Virology Flashcards
Where do most of the errors within the virological total testing process lie
Preanalytical
Name 10 examples of pre analytical errors within the total testing process
• Incorrect analysis ordered
• orderer of test not marked
• incorrect test request
• test request lost
• pt id error
• pt preparation error
• mislabelling of test tube
• sample collection error
• incorrect handling of samples
• transport error
Name 4 examples of analytical errors within the total testing process
• Sample lost
• sample mix up
• equipment failure
• analytical error
(Least errors)
Name 4 examples of post analytical errors within the total testing process
• test result lost
• turnaround time
• transcription error
• incorrect interpretation
Name 6 complications of measles infection
• Otitis media
• diarrhoea
• pneumonia
• encephalitis
• persistent measles infection
- subacute sclerosing panencephalitis sspe
- measles inclusion body encephalitis MIBE in inmunosuppressed
• higher mortality in children, especially under 5 years
Name 3 common symptoms of congenital rubella syndrome
• Eyes: cataracts > pigmentatory retinopathy > glaucoma
• ears: hearing loss
• heart: congenital heart disease- PDA > ps
Test for hepatitis A?
Hepatitis A IGM blood specimen
Test for hepatitis B infection?
Hep B surface antigen, blood sample
Test for hepatitis B immunity?
Blood: surface antibody
Test for hepatitis C infection?
Blood: Hepatitis C antibodies
If positive, confirm with HCV PCR
What does hiv-1 DNA pcr test detect
Viral DNA and RNA
Which patients get hiv-1 DNA pcr test
Infant diagnosis <24 months to avoid false positive with ELISA (maternal antibodies)
Confirm positive with another PCR
What does HIV ELISA test detect
Antibodies and p24 antigen
Which patients receive HIV ELISA test
> 24 months
What does rapid HIV test detect
HIV antibodies only
Who receives rapid HIV test
•>24 months
Confirm positive rapid tests with pcr in all children 18-24 months
Major side effect of zidovudine (azt)?
Bone marrow suppression: anaemia, neutropenia
Major side effect of NRTI drugs (eg tenofovir TDF, lamivudine 3Tc, abacavir, zidovudine)?
Mitochondrial dysfunction: lactic acidosis, hepatic toxicity, pancreatitis, peripheral neuropathy, lipoatrophy, myopathy
Name 7 risk factors for severe SARS cov 2 disease or mortality
• older age
• ht
• cardiovascular disease
• COPD
• Diabetes
• obesity
• Malignancy
Name 2 major side effects of tenofovir TDF (NRTI)
• Mitochondrial dysfunction: lactic acidosis, hepatic toxicity, pancreatitis,peripheral neuropathy, lipoatrophy, myopathy
. Renal toxicity: renal tubular dysfunction
Name 4 major side effects of protease inhibitors (eg lopinavir/ rotinavir)
• Hyperlipidaemia, fat accumulation
• insulin resistance, diabetes
• osteopenia
• some cause skin rashes and hypersensitivity reactions
Name major side effects of NNRTI (eg nevirapine NvP, efavirenz efv)
Skin rashes and hypersensitivity reactions
Name 2 major side effects of abacavir ABC (nrti)
• Skin rashes and hypersensitivity reactions
• mitochondrial dysfunction: lactic acidosis, hepatic toxicity, myopathy, pancreatitis, peripheral neuropathy, lipoatrophy
Define art treatment failure
Unsuppressed viral load >1000 for >3 months
Test for measles infection (rubeola) (2)
• Serology igm/igg
• PCR of nasopharyngeal /throat swab within 5 days of macula popular rash onset, or urine.
Test for rubella infection (German measles) (2)
• Serology igm/igg
• PCR of throat swab or urine
Test for Herpes 6/7 infection (roseola infantum) (2)
Mostly clinical dx, not routine lab test: fever then maculopopular rash on trunk
Can do
• serology hhv -6 igm/igg only some labs
• Blood PCR
Test for parvovirus B19 infection (slapped cheek disease ) (2)
• Serology ig m/ig G
• Blood PCR
Test for vesicular rashes in childhood?
Eg VZv, hsv, enterovirus
Vesicle flood PCR for all
Test for mumps infection (2)
• Serology igm/ig G
• PCR of oral /buccal swab, or urine
Test for viral CNS meningitis and encephalitis?
Eg enterovirus meningitis, mumps meningitis, HSV 1/2 encephalitis
All CSF PCR
Test for rabies encephalitis?
Saliva PCR
notifiable
Test for CNS polio?
2 stools 2 days apart within 2 weeks of onset: cell culture, PCR
Notifiable
(Stool most sensitive test)
Test for HsV ocular dendritic ulcer?
Corneal/vesicle swab for PCR
Test for adenovirus pink eye?
Eye or throat swab PCR
Test for viral upper respiratory infections?
Eg rhino, coronavirus
Nasal/throat swab PCR
Test for viral lower respiratory infections?
NPA PCR
Test for viral gastroenteritis?
Eg rotavirus, norovirus
Stool PCR
Name 9 category 1 viral notifiable conditions, and who and how to report
Immediate reporting within 24 hours by healthcare provider and lab
• acute flaccid paralysis
• measles
• poliomyelitis
• rabies
• Respiratory disease caused by novel respiratory pathogen
• rift valley fever
• smallpox
• viral haemorrhagic fever diseases
• yellow fever
Name 5 category 2 viral notifiable conditions, and who and how to report
Within 7 days by healthcare provider and lab
• congenital rubella syndrome
• hepatitis A, b, c, E
Name 3 category 3 viral notifiable conditions, and who and how to report
Within 7 days by lab
• West Nile virus, Sindbis virus, chikungunya virus
. Dengue fever virus, other imported arboviruses
• rubella virus
How long defer art if cryptococcal or Tb meningitis
4-6 weeks
HIV prophylaxis for infant with maternal vl at delivery <1000
Nevirapine only 6 weeks
HIV prophylaxis for infant with maternal vl at delivery > 1000 and breastfed
NvP 12 weeks, AZT 6 weeks
HIV prophylaxis for infant with maternal vl at delivery > 1000 and formula fed
NVp 6 weeks AZT 6 weeks
Name 3 drugs that treat both hepatitis B and HIV
. Lamivudine
• tenafovir
• entricitabine
Describe epi vaccination against polio
OPV: birth, 6 weeks (can cause Vapp)
IPV (as part of Dtap - ipv-hib- hepb): 6 weeks, 10 weeks, 14 weeks, 18 months
Max age that can give rotavirus vaccine?
24 weeks (cause intussasception)
