Flashcards in Virus CIS Deck (41):
1
50yo F one day fever, weakness, aches, hurts all over, T 102, WBC 5,900 1% bands
nasal swab influenza A
2
most appropriate initial therapy for influenza
oseltamivir
3
neurominidase inhibitor
oseltamivir
zanamivir
4
mechanism of oseltamivir
neuroanimidase inhibitor
-influenza A and B
-blocks release of virions
5
active against influenza A and B
oseltamivir
6
block release of influenza A only
rimantadine and amantadine
prevents penetration of influenza A - block uncoating of virus
7
benefit of beginning antiviral tx
prevent viral shedding
-within 48 hours
-decrease duration of symptoms 1 - 2 days
8
used with contraindication in asthma/COPD patient
zanamivir
-bronchospasm, decreased pulmonary function
9
side effect of oseltamivir
diarrhea, nausea, vomiting
10
3mo infant, fever, difficulty feeding, nasal discharge, stop breathing when feeding, premature birth and congenital heart disease
respiratory syncytial virus
11
RSV
age < 12 mo
winter season
lower resp tract
12
Tx of RSV
primarily supportive
and possibly bronchodilators - if wheezing
13
ribavirin
inhalation aerosol
nucleoside analog - inhibit RNA and DNA virus replication, inhibit viral protein synthesis
toxic to healthcare workers
only for life-threatening disease
14
palivizumab
monoclonal Ab
-prophylaxis for RSV given monthly
15
52yo M kidney transplant follow up, DMII, elevated serum Cr (normal with kidney transplant)
trimethoprim/sulfamethoxazole (bactrim) - prophylaxis for PCP
pneumocystic jirovecii
immunocompromised patient
16
TMP-SMX
trimethoprim/sulfamethoxazole - prophylaxis for PCP
17
alternative for sulfa given bactrim
atovaquone
dapsone
inhaled pentamidine
18
valganciclovir
prophylaxis for CMV
19
CMV prophylaxis
valganciclovir
20
CMV
most common following solid organ transplant
1-4 months after transplant
highest risk if donor + for CMV in negative recipient
21
34yo M painful rash on left back and chest, pain, burning, tingling
varicella zoster
22
varicella zoster
respiratory droplets
human mucosa and nerves
infected when child with chicken pox
remains dormant in CN ganglia - dorsal ganglia
reactivation - herpes zoster
23
Tx of varicella zoster
acyclovir
oral - shingles
IV - if immunocompromised
24
varicella zoster vaccine
adults > 60yo
live attenuated
not in immunocompromised
-AIDS, HIV, CD4 < 200, anti-tumor necrosis factor
25
virus specific acyclovir
requires viral specific thymidine kinase activation step
inhibits DNA synthesis
26
limitation of acyclovir
low bioavailability
valacyclovir - higher bioavailability - absorbed better
27
varicella zoster tx
onset of rash - within 72 hours
moderate reduction in postherpetic neuralgia
28
9yo M, ER, fever, cough, difficulty breathing, rash started on face and spread downward, T 104, pulse 140, throat small red spots with blue - white centers, blotchy red rash over body, CXR infiltrate
koplik spots
measles
29
koplik spots
blue white centers small red dots - in throat
seen with measles
30
rubeola virus
measle
paramyxovirus
31
spread of rubeola virus
resp droplets
32
3 C of rubeola
measles
cough, coryza, conjunctivitis
33
how long measles infectious
4 days prior to rash until 4 days after onset of rash
34
complications of measles
diarrhea, otitis media, pneumonia
postinfection encephalomyelitis
subacute sclerosing panencephalitis (severe) - years after measles - fatal
35
measles prevention
MMR vaccine
36
16yo M, fever, HA, malaise, facial swelling 3 days, pain in testicles, swollen/tender
mumps
parotitis
aseptic meningitis
orchitis
37
mumps transmission
droplet spread - upper resp secretions
38
55yo M nurse, fever, chills, myalgia, HA, T 100, Sx progress weakness, HA, confusion, SOB, N/V/D, rash, petichiae on legs, liver enzymes elevated, prolonged PT and PTT, fibrin degradation products, multiorgan failure, death
DIC - long PT, PTT, fibrin degradation products
ebola
39
ebola
single-strand RNA virus
-hemorrhagic fever virus
coag defect, cap leak syndrome, shock
begins non-specific flu sx
tx - supportive
-experimental - ZMapp - monoclonal Abs for ebola viral glycoprotein
40
4yo M dyspnea, fever, runny nose, sneezy, cough body aches, severe SOB last couple days, hypoxic, expiratory wheezing, CXR b/l interstitial infiltrates, tx goes home, 2 weeks later flaccid paralysis of lower extremities
DDx - polio, guillane barre, botulism
anterior myelitis on MRI - polio
enterovirus D68
41