Viral Diseases Flashcards
1
Q
Virus that causes non-specific upper respiratory symptoms?
A
Rhinovirus
2
Q
How do you diagnose rhinovirus?
A
Clinically
3
Q
How long do rhinovirus symptoms usually last for?
A
Less than 10 days
4
Q
How do you treat rhinovirus?
A
Supportive Care
- Saline Wash
- NSAIDs
- Rest
- Fluids
- Decongestants
5
Q
When and why might you consider giving antibiotics for someone with rhinovirus?
A
Symptoms lasting longer than 10 days
Purulent discharge
6
Q
Influenza virus is primarily spread via what?
A
Respiratory Droplets
7
Q
Type of influenza that infects a variety of mammals such as horses, cats, dogs, swine, and people.
A
Type A Influenza
8
Q
Types of influenza that infect humans almost exclusively.
A
Type B and C Influenza
9
Q
What type of influenza is usually mild and not tested for?
A
Type C Influenza
10
Q
What is the average incubation time for influenza?
A
1 - 4 days
11
Q
Outbreaks of this occur annually in the fall and winter.
A
Influenza Type A
12
Q
What allows for outbreaks of influenza yearly?
A
Antigenic Drifts
13
Q
What type of influenza presents with GI symptoms?
A
Influenza Type B
14
Q
What are the signs and symptoms of Influenza?
A
SUDDEN ONSET of SYMPTOMS
- Fever and Chills
- Malaise
- Headache
- Myalgia (Lower Extremities and Back)
- Upper Respiratory Symptoms
- NON PRODUCTIVE COUGH
15
Q
Common and cheap lab tests that is specific but not sensitive to Influenza virus.
A
Rapid Tests
16
Q
What type of Influenza testing is most specific and sensitive?
A
PCR Testing
17
Q
Influenza will show what on a CBC?
A
Leukopenia
Lymphocytopenia
18
Q
What is the primary complication of influenza?
A
Pneumonia
19
Q
What are the common causes of pneumonia, secondary to influenza?
A
Streptococcus pneumonia
Haemophilus influenza
20
Q
When should you suspect a secondary bacterial infection with influenza?
A
Fever that recurs or longer than 4 days
Productive Cough
WBC of 10,000 or more
21
Q
Treatment of Influenza.
A
Supportive Care
- Antivirals can reduce symptoms but not mortality
22
Q
FDA approved treatment for Types A & B Influenza
A
Oral Oseltamivir
(Neuraminidase inhibitor)
23
Q
When do you admit someone to the hospital for influenza?
A
Limited support services
Pneumonia
Decreased O2 saturation
Altered mental status
Possibly pregnancy
24
Q
When is the flu vaccine recommended?
A
All persons over 6 months
25
Who should get a high dose version of the influenza vaccine?
Patients over 65
26
Rapidly progressive liver failure and encephalopathy that usually occurs in young children, it is associated with Aspirin use in combination with viral infection
Reye Syndrome
27
Recurrent grouped vesicles on an erythematous base that is usually acquired asymptomatically during childhood?
Herpes Simplex Virus
28
What are the symptoms of herpes simplex virus
- Vesicular or ulcerative lesions
- Burning or Stinging
- Neuralgia
- Regional lymph node swelling
- Lesions crust and heal in one week
29
What is the rapid, sensitive diagnostic test for HSV?
Direct Fluorescent Antibody Staining
30
What are commonly available tests for HSV in the clinical setting?
Viral Culture
Polymerase Chain Reaction (PCR)
31
An old test used to diagnose HSV, however, it is not commonly used anymore?
Tzanck Smear
32
How do you treat a first episode of oral or genital HSV infection?
Acyclovir
Valacyclovir
Famciclovir
33
Transmission of Varicella Zoster occurs via what routes?
Direct Lesion Contact
Droplet
Airborne
34
A vesicular and itchy rash that has erythematous macule that becomes papule then vesicles and pustules, and the crust over. All of these stages occur simultaneously.
(Dew Drops On A Rose Petal)
Chickenpox (VZV)
35
What testing has the highest yield when testing for Chicken Pox?
Polymerase Chain Reaction (PCR)
36
What is the treatment for Chicken Pox?
Healthy child under 12
- Supportive
Everyone over 12
- Acyclovir
37
Unilateral vesicular rash with dermatomal involvement. The rash does not cross the midline.
Herpes Zoster (Shingles)
38
Shingles outbreak that affects the facial nerve near one of a patients ears. Presents with ipsilateral facial palsy, vertigo, tinnitus, and hearing deficits.
Ramsey Hunt Syndrome
39
How do you treat Shingles?
Valacyclovir or Famciclovir
Corticosteroids
40
How do you treat post herpatic neuralgia?
Gabapentin
Lidocaine patches
Tricyclic Antidepressants
Capsaicin cream
41
What are the common strains of HPV that are also considered to be low-risk?
HPV 6 and 11
42
What are the high risk strains of HPV that are oncogenic and responsible for the majority of cervical cancers.
HPV 16 and 18
43
What is the incubation period of HPV?
2-18 months
44
What is the name of the common wart caused by HPV?
Verruca Vulgaris
45
Name of the genital warts caused by HPV?
Condyloma Acuminatum
46
What strains of HPV causes 90% of genital warts?
HPV 6 and 11
47
Name of the plantar warts caused by HPV?
Verruca Plantaris
48
Wart like appearance that interrupts normal skin lines and often appear to have "seeds"
Plantar Warts
49
How do you treat plantar warts?
Liquid Nitrogen
Topical Salicylic Acid
Blunt Dissection (if refractory)
50
What is the treatment of choice for genital warts in men?
Podophyllum Resin
51
What is the treatment of choice for genital warts in women?
Imiquimod Cream
52
What virus causes mononucleosis and infects more than 95% of adults worldwide and persist for the lifetime of the host in latency?
Epstein-Barr Virus
53
What type of cells does Epstein-Barr Virus infect?
B and T Lymphocytes
54
What happens if you treat a patient who has Epstein-Barr Virus with amoxicillin or ampicillin?
Erythematous Rash (80% of the time)
55
How do you test for Epstein-Barr Virus?
Heterophile Antibody (Monospot)
IgM Antibody to EBV Virus Capsid Antigen
56
How do you treat Epstein-Barr Virus?
Supportive Care
(usually resolves in 2-4 weeks)
57
What is a rare complication of Epstein-Barr Virus?
Splenic Rupture (rare)
- no contact sports for 4 weeks
58
What percentage of patients may develop splenomegaly from EBV?
50% or more
59
Acute onset of unilateral or bilateral Parotid gland or other salivary gland enlargement.
Mumps
60
What virus causes Mumps?
Paramyxovirus
61
What is the leading cause of pancreatitis in children?
Mumps
62
What is the most common complication of Mumps
Epididymo-orchitis
63
How do you treat mumps?
Supportive Therapy
(isolate until swelling subsides)
64
What is the prognosis for mumps?
Excellent!
(rarely fatal, due to encephalitis)
65
Viral exanthem caused by Human Parvovirus B19
Erythema Infectiosum (Slap Cheeks Disease)
66
How can we prevent mumps?
Vaccination
- 2 series
- Live Vaccine
67
Characteristic rash of Erythema Infectiosum appears in 3 stages. What are the stages?
1. Slapped Cheek with Circumoral Pallor
2. Symmetric maculopapular rash on the trunk
3. Lacy and reticulated rash.
68
How do you treat erythema infectiosum?
Supportive Care
69
When are children typically contagious with erythema infectiosum?
Prior to developing the rash
70
What disease is caused by Human Herpesvirus 6 and 7?
Roseola Infantum
(Sixth Disease)
71
What childhood rash has an abrupt onset of high fever (often reaching 104F) and lymphadenopathy?
Roseola
72
Rose-pink blanchable rash that BEGINS on the TRUNK, BUTTOCKS, and NECK before spreading to the face?
Roseola
73
Erythematous papule, macule, or ulcers on the soft palate and uvula?
Nagayama Spots
74
How do you treat roseola?
Supportive care
75
What virus causes measles?
Measles (Rubeola) virus
76
What are the three "C"s of Measles?
Cough
Coryza
Conjuntivitis
77
Small 1-3mm pale white papules with an erythematous base on the buccal mucosa opposite of the second molars. Appears around 48 hours after the onset of rash.
Koplik Spots
78
Morbilliform (maculopapular), brick-red rash that begins at the hairline and neck that then darkens and coalesces.
Measles (Rubeola)
79
How do you treat measles (Rubeola)?
Supportive
Vitamin A in severe cases
80
What disease is caused Togavirus?
Rubella (German Measles)
81
What disease has a prodrome of lymphadenopathy and a low-grade fever?
Rubella (German Measles)
82
Irregular pink or light red non-confluent maculopapular rash that starts on the face and spreads to the trunk and extremities. It typically spares the palms and soles. (3 day Measles)
Rubella (German Measles)
83
Small red macule or petechiae on the soft palate
Forchheimer Spots (Rubella)
84
How do you diagnose Rubella?
Serologic Confirmation
(IgM antibody)
85
What is the treatment for Rubella?
Supportive Care
86
Clinical disease seen primarily in immunocompromised patients and caused by the Human herpesvirus 5
Cytomegalovirus
87
How do the symptoms of Cytomegalovirus usually present?
Similar to Epstein-Barr Virus (Mononucleosis)
88
How long do the symptoms of CMV usually last?
7-8 weeks
89
How do you treat Cytomegalovirus in immunocompromised patients?
Oral Valganciclovir
IV Ganciclovir
90
What is the most common congenital viral infection?
Congenital Cytomegalovirus
91
What is the most common health problem from congenital cytomegalovirus?
Hearing loss in more than 50% of infants
92
How do you treat congenital cytomegalovirus?
Ganciclovir or Valganciclovir (6 months)
93
Arthropod-borne arbovirus that is carried by mosquitos mostly in mid-July through early September. Most common domestically acquired arbovirus in the United States.
West Nile virus
94
What are the two versions of West Nile Virus?
Mild (self-limited)
Neuroinvasive (long-term sequelae)
95
What are the symptoms of West Nile Virus
Acute Fever and Flu Symptoms
Meningitis
Encephalitis
- altered mental status
- tremor
- seizure
- acute flaccid paralysis
96
What are the complications of West Nile Virus?
Bronchial pneumonia
Prolonged weakness and associated problems
Retinopathy
Hepatitis
Pancreatitis
97
How do you treat West Nile Virus?
Supportive Treatment
- no vaccine or antiviral
98
Viral hemorrhagic fever that is transmitted by contact with body fluids and skin. It has a 2-21 day incubation period and is not transmissible prior to symptoms.
Ebola
99
Flavivirus that is primarily transmitted by mosquitoes mostly in tropical areas. Can also be transmitted via sex, as well as maternal-fetal.
Zika Virus
100
Where is Zika virus most commonly found?
Central and South America
Caribbean
101
How do most cases of Zika Virus present?
Asymptomatically
102
What is the test of choice for Zika virus?
Serum or Urine IgM
103
If Zika is symptomatic, how can it present?
Pruritic Rash
- face, trunk, extremities, palms, soles
Arthralgia
Conjunctivitis
Hematospermia (males)
104
What are the 5 main features of Congenital Zika Syndrome?
1. Microcephaly
2. Decreased Brain Tissue
3. Ocular Damage
4. Congenital Contractures
5. Hypertonia
Many will die before the age of 2.
105
How do you treat Zika Virus?
Supportive Treatment
- Do not use NSAIDs in pregnant women >32 weeks
106
What is the ToRCH Syndromes?
Toxoplasma Gondii
Other Agents
- Treponema Pallidum, VZV, Parvovirus B19, HIV
Rubella
Cytomegalovirus
Herpes Simplex Virus
