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House Microbiology > Viral Encephalitis and Poliomyelitis > Flashcards

Viral Encephalitis and Poliomyelitis Flashcards

1
Q

Introduction

Encephalitis is a/an (acute or chronic?) inflammatory process affecting the ___________

A

Acute

brain parenchyma

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2
Q

Causes

Herpesviruses
List 6

Flaviviruses
List 4

Togaviridae
List 3

A

HSV – 1, HSV – 2, VZV, CMC, EBV, HHV – 6

West Nile
Japanese encephalitis
St. Louis encephalitis
Tick borne encephalitis virus

Eastern equine encephalitis
Western equine encephalitis Venzuelan equine encephalitis virus

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3
Q

Causes
Enteroviruses
Measles virus
Mumps virus
Rabies virus
Lymphocytic choriomeningitis virus Colorado tick fever virus
Influenza virus
Adenoviruses

T/F

A

T

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4
Q

ARBOVIRUS

The arboviruses are a miscellaneous group of

(Naked or Enveloped?)
____RNA viruses that infect animals.

They are transmitted from one vertebrate host to another via _________
The main reservoirs are wild birds and small mammals. Man may be infected if bitten by the insect vector.

A

Enveloped

ss

blood sucking arthropods.

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5
Q

ARBOVIRUS

The main reservoirs are ______ and _______. Man may be infected if _______________

A

wild birds and small mammals

bitten by the insect vector.

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6
Q

Flaviviruses

_________, 40 - 60 nm or more in diameter

Naked or Enveloped?
_____-stranded RNA
________ sense, about 11 kb

Replication: ________.
Assembly: within ___________.

A

Spherical

Enveloped; single; positive

cytoplasm

endoplasmic reticulum

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7
Q

Flaviviruses

Envelope. _____ structural protein
•list : ___________________________________

Non structural:
•list !!!

A

Three

Capsid (C), Membrane (M), Envelope (E)

NS1, NS2A, NS2B, NS3, NS4A, NS4B, NS5

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8
Q

Togavirus

_________, 70 nm in diameter

nucleocapsid has ____ capsomeres.

Genome: ________-sense, _____-stranded RNA, 11–12 kb in size.

(Naked or Enveloped?).

Replication: ________.
Assembly: ______ through ________

A

Spherical; 42

positive; single

Enveloped

cytoplasm

Budding ; host cell membranes.

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9
Q

Togavirus

Envelope:

_____________ major structural polypeptides

______ are _________.

A

Three or four

two

glycosylated

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10
Q

Clinical features of viral encephalitis
Fever
Headache
Malaise
Anorexia
Nausea and Vomiting
____________/_________
______ aberrations: ________,_______

A

Altered sensorium/coma

Mental

hallucination; agitation

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11
Q

Clinical features of viral encephalitis

___________ change
_________ disorders
occasionally __________

A

personality

behavioral

frank psychosis

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12
Q

Clinical features of viral encephalitis

_____________ seizures in >50% severe cases.

(Mild or Severe?) focused _______ deficits

Virtually every possible ____________________ has been reported.

A

Focal or general

Severe; neurologic

focal neurological disturbance

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13
Q

Clinical features of viral encephalitis

Most Common
•______ and ______
•Hemi______ with ________ tendon reflexes
• (voluntary or Involuntary?) movements
•________ nerve deficits (_____palsies, ______ weakness)

A

Aphasia; Ataxia

paresis; hyperactive

Involuntary

Cranial; ocular; facial

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14
Q

Laboratory diagnosis of viral encephalitis

CSF
• usually _______
• __________________ pressure
•initially a _________ ________, which rapidly converts to ________
• proteins are ________
• glucose is _______

PCR
Virus culture
Serology – IgG, IgM

A

colorless

Slightly increased

neutrophilic pleocytosis; lymphocytes

Increased

normal

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15
Q

Treatment
HSV – Acyclovir
• 10mg/kgintravenouslyevery8hours. • Duration 14-21 days.
Ganciclovir can be used in CMV infections.
Fever, dehydration, electrolyte imbalances, and convulsions require treatment.
For cerebral edema severe enough to produce herniation, controlled hyperventilation, mannitol, and dexamethasone.
Patients with cerebral edema must not be overhydrated. monitoring ICP should be considered.

A
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16
Q

Treatment of viral encephalitis

HSV – _______

___________ can be used in CMV infections.

Fever, dehydration, electrolyte imbalances, and convulsions require treatment.

A

Acyclovir

Ganciclovir

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17
Q

Treatment of viral encephalitis

For cerebral edema severe enough to produce _______, controlled _____,_________, and ————-

Patients with cerebral edema must not be ————-. monitoring _____ should be considered.

A

herniation

hyperventilation, mannitol, and dexamethasone.

overhydrated; ICP

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18
Q

Prognosis of viral encephalitis

Outcomes are variable depending on _____.

———- and ______ encephalitis generally have high mortality rates and Severe neurologic sequelae among survivors.

______ is associated with significant morbidity and morality.

A

etiology

EEE and St. Louis

WNV

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19
Q

Prognosis of viral encephalitis

Mortality of HSV encephalitis before acyclovir was _____% to _____%, and with treatment approximately _____%.

_______ disability, _____, and ______ deficits are common sequelae seen among survivors

A

60; 70

30

Cognitive; seizures; motor

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20
Q

Prevention
Vaccination
List 4

Mosquito control
Use of insect repellant
Insecticide spray
Mosquito nets

A

VZV
Rabies virus
Japenese encephalitis virus
Tick borne encephalitis virus

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21
Q

Post infectious encephalitis

develop in the _______ phase, following a number of common viral infections

(Common or Uncommon?)

Measles, mumps, rubella and primary varicella-zoster virus infection.

A

convalescent

Uncommon

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22
Q

Post infectious encephalitis

Following exposure to certain vaccines, such as: ______ virus and the older ______________ vaccines.

A

vaccinia

neurotissue rabies

23
Q

Post infectious encephalitis

(Focal or Widespread?) _______ lesions develop involving the ________ in the ________________.

A

Widespread; demyelinating

white matter

brain and spinal cord.

24
Q

Post infectious encephalitis

Characteristic histological features include: ________ infiltration and __________ of adjacent blood vessels.

The causative agent (can or cannot?) be isolated from brain tissue or CSF.

A

lymphocytic; perivascular cuffing

Cannot

25
Q

Post infectious encephalitis

The aetiology is somewhat obscure, but it is thought to be a ____________ auto-immune phenomenon, triggered by exposure to foreign antigens which are ______________________________________ (__________________ ).

A

T cell-mediated

closely related to host proteins normally present in brain tissue

molecular mimicry

26
Q

Guillain Barre syndrome

Characterised by ________ which develops ________ to _____ after the _______ phase of a certain bacterial or viral infections.

The disease is due to __________ of _________ nerves.

A

poly-neuritis

a few days to weeks

acute; demyelination

peripheral

27
Q

Guillain Barre syndrome

Patients present with ______ paralysis, associated with ______.

Like post infectious encephalomyelitis, it is believed to be __________ phenomenon.

A

an ascending; paraesthesia

an immunological

28
Q

Guillain Barre syndrome

Patients usually recover ______________________________________ as affected nerves are _____________

A

spontaneously over a few weeks or months

re-myelinated.

29
Q

Polio virus

Polio (poliomyelitis) mainly affects _______________________

1 in 200 infections leads to (reversible or irreversible?) paralysis.

A

children under 5 years of age.

irreversible

30
Q

Polio virus

Among those paralysed, 5% to 10% die when their ———- muscles become immobilized.

A

breathing

31
Q

Polio virus

The reduction in prevalence is the result of the global effort to ____________

A

eradicate the disease.

32
Q

As long as a single child remains infected, ______________________________

~WHO 2016

A

children in all countries are at risk of contracting polio.

33
Q

Poliomyelitis

______ stranded
(linear or circular?)
________ sense RNA

Transmission is ________

A

Single
Linear
positive

faeco-oral

34
Q

Poliomyelitis

Primary multiplication takes place in the _________ or ________

The virus first multiplies in the _____, the _______ of the neck, ————, and the __________.

The CNS may then be invaded by way of the __________. Spread along _______ of ___________ to the CNS.

A

oropharynx or intestine.

tonsils; lymph nodes ; Peyer patches

small intestine; circulating blood

axons of peripheral nerves

35
Q

In Poliomyelitis

Some cells that lose their function may recover completely

T/F

A

T

36
Q

Clinical finding of poliomyelitis

Incubation period:_________ (range ___-____ days)

Could be a Mild disease

Or

____________ polio

_________ polio
.

__________ ———poliomyelitis _________

Virus shedding in stool for _________

A

1 – 2 weeks; 3 – 35

Non paralytic

Paralytic

Progressive post; muscle atrophy

6 – 8 weeks

37
Q

Clinical finding of poliomyelitis

Non paralytic polio can lead to ___________

Paralytic polio
•(Acute or Chronic?) (flaccid or spastic?) paralysis resulting from (upper or lower?) motor neuron damage.

A

aseptic meningitis

Acute flaccid

Lower

38
Q

Clinical finding of poliomyelitis

Progressive post poliomyelitis muscle atrophy

•A recrudescence of ____________ and _________ decades after their experience with ______________

A

paralysis and muscle wasting

paralytic poliomyelitis

39
Q

Laboratory diagnosis of poliomyelitis

Specimen-_____,_______,_______

PCR
Virus culture
Serology

A

stool, throat swab, CSF

40
Q

Acute flaccid paralysis (AFP) surveillance

•finding and reporting children with AFP
•transporting ——- samples for analysis
•isolating and identifying poliovirus in the laboratory
•_____the virus to determine the —————

A

stool

mapping

origin of the virus strain.

41
Q

Global eradication strategy

Polio virus type —— was declared eradicated in ______. last case in ______.

A

2

2015

1999

42
Q

Global eradication strategy
Nigeria was taken off the list of polio endemic countries in _____ _______ because a year had passed with no reported cases of WPV

But ____ cases this year from _____ state

A

September 2015

3; borno

43
Q

Polio vaccines

Oral polio vaccine (OPV) by _______
in ———
Inactivated polio vaccine (IPV) by ________ in ______

A

Albert Sabin; 1961

Jonas Salk ; 1955

44
Q

Oral polio vaccine

OPV also produces a local, mucosal immune response in the ___________________

In the event of infection, these mucosal antibodies limit the replication of the _____ poliovirus inside the _____.

This ______ immune response to OPV is thought to be the main reason why mass campaigns with OPV can rapidly stop person-to-person transmission of wild poliovirus.

A

mucous membrane of the intestines.

wild; intestine

intestinal

45
Q

Which vaccine is cheaper??

A

OPV

46
Q

The inactivated polio vaccine produces antibodies in the blood to all three types of poliovirus

T/F

A

T

47
Q

The oral polio vaccine produces antibodies in the blood to all three types of poliovirus

T/F

A

T

48
Q

In some cases it is believed that this vaccine-associated paralytic polio (VAPP) may be triggered by ________

A

immune deficiency.

49
Q

IPV induces (very high or very low?) levels of immunity in the intestine.

A

Very low

50
Q

WHO Region of the Americas was certified polio-free in _______ ,

the WHO Western Pacific Region in _______
and the WHO European Region in June _______.

On 27 March 2014, the WHO _______ Region was certified polio-free,

In 2020, Africa became the _______ region to be certified wild poliovirus-free.

A

1994,

2000

June 2002.

South-East Asia

fifth

51
Q

Circulating vaccine-derived polioviruses (cVDPVs
are (common or rare?) rare strains of poliovirus that have __________ from the strain contained in the __________, and which can only emerge and circulate in __________ communities.

If the vaccine-virus is able to circulate for a prolonged period of time uninterrupted, it can mutate and, over the course of __________, reacquire infectious strength.

A

rare ; OPV; under-immunized

12-18 months

52
Q

Circulating vaccine-derived polioviruses (cVDPVs

The (lower or higher?) the population’s immunity, the longer the cVDPV can survive.

The longer they survive, the more they replicate, change, and __________________ with other viruses as they spread.

A cVDPV can cause cases of ________ in those it circulates to.

If a population is fully immunized against polio, it will be protected against the spread of ____________________________ strains of poliovirus.

A

Lower

exchange genetic material

paralysis

both wild and vaccine derived

53
Q

Circulating vaccine-derived polioviruses (cVDPVs

The switch from ____valent to ____valent oral polio vaccine (OPV) has dramatically reduced the risk of cVDPV. This is because the greatest risk of cVDPV arises from type ____ polio vaccine, which is _____ from ________ OPV.

A

trivalent ; bivalent

type 2 polio

absent

bivalent

House Microbiology (93 decks)

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