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Senior - ID 2 > 12 - Common Virals > Flashcards

12 - Common Virals Flashcards

(103 cards)

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1
Q

Measles is aka?

A

Rubeola

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2
Q

Spread of rubeola?

A

Droplet contact

  • highly communicable viral disease
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3
Q

Prodromal symptoms for measles/rubeola?

A

Fever
Conjunctivitis
Coryza
Cough

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4
Q

Pathognomonic form measles?

A

Koplik spots

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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

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6
Q

Labs for measles?

A

Leukopenia is common

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7
Q

Who gets measles?

A

Antivaxers
Shit-hole countries
Kids who dont sero-convert

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8
Q

Deficiency that puts pts at a high risk for measules?

A

Vitamin A deficiency

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9
Q

Fatality rate for rubeola?

A

10% globally

Up to 10-30% in some locations

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10
Q

Complications of rubeola?

A 
Otitis media
Croup
Encephalitis
Pneumonia
Diarrhea
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11
Q

Rubeola is more sever in?

A

Infants and adults

So people? Dont blame me its on the slides page 17

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12
Q

US death rate for rubeola?

A

2-3/1000 cases

Mostly <5 y/o

Pneumonia or encephalitis

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13
Q

Diagnosis for rubeola?

A

Clinical or epidemioligic grounds

Measles specific IgM

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14
Q

When are the measles pax communicable?

A

Just before the prodromal period

4 days after the appearance of the rash

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15
Q

Measles immunity?

A

Acquired immunity after the illness is permanent

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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

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17
Q

Who gets the immune globulin?

A

Persons not immunized

  • best - 72hrs after exposure
  • up to 6 days of expsure
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18
Q

Exposed pax also need?

A

Vitamin A

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19
Q

Rubella is not?

A

Measles

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20
Q

identification of rubella

A

Mild febrile diseasea

Diffuse punctate, maculo-papular rash

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21
Q

Rubella resembles?

A

Scarlet fever
Coxsackie virus
Mono rash

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22
Q

S/s for rubella (kids)

A

Few or no constitutional symptoms

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23
Q

Adult rubella presentation?

A 
Low grade fever
Mild coryza
HA
Conjunctivitis
Malaise
Lymphadenopathy
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24
Q

Lymphadenopathy for rubella?

A

Postauricular, occipital and post cervical

Most characteristic clinical feature

Precedes rash by 5-10 days

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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

Senior - ID 2 (6 decks)

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