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viruses Flashcards

1
Q

DNA virus - diagram

A

DNA virus –> 1. complex nucleocapsid 2. icosahedral nucleocapsid
1. DNA virus –> complex nucleocapsid –> envelop –> DS linear –> poxvirade –> a. smallpox b. molloscum contagiosum c. cowpox
2. DNA virus –> icosahedral nucleocapsid –> a. enveloped
b. non envelop
A. DNA virus –> icosahedral nucleocapsid –> enveloped:
- DS circular –> HEPADNAVIRIDAE (HBV)
- DS linear –> HERPESVIRIDAE (HSV1, HSV2, CMV, EBV, HHV6-8, VZV)
B. DNA virus –> icosahedral nucleocapsid –> nonenveloped:
- DS linear –> Adenoviridae
- DS circular –> Papovaviridae (Papillomavirus, Polyomavirus)
- SS linear –> Parvoviridae (B19)

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2
Q

Adenovirus - causes

A
  1. febrile pharyngitis (sore throat)
  2. Acute hemorrhagic cystitis
  3. Pneumonia
  4. Conjunctivitis (“pink eye”)
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3
Q

Papillomavirus (HPV) causes

A
  1. warts (serotypes 1,2, 6, 11) (condylomata acuminata on genitalis -6, 11)
  2. Cervical intraepithelial neoplasia (most commonly 16, 18)
  3. Cervical cancer (most commonly 16, 18)
  4. penile/anal cacrinoma (most commonly 16, 18)
  5. head and neck cancer (mc 16)
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4
Q

B19 virus causes

A
  1. aplastic crisis in sickle cell disease, thalassemia β, hereditary spherocytosis,
  2. slapped cheeks (erythema inectiosum or fifth disease)
  3. during pregnancy RBCs destruction –> fetal death (1st trimester), hydrops fetalis (2nd trimester), not significant in 3rs trimester
  4. RBCs destruction also leads to Rheumatoid arthritis - like symptoms and pure RBC aplasia
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5
Q

poxvirus - viruses?

A

a. smallpox b. molloscum contagiosum c. cowpox

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6
Q

cowpox causes

A

milkmaid blisters

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7
Q

Moloscum contagiosum - presentation

A

flesh colored papule with central umblication

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8
Q

HHV-6 causes

A

Roseola infantum (exanthem subitum) (6th disease)

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9
Q

HHV-7 causes

A

Roseola infantum (exanthem subitum) (6th disease) (LESS COMMONLY)

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10
Q

Roseola infantum (exanthem subitum) (6th disease) - presentation

A

high fevers for several days that can seizures, followed by a diffuse macular rash

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11
Q

CMV is also called / transmission

A

HHV-5

  1. congenitally
  2. transfusion
  3. sexual contact
  4. saliva
  5. urine
  6. transplant
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12
Q

CMV (HHV-5) causes

A
  1. mononucleosis with (-) Monospot in immunocompoment)
  2. congenital infection
  3. in immunocompromised patients (pneumonia, retinitis, hepatitis, encephalitis, neuropathy) –> esp pneumonia in transplant
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13
Q

CMV (HHV-5) retinitis?

A

AIDS retinitis –> hemorrhage, cotton-wool exudates, vision loss

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14
Q

CMV (HHV-5) latent in / histology

A

mononuclear cels

characteristic “owl eye” inclusions

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15
Q

EBV is AKA / transmission

A

HHV-4

resp secretions, saliva

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16
Q

EBV (HHV-4) causes

A
  1. Mononucleosis
  2. endemic Burkit lymphoma
  3. Hodgkin lymphoma
  4. nasopharyngeal carcinoma
  5. primary CNS lymphoma in immunocompromised patients)
  6. Hairy leukoplakia (HIV+, organ transplant recipients)
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17
Q

Hairy leukoplakia is occurs in

A

HIV+, organ transplant recipients

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18
Q

VZV - transmission / aka

A

respiratory secretions

HHV-3

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19
Q

VZV causes

A
  1. chickenbox
  2. shingles
  3. encephalitis
  4. pneumonia
  5. Acute disseminated (postinfectious) encephalomyelitis (after)
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20
Q

HSV-1 causes

A
  1. oral lesions (gingivostomatitis, herpes labialis)
  2. keratinoconjuctivitis
  3. temporal lobe encephalitis
  4. genital lesions (rare) (herpes genitalis)
  5. herpes whitlow
  6. Kluver-Bucy
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21
Q

HSV-1 - temporal lobe encephalitis - presentation

A
  1. altered mental status
  2. seizures
  3. aphasia
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22
Q

HSV-2 causes

A
  1. Herpes genitalis
  2. neonatal herpes
  3. oral lesion (rare)
  4. herpes whitlow
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23
Q

HSV identification - process

A
  1. viral culture for skin/genitalia
  2. CSF pcr for herpes encephalitis
  3. Tzanck test - a smear of an opened skin vesicle to detect multinucleated giant cells commonly seen in HSV1, 2 and VZV infection
  4. Intranuclear inclisions also seen with HSV-1, HSV-2, VZV
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24
Q

Viral vaccines - categories and viruses

A

A. Live attenuated vaccines (1. smallpox 2. yellow fever 3. rotavirus 4. VZV 5. Sabin polio 6. Influenza (intransal) 7. Measles 8. Mumps 9. Rubella)
B. Killed (1. Rabies 2. Influenza (injected) 3. Salk Polio 4. HAV)
C. Subunit (1. HBV (antigen=HBsAg) 2. HPV (types 6, 11, 16, 18))

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25
Q

6th disease?

5th disease?

A

6- Roseola infantum (exanthem subitum)

5- slapped cheeks (erythema inectiosum)

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26
Q

RNA virus - helical nucleocapsid - diagram

A

helical nucleocapsid –> enveloped:

  1. SS- segmented:
    a. Bunyaviridae)
    b. Arenoviridae (Arenovirus)
    c. Orthomycoviridae (Influenza A,B,C)
  2. SS+ nonsegmented
    a. Coronoviridae –> Coronovirus
  3. SS- nonsegmented
    a. Filoviridae (filovirus)
    b. Rhbdoviridae (lyssavirus)
    c. Paramyxoviridae (Parainfluenza, RSV, Measles, Mumps)
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27
Q

RNA virus - icosahedral nucleocapsid - diagram

A
  1. Nonenveloped
    A. SS+ non-segmented
    - Picornaviridae –> a. Rhinovirus B. enterovirus (Poliovirus, Hepatitis A virus, coxsackievirus, echovirus)
    - Caliciviridae –> Clicivirus (Norovirus, Hepatitis E)
    B. DS segmented –> Reoviridae (Rotavirus, Coltivirus)
  2. Enveloped
    A. SS+ diploid –> Retrovirus (HIV, HTLV-1, HTLV-2)
    B. SS+ non-segmented
    - Flaviviridae (Flavivirus)
    - Togaviridae (rubella, Eastern equine encephalitis, Western equine encephalitis)
    C. SS- circular –> Deltavirus (NOT EXACTLY icosahedral nucleocapsid)
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28
Q

coronovirus causes

A
  1. common cold
  2. Severe acute respiratory syndrome (SARS)
  3. Middle East Respiratory Syndrome (MERS)
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29
Q

Lassa virus causes

A

Lassa fever ecephalitis (a form of hemorrhagic fever)

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30
Q

Lassa virus transmission

A
  • spread by rodents (contaminated food or water by rodent urine
  • person to person via bodily fluids
31
Q

Hantavirus - characteristics clinical manifestation

A

hemorrhagic fever, pneumonia

32
Q

Embola virus - course

A

abrupt onset of flu-like symptoms, diarrhea/vomiting, high fever myalgia –> DIC, diffuse hemrrhage, shock –> high mortality rate

33
Q

Rabies virus - Post-exposure prophylaxis

A
  1. wound cleaning
  2. imunization with killed vaccine
  3. rabies immunoglobulin
    (PASSIVE ACTIVE IMMUNITY)
34
Q

RSV causes

A

respiratory tract infection (bronchiolitis, pneumonia) in infants

35
Q

Mumps virus infection - symptoms

A
  1. parotitis
  2. orchitis
  3. Aseptic meningitis
  4. Pancreatisis
36
Q

Mumps virus infection - complication

A

can cause sterility, especially after puberty

37
Q

measles (rubeola) usual presentation

A

prodromal fever with cough, fever and conductivities, then eventually Koplik spots, followed (1-2days) by maculopapular rash that starts on at the head/neck and spreads downward
- Lymphadenitis with Warthin-Finkeldey giant cells (fused lymphocytes) in a background of paracortical hyperplasia

38
Q

Koplik spots?? They are associated with?

A

bright red spots with blue-white center on buccal mucosa that precede the measles rash by 1-2 days
measles (rubeola)

39
Q

measles (rubeola) - possible sequelae

A
  1. Subacute sclerosing panencephalitis (SSPE) - years later
  2. enecephalitis (1:2000)
  3. giant cell pneumonia (rarely, in imminosuppressed)
40
Q

Coxsackievirus causes

A

aseptic meningitis, herpangina (mounth blisters, fever), hand - foot and mount disease, myocarditis, pericarditis

41
Q

Norovirus causes

A

viral gastroenteritides

42
Q

Rotavirus causes

A
  • MCC of fatal diarrhea in children
  • the most important global cause of infantile gastroenteritis
  • Major cause of diarrhea in USA during winter especially in day care centers, kindergartens
43
Q

Coltivirus causes

A

Corolando tick fever

44
Q

Poliovirus - vaccine (type and rout)

A
  1. Salk –> killed (inactivated poliovirus vaccine (IPV)) –> injection
  2. Sabin –> live attenuated vaccines (oral poliovirus vaccine (OPV)) –> oral
45
Q

Yellow fever - transmission / reservoir

A

Aedes mosquitoes (monkey or human reservoir)

46
Q

Yellow fever symptoms

A

high fever
black vomitus
jaundice

47
Q

Rubella virus causes (and aka)

A

rubella (German (3-day) measles)

48
Q

rubella - symptoms

A

MILD disease in children but SERIOUS congenital disease

  1. Fever
  2. postauricular and other lymphadenopathy
  3. arthralgias
  4. fine rash (confluent macules that starts on the face and spread centrifugically to involve the trank and extremities
49
Q

congenital rubella causes

A
  1. Blueberry muffin appearance (rash)

2. classic triad a. PDA (or pulmonary artery hypoplasia b. cataracts c. deafness

50
Q

interferons - clinical use

A

Interferons - α: 1. chronic hepatitis B, C 2. Kaposi sarcoma 3. hairy cell leukemia 4. condyloma acuminatum 5. renal cell carcinoma 6. malignant melanoma
Interferons - β: multiple sclerosis
Interferons - γ: chronic granulomatous disease

51
Q

interferons - side effects

A
  1. neutropenia
  2. myopathy
  3. Flu-like symptoms
  4. depression 1
52
Q

HSV causes (on CNS)

A

HSV-1 –> encephalitis

HSV-2 –> meningitis

53
Q

Hand-foot-month disease is caused by? clinical presentation

A

Coxsackievirus type A
OVAL-haped vesicles on palms and soles
vesicles and ulcers in oral mucosa

54
Q

Rubeola (Measles) is caused by? clinical presentation

A

Beginning at head and moving down (maculopapular). Rash is preceded by cough, coryza, conjuctivitis, and blue white (Koplik) sptos on buccal mucosa

55
Q

Chickenpox is caused by? clinical presentation

A

VZV

vesicular rash begins on trunk –> spreads to face and extremities with lesions of DIFFERENT STAGES

56
Q

hepres zoster (shingles) - clinical features

A
  • prodromal: itching, tingling, burning in dermotomal distribution
  • rash: papules + vesicles on erythematuous base, ulceration + crusting, acute neirtic pain
  • postherpetic neuralgia: neeuritic pain pain more than 4 months after rash onset
57
Q

herpes zoster (shingles) - treatment

A
  • antiviral therapy: acyclovir, valacyclovir, famciclovir

- neuralgia: TCA, pregabaln, gabapentin

58
Q

CMV mononucleosis - manifestation

A

persistent fever, malaise, fatique with absolute atypical lyymphocytosis on complete blood count and atypical lymphocytes on peripheral blood smear
- unlike EBV: no pharyngitis, lymphadenopathy or splenomegaly

59
Q

Parvovirus B19 infection - manifestation

A
  • Most are asymptomatic or flulike symptoms
  • erythema infectiosum (5th disease): fever, nausea, SLAPPED CHEEK (in children)
  • acute summertic arthritis (like RA)
  • transient pire red cell aplasia
60
Q

Parvovirus B19 infection - diagnosis

A

acute infection : IgM in immunocompetent, NAAT for DNA in immunocompromised
previous: IgG
Reactivation: NAAT for B19 DNA

61
Q

adults at high risk for influenza complications

A
  1. older than 65
  2. women who are pregnant + up to 2 wks postpartum
  3. chronic medical illness
  4. immunosuppression
  5. morbid obesity
  6. native americans
  7. nursing home or chronic care facility residents
62
Q

indications of oseltamivir in flu

A
  1. RF (65 or older, chronic medical problems, pregnancy

2. without RRD who come within 48 hours

63
Q

IM - complications

A

airway compromise

  1. autoimmune hemolytic anemia
  2. thrombocytopenia
64
Q

exposure to HBV of a nonimmunized - next step

A

both HB vaccine (within 12 hours) and immune globulin (within 24 hours)

65
Q

Infect mono - heterophile antibody test

A

negative at the beginning (look for atypical lymphocytes)

66
Q

clinical featrues of chronic HCV - clinical presentation

A

asymptomatic or nonspecific symptoms

  • high transminases
  • progression to cirrhosis in 220% and HCC
67
Q

chronic HCV - extrahepatic

A
  • hematologic, mixed cryoglobulinemia syndrome
  • membranoproliferative glumeruloneph
  • dermatologic: porphyria cutanea tarda, liches planus
68
Q

HCV antibodies positive - next step?

A

HCV RNA PCR testing
- the diagnosis of chronic infection is a 2 step process that requires both positive serologic antibodies + a confirmatory molecular test for the presensnce of circulating HCV RNA

69
Q

dermatological manifestation of HCV

A
  1. porphyria cutanea tarda

2. lichen planus

70
Q

HCV treatment

A

ledipasvir-sofosbuvir

71
Q

check for HSV when STD diagnosis

A

no: reserved for active symptoms

72
Q

infectious mono - for how long avoid sports

A

3 weeks for sports and 4 weeks for contact sports

73
Q

HBV infection - chances of recovery?

A

depends of age:

  • healthy adults: more than 95% of recovery
  • 1-5 years old 50-80% recovery
  • perinatal: always chronic infection

Infectious diseases (13 decks)

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