Virology

Question 1

What reasons would you have to order lab tests?

Answer 1

O diagnosis
O screening
O Monitoring
O research

Question 2

What are some pre-analytical errors that can occur?

Answer 2

O mislabelled sample
O incorrect test tube used
O pt ID incorrect
O form not completed properly
O test request lost
O incorrect test ordered
O sample collection error
O transport error
O incorrect sample handling

Question 3

What tests are used in the virology lab?

Answer 3

Oserology- antibody testing
O molecular - (pcr, Elisa)

Question 4

What viruses are common in the prenatal period? (LIST 6)

Answer 4

O CMV
O parvovirus b19
O rubella
O hsv
O HIV
O EBV
O hepatitis b+c
o varicella zoster
O zika virus

Question 5

What viruses are common in the perinatal/postnatal period? (List 6)

Answer 5

O HIV
Ohsv
O CMV
Oenterovirus
O Varicella zoster
O hepatitis b+c
o adenovirus

Question 6

What viruses are common in the postnatal period? (List 5)

Answer 6

O enterovirus
O rotavirus
O CMV
O varicella zoster
O hepatitis
O influenza
O adenovirus

Question 7

How do you determine what sample to take to isolate the virus?

Answer 7

Falco-oral transmission = stool
Resp droplets = vesicle fluid
Vertical = blood

Question 8

Specimen + test for HSV

Answer 8

O vesicle fluid
O CSF
= HSV PCR

Question 9

Enterovirus specimen and test?

Answer 9

O throat swab / stool
= Enterovirus PCR

Question 10

Varicella zoster specimen + test?

Answer 10

O vesicle fluid /blood / clinically
=Varicella zoster PCR
= blood = Igm

Question 11

What type of rash is in picture 2?

Answer 11

Maculapapular

Question 12

What type of rash is in picture 3?

Answer 12

Vesicular

Question 13

What type of rash is in picture 4?

Answer 13

Pustules

Question 14

What type of rash is in picture 5?

Answer 14

Bulla

Question 15

What type of rash is in picture 6?

Answer 15

Nodules

Question 16

Measles presentation, specimen, + test

Answer 16

O presentation
> koplik spots
> maculopapular rash
> 3 C’s = conjunctivitis, cough, coryza
O specimen = blood, throat swab within 5 days of rash
O serology = IgM/G
Swab = PCR

Question 17

Complications of measles

Answer 17

O Otitis media
O diarrhoea
O pneumonia
O encephalitis

Question 18

Measles treatment +prevention

Answer 18

O vaccine 6 + 12 months
O treatment = supportive (vit A)

Question 19

Rubella sx, specimen + test

Answer 19

O sx
> maculopopular rash
> many asymptomatic
O specimen
>blood = IgG/M (older)
> throat swab = PCR (congenital)

Question 20

Complications of congenital rubella

Answer 20

O miscarriage
O congenital rubella syndrome ( healing loss, heart defects, glaucoma cataracts )
O abnormal fetal growth

Question 21

HHV 6/7 sx, specimen, test

Answer 21

① fever without rash
② rash without fever

Specimen = clinical/blood (IgG/M or PCR)

Question 22

Parvovirus sx, specimen, test

Answer 22

Sx
O slapped cheeks malar rash
O trunk maculopapular rash

Specimen = blood (IgG/M or PCR)

Question 23

Mumps sx, specimen, test

Answer 23

Swelling of the parotid gland (parotomegaly)
Specimen = blood/ buccal swab (IgG/M or PCR)

Question 24

CNS viruses, specimen + test

Answer 24

Enterovirus, Mumps, HSV 1, rabies -“ panel” done which screens for all ( CNS viral)
All CSF = PCR
Except rabies ( saliva = PCR )

Question 25

Polio specimen + test

Answer 25

O 2 stool,s 2 days apart within 2 weeks of sx =PCR and cell culture

Question 26

What is pathognemonic of HSV infection

Answer 26

Dendritic ocular ulcer

Question 27

Resp viruses, specimen + test

Answer 27

Nasopharyngeal swab →PCR

Question 28

HIV diagnosis protocol

Answer 28

O > 24months = serology (ELISA) → antibodies x2 + tests
O <24 months = HIV PCR (antibodies may be from mom) → x2 + tests

• exception = 18 - 24m: screen first with serology, lf positive, confirm with PCR

Injury on duty = serology
HIV = own test tube

Question 29

How is covid-19 transmitted ?

Answer 29

O resp droplets > 5 micrometers, travel < 1m
O direct contact
O indirect contact

Question 30

Complications of SARS COVID-19 ?

Answer 30

Pneumonia
ARDS
Septic shock
Acute kidney injury
Death

Question 31

Risk factors for covid-19 complications

Answer 31

O hypertension
O older age
O diabetes
O obesity
O COPD
O cardiovascular disease
O malignancy

Question 32

Drugs used for covid19 treatment

Answer 32

① dexamethasone (steroid)
②antivirals
> protease inhibitors - paxlovid
> nucleoside analogues - remdesivir
> monoclonal antibodies - sotrovimab ( strain variant specific)

Question 33

What is the 90 -90 - 90 target?

Answer 33

① 90% of HIV + pt will know their diagnosis
② 90% of HIV pt have access to treatment
③ 90% of already diagnosed on treatment will have VL LDL

Question 34

What does me “test and treat” HIV guideline say?

Answer 34

Treatment will be initiated after confirmation of HIV infection (regardless of CD4 count level)

• crypococcus + Tb meningitis = defer tx 4-6 weeks

Question 35

What is the 1st line HIV regimen?

Answer 35

3TC + TDF + DTG ( >35kg +>10y)
Lamivudine + Tenofavir + dolutegravir

Question 36

How do you know when 1st line ARV’s are failing?

Answer 36

Vl >1000 for 3 months with compliant patient

Question 37

ARV side effects

Answer 37

O git → diarrhoea, nausea
O rash
O neuro → dizziness, headaches, vertigo
O weight gain

Question 38

Which hepatitis lead to chronicity and what does it lead to?

Answer 38

Hep b+c
> cirrhosis
> liver ca
> liver failure

Question 39

What test do you do for hep B?

Answer 39

O acute
anti-HBs
HBsAg

O chronic
HBsAg
Total anti-HBc

Question 40

HBV treatment

Answer 40

Tenofevir
Lamivudine

Question 41

What is gold standard of HCV active infection?

Answer 41

Detection of HCV RNA

Question 42

HCV treatment

Answer 42

O pegylated interferon and ribavirin = standard

Question 43

What is the polio vaccine called?

Answer 43

OPV ( oral )

Question 44

Hpv vaccine

Answer 44

Gardasil (9 - 26y)