Viral Infections

Question 1

What does EBV stand for?

Answer 1

Epstein Barr virus

Question 2

What does EBV present as?

Answer 2

Glandular fever

Question 3

Can you detect the core antigen of EBV?

Answer 3

No

Question 4

Do IgG and IgM appear separately or together?

Answer 4

Together

Question 5

When does the IgG nuclear component of EBV present?

Answer 5

Late

Question 6

Causative organism of slapcheek

Answer 6

Parovirus B19

Question 7

When does the rash come in slapcheek?

Answer 7

When virus has settled

Question 8

Consequences of a pregnant lady with slapcheek

Answer 8

Miscarriage

Hydrops fetalis

Question 9

What is hydrops fetalis?

Answer 9

Foetus dies due to aplastic crisis

Question 10

Tests for slapcheek in a pregnant lady

Answer 10

1. IgG for parovirus. If +ve = immune
2. IgM
3. Repeat test at 4 weeks. If IgM -ve, then shouldn’t cause any problems. If IgG is +ve then problem.

Question 11

Who does aplastic crisis occur in?

Answer 11

Predisposed RBC malformed patients e.g. sickle cell

Question 12

Presentation of slap cheek in adults

Answer 12

Rash
Arthralgia (immune reaction)
Malaise
Headache
Aplastic crisis
Chronic anaemia

Question 13

When testing for varicella zoster infection, if you are IgG -ve, what does this mean?

Answer 13

Never had chickenpox before

Question 14

What does VZV result in in pregnancy?

Answer 14

Foetal varicella syndrome

Question 15

Px of foetal varicella syndrome

Answer 15

Microthalmia

Limb hypoplasia

Question 16

When does the infectivity of VZV start and stop?

Answer 16

2 days before rash until crusting over

Question 17

Who is the chickenpox vaccine contraindicated in and why?

Answer 17

Pregnant women

As it is a live vaccine

Question 18

Who gets a vaccine for herpes zoster virus?

Answer 18

> 70 y/os

Question 19

Feature of EBV

Answer 19

Haemolytic anaemia

Question 20

Another name for glandular fever

Answer 20

Infectious mononucleosis

Question 21

What are the cancers that are associated with EBV?

Answer 21

Non Hodgkin’s lymphoma
Burrkits lymphoma
HIV associated CNS lymphomas
Nasopharyngeal carcinomas

Question 22

Features of adenovirus

Answer 22

Fever
Pharyngitis
Conjunctivitis

Question 23

Is there a vaccine against mumps? What is it called?

Answer 23

Yes - MMR vaccine

Question 24

What kind of organism causes mumps?

Answer 24

RNA virus

Question 25

Efficacy of MMR vaccine

Answer 25

80%

Question 26

How is mumps spread?

Answer 26

Droplets

Question 27

Presentation of mumps

Answer 27

Fever Malaise Myalgia Parotitis (pain on eating, earaches - unilateral then bilateral in 70%)

Question 28

Treatment of mumps

Answer 28

Rest | Paracetamol

Question 29

Is mumps a notifiable disease?

Answer 29

Yes

Question 30

Complication of mumps

Answer 30

Orchitis Hearing loss Meningoencephalitis Pancreatitis

Question 31

What is the common cold caused by?

Answer 31

Rhinovirus

Question 32

Common triad of glandular fever

Answer 32

Sore throat Lymphadenopathy (anterior and posterior triangles) Pyrexia

Question 33

How long does infectious mononucleosis take to resolve?

Answer 33

2 - 4 weeks

Question 34

Investigations of infectious mononucleosis

Answer 34

Heterophil antibody test (monospot test) + FBC in 2nd week to confirm diagnosis

Question 35

Treatment of infectious mononucleosis

Answer 35

``` Rest Fluids No alcohol Analgesia No contact sports for 8 weeks to reduce the risk of splenic rupture ```

Question 36

Parvovirus B19 can cause what (as a Cx)?

Answer 36

Red cell aplasia leading to anaemia with a low reticulocyte count

Question 37

99% of patients with infectious mononucleosis who take amoxicillin develop what?

Answer 37

Rash

Question 38

What is the commonest cause of viral encephalitis in the adult population?

Answer 38

HSV

Question 39

What do atypical lymphocytes indicate?

Answer 39

Infectious mononucleosis

Question 40

Renal transplant and infection is most likely caused by what?

Answer 40

CMV