MED VIRO

Question 1

anterograde example

Answer 1

reactivation of herpes virus

Question 2

Rabies are example of

Answer 2

retrograde.
to the cell body –> cns

Question 3

Acute Disseminated Encephalo-myelitis (ADEM) is also known

Answer 3

 Post-infectious encephalomyelitis
- autoimmune

Question 4

aseptic meningitis treatment is

Answer 4

supportive

Question 5

non envelope are

Answer 5

very togh

Question 6

Poliomyelitis–

Answer 6

spinal cord

Question 7

poliomyelitis control

there is a polio vaccine derived

Answer 7

Vaccines
* OPV (live attenuated, Sabin 1/2/3)
* IPV (killed, Salk)

Question 8

Laboratory Diagnosis
of enteroviruses

Answer 8

PCR
– More easily available
– CSF, stool, (respiratory samples)

Question 9

when you suspect herpes simplex encephilitis you need to

Answer 9

react fast, the patient will done

Question 10

A patient with meningitis would clinically present with (4):

Answer 10

• Headache
• neck stiffness
• photophobia
• nausea and vomit
  —–> with normal brain function (i.e., no focal neurologic)

Question 11

Patient with encephalitis generally present with: (1)

Answer 11

Altered brain function

Question 12

What is myelitis?

Answer 12

inflammation of the spinal cord

Question 13

Symptom triad of aseptic meningitis.

Answer 13

Fever, meningitis irritation, headache

Question 14

Most common causes of viral meningitis. (3)

Answer 14

1. Enterovirus (< 1y/o)
2. HSV (HSV-2 adults)- Mollaret’s meningitis
3. Mumps- MMR vaccine

Question 15

Human enteroviruses
(4)

(stable in acidic pH)

Answer 15

• Echoviruses
• Enteroviruses
• (Coxsackieviruses)
• (Polioviruses  poliomyelitis)

Question 16

Which part of the brain often affected by HSV encephalitis

Answer 16

temporal lobes

Question 17

Emergency treatment for HSV encephalitis.

Answer 17

acyclovir

Question 18

Risk factors for CMV encephalitis (2)

Answer 18

• HIV‐associated + immunocompromised

Question 19

Paramyxoviruses : (2)

Answer 19

• Mumps
• Measles

Question 20

Measles inclusion body encephalitis
(MIBE) risk factor

Answer 20

• Immune‐compromised patients

Question 21

What would be your management if the present with category 1

Hx: Touching/feeding animal, licking of intact skin

Answer 21

No action if reliable history

Question 22

How would you manage a patient with exposure rabies
Hx: Scratch (no bleeding,) nibble, or lick of broken skin

Answer 22

vaccine

Question 23

Category 3: Lick of mucous membranes, bites or scratches that draw blood

How would you management?

Answer 23

Vaccine + Rabigam

Question 24

Is it a good or bad idea to test for virus in a CSF in a patient with Post-infectious encephalomyletis? Why ?

Answer 24

 For post-infectious encephalomyelitis, the disease
is due to immunopathology thus the virus that
triggered the disease would not be present in CSF.
 PCR would not be a useful diagnostic test here
 Antibody tests like IgG or IgM to specific viruses are
not very useful either.

Question 25

Pathophysiology Acute Flaccid Paralysis

Answer 25

Enteroviruses and polio virus enter through the gut and enters CNS via blood stream Virus replicates in the cell body of neurons The viral replication is cytolytic

Question 26

Pathophysiology of Post-infectious encephalomyelitis

Answer 26

Following a viral infection in some individuals, T- cell confused the myelin in the brain with viral antigen epitope This results in white matter lesions in the CNS “Molecular mimicry” This can also happen in peripheral nerves – Guillain Barre syndrome (see resource pack)

Question 27

Which viruses can spread to the central nervous system via retrograde axonal transport?

Answer 27

Herpes simplex virus (HSV) and rabies virus

Question 28

Which cranial nerve can be used as a route of entry for certain viruses to reach the brain?

Answer 28

Olfactory nerve

Question 29

What is the most common symptom triad seen in viral aseptic meningitis?

Answer 29

Fever, meningeal irritation, and headache

Question 30

Which type of viruses are stable in acid pH and can cause aseptic meningitis?

Answer 30

Enteroviruses

Question 31

What is the most common cause of sporadic viral encephalitis?

Answer 31

Herpes simplex virus (HSV)1

Question 32

Which virus is responsible for causing subacute sclerosing panencephalitis (SSPE)?

Answer 32

Measles virus

Question 33

Which virus is associated with post-infectious encephalomyelitis (PIEM)?

Answer 33

Rubella virus

Question 34

Which arbovirus is transmitted by mosquitoes and can cause diseases like Rift Valley fever and West Nile fever?

Answer 34

West Nile virus

Question 35

What is the recommended treatment for suspected cases of rabies infection in humans?

Answer 35

Post-exposure prophylaxis with rabies vaccine and administration of rabies immunoglobulin if necessary.

Question 36

Which viral infection is the most common cause of sporadic viral encephalitis? a) Measles b) Rabies c) Herpes simplex d) Mumps

Answer 36

c

Question 37

Which viral family does the causative agent of poliomyelitis belong to? a) Paramyxoviridae b) Picornaviridae c) Herpesviridae d) Flaviviridae

Answer 37

B

Question 38

Which neurological syndrome is characterized by cognitive dysfunction, dementia, seizures, ataxia, and coma, and is associated with JC virus infection? a) Progressive multifocal leukoencephalopathy (PML) b) Measles inclusion body encephalitis (MIBE) c) Subacute sclerosing panencephalitis (SSPE) d) Acute disseminated encephalomyelitis (ADEM)

Answer 38

A