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pm infectious disease > Viruses > Flashcards

Viruses Flashcards

1
Q

Cytomegalovirus (type, appearance, patterns):

A
  • herpesvirus
  • typically only disease causing in immunocompromised
  • owl’s eye appearance (intranuclear inclusion bodies)
  • congenital, mononucleosis, retinitis, encephalopathy, pneumonitis, colitis
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2
Q

Congenital CMV infection:

A
  • growth retardation
  • pinpoint petechial blueberry muffin skin lesions
  • microcephaly
  • sensorineural deafness
  • encephalitis (seizures)
  • hepatosplenomegaly
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3
Q

CMV mononucleosis:

A
  • infectious mono like illness

- may develop in immunocompetent

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4
Q

CMV retinitis:

A
  • common in HIV patients

- visual impairment e.g. blurred vision, fundoscopy: retinal haemorrhages and necrosis (pizza retina)

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5
Q

Dengue fever (transmission, incubation, features, management)

A
  • viral haemorrhage fever
  • transmitted by Aedes Aegypti mosquito
  • incubation 7 days
  • form of DIC - dengue shock syndrome
  • headache, fever, myalgia, pleuritic pain, facial flushing, maculopapular rash, reduced platelet, increased ALT
  • manage symptomatically, no antivirals
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6
Q

Ebola (virus type, locations, transmission, incubation)

A
  • Filoviridae family
  • West Africa - Guinea, Sierra Leone, Liberia
  • human to human direct contact transmission
  • incubation: 2-21 days
  • not infectious until symptomatic
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7
Q

Features of ebola:

A
  • sudden onset fever, fatigue, myalgia, headache, sore throat
  • vomiting, diarrhoea, rash
  • impaired liver and kidney
  • internal and external bleeding
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8
Q

Malignancies associated with EBV:

A
  • Burkitt’s lymphoma
  • Hodgkin’s lymphoma
  • nasopharyngeal carcinoma
  • HIV - associated CNS lymphoma
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9
Q

Non-malignant association with EBV:

A

harry leukoplakia - indicative of HIV

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10
Q

Infectious mononucleosis causes and features:

A
  • HHV4, CMV, HHV6
  • triad: sore throat, lymphadenopathy, pyrexia
  • malaise, anorexia, headache
  • palatal petechiae
  • splenomegaly (rare splenic rupture)
  • hepatitis (transient increase ALT)
  • lymphocytosis
  • haemolytic anaemia secondary to cold agglutinins IgM
  • maculopapular pruritic rash if ampicillin/amoxicillin whilst having mono
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11
Q

Diagnosis of infectious mononucleosis:

A

heterophil Ab test (monospot) - second week illness

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12
Q

What needs to be avoided with infectious mono?

A

contact sports 8 weeks after

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13
Q

Mumps virus type, spread, features, management:

A
  • RNA paramyxovirus
  • spread by droplets
  • infective 7 days before and 9 days after parotid swelling starts
  • incubation period: 14-21 days
  • MMR vaccine
  • fever, malaise, muscular pain, parotitis (unilateral initially becomes bilateral in 70%)
  • manage with paracetamol, notifiable disease
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14
Q

Complications of mumps:

A
  • orchitis - uncommon pre-pubertal males (4-5 days after start of parotitis)
  • hearing loss - unilateral and transient
  • meningoencephalitis
  • pancreatitis
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15
Q

Norovirus (type, symptoms, transmission, diagnosis)

A
  • most common cause gastroenteritis
  • range of non encapsulated RNA virus species
  • symptoms: 15-20 hours
  • nausea, vomiting, diarrhoea, headaches, low grade fever, myalgia
  • faeco-oral route
  • virus enters cell via host receptor mediated endocytosis and replicates in small intestine
  • diagnose with stool culture viral PCR
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16
Q

Parvovirus B19 - erythema infectiosum:

A
  • fifth disease/slapped cheek syndrome
  • mild fever
  • noticeable rash after few days
  • feels better after rash appears
  • warm bath, sunlight, heat or fever can trigger recurrence of rash
  • non infectious once rash appears
  • adult - acute arthritis
  • affects unborn baby in first 20 days
17
Q

Other presentations of parvovirus B19:

A
  • asymptomatic
  • pancytopaenia in immunosuppressed patients
  • aplastic crises e.g. in sickle cell (virus suppresses erythropoiesis for week)
18
Q

Rabies

A
  • causes acute encephalitis
  • RNA rhabdovirus
  • majority dog bites, also bat, raccoon and skunk
  • travels up nerve axons towards CNS in retrograde way
  • poor rural areas of Africa and Asia
19
Q

Features of rabies:

A
  • prodromal: headache, fever, agitation
  • hydrophobia: water provoking muscle spasms
  • hypersalivation
  • negri bodies: cytoplasmic inclusion bodies found in infected neurons
20
Q

Management of rabies:

A
  • wash wound
  • if already immunised - 2 further doses of vaccine
  • if not, human rabies Ig along full vaccination course (administer around wound)
21
Q

Rubella

A
  • german measles
  • togavirus
  • congenital rubella syndrome risk
  • 14-21 day incubation period
  • infectious 7 days before and 4 days after rash onset
  • prodrome e.g. low grade fever
  • rash: maculopapular, initially face before spreading to whole body, usually fades by 3-5 days
  • lymphadenopathy: sub occipital and postauricular
22
Q

Complications of rubella:

A
  • arthritis
  • thrombocytopaenia
  • encephalitis
  • myocarditis
23
Q

Yellow fever

A
  • type of viral haemorrhage fever
  • zoonotic infections e.g. Aedes mosquito
  • incubation: 2-14 days
  • mild flu-like illness lasting less than 1 week
  • high fever, riggers, n&v, bradycardia
  • brief remission followed by jaundice, haematemesis, oliguria
  • if severe jaundice, haematemesis
  • councilman bodies (inclusion bodies) - may be seen in hepatocytes
24
Q

What are the live attenuated vaccines?

A
  • BCG
  • MMR
  • Influenza (intranasal)
  • oral rotavirus
  • oral polio
  • yellow fever
  • oral typhoid
25
Q

What are the inactivated vaccines?

A
  • rabies
  • hepatitis A
  • influenza IM
26
Q

What are the toxoid (inactivated toxin) vaccines?

A
  • tetanus
  • diphtheria
  • pertussis
27
Q

Conjugate vaccines:

A
  • pneumococcus
  • haemophilus
  • meningococcus
28
Q

HPV vaccine:

A
  • gardasil
  • 6,11,16,18
  • 12-13 year old girls and boys (2 doses)
  • also mwhswm <45yo against anal, throat and penile cancers
  • injection site reactions common
29
Q

Influenza vaccine in children:

A
  • intranasal
  • 1st at 2-3yo then anual
  • live vaccine
  • immunosuppressed - inactive, injection
  • 2 doses if 2-9yo and never had vaccine
  • more effective than injection
30
Q

Contraindications to intranasal influenza vaccine:

A
  • immunocompromised
  • <2yo
  • current febrile illness or blocked nose/rhinorrhoea
  • current wheeze or history of severe asthma
  • egg allergy
  • pregnancy/breast feeding
  • aspirin e.g. for Kawasaki’s due to Reye’s risk
31
Q

ADR of intranasal influenza vaccine:

A
  • blocked nose
  • headache
  • anorexia
32
Q

How effective is the influenza vaccine:

A

75%

-10-14 days for Ab levels to be protective

33
Q

When is the tetanus vaccine administered:

A
  • 2mo, 3mo, 4mo, 3-5yrs, 13-18yrs

- 5 doses - long term protection

34
Q

What do you give to someone who has a wound and had a full course of tetanus vaccines with the last dose <10 years?

A

nothing

35
Q

What do you give to someone who has a wound and has had a full course of vaccines with the last dose >10 years?

A
  • if tetanus prone wound: reinforcing dose of vaccine

- high risk wound: reinforcing dose + Ig

36
Q

What do you give to someone who has a wound and an incomplete/unknown vaccine history?

A
  • reinforcing dose of vaccine

- tetanus prone and high risk wounds: reinforcing dose of vaccine + Ig

pm infectious disease (6 decks)

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