Viruses Flashcards
1
Q
Basic morphology of a virus
A
Nucleic acid (DNA or RNA)
Capsid
Envelope
2
Q
What are the two types of RNA viruses?
A
+ stranded
- stranded
3
Q
Describe positive stranded RNA viruses
A
RNA just like mRNA and can be translated immediately
4
Q
Describe negative stranded RNA viruses
A
RNA needs to be transcribed into positive strand of RNA and the positive strand can then be translated
5
Q
What special enzyme do negative RNA viruses carry?
A
RNA dependent RNA polymerase
6
Q
Describe DNA viruses
A
Have positive and negative strand (double stranded) and negative strand must be transcribed into mRNA
7
Q
What are the two types of capsids?
A
Icosahedral symmetry capsids
Helical symmetry capsids
8
Q
Only this type of virus (nucleic acid) makes helical symmetry capsids
A
RNA
9
Q
Viruses with membranes formed from the host cell’s glycoproteins
A
Enveloped
10
Q
Viruses without glycoprotein membranes
A
Naked
11
Q
What is the acronym used to remember DNA viruses? And the viruses?
A
HHHAPPPy
Herpes
Hepadna
Adeno
Papova
Parvo
Pox
12
Q
Describe most DNA viruses
A
Double stranded icosahedral
13
Q
DNA viruses with envelopes
A
Herpes
Hepadna
Px
14
Q
Three naked DNA viruses
A
Papova
Adeno
Parvo
15
Q
Description for most RNA viruses
A
Single stranded
Enveloped
Helical capsid symmetry
16
Q
DNA or RNA virus- toga
A
RNA
17
Q
DNA or RNA virus- corona
A
RNA
18
Q
DNA or RNA virus- retro
A
RNA
19
Q
DNA or RNA virus- picorna
A
RNA
20
Q
DNA or RNA virus- herpes
A
DNA
21
Q
DNA or RNA virus- calci
A
RNA
22
Q
DNA or RNA virus- reo
A
RNA
23
Q
DNA or RNA virus- hepadna
A
DNA
24
Q
DNA or RNA virus- adeno
A
DNA
25
DNA or RNA virus- flavi
RNA
26
DNA or RNA virus- papova
DNA
27
DNA or RNA virus- orthomyxo
RNA
28
DNA or RNA virus- paramyxo
RNA
29
DNA or RNA virus- rhabdo
RNA
30
DNA or RNA virus- parvo
DNA
31
DNA or RNA virus- pox
DNA
32
DNA or RNA virus- bunya
RNA
33
DNA or RNA virus- arena
RNA
34
DNA or RNA virus- filo
RNA
35
What 3 RNA viruses are nonenveloped?
Picorna
Calici
Reoviridae
36
What 3 RNA viruses are nonenveloped?
Picorna
Calici
Reoviridae
37
Only double stranded RNA virus
Reovirus
38
Acronym for positive rna
The calcified Pico spilled flavorful Corona on his retro toga
Calici
Pico
Flavi
Corona
Retro
Toga
39
Acronym for negative RNA viruses
Old Pete's Rabid dog Filo fights Paul Bunyon in the Arena
Orthomyxo
Paramyxo
Rhabdo
Filo
Bunya
Arenaviridae
40
Viral replication steps
1) adsorption and penetration
2) uncoating of virus
3) synthesis and assembly of viral products
4) release of visions from host cell
41
What are the 4 host cell outcomes of viral infection?
1) death
2) transformation
3) latent infection
4) chronic slow infection
42
What important virus is in the orthomyxoviridae family?
Influenza virus
43
What important viruses are in the paramyxoviridae family?
1. Parainfluenza virus
2. respiratory syncytial virus
3. Metapneumovirus
4. Mumps virus
5? Measles (rubeola) virus
44
Main disease manifestations of parainfluenza and rsv in children
Bronchitis
Viral pneumonia
Croul
45
Main disease manifestations of parainfluenza and rsv in adults
Cold / flu
46
Diseases caused by metapneumovirus.
Who is at highest risk?
- uri / pro
Young children and older adults
47
Classic clinical symptoms of mumps
Parotitis
Testicular inflammation
48
Classic clinical manifestation measles
Prodrome
Koplik's spots
Rash
Encephalitis
49
Symptoms flu
High fever
Chills
Headache
Malaise
Myalgias (muscle pain)
Dry cough
Sore throat
Rhinorrhea
50
What type of flu causes pandemic influenza?
Influenza A virus
51
Clinical manifestation with pandemic influenza
-primary pneumonia
- weakens immune system for secondary bacterial pneumonia / otitis media
Staph aureus
Haemophilus influenzae
Strep pneumo
52
What are the two types of glycoproteins on influenza virus?
Hemagglutinin
Neuraminidase
53
Purpose of hemagglutinin
Adsorption by fusing to sialic acid
54
Purpose of neuraminidase
Cleaves cell mucin barrier
55
What are the three types of influenza?
A
B
C
56
What animals can be infected by influenza A
Humans, other mammals (swine), birds
57
What is the reservoir for influenza B and influenza C
Humans
58
Small changes due to mutations that occur during viral replication
Antigenic drift
59
How long does it usually take the flu symptoms to resolve?
3-7 days
60
What type of influenza can antigenic shift occur in
Influenza A
61
When there is a complete change in HA, NA, or both. Occurs when 2 influenza types (usually animal + human) coinfect the same cell and RNA segment mispackaged into another virus
Antigenic shift
62
What type of antigenic change is responsible for seasonal epidemics
Antigenic drift
63
What type of antigenic change is responsible for pandemics
Antigenic shift
64
Dx for influenza
1. Viral culture
2. Antigen detection
3. RNA detection via PCR
4. Serological- 4 fold increase over 2 weeks
65
How flu vaccines are made
Grown in chick embryos and inactivated and purified, choose 3-4 strains
66
Who should receive the vaccine
All persons six months or older
Immunocompromised
HCP
67
What is cold adapted influenza vaccine trivalent (CAIV-T)
Live, attenuated vax nasal spray for 2-49 years
68
Which influenza drugs are becoming less effective due to resistance?
Adamantanes (amantadine and rimantadine)
69
Antivirals effective against all strains of influenza, decrease duration of infection and likelihood of developing secondary bacterial infection if given within 48 hours of symptom onset
Neurominidase inhibitors (zanamivir and oseltamivir)
70
What is a prophylactic drug given after exposure to influenza?
Neurominidase inhibitors (ie zanamivir or oseltamivir)
71
Clinical signs H5N1
2-4 day incubation
Normal flu-like symptoms
Pneumonia with diffuse, patchy infiltrates progresses to acute respiratory distress syndrome (ARDS)
72
Mortality rate H5N1
50 percent
73
Basic description paramyxoviridae
Negative stranded RNA
HA and NA same protein spike
Fusion protein
74
Syncytial cells, where fusion protein causes host cell's to fuse together
Multinucleated giant cells
75
Who do paramyxoviridae viruses impact?
Pediatric
76
Where do paramyxoviridae adsorb and replicate?;
Upper respiratory tract
77
All paramyxoviridae viruses can disseminate and cause ....
Veremia
78
What family is parainfluenza virus in?
Paramyoxviridae
79
Parainfluenza virus that infects larynx and upper resp tract in children. Causes airways to narrow
Croup
80
Typical symptoms croup (parainfluenza virus);
Stridor (wheezing)
Barking cough
81
Paramyxoviridae virus that has fusion protein that causes giant multinucleated cells and lacks HA and NA proteins. Causes resp infection
Respiratory syncytial virus
82
Number 1 cause of pneumonia in young children, esp infants less than 6 months
RSV
83
Season for RSV
Winter/ spring
84
Monoclonal antibody for RSV
Palivizumab
85
Paramyxoviridae isolated in 3001, and determined to be the second most common cause of lower resp infection in young kids
Metapneumovirus
86
Ages for RSV and metapneumovirus
RSV- under 6 months
Metapneumovirus- 1 year old
87
Season for metapneumovirus
Winter/ early spring
88
Symptoms of metapneumovirus
Bronchiolitis
Croup (20%)
Pneumonia (<10%)
89
Incubation period for mumps
About 3 weeks
90
Family of mumps
Paramyxoviridae
91
Pathogenesis of mumps
Replicates in upper respiratory tract and regional lymph nodes, spread via blood to other organs
92
Most common symptoms of mumps
Parotitis
Orchitis
93
Vaccine for mumps
Live attenuated, mmr
94
Another name for measles
Rubeola
95
Family of measles
Parmyxoviridae
96
Transmission of measles
Airborne or direct contact with nasopharyngeal secretions
97
First phase of measles
Prodrome
98
Incubation period for measles
Approx 10 days
99
How long does the prodrome last?
3-4 days
100
How long do koplik spots last?
1-2 days
101
How long does the measles rash last
6 days
102
Symptoms measles prodrome
Conjunctivitis, photophobia
Rhinitis, cough
High fever
Malaise
103
Describe koplik spots
Develop 1-2 days before rash of measles, small red lesions with blue white centers in the mouth
104
What does the rash of measles look like?
-Red, flat or slightly bumpy (maculopapular)
-Descending - forehead to face neck and torso, feet by day 3
- disappears in order it appears
105
Complications of measles
Pneumonia
Eye damage
Myocarditis
Encephalitis (10%)
Subacute sclerosing panencephalitis (SSPE)
Pregnant women - spontaneous abortion
106
Prevention measles
MMR vax
107
RNA hepatitis viruses
1) hepatitis A virus
2) hepatitis C virus
3) hepatitis D virus
4) hepatitis E virus
5) hepatitis G virus
108
What is the one DNA hepatitis virus called?
Hepatitis B virus
109
Hepatitis transmitted via the fecal oral route
Hepatitis A and hepatitis E
110
Which types of hepatitis are transmitted by blood?
Hepatitis B, hepatitis C, and hepatitis D
111
Sudden onset of viral hepatitis with a mild to severe coarse followed by complete resolution
Acute viral hepatitis
112
Hepatitis following a prolonged course of active disease or silent asymptomatic infection
Chronic viral hepatitis
113
What are the liver function enzymes?
Aspartate aminotransferase (AST)
Alanine aminotransferase (ALT)
Gamma-glutamyl transpeptidase (GGT)
Alkaline phosphatase
114
Symptoms acute viral hepatitis
2 weeks after symptoms onset:
Jaundice
Painful, enlarged liver
Elevated liver enzymes on blood
115
What two liver enzymes typically spike with acute viral hepatitis?
ALT and AST
116
Describe basics of Hepatitis A Virus
Naked
icosahedral capsid
+ Single strand RNA
Family picornaviridae
Fecal oral
117
Incubation period Hepatitis A
15-40 days
118
Test for acute HAV infection
Serology- IgM
119
Reservoir for HBV
All human body fluids (semen, urine, saliva, blood, breast milk)
120
Basic description HBV
Enveloped
Icosahedral capsule
Double stranded DNA
121
Name for intact HBV virus (DNA polymerase, DNA, proteins, envelope, isocahedral capsule)
Dane particle
122
Filamentous structures composed of the envelope and some capsid proteins that have disassociated from the intact HBV virion
Hepatitis B surface antigen
123
If you have this antibody, you are immune to HBV
Hepatitis B surface antigen (anti-HBsAg)
124
Viral core without HBSaG
Hepatitis B core antigen (HBcAg)
125
Are anti-HBcAg protective against HB
No
126
HBV marker for active disease and a highly infectious state
HBeAg
127
Describe HBV transmission
Parenteral
128
Most contagious hepatitis virus
HBV
129
Can Hepatitis A be chronic?
No, only acute
130
Disease states of HBV
1) acute hepatitis B
2) Fulminant hepatitis B (severe)
3) chronic hepatitis B
4) co-infection with Hepatitis delta virus
131
Forms of chronic HBV
1) asymptomatic carrier
2) chronic persistent hepatitis
3) chronic active hepatitis (acute state without normal recover last over 6 months)
132
What actually damages the liver in HBV?
Immune system, so immunocompromised tend to be asymptomatic
133
Complications of HBV
Primary hepatocellular carcinoma
Cirrhosis
134
Presence of this antigen always means there is live HBV virus and infection, either acute, chronic, or carrier
HBsAg
135
This antibody means the person is immune or cured and has no active HBV disease
Anti-HBsAg
136
Core HBV IgM antibody indicative of new infection
IgM anti-HBcAg
137
Core antibody indicative of old HBV infection
IgG anti-HBcAg
138
Antigen that indicates HBV infection present with hight infectivity
HBeAg
139
Presence of this antibody means HBV present with low infectivity
Anti-HBeAg
140
HBV prevention
HBv vax- recombinant vax
Birth, 1-2 months, 6-18 months
141
Is there a treatment for HBV?
Yes- interferon and oral antivirals, but cannot cure HBV
142
Basic description HDV
Can only replicate with HBV
RNA
Parenteral transmission
Used HBV envelop
143
Types of infection with HDVx
1) co-infection
2) superinfection
144
How does HBV and HDV co-infection work?
Infected with both viruses at the same time and cause acute hepatitis.
Both can be cleared of anti-HbsAg antibodies form
145
How does HDV and HBV superinfection work?
HDV infects person with chronic HBV
Acute hepatitis
Severe, Fulminant disease
Chronic infection with both
146
Prevention of HDV
HBV vaccine
147
Leading cause of chronic hepatitis in the US
Hepatitis C
148
If infected as adult, what percent of acute hep b will continue to chronic HBV?
10%
149
What percentage of HCV cases become chronic?
85%
150
Basic description HCV
Enveloped
Icosahedral
RNA
Flavovirus
151
What are the HCV genotypes? Which is most common in the US?
1, 2, 3
Genotype 1 most common in US
152
Transmission HCV
Parenteral, most often IV drug use
153
Incubation for Hep c
6-12 weeks
154
Usual symptoms of acute HCV infection
Asymptomatic
Few fever, right upper quadrant pain, jaundice
85% develop chronic
20% corrhosis
155
How long after HCV exposure are anti-HCV detectable?
6-8 weeks
156
Confirmatory test for positive anti-hcv
HCV RNA
157
Treatment for HCV
Combo antivirals (interferon-free)
8-12 weeks
Cure rates greater than 90%
High cost
158
Where is HEV endemic?
Asia, India, Africa, central America
159
Transmission HEV?
Fecal oral
160
What makes retroviridae viruses unique
Retroviruses
Can cause cancer
161
How do retroviruses work
Carry reverse transcriptase. rNA coded into DNA and incorporated into host genome
162
How can retroviruses cause cancer?
Carry oncogenes
163
Major HIV capsid protein that can be measured in serum to detect early HIV infection
P24
164
What subgroup of HIv Is responsible for most of the world's infections
M
165
What is the predominate HIV subtype in North America and Europe
HIV-1 type B
166
Barrier to universal HIV vaccine
Genetic variation in gp 120 glycoprotein
Variation between subtypes
167
Number living with HIV worldwide and estimated new infections each year
34 million
2.7 million
168
Estimate for HIV in US
1.2 mil
169
HIV trandmission
Sex
Blood products
iV drug use
Transplant
Other parenteral
170
What is the only blood product that has not been associated with HIV transmission
Gamma globulin
171
How do they screen blood products for HIV?
ElLISA for antibodies to HIV-1 and HIV-2 and p24 antigen
PCR
172
How can HIV spread from mother to baby
Transplacental
During delivery
Perinatally
173
Risk for contracting HIV from needle stick contaminated with HIV infected blood
0.3%
174
What increases the risk for contracting HIV from a needle stick?
- deep puncture
- needle in patient's artery or vein
- needle had visible blood on it
- patient has high viral load
175
Risk of transmission of the following after HCP needle stick:
HIV
HCV
HBV
1. HIV: 0.3%
2. HCV: 3%
3. HBV: 30%
176
Can casual contact or salaiva, urine, tears, or sweat transmit HIV?
No evidence for that, no
177
What cells does the HIV virion bind to?
CD4 T-helper cells
178
What receptors must be present for HIV virions fo bind to the host cell?
CCR5
179
HIV is integrated into the host DNA. What are some things that may activate it to start the replication process?
Infections: TB, PCP, cytomegalovirus, herpes, mycoplasma
Immunizatiobs
180
What are the 3 stages of HIV
1) acute viral illness
2) clinical latency
3) AIDS
181
Symptoms of acute viral stage of HIV
Like mono-
Fever
Malaise
Lymphadenopathy
Pharyngitis
182
When does acute phase of HIV happen?
1 month after exposure
183
Pathogenesis of acute viral HIV
- High levels of viremia (HIV in blood)
- Virus infects lymph nodes
- Immune response occurs and decreased veremia
- Replication continues in lymph nodes
184
What happens during HIV latency period?
- No clinical symptoms for about 8 years
- Steady gradual destruction of CD4 T lymphocytes
185
What is the CD4 count for AIDS
Less than 200
186
What are typical opportunistic infections in AIDS patients?
Candida esophagitis
Pneumocystis jeroveci pneumo
Kaposi's sarcoma
cryptococcus neoformans
Toxoplasma gondii
187
What are normal CD4 count
1000 cells/ ul blood
188
How many CD4 cells per year on average decline in HIV infected person?
60 cells per year
189
What are the clinical symptoms and common infections when CD4 counts drop to 200-400
Weight loss
Fever
Night sweats
Adenopathy
Skin infections (candida, herpes zoster)
Bacterial infections (TB)
190
Infection common in AIDS patients with CD4 counts of 0-50
Disseminated disease from Mycobacterium avium intracellulare
Cytomeglovirus
191
What does viral load tell you about HIV?
Speed it's progressing
192
What do CD4 counts tell about the HIV patient?
How likely they will develop opportunistic infection
193
Are there neurological effects of HIV?
Yes, also grows in macrophages and monocytes which can cross blood brain barrier
194
What are the potential neurological symptoms of AIDS?
- encephalopathy
- AIDS dementia complex (reduced cognitive function)
- aseptic meningitis
- myelopathy (infected spinal cord)
- neuropathy
195
What malignancies are people with AIDs at increased risk for?
- b cell lymphoma (EBV)
- Kaposi's sarcoma (HHV-8)
- non-hodgkin's lymphoma
- cervical cancer (HPV)
-anal neoplasia
196
What is an opportunistic infection?
Bugs that do not normally infect someone with an intact immune system but will infect someone with a compromised immune system
197
What type of immunity does HIV impact?
Humoral
198
Common opportunisitc bacterial infections in AIDS patients
- encapsulated bacteria - esp strep pneumo
- mycobacterium tuberculosis
-mycobacterium avium intracellulare
199
Common opportunistic fungal infections in AIDS patients
1) candida albicans
2) cryptococcus neoformans
3) histoplasma capsulatum
4) coccidioides immitis
5) pneumocystis jirovechii pneumonia
200
Difference between meningitis in AIDS patients and immunocompetent patient
- Don't present with normal sign and symptoms (headache, stiff neck)
- May just present with fever
201
Most common opportunistic infection of AIDS patients in the US
Pneumocystis jirovechii pneumonia
202
What can be done to prevent PCP in AIDS patients?
Prophy
203
What are the most common opportunistic viral infections in AIDS patients
- herpes zoster
- EBV
- herpes simplex virus
- cytomegalovirus
204
What impacts can cytomeglovirus have on the AIDS patient?
Retinitis
Esophagitis
205
What are the opportunistic protozoa infections that are common in AIDS patients?
- toxoplasma Gondii (masses in brain)
- cryptosporidium (diarrhea)
- microsporodia (diarrhea)
- isospora belli (diarrhea)
206
When do antibodies form for HIV?
3-6 weeks
207
What serological tests are used to DX HIV
1. ELISA (sensitive- false positives)
2. Confirm with western blot
208
Describe the window period for HIV
3-6 weeks
HIV virus circulating in blood but no antibodies formed
209
What test can be used during the window period to diagnose HIV?
PCR for HIV RNA
210
What are prevention strategies for HIV?
Education
Antiviral prophylaxis (PEP and PrEP)
Screening blood products
211
Describe PEP for pneumocystis jirovechi pneumonia in AIDS patients
tmp-smp when CD4+ counts drop below 200
212
Treatment toxoplasmosis in AIDS patients
Tmp-smp (also a prophy to prevent PCP)
213
Prophy for MAC in AIDS patients
Azithromycin/ clarithromycin
214
What are the 3 general things that all herpesviridae have in common?
1) latent state
2) cause cells to become multinucleated giant cells with intranuclear inclusion bodies
3) held at bay by cell mediated immune response
215
Acronym to remember organisms that can cross the placental barrier
TORCHES
TOxoplasmosis
Rubella
Cytomeglovirus
Herpes, HIV
Syphilis
216
Different manifestations of HSV 1 and HSV 2
1) gingivistomatis
2) genital herpes
3) herpatic keratitis
4) neonatal herpes
5) herpatic Whitlow (hands)
6) disseminated herpes (immunocompromised)
7) encephalitis
217
Most common infectious cause of corneal blindness in the US
Herpetic kertosis
218
Most common cause of viral encephalitis in the US
HSV-1
219
Infection rate for VZV?
90%
220
Season for varicella zoster virus
Winter and spring
221
Incubation period varicella
About 2 weeks
222
First signs of chickenpox
Fever, malaise, headache
223
What does the chickenpox rash look like
Starts on face and trunk and spreads everywhere on body including mucous membranes
Lesions have red base with fluid filled top, and scab over. Arise in crops and crops form at different stages
224
Chickenpox or smallpox: superficial lesions
Chickenpox
225
Chickenpox or smallpox: lesions usually not umbilicated
Chickenpox
226
Chickenpox or smallpox: lesions at different stages of development
Chicken pox
227
Chickenpox or smallpox: lesions more common on the trunk
Chickenpox
228
Chickenpox or smallpox: deep hard lesions
Smallpox
229
Chickenpox or smallpox: lesions often umbilicated (central depression)
Smallpox
230
Chickenpox or smallpox: lesions at the same stage of development
Smallpox
231
Chickenpox or smallpox: lesions more common on the extremities
Smallpox
232
When varicella reactivates and migrates to peripheral nerves, causing burning, painful skin in area supplied by sensory nerves
Shingles
233
What drug can decrease the severity of varicella infection?
Acyclovir
234
In immune compromised patients such as with leukemia or AIDS varicella can be more serious leading to..
Pneumonia and encephalitis
235
What is recommended for immuno compromised patients who were exposed to varicella?
Varicella immune globulin
236
Term for when infected cells become swollen
Cytomegaly
237
What are the four infectious states of cytomegalovirus?
1) asymptomatic infection
2) congenital disease
3) cytomegalovirus mononucleosis
4) reactivated cytomeglovirus and amino compromised patients
238
What percentage of cytomegalovirus is asymptomatic an adults?
80%
239
Most common viral cause of mental retardation
Cytomeglovirus
240
What congenital diseases can CMV cause?
- mental retardation
- microcephaly
- deafness
- seizures
- other birth defects
241
What does CMV look like when it's reactivated and immunocompromised patients?
Retinitis (blindness)
Pneumonia
Disseminated infection
Death
242
What does CMV look like in AIDS patients with CD4 counts below 50 to 100 cells?
CMV veremia
Retinitis (leads to blindness unless treated)
CMV colitis
243
How does CMV prevent in reactivation or new infection in bone marrow transplant recipients?
CMV pneumonia which is rare in AIDS patients
244
What are the three CMV tests?
1) Buffy coat
2) antigen
3) PCR
245
What cancers is Epstein-Barr virus responsible for?
Burkitt's lymphoma
Nasopharyngeal cancers
246
What herpes virus causes Kaposi's sarcoma?
HHV8
247
What makes poxviridae different from other DNA viruses?
- most complex virus, large with DNA to code for hundreds of proteins
- carries most of its own enzymes
- replicates in cytoplasm of cell
248
Describe the transmission of small pox
Person to person via large droplets, sometimes aerosol
249
Describe droplet transmission
Particles over 5 microns propelled 3-6 ft and deposited onto mucous membrane of another person or env surface
250
Describe aerosol transmission
Particles less than 5 microns remain suspended for long periods of time and may travel long distances, inhaled
251
Describe molluscum contagiosum and who it effects
Pox virus
Small white bumps, similar to warts
AIDS patients
252
What are the 2 members of the papaviridae family that infect humans
Papillomavirus
Polyomavirus
253
General description papoviridae
DNA virus
Circular double stranded DNA, naked icosahedral
254
What conditions does papilloma virus cause?
Warts and cervical cancer
255
What are the two HPV strains that cause cervical cancer?
HPV 16 and 18
256
Who is primarily impacted by the DNA virus polyomavirus?
Pediatric
257
Polyomavirus that causes nephritis and uterus sepsis in renal transplant patients
Bk polyomavirus
258
Polyomavirus that causes hemorrhagic cystitis in bone marrow transplant recipients
BK polymoavirus
259
How does BK polymoavirus usually present?
Ubiquitous, mild or asymptomatic infection in children
260
What opportunistic disease does JC polyomavirus cause?
Progressive multifocal leukoencephalopthy
261
More than 10% of childhood respiratory disease is cause by this DNA virus and virtually all adults have serological evidence of prior exposure to it
Adenovirus
262
What are the most common respiratory illnesses in children?
1) RSV
2) metapneumovirus
3) parainfluenza
4) rhinovirus
5) adenovirus
263
What does parvovirus cause?
Fifths disease in children
264
Another name for fifths disease
Erythema infectiosum
265
Are arboviruses DNA or RNA?
RNA
266
What are the arbovirus families?
Togavirodae
Flaviviridae
Bunyaviridae
267
What are the two members of togaviridae that infect humans
1) alpha virus
2) rubivirus
268
What symptoms do the alpha viruses cause?
Encephalitis
Fever
269
What is the vector for alphaviruses?
Mosquitoes
270
What disease does rubivirus cause?
Rubella
271
What diseases do the alphaviruses cause?
Western equine encephalitis
Eastern equine encephalitis
Venezuelan equine encephalitis
Chickungunya
272
True or false- rubivirus are spread by mosquitoes
False- only humans are infected
273
Symptoms of rubella
Mild febrile rash
274
Concern for rubella
Congenital rubella
275
Mode of transmission for rubella
Resp secretions
276
Clinical presentation of rubella
-Prodrome- fever, lymphadenopathy and flu like symptoms
-Rash- red maculopapular from face to torso to extremities
- arthritis- women
277
How long does the rubella rash last?
3 days
278
When is there the greatest risk of congenital rubella?
Early in pregnancy
279
What body areas are affected by rubella?
1) heart
2) eye
3) CNS
280
Should rubella vaccine be given to pregnant women
No, theoretical risk to fetus because love vax
281
What ailment do flaviviridae cause? Vector?
- encephalitis
- mosquito
282
Naming convention for encephalitis caused by flaviviridae
By place
St. Louis encephalitis
Japanese encephalitis
Russian encephalitis....
283
Second leading cause of epidemic viral encephalitis in the US
St. Louis encephalitis
284
What febrile diseases are part of the flaviviridae family?
1) yellow fever
2) dengue fever
3) zika
285
What is another name for dengue fever?
Break-bone fever
286
Transmission of zika
1) mosquito
2) mother to fetus
3) sex
287
Complications of zika
In adults, zika typically mild and self limited BUT
1) microcephaly (babies)
2) GBS (adults)
288
Flavovirus that is spread mainly by mosquitoes and causes epidemics across the US, infects humans, birds, horses
West Nile Virus
289
Type of virus (DNA or RNA): West Nile and other flaviviruses
RNA
290
Transmission of WNV
Mainly mosquitoes
Blood transfusion
Organ transplant
Transplacentally
Breast milk
Blood innoculation (lab accident)
291
Who is at highest risk for complicated WNV infection?
Elderly
292
Clinical manifestation WNV
1) asymptomatic (most people)
2) mild- rash and headache for a week
3) neuroinvasive (meningitis, encephalitis, paralysis)
293
Dx of WNV
1) PCR
2) CSF IgM
3) four fold rise IgG
4) neutralization
PCR not best test, should always do with antibody titers
294
Treatment WNV
Supportive
Prevention is best
295
Diseases cause by RNA viral family bunyaviridae
California encephalitis
Rift valley fever
Hantavirus
296
Picornaviridae genera
Enterovirus
Rhinovirus
Hepatovirus
Parechovirus
297
What are the 5 subgroups of enterovirus?
1) poliovirus
2) Coxsackie A virus
3) Coxsackie B virus
4) echovirus
5) new enteroviruses (including rhinovirus)
298
Where can polio infect?
Peters patches of intestine
Motor neurons
299
Clinical presentations of polio
Mild illness or asymptomatic infection
Aseptic meningitis that clears in a week
Or
Paralytic poliomyelitis
300
Who typically has the most serious effects from polio infection?
Adults
301
Acronym for live vaccines
Mr Rota and Ms Yellow are Small but VIP
MMR (Mr)
Roatavirus (Rota)
Adenovirus (and)
Yellow fever (yellow)
Smallpox (small)
Varicella, influenza, and oral polio virus (VIP)
302
Most common cause of aseptic (no bacterial) meningitis in U.S.
Enteroviruses
303
What enterovirus causes hand foot and mouth and herpangina?
Coxsackie A
304
Type of Coxsackie A illness that is a mild self limiting illness characterized by fever, sore throat, and small red based vesicles over the back of the throat
Herpangina
305
Common acute illness, primarily in children, characterized by fever, oral vesicles, and small tender lesions on the hands, feet, and buttocks
Hand, foot, and mouth syndrome
306
This type of enterovirus causes pleurodynia and myocarditis/ pericardotis
Coxsackie B
307
This Coxsackie B virus causes fever, headache, and severe lower thoracic pain on breathing (pleuritic pain)
Pleurodynia
308
Enterovirus associated with 50% of myocarditis/ pericardotis cases
Coxsackie B
309
Viruses that cause the common cold
Rhinoviruses (85%) and coronaviruses (15%)
310
Viruses implicated in diarrhea
Calicivirus
Roatavirus
Adenovirus
Astrovirus
311
What is the most important virus in caliciviridae?
Norovirus
312
Population at highest risk for caliciviridaw
Young children and infants
313
Virus responsible for 90% of nonbacterial outbreaks of gastroenteritis
Norovirus
314
Symptoms of caliciviridae
Fever, vomiting, diarrhea
315
General about coronasviruses
Respiratory
High mortality rates
Spread bats to humans- pandemic
SARS, MERS, COVID
316
One of leading causes of acute infectious diarrhea and major cause of infant mortality worldwide
Rotavirus
317
True or false- there are vaccines for rotavirus
True, part of standard vax. Rotateq and rotatrix
318
Describe astrovoruses
RNA virus that cause periodic outbreaks of diarrhea in infants, children, and the elderly
319
What care is offered, especially in underdeveloped nations for viral diarrheal illnesses?
Dehydration can kill so supportive
Use oral rehydration therapy when IV not accessible
320
Collection of rabies virions in the cytoplasm
Negri bodies
321
Family of rabies
Rhabdoviridae
322
Disease with the highest case fatality ratio of any infectious disease
Rabies
323
Important viruses in filoviridae
Marburg and ebola
324
Transmission of filoviridae viral hemorrhagic fevers
Direct contact with body fluid
Possible airborne in HCP
325
What body fluids carry ebola
Blood
Vomit
Urine
Stool
Semen
(Living or dead)
326
Precautions for filoviridae
Contact precautions
Face shield
Droplet precautions
Consider airborne
327
How to dispose of Ebola waste (laundry/ equip)
Incinerate, autoclave, or wash with bleach
328
Group of viruses with slower but similar manifestations to filoviridae
Arenaviridae
329
Examples of arenaviridae
Lassa fever
Lymphocytic choriomeningitis virus
South American hemorrhagic fevers
330
Transmission of arenoviruses
Direct contact with rodent droppings/ urine through broken skin, inhalation, or ingestion
331
Treatment for arenaviruses
High dose ribavirin
