Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuro > Viruses > Flashcards

Viruses Flashcards

1
Q

Which herpes viruses cause meningitis/encephalitis?

A

HSV 1&2 VZV EBV CMV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which paramyxoviruses cause meningitis/encephalitis?

A

Mumps Mealses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which enteroviruses cause meningitis/encephalitis?

A

Polio Coxsackie Echovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which arboviruses cause meningitis/encephalitis?

A

Eastern equine

Western equine

Venezuelan equine

California encephalitis

La Crosse virus

St. Louis encephalitis

West Nile

Powasson

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which arenavirus causes meningitis/encephalitis?

A

LCMV (lymphocytic choriomeningitis virus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Name 3 other viruses that cause meningitis/encephalitis.

A

HIV Adenovirus Rabies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

LP shows PMNs + glucose < 34

A

Bacterial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

LP shows lymphocytes + glucose 70

A

Virus (CSF glucose normally 2/3 of plasma so 70 is normal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

LP shows lymphocytes + glucose < 34

A

Fungus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

CSF protein > 220

A

Bacterial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

List some complications of meningitis

A

Death,hydrocephalus, deafness, seizures, herniation More common with bacterial etiologies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How could you be >99% certain a CSF infection is bacterial?

A

Presence of ONE of the following: Protein > 220 Glucose < 34 WBC > 2000 PMNs > 1180

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

MCC viral meningitis? 2nd? Third?

A

Enteroviruses (Coxsackie, polio, echo) Mumps (before MMR) HSV2, HIV, VZV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Recurrent viral meningitis

A

HSV 1 or 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

URI followed by nuchal rigidity, HA, fever, lumbago, malaise

A

Viral meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MCC sporadic encephalitis in the US?

A

HSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When does viral meningitis usually resolve?

A

10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

MCC epidemic encephalitis in US?

A

St. Louis encephalitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What two classical scenarios suggest recurrent bacterial meningitis in a kid or adult?

A

Kid - ear infections then meningismus Adult - head trauma then meningismus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Route of enteroviruses?

A

Fecal-oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which virus can quickly seed the meninges?

A

HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

MCC arboviral-induced pediatric encephalitis in the US?

A

La Crosse virus (bunyaviridae)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

A patient presents with fever, HA, nuchal rigidity, and the following findings on LP:

Protein - 200

Lymphocytes - 100

PMNs - 1

Glucose - 67

Dx?

A

HSV encephalitis

(CSF characteristic of aseptic meningitis + Mollerat cells**, which are **activated monocytes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Several family members present to the ED with fever, nuchal rigidity, HA, and a history of URI. Most likely agents?

A

Enteroviruses (Coxsackie, echo, polio) - tend to run in families

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

MCC viral encephalitis? 2nd? 3rd? Most serious?

A

Arboviruses (St. Louis, West Nile, La Crosse, etc)

HSV-1 - most serious

Enteroviruses (echo, coxsackie, polio)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

When do arbovirus infections tend to occur?

A

Spring, summer, early fall

(When ticks and mosquitos are prevalent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Who is most likely to become infected with an arbovirus?

A

Children and elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which symptoms suggest encephalitis over meningitis?

A

Confusion, seizures, coma, death

(Both can have fever, HA, lethardy, prodromal URI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

A patient presents with fever, HA, lethargy, and confusion. First step in managment?

A

Empirical antiobiotics and acyclovir

(This could be either bacterial or viral encephalitis; if it’s HSV-1 encephalitis, it needs to be treated immediately)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Describe postinfectious/post-vaccinial immune-mediated encephalitis

A

AKA subacute sclerosing panencephalitis

Follows measles infection/vaccination in infancy

Antibodies attack myelin basic protein/oligodendrocytes and neurons (panencephalitis)

Slowly progressive with neuro signs developing years later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Tx for HSV-1? CMV?

A

Acyclovir

Ganciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

A 30 year old presents to the ED with high fever, HA, N/V, confusion, and focal seizures. MRI shows this finding. Dx?

A

HSV encephalitis

(Shows temporal lobe necrosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

A 30 year old presents to the ED with high fever, HA, N/V, confusion, and focal seizures with spike and wave changes in the temporal lobe. What do you expect to see in the CSF?

A

RBC’s

Lymphocytes

Normal glucose

(These symtpoms with temporal lobe involvement suggests HSV encephalitis; the characterisitc finding in the CSF is RBC’s due to temporal necrosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Who gets acute HSV encephalitis? Reccurent?

A

Acute - newborns, usually HSV-2

Recurrent - adults, usually HSV-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Prognosis of HSV encephalitis if treated? Untreated?

A

Good, curable

70% fatality if untreated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Which are the togaviruses/alphaviruses? Flaviviridae? Bunyaviruses?

A

Togaviruses/alphaviruses - Eastern equine, Western equine, Venezuelan equine, Rubella

Flaviviridae - St. Louis encephalitis, West Nile, yellow fever virus, Dengue virus, pestiviruses, hepaciviruses

Bunyaviruses - La Crosse virus, California virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Flaviviruses are (enveloped, nonenveloped) (segmented, nonsegmented) (+, -, ambisense) (DNA, RNA)

A

Enveloped nonsegmented + RNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

With regards to replication cycle, the flaviviruses (SLE, West Nile, JE) are similar to ______ except:

A

Picornaviruses (rhinovirus, enterovirus) except flaviviruses have a 5’ cap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Describe the replication cycle of the flaviruses (SLE, WN, JE)

A
  1. Enter cell via receptor-mediated endocytosis
  2. Virions released in a pH-dependent fusion event
    • genome translated in nucleus into single polyprotein
  4. Polyprotein cleaved in nucleus via viral and host proteases
  5. Virions assemble in intracellular organelles
  6. Enveloped viruses released at cell surface
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

(T/F): Flaviviruses lyse host cells

(T/F): Humans are the primary host for flaviviruses

A

Both false

(Transmitted from wild birds –> mosquitos –> back to birds and incidentally to humans)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Describe the disease course of the flaviruses (SLE, WN, JE)

A

Mosquito bites human and releases flavivirus

Day 2-3 = Replicates at inoculation site - PRIMARY VIREMIA

Day 3-7 = Replicates in RES - flu-like symptoms

SECONDARY VIREMIA

Encephalitis (SLE, JE), hepatitis (WN), DSS/DHI (Dengue virus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Which demographic of patients would experience a secondary viremia with the flaviruses (SLE, WN, JE)?

A

Elderly, infants, immunocompromised

(Most infections do not progress past the initial flu-like symptoms phase; with continued replication, secondary viremia results)

43
Q

Geography of St. Louis virus infections?

A

North, South, Central America

(In N. America, especially Colorado, Florida, Texas, and Arkansas)

44
Q

Three illnesses caused by SLE?

A

Febrile HA

Aseptic meningitis

Encephalitis

45
Q

Describe the progression of symptoms of SLE

A
  1. 4-21 days post exposure = flu-like symptoms (most people don’t progress from here)
  2. 1-4 days later = meningeal and encephalopathic symptoms
46
Q

Prognosis of SLE infection?

A

Low mortality rate but if patient has a fatal infection, 50% die within first week and 80% die within two weeks

47
Q

Tx SLE?

A

No vaccine or anti-viral proven effective

Control mosquito population

48
Q

Where is West Nile virus found?

A

US, Africa, West Asia, Europe, Middle East

49
Q

___% of people infected with West Nile virus get severely ill

A

1%

50
Q

Most West Nile fatalities occur in what demographic?

A

Elderly

51
Q

Tx West Nile?

A

Supportive

(No vaccine or antivirals)

52
Q

Alphaviruses (WEE, EEE, VEE) are (enveloped, nonenveloped) (segmented, nonsegmented) (+, -, ambisense) (DNA, RNA)

A

Enveloped

Nonsegmented

+ RNA

53
Q

Difference between rubivirus and alphaviruses? (besides disease)

A

Humans are only known reservoir for rubella

54
Q

Alphaviruses (WEE, EEE, VEE) replicate in:

A

Muscles and fibroblasts

55
Q

Alphaviruses (WEE, EEE, VEE) disease prevalence corresponds to:

A

Prevalence of insect vector

56
Q

The severity of alphavirus WEE, EEE, VEE) infection depends on:

A

Age and dose

57
Q

Describe the replication process of the alphaviruses (WEE, EEE, VEE)

A
  1. Receptor-mediated endocytosis
  2. pH-dependent uncoating in lysosome
  3. Polyprotein translated and cleaved into non-structural proteins
  4. NSP’s form - strand complementary RNA
    • strand serves as template for genomic RNA
  6. Another polyprotein translated and cleaved into structural proteins
  7. Virions assembled in intracellular organelles
  8. Bud from cell surface
58
Q

Describe the disease progression of the alphaviruses (WEE, EEE, VEE)

A

Low grade viremia within 24 hours

Febrile illness for ~ 2 weeks

Abrupt onset of encephalitis - confusion, dizziness, vomiting, increasing loss of consciousness

50-80% die within 2-3 days

59
Q

An adult infected with an alphavirus (WEE, EEE, VEE) would experience ___, while a child or elderly patient might experience ____

A

Mild febrile illness

Encephalitis

60
Q

Which of the alphaviruses (WEE, EEE, VEE) has a vaccine? Who gets it?

A

VEE

Lab workers and military

61
Q

Bunyaviridae (La Crosse virus, California encephalitis virus) are (enveloped, nonenveloped) (segmented, nonsegmented) (+, -) (RNA, DNA)

A

Enveloped segmented - RNA

62
Q

Bunyaviridae (La Crosse virus, California encephalitis virus) vs. influenza

A

Both are segmented and can undergo reassortment but bunyaviridae replicate only within the cytoplasm and its mRNA do not get spliced

63
Q

Why are bunyaviridae (La Crosse virus, California encephalitis virus) unique among - RNA viruses?

A

Their genes are found on 2-3 separate RNA segments

64
Q

Describe the disease progression of Bunyaviridae (La Crosse virus, California encephalitis virus)

A

SIMILAR TO FLAVIVIRUS

Mosquito bites kid

2-3 days = replication at innoculation site

4-21 days = flu-like symptoms = PRIMARY VIREMIA

Most cleared by RES

If replication continues = encephalitis = SECONDARY VIREMIA

65
Q

(T/F): Many kids die of Bunyaviridae (La Crosse virus, California encephalitis virus) infection and those who don’t have severe neurological sequelae

A

False

(Most recover completely with <1% fatality)

66
Q

Rabies is (enveloped, nonenveloped) (segmented, nonsegmented) (+, -, ambisense) (DNA, RNA)

A

Enveloped, nonsegmented - RNA

67
Q

Rhabdoviruses vs. paramyxoviruses

A

Rhabdoviruses (rabies) uses single G protein to enter cell in a pH-dependent manner without forming syncytia

Paramyxoviruses (measles and mumps) use one protein (F) for fusion and another for attachment and form syncytia

68
Q

Describe the disease progression of rabies

A

2-10 days after exposure = prodromal stage = fever, chills, HA, malaise

Months-years after exposure = acute neurological phase = dumb or furious rabies

2-7 days after that = coma

3-30 days after coma = death

69
Q

Where is rabies found in highest concentrations in the body?

A

Submaxillary salivary gland (mechanism of spread via bites)

70
Q

Where in the brain does rabies predominate?

A

Limbic system, hypothalamus, midbrain

71
Q

Describe how rabies spreads from bite site to salivary gland

A

Local replication in muscle

Spreads up peripheral sensory nerve to dorsal root ganlia

Replicates in DRG

Spreads up spinal cord to brain

Spreads via efferent nerves to submaxillary salivary glands

Replicates to high concentrations

72
Q

Why do rabies patients exhibit hydrophobia?

A

Protective airway response

73
Q

Three things to do when someone presents with an animal bite

A
  1. Wash wound
  2. Anti-rabies IgG into wound site
  3. 5 rounds of rabies vaccine
74
Q

Is the rabies vaccine activated or inactivated?

A

Inactivated (cell culture)

75
Q

Arenaviruses (LCMV) are (enveloped, nonenveloped) (segmented, nonsegmented) (+, -, ambisense) (DNA, RNA)

A

Enveloped segmented ambisense RNA

76
Q

What is contained within the arenavirus (LCMV) virions?

A

2 RNA segments + host ribosomes

77
Q

Describe the replication strategy of arenaviruses

A

pH-dependent endocytosis

NP and L mRNA translated from genome from short and long segments, respectively

NP and L proteins promote translation

Polymerase produces full-length + sense antigenome for both segments

+ sense antigenome used as template for glycoprotein mRNA

Assembly and budding

78
Q

How are arenaviruses (LCMV) transmitted?

A

Inhalation of aerosolized rodent excreta or saliva

79
Q

Describe the disease progression of the arenaviruses (LCMV)

A

Primary viremia = fever, HA, N/V

10 days later = aseptic meningitis sometimes with DEAFNESS

80
Q

Prognosis of arenavirus (LCMV) infection

A

1/3 asymptomatic, 1/2 get prodrome but don’t progress

Most who do get the meningitis recover without neuro problems but occasional deafness during meningeal phase

81
Q

MC neuro infection of HIV patients?

A

Toxoplasmosis

82
Q

A patient mentions during a routine physical in May that he needs a 90 day prescription for his blood pressure medication rather than his usual 30 day as he will be traveling to India for a couple months on a work trip. You should recommend vaccination against:

A

Japanese encephalitis

(Vaccine available for people travelling to Asia, eastern Soviet Union, India for > 1 month especially during the summer months when mosquitos are cray cray)

83
Q

A 30 yo male on long-term corticosteroids presents to the ED with high fever, confusion, tremor, HA, N/V, and convulsions. His wife reports that he has “the flu” that started when they returned from a trip along the Mississippi-Ohio river basin about two weeks ago. Dx?

A

St. Louis encephalitis

(Flu-like symptoms followed by encephalopathic symptoms + Mississippi-Ohio river basin = SLE)

84
Q

An 86 yo woman presents to the ED in a very confused state with a high fever. Her caretaker states she had been running a fever for over a week then woke up that morning with confusion, vomiting, and dizziness. Dx?

A

Alphaviruses (WEE, EEE, VEE)

(Age of patient + history of fever for over a week then abrupt onset of encephalitis)

85
Q

A 50 yo male presents to the ED with HA, muscle pain, and the rash shown below. A few days later he comes back with confusion, neck stiffness, high fever, severe HA, convulsions, and tremors. Dx?

A

West Nile meningoencephalitis

(Rash with flu-like sx is characteristic of West Nile)

86
Q

Which viruses are associated with a high mortality rate?

A

HSV, alphaviruses (EEE. WEE, VEE), rabies

87
Q

Sudden deafness

A

Arenavirus (LCMV)

88
Q

An 11 year old presents in the ED with fever, severe HA, vomiting, tremor, and a history of seizure. His mother notes that he returned home from visiting family in Southeast Asia about a week ago. She denies rash prior to these symptoms. They declined vaccines recommended by their PCP for religous reasons. Dx?

A

Japanese encephalitis virus

89
Q

Not transmitted by mosquitos

A

Arenavirus (LCMV; aerosolization of rodent feces/saliva)

Rabies (bites)

90
Q

An 8 year old returning home one week ago from summer camp complains of fever for 2-3 days duration, N/V, HA, and fatigue. His mother brings him to the ED after he experiences a seizure. Dx?

A

La Crosse virus

(MCC pediatric encephalitis, seizures common with LCV, summer camp = mosquitos)

91
Q

For which two viruses do horses routinely get vaccinated?

A

Alphaviruses (WEE, EEE, VEE)

West Nile virus

92
Q

Which virus(es) have hemagluttinin on the caspid?

A

Togavirdae (Rubella, EEE, WEE, VEE)

93
Q

Which encephalopathic virus(es) can undergo reassortment?

A

Bunyaviridae (La Crosse virus, California encephalitis virus)

(Segmented genome)

94
Q

No vaccine available for:

A

West Nile

La Crosse

California encephalitis

WEE

EEE

HSV

LCMV

95
Q

Vaccines ARE available for:

A

Rubella

ZEE (lab workers, military only)

Rabies

96
Q

Dx?

A

Rabies

(Bullet-shaped morphology)

97
Q

Multiple RNA segments

A

Bunyaviridae (La Crosse, California encephalitis)

Arenavirus (LCMV)

98
Q

Segmented genomes

A

Bunyaviridae

Arenavirus

99
Q

A researcher working on Alzheimer’s progression in a rat model develops a HA, fever, and N/V. About 10 days later, she experiences nuchal rigidity, worsened HA, and sudden deafness. Dx?

A

LMCV meningitis

(Rats, sudden deafness, meningitis 10 days after prodrome)

100
Q
A
101
Q
A
102
Q
A
103
Q
A
104
Q
A

Neuro (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions