Mi - Opportunistic Viral Infections Flashcards

(43 cards)

1
Q

Egs of AIDs defining illnesses

A

CMV retiinitis
HSV oesophagi’s/bronchitis/pneumonitis
Kaposi’s
Burkitt’s lymphoma
Progressive multifocal leukoencephalopathy

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2
Q

JC virus in an immunocompromised patient –>

A

Progressive multifocal leukoencephalopathy

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3
Q

In BMT patients, why are they so immunocompromised?

A

Continuous immunosuppression to prevent GvHD

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4
Q

Immunosuppressive treatments:
Depleting antibody treatment?
Non-depleting antibody treatment?

A

Depleting: Rituximab (antiCD20)
Non-depleting: Basiliximab (antiCD25)

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5
Q

In a patient who is post-BMT, which lab investigation result would make you suspicious of an opportunistic infection?

A

Raised transaminases (AST/ALT)

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6
Q

Which lab investigation is pointless in identifying presence of opportunistic infection in a post-BMT patient? therefore which investigation should you request?

A

Serology (pt can’t yet amount an immune response)

  • viral PCR or rapid Ag test
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7
Q

3 routes of viral infection in transplant patients

A

1) From the GRAFT
2) immunosuppression –> REACTIVATION
3) immunosuppression –> INFECTION from outside

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8
Q

Name 2 herpes viruses which reside in WBCs?

A

EBV
CMV

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9
Q

When does HSV tend to affect transplant patients?

A

<1 month Post-transplant

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10
Q

How can HSV reactivation be prevented in transplant patients?

A

Acyclovir prophylaxis

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11
Q

In solid organ transplantation, what kind of CMV serology is at highest risk of CMV infection in recipient

A

Donor +
Recipient -

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12
Q

In bone marrow transplantation, what kinda serology is at highest risk of CMV infection

A

Donor -
Recipient + (as chemo/radio wipes out the recipient’s antibodies)

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13
Q

CMV prophylaxis in solid organ transplant patients?

A

Valganciclovir for 10 days

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14
Q

How is potential CMV infection monitored in bone marrow transplantation patients?

A

CMV viral load monitoring and treated when it rises

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15
Q

1st line tx of CMV infection

A

Vancyclovir

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16
Q

2nd line tx of CMV infection

A

Foscarnet

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17
Q

which Ix confirms post transplant lymphoproliferative disease

A

Lymph node biopsy (+ viral load)

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18
Q

Post-transplant lymphoproliferative disease - responsible virus?

19
Q

Progressive multifocal leukoencephalopathy
- Cause?
- Pathology?

A

JC virus
Demyelination of white matter

20
Q

Haemorrhagic cystitis in a post-transplant patient : potential causative organism?

21
Q

Transmission of Hepatitis E

A

Undercooked meat (+blood transfusion??)

22
Q

Viral classification system? What is it based on?

A

Baltimore - how viruses replicate, whether DNA or RNA

23
Q

Definition of opportunistic virus

A

Doesn’t affect an immunocompetent person, but will to an immunocompromised person

24
Q

What does IgM presence mean?

A

Active infection

25
What does IgG presence mean?
Previous infection in last 6 weeks
26
How do you directly detect a virus?
PCR
27
Which HIV patients are most at risk of bad CMV?
If CD4 <200
28
Tx of HSV in immunocompromised pt?
Prophylaxis - HSV Ig test
29
Tx of VZV in immunocompromised patients?
7-10 days antivirals if chicken pox Antiviral IV if disseminated +/- steroids
30
Complications of EBV
Oncogenic - PTLD or B cell lymphoma
31
Dx of EBV?
biopsy lymph nodes
32
What drug may work for EBV?
Rituximab
33
CMV Sx
Retinitis, polyradiculopathy, pneumonitis, encephalitis, GI disease
34
Which HIV pts get CMV?
If CD4 <50 (very low)
35
Which hepatitis virus is this: severe, vaccinate against?
A
36
Which hepatitis virus is this: reactivation, only occurs in presence of hep D, vaccinate or prophylaxis against?
B
37
Which hepatitis virus is this: causes fibrosis. Can give antivirals for a potential cure?
C
38
Which hepatitis virus is this: chronic infection, need to reduce immunosuppression as no cure?
E
39
What is this persons hepatitis status: sAg+ eAg+ IgM+?
Current infection
40
What is this persons hepatitis status: sAb+ eAB+?
Prior infection & immune
41
What is this persons hepatitis status: sAb+ eAb-?
Vaccinated
42
Mx of monkey pox?
Isolation Small pox vaccine (low stock) Tecovirimat if very severe (££££) Screen for STDs inc HIV Inform UKHSA
43
Sx of monkeypox
Systemic illness eg fever Atypical rash on genitals