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Flashcards in Childhood Viruses (lecture) Deck (11):
1

Paramyxoviruses are __________ (enveloped/nonenveloped), ____________ (negative/positive) sensed _________ (single/doubled) stranded _________ (RNA/DNA) virus.

enveloped
negative
single
RNA

2

What titer measure marks the transition from acute to convalescent phases of viral infection?

A 4 x increase in viral antibodies marks the transition from acute infection to convalescence.

3

What is the pathophysiology of multinucleate giant cells associated with viral infections?

Spikes (glycoproteins) from the virus are expressed on infected host cells. These spike can induce cell agglutination and subsequent fusion, leading to multinucleate giant cells.

4

A 4 month old child presents with mild respiratory distress, a temperature of 100.5, and productive cough in February. H and E of sputum reveals multinucleate giant cells. What is the most likely agent of infection?

RSV is usually contracted during the winter months and usually infects those under 6 months of age. It usually will result in non specific symptoms, but may progress to pneumonia.

5

A 2 year old child presents with a barking cough in October. Isolation of the causative agent from sputum reveals multinucleate giant cells. What is the genome of them most likely causative agent?

This is most likely parainfluenza 1 or 2 (usually infects 6 month to 5 y.o. in the autumn and is a cause of croup). The genome is single stranded negative sense RNA.

6

10 year old male immigrant from South America presents with parotid gland swelling and orchitis. What is the genome of the probably causative agent and type of vaccine that is typically given to prevent infection?

This is probably Mumps, a paramyxovirus (SS, negative sense RNA virus). It is prevented by administration of a live attenuated vaccine (part of MMR).

7

3 y.o. female immigrant presents with a diffuse trunkal rash, photophobia, conjunctivitis, blue/white spots on the inside of her cheeks and increased lymphocytes. What type of hypersensitivity is responsible for the rash, the genome of the agent, and the type of vaccine that would have prevented this infection?

This is measles (a paramyxovirus - SS, negative sense RNA). The rash is due to CD 8 cells (HS type IV). It is prevented by administration of a live attenuated vaccine (part of MMR).

8

Neonate from an immigrant mother is found to have cataracts and deafness. You notice the mother has a macular papular rash that involves the skin medial to the nasolabial folds. What is the most likely causative agent, its genome and the type of vaccine that would have prevented the illness?

This is likely Rubella (a Togavirus - positive-sense SS RNA virus). Vaccination is with a live attenuated vaccine (MMR).

9

3 y.o African American with a maculopapular rash that is limited to the lateral side of her face is brought to your office by her pregnant mother. If a viral infection is implicated, what are the largest concerns for both the child and mother?

This is likely Parvovirus B19. It is known to cause Aplastic Crisis which is fatal in Sickle Cell patients (the child is at risk for SC) and can cause hydrops fetalis.

10

7 y.o. immigrant is brought to your office with a history of diffuse papules that progressed to vesicles. She now has multiple 1 cm lesions with a crusty covering (all within 10 days' time). Other symptoms included a low fever and general malaise. What is the most likely causitive agent and what is she at risk of developing in her 5th to 6th decade of life?

This is likely chickenpox (caused by VZV). She may develop shingles later on (very painful rashes that follow dermatome distribution).

11

Be familiar with the recommended vaccine schedule: http://www.cdc.gov/vaccines/schedules/easy-to-read/child-easyread.html

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