Viral Encephalitis and Poliomyelitis Flashcards by Iseoluwa Ojo

Introduction

Encephalitis is a/an (acute or chronic?) inflammatory process affecting the ___________

Acute

brain parenchyma

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Causes

Herpesviruses
List 6

Flaviviruses
List 4

Togaviridae
List 3

HSV – 1, HSV – 2, VZV, CMC, EBV, HHV – 6

West Nile
Japanese encephalitis
St. Louis encephalitis
Tick borne encephalitis virus

Eastern equine encephalitis
Western equine encephalitis Venzuelan equine encephalitis virus

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Causes
Enteroviruses
Measles virus
Mumps virus
Rabies virus
Lymphocytic choriomeningitis virus Colorado tick fever virus
Influenza virus
Adenoviruses

T/F

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ARBOVIRUS

The arboviruses are a miscellaneous group of

(Naked or Enveloped?)
____RNA viruses that infect animals.

They are transmitted from one vertebrate host to another via _________
The main reservoirs are wild birds and small mammals. Man may be infected if bitten by the insect vector.

Enveloped

blood sucking arthropods.

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ARBOVIRUS

The main reservoirs are ______ and _______. Man may be infected if _______________

wild birds and small mammals

bitten by the insect vector.

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Flaviviruses

_________, 40 - 60 nm or more in diameter

Naked or Enveloped?
_____-stranded RNA
________ sense, about 11 kb

Replication: ________.
Assembly: within ___________.

Spherical

Enveloped; single; positive

cytoplasm

endoplasmic reticulum

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Flaviviruses

Envelope. _____ structural protein
•list : ___________________________________

Non structural:
•list !!!

Three

Capsid (C), Membrane (M), Envelope (E)

NS1, NS2A, NS2B, NS3, NS4A, NS4B, NS5

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Togavirus

_________, 70 nm in diameter

nucleocapsid has ____ capsomeres.

Genome: ________-sense, _____-stranded RNA, 11–12 kb in size.

(Naked or Enveloped?).

Replication: ________.
Assembly: ______ through ________

Spherical; 42

positive; single

Enveloped

cytoplasm

Budding ; host cell membranes.

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Togavirus

Envelope:

_____________ major structural polypeptides

______ are _________.

Three or four

two

glycosylated

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Clinical features of viral encephalitis
Fever
Headache
Malaise
Anorexia
Nausea and Vomiting
____________/_________
______ aberrations: ________,_______

Altered sensorium/coma

Mental

hallucination; agitation

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Clinical features of viral encephalitis

___________ change
_________ disorders
occasionally __________

personality

behavioral

frank psychosis

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Clinical features of viral encephalitis

_____________ seizures in >50% severe cases.

(Mild or Severe?) focused _______ deficits

Virtually every possible ____________________ has been reported.

Focal or general

Severe; neurologic

focal neurological disturbance

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Clinical features of viral encephalitis

Most Common
•______ and ______
•Hemi______ with ________ tendon reflexes
• (voluntary or Involuntary?) movements
•________ nerve deficits (_____palsies, ______ weakness)

Aphasia; Ataxia

paresis; hyperactive

Involuntary

Cranial; ocular; facial

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Laboratory diagnosis of viral encephalitis

CSF
• usually _______
• __________________ pressure
•initially a _________ ________, which rapidly converts to ________
• proteins are ________
• glucose is _______

PCR
Virus culture
Serology – IgG, IgM

colorless

Slightly increased

neutrophilic pleocytosis; lymphocytes

Increased

normal

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Treatment
HSV – Acyclovir
• 10mg/kgintravenouslyevery8hours. • Duration 14-21 days.
Ganciclovir can be used in CMV infections.
Fever, dehydration, electrolyte imbalances, and convulsions require treatment.
For cerebral edema severe enough to produce herniation, controlled hyperventilation, mannitol, and dexamethasone.
Patients with cerebral edema must not be overhydrated. monitoring ICP should be considered.

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Treatment of viral encephalitis

HSV – _______

___________ can be used in CMV infections.

Fever, dehydration, electrolyte imbalances, and convulsions require treatment.

Acyclovir

Ganciclovir

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Treatment of viral encephalitis

For cerebral edema severe enough to produce _______, controlled _____,_________, and ————-

Patients with cerebral edema must not be ————-. monitoring _____ should be considered.

herniation

hyperventilation, mannitol, and dexamethasone.

overhydrated; ICP

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Prognosis of viral encephalitis

Outcomes are variable depending on _____.

———- and ______ encephalitis generally have high mortality rates and Severe neurologic sequelae among survivors.

______ is associated with significant morbidity and morality.

etiology

EEE and St. Louis

WNV

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Prognosis of viral encephalitis

Mortality of HSV encephalitis before acyclovir was _____% to _____%, and with treatment approximately _____%.

_______ disability, _____, and ______ deficits are common sequelae seen among survivors

60; 70

Cognitive; seizures; motor

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Prevention
Vaccination
List 4

Mosquito control
Use of insect repellant
Insecticide spray
Mosquito nets

VZV
Rabies virus
Japenese encephalitis virus
Tick borne encephalitis virus

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Post infectious encephalitis

develop in the _______ phase, following a number of common viral infections

(Common or Uncommon?)

Measles, mumps, rubella and primary varicella-zoster virus infection.

convalescent

Uncommon

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Post infectious encephalitis

Following exposure to certain vaccines, such as: ______ virus and the older ______________ vaccines.

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vaccinia

neurotissue rabies

Post infectious encephalitis

(Focal or Widespread?) _______ lesions develop involving the ________ in the ________________.

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Widespread; demyelinating

white matter

brain and spinal cord.

Post infectious encephalitis

Characteristic histological features include: ________ infiltration and __________ of adjacent blood vessels.

The causative agent (can or cannot?) be isolated from brain tissue or CSF.

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lymphocytic; perivascular cuffing

Cannot

Post infectious encephalitis The aetiology is somewhat obscure, but it is thought to be a ____________ auto-immune phenomenon, triggered by exposure to foreign antigens which are ______________________________________ (__________________ ).

T cell-mediated closely related to host proteins normally present in brain tissue molecular mimicry

Guillain Barre syndrome Characterised by ________ which develops ________ to _____ after the _______ phase of a certain bacterial or viral infections. The disease is due to __________ of _________ nerves.

poly-neuritis a few days to weeks acute; demyelination peripheral

Guillain Barre syndrome Patients present with ______ paralysis, associated with ______. Like post infectious encephalomyelitis, it is believed to be __________ phenomenon.

an ascending; paraesthesia an immunological

Guillain Barre syndrome Patients usually recover ______________________________________ as affected nerves are _____________

spontaneously over a few weeks or months re-myelinated.

Polio virus Polio (poliomyelitis) mainly affects _______________________ 1 in 200 infections leads to (reversible or irreversible?) paralysis.

children under 5 years of age. irreversible

Polio virus Among those paralysed, 5% to 10% die when their ———- muscles become immobilized.

breathing

Polio virus The reduction in prevalence is the result of the global effort to ____________

eradicate the disease.

As long as a single child remains infected, ______________________________ ~WHO 2016

children in all countries are at risk of contracting polio.

Poliomyelitis ______ stranded (linear or circular?) ________ sense RNA Transmission is ________

Single Linear positive faeco-oral

Poliomyelitis Primary multiplication takes place in the _________ or ________ The virus first multiplies in the _____, the _______ of the neck, ————, and the __________. The CNS may then be invaded by way of the __________. Spread along _______ of ___________ to the CNS.

oropharynx or intestine. tonsils; lymph nodes ; Peyer patches small intestine; circulating blood axons of peripheral nerves

In Poliomyelitis Some cells that lose their function may recover completely T/F

Clinical finding of poliomyelitis Incubation period:_________ (range ___-____ days) Could be a Mild disease Or ____________ polio _________ polio . __________ ———poliomyelitis _________ Virus shedding in stool for _________

1 – 2 weeks; 3 – 35 Non paralytic Paralytic Progressive post; muscle atrophy 6 – 8 weeks

Clinical finding of poliomyelitis Non paralytic polio can lead to ___________ Paralytic polio •(Acute or Chronic?) (flaccid or spastic?) paralysis resulting from (upper or lower?) motor neuron damage.

aseptic meningitis Acute flaccid Lower

Clinical finding of poliomyelitis Progressive post poliomyelitis muscle atrophy •A recrudescence of ____________ and _________ decades after their experience with ______________

paralysis and muscle wasting paralytic poliomyelitis

Laboratory diagnosis of poliomyelitis Specimen-_____,_______,_______ PCR Virus culture Serology

stool, throat swab, CSF

Acute flaccid paralysis (AFP) surveillance •finding and reporting children with AFP •transporting ——- samples for analysis •isolating and identifying poliovirus in the laboratory •_____the virus to determine the —————

stool mapping origin of the virus strain.

Global eradication strategy Polio virus type —— was declared eradicated in ______. last case in ______.

2 2015 1999

Global eradication strategy Nigeria was taken off the list of polio endemic countries in _____ _______ because a year had passed with no reported cases of WPV But ____ cases this year from _____ state

September 2015 3; borno

Polio vaccines Oral polio vaccine (OPV) by _______ in ——— Inactivated polio vaccine (IPV) by ________ in ______

Albert Sabin; 1961 Jonas Salk ; 1955

Oral polio vaccine OPV also produces a local, mucosal immune response in the ___________________ In the event of infection, these mucosal antibodies limit the replication of the _____ poliovirus inside the _____. This ______ immune response to OPV is thought to be the main reason why mass campaigns with OPV can rapidly stop person-to-person transmission of wild poliovirus.

mucous membrane of the intestines. wild; intestine intestinal

Which vaccine is cheaper??

OPV

The inactivated polio vaccine produces antibodies in the blood to all three types of poliovirus T/F

The oral polio vaccine produces antibodies in the blood to all three types of poliovirus T/F

In some cases it is believed that this vaccine-associated paralytic polio (VAPP) may be triggered by ________

immune deficiency.

IPV induces (very high or very low?) levels of immunity in the intestine.

Very low

WHO Region of the Americas was certified polio-free in _______ , the WHO Western Pacific Region in _______ and the WHO European Region in June _______. On 27 March 2014, the WHO _______ Region was certified polio-free, In 2020, Africa became the _______ region to be certified wild poliovirus-free.

1994, 2000 June 2002. South-East Asia fifth

Circulating vaccine-derived polioviruses (cVDPVs are (common or rare?) rare strains of poliovirus that have __________ from the strain contained in the __________, and which can only emerge and circulate in __________ communities. If the vaccine-virus is able to circulate for a prolonged period of time uninterrupted, it can mutate and, over the course of __________, reacquire infectious strength.

rare ; OPV; under-immunized 12-18 months

Circulating vaccine-derived polioviruses (cVDPVs The (lower or higher?) the population’s immunity, the longer the cVDPV can survive. The longer they survive, the more they replicate, change, and __________________ with other viruses as they spread. A cVDPV can cause cases of ________ in those it circulates to. If a population is fully immunized against polio, it will be protected against the spread of ____________________________ strains of poliovirus.

Lower exchange genetic material paralysis both wild and vaccine derived

Circulating vaccine-derived polioviruses (cVDPVs The switch from ____valent to ____valent oral polio vaccine (OPV) has dramatically reduced the risk of cVDPV. This is because the greatest risk of cVDPV arises from type ____ polio vaccine, which is _____ from ________ OPV.

trivalent ; bivalent type 2 polio absent bivalent

Viral Encephalitis and Poliomyelitis Flashcards

(53 cards)