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Infection > Viral Infections > Flashcards

Viral Infections Flashcards

1
Q

What are the key features of adenovirus?

A

it is non enveloped, ds linear DNA

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2
Q

What infections does adenovirus commonly cause and breifly describe the transmission for each?

A
  • resp tract infections (droplets)
  • gastroenteritis (infected food)
  • conjuctivitis (swimming pools)
  • common cold
  • disease caused generally related to mode of transmission
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3
Q

How can adenovirus infection be identified? is this often done?

A
  • ELIZA of stool or PCR of throat swab

- not normally done

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4
Q

What type of virus is norovirus?

A

a non enveloped single stranded RNA virus

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5
Q

How is norovirus transmitted

A

faecal oral
aerosols in vomit
it is highly contagious

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6
Q

What disease does norovirus commonly cause?

A

gasteroenteritis - winer vomiting bug

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7
Q

How can norovirus be identified?

A

PCR

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8
Q

What are symptoms of norovirus?

A

nausia, vomiting, diarrhoea, abdopain, weakness, headaches, tempreature normally normal

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9
Q

What type of virus is EBV?

A

enveloped DNA virus

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10
Q

What does EBV cause?

A

infective mononucleosis/ glandular fever

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11
Q

Describe the course of infection of EBV?

A
  • initial replication in orophaygeal epithilium causing fever, sore throa, nausia, malaise, headache
  • then latent infection of B lymphocytes meaning 2 weeks later hepatomegaly, enlarged lymph nodes, high fever (38+), some jaundice, nausia, light intolerance
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12
Q

How is EBV transmitted?

A

in saliva

kissing disease

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13
Q

What cancer is EBV associated with?

A

burkitts lymphoma as it causes over replication of infected cells

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14
Q

What is incubation period of EBV virus?

A

4- 6 weeks (after infection, symptoms will arise)

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15
Q

What is key sign of EBV on FBC?

A

very high lyphocytes (and monocytes)

ALT and AST may also be high in late stages, platelets may be low

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16
Q

How is EBV specifically detected?

A
  • specific EBV antibodies can be tested for in blood

- also heterophile negative antibodies

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17
Q

How is infective mononucleosis managed?

A
  • no alcohol for 2 weeks post infection
  • no sport for 2-3 weeks
  • paracetamol and fluids
  • usually self limiting
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18
Q

What are blood test results for someone with hep B or C?

A
  • high bilirubin
  • high ALT and AST
  • normal- high ALP (bile duct destruction limited)
  • Albumin low
  • PT and APTT longer (poor coagulation)
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19
Q

How is hep B and C spread?

A
  • verticle transmittion
  • sexual contact
  • sharing needles (90% of Hep C)
  • blood exposure
  • needle stick injuries
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20
Q

Is hep B or C more likely to progress to a chronic infection?

A 
hep C (80% become chronic)
in hep B only 10% become chronic
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21
Q

Are you more likely to get acute symtoms of Hep C or B infection? What are these symptoms?

A 
Hep B
- jaundice 
- fatigue 
- abdo pain 
- anorexia
- nausia 
- vomiting 
symptoms usually clear in 6 months, hep C usually has no acute symptoms
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22
Q

What is incubation period for hep B?

A

6 weeks- 6 months

23
Q

What % of hep B infections and hep C infections present with symptoms?

A

hep B- 50%

hep C- 80% (neither chronic nor acute symptoms)

24
Q

What are the effects of chronic hep B and C infections?

A

both lead to cirrhosis (25%)/ liver disease. very few lead to carcinomas (5%)

25
Q

How is hep B managed?

A
  • no cure
  • try and keep viral load low- lifelong antivirals
  • post exposure prohylaxsis can be offered to anyone exposed but not vaccinated
26
Q

How is hep C managed?

A
  • can be cured by 8-12 week course of drugs

- which has 90% success rate but is expensive

27
Q

How are Hep B and C prevented?

A
  • Hep B prevented with vaccine against surface antigen (3 doses + booster)
  • Hep C no vaccine just risk avoidance
28
Q

How is hep c diagnosed?

A
  • Hep C antibpdy can be detected at any stage of the disease, even after it has been cured
  • viral PCR if the hep C anitbody is present, this will confirm the disease is ongoing/ chronic
29
Q

Describe the serology changes of someone who has has an acute Hep B infection which clears

A
  • Surface antigen (HbsAg) rises within first 6 weeks and then drops when acute infection cleared, if remains high for more than 6 months- chronic infection
  • E- antigen (HbeAg) raises, then drops- indicated highly infectious period
  • Core antibody (HbcAb) raises and will remain high for life regardless of chronic or cleared infection (IgM initially, but IgG persists for life)
  • e antibody appears and dissapears
  • surface antibody is last to appear but will only appear if infection is cleared, it will never be present in chronic infection
30
Q

What will serology be of someone with chronic hep B infection?

A
  • high surface antigen
  • high core antibody
  • low surface antibody
31
Q

What type of virus is HIV?

A

enveloped single stranded RNA virus

32
Q

Where doe HIV cells replicated?

A

Inside cells with CD4+ receptors (T- helper cells)

33
Q

How is HIV transmitted?

A
  • sexual contact (1/1220)
  • tranfusions (90-100%)
  • needle stick injury (1/333)
  • mucous membrane exposure (1/159)
34
Q

Describe how HIV viruses infect T - helper cells

A
  1. binding to CD4 and over receptors
  2. infection by injecting ss RNA
  3. reverse transcription (ssRNA-> dsDNA)
  4. integration of viral DNA into host by integrase
  5. viral DNA replicated and used to create viral proteins
  6. proteins come together and bud off
  7. maturation- proteases cut protein chains which recombine to create working virus
35
Q

Describe how the viral load and T helper cell number changes throughout a HIV infection

A
  • in first months viral load increases rapidly and a dip is seen in T helper cell number (this stage is usually asymptomatic and they’re highly contagious)
  • then viral load drops and t helper cells recover in stage 1
  • in stage 2/3 the viral load increases and t helper cells decrease to 500-200 cells/mm^3, symptoms start to arise
  • then severe HIV/ AIDS at CD4< 200 cells/ mm^3, serious problems arise
36
Q

Describe the symptoms of HIV that start to arise in stage 2/3 of the disease

A
  • fever and weight loss
  • enlarged lymph nodes
  • nausia/ vomiting
  • spleno and hepatomegaly
  • cough and sore throat (longer than 3 weeks)
  • thrush
  • kasposi sarcoma (herpres virus/ rash)
  • commonly these pts will present in 30s/ 40s
37
Q

Describe the symptoms of acute HIV infection which often go unnoticed

A
  • fever
  • weightloss
  • sores and thrush
  • rash
  • headaches
    most go unnoticed/ dismissed for cold
38
Q

What opportunistic infections are often common with AIDS?

A
  • TB
  • PCP
  • cryptococcal disease
  • taxoplasmosis
  • candidiasis
  • STIs like gonorrhoea
39
Q

What are symptoms and investigations for TB?

A
  • weightloss, night sweats, cough, SoB, blood in sputum, headache, meningitis, seizures, joint pain, joint swelling, abdo pain
  • do acid fast test (+), do CXR (white), do head CT (often brain legions)
40
Q

What is PCP? what is its effect?

A

a fungal infection of resp tract

causes SoB on exertion, dry cough, fatigue, white CXR but normal breath sounds

41
Q

What is cryptococcal disease and effects?

A
  • fungal infection

- causing headaches, fever, meningism, cough, seizures and coma

42
Q

What is taxoplasmosis and its effect?

A

a protozoa

causes cerebral abecesses (ring enhanced legions), seizure, vomiting and coma

43
Q

What is ghonorrhoea?

A
  • a gram negative diplococcal infection
  • often sexually transmitted
  • causes a white discharge
44
Q

How can HIV be tested for?

A
  • serology: HIV antigen and antibody can be tested for after 4 weeks, results available on same day
  • PCR: sensitive and early detection but takes a week and is expensive- more used for treatment response than diagonsis
  • rapid tests: fingerpricks can be done in home and are accurate if negative but not as much if positive
45
Q

Who should be tested for HIV?

A
  • those with pneumonia/ TB
  • meningitis/ demenita
  • psoriasis/ shingles
  • diahorrea and unexplained weight loss
  • anal cancer and lymphoma
  • any STI
46
Q

What are the types of antiretroviral drugs?

A
  • nucleoside reverse transcriptase inhibitors
  • non- nucleoside revers TIs
  • protease inhibitors
  • integrase inhibitors
  • CCR5 (entry) inhibitors
47
Q

Why should 3 different anti retrovirals be given?

A

to prevent resistance forming

48
Q

What is prognosis of HIV on retrovirals??

A

very good

viral load can be reduced almost so low it cant be transmitted

49
Q

Give an example of an exclusively acute viral infection?

A

influenza

polio

50
Q

What type of viruses tend to become chronic infections?

A

RNA viruses

51
Q

Why do chronic infections occur?

A

viral particles continue to be shed even after acute illness because the host immune system cannot clear it

52
Q

How is HPV spread?

A

sexual intercourse, skin- skin contact

53
Q

What areas are most commonly affected by HPV?

A

cervix, mouth and throat, anus

54
Q

What does HPV cause in short and long term?

A

short term- usually genital worts

long term- linked to cervical cancer

Infection (9 decks)

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