Flashcards in Exam #7: Viral Infections of Circulatory, RES, & Lymphatic System II Deck (45):
What is viral myocarditis?
Inflammation of the middle musclar layer of the heart wall leading to ventricular dysfunction
- Most prevalent in adult men
What is the typical presentation of viral myocarditis?
What are most US myocarditis cases associated with?
What viruses most commonly cause myocarditis?
- Adenovirus (Type 2&5)
- Enterovirus (Coxsackievirus B)
- B19 Parvovirus
How is viral myocarditis diagnosed?
- A high index of suspicion in patient's with "CHF of unknown origin"
- CXR, ECG, & endomyocardial biopsy
- Nucleic acid test of biopsied material
How is viral myocarditis treated?
1) Manage CHF & arrhythmia
2) Bed rest & observation if only mild disease
What is the prognosis of viral myocarditis?
50% have full cardiac function restored
What are the symptoms of mumps? What is the typical age of onset?
5-14 year old with:
- Swollen, tender parotid glands
- Sometimes accompanied by submandibular gland swelling
*Prodrome of malaise & anorexia for 1-2 days
List the characteristics of the mumps virus.
- Paramyoxviridiae family
- One serotype
What are the complications of Mumps?
Orchitis (testicular inflammation)
Myocarditis (rare, but often fatal)
How is mumps diagnosed?
- Clinically, acute onset of parotid gland swelling lasting more than 2 days without any other apparent cause
- Lab assays to detect viral genomes
How is Mumps treated?
Uncomplicated cases resolve without intervention within ~10 days
How is Mumps transmitted?
Direct contact with:
- Respiratory droplets
- Contaminated fomites
How is Mumps prevented?
IM live attenuated vaccine that is part of the MMR & MMRV (Mumps, Measles, Rubella, & Varicella) vaccine combinations
- 1 dose 12-15 months
- Another before Kindergarden
*One dose for adults
**Note that 1 dose is ~78% effective & 2x is ~88% effective
Who is at increased risk for Mumps?
- Healthcare workers
- International travelers
- Students at post high-school educational institutions
What is Kaposi's Sarcoma (KS)?
Multicentric tumor associated with hyperproliferation of endothelial cells
Describe the presentation of KS.
- Initially, flat or slight raised spots on the skin that can range from light pink to purple
- Progressively become larger nontender nodules
- Can become confluent or clump together
How are KS cells histologically identified?
Spindle morphology (elongated) of cells vs. cuboid or round morphology
What is KS associated with?
*There was a sharp increase in the number of cases during the AIDS epidemic
What are the different types of KS?
Describe Classic KS.
- Found in those with middle eastern or mediterranean descent
- Few lesions
- Rarely life-threatening
Describe Endemic KS.
- Most common in Africa
- Two forms: 1 is identical to classic, other is more aggressive & seen in prepubescent children (fatal in 3 years of onset)
Describe Transplant-related KS.
KS seen in post-transplant immunosuppression
Describe AIDS-related KS.
KS seen in AIDS patients
- More lesions that involve multiple organ systems
- Lung involvement is fatal
What virus causes KS?
Kaposi's sarcoma-associated herpesvirus (KSHV)/ HHV-8
List the characteristics of KSHV.
How is HHV-8 transmitted?
What diseases besides KS are associated with KS?
Primary effusion lymphomas
How is HHV-8 prevented?
- No vaccine
- Prevent transmission by practicing safe-sex & avoiding needle sharing
How is HHV-8 or KS treated?
- Often, controlling immunosuppresion is more important than "treating" KS--allowing the immune system to combat KS will clear lesions
- Typical cancer
Why can't herpes antivirals be used to treat KS?
What is ATL?
Adult T-cell Lymphoma
Describe the clinical presentation of ATL.
Skin infiltration of tumor cells
How does skin infiltration of tumor cells present?
What is the key cytological marker for ATL?
"Flower cells"--multi-lobulated nuclei in T-cells
Where is ATL endemic?
How is ATL diagnosed?
Detection of antibodies to Human T-cell leukemia virus-1 (HTLV-1)
Aside from ATL, what other disease is HTLV-1 associated with?
HAM (HTLV-1 Associated Myelopathy)
What is HAM? What are the symptoms?
HTLV-1 Associated Myelopathy, a disease that causes demyelination of neurons within the spinal
- Stiff gait
- Lower extremity weakness
- Back pain
*Note that this is most common in women & endemic in the same regions as ATL (japan, central africa, & caribbean)
List the characteristics of HTLV-1.
What cells does HTLV-1 infect?
CD4 & CD8 positive T-cells
What receptor does HTLV-1 use?
How is HTLV-1 transmitted?
*note that this is cell-assocaited
How is HTLV-1 prevented?
Nursing is discouraged
Screen blood supply