G6 Flashcards
(207 cards)
1
Q
What is the age of the child with persistent low-grade fever and itchy rash?
A
10 years old
2
Q
What symptoms did Kiko present with besides fever?
A
fatigue loss of appetite irritability
3
Q
Where did Kiko’s rash first appear?
A
trunk and back
4
Q
Where did the rash spread after 48 hours?
A
face scalp extremities
5
Q
What types of lesions did Kiko have?
A
fluid-filled vesicles crusted lesions
6
Q
What was notable about the pruritus of Kiko’s lesions?
A
intensely pruritic excoriated
7
Q
What was found in Kiko’s oropharynx?
A
mild erythema no ulcerations
8
Q
What were absent on physical exam in Kiko?
A
respiratory distress lymphadenopathy
9
Q
What did Kiko’s complete blood count show?
A
mild leukocytosis lymphocytic predominance
10
Q
What were Kiko’s liver function tests and urinalysis results?
A
unremarkable
11
Q
What did Tzanck smear from Kiko’s vesicular lesion show?
A
multinucleated giant cells
12
Q
What was included in the differential diagnosis for Kiko?
A
hand-foot-and-mouth disease impetigo
13
Q
What is the most likely diagnosis for Kiko?
A
varicella or chickenpox
14
Q
What is the specific species designation for varicella-zoster virus?
A
Human alphaherpesvirus 3
15
Q
To which family does varicella-zoster virus belong?
A
Herpesviridae
16
Q
What type of virus is varicella-zoster virus?
A
large enveloped DNA virus
17
Q
What subfamily does varicella-zoster virus belong to?
A
Alphaherpesvirinae
18
Q
What genus is varicella-zoster virus classified under?
A
Varicellovirus
19
Q
What diseases are caused by viruses in the Varicellovirus genus?
A
chickenpox shingles
20
Q
What is the genome type of varicella-zoster virus?
A
double-stranded DNA
21
Q
What is the shape and size of varicella-zoster virus capsid?
A
icosahedral 100 to 110 nanometers
22
Q
What covers the varicella-zoster virus capsid?
A
lipid envelope with glycoproteins
23
Q
What characterizes varicella or chickenpox?
A
highly contagious blisterlike rash intense itching fever
24
Q
Where do vesicular lesions first appear in chickenpox?
A
face and trunk
25
How does chickenpox rash spread?
to other areas of the body
26
How is chickenpox severity in healthy children?
mild self-limiting
27
What is the most common complication of chickenpox in children?
secondary bacterial skin infections from scratching
28
How severe is chickenpox in adults neonates pregnant women?
more severe larger number of lesions higher complication risk
29
What complications can chickenpox cause in pregnant women?
premature labor congenital malformation severe neonatal infection
30
What complications occur in immunocompromised patients with chickenpox?
disseminated disease extensive rash neurological conditions pneumonia hepatitis nephritis
31
What is herpes zoster or shingles?
painful vesicular rash from varicella-zoster virus reactivation
32
How does varicella-zoster virus enter the host?
respiratory tract conjunctiva
33
Where does varicella-zoster virus replicate initially?
nasopharynx regional lymph nodes
34
When does primary viremia occur after infection?
four to six days
35
What organs are infected during primary viremia?
liver spleen sensory ganglia
36
What follows primary viremia in varicella-zoster virus infection?
secondary viremia viral skin infection
37
Where does varicella-zoster virus establish latency?
sensory ganglia
38
What triggers varicella-zoster virus reactivation?
compromised immune mechanisms medications illness malnutrition stress aging
39
What symptoms occur on varicella-zoster virus reactivation?
sensory loss pain neurological complications weakness
40
What rare neurological involvement can occur in shingles?
leptomeningeal involvement ophthalmic branch trigeminal nerve
41
How is varicella-zoster virus transmitted?
respiratory droplets direct contact with blister fluid transplacental transmission
42
What are varicella symptoms?
fever malaise fatigue loss of appetite pruritic vesicular rash
43
What complications can occur in varicella?
bacterial superinfection pneumonia encephalitis Reye's syndrome
44
What are herpes zoster symptoms?
pain tingling unilateral vesicular rash dermatomal distribution
45
What are herpes zoster complications?
postherpetic neuralgia ophthalmic zoster Ramsay Hunt syndrome secondary bacterial infections
46
What is the method of choice for diagnosing varicella-zoster virus infection?
real-time polymerase chain reaction for viral DNA
47
What test uses fluorescent-labeled antibodies to detect varicella-zoster virus?
direct fluorescent antibody test
48
What cytological test detects multinucleated giant cells in vesicular fluid?
Tzanck smear
49
What assay reduces detection time and increases sensitivity for varicella-zoster virus?
shell vial assay
50
What is the most sensitive and reliable serological test for varicella-zoster virus antibody?
fluorescent antibody to membrane antigen test
51
What enzyme-linked immunosorbent assay detects varicella-zoster virus envelope glycoprotein antibody?
ELISA method
52
What serology tests detect acute or past varicella-zoster virus infection?
varicella-zoster virus specific immunoglobulin M and immunoglobulin G antibodies
53
What treatment is required for varicella in normal children?
no treatment needed
54
What type of vaccine is used for varicella prevention?
live attenuated varicella virus vaccine
55
At what age is the first varicella vaccine dose given?
between 12 and 15 months
56
When is the second varicella vaccine dose administered?
between 4 and 6 years
57
Who should receive varicella vaccination?
all children adolescents adults never infected or vaccinated
58
What is the effectiveness of two varicella vaccine doses?
ninety-four to ninety-seven percent prevention of chickenpox
59
What vaccine is licensed for herpes zoster prevention in persons aged 60 or older?
single agent varicella-zoster virus vaccine
60
Why is live attenuated varicella vaccine not recommended for immunocompromised persons?
risk of infection reversion
61
When should antiviral drugs or varicella immune globulin be given after exposure?
within ninety-six hours
62
What is the primary prevention method for varicella?
vaccination with live attenuated vaccine
63
What is postexposure prophylaxis for immunocompetent individuals?
varicella vaccine within three to five days post-exposure
64
What is postexposure prophylaxis for immunocompromised or high-risk individuals?
varicella-zoster immune globulin within ninety-six hours
65
What antiviral agent may be used as adjunct postexposure prophylaxis?
acyclovir
66
What infection control measure is recommended for active chickenpox or shingles?
isolation
67
Until when are chickenpox patients contagious?
until all lesions crust over
68
What precautions should shingles patients take?
cover rash avoid contact with immunocompromised pregnant women infants until lesions crust
69
What hygiene practice reduces varicella viral spread?
frequent handwashing avoid sharing personal items
70
Why are "chickenpox parties" discouraged?
risk of severe disease complications
71
What should be done to prevent secondary bacterial skin infections?
keep fingernails trimmed
72
Which medication should be avoided in children with chickenpox to prevent Reye syndrome?
aspirin and salicylates
73
What symptom relief methods help with varicella itching?
cool compresses calamine lotion oatmeal baths
74
When should medical consultation be sought in varicella?
high-risk or severe cases for antiviral treatment
75
What percentage of countries have universal varicella vaccination programs?
approximately twenty-four percent
76
What percentage of countries offer vaccination to risk groups only?
seven percent
77
What vaccination schedule is adopted globally to optimize varicella immunity?
two-dose schedule
78
Which strain is commonly used in varicella vaccines worldwide?
Oka strain
79
What does World Health Organization recommend regarding varicella vaccination?
vaccination where disease burden is significant and coverage sustainable
80
What vaccination programs exist for shingles?
herpes zoster vaccination for older adults
81
Has the Philippines implemented universal varicella vaccination?
no
82
How is varicella vaccination accessed in the Philippines?
private basis limited coverage higher-income populations
83
What are the public health efforts in the Philippines for varicella?
surveillance outbreak control hygiene education isolation
84
What is the ongoing discussion regarding varicella vaccine in the Philippines?
introducing vaccine into national immunization program
85
What infection control measures does the Philippines follow for varicella?
avoiding contact with infected individuals promoting hygiene
86
What viral illness was Bong Go most likely suffering from?
influenza
87
What family do influenza viruses belong to?
Orthomyxoviridae
88
Which influenza types cause seasonal epidemics?
influenza A and influenza B
89
Which influenza type causes mild self-limiting respiratory infections?
influenza C
90
What is the genome type of influenza viruses?
enveloped single-stranded RNA
91
What antigenic changes cause influenza epidemics?
antigenic shift and antigenic drift
92
Which influenza virus is known for causing pandemics?
influenza A
93
Which influenza virus primarily affects humans with seasonal outbreaks?
influenza B
94
What animals can influenza A infect?
humans birds mammals
95
What are the viral surface antigens that mutate rapidly in influenza?
hemagglutinin and neuraminidase
96
What is the incubation period of influenza?
1 to 4 days
97
How is influenza transmitted?
airborne respiratory droplets direct contact with contaminated surfaces
98
What is the period of infectivity for influenza?
1 day before to 5 to 7 days after symptom onset
99
What are common symptoms of influenza?
sudden high-grade fever severe headache generalized body aches dry cough sore throat nasal congestion extreme fatigue malaise anorexia
100
What does influenza virus bind to on respiratory epithelial cells?
sialic acid receptors
101
Which viral protein mediates binding to host cells in influenza?
hemagglutinin
102
What immune mediators contribute to systemic influenza symptoms?
interleukin-6 tumor necrosis factor alpha
103
What is the gold standard diagnostic test for influenza?
reverse transcription polymerase chain reaction
104
What does RT-PCR detect in influenza diagnosis?
viral RNA
105
What rapid test detects influenza viral antigens?
rapid influenza diagnostic tests
106
What is a common blood count finding in influenza?
leukopenia
107
What does mildly elevated C-reactive protein indicate in influenza?
viral infection rather than bacterial
108
What viruses were ruled out in Bong Go's viral panel?
COVID-19 respiratory syncytial virus adenovirus parainfluenza
109
What did Bong Go's chest X-ray show?
unremarkable no pneumonia
110
What are influenza A virus subtypes defined by?
hemagglutinin and neuraminidase combinations
111
What are common human influenza A subtypes?
H1N1 H3N2
112
What is the shape and size of influenza virions?
rounded 80 to 120 nanometers diameter
113
What is the function of influenza neuraminidase?
enables virion release and movement through mucus
114
What is the function of influenza matrix protein M1?
forms capsid supports viral envelope
115
What is the role of influenza matrix protein M2?
forms ion channel for uncoating virus
116
What is the role of influenza non-structural protein 1?
inhibits host immune response interferon production
117
What is the influenza RNA polymerase complex composed of?
PB1 PB2 PA proteins
118
What is cap-snatching in influenza viral mRNA transcription?
hijacking host capped pre-mRNAs for viral mRNA synthesis
119
Where does influenza viral RNA replication occur?
nucleus of host cell
120
What is the focus of supportive care in influenza management?
alleviating symptoms maintaining hydration supporting immune response
121
Which medication helps reduce fever and relieve headache or muscle pain in influenza?
paracetamol
122
Why should aspirin be avoided in children and adolescents with suspected viral infections?
risk of Reye's syndrome
123
What role did supportive care play in Bong Go's influenza case?
managing systemic symptoms aiding recovery preventing complications
124
What is the first-line oral antiviral treatment for influenza?
oseltamivir
125
What type of drug is oseltamivir?
neuraminidase inhibitor
126
Who can safely receive oseltamivir?
patients of all ages including pregnant women chronic illnesses
127
What inhaled antiviral is used for uncomplicated influenza?
zanamivir
128
Who should avoid zanamivir?
asthma chronic obstructive pulmonary disease patients
129
What intravenous antiviral is used for severe influenza in hospitals?
peramivir
130
What oral antiviral with single-dose regimen treats uncomplicated influenza?
baloxavir marboxil
131
What is the primary prevention method for influenza?
annual vaccination
132
Why is influenza vaccine updated yearly?
antigenic drift in hemagglutinin and neuraminidase proteins
133
Who is recommended to receive annual influenza vaccination?
everyone six months and older especially high-risk groups
134
Name high-risk groups for influenza vaccination.
elderly health workers pregnant women chronic illness patients
135
What hygiene practice reduces influenza transmission?
frequent handwashing with soap or alcohol-based sanitizers
136
What cough etiquette reduces influenza spread?
covering mouth and nose with tissue or elbow
137
How do face masks help prevent influenza?
limit spread in public and enclosed spaces
138
Why is self-isolation encouraged for symptomatic influenza individuals?
prevent transmission especially to vulnerable groups
139
What groups are vulnerable to severe influenza illness?
elderly immunocompromised individuals
140
What is the role of the National Immunization Program in influenza control?
provides free annual vaccination to vulnerable populations
141
Which populations are prioritized in the National Immunization Program?
senior citizens children six to fifty-nine months pregnant women healthcare workers chronic condition patients
142
What does the Philippine Integrated Disease Surveillance and Response system monitor?
communicable diseases including influenza-like illness
143
What is the purpose of sentinel surveillance sites in PIDSR?
report weekly influenza-like illness data for outbreak detection
144
How does PIDSR support global influenza control?
contributes data to World Health Organization Global Influenza Surveillance and Response System
145
When does the Department of Health conduct seasonal influenza campaigns?
June to November
146
What activities are included in DOH seasonal influenza campaigns?
mass vaccination drives health education promotion of cough etiquette hand hygiene
147
What is the goal of DOH seasonal influenza campaigns?
reduce influenza incidence enhance community preparedness health literacy
148
What infection likely affected Cynthia's child with symptoms like jaundice hepatosplenomegaly and microcephaly?
congenital cytomegalovirus infection
149
What virus causes congenital cytomegalovirus?
human cytomegalovirus
150
What is another name for human cytomegalovirus?
human herpesvirus 5
151
To which virus family does cytomegalovirus belong?
Herpesviridae
152
What is the structure of cytomegalovirus?
large enveloped double-stranded DNA virus with icosahedral capsid tegument layer lipid envelope
153
What cells can cytomegalovirus infect?
epithelial endothelial smooth muscle fibroblasts immune cells
154
What is the epidemiology of congenital cytomegalovirus?
most common congenital infection worldwide affects 0.5 to 2.5 percent of live births
155
What percentage of infected newborns are asymptomatic at birth?
about ninety percent
156
What percentage of symptomatic newborns develop long-term complications?
up to fifty percent
157
Who has higher prevalence of cytomegalovirus infection?
women exposed to young children daycare workers developing countries
158
What types of maternal CMV infection can cause congenital infection?
primary infection reactivation reinfection
159
Which trimester maternal infection poses highest fetal risk?
first and second trimester
160
How does cytomegalovirus cross to the fetus?
transplacental transmission
161
What central nervous system abnormalities does CMV cause in fetus?
disrupted neuronal migration destruction of ependymal and glial cells periventricular calcifications sensorineural hearing loss
162
What multisystem involvement occurs in congenital CMV?
liver spleen brain bone marrow
163
What clinical features result from multisystem involvement?
hepatosplenomegaly thrombocytopenia elevated liver enzymes
164
What are maternal symptoms of CMV infection during pregnancy?
persistent fatigue low-grade fever muscle aches occasional headaches mild lymphocytosis elevated liver enzymes slightly elevated CMV immunoglobulin G
165
What are neonatal signs of symptomatic congenital CMV?
small for gestational age mild jaundice hepatosplenomegaly petechiae microcephaly bilateral sensorineural hearing loss periventricular calcifications
166
What laboratory findings confirm congenital CMV in newborn?
CMV DNA by polymerase chain reaction thrombocytopenia mildly elevated transaminases
167
What prenatal serologic tests are used for CMV?
CMV immunoglobulin M immunoglobulin G rising titers avidity testing
168
When is amniocentesis for CMV PCR recommended?
after 21 weeks gestation at least 6 weeks post maternal infection
169
What postnatal tests confirm congenital CMV?
CMV PCR from saliva or urine blood viral load cranial ultrasound auditory brainstem response complete blood count liver function tests
170
What is the gold standard specimen for newborn CMV screening?
saliva polymerase chain reaction
171
Why confirm positive saliva CMV PCR with urine test?
to rule out contamination from maternal secretions
172
What cranial ultrasound findings are characteristic of congenital CMV?
periventricular calcifications ventriculomegaly migrational abnormalities cysts
173
What does auditory brainstem response detect in congenital CMV?
sensorineural hearing loss
174
What lab abnormalities support systemic CMV disease in infants?
thrombocytopenia elevated alanine aminotransferase aspartate aminotransferase
175
Why is testing beyond 21 days of life limited for congenital CMV diagnosis?
cannot distinguish congenital from postnatal infection
176
What ophthalmologic screening is recommended in symptomatic congenital CMV?
pediatric ophthalmologist exam for chorioretinitis
177
What are the two key goals in managing congenital cytomegalovirus infection?
minimizing disease progression supporting affected infants and families
178
Which infants are recommended antiviral therapy for congenital CMV?
symptomatic infants with central nervous system involvement sensorineural hearing loss severe systemic disease
179
Are asymptomatic infants routinely treated for congenital CMV?
no evaluated case-by-case
180
What antiviral drug is used intravenously for critically ill neonates with congenital CMV?
ganciclovir
181
What is the usual duration of intravenous ganciclovir treatment?
initial six weeks
182
What oral prodrug is used for long-term outpatient therapy of congenital CMV?
valganciclovir
183
What is the typical duration of oral valganciclovir therapy?
six months
184
What benefits does early valganciclovir therapy provide?
improved hearing neurodevelopmental outcomes
185
What is the mechanism of action of ganciclovir and valganciclovir?
inhibit viral DNA polymerase reduce viral replication
186
What laboratory tests are monitored during antiviral therapy for congenital CMV?
complete blood count liver function tests renal function tests
187
What supportive care is important during congenital CMV treatment?
hearing and developmental follow-up multidisciplinary care
188
Which specialties are involved in multidisciplinary care for congenital CMV?
audiology neurology ophthalmology therapy services
189
Is there a licensed vaccine for cytomegalovirus as of 2025?
no
190
What types of CMV vaccines are under development?
mRNA-based protein subunit live attenuated
191
What is the goal of primary prevention for congenital CMV?
minimize maternal exposure reduce fetal transmission
192
What hand hygiene practices reduce CMV transmission?
frequent thorough handwashing with soap and water especially after changing diapers wiping nose feeding handling toys
193
What sharing behaviors should pregnant women avoid to prevent CMV?
sharing food drinks utensils toothbrushes with young children
194
Why should surfaces contaminated with saliva or urine be cleaned regularly?
to reduce CMV transmission
195
Who are target populations for congenital CMV prevention?
CMV-seronegative pregnant women women exposed to young children healthcare and childcare workers
196
What educational strategies promote CMV prevention?
prenatal counseling public health campaigns provider training
197
What occupational health recommendations reduce CMV risk?
safety standards reassignment from high-exposure tasks workplace education
198
Why is CMV vaccine development a global health priority?
to prevent maternal infection eliminate congenital CMV burden
199
What newborn screening is standard for congenital CMV?
universal newborn hearing screening targeted CMV testing for failed hearing screens
200
What specimens are used for newborn CMV PCR testing?
saliva urine
201
Why confirm positive saliva CMV PCR with urine test?
to rule out contamination
202
What early intervention services support infants with congenital CMV?
speech language therapy occupational physical therapy audiology family counseling social support
203
Why is early developmental support critical in congenital CMV?
mitigate long-term disability before delays worsen
204
What public education gaps exist for congenital CMV?
low awareness limited prenatal discussion
205
Which groups are targeted in CMV awareness campaigns?
pregnant women daycare workers obstetricians midwives general practitioners
206
What health system integrations improve congenital CMV prevention?
prenatal care protocols provider counseling screening algorithms in medical records
207
What research areas advance congenital CMV management?
vaccine development antiviral treatments neurodevelopmental outcomes surveillance registries
