VIRAL Flashcards
(140 cards)
1
Q
How is herpes zoster can be separated from anterior poliomyelitis
A
unilateral , segmental localization and greater involvement of dorsal root ganglion
2
Q
Histologic hallmark of SSPE
A
Eosinophilic inclusion in cytoplasm and nuclei of glia cells
3
Q
Differential Diagnosis of SSPE:
A
Lipid storage disease
CJD
Schilder type demyelinating disease
4
Q
Treatment of Toxoplasmosis
A
Pyrimetamine (100 mg then 25mg daily)
Sulfonamide
5
Q
Pathology of Herpes occipitocollaris
A
necrotizing inflammatory myelopathy and vasculitis
6
Q
2 forms of Neurosyphilis
A
Syphilitic Menigitis
Meningovascular syphilis
7
Q
Test culture of Cryptococcal Meningitis
A
India Ink
8
Q
Conversion of normal cellular protein involves conversiopn of Prp to
A
PrPsc
9
Q
PCR in HSV:
- False negative?
- False positive
- Sensitivity
A
- first 48 hours of fever
- first 3 weeks of illness
- 95%
10
Q
Treatment pf PML
A
Non-AIDS: non-treatable
AIDS: aggressive ARV with protease inhibitor (slows the progression)
11
Q
Fatality rate of HSC
A
30-70%
12
Q
This condition is has a histopathologic findings of gliosis mainly in the MEDIAL THALAMIC NUCLEI
A
Famililal Fatal insomnia (FFI)
13
Q
How many cases of PML has AIDS?
A
75%
14
Q
Quertet of Human Disease (Prion)
A
a. CJD
b. Gertesmann Straussler Scheiker
c. Kuru
d. Fatal insomnia
15
Q
Death occurrence in patients with PML
A
3-6months
16
Q
non-progressive in nature occurring 2-3 years of life characterized by clumsiness with frank ataxia
A
Progressive Rubella Panencephalitis
17
Q
How is post-exposure prophylaxis given in rabies
A
a. HRIG at 20u/kg (1/2 IM and 1/2 wound)
b. human diploid cell vaccine - given 1ml day 0-3-7-14-28
18
Q
Pattern of deterioration of SSPE
A
a. deterioration in proficiency at school
b. progressive intellectual deterioration(seizure and myoclonus)
c. Hyperactive DTR
d. Decorticate
19
Q
Most common cause of Aseptic Meningitis
A
- Entero virus (1st)
- HSV2 -2nd common
- EBV CMV Leptospira , HSV2 and mycoplasma (3rd)
20
Q
What is involved if deglutition is affected in poliomyelitis
A
Nucleus ambiguus
21
Q
Lentivirus causes?
A
HIV
22
Q
Incubation period of poliomyelitis
A
1-3 weeks
23
Q
2 TB infection to complicate AIDS
A
M. Tuberculosis
M. Avium intracellulare
24
Q
What is the other name of Somnolent-ophthalmoplegic encephalitis
A
von Economo Disease, Sleeping Sickness
ENCEPHALITIS LETHARGICS
25
Most common site of Herpes Zoster
T5-T10
26
Epidemiology of HIV (4)
1. 9% of population
2. 2% hemophiliacs
3. 80% of african: heterosexual contact
4. 2/3 homosexual and bisexual men
27
treatment, dose and duration of HSV
1. Acyclovir at 30mg/kg 10-14 days
28
What strain of Parvovirus causes encephalitis and meningitis
B-19
29
Viral infection associated with cauda equina neuritis (2)
HIV and HSV
30
What differentiate cerebral lipidosis from CJD?
Retinal changes and chronicity
31
What is the reason for myoclonus in CJD?
loss of inhibitory neurons in thalamic reticular neurons that corresponds with positive sharp waves
32
Evidences that viral infection leads to chronic disease:
a. Demonstration of degeneration of nigral neurons (encephalitis lethargica)
b. Presence of inclusion bodies ( SSPE)
c. slow viral infection with long incubation period (VISNA)
d. EM of viral particles (PML)
33
Earliest pathologic findings in poliomyelitis
central chromatolysis of Anterior horn cells
34
Herpes Zoster associated with malignancy that tends to be generalized?
Herpes Zine Herpete
35
Measles or exposure to measles precedes encephalitis by 1-6 months that occurs in children and adult secondary to cell mediated immune response?
Subactute Measles encephalitis with Immunosupression
36
Mortality rate of poliomyelitis
5-10%
37
Prognosis of poliomyelitis
if survive the acute stage - recovers completely
| Muscle recovery at 3-4 months
38
Treatment of CMV
Foscarnet and Ganciclovir
39
Etiology of Acute ANterior Poliomyelitis
Entero virus
Coxsackie A and B
Japanese Encephalitis (west nile)
40
How many percent occurrence of ophthalmic zoster
15%
41
Viral organism associated with encephalitis in Stem Cell transplant
Roseola (exanthem subitum)
42
Causes of Non-poliovirus myelitis
Echo Virus:
70 (residual paralysis and hemorrhagic conjunctivitis)
71 ( Hand and foot and mouth disease)
West nile virus
43
In viral infection glucose is always normal, if the level is decreased suspect for the following condition:
1. Mumps
2. HSV 2
3. LCM
4. VZV
44
Reason for tingling sensation at bite site of rabies
inflammatory response when virus reaches the sensory ganglia
45
2 forms of Cranial Herpes Syndromes
1. Ophthalmic - Gasserian
| 2. Geniculate- Ramsay Hunt ganglion
46
prognosis of patients with HSV? (3)
1. if unconscious - poor
2. if treatment begun 4 days and awake - good
3. residual symptoms - Korsakoff amnesic defect , seizure and dementia
47
Mode of transmission of HTL-1
mother to child
Across placenta
IV drug
Blood Transfusion
48
Death rate of SSPE
1-3 years
49
AIDS Dementia Complex is how many percent among AIDS patients
3%
50
When does VZV set in HIV
when CD4 is below 500
51
SSPE: Age of onset
Rarely beyond 10 years old
Almost 2 years old
52
MRI findings of CJD
hyperintensity of lenticular nuclei (T2 and BWI) in basal ganglia and cortex
Long contiguous segment of cortex (90%)
53
EEG findings of SSPE
Burst suppression 2-3 high voltage
54
What condition has a histopathologic findigs of:
Widepsread neuronal loss and gluosis by vacuolation and accumulation of specific protein (amyloid, tau, synucleun and ubiquitin)
CJD
55
3 Groups of Von Economo Disease
a. Ophthalmoplegia and somnolence
b. Overly acitive
c. Bradykinesia, catalepsy, mutism and chorea
56
EEG findings of HSV
PLEDS
57
Kuru plaques are characterized by:
non-inflammatory neurons and spongiform changes throughout cerebellar cortex and Stellate plaques of amyloid like material
58
Virus that resides latent in tissue (kidney and BM)
JC virus
59
Other term of SSPE
inclusion body encephalitis
Result from chronic measles virus infection
60
Quartet of Vogt Koyagan Harada Syndrome
1. Iridocyclitis
2. Depigmentation of hair
3. Loss of eyelashes
4. Deafness
61
2 forms of acute encephalitis
1. Direct invasion
| 2. Postinfectious encephalomyelitis
62
treatment of ophthalmic zoster
Acyclovir every hour 0.1 or 0.5 ointment 4-5 days
63
3 forms of poliomyelitis
1. Inapparent - mild symptoms (abortive)
2. Non-paralytic
3. Paralytic
64
PrP is encoded with what gene
Short arm of Chr. 20
65
Patient who develop this condition has a preceding pharyngitis with elevated ASO and oligoclonal bands
Von economo disease
66
DIagnostic criteria for SSPE (3)
Periodic complexes in EEG
Elevated Oligoclonal bands
Elevated IgG and Measles AB titer
67
Pathologic findings in JCL
Inclusion bearing oligodendrocytes
JC VIRUS
68
Limbic encephalitis and brainstem encephalitis is associated with what malignancy?
Distant lung cance
69
MRI findings of acute cerebellitis
normal or with enhancement of cerebellar cortical ribbon
70
inclusion body found in Herpes Zoster Virus
Lipshütz Inclusion Body
71
Histologic findings of SSPE
degeneration of medullated fibers with perivascular cuffing and fibrous gliosis (sclerosing encephalitis_
72
Characterized by intractable seizure and progressive hemiparesis?
Rasmussen's encephalitis
73
What condition where there is acute inflammatory reaction in isolated spinal, cranial sensory ganglia lesser in posterior and anterior roots and posterior grey matter
Herpes Zoster Virus
74
Molecular abnormalities of Familial Fatal insomnia
mutation at codon 178 with methionine at codon 129 om chr 20 (sporadic)
75
What condition will you see a viral infection localized to midbrain, subthalamus and hypothalamus with depigmentation of substantia nigra
Von economo disease
76
Slow infection caused by unconventional transmissible agents to be documented in human beings?
Kuru
77
Pattern of symptoms of CJD
Changes in behavior --> intellectual function --> ataxia --> visual abnotmalitis (BIAV)
78
Prevalence of Toxoplasmosis in AIDS
13%
79
Causes ependymal and acqueductal stenosis
Mumps
80
Neuroaxis affected by HSV (3)
1. inferomedial or lateral frontal
2. temporal lobes
3. insula
81
What condition you can see intense hemorrhagic necrosis:
HSV
82
Transmission of Fatal insomnia
inoculation
83
What type of HSV causes encephalitis?
HSV-1
84
CSF picture of abortive poliomyelitis
aseptic meningitis
85
First slow virus in human
von economo disease
86
When is atrophy detected in paralytic poliomyeltis
3 weeks of onset (maximal 12-15 weeks)
87
MRI of CMV
concentrated on ventricular borders with meningeal enchancement
88
Biogenic amines implicated for this virus for entry to oligodendrocytes
Serotonin
89
What condition is characterized by progressive and profound dementia with diffuse myoclonic jerks
Creutzfeldt-Jakob Disease
90
Condition associated with PML (6)
```
CLL
Hodgkins
Lymphosarcoma
Myeloproliferative disease
TB
Sarcoidosis
```
91
Immune reponses assocated with Rasmussen Encephalitis
(+) Glutamate receptor
92
Among the organism associated with aacute poliomyeltis, what causes severe and persistent asymmetrical paralysis?
WESL NILE
93
Classification of CJ based on Genotypes:
1. Least common
2. Most common
3. EEG findings seen in what type?
4. What codon are methionine and valine found:
1. MM
2. MM2
3. Type 1
4. Codon 129
94
Immunoassay in CJD
brain fragments of 14-3-3
95
MRI findings of HSV
high intensity T2 and low intensity T1 and always enhancing
96
Imaging findings of AIDS Dementia Complex
CT: widening of sulci
| MRIL patchy but confluence, diffuse white matter changes
97
Acute cerebellitis is secondary from what infections? (2)
Small pox and typhoid
98
Lab test and CSF findings of CJD
Normal
99
Presence of this will yield false positive for syphilis
HIV
100
EEG findings of CJD
diffuse and non-specific slowing of stereotyped high voltage slowing and sharp wzve complexes (pseudoperiodic and synchronous myoclonus)
101
Clinical manifestation of CMV (3)
Acute confusional state), delirium, CN ophthalmoparesis)
102
Iron lung is seen in what condition?
Acute poliomyelitis
103
Mollaret recurrent meningits is associated with what infection:
HSV-1 (steel) and HSV-2
104
Prognosis of Encephalitis lethargica
20% dies within weeks
If survives, with neurologic deficits
105
Associated with acute confusional dementia
HIV-type 2
106
brain fragments of 14-3-3:
1. What is the use?
2. Sensitivity?
3. Specificity?
1. separates CJD from other chronic inflammatory cause of Dementia
2. 92%
3. 80%
107
Incubation period of Rabies
20-60 days (as early as 14 days - neck and face)
108
How many percent develop myelopathy in HTLV-1
| HTLV associated myelopathy
2%
109
Treatment of SSPE
Amantadinr and inosine Pranobex
110
Transmitted in proteinacious infectious particles that is devoid of nuclei acid
Prion Disease
111
How many percent of CJD will present with stroke-like suddenness
10%
112
inorder for a virus to cause infection host must have this for attachement of virus
Cytoplasmic membrane
113
What lobe is affected by HHV encephalitis- associated stem cell transplant
Medial temporal lobe (llimbic encephalitis)
114
What family of virus causes anterior poliomyelitis
Picornavirus (RNA)
115
Condition characterized by hemiparesis, hemianesthesia, aphasia and retinal defects that complicates VZV infection
Zoster angitis
116
Features of MadCow disease vs CJD (3)
1. young onset
2. no typical eeg findings
3. variant of CJD
117
Treatment for post herpetic neuralgua
Amitryptilline
Others CBZ, gabapentin, pregabalin, valprotte
118
What is the TREATMENT and CONDITION associated with initial treatment of ARV?
CONDITION: PML
TREATMENT: Corticosteroids
119
Variant of CJD where ataxia is prominent?
Brownell-oppenheimer variant
120
Most common non focal neurologic complication of AIDS
CMV
121
Clinical manifestation of FFI
intractable insomnia, symathetic overactivity and dementia
122
Diagnosis of Herpes Zoster
Membrane antigen (VAMA) found in CSF and serum
123
Meningeal infections that are difficult to isolate? (3)
TB fungal and syphilis
124
Imaging findings of PML
Non-enhancing lesion with variable size and location
125
What inclusion bodies seen in rabies and describe? (2)
a. negri bodies - cytoplasmic eosinophilic inclusion
| b. babes nodule - focal collection of microglia
126
Cognitive domain affected in AIDS dementia complex?
loss of retentive memory
127
Most gravest and common viral infection?
HSV
128
Variant of CJD where visual disturbance is prominent?
Hedeinhain variant
129
Where is JC virus Dormant?
Kidney
130
Complication of HIV treatment
Immune Reconstitution of Syndrome (PML)
131
Prevention of Poliomyelitis
Salk Vaccine
| oral dose two dose 8 weeks apart
132
HIV myelopathy pathophysoiology
Vacuolar degeneration (resemble to SCD B12)
133
Rule of paralysis in paralytic poliomyelitis
weakness while fever is at its height
| No progression of weakness once temperature is normal within 48 hours
134
First viral polyneuropathy in human
zoster - ganglionopathy
135
Massive multifocal zone of destruction of both myelin and axon mainly of cerebral hemisphere
Progressive Multifocal Leukoencephalopathy (PML)
136
At what temperature CJD can be deactivated
132C in 1 hour
137
What condition characterized by ataxia, dysarthria and mild dementia occuring in midlife and runs a chronic course where dysesthesia in proximal leg is prominent?
Gerstsmann-Sträussler-Scheinker Syndrome
138
Mechanism of spread of CJD
Iatrogenic (tonsils and nasophayrnx)
139
Herpes zoster in palate, pharymx, and retroauricular area
Herpes occipitocollaris
140
What markers are elevated in CSF of patients with CJD
Neopterin and enolase
