Viral diseases (Med Micro 1)

Question 1

What is the difference between positive-sense and negative-sense viral RNA?

Answer 1

Positive-sense RNA is similar to mRNA and can be directly translated into proteins, while negative-sense RNA needs conversion before translation.

Question 2

How are viruses detected?

Answer 2

Methods include:
* PCR for genomes
* ELISA for proteins
* Electron microscopy for particles
* Immunostaining for immune responses

Question 3

What are the main steps in a PCR reaction?

Answer 3

The main steps are:
* Denaturation
* Annealing
* Extension

Question 4

What does ELISA quantify?

Answer 4

Antigens of interest.

Question 5

What are arboviruses?

Answer 5

A group of RNA viruses transmitted by blood-feeding arthropods like mosquitoes and ticks.

Question 6

Give examples of arboviruses.

Answer 6

• Dengue
• Zika
• West Nile
• Chikungunya

Question 7

What is flavivirus?

Answer 7

A genus of single-stranded RNA viruses within the family Flaviviridae, many of which are arboviruses.

Question 8

What is the main vector for West Nile virus?

Answer 8

Culex mosquitoes.

Question 9

What are common symptoms of Zika virus?

Answer 9

Mild symptoms include fever, rash, joint pain, and conjunctivitis.

Question 10

How is yellow fever transmitted?

Answer 10

By mosquitoes, specifically Aedes aegypti.

Question 11

What are the symptoms of chikungunya?

Answer 11

Fever, severe joint pain, muscle pain, red eyes.

Question 12

What is Severe Fever with Thrombocytopenia Syndrome (SFTS)?

Answer 12

An emerging tick-borne viral disease that can cause hemorrhagic fever, multiple organ failure, and death.

Question 13

How many people are living with HIV worldwide?

Answer 13

40 million.

Question 14

What percentage of people living with HIV are in Sub-Saharan Africa?

Answer 14

64%.

Question 15

What is the global management goal for HIV?

Answer 15

95 / 95 / 95 - aware, treated, virally suppressed.

Question 16

What is the first stage of HIV infection?

Answer 16

Acute HIV infection: asymptomatic/generalised lymphadenopathy/fever.

Question 17

What is Kaposi’s Sarcoma?

Answer 17

The most common AIDS-defining malignancy caused by Human Herpesvirus 8.

Question 18

What is Pneumocystitis jirovecii pneumonia (PCP)?

Answer 18

The most common AIDS-defining illness in the UK/USA, caused by a fungal infection.

Question 19

What are the components of the WHO recommended regimen for adults with HIV?

Answer 19

2 x NRTI + 1 x INSTI/NNRTI/PI.

Question 20

How is HIV transmitted from mother to child?

Answer 20

Through pregnancy, childbirth, or breastfeeding.

Question 21

What is the preferred first-line treatment for HIV in the Philippines?

Answer 21

Integrase inhibitor (Dolutegravir) in the TLD regimen.

Question 22

What is the preferred first-line treatment for HIV?

Answer 22

Integrase inhibitor (Dolutegravir)

This is part of the TLD regimen.

Question 23

What is the cause of rabies?

Answer 23

Rhabdovirus

It attacks the central nervous system, specifically the brain and spinal cord.

Question 24

How is rabies transmitted?

Answer 24

Saliva of infected animals

Most commonly through bites or scratches, but also via contact with infected saliva in eyes, mouth, or open wounds.

Question 25

What are some symptoms of rabies?

Answer 25

Fever, headache, fatigue, anxiety, irritability, seizures, hallucinations, paralysis, difficulty swallowing ## Footnote These can lead to coma and death.

Question 26

What is the case fatality rate for rabies in humans?

Answer 26

100% ## Footnote This highlights the severity of the disease once symptoms appear.

Question 27

What is the incubation period for rabies?

Answer 27

1-3 months ## Footnote The duration can vary based on the site of infection and the viral load.

Question 28

What are the two forms of rabies?

Answer 28

Furious rabies and paralytic rabies ## Footnote Furious rabies is characterized by hyperactivity and agitation, while paralytic rabies leads to paralysis.

Question 29

How is rabies diagnosed?

Answer 29

Clinical symptoms and biopsy/saliva tests ## Footnote Diagnosis typically relies on aerophobia and hydrophobia symptoms.

Question 30

What is the prevention method for rabies?

Answer 30

Vaccine Post-exposure prophylaxis (PEP) ## Footnote This includes immediate wound care and administration of human rabies immune globulin (HRIG).

Question 31

What type of treatment is available for rabies?

Answer 31

Supportive and palliative care ## Footnote This includes providing a quiet, isolated room, anxiolytics, and antipyretics.

Question 32

What was established in the Philippines to address HIV and AIDS?

Answer 32

Philippines HIV & AIDS Policy Act 2018 ## Footnote This act aims to improve the response to the HIV epidemic.

Question 34

What does NRTI stand for?

Answer 34

Nucleoside/Nucleotide Reverse Transcriptase Inhibitors

Question 35

Name a well-tolerated NRTI that is also effective against Hepatitis B

Answer 35

Tenofovir (TDF)

Question 36

What are the potential long-term effects of Tenofovir (TDF)?

Answer 36

Nephrotoxicity and reduced Bone Mineral Density (BMD)

Question 37

Which newer NRTI has fewer side effects compared to Tenofovir (TDF)?

Answer 37

Tenofovir Alafenamide (TAF)

Question 38

What is the backbone drug in all regimens among NRTIs?

Answer 38

Lamivudine (3TC) and Emtricitabine (FTC)

Question 39

Which NRTI is recommended for pediatrics and in cases where other NRTIs are ineffective in adults?

Answer 39

Abacavir (ABC)

Question 40

What type of reaction is associated with Abacavir (ABC)?

Answer 40

Febrile hypersensitivity reaction

Question 41

What does INSTI stand for?

Answer 41

Integrase Strand Transfer Inhibitors

Question 42

What is a recently developed INSTI that is well tolerated and low cost?

Answer 42

Dolutegravir (DTG)

Question 43

List some side effects of Dolutegravir (DTG).

Answer 43

* Weight gain * Sleep disturbances * Dizziness * Paraesthesias * Hyperglycaemia

Question 44

What is Cabotegravir?

Answer 44

A long-acting injection integrase strand transfer inhibitor

Question 45

What does NNRTI stand for?

Answer 45

Non-nucleoside Reverse Transcriptase Inhibitors

Question 46

Which NNRTI was the first line treatment before the arrival of Dolutegravir (DTG)?

Answer 46

Efavirenz (EFV)

Question 47

What are some significant side effects of Efavirenz (EFV)?

Answer 47

* Gynaecomastia * Neuropsychiatric disorders

Question 48

Name three potent Protease Inhibitors (PIs).

Answer 48

* Darunavir * Atazanavir * Lopinavir

Question 49

What revolutionized antiretroviral therapy (ART) in the mid-1990s?

Answer 49

HAART (Highly Active Antiretroviral Therapy)

Question 50

List some side effects associated with Protease Inhibitors.

Answer 50

* Jaundice * Lipodystrophy syndrome

Question 51

Which opportunistic infections are characteristic of Stage 2 HIV?

Answer 51

recurrent URTIs, papular pruritic eruptions, herpes zoster, seborrhoeic dermatitis, fungal nail infections ## Footnote Papular pruritic eruptions are a sign of immune dysregulation and prolonged allergic reaction to insect bites.

Question 52

What conditions are associated with Stage 3 HIV?

Answer 52

Pulmonary TB, oral hairy leukoplakia, severe weight loss (>10%), oral candidiasis ## Footnote Tuberculosis is a common opportunistic infection in advanced HIV.

Question 53

What conditions are associated with Stage 4 advanced immunosuppression in HIV?

Answer 53

Miliary TB, Kaposi sarcoma, oesophageal candidiasis ## Footnote Advanced immunosuppression leads to increased risk of severe infections and cancers.

Question 55

What is a recombinant vaccine?

Answer 55

Recombinant protein vaccine is composed of protein antigens which are biologically synthesised in animal cells or insect cells. Considered safe and stable as they do not contain live pathogen.