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CMT > Viral Infections > Flashcards

Viral Infections Flashcards

1
Q

General notes on viruses

Dx tests/Tx

A

not always required

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2
Q

General notes on viruses

Prognosis

A

usually benign and self-limited

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3
Q

General notes on viruses

need for consultations

A

unlikely with typical presentations

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4
Q

Herpes Simplex Virus

where does the virus lie dormant?

A

in neurons
can have asx viral shedding

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5
Q

Herpes Simplex Virus

when does the virus reactivate

A
  • follows minor infection, trauma, stress, sun exposure, menstruation
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6
Q

Herpes Simplex Virus

Consideration in pregnancy

A

risk of transmission during delivery

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7
Q

Herpes Simplex Virus

what to do during genital flare up during birth?

A

deliver via c-section to not spread to baby

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8
Q

Herpes Simplex Virus

HSV 1 epi

A
  • common for oral and genital ulcers in young females
  • positive serology common
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9
Q

Herpes Simplex Virus

HSV 2 epi

A
  • most common cause of genital ulcers in developed world
  • many unaware they are infected
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10
Q

Herpes Simplex Virus

describe lesions

4 things

A
  1. skin or mucous membrane
  2. vesicle changing to painful ulcer over several days
  3. prodrome of pain
  4. regional tender lymphadenopathy
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11
Q

Herpes Simplex Virus

what does suppressive tx do?

A

reduces transmission and sx

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12
Q

Herpes Simplex Virus

ophthalmicus heals well when limited to?

A

epithelium

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13
Q

Herpes Simplex Virus

ophthalmicus when involves the stroma can lead to?

3

A
  1. uveitis
  2. scarring
  3. blindness
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14
Q

Herpes Simplex Virus

Complications

A
  1. meningitis
  2. disseminated infection
  3. bell palsy
  4. esophagitis/proctitis
  5. erythema multiforme minor
  6. stevens-johnson syndrome
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15
Q

Herpes Simplex Virus

Dx for meningitis

A
  • CSF for HSV DNA PCR
  • CSF for HSV antibodies later in disease
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16
Q

Herpes Simplex Virus

Dx for oxular disease

A
  • branching ulcers that stain with fluorescent
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17
Q

Herpes Simplex Virus

Dx GI disease

A
  • biopsy with HSV PCR and culture
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18
Q

Herpes Simplex Virus

Dx pneumonia

A
  • diagnosed by clinical, pathologic, and radiographic findings
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19
Q

Herpes Simplex Virus

Tx

A
  1. treat to inhibit replication for both hsv-1 and hsv-2
  2. Aycylovir- dosage varies based on goal of tx
  3. Trifluridine- for eye infection
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20
Q

Herpes Simplex Virus

Acyclovir- 3 categories for tx

A
  1. mild-moderate disease
  2. severe disease/immunocompromised
  3. suppression
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21
Q

Herpes Simplex Virus

Acyclovir- mild/moderate tx

dosage/duration/freq

A

400-800mg PO, Q8 hrs, 10 days

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22
Q

Herpes Simplex Virus

Acyclovir- severe disease/immunocomp

dosage, duration, freq

A

5-10mg/kg IV, Q8 hrs

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23
Q

Herpes Simplex Virus

Acyclovir- suppression

dosage, frequency, duration

A

400-800mg PO, Q12 hrs

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24
Q

Varicella

AKA

A

chicken pox

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25
Q

Varicella

incubation period

A

10-20 days

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26
Q

Varicella

mode of transmission

A

respiratory droplets
contact with lesions

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27
Q

Varicella

most typically presents in:

A

children

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28
Q

Varicella

varicella zoster virus aka

A

human herpesvirus-3

and this = varicella/chicken pox

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29
Q

Varicella

herpes zoster aka

A

shingles

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30
Q

Varicella

sx & signs

A
  • fever
  • malaise
  • headache
  • abd pain
  • rash
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31
Q

Varicella

describe rash

A
  • contagious from 1-2 days before rash until all lesions crusted
  • successive crops, lesions in dif stages development
    crust 4-7 days after onet
  • maculopapular rash that quickly transforms to vesicles that become pustular and then crusts
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32
Q

Varicella

distribution of rash

A
  • starts on face/scalp/trunk
  • spreads to extremities later
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33
Q

Varicella

change in incidence due to vax

A

79% decrease

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34
Q

Varicella

dx

A

clinical

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35
Q

Varicella

treatment

A
  • usually self-limiting in children, treat symptomatic
  • Acyclovir 20mg/kg PO, Q24 hrs, 7 days
  • initiate treatment w/in 24 hrs of dx
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36
Q

Varicella

max dose of acyclovir daily

A

800 mg

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37
Q

Varicella

pt’s at highest risk of complications

4 groups

A

unvax children/adults
pregnant women
immunocomp

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38
Q

Varicella

complications

4 things

A
  1. skin infection
  2. pneumonia
  3. encephalitis
  4. death
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39
Q

Varicella

what do we give for PEP?

A

immune globin varizig IM

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40
Q

Varicella

who do we give PEP to?

A

those at higher risk of complications

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41
Q

Congenital Varicella

what can happen if preg women becomes ill?

6 things

A
  • spontaneous abortion
  • chorioretinitis
  • catarats
  • limb atrophy
  • cerebral cortical atrophy
  • neurological disability
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42
Q

Congenital Varicella

Rate of spontaneous abortion if infection is during first trimester?

A

3-8%

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43
Q

Congenital Varicella

varizig rec to who?

4 groups

A
  1. newborns with significant exposure to VZV
  2. neonates whose mom’s have s/s within 5 days before or 2 days after delivery
  3. hosp preterm infants born > 28 wks whose mom’s aren’t immune (no vax hx, or neg serology)
  4. hosp permature infants born < 28 wks or wt < 1000g
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44
Q

Herpes Zoster

describe rash

A
  • tingling
  • pain
  • eruption of vesicles in a dermatomal distribution
  • evolving to pustules followed by crusting
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45
Q

Herpes Zoster

how do people become ill with this?

A

VZV remains latent in root ganglia after varicella infection.

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46
Q

Herpes Zoster

Primary infection= ?
Secondary infection= ?

A
  1. chicken pox
  2. shingles
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47
Q

Herpes Zoster

vax series?

A

2 dose vax rec at age 50

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48
Q

Infectious Mononucleosis

most common virus

A

epstein barr virus (EBV)

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49
Q

Infectious Mononucleosis

EBV AKA

A

human herpesvirus-4 (HHV4)

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50
Q

Infectious Mononucleosis

who is most affected?

age/gender/race

A

young adults (15-25)
gender/races equally

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51
Q

Infectious Mononucleosis

how long is saliva infectious?

A

up to 6 mo after sx onset

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52
Q

Infectious Mononucleosis

incubation period

A

30-50 days

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53
Q

Infectious Mononucleosis

what can insufficient cellular immune responses result in?

A

EBV induced malignancy

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54
Q

Infectious Mononucleosis

signs & sx

5 categories, 10ish things

A
  1. abrupt onset severe sore throat/pharyngitis with posterior cervical lymphadenopathy
  2. gradual onset low-grade fever, malaise, arthralgia, myalgia
  3. splenomegaly
  4. abd pain/discomfort
  5. hepatomegaly (meh, elevated ALT/AST)
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55
Q

Infectious Mononucleosis

how many pts have mono rash?

A

15%

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56
Q

Infectious Mononucleosis

describe mono rash

A
  • faint and not pruritic
  • first on trunk and upper arms
  • extends to face and forearms
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57
Q

Infectious Mononucleosis

what makes the mono rash more intensive or extensive?

A

abx use!
seen 2-10 days after cessation of tx

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58
Q

Infectious Mononucleosis

complications

6 things

A
  1. severe upper airway obstruction
  2. splenic rupture
  3. fulminant hepatitis
  4. encephalitis
  5. severe thrombocytopenia
  6. hemolytic anemia
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59
Q

Infectious Mononucleosis

Dx

A
  • Lymphocytosis
  • Heterophile antibodies
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60
Q

Infectious Mononucleosis

what do we see in mono with heterophile antibodies?

A
  1. pos 2-9 wks after infection
  2. can be pos for > 1 yr
  3. not everyone develops these after infection
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61
Q

Infectious Mononucleosis

what test for heterophile antibodies?

A

heterophile agglutination test (monospot)

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62
Q

Infectious Mononucleosis

Tx

A
  • supportive care
  • hydration
  • antipyretics
  • analgesics
  • avoid contact sports for at least 4 wks to reduce risk of splenic rupture
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63
Q

Cytomegalovirus (CMV)

sx in general population?
similar to what in immunocompromised pts?

A
  • asx in general pop
  • mono like in immunocomp group
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64
Q

Cytomegalovirus (CMV)

mode of transmission

5 components

A
  • close contact
  • sexual
  • blood transfusion/transplant
  • occupational
  • perinatal
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65
Q

Cytomegalovirus (CMV)

Complications

4

A
  • retinitis
  • GI/hepatobiliary
  • pneumonitis
  • neurologic syndromes
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66
Q

Congenital CMV

Neurodevelopmental Complications

5 things

A
  1. sensorineural hearing loss
  2. cerebral palsy
  3. intellectual disability
  4. vision impairment
  5. seizures
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67
Q

Congenital CMV

Dx and Tx

A
  • Dx: test urine or saliva
  • Tx: ganciclovir or valganciclovir
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68
Q

Cytomegalovirus (CMV)

Dx

A

PCR test

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69
Q

Cytomegalovirus (CMV)

Tx

general pop vs immunocompro

A
  • general: supportive care only
  • immunocomp: ganciclovir IV or valganciclovir PO
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70
Q

Rotavirus

most common in children of what ages?

A

6 mo to 2 yrs

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71
Q

Rotavirus

3 factors that play a role in pathogenesis of diarrhea

A
  1. loss of brush border enzymes
  2. direct effect of rotavirus enterotoxin NSP4
  3. activation of enteric nervous system
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72
Q

Rotavirus

Sx

3 big ones

A
  • vomiting
  • watery, nonbloody diarrhea
  • fever
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73
Q

Rotavirus

Sx/Complications of severe cases

A
  1. dehydration
  2. seizures
  3. death
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74
Q

Influenza

Seasonality?

A

fall/winter

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75
Q

Influenza

Types

3

A
  1. Influenza A
  2. Influenza B
  3. Influenza C
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76
Q

Influenza

which are most common?
which rarely results in illness?

A
  1. A & B
  2. C
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77
Q

Influenza

Who is at highest risk?

6 categories

A
  1. children
  2. elders
  3. immunocompromised
  4. pregnant
  5. co-morbid conditions
  6. morbid obesity
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78
Q

Influenza

Incubation period

A

1-4 days

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79
Q

Influenza

A
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80
Q

Influenza

Clinical presentation

A
  1. fever/chills/sweats
  2. myalgia
  3. headache
  4. malaise/fatigue
  5. anorexia
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81
Q

Influenza

Dx

A
  • rapid molecular assays (NP swab)
  • PCR testing (rec for hosp patients)
  • viral culture (only in unusual cases)
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82
Q

Influenza

Tx

A
  • Supportive care (rest/fluids/antipyretics/analgesics/anti-tussives)
  • Oseltamivir
  • Zanamivir
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83
Q

Influenza

dosage/duration/freq of oseltamivir

adults only

A

75mg PO, Q12 hrs, 5 days

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84
Q

Influenza

admin route of zanamivir

A

inhaled or IV
only used if resistance to oseltamivir

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85
Q

Influenza

admin route of paramivir

A

IV- use if they cannot tolerate Tamiflu

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86
Q

Influenza

Who to treat?

A

adults/children who meet the following criteria:
* hospitalization
* severe or progressive illness
* high risk patients
* children < 2 yrs or > 65 yrs
* pregnant women and those within 2 wks of being postpartum

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87
Q

Influenza

consider treating

A
  • outpatients with illness onset < 48 hrs before presentation
  • patients who have high risk contacts at home
  • sx health care providers
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88
Q

Influenza

Decision to Admit

A

admit if severe illness/progressing illness in pregnant women, children < 5 y/o, adults > 65 y/o

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89
Q

Influenza

Decision to admit to ICU

A
  1. rapidly declining respiratory function/hypoxia
  2. bilateral diffuse pneumonia
  3. hemodynamic instability
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90
Q

Influenza

Risks of influenza illness during pregnancy?

A
  • increased risk for hospitalization but not mortality
  • increased risk for pre-term birth or SGA infants
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91
Q

Influenza

when to vax pregnant women

A

any trimester

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92
Q

SARS-COV-2 (COVID)

incubation period

A

< 14 days

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93
Q

SARS-COV-2 (COVID)

typical sx

general

A

URI
fever
cough

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94
Q

SARS-COV-2 (COVID)

Complications

A
  • respiratory failure
  • cardiovascular
  • thromboembolic complications
  • neurologic complications
  • inflammatory complications
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95
Q

SARS-COV-2 (COVID)

Tx

A

Nirmatrelvir-ritonavir (paxlovid)

96
Q

SARS-COV-2 (COVID)

Timeframe for initiating paxlovid

A

within 5 days of sx onset

97
Q

SARS-COV-2 (COVID)

Vaccination

A
  • can wait 3 mo from infection
  • reduces risk of multisystem inflammatory syndrome
  • safe during pregnancy
98
Q

Viral Encephalitis (Rabies)

mode of transmission

A

infected saliva that enters the body by an animal bite or open wound

99
Q

Viral Encephalitis (Rabies)

Incubation period

A

typically 3-7 wks but could be yrs

100
Q

Viral Encephalitis (Rabies)

what does incubation period depend on?

A

distance of wound from CNS

101
Q

Viral Encephalitis (Rabies)

pathophys

A

virus travels in nerves to brain, multiplies in brain, then migrates along efferent nerves to salivary glands

102
Q

Viral Encephalitis (Rabies)

Signs & sx in non-specific prodrome

A
  • pain at infection site
  • fever/malaise/headache/n/v
  • aerophobia (skin temp change sensitivity)
  • percussion myoedema
  • abnormal sexual behavior
103
Q

Viral Encephalitis (Rabies)

When does CNS stage begin?

A

10 days after prodrome

104
Q

Viral Encephalitis (Rabies)

two categories of CNS stage & % of people impacted by each

A
  1. Encephalitic (80%)
  2. Paralytic (20%)
105
Q

Viral Encephalitis (Rabies)

Describe Encepahlitic CNS stage

A
  • delirium alternating w/ periods of calm
  • severe laryngeal or diaphragmatic spasms
  • sensation of choking
  • hypersalivation, lacrimation, sweating, dilated pupils
106
Q

Viral Encephalitis (Rabies)

Describe paralytic CNS stage

A
  • paralysis ascends
  • onset of dense paraplegia w/ loss of sphincter tone
  • paralysis of swallowing & resp muscles
107
Q

Viral Encephalitis (Rabies)

what is after CNS stage?

x x

A

coma, ANS dysfunction, death

108
Q

Viral Encephalitis (Rabies)

Dx in domesticated animals

A
  1. animals (dogs/cats) should be quarantined and observed for 10 days after bite
  2. if animal dies in 10 day period, test animal for rabies
109
Q

Viral Encephalitis (Rabies)

Dx in wild animals

A
  1. capture and kill animal
  2. send brain to lab for examination

if animal can’t be captured, assume pos

110
Q

Viral Encephalitis (Rabies)

rabies tx (at time of bite)

A
  1. cleanse, debride, flush wound
  2. PEP when indicated (pos animal or wild animal that wasn’t captured)
111
Q

Viral Encephalitis (Rabies)

tx once sx

A
  • palliative care
  • rabies isn’t really survivable
112
Q

Poliomyelitis

mode of transmission

A

fecal oral

113
Q

Poliomyelitis

what are vaccine-associated paralytic polio or vaccine-derived polio viruses?

A

consequence of the oral polio vaccine that has mutated and reverted to the neuro variant

(only inactivated vax given now)

114
Q

Poliomyelitis

describe abortive poliomyelitis

A
  • non-specific & mild sx over 2-3 days
  • fever, headache, vomiting, diarrhea, constipation, sore throat
115
Q

Poliomyelitis

Describe non-paralytic polio

A
  • non-specific symptoms
  • muscle spasms without paralysis
  • signs of meningeal irritation (neck stiffness, irritability, PE findings)
116
Q

Poliomyelitis

Paralytic Polio

A
  • flaccid asymmetric paralysis, mostly proximal MM of LE
  • sensory loss (rare)
117
Q

Poliomyelitis

2 types of paralytic polio

A
  1. spinal polio (spinal nerves)
  2. bulbar polio (cranial nerves, resp, vasomotor centers)
118
Q

Poliomyelitis

post-polio syndrome

A
  • progressive muscle limb paresis
  • MM atrophy
  • fasciculations/fibrillations (during rest activity)
  • restless leg syndrome
119
Q

Poliomyelitis

Dx

A
  • PCR of throat washings (early)
  • PCR of stool (later)
  • rarely present in spinal fluid
120
Q

Poliomyelitis

Tx

A
  • supportive
  • hospitalize when paralytic polio
  • physiotherapy
121
Q

Poliomyelitis

prognosis

3 PPP

A
  • course of disease is worse in adults/pregnant women vs children
  • bulbar polio has mortality rate 75%
  • postpolio muscular atrophy occurs in 30-40% of paralyzed limbs 20-30 years later
122
Q

Ebola Viral Disease (EVD)

mode of transmission

2 types

A
  • zoonotic (contact w/ reservoir species)
  • P2P (via infected bodily fluids)
123
Q

Ebola Viral Disease (EVD)

incubation period

A

2-21 days

124
Q

Ebola Viral Disease (EVD)

stages of sx

A
  1. non-specific febrile illness
  2. 3-5 days into sx
125
Q

Ebola Viral Disease (EVD)

signs/sx of non-specific febrile illness phase

A
  1. fever
  2. headache
  3. dizziness
  4. weakness
  5. fatigue
  6. myalgias
  7. arthalgias
126
Q

Ebola Viral Disease (EVD)

signs/sx within 3-5 days of onset

A
  1. abd pain, n/v/d
  2. beginning of neurologic sx (confusion, slowed cognition, agitation, occasional seizures)
  3. hypovolemic shock
  4. hemorrhagic issues in 1-5% of cases
127
Q

Ebola Viral Disease (EVD)

Dx- testing early on in infection

A
  • antigen elisa test
  • IGM elisa or RT-PCR

if negative, but EVD is still suspected you should retest later

128
Q

Ebola Viral Disease (EVD)

Dx- testing later on in infection

A
  • IgM and IgG serologic testing
    (IgM raises first, followed by IgG)
129
Q

Ebola Viral Disease (EVD)

expected abnormalities on blood work

A
  • thrombocytopenia
  • elevated LFTs
  • coagulopathy
  • elevated creatinine
  • electrolyte abnormalities
130
Q

Ebola Viral Disease (EVD)

Tx

A
  • supportive care
  • IV fluid can decrease mortality rate to < 50%
  • no approved meds
  • native abs persist for at least 10 yrs in survivors
131
Q

Ebola Viral Disease (EVD)

mortality

in endemic areas & in pregnancy

A
  1. 70%
  2. 86%
132
Q

Ebola Viral Disease (EVD)

prevention

A
  • minimize animal contact
  • isolation/contact tracing/IP precautions
  • vax used in endemic areas
133
Q

Arboviruses

come from what vector?

A

mosquitos

134
Q

Arboviruses

4 categories

A
  1. togaviruses
  2. flavivurses
  3. orthobunyaviruses
  4. alphaviruses
135
Q

Arboviruses

examples of togaviruses

mosquitos

A

western/eastern/venezuelan equine encephalitis

136
Q

Arboviruses

examples of flaviviruses

mosquitos

A
  • west nile virus
  • dengue
  • zika
137
Q

Arboviruses

examples of orthobunyaviruses

mosquitos

A

california serogroup of viruses

138
Q

Arboviruses

examples of alphaviruses

mosquitos

A
  • chikungunya
  • mayaro virus
139
Q
A
140
Q

Tick Borne Pathogens

examples of flavivirus

A
  • powassan encephalitis
  • tick-born encephalitis virus
  • colorado tick fever retrovirus
141
Q
A
142
Q

West Nile Virus

seasonality

A
  • outbreaks most often occur mid July to early sept
  • increases with higher temps and rainfall
  • circulates between birds and mosquitos
143
Q

West Nile Virus

mode of transmission

A

P2P only from blood transfusions/organ transplants
vector (mosquitoes)

144
Q

West Nile Virus

incubation period

A

2-14 days

145
Q

West Nile Virus

how many are symptomatic?
what % of those progress to neuroinvasive disease?

A
  1. 10% symptomatic
  2. 10% of those progress to neuroinvasive disease
146
Q

West Nile Virus

sx of neuroinvasive disease

A
  • meningitis
  • encephalitis
  • asymmetric acute flaccid paralysis
147
Q

West Nile Virus

mortality of neuroinvasive disease

A

3-15%

148
Q

West Nile Virus

Typical presentation

A
  • fever
  • altered mental status
  • seizures
  • tremors
  • cranial nerve palsies
  • nonpruritic rash (not always)
149
Q

West Nile Virus

complications

A
  • bronchial pneumonia
  • retinopathy (24%)
  • renal infection
150
Q

West Nile Virus

Issues by age/group:
* young
* middle age
* older adults
* immunocompromised

A
  • young: acute febrile illness, mild neurologic sx
  • middle age: aseptic meningitis, polio like sx
  • older: frank encephalopathy
  • immunocomp: more severe, higher mortality
151
Q

West Nile Virus

Dx

A
  1. IgM for WNV in Serum or CSF (if IgM is in CSF = neuroinvasive)
    or
  2. 4x increase from baseline IgG titer

WBC is typically normal

152
Q

West Nile Virus

Tx

A
  • supportive care, no specific antivirals
153
Q

West Nile Virus

Prognosis

A

mostly good
most fatalities with neuroinvasive disease & sx may persist for at least 6 mo

154
Q

West Nile Virus

prevention

A

mosquito avoidance

155
Q

Dengue

where are bulk of cases?
what do pt’s with dengue usually report?

A
  • 75% of cases occur in Asia
  • travel to endemic area in previous 14 days
156
Q

Dengue

incubation period

A

7-10 days

157
Q

Dengue

Febrile Phase sx

A
  • high fever
  • facial flushing
  • sore throat
  • eye pain
  • malaise
  • arthralgias
  • maculopapular rash

most pts recover and fever resolves by day 8

158
Q

Dengue

Severe Dengue signs & sx

3

A
  • plasma leakage
  • hemorrhage
  • organ involvement
159
Q

Dengue

components of plasma leakage w/ severe dengue

3

A
  • increased liver size
  • vomiting
  • abd pain
160
Q

Dengue

components of hemorrhage with severe dengue

3 things

A
  • ecchymosis
  • GI bleeding
  • epistaxis
161
Q

Dengue

components of organ involvement in severe dengue

A
  • hepatitis
  • encephalitis
  • myocarditis
162
Q

Dengue

Sx of shock

7 things

A
  • LOC
  • hypothermia
  • hypoperfusion
  • metabolic acidosis
  • organ impairment
  • DIC
  • AKI
163
Q

Dengue

Dx

A
  • IgM and IgG Elise after febrile phase
  • IHC for antigen detection from tissue/dried blood
164
Q

Dengue

Complications

A
  • neurologic complications
  • maternal infection = risk of hemorrhage
  • many!
165
Q

Dengue

Tx

A

no known tx

166
Q

Dengue

Prevention

3 things

A
  1. mosquito control
  2. screen blood transfusions in endemic areas
  3. vax approved for endemic areas
167
Q

Erythema Infectiosum (Fifth Disease)

Signs & sx

A
  • often asymptomatic
  • non-specific prodrome sx: low grade fever, coryza, headache, nausea, diarrhea
  • “slapped cheek rash”
168
Q

Erythema Infectiosum (Fifth Disease)

Describe slapped cheek rash

A
  • erythematous malar rash
  • relative circumoral pallor
169
Q

Erythema Infectiosum (Fifth Disease)

when does slapped cheek rash begin? how long does it last?

A

2-5 days after prodrome
fades in 2-4 days

170
Q

Erythema Infectiosum (Fifth Disease)

what does the slapped cheek rash develop into?

A

reticular rash on trunk/extremities

171
Q

Erythema Infectiosum (Fifth Disease)

incubation period

A

14 days

172
Q

Erythema Infectiosum (Fifth Disease)

seasonality

A

winter/spring

173
Q

Erythema Infectiosum (Fifth Disease)

caused by what?

A

parvovirus B19

174
Q

Erythema Infectiosum (Fifth Disease)

Three phases of infectiousness

A
  1. Slapped Cheeck Rash
  2. Erythematous Macules which fade to reticular
  3. Clearing/waning of rash over weeks/months
175
Q

Erythema Infectiosum (Fifth Disease)

Tx

A
  • symptomatic tx
  • immunocomp (HIV): IV IG?
176
Q

Erythema Infectiosum (Fifth Disease)

Notable for Pregnancy

3 things

A
  1. congenital disease
  2. 30-40% of women are seronegative for B19V and susceptible to infection
  3. Can cause spontaneous abortion, anemia, intrauterine fetal death
177
Q

Erythema Infectiosum (Fifth Disease)

Notable for immunocomp people

A

can result in chronic red cell aplasia or anemia

178
Q

Rubeola (Measles)

mode of transmission

A

resp droplets
airborne

179
Q

Rubeola (Measles)

incubation period

A

7-18 days

180
Q

Rubeola (Measles)

When is someone first infectious?

A

4-5 days before & after rash appears

181
Q

Rubeola (Measles)

3 major sx

the 3 C’s

A
  1. cough
  2. Coryza
  3. Monjunctivitis
182
Q

Rubeola (Measles)

signs & sx

5

A
  • fever
  • malaise
  • irritability
  • photophobia
  • koplik spots
183
Q

Rubeola (Measles)

Describe Koplik Spots

A

small, irregular, red with whiteish center on mucous membrane

184
Q

Rubeola (Measles)

Describe rash

visually, distribution, onset

A

maculopapular
begins on face then travels downward & outward
onset 3-4 days after prodrome (marks beginning of exanthem)

185
Q

Rubeola (Measles)

Stages

2

A
  1. prodrome
  2. Exanthem
186
Q

Rubeola (Measles)

Dx

A
  • classic presentation, clinical dx
  • Serum for mealses IgM ab
  • Throat/NP swab, urine for viral culture
187
Q

Rubeola (Measles)

who is this dx unlikely in?

A

vaccinated individuals

188
Q
A
188
Q
A
189
Q

Rubeola (Measles)

Tx

A
  • supportive case
  • isolation for 4 days from onset of rash
  • Infants < 1 y/o receive IM immunoglobin
190
Q

Rubeola (Measles)

Concerns for infection in pregnancy

A
  • not a known teratogenic
  • Associated with spontaneous abortion, premature labor, low birth weight
191
Q

Rubeola (Measles)

Prevention

A

vax

192
Q

Mumps

mode of transmission

A
  • paroxysmal disease
  • respiratory droplets
193
Q

Mumps

incubation period

A

12-25 days

194
Q

Mumps

which age group has worse sx?
which age group is more often infected?

A
  1. adults
  2. children
195
Q

Mumps

signs & sx

A
  • painful, swollen parotid glands
  • facial edema
196
Q

Mumps

what other body parts are impacted in unvax pts?

3 things

A
  1. testes
  2. pancreas
  3. meninges
197
Q

Mumps

Dx

A
  1. clinical diagnosis
  2. Serum IgM
198
Q

Mumps

Tx

A
  1. supportive- usually illness is brief
  2. topical compresses
  3. isolation
199
Q

Rubella

caused by which virus?

A

togavirus

200
Q

Rubella

incubation period

A

14-21 days

201
Q

Rubella

who has a prodrome phase?

A

adults- children do not!

202
Q

Rubella

Sx of prodrome in adults

A
  1. fever
  2. malaise
  3. coryza
203
Q

Rubella

Timing of rash relative to prodrome

A

sx coincide with rash or precede it by up to 5 days

204
Q

Rubella

signs & sx 5 days after initial onset

A

posterior cervical & postauricular lymphadenopathy

205
Q

Rubella

describe rash

visually, duration, onset

A
  • fine, pink, maculopapular
  • 3 days duration
  • spreads face to trunk to extremities over course of 2-3 days
206
Q

Rubella

Dx

A
  • Rubella IgM antibodies elevated/4-fold increase in IgG
  • cannot make dx based on single IgM isolation
207
Q

Rubella

Tx

A

supportive

208
Q

Rubella

Concerns of Congenital Rubella Infection

A
  • hearing loss
  • developmental delay
  • growth retardation
  • cardiac/opthalmic defects
209
Q

Roseola

incubation period

A

9-10 days

210
Q

Roseola

who is most likely to be infected?

A

children under 2

211
Q

Roseola

Signs & sx

A
  1. 3-5 days of high fever that abruptly resolves
  2. Onset of rash after fever resolution
212
Q

Roseola

describe rash

visually, onset, spread

A
  1. morbilliform rash
  2. begins once fever resolves
  3. spreads from neck/trunk to the face/extremities
213
Q

Roseola

Dx

A

clinical

214
Q

Roseola

Tx

A

supportive care

215
Q

HFM Disease

incubation period

A

3-5 days

216
Q

HFM Disease

caused by what virus?

A

enterovirus

217
Q

HFM Disease

where are blisters?

A

hands, feet, mouth hehe

218
Q

HFM Disease

who is usually infected by this? rarely infected? risk of more severe disease?

A
  1. children under age of 10
  2. rarely adults
  3. elderly, immunocomp, pregnant women
219
Q

HFM Disease

Transmission

A

direct contact w/ skin, nasal, oral secretions
fecal contamination

220
Q

HFM Disease

how long is someone infectious?

A
  1. blisters: until dried up
  2. stool: up to a month
221
Q

HFM Disease

seasonality

A

summer/fall

222
Q

HFM Disease

describe rash

A

flat pink patches on dorsal and palmar surfaces of hands & feel which progress to small, gray blisters

223
Q

HFM Disease

describe ulcers in mouth

A

small vesicles
sometimes painful leading to anorexia

224
Q

HFM Disease

describe atypical disease

A

widespread red, crusted papules
no blisters
skin peeling, nail shedding

225
Q

HFM Disease

where are lesions in kids wtih atopic dermatitis?

A

in skin affected by eczema

226
Q

HFM Disease

Dx

A
  • clinical dx
  • labs: elevated WBCs, elevated CRP, atypical lymphs
  • can do skin biopsy of blister or serology from stool
227
Q

HFM Disease

tx

A
  • supportive
  • do not rupture blisters
  • fluids
  • antiseptic mouthwash
  • topical analgesics
228
Q

HFM Disease

Complications

A
  1. dehydration
  2. finger/toe nail changes
  3. serious infection
229
Q

HFM Disease

complications in pregnancy

A
  1. spontaneous abortion
  2. fetal growth restriction
230
Q

Mpox

incubation period

A

13 days

231
Q

Mpox

mode of transmission

A

contact with sores
limited P2P

232
Q

Mpox

signs & sx

A
  1. lymphadenopathy
  2. fever
  3. rash
233
Q

Mpox

dx

A
  • ELISA
  • PCR
  • Viral culture of blisters
234
Q

Mpox

describe rash

A
  • well circumscribed lesions
  • all lesions in same stage of development
235
Q

Mpox

tx

A

no standardized regimen
Cidofovir

CMT (72 decks)

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