Viral infections

Question 1

meningitis (no cutaneous lesions)

Answer 1

varicella zoster (reactivation, shingles)

Question 2

meningitis - young children

Answer 2

parecho virus

Question 3

meningitis - plus or minus parotitis

Answer 3

mumps

Question 4

meningitis enterovirus (Non specific flu like symptoms)

Answer 4

poliovirus

Question 5

meningitis other

Answer 5

HSV 2

Question 6

encephalitis - retrovirus

Answer 6

HIV 1 + 2

Question 7

encephalitis - herpes

Answer 7

vzv
hsv1
hhv6

immunocomprimised
ebv/cmv

Question 8

encephalitis - rare

Answer 8

rabies

Question 9

encephalitis - equine borne, eastern, western, venezualan

Answer 9

togavirus

Question 10

encephalitis - tick borne - west nile and europe

Answer 10

Flavivirus (Japanese B)

Question 11

infection of spinal cord

Answer 11

HIV

Question 12

myelitis and reticulitis

Answer 12

VZV/CMV ( secondary to HIV?)

Question 13

infections of spinal cord, drg and brainstem

Answer 13

poliovirus and HTLV1/2

Question 14

mildest infection

Answer 14

enterovirus (often self limiting)

Question 15

most severe infection

Answer 15

HSV

Question 16

can cause paralytic polio, faecal oral

Answer 16

enterovirus

Question 17

aseptic meningitis caused by…

Answer 17

enterovirus

Question 18

aseptic meningitis due to… (3)

Answer 18

inflamm eg SLE/sarcoid
chronic inflam eg BMT/chemo/agammaglobulinaemia
partially treated bacterial meningitis

Question 19

aseptic meningitis most common in…

Answer 19

under 40s - babies

Question 20

aseptic meningitis features (6)

Answer 20

no altered neuro function
sore throat
nandv
headache
neck stiffness
photophobia

Question 21

aseptic meningitis presentation - neonates (5)

Answer 21

irritable
fever
off food
abnormal LFT
normal CSF

Question 22

aseptic meningitis complication

Answer 22

fulminant multi organ failure

Question 23

CSF changes enterovirus - white cells

Answer 23

very elevated lymphocytes

Question 24

CSF changes enterovirus - protein

Answer 24

0.45-0.9

Question 25

CSF changes glucose enterovirus

Answer 25

1.0-1.7 below serum

Question 26

enterovirus CSF changes could indicate... (3)

Answer 26

tb lymphocytic leukaemia abcess

Question 27

enterovirus management

Answer 27

symptomatic good prognosis may be recurrent if HSV

Question 28

sporadic encephalitis causes (3)

Answer 28

hsv1/2 EBV VZV

Question 29

hsv location

Answer 29

temporal lobe ipsilateral olfactory nerve (unilateral oribtofrontotemporal) diffuse in children

Question 30

cowdry a inclusions (nuclear DNA)

Answer 30

hsv1/2

Question 31

infection in utero/parturition - genital infection shedding

Answer 31

HSV2

Question 32

HSV1 HSV2 which recurrs more often?

Answer 32

HSV2

Question 33

winter and spring sporadic encephalitis

Answer 33

VSV

Question 34

sporadic encephalitis along sensory nerves to ganglia

Answer 34

vsv (shingles)

Question 35

rare respiratory spread of sporadic encephalitis

Answer 35

VZV

Question 36

GBS complication

Answer 36

vzv

Question 37

opthalmalgic trigeminal pain, dysaesthesia before rash, persistent pain

Answer 37

VZV

Question 38

CSF pleocytosis and inc protein

Answer 38

EBV

Question 39

complications of ebv (7)

Answer 39

``` aseptic meningitis encephalitis gbs bells palsy transverse myelitis acute cerebellar syndrome ```

Question 40

lymphoma can develop if immunocomprimised

Answer 40

EBV

Question 41

EBV - easy or difficult to recover?

Answer 41

difficult

Question 42

post infectious encephalitis - rare (5)

Answer 42

measles, mumps, rubella, chickenpox, influenza

Question 43

chronic progressive encephalitis (2)

Answer 43

hiv rabies sspe pml

Question 44

SSPE symptoms

Answer 44

dementia, motor disturbance, cerebellar ataxia, myoclonic jerks, seizures, focal retinopathy

Question 45

SSPE age

Answer 45

7-8y/o (3:1 M:F)

Question 46

PML virus

Answer 46

papovavirus

Question 47

PML pathology

Answer 47

kills oligos, transforms astrocytes, white matter necrosis

Question 48

PML inital infection

Answer 48

GI/resp

Question 49

PML virus found in...

Answer 49

urine and throat

Question 50

PML symptoms

Answer 50

visual, motor, cognitive and speech probs - death in 3-6months

Question 51

PML treatment

Answer 51

no cytosine arabinoside no JCV antigen no serology must restore immunocompetence

Question 52

Epidemic encephalitis characteristics (3)

Answer 52

seasonal tick borne? mosquitoes?

Question 53

detect vzv/hsv by...

Answer 53

pcr

Question 54

detect enterovirus/arbovirus by...

Answer 54

csf

Question 55

CNS SOL manifestations of hiv

Answer 55

toxoplasmosis, lymphoma, PML, tuberculoma

Question 56

CNS diffuse manifestations of hiv

Answer 56

cryptococcal, meningitis, acute infection, dementia

Question 57

sspe virus

Answer 57

measles