Common Viral Diseases Flashcards
(81 cards)
1
Q
How small are viruses
A
Very, very small
2
Q
Like, HOW small?
A
15 - 25 NANOmeters in diameter
3
Q
What contains the DNA?
A
The capsid. Protects genetic material from damage.
4
Q
6 steps to viral infection and replication?
A
Adsorption: binding to host cell
Penetration: Injection of genome into host
Viral genome replication
Assembly
Maturation
Release: new virus expelled from host cell
5
Q
Class I
A
Double stranded DNA papalovirus adenovirus herpesvirus poxvirus
6
Q
Class II
A
Single stranded DNA
Parvovirus
7
Q
Class III
A
Double stranded RNA Coronavirus Picornavirus (polio, common cold) Togavirus (rubella, yellow fever) Hepatitis C virus
8
Q
Class IV
A
Positive single stranded RNA (mRNA) Rhabdovirus Paramyxovirus (measles, mumps) Orthomyxovirus (flu viruses) Bunyavirus (korean hemorrhagic fever) Arenavirus
9
Q
Class V
A
Negative single stranded RNA
Reovirus (diarrhea)
10
Q
Class VI
A
Postiive single stranded RNA with a DNA intermediate in replication
Retrovirus (leukemia, aids)
11
Q
Class VII
A
Double stranded DNA with an RNA intermediate
Hepatitis B
12
Q
HHV-1
A
HSV 1
13
Q
HHV-2
A
HSV 2
14
Q
HHV-3
A
Varicella zoster
15
Q
HHV-4
A
Epstein Barr Virus
16
Q
HHV-5
A
Cytomegalovirus
17
Q
HHV-6
A
Exanthema subitum
18
Q
HHV-7
A
T-lymphotropic virus
19
Q
HHV-8
A
Virus associated kaposis sarcoma
20
Q
Herpes simplex
A
HSV1 = orolabial herpes
HSV2 = genital herpes
Can affect almost any body tissue
21
Q
90% of ppl have ___?
A
HSV-1 by age of 30
22
Q
Common places to harbor dormant HSV?
A
Trigeminal ganglia
Pre-sacral ganglia
23
Q
HSV clinical presentation
A
Dew drop on rose petal ***
Herpes labialis - cold sores
Oral and facial lesions
Gingivostomatitis, pharyngitis
24
Q
HSV Urogenital lesions
A
Can be caused by 1 or 2.
Headache, fever, malaise, myalgia
Vesicular lesions of external genitalia
DIscharge, dysuria, inguinal lymphadenopathy
25
HSV complicaitons
Ocular disease
Neonatal and congenital infections
Bells palsy
Enchephalitis and recurrent meningitis
26
HSV diagnosis
Viral culture
HSV PCR
Direct fluorescent antibody
Serology
27
Varicella Zoster Virus
Primary: chickenpox
Recurrent: Zoster
28
Primary transmission of primary varicella zoster in most like by which route?
Respiratory
29
Varicella Zoster incubation period?
10 - 21 days (usually 14-17)
30
Patients are infectious during which period?
48 hrs before onset until all vesicles are crusted over.
31
Chickenpox presentation
Rash, fever (100 - 103) lasting 3-5 days, malaise
Skin lesions, maculopapules
Crops of lesions on erythematous base
32
Tzanch smear looks for?
Multinucleated inclusion giant bodies.
Used for Herpes simplex
not used anymore
33
Shingles presentation
Unilateral vesicular eruptions that develop on a single dermatome
Severe pain
34
Epstein-Barr Virus
Mono - Kissing disease
4-8 week incubation period
Peak incidence btw 14 and 18 years of age
35
EBV shed from oropharynx for up to ____ months post infection.
18
36
EBV clinical triad
Fever/chills: 7-14 days
Lymphadenopathy: Rarely exceeds 3 wks
Severe pharyngitis w/ exudates: maximal for a week and resolves over a week.
37
EBV labs
Heterophil ab
Monospot
Lymphocytosis
EBV specific immune response
38
Mono complications
Strep pharyngitis
Thormbocytopenia, neutropenia
Splenic rupture
Bells palsy, Gullian-Barre syndrome, encephalitis
39
Mono mgmt
```
95% are self-limiting
Acetaminophen or NSAIDS
Warm saline gargles
Rest
Avoid contact sports for 6-8 wks
```
40
Cytomegalovirus
1% of newborns are infected
Transmitted by close contact, body fluids
Lifelong infection
Can be transmitted form mother to baby and nursing
41
CMV presentation
Congenital: petechiae, organomegaly, jaundice
microcephaly, growth retardation, prematurity
Perinatal: Poor weight gain, adenopathy, rash, hepatitis, anemia, atypical lymphocytosis
CMV mono: Heterophil Ab negative mono synrome
Prolonged high fevers, malaise
Myalgias, HA
Exudative pharyngitis
42
CMV diagnosis
Viral culture**
PCR
Antigen Assays
43
CMV Tx
Ganciclovir
44
characteristic CMV lesions?
Blueberry muffins
45
Fifth Disease (Erythema Infectiosum)
Human parvovirus B19
| Respiratory tract is the route of infection
46
Fifth disease presentation
Mild febrile exanthematous disease with little to no prodrome.
Low grade fever, conjunctivitis, URI, cough, myalgia, itching, nausea, diarrhea
47
Classic Fifth disease sign?
Slapped face lesion.
Indurated, confluent erythema of the cheeks, fiery red.
Bilateral symmetric eruptions
Usually lasts 1 week.
48
5th disease dx
Usually made clinically in kids
Elevated IgM anti-parvovirus antibodies
PCR in serum
49
5th disease Tx
NSAIDS
| Can start at 6 months of age
50
Roseola (Infantum)
HHV-6: b-cell lymphotropic virus
Benign disease of infants 6 months to 4yo.
Most commonly seen < 2yo
51
Roseola is a major cause of infantile _____?
Seizures
52
Roseola presentation
5-15 days of incubation
Abrupt onset of irritability and fever: very high (3-5 days)
Rash appears several hours after sudden drop in temperature
53
Roseola rash
```
Faint small (2-3mm) macules or maculopapules over neck and trunk extendign to thighs and buttocks.
Lasts from a few hours to 1-2 days
```
54
Measles (Rubeola)
Remains worldwide health issue
Transmitted through nasopharyngeal secretions
Highly contagious
55
Measles presentation
Acute febrile eruption for 9-11 days
| 10% mortality from encephalitis
56
Measles rash
Koplik's spot.
Small, red irregular lesions with blue-white centers appearing on oral mucosa.
Brick red, irregular rash
57
Measles Tx
Isolation
Bedrest
Antipyretics
Fluids
58
Rubella
"3 day measles"
Nasopharyngeal secretions transmit virus
Transplacental transmission
59
Rubella Presentation
Viral exanthematous primary disease, milder than measles.
Lymphadenopathy
Rash 14 - 21 days after exposure following same pattern as rubeola
60
Congenital Rubella
```
Heart malformations
Eye lesions
Microcephaly
Mental retardation
organomegaly
intrauterine growth retardation
```
61
Rubella Dx
Antibodies to togavirus
| Leukopenia
62
Mumps
A paramyxovirus
Occurs most frequently in spring
Spread by respiratory route
63
Mumps presentation
```
12 - 25 days of incubation
Swollen parotid glands
Very tender parotids
Epididymoorchitis - spread to testis
25-30% of males get this testi thing
```
64
Viruses causing common cold (3)
Rhinovirus
Coronavirus
Adenovirus
65
Influenza
Caused by orthomyxoviridae
A B and C are surface antigens
Major antigenic shifts occur regularly
B and C are humans only
66
Influenza Presentation
Abrupt onset of systemic symptoms
HA, fever, cough, pharyngitis
Cough, dyspnea
Generally resolves in one week
67
Influenza complications
Pneumonia
Reye's syndrome (young kids)
Myositis, rhabdo
Myocarditis, pericarditis
68
Influenza Tx
APAP
Rest
Fluids
Abx for pneumonia
69
Anti-influenza drugs
```
Neuroaminidase inhibitors:
Oseltamivir (Tamiflu)
Zanamavir (Relenza)
Adamantane Inhibitors/H2 inhibitors:
Amantadine
Rimantadine
```
70
Flu shot contraindicated if allergic to?
Eggs
71
Bronchiolitis
```
Respiratory Syncitial Virus (RSV)
Paramyxovirus genus
Major respiratory pathogen of young children
Close contact will transmit
Incidence rates highest in 1-6 months
```
72
Bronchiolitis Presentation
Rhinorrhea, low grade fever, cough, wheezing
Severe: tachypnea, dyspnea, hypoxia, wheezing, rhonchi and rales
Young children tend to get pneumonia
73
Bronchiolitis Tx
Ribavirin
| Isolation, oxygen, hydration, antibronchospastic agents
74
Croup
Caused by parainfluenza viruses
Type 1: most frequent cause
Type 2: less severe
Type 3: Bronchiolitis and pneumonia in infants
75
Croup Presentation
Acute febrile illness in children
Coryza, ST, hoarseness
Breathing difficulty
Much worse at night
76
Croup Tx
```
Cool or moist air can bring relief
APAP
Aerosolized epinephrine
Pred to go
Avoid cough medicines
```
77
Rabies
caused by rhabdovirus
Urban : dogs and cats
Sylvatic: skunks, foxes, raccoons, wolves and bats
78
Rabies presentation
FLS prodrome for a few days
| Parasthesias around site of innoculation
79
Rabies encephalitis
Development of excessive motor activity
Confusion, hallucinations
Sensitivity to bright light, dilated pupils
Fever
80
Rabies brainstem dysfxn
Occur shortly after encephalitis
Dysphagia (foaming at mouth)
Coma, respiratory failure
Scared of water, wont drink
81
Variola (Smallpox)
Rash starts on face
Deep lesions
Often on palms soles
Back has more than abdomen
