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AAA-MEDICINE (INFECTIOUS) > DENGUE 1.1 (AB) > Flashcards

DENGUE 1.1 (AB) Flashcards

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1
Q

What is considered the most important and rapidly spreading mosquito-borne viral disease in the world?

A

Dengue

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2
Q

What are the two most common arthropod-borne diseases?

A

Dengue and Malaria

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3
Q

What regions are particularly burdened by dengue?

A

Tropical and subtropical countries

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4
Q

What is the estimated number of new dengue infections yearly according to WHO?

A

50 to 100 million

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5
Q

Who are primarily affected by severe dengue in Asia and Latin America?

A

Children

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6
Q

Is there a specific antiviral treatment for dengue?

A

No, but prompt recognition and timely intervention are crucial

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7
Q

Which four Western Pacific countries reported over a million dengue cases between 2001 and 2008?

A

Cambodia, Malaysia, Philippines, and Vietnam

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8
Q

What was the combined death toll in these four countries from 2001 to 2008?

A

4798

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9
Q

When was a national dengue epidemic declared in the Philippines?

A

2019

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10
Q

How many dengue cases were reported in the Philippines in October 2022?

A

181971

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11
Q

What was the percentage increase in dengue cases in 2022 compared to the previous year?

A

0.91

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12
Q

What is the case fatality rate of dengue in the Philippines?

A

0.003

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13
Q

Why should no one die of dengue with proper management?

A

Because the case fatality rate is low with proper management

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14
Q

Where did DENV likely originate from before infecting humans?

A

Monkeys in Southeast Asia or Africa

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15
Q

When did DENV infection first get recognized in Thailand and the Philippines?

A

1850s

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16
Q

Which DENV serotypes were most prevalent before 2000 and 2000-2009?

A

DENV-2 before 2000 and DENV-3 between 2000 and 2009

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17
Q

Which DENV serotype dominated after 2010?

A

DENV-4

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18
Q

What type of virus is DENV?

A

Single-stranded, positive-sense RNA virus of the Flaviviridae family

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19
Q

How many serotypes of DENV exist?

A

Four (DENV-1, DENV-2, DENV-3, DENV-4)

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20
Q

Does infection with one DENV serotype confer lifelong immunity to all serotypes?

A

No, only to the infected serotype with short-term cross-immunity

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21
Q

What are the major envelope proteins necessary for DENV infectivity?

A

E and M proteins

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22
Q

What receptors does DENV bind to on human cells?

A

Mannose receptor (MR) and DC-SIGN

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23
Q

What is the primary mode of DENV entry into human cells?

A

Clathrin-mediated endocytosis and pH-dependent fusion

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24
Q

Where does viral RNA replication of DENV occur?

A

Endoplasmic reticulum (ER) surface

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25
How is the mature virion released from the host cell?
By exocytosis
26
What are the two primary mosquito vectors for DENV?
Aedes aegypti and Aedes albopictus
27
Which mosquito species is the principal DENV vector?
Aedes aegypti
28
Which vector is more cold-tolerant and has wider distribution?
Aedes albopictus
29
What other diseases can Aedes mosquitoes transmit?
Zika and Chikungunya
30
Where does Aedes aegypti breed?
In and around houses, in both man-made and natural water containers
31
When does Aedes aegypti usually bite?
From sunrise to sundown (daytime feeder)
32
What is the lifespan of an adult Aedes aegypti mosquito?
2 to 4 weeks
33
How many eggs can a female mosquito lay in her lifespan?
At least 4-5 times, 10 to 100 eggs each spawn
34
How long can mosquito eggs survive in dry conditions?
Up to six months
35
What are the three diverse polytypic forms of Aedes aegypti?
Sylvan, Domestic, and Peridomestic types
36
Where does the Sylvan type breed?
In tree holes, typically in forests
37
Where does the Domestic type breed?
In municipal surroundings, around houses
38
Where does the Peridomestic type survive?
In biologically modified areas like coconut farms
39
What is hyperendemic dengue?
Continuous circulation of multiple DENV types in an area
40
What type of dengue transmission pattern does the Philippines have?
Hyperendemic
41
What factors influence dengue transmission?
Vector density, mosquito incubation period, movement of vectors and people, host density, and viremia level
42
What is the extrinsic incubation period?
The incubation period of DENV in the mosquito
43
What is the intrinsic incubation period?
The incubation period of DENV in humans (3-14 days)
44
How is dengue virus transmitted?
Human to mosquito to human cycle via mosquito bites
45
Which mosquito is most efficient at transmitting DENV?
Aedes aegypti
46
What is the incubation period of the virus in the mosquito?
8-12 days
47
What is the incubation period of dengue in humans?
3-14 days
48
Can dengue be transmitted via blood transfusion or organ transplant?
Yes, though rare
49
Can vertical transmission of dengue occur?
Yes, from mother to fetus or neonate
50
What symptoms are common in congenital dengue cases?
Fever, thrombocytopenia, hepatomegaly, hemorrhagic manifestations
51
What are the three phases of clinical dengue illness?
Febrile phase, critical phase, recovery phase
52
Is dengue a platelet count disease?
No, platelet count is just one manifestation and does not always require transfusion.
53
What phase follows the febrile phase if recovery doesn't occur?
Critical phase
54
What marks the transition from febrile to critical phase?
Defervescence (temperature drop below 38°C)
55
What is the earliest abnormality in dengue full blood count?
Progressive decrease in total white cell count
56
What kind of fever pattern occurs in 5% of dengue cases?
Biphasic (saddleback) fever
57
What does a positive tourniquet test indicate?
Increased probability of dengue
58
What are the mild hemorrhagic manifestations in dengue?
Petechiae and mucosal bleeding (e.g., gums, nose)
59
What signs may occur in the critical phase of dengue?
Abdominal pain, persistent vomiting, mucosal bleeding, lethargy, liver enlargement, fluid accumulation
60
What are laboratory signs of critical phase in dengue?
Increased hematocrit with rapid platelet decrease
61
How long does plasma leakage last in the critical phase?
24-48 hours
62
What is a key danger of excessive IV fluids during recovery?
Fluid overload, leading to pulmonary edema or heart failure
63
What clinical signs indicate progression to recovery phase?
Improved well-being, stable hemodynamics, diuresis, biphasic fever, bradycardia, 'isles of white in sea of red'
64
What lab findings are typical in the recovery phase of dengue?
Hematocrit stabilizes, WBC rises, platelets remain low initially
65
What are complications of the febrile phase?
Dehydration, neurological disturbances, febrile seizures
66
What are complications of the critical phase?
Shock, severe hemorrhage, organ impairment
67
What are complications of the recovery phase?
Hypervolemia, pulmonary edema
68
What are the 3 categories in the WHO 1997 dengue classification?
Dengue Fever, Dengue Hemorrhagic Fever, Dengue Shock Syndrome
69
What are the 4 criteria for Dengue Hemorrhagic Fever?
Fever, hemorrhagic manifestation, thrombocytopenia ≤100,000, evidence of plasma leakage
70
What are signs of plasma leakage?
Pleural effusion, ascites, hemoconcentration, hypoproteinemia
71
What defines Dengue Shock Syndrome?
Narrow pulse pressure (≤20 mmHg) and signs of poor perfusion (cold extremities, delayed cap refill, rapid pulse)
72
What is the difference between compensated and decompensated shock?
Compensated: normal BP with tachycardia and cold extremities; Decompensated: hypotension, possible multi-organ failure
73
What is DHF Grade I?
Fever, hemorrhagic manifestation (positive tourniquet test), plasma leakage
74
What is DHF Grade II?
Grade I plus spontaneous bleeding (e.g., gums, nose)
75
What is DHF Grade III?
Grade I or II plus narrowing pulse pressure or hypotension
76
What is DHF Grade IV?
Grade III plus profound shock with undetectable BP and pulse
77
What are the 3 WHO 2009 dengue classifications?
Dengue without warning signs, dengue with warning signs, severe dengue
78
What clinical criteria define probable dengue?
Lives/traveled to endemic area, fever, and ≥2: nausea/vomiting, rash, aches, positive tourniquet test, leukopenia, warning signs
79
What are warning signs of dengue per WHO 2009?
Abdominal pain, persistent vomiting, fluid accumulation, mucosal bleeding, lethargy, liver enlargement, HCT increase with platelet drop
80
What defines severe dengue?
Severe plasma leakage, severe bleeding, or severe organ involvement (e.g., AST/ALT ≥1000, CNS or heart impairment)

AAA-MEDICINE (INFECTIOUS) (5 decks)

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