VHF

Question 1

What is the causative agent of Bolivian Haemorrhagic fever?

Answer 1

Machupo virus
-it is one of the VHF found in South America
-The Vector: mouse.

Question 2

Arthropod borne VHF?

Answer 2

Mosquito borne :
1- Dengue
2- Yellow fever
3- Rift Valley Fever
————————–
Tick borne :
1- CCHF
2- Colorado Tick virus

Question 3

Non- arthropod VHF?

Answer 3

• Bat viruses :
  Ebola
  Marburg
• Rodents:
  Hantavirus
  Lassa
  South American VHF

Question 4

What are the Bunyaviridae?

Answer 4

CCHF virus
Hanta viruses
Sandlfy viruses
Rift Valley Fever

Question 5

Which disease can transmit by Anopheles mosquito?

Answer 5

1- Malaria

2- filariasis - Wuchereria & Brugia

3- O’nyong’nyong

Question 6

Which disease can transmit by black fly (Simulum ) ?

Answer 6

1- Onchocerciasis
2- filariasis- Mansonella ozzardi

Question 7

Which disease can transmit by Aedes mosquito?

Answer 7

1-Yellow fever
2- dengue fever
3- chikungunya
4- West Nile virus

Question 8

Which disease can transmit by Culex mosquito?

Answer 8

1- Avian malaria
2- Wuchereria bancrofti
3- variety of arboviruses
-West Nile virus
-Western equine encephalitis
-Japanese encephalitis
-St. Louis encephalitis

Question 9

Which disease can transmit by Deer fly (Chrysops) ?

Answer 9

1- Loiasis (loa loa)
2- Tularaemia

Question 10

What are the main symptoms of Lassa ?

Answer 10

fever - arthralgia - myalgia
sore throat - usually self-limiting
in severe cases:
oedema and haemorrhage

Question 11

lassa is endemic in which country?
and what is the only animal reservoir ?

Answer 11

Nigeria, Sierra Leone and Liberia
Mastomys rat

Question 12

transmission of CCHF ?
How it present?

Answer 12

1- Tick bite
2-animal blood or tissues
IP : Max of 13 days
-Fever, myalgia , dizziness, severe headache, sore eyes and photophobia
- N,V,D and abdominal pain - Sharp mood swings , confusion and agitation progress to sleepiness
- ecchymosis and mucosal bleeding
- AKI , hepatitis , resp failure and death.
—————–
Central asia (pakistan , Turkey ) central Europe and africa
outbreaks ?ass with ostrich as reservoir

Question 13

Old World/New World Arenaviruses?

Answer 13

Old World:
lassa
Lugo
Lymphocytic choriomeningitis (LCM)
new world:
Chapare virus - Bolivia
Machepo - Bolivia
Sabia hemorrhagic fever -Brazil
Junín virus - Argentine
Guanarito virus-Venezuelan

Question 14

symptoms and transmission of Ebola?

Answer 14

Transmission:
fruit bat and contact with body fluids
—————
- Fever, myalgia , severe headache,Sore throat.
- Severe GI symptoms :
abdominal pain, watery diarrhea and vomiting
- bleeding or bruising

Question 15

What are the two syndromes associated with hantavirus ??

Answer 15

1) haemorrhagic pulmonary syndrome (found in Americas)
2) haemorrhagic fever with renal syndrome (Asia and Europe – in Scandinavia milder form ‘nephropathia epidermica’)

Question 16

What are the parvoviridae , and what is the genome type ?

Answer 16

parvovirus B19 , Bocavirus and adeno - associated viruses.

single stranded DNA

Question 17

What is the genome type of : Herpesviruses, adenoviruses, poxviruses:
??

Answer 17

linear double stranded DNA

Question 18

What are the genome type of Papillomaviruses (HPV), polyomaviruses (JC) & BK virus ?

Answer 18

Non-enveloped , Circular double stranded DNA.

Question 19

What is the genome type of reoviruses (rotavirus)?

Answer 19

Non-envelope.
The only known double stranded RNA.

Question 20

What are the known non-enveloped viruses?

Answer 20

1-Papovaviruses (papiloma , polyoma)

2-Parvoviridae ( parvovirus B19 , bocavirus ,adeno-ass)

3- Caliciviridae (norovirus)

4- Reoviridae (rota virus)

5- Picornaviridae (positive sense ssRNA) : enteroviruses including Coxsackie , polio rhino and hepatitis A virus

6- Adenovirus
7- hepatitis E

Question 21

What are the genome type of the arenaviruses (Lassa, ), bunyaviruses (hantavirus, RVFV , CCHF)?

Answer 21

• arenaviruses : 2 separate ssRNA
• Bunyaviruses: Negative sense ssRNA

Question 22

What are the viral receptors of the following viruses:
EBV, HIV, Influenza , JC , Parvovirus B19 , Polio , Rabies , SARS Cov ?

Answer 22

EBV: CD21 plus HLA II
HIV: CD4 plus CXCR4/CCR5
Influenza :Receptor containing sialic acid residues
JC virus: Serotonin receptor on oligodendrocytes
Parvovirus B19: Erythrocyte P receptor
———-
Polio: CD155 (immnuoglobulin superfamily glycoprotein)
———-
Rabies: nicotinic acetyl choline receptor (nAChR)
SARS coronavirus: ACE-2 receptor
——–

Question 23

What is the genome type of Flaviviridae
HCV, Japanese encephalitis , Dengue, Yellow fever and Zika?

Answer 23

Positive sense
ssRNA

Question 24

what are the Togaviruses and what is the Genome type?

Answer 24

1- Rubella
2- Alphaviruses :
equine encephalitis , Onyongnyong and Chikungunya
——
positive sense
ssRNA

Question 25

What are the Negative sense ssRNA viruses?

Answer 25

1- Orthomyxoviridae : Influenza A,B,C -------- 2-Paramyxoviridae : parainfluenza, Metapneumovirus , RSV Measles, Mumps , hendra/Nipah. ------ 3-Rhabdo : Rabies ------- 4- Filoviridae (filamentous shape): Ebola & Marburg ------- 5-Bunyaviridae : CCHF, RVF , Hanta

Question 26

What is the genome type of hepatitis E ?

Answer 26

non-enveloped single stranded positive sense RNA virus.

Question 27

who is at greatest risk of chronic Hepatitis E ?

Answer 27

Patients with impaired T cell immunity (such as solid organ transplant recipients, especially if receiving tacrolimus)

Question 28

gold standard diagnostic test for HEV?

Answer 28

HEV RNA in serum and stool

Question 29

What is the recommendation for pt with past HBV infection starting on rituximab or other B cell-depleting therapies?

Answer 29

1- prophylaxis with lamivudine 2- Start prophylaxis before beginning immunosuppressive therapy and continue for a minimum of 6 months after stopping

Question 30

the infectious period of parvovirus B19?

Answer 30

7-10 days before the rash develops, until 1 day after rash appears

Question 31

Maternal VZV infection 4d before and 2 d after delivery?

Answer 31

1- VZIG (or IVIG 400) within 24-48h 2- IV Acyclovir 30mg/kg/day in 3 doses from day 7 of maternal eruption for 10 d 3- if neonate develops rash despite all this measures, Treat with IV acyclovir x 3 weeks

Question 32

Maternal VZV infection from d3 to d28 postpartum , how to manage the neonate ??

Answer 32

1- prophylactic acyclovir 80 mg/kg/day in 4 doses. from d7 of maternal rash and for 10 days 2- if neonate become symptomatic : to hospitalise and switch to intravenous acyclovir for at least 3 weeks

Question 33

maternal VZV from d20 to d5 before delivery?

Answer 33

1- Keep newborn and mother for at least 3 days hospitalised 2- VZIG (or IVIG) Within 24-48h and monitor 3- If vesicles are present at birth or appear, add acyclovir PO 80 mg/kg/day divided into four doses and maintain over 7 days

Question 34

What is the recommended initial ART when there is evidence of transmitted resistance (e.g HIV when on PrEP) ??

Answer 34

NRTI Backbone plus: dolutegravir, bictegravir or boosted darunavir. ---- Note: Bictegravir is currently only available in combination with TAF

Question 35

T/F The only available treatment for Lassa fever is symptomatic ?

Answer 35

F Ribavirin significantly reduces mortality, from 26% to 5%

Question 36

diseases transmit effectively by Culex?

Answer 36

Japanese encephalitis v west nile encephalitis Lymphatic filariasis

Question 37

diseases transmit effectively by Aedes?

Answer 37

yellow fever Dengue Zika Chikungunya RVF Lymphatic filariasis

Question 38

diseases transmit effectively by Anopheles ?

Answer 38

Malaria Filaria

Question 39

T/F all smallpox vaccines are safe to administer in HIV ?

Answer 39

F 1- Live vaccinia can be given as 1ry prophylaxis only if CD4>200 , and can be given after direct contact if CD4>50 2- non-replicating (Imvanex) : can be give regardless CD4 count

Question 40

T/F: Both HNIG and IVIG are used in the post-exposure of measles

Answer 40

T: Both can be used in individuals for whom MMR vaccine is not appropriate. HNIG is used in pregnancy and infancy; IVIG is used for immunosuppressed individuals.

Question 41

infectious period of Measles?

Answer 41

4d before to 4d after rash exposed pregnant should be tested for IgG before HNIG if possible infant contacts under 6 months, and all household infant contacts under 9 months should receive HNIG without any testing. HNIG is used within 6 days of exposure.