12 - Common Virals Flashcards
(103 cards)
1
Q
Measles is aka?
A
Rubeola
2
Q
Spread of rubeola?
A
Droplet contact
- highly communicable viral disease
3
Q
Prodromal symptoms for measles/rubeola?
A
Fever
Conjunctivitis
Coryza
Cough
4
Q
Pathognomonic form measles?
A
Koplik spots
5
Q
S/s of measles?
A
Red blotchy rash
- appears day 3-7
Begins on face -> trunk -> extremeties
Lasts 4-7 days
Sometimes desquamanated
6
Q
Labs for measles?
A
Leukopenia is common
7
Q
Who gets measles?
A
Antivaxers
Shit-hole countries
Kids who dont sero-convert
8
Q
Deficiency that puts pts at a high risk for measules?
A
Vitamin A deficiency
9
Q
Fatality rate for rubeola?
A
10% globally
Up to 10-30% in some locations
10
Q
Complications of rubeola?
A
Otitis media Croup Encephalitis Pneumonia Diarrhea
11
Q
Rubeola is more sever in?
A
Infants and adults
So people? Dont blame me its on the slides page 17
12
Q
US death rate for rubeola?
A
2-3/1000 cases
Mostly <5 y/o
Pneumonia or encephalitis
13
Q
Diagnosis for rubeola?
A
Clinical or epidemioligic grounds
Measles specific IgM
14
Q
When are the measles pax communicable?
A
Just before the prodromal period
4 days after the appearance of the rash
15
Q
Measles immunity?
A
Acquired immunity after the illness is permanent
16
Q
Maternal antibody?
A
Protects the kid till they get the vaccine at 15 mo
Also makes the vaccine not work on younger kids
17
Q
Who gets the immune globulin?
A
Persons not immunized
- best - 72hrs after exposure
- up to 6 days of expsure
18
Q
Exposed pax also need?
A
Vitamin A
19
Q
Rubella is not?
A
Measles
20
Q
identification of rubella
A
Mild febrile diseasea
Diffuse punctate, maculo-papular rash
21
Q
Rubella resembles?
A
Scarlet fever
Coxsackie virus
Mono rash
22
Q
S/s for rubella (kids)
A
Few or no constitutional symptoms
23
Q
Adult rubella presentation?
A
Low grade fever Mild coryza HA Conjunctivitis Malaise Lymphadenopathy
24
Q
Lymphadenopathy for rubella?
A
Postauricular, occipital and post cervical
Most characteristic clinical feature
Precedes rash by 5-10 days
25
Pathognomonic for rubella?
Forscheimer spots
26
Complications for rubella?
Arthralgia
Arthritis (less common)
Encephalitis (rare in kids)
27
Arthralgia and arthritis from rubella is especially common in?
Young adult females
28
Labs for rubella?
Non-diagnositic
- leukopenia
- thrombocytopenia
29
Why do we care about rubella?
```
Potential fetal anomalies
Risk of fetal defects
Maternal infection (early)
```
30
CRS?
Congenital rubella syndrome
- 1st 16 weeks is highest risk
31
If rubella is acquired in 1st trimester?
80% get CRS
32
Early fetal infection causes?
Intra-uterine death
Spontaneous abortion
Congenital malformation
33
Major organ systems affected in babies:?
Deafness
Cataracts
Microphthalmia
Glaucoma
34
Other concerns for preggos?
```
Microcephaly
MR
Hepatosplenomegaly
Bone disease
Meningo-encephalitis
Varied cardiac anomalies
Icterus
```
35
Milder cases of CRS?
May be unrecognized for years
Linked to DM1
36
Labs for rubella?
Rubella-specific IgM on ELISA
4 fold rise in specific antibody titer
CSF of newborn
37
Occurrence for rubella?
World-wide
Winter/spring
Children
38
Only reservoir of rubella?
Humans
39
Rubella transmission?
Infected nasopharyngeal secretions
CRS kids
- spread large quantities
- secretions in urine
40
Infants communicability for rubella?
From 1 week before onset
To 4 days after onset of rash
Highly communicable
41
Susceptible adults in the US?
10-20% are still susceptible
42
With preggos never
Immunize w rubella
43
CMV is?
Very common
| Rarely symptomatic
44
The most sever form of cmv
Occurs in 5-10% of infants
- infected in perinatal period
- following intrauterine infection
- blood transfusions
45
Severe cmv affects?
CNS
| Liver
46
Symptoms of severe CMV?
```
Lethargy
Icterus
Purpura
Chorioretinitis
Pulmonary infiltrates
Convulsions
Petechiae
Hepatosplenomegaly
Intra-cerebral calcifications
```
47
Survivors of CMV can exhibit?
```
MR
Microcephaly
Motor disabilities
Hearing loss
Chronic liver disease
Death - in utero infection
```
48
Cmv is a big deal when?
```
HIV
Disseminated pneumonia
Retinitis
GI tract disorders
Hepatitis
```
49
MC cause of CMV problems?
Post transplant infections
50
Diagnosis of CMV?
Newborns - urine
Adults - not as easy
Viral isolation
CMV antigen
CMV DNA detection
51
CMV transmission?
```
urine
Semen
Saliva
Cervical secretions
Breast milk
```
Day care
52
What is the reservoir for CMV?
Humans
53
Communicability for CMV?
Excreted for months
(Maybe years)
Longer for neonates
54
Tx for CMV?
Antivirals
- valganciclovir
- gancicolvir
- foscarnet
55
Definition of mononeculosis
Acute viral syndrome characterized clinically by:
- fever
- sore throat (exudative)
- cervical lymphadenopathy
- splenomegaly
56
What differentiates Mono from strep?
Lymphocytosis
Splenomegaly
Extreme fatigue
57
S/s of mono?
```
Fever (7-10 days)
Chills
Malaise
Fatigue
Myalgia
Sever sore throat
Prolonged recovery
Jaundice
Splenomegaly
```
58
Causative agent for mono? (Possible connection)
Burkitt lymphoma
| Nasopharyngeal cancer
59
Labs for mono?
Lymphocytosis (>50%)
Abnormal LFT (AST)
Mono-spot test
60
Infectious agent for mono?
EBV (HHV4)
61
How is mono spread?
Humans are the reservoir
Person to person transmission via oropharyngeal route (kissing)
62
Incubation period for mono?
4-6 weeks
63
How communicable is mono?
Prolonged
Pharyngeal virus exertion up to 1 yr after infection
64
Immunity for mono?
Infection gives a high degree of resistance NOT IMMUNITY
65
Tx for mono?
Symptomatic
Rest
66
What is mumps?
Acute viral disease with fever, swelling/tenderness of 1 or more salivary glands
- usually the parotid
- sometimes the sulingual/submaxillary
67
S/s of mumps?
```
Orchitis (unilateral)
Oophoritis
Sterility (uncommon)
Encephalitis (uncommon)
Pancreatitis (mild)
Mortality (rare)
Neurologic involvment
Deafness (rare, unilateral)
Spontaneous abortion (1st trimester)
```
68
Diagnosis for mumps?
Viral isolation
- ELISA IgM
Skin test - unreliable
69
1/3 of mumps infections are?
Subacute infections
Especially <2yrs old
70
How is mumps spread?
Droplet spread
Saliva
Humans are the reservoir
71
When is mumps contagious?
In saliva
- 6-7 days before parotitis
- 5 days after onset
Max 48hrs before onset
72
Mumps will be in the urine?
Up to 14 days after illness onset
73
Immunity to mumps?
Usually a lifelong immunity after infection
74
Acute poliomyelitis?
Viral infection - acute onset of flaccid paralysis
75
Poliomyelitis infection starts?
In the GI tract
- flacid paralysis occurs
- 90% are subacute
(Fecal oral)
76
Common s/s of polio?
Usually its minor
- fever
- malaise
- HA
- N/V
77
Major illness polio s/s?
Severe muscle pain
Neck/back stiffness
- w or w/o flaccid paralysis
78
Describe the paralysis of polio
Asymmetric
Fever
w/o sensory loss
Legs>arms
79
Categories of poliomyelitis?
- Abortive poliomyelitis (mild)
- Non-paralytic poliomyelitis (meningeal and muscle spasms)
- paralytic poliomyelitis
80
Paralytic polio includes?
Spinal : innervated by spinal nerves
Bulbar : CN-respiratory/vasomotor
81
Complications of polio?
Life-threatening paralysis
Destruction of the spinal cord nerve cells
82
Lab and diagnosis for polio?
Labs isolate polio in
- stool
- CSF
- oral pharyngeal secretions
Fourfold + rise in antibody levels
83
Occurrence of polio?
Rare in developed countries
Sporadic appearance/occasional epidemics
Primary kids
84
Differentiating between GBS and polio?
GBS is:
- typically symmetric
- High protein in CSF
- Fever, HA, N/V absent
85
Transmission of polio
Person to person
Fecal oral
Pharyngeal spread
86
Types of polio vaccines?
OPV
- live trivalent
IPV
- inactivated
- higher GI excretion
87
Varicella is?
Chickenpox
An acute generalized viral disease w
- sudden onset low grade fever,
- mild constitutional symptoms
- skin eruptions (quickly evolving)
88
Skin eruptions of varicella?
Progression
1. Maculopapular rash
2. Vesicular rash
3. Granular scab
Vesicles are monocular
Collapse on puncture
89
Varicella rash has?
Multiple stages of maturity
90
Atypical locations for varicella rash?
```
Scalp
High on axilla
Mucous membranes of mouth
URT
Conjunctiva
```
91
With varicella adults typically have?
Severe fever/constitutional symptoms
Death:
Kids 2/1000
Adults 30/1000
92
With varicella what are common causes of death?
Primay viral pneumonia (adults)
Sepsis (kids)
Encephalitis (kids)
Congenital malformations (early pregnancy)
93
Complications of varicella?
Reyes syndrome
| Herpes zoster
94
S/s of herpes zoster?
- Vesicles on an erythematous base
- restricted to dermatomes
- irregular crops of lesions
- unilateral
- more closely aggregated than varicella
95
Diagnosis of varicella and zoster?
PCR
EM visualation of virus
FA Viral antigen in spears
Cell culture
96
Infectious agent or varicella and zoster?
Human alpha herpesvirus 3
97
Varicella transmission?
Person to person direct contact
Droplet/airborne spread of vesicle fluid
Respiratory tract secretion
98
Zoster transmission?
Reactivation of dormant varicella from a dorsal root ganglia
99
When are you contagious with varicella?
- 1-2 days before rash
- 5 days after 1st crop of vesicles
Scabs are not infectious
100
When is zoster infectious?
1 week after appearance
101
Resistance for varicella?
You never get chicken pox again
But...
Welcome to the risk of zoster
102
Prevention/tx of varicella and herpes?
VZIG w/in 96hrs of exposure
Varicella virus vaccine
Acyclovir
103
Polio builds character
Vaccine free is the way to be
