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Peds Patho > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

viral stages

A

1) primary
2) latency
3) reactivation

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2
Q

disease in which you see most of rash on the trunk

A

varicella

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3
Q

shingles

A

reactivation of the chicken pox

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4
Q

how long does latency last with varicella?

A

can go on for decades

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5
Q

when does our immune system begin to deteriorate?

A

at age 40

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6
Q

prodrome

A

an early symptom (or set of symptoms) that might indicate the start of a disease before specific symptoms occur

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7
Q

trigger of reactivation of CMV?

A

we don’t know

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8
Q

trigger of reactivation of HSV?

A

often ppl will know: sunlight, beginning of menses, stress, etc

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9
Q

eczema/atopic dermatitis

A

an immune deficiency localized to certain areas of the skin

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10
Q

what is the atopic triad?

A

atopic dermatitis, allergic rhinitis, asthma

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11
Q

atopic derm definition

A

a complex genetic disorder that results in a defective skin barrier, reduced skin innate immune responses, and exaggerated T-cell responses to environmental allergens and microbes that lead to chronic skin inflammation

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12
Q

HSV results from what strain?

A

HSV 1 = 90%

HSV 2= 10%

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13
Q

primary herpetic gingivostomatitis

A

oral infection caused by HSV1; can cause significant mouth discomfort (extremely painful), fever, lymphadenopathy, and difficulty with eating and drinking. Symptoms may persist for 2 weeks.
–most often seen in ages 6 mo - 5 yrs

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14
Q

during primary and nonprimary initial reactions, where does HSV establish latent infection?

A

in regional sensory ganglion neurons

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15
Q

incubation period of HSV

A

relatively short: 2 days - 2 weeks

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16
Q

are recurrent infections (reactivation) of HSV symptomatic?

A

may be symptomatic (w/typical or atypical herpatic lesions) or asymptomatic

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17
Q

can HSV be transmitted to others even if infected person is asymptomatic?

A

yes–infected person can have reactivation of HSV without symptoms, but still be contagious to individuals they come in contact with

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18
Q

how does HSV cause encephalitis?

A

via intraneuronal transport to the CNS

  • -child may just start acting “strange”
  • -usually from HSV-1 (except in neonates)
  • -can result from primary or recurrent disease
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19
Q

hallmarks of common HSV infections

A

1) skin vesicles (small, 2-4 mm; may be surrounded by erythematous base)
2) shallow ulcers (minially erythematous ulcers evolve from the vesicles)
* *non-classic presentations are also common!

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20
Q

primary sx of HSV infection

A

lesions

also: fever

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21
Q

how does HSV manifest in oral infection?

A

in FRONT of mouth at mucocutaneous border

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22
Q

Herpes Whitlow

A

herpes lesion on finger from touching infected mouth or from sucking thumb

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23
Q

herpetic keratoconjunctivitis

A

usually unilateral, assoc. w/blepharitis & tender preauricular lymphadenopathy
–typically have fever
–may see vesicular lesions on lid margins & periorbital
skin
–generally resolves in 2-3 weeks
–can –> blindness
–often need antiviral drops

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24
Q

blepharitis

A

inflammation of the eyelid

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25
Q

signs of primary HSV infection (impt in pregnant women)

A

trouble/pain w/urination; fever

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26
Q

risk of neonatal HSV infection when mom has primary disease

A

up to 70% if baby passes through birth canal

30-50% risk even w/no visible lesions at delivery

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27
Q

when does HSV present in neonates?

A

usually late in 1st week or 2nd week of life; up to 4-6 weeks

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28
Q

clinical picture of neonate w/HSV?

A

–hyperthermia or hypothermia
–irritability
–poor feeding
–vomiting
(similar to bacterial sepsis)
also: resp. distress, cyanosis, apneic spells, jaundice, purpuric rash, CNS disease, seizures

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29
Q

management of neonatal herpes

A

tx immed. w/Acyclovir

early recognition so impt!!

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30
Q

hallmark of varicella prodrome

A

irritability, a little fever

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31
Q

hallmark of varicella lesions

A

lesions IN DIFFERENT STATES across the body for 7 days

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32
Q

smallpox lesions

A

lesions in ONE stage across body

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33
Q

Reye syndrome

A

–hepatic dysfunction with hypoglycemia & encephalopathy
from varicella and treating w/aspirin (salicylates)
switch to tylenol –> goes away

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34
Q

zoster

A

usually reactivation from 1 dorsal root ganglion

–if see >50 lesions outside dermatome, think: immunocompromised?

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35
Q

hemorrhagic disease

A

can occur w/ varicella

–causes purpura

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36
Q

when was varicella vaccine introduced?

A

1995

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37
Q

incubation period of varicella

A

10-21 days

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38
Q

hemorrhagic disease

A

hemorrhagic vesicles are a complication of varicella

–most risk if mom gets chicken pox 4 days prior to delivery

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39
Q

what disease is particularly common in daycare centers?

A

CMV

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40
Q

why are women of higher socioeconomic classes at higher risk of CMV when pregnant?

A

bc they were less likely to have had it as children–so higher risk of primary disease during pregnancy

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41
Q

hallmark of congenital CMV infection

A

RASH: petechial, erythematous, comes & goes in first week of life

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42
Q

most common cause of congenital infection

A

CMV

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43
Q

CMV s&s in adolescents/adults

A

mono-like: fatigue, malaise, myalgia, headache, fever, hepatosplenomegaly, elevated liver enzyme values, atypical lymphocytosis
–us. mild, lasting 2-3 wks

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44
Q

tx for congenital CMV

A

Ganciclovir

but effect on development?

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45
Q

s&s of EBV infection

A

older kids: v. sore throat, severe headache

younger kids: less specific sx

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46
Q

EBV infection: classic triad

A

fatigue, pharyngitis, generalized lymphadenopathy

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47
Q

complication of EBV?

A

splenic rupture can occur

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48
Q

EBV mostly affects what type of cells

A

B cells

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49
Q

what group has a predisposition to EBV?

A

Asian men

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50
Q

Roseola (& sx?)

A

“6th disease”

–high, high fever with rash after

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51
Q

measles is what type of virus?

A

RNA virus

–one of most contagious viral diseases

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52
Q

prodrome of measles?

A

fever, cough, runny nose

occur before rash

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53
Q

cause of rash with varicella?

A

varicella causes the rash!

54
Q

cause of rash with measles?

A

immune-mediated! measles does not cause the rash

55
Q

subacute sclerosing panencephalitis (SSPE)

A

aberrant immune response seen after Measles infection: chronic complication with delayed onset, almost always
(characterized by a history of primary measles infection usually before the age of 2 years, followed by several asymptomatic years (6–15 on average), and then gradual, progressive psychoneurological deterioration, consisting of personality change, seizures, myoclonus, ataxia, photosensitivity, ocular abnormalities, spasticity, and coma)
–> death
–don’t see much anymore

56
Q

Koplick’s Spots

A

can see with Measles, but not always!

  • -discrete red lesions with bluish white spots in the center on the inner aspects of the cheeks at the level of the premolars
  • -may spread to lips, hard palate, & gingiva
  • -may also occur in conjunctival folds & vaginal mucosa
57
Q

prodromal phase of measles

A

the 3 c’s: conjunctivitis, cough, coryza

also: mild to increasing fever, photophobia

58
Q

characteristics of measles rash

A

papular-like lesions; get to be confluent as there are so many
–desquamation in recovery

59
Q

spread of rubella rash

A

from head, down

–upper parts start to heal as it spreads down

60
Q

mumps: s&s

A
  • -swelling of parotid gland (may have unilateral involvement)
  • -s&s tend to be milder
61
Q

physiological effects of polio

A

motor neuron damage: can’t walk or breathe

62
Q

polio: type of virus

A

RNA virus, Enterovirus family

63
Q

occurrence of paralytic polio

A

1/1000 in infant infection

1/100 in adolescent infection

64
Q

transmission route of polio

A

fecal-oral route

65
Q

postpolio syndrome

A

appears after 30-40 yrs: muscle pain & exacerbation of existing weakness, or develop. of new weakness or paralysis

66
Q

non-polio enteroviruses: primary site of invasion

A

GI tract

–also primary source of invasion & replication & source for transmission

67
Q

examples of non-polio enteroviruses

A

Coxsackie A & B (hand-foot-and-mouth disease)

echoviruses

68
Q

hand-foot-and mouth disease (& sx?)

A

a type of non-polio enterovirus

  • -us. mild with low-grade fever
  • -see lesions on BACK of the throat
69
Q

Fifth Disease

A

Parvovirus B19

–fever followed by rash, arthritis, arthralgia

70
Q

what causes rash in 5th Disease?

A

rash is immune mediated!

71
Q

when do you see “slap-cheek appearance?”

A

Fifth Disease

72
Q

serious complication of Fifth Disease

A

myeocarditis

73
Q

cause of Scarlet Fever

A

Gp A Strep

74
Q

strawberry tongue

A

see with scarlet fever

75
Q

complications of scarlet fever

A
  • -Rheumatic Fever

- -Post-streptococcal Glomerulonephritis

76
Q

when do you see whooping w/pertussis?

A

in older child/adol/adult

–do NOT hear whooping in infants in 1st 6 mos–just stop breathing, turn red

77
Q

pertussis death rate

A

as high as 10% in first 6 mos of life

78
Q

arthralgia

A

joint pain

79
Q

myalgia

A

muscle pain

80
Q

when do Koplick’s Spots appear?

A

appear 1-4 days before the Measles rash

81
Q

Koplick’s Spots can spread where?

A

lips, hard palate, gingiva

82
Q

Koplick’s Spots may also occur where?

A

conjunctival folds & vaginal mucosa

83
Q

is encephalitis caused by HSV associated with presence of HSV skin lesions?

A

no! no assoc. w/presence or absence of skin lesions

84
Q

rubeola

A

measles

85
Q

w/hand-foot-and-mouth disease, where are lesions in the throat found?

A

in the BACK of the throat

86
Q

what causes zoster?

A

usually reactivation from 1 dorsal root ganglion

87
Q

what causes hemorrhagic disease of the newborn?

A

Vitamin K deficiency

88
Q

Antigenic Drift

A

how flu evolves: our antibodies against the older strains no longer recognize the “newer” virus –> reinfection
**due to frequent point mutation during replication in a subtype

89
Q

Antigenic Shift

A

appearance of a “new” subtype after genetic reassortment

ex: H1N1 & H3N2 reassort to give H1N2

90
Q

Types of Influenza A

A

H1N1, H1N2, H3N2, 2008 H1N1

91
Q

Types of Influenza B

A

Yamagata & Victoria lineages

92
Q

transmission of influenza

A
  • -airborne via large particles/cough

- -contact w/respiratory droplets/surfaces

93
Q

incubation period of influenza

A

1-4 days

94
Q

s&s of influenza

A

abrupt onset of non-productive cough, fever, myalgia, headache, sore throat, & runny nose for 3-7 days

95
Q

s&s of influenza in children

A

otitis media, nausea, & vomiting

96
Q

length of time for virus shed in respiratory secretions

A

1-2 days prior to symptoms, through day 10

97
Q

complications of influenza

A

pneumonia w/secondary bacterial infection, febrile seizures, encephalitis, transverse myelitis, myocarditis

98
Q

when can you see severe influenza disease?

A

in infants < 1 yr

99
Q

which influenza vaccine is most effective?

A

nasal vaccine!

100
Q

Rotavirus sx

A

usually not a lot of #s of diarrhea, but 1 stool w/ high-volume loss
–> dehydration!

101
Q

Cholera

A

causes watery/”rice-water” diarrhea

–major rehydration required!

102
Q

influenza is what type of virus?

A

a segmented RNA virus

can infect diff. mammals: humans, pigs, birds…

103
Q

TX: Flu A

A

Amantidine (Symmetrel) & Rimantidine

Oseltamavir (Tamaflu) & Zanamivir

104
Q

TX: Flu B

A

Oseltamavir & Zanamivir

105
Q

3 causes of acute diarrhea in children

A

bacteria, parasites, viruses

106
Q

6 infections caused by the Herpes virus

A

1) Herpes simplex
2) Varicella zoster virus (VZV)
3) Epstein Barr virus
4) Cytomegalovirus
5) Roseola
6) HHV-6, 7, 8

107
Q

most common cause of bronchiolitis

A

RSV (respiratory syncytial virus)

108
Q

primary infection of VSV

A

varicella (chicken pox)

109
Q

primary infection of HSV

A
  • oral mucocutaneous disease
  • -genital ulcer disease
  • -encephalitis
110
Q

primary infection of CMV

A

–mononucleosis-like viral illnesses; other clinical illnesses

111
Q

how does reactivation of HSV manifest?

A
  • -recurrent mucocutaneous lesions

- -recurrent genital ulcer disease

112
Q

how does reactivation of CMV manifest?

A

intermittent viral excretion, symptoms ?

113
Q

eczema herpeticum

A

manifestation of hsv:

lesions concentrated in eczematous areas

114
Q

incubation period of primary gingivostomatitis

A

2 days - 2 weeks

115
Q

HSV virus shedding

A

high titer, 1-2 weeks, then intermittently

116
Q

primary infection of HSV

A

often asymptomatic, with shedding

117
Q

what do you see with encephalitis caused by HSV?

A

acute onset of fever, altered state of consciousness, personality changes, convulsions, focal neurological changes, coma & death if untx’d

118
Q

what are of the brain does HSV encephalitis affect?

A

temporal lobe (except in neonates)

119
Q

neonatal herpes is usually assoc. w/what?

A

primary maternal genital disease

HSV-2

120
Q

Skin, Eye, Mouth (SEM) Disease

A
  • -assoc. w/neonatal herpes
  • -vesicular lesions in areas of trauma (occiput, umbilicus, etc.)
  • -eye: conjunctivitis, keratitis, chorioretinitis
121
Q

how much of SEM disease may disseminate?

A

up to 30%

122
Q

herpes labialis

A

cold sores

123
Q

recurrent HSV prodrome

A

tingling

124
Q

viral shedding in HSV

A

highest titer in 1st 24 hrs, low titer for <5 days

–also have asymptomatic shedding

125
Q

when do you see “rice-water” diarrhea?

A

with cholera!

126
Q

what type of rash do you see with scarlet fever?

A

sandpaper-like rash w/perioral sparing

127
Q

tx for scarlet fever?

A

penicillin

128
Q

characteristic clinical stages of pertussis?

A

1) Catarrhal (1-2 wk)
2) Paroxysmal (2-6 wk)
3) Convalescent (>2 week)

129
Q

pathogen that causes pertussis

A

Bordatella pertussis

130
Q

incubation period of pertussis

A

3-12 days

Peds Patho (8 decks)

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