Viruses

Question 1

Describe the Sx of measles?

Answer 1

Viral prodrome
Koplik’s spots
Maculopapular rash starting on the face

Question 2

How long is measles infective?

Answer 2

4days either side of the rash

Question 3

What are the complications of measles?

Answer 3

Pneumonia
Otitis media
Diarrhoea
Encephalitis
SSPE

Question 4

How is PEP for measles given?

Answer 4

Check IgG first (positive then don’t need)
Within 3 days of exposure: MMR vaccine/ immunoglobulin

Question 5

How long is Chickenpox incubated?

Answer 5

14 days

Question 6

What is the progression of Chickenpox spots?

Answer 6

Macule, Papule, Vesicles, Pustule, Ulcer

Question 7

What are the complications of Chickenpox?

Answer 7

Secondary skin infections
Encephalitis (Cerebellar presentation)
Pregnancy complications

Question 8

What are the pregnancy complications with Chickenpox?

Answer 8

1st Trimester: Congenital Varicella Syndrome
Mid-Trimester: Severe maternal infection including pneumonia

Question 9

What is Ramsay-Hunt Syndrome? How does it present?

Answer 9

Shingles in Geniculate ganglion (CN7)
Facial palsy
Rash in & around ear
Taste & vestibular features
Only place where shingles has a motor feature

Question 10

Who gets the shingles vaccine?

Answer 10

Over 70s

Question 11

Where does the Rubella rash start?

Answer 11

Behind ears then face then trunk then extremities

Question 12

Where do you find lymph nodes in Rubella?

Answer 12

Sub-cooipital
Post-Auricular

Question 13

How is Rubella confirmed?

Answer 13

IgM, IgG, PCR blood/saliva

Question 14

What would you see in a baby with congenital rubella syndrome?

Answer 14

1st Trimester: Microcephaly, deafness, blindness, hepatosplenomegaly, growth retardation

Question 15

Which virus causes Mumps?

Answer 15

Paramyxovirus

Question 16

What are the Sx of Mumps?

Answer 16

Parotitis (unilateral)
Trismus
Neck oedema
High fever

Question 17

What are the complications of Mumps?

Answer 17

Orchitis (rarely bilateral)
Meningism
Deafness (usually recovers)
Other organs (pancreatitis)

Question 18

Is pertussis gram positive or negative?

Answer 18

Gram Negative Cocci

Question 19

What is the incubation time for Pertussis?

Answer 19

1-3/52

Question 20

Is there treatment for Pertussis?

Answer 20

Macrolides
Doesn’t’t alter clinical course but reduces transmission

Question 21

What are the other name of slapped cheek syndrome? What is it caused by?

Answer 21

Erythema Infectiosum
Fifth disease
Parvovirus B19

Question 22

Is Erythema infectiosum notifiable?

Answer 22

No

Question 23

What are the Sx of erythema infectiosum?

Answer 23

Rash- bright red cheeks
Fingers swell
Mild arthropathy

Question 24

What are the complications of erythema infectiosum?

Answer 24

Aplastic anaemia
High marrow turnover = aplastic crisis
Pregnancy = High fetal mortality in 1st trimester- Hydrops Fetalis

Question 25

How is erythema infectiosum investigated?

Answer 25

IgG (immunity)
IgM (acute infection)

Question 26

How is RSV diagnosed?

Answer 26

Immunofluorescence of secretions

Question 27

What virus causes Croup?

Answer 27

Parainfluenza

Question 28

What do the different types of Herpes Simplex cause?

Answer 28

Type 1: Coldsore
Type 2: Genitals
Both include reactivations

Question 29

How is Herpes type 2 transmitted?

Answer 29

Vertical transmission
E.g if mother has herpes ulcers at time of delivery can pass on to baby. Presents as disseminated infection

Question 30

Which type of herpes is related to encephalitis? Which areas does it effect?

Answer 30

Type 1
Frontal & temporal lobes
Can be from primary infection or reactivation of old infection

Question 31

How is herpes encephalitis treated?

Answer 31

Aciclovir
Very high mortality

Question 32

Which conditions give a false positive on a Monospot test?

Answer 32

Leukaemia
Lymphoma
Hepatitis

Question 33

What are the complications associated with cytomegalovirus?

Answer 33

Retinitis
Hepatitis
Colitis
Pneumonitis
Reactivation in immunocompromised