Viral Infections Flashcards
A patient presents with runny nose, pharyngitis, cough, and low-grade fever. There is also increased mucus production and eustachian tube obstruction.
Infection is confined to cooler passages of upper airway – nasal respiratory epithelial cells.
Pathogen?
Rhinovirus (RNA virus)
“Rhino has a runny nose”
An elderly patient presents in January with rapid onset of constitutional symptoms, including a nonproductive cough. The patient has both upper respiratory symptoms and lower respiratory symptoms (tracheitis, bronchitis, and pneumonia).
The patient dies, and at autopsy she is found to have necrotizing bronchitis and diffuse, hemorrhagic necrotizing pneumonia.
Pathogen?
Influenza virus (RNA virus)
–Winter
–Rapid onset
–Very young/elderly are predisposed to severe infections
–Predisposes to bacterial pneomonia – esp Staph aureus, Strep pneumo
A young child presents with fever, hoarseness, and a barking cough with inspiratory stridor (croup).
Pathogen?
Parainfluenza virus (RNA virus)
- -young children
- -croup is due to laryngotracheitis
An infant presents with wheezing, cough, and respiratory distress. What is the most likely pathogen responsible for this infant’s bronchiolitis?
Respiratory Syncytial Virus (RNA virus)
“RSV causes bronchiolitis in infants” - Rubin
-self limited, resolves in 1-2wks
A novel coronavirus responsible for a 2002 epidemic of severe pneumonia in China.
Presents as fever and headache, followed shortly by cough and dyspnea. Lymphopenia and elevated aminotransferase levels are common.
What is the name of this illness?
Severe Acute Respiratory Syndrome (SARS)
A young child presents with an acute respiratory infection characterized by cough, coryza, and conjuctivitis. The child displays Koplik spots on the posterior buccal mucosa (gray-white dots on a red base).
The child dies, and histologic examination of the lungs at autopsy reveals multi-nucleated giant cells.
Pathogen?
Measles (viral exanthem)
–4 C’s: cough, coryza (=cold symptoms), conjunctivitis, Koplik spots
–Warthin-Finkeldey giant cells
A patient develops a slow, chronic neurodegenerative disorder. The patient’s history is significant for a measles infection several years previous. What is the name of this uncommon complication of measles?
Subacute sclerosing panencephalitis
A pregnant woman presents with a mild acute febrile illness characterized by rhinorrhea, conjunctivitis, postauricular lymphadenopathy, and a rash that spreads from face to trunk to extremities.
What is the pathogen you are most worried about?
Rubella aka “german measles” (RNA virus)
Rubella infection in utero is associated with congenital anomalies such as deafness, cataracts, glaucoma, heart defects, and mental retardation.
A patient presents with fever, malaise, parotid gland swelling, and meningoencepalitis symptoms (headache, stiff neck, vomiting).
Pathogen?
Mumps (RNA virus)
- parotid gland swelling
- meningoencephalitis
What is the most common cause of severe diarrhea in children under age 5?
Rotavirus (RNA virus)
ROTA - right out the anus
- -severe, watery diarrhea
- -children
- -fecal/oral spread
A 30-year old man presents with abrupt onset of constitutional symptoms. He had just returned from a trip to South America. His disease progresses to a fulminant hepatic failure featuring extensive hepatic necrosis and jaundice. There is some clotted blood in his vomit (“black vomit”).
What does this patient likely have?
Yellow Fever (RNA virus)
- -acute hemorrhagic fever
- -fulminant hepatic failure
- -black vomit
- -jungles and urban areas of S. America and Africa
This disease is described as a “fatal African disease.” It begins with constitutional symptoms, and progresses to shock due to widespread, necrotic, hemorrhagic tissue lesions. Some patients develop overt hemorrhages, internal and external. What is the name of this disease?
Ebola Hemorrhagic Fever (RNA virus)
A severe hemorrhagic fever found predominantly in Africa (in tropical areas, I think).
This pathogen is spread by birds and mosquito vectors. It is usually subclinical, or might present as constitutional symptoms with polyarthropathy. Patients with severe illness can develop an acute aseptic meningoencephalitis.
West Nile Virus (RNA virus)
–polyarthropothy and acute aseptic meningoencephalitis seem to be somewhat specific for WNV, but accurate diagnosis probably would depend on other contextual factors (geographical location).
A 24-year-old military recruit presents with a necrotizing bronchitis and bronchiolitis. A biopsy of the bronchiolar epithelium reveals two types of intranuclear inclusions – smudge cells and Cowdry type A inclusions.
What is the most likely pathogen?
Adenovirus (DNA virus)
- smudge cells
- Cowdry type A inclusions
-certain serotypes are common in military settings
Two strains of this pathogen can cause diarrhea; while patients with AIDS are susceptible to developing UTIs as a result of this pathogen.
A 29-year-old woman (gravida 3, para 2) delivers a premature infant at 28 weeks of gestation. At birth, the neonate shows signs of profund anemia and generalized edema (hydrops fetalis).
The disease is most likely caused by an intrauterine infection with which TORCH agent?
Parvovirus B19 (DNA virus)
- causes systemic infections characterized by rash, arthralgias, and transient defects in erythropoiesis
- it is a mild infection in most patients, displaying “erythema infectiosum”
- in fetus, the transient defect can cause hydrops fetalis
