

Measures the ability of a dilution of the patient’s serum (containing antibodies) to neutralize the virus. The last concentration of serum that is able to fully neutralize the virus is the titer concentration.

24
Q

What happens in a hemagglutination inhibition assay?

A

Determines the highest serum dilution that inhibits RBC agglutination.

25
Q

Why do we often get reinfected with PIV/RSV?

A

Because mucosal immunity (IgA mediated) is not long lived. So we may have some residual immunity but not enough to prevent infection.

26
Q

Rubella virus (NOT A PARAMXYOVIRUS). What kind of virus is this?

A
  1. Togovirus.
  2. Transcribes a single long polypeptide that is cleaved into active proteins.
  3. +ssRNA
  4. Enveloped
27
Q

What vaccine prevents rubella?

A

MMR-live attenuated vaccine

28
Q

Childhood rubella

A
  1. Painful postauricular and occipital lymphadenopathy
  2. Maculopapular, descending rash (moves faster than measles and doesn’t coalesce)
  3. Fever, fatigue
29
Q

Congenital rubella (infection in 1st trimester). Presentation?

A
  1. PDA
  2. Deafness/blindness
  3. Cataracts
  4. Microcephaly
  5. Jaundice
  6. Blue berry muffin rash
30
Q

Adult rubella presentatin?

A
  1. Arthralgia and arthritis
  2. Flu-like illness
  3. Rash (mild)
31
Q

Explain the complement fixation test

A

The point is to figure out if you were infected with a certain antigen.
1. You take a known antigen (say rubella antigen) and add it to pt serum. If you made antibodies to that antigen, Ag+Ab complex will bind with complement. When you add sheep RBC, all the complement is used up and won’t lyse the RBC.

If you didn’t have the antibodies present (aka weren’t infected with rubella) then Ag+Ab complexes will not bind up all your complement so that when you add sheep RBC, complement can be used to lyse the RBC.

32
Q

How much of a serum titer increase between acute serum and convalescent (post-infection) serum is needed to say you had a recent infection

A

> 4 fold increase between acute infection serum and convalescent serum

33
Q

Neutralizing antibodes against influenza virus most likely react with which viral particle (this was a practice question in the lecture)

A

Hemagglutinin (glycoprotein on surface of virus)

34
Q

How does Tamiflu work?

A

Prevents virus release (it is a neuraminidase inhibitor)

35
Q

Parvovirus B19 causes what?

A
  1. Erythema infectious (5th disease)–slapped cheek
  2. Hydrops fatalis
  3. Polyarthritis
  4. Aplastic crisis in people with chronic hemolytic anemia
36
Q

Where does parvovirus B19 replicate

A

immature RBCs

37
Q

HHV 6 and HHV 7 causes what?

A
  1. Roseola (exanthem subitum, 6th disease). Causes rash
  2. Mono
  3. Febrile seizure
38
Q

What infections do HHV6 and HHV 7 cause in the immunocompromised?

A
  1. Encephalitis

2. Pneumonitis

39
Q

VZV causes

A
  1. Chicken pox in kids

2. Shingles in adults

40
Q

Enterovirus includes what viruses

A
  1. Cox A/B
  2. Echovirus
  3. Poliovirus
41
Q

Enterovirus is the most common cause of

A

Meningitis

Multisystem Micro (4 decks)

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