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HD 2 > Viral Infections in Childhood > Flashcards

Viral Infections in Childhood Flashcards

1
Q

What forms the nucleocapsid?

A

Nucleic acid and protein coat (capsid)

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2
Q

DNA viruses are usually ____-stranded and RNA ____-stranded.

A

Double

Single

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3
Q

What is the exception to the rule that DNA viruses are usually double stranded?

A

Parvovirus (single stranded)

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4
Q

What is the exception to the rule that RNA viruses are usually single stranded?

A

Reoviruses (double stranded)

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5
Q

What are the five steps in the viral life cycle?

A
  1. ATTACHMENT
  2. ENTRY
  3. UNCOATING
  4. SYNTHESIS OF VIRAL COMPONENTS
  5. ASSEMBLY AND RELEASE
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6
Q

What is required for step 1 of the viral life cycle (attachment)?

A

Cell must be permissive (ie have all the right intracellular components required by the virus to replicate) and have receptors (and co-receptors) on the plasma membrane of the cell. There must also be binding sites on the virus.

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7
Q

What happens in step 2 of the cycle (entry)?

How long does it take?

A

Enveloped viruses undergo membrane fusion and may undergo receptor-mediated endocytosis.
Seconds to minutes

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8
Q

Where can step 3 take place (uncoating)?

What does it result in?

A

Endosome, cytosol, nuclear membrane

Results in transport to the right part of the cell to begin new virion production

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9
Q

What does step 4 involve/require?

A

Requires viral mRNA to enable viral polypeptides and nucleic acid to be synthesized by cell machinery. DNA viruses that enter the nucleus can use only cellular enzymes, but all other viruses must synthesize their viral mRNA (may carry their own enzymes).

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10
Q

What does step 5 involve/require?

A

New virions assembled and are released by cell lysis.

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11
Q

What are the important enveloped DNA viruses in this lecture?

A

Herpes viruses (herpes simplex, varicella zoster, CMV, Epstein-Barr, HHV 6/7/8)
Hepatitis B
Poxviruses

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12
Q

What are the important non-enveloped DNA viruses in this lecture?

A

Papillomavirus
Adenovirus
Parvovirus (single stranded DNA)

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13
Q

What does herpes simplex cause in neonates? (2)

A

Disseminated HSV - a sepsis-like syndrome with high mortality. It causes hepatitis and coagulopathy.

HSV encephalitis - this presents with fever and seizures. There is haemorrhagic infarction of white matter and cortex.

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14
Q

How is disseminated HSV treated?

A

IV aciclovir

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15
Q

What can be said about viral infections in early life? (3)

A

Often more severe
More likely to become chronic
Prolonged shedding

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16
Q

Why are viral infections more severe in early life?

A

Antiviral immunity is not well developed

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17
Q

Cytomegalovirus - for which population of patients is this NOT subclinical/self-limited?
What types of symptoms does it cause?

A

Immunosuppressed

Mononucleosis-type illness

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18
Q

What is the most common congenital infection in developed countries?

A

Congenital CMV

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19
Q

How many % of babies with congenital CMV are symptomatic at birth?

A

10%

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20
Q

What are the long-term complications of congenital CMV?

A

Long term hearing deficit

Neuro-developmental delay

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21
Q

How is congenital CMV treated?

A

IV ganciclovir or oral valganciclovir (pro-drug) – this inhibits DNA synthesis

6 months of treatment

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22
Q

What are the problems associated with long-term treatment for congenital CMV?

A

Neutropenia
Thrombocytopenia
IV access

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23
Q

What treatments might cause varicella zoster to be severe? (2)

A

Steroid treatment

Chemotherapy

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24
Q

What are the complications of varicella zoster?

A

Secondary bacterial infection

25
Q

Is chickenpox more severe in children or adults?

What can it cause?

A

Adults (particularly pregnant women)

Pneumonitis

26
Q

Epstein Barr Virus - how does it present in early life vs when 15-25 years old?

A

Usually asymptomatic vs infectious mononucleosis (glandular fever)

27
Q

What is Burkitt’s lymphoma caused by?

A

EBV infection at early age plus chronic immunosuppression (e.g. due to endemic malaria in Africa).

28
Q

What is caused by HHV 6 and 7?

When is it common?

A 
Roseola infantum (also known as exanthem subitum)
6 months to 2 years
29
Q

How does roseola infantum present?

A

Sudden onset of high fever, lasts few days then suddenly stops and a rash appears.

30
Q

What are the four stages of Hep B?

A

Tolerance
Clearance
Latency
Reactivation

31
Q

What are the consequences of a chronic hep B infection? (2)

A

Cirrhosis

Hepatocellular carcinoma

32
Q

When was smallpox eradicated and how?

A

1977
Combination of routine vaccination and isolation of cases (outbreak control). It is a severe disease that is easy to identify and has poor transmissibility due to slow spread. There are no animal reservoirs or carrier state. The vaccine was easy to produce and distribute.

33
Q

Where is Molluscum contagiosum often found? How is it spread?

A

Moist areas e.g. groin, axilla

Spread by direct contact or fomites

34
Q

What is papillomavirus a cause of?

A

Cervical cancer

35
Q

Which papillomavirus serotypes are carcinogenic? Which vaccine protects against these?

A

Serotypes 16, 18 - Cervarix

36
Q

Which papillomavirus serotypes cause genital warts?

A

Serotypes 6, 11

37
Q

Which vaccine protects against HPV serotypes 6, 11, 16 and 18?

38
Q

What does adenovirus cause?

A

Upper resp tract infection/pneumonia
Conjunctivitis
Diarrhoea
Disseminated disease in immunocompromised hosts

39
Q

Where does parvovirus B19 attach to?

A

Blood group P antigen

40
Q

In people with haematological problems, parvovirus replicates in _____ ____ cells (____ ____ precursors). What does this lead to?

A

Rapidly dividing cells (red cell precursors)

Aplastic crisis

41
Q

What is another name for parvovirus?

A

‘Slapped cheek’ syndrome

42
Q

What are the important enveloped RNA viruses in this lecture?

A

Measles, mumps, rubella
RSV, influenza, parainfluenza
Hepatitis C
HIV

43
Q

What are the important non-enveloped RNA viruses in this lecture?

A

Rotavirus
Enteroviruses (includes polio)
Hepatitis A

44
Q

Which viruses lead to latency? (3)

A

CMV, EBV, VZV

45
Q

How long is the incubation period for measles?

46
Q

What are the symptoms of measles?

A

Fever, cough, conjunctivitis, miserable

47
Q

What sign is pathognomonic of measles?

A

Koplik spots

48
Q

What long term neurological consequence can measles have?

A

Subacute sclerosing pan-encephalitis (SSPE) - these children are often infected at a young age and present years later with neurodegenerative disease.

49
Q

What is another name for rubella?

A

German measles

50
Q

What are the signs/symptoms of rubella?

A

Fever
Occipital lymphadenopathy
Mild rash

51
Q

What are the signs/symptoms of congenital rubella?

A

EYES: cataracts, micro-ophthalmia, glaucoma
EARS: sensorineural deafness
HEART: pulmonary artery stenosis, VSD
Low birth weight, rash, microcephaly

52
Q

What is bronchiolitis?

A

Viral infection of infants, causing inflammation of bronchioles.

53
Q

What causes 70% of bronchiolitis?

54
Q

What are the signs/symptoms of bronchiolitis?

A

Cough, respiratory distress, wheeze

55
Q

How is bronchiolitis prevented?

A

Palivizumab (monoclonal antibody)

56
Q

Is HIV more severe in infants or adults? Why?

A

Infants
High viral load, rapid progression, no reliable markers, fewer drug options, challenging adherence, long-term costs, toxicity of antiretroviral drugs…

57
Q

What is the most common cause of hospital admission in Europe/USA?

A

Rotavirus diarrhoea

58
Q

What are the symptoms of rotavirus infection?

A

Fever, vomiting, watery diarrhoea

59
Q

What two oral vaccines are now being rolled out for rotavirus?

A

RotaTeq

RotaRix

HD 2 (25 decks)

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