Viruses Flashcards by Seth LaPorte

Name all the members of the picornavirus family and their shared characteristics

Shared features:

Positive sense, Replicate in cytoplasm, Form large polyportein product activated by cleavage into smaller segments
Naked; Acid-stable; Fecal-oral transmission

Members: Hep A, Rhinovirus, Polio, Coxacki A & B

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This virus is most known for causing acute viral hepatitis (vomiting, pain, fever, nausea, & RUQ pain). It can cause aversion to smoking tobacco and has no chronic state.

Hepatitis A

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This is the cause of the common cold. It’s transmission is respiratory inhalation and is acid labile (both unlike the other picornaviruses)

Rhinovirus

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Young patient presents with generalized flu symptoms and has started to develop asymmetric paralysis in the lower legs that seems to be ascending. The problem apepars to be in the anterior horn and LMN cell bodies. What agent causes this?

Polio

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Patient comes in with a red vesicular rash on his hands, feet, and mouth. Labs show no bacteria or fungal infection, and it is the middle of July. What is the most likely culprit?

Coxsackie A virus

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A patient presents with extremely sharp pain in one side of his chest that makes it difficult to breathe. X ray shows a dilated heart. Labs show no bacteria or fungal infection. What is most likely diagnosis?

Coxsackie B virus –> causes “The Devil’s Grip” (aka: Bornholm’s disease / Pleurodynia)

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A 30 year old male presents with explosive watery diarrhea. HPI shows he just got home from a cruise. Labs show no bacteria or fungal infection. What is most likely diagnosis?

Norovirus –> most common cause of viral gastroenteritis & is 90% of all cruise outbreaks

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What are the members of the Flavivirus family and what are their shared characteristics?

Shared features: Enveloped; Non-segmented ssRNA viruses
-Transmission: Aedes Egyptei Mosquito (except Hep C)

Members: Dengue virus, Yellow Fever virus, West Nile virus, & Hep C

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Pt in Africa presents with fever, headache, and intense muscle & joint pains. Serology shoes thrombocytopenia & Pt is at bleeding risk. Labs show no bacteria or fungal infection. What is most likely diagnosis?

Dengue virus

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Pt in Africa presents with jaundice, backache, bloody stool, and bloody vomit. Labs show no bacteria or fungal infection. What is most likely diagnosis?

Yellow Fever virus

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Pt in Africa presents with neurologic symptoms due to encephalitis. He also has myelitis with resulting flaccid paralysis & meningitis. Labs show no bacteria or fungal infection. What is most likely diagnosis?

West Nile virus

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An IV drug user presents with with jaundice and RUQ pain. Serology shows increased ALT and liver enzymes and biopsy shows high level of lymphocytes in portal tract. What is the most likely diagnosis and what is this patient at risk for in the future?

Pt has Hep C (80% of cases go chronic) –> has chance of hepatocellular carcinoma

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A 5 year old presents with a maculopapular rash that starts on the face and spreads down the body; the spots do not darken or coalesce (combine). Physical exam also shows fever w/ postauricular and occipital lymphadenopathy. Labs show no bacteria or fungal infection. What is most likely diagnosis?

Rubella

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What is the triad of congenital Rubella?

Cataracts + Sensory-neural deafness + Patent ductus arteriosis

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Patient presents with acute bronchitis, fever, myalgia, lethargy, cough, and sore throat. Labs show no bacteria or fungal infection. Serum shows a virus with a helical shaped capsule. What is most likely diagnosis?

Coronavirus –> SARS (Severe acute respiratory syndrome)

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This virus causes influenza (the “flu”). CSF shows high protein with low WBC count (albumino-cytologic dissociation). Name the virus and its unique feature of replication, the 3 important virulence factors, and the 2 most important clinical associations.

Orthomyxovirus –> only RNA virus that replicates in nucleus
Hemagluttinin (HA): binds sialic acid & causes RBC clumping
- Neurominidase (NA): cleaves sialic acids
- M2 protein: creates pH for viral uncoating
Pneumonia (staph. aureus especially)
- Guillain-Barre Syndrome (ascending paralysis)

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If a child is suspected to have a viral infection with Orthomyxovirus, what is a primary medication contraindication and resulting risk factor?

Aspirin –> can cause Reye’s syndrome (life-threatening encephalitis + liver failure)

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A 5 year old presents with cough, a runny nose, itchy/inflamed eyes, and a rash on the face that includes the inside of the mouth & is spreading down the rest of the body. Tissue sample shows giant cells with red inclusion bodies (Warthin-Finkledey cells). Labs show no bacteria or fungal infection. What is most likely diagnosis and what is an unexpected nutrient that can treat this?

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Measles –> Vitamin A helps decrease symptoms

Remember the 4 C’s: cough, coryza (runny/stuffy nose), conjuctivitis, Koplik spots (blue-white spots w/ red background of buccal mucosa / inner cheek)
SSPE (Subacute sclerosing panencephalitis) is a future complication

A 5 year old has puffy face due to inflamed parotid gland, painful inflamed testicals (orchitis) and CNS symptoms of meningitis. What is the diagnosis?

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Mumps

A 2 month old infant is brought in with bronchiolitis, pneumonia, rhinitis (stuffy nose), and pharyngitis. Labs show no bacteria or fungal infection. What is most likely diagnosis?

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RSV (respiratory syncytial virus)

–#1 cause of pneumonia and BRONCHIOLitis in infants less than 6 months of age

Dude got bit by a bat and you’re scared of infection from ____ virus, which causes ____. His future symptoms could involve fever, encephalitis, and foaming at the mouth, as well as having an aversion to drinking fluids. This virus has a ____ shaped envelope and shows cytplasmic bodies called ____.

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Rhabdovirus –> causes Rabies

Has bullet-shaped envelope
Shows cytoplasmic Negri bodies in brain cells

What are the segmented viruses?

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BOAR - Bunyavirus, Orthomyxovirus, Arenavirus, & Reovirus

Patient visited Africa and developed fever with petechial rash. Within days, his fever progressed to hemorrhagic fever & he underwent hypovolemic shock and died. Serology showed a virus with a helical shaped capsid. Labs show no bacteria or fungal infection. What is most likely diagnosis?

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Ebola virus or Marburg virus

Patient presents with pulmonary edema due to capillary leak & pre-renal azotemia (high lvls of nitrogen waste products in blood). Serology shows a segmented virus with 3 segments and appears to be rodent-borne. What is the diagnosis?

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Hanta virus

Patient was bit by an Aedes Mosquito and developed myalgias, fever, & neurological problems including seizure and encephalitis. Labs show no bacteria or fungal infection and a segmented virus. What is most likely diagnosis?

Arboviruses of the Bunyavirus family --> Rift Valley Fever / California Encephalitis

What are the members of the Reovirus family and why are they unique viruses?

Rotavirus & Colorado Tick Virus | --They are dsRNA viruses

Infant is brought in due to explosive watery diarrhea. Serology shows a segmented virus and NSP4 toxin; it is also middle of the winter time. Labs show no bacteria or fungal infection. What is most likely diagnosis?

Rotavirus -- #1 cause of severe diarrhea in infants and young children

Hiker comes in after being bit by a dermacentor tick. He has fever, vomiting, and myalgias but no rash on physical inspection. Labs show no bacteria or fungal infection. What is most likely diagnosis? What does the vaccine for this bug increase risk for?

Colorado Tick Virus --Vaccine increases risk of intussusception in children

Name the DNA viruses and their shared features

Shared features: Replicate in nucleus (Except Pox virus & Hep B) Members: Herpes family (HSV, Varicella zoster, EBV, CMV, Roseola, HHV-8) - Polyomavirus - HPV - Parvovirus B19 - Adenovirus - Poxvirus family - Hep B

This bug is known for causing "cold sores" and is the #1 cause of sporadic encephalitis in the US. It has a characteristic appearance of ___________, which is called ____ when these appear on the finger.

HSV 1 - Has "dew drops on a rose petal" appearance (clear vesicles atop erythematous base) - -On finger is called Herpetic whitlow (common in dentists)

EBV /HHV-4 (Mono) causes fever, posterior cervical lymphadenopathy, pharyngitis (only in teens/adults), tonsillar exudates, and lethargy/malaise for 7+ days. It should show ____ cells on blood smear. It also predisposes the patient to 3 types of cancers. Name them

Shows Reactive CD8 CTLs (Downey / atypical cells) * Two are B cell lymphomas 1. Mixed cell Hodgkins lymphomas -- shows owl's eye Reed-Sternberg cells 2. Burkitt's lymphoma -- presents with large jaw lesion and swelling 3. Nasopharyngeal carcinoma (in ppl of Asian ancestry)

This virus is the #1 cause of congenital viral infection, MR from congenital infection, & sensorineural hearing loss in children. It shows Owl's eye inclusion bodies and has a negative monospot test.

Cytomegalovirus/CMV (HHV-5)

In AIDS patients, this virus can cause a particular esophagitis with singular, deep ulcerations in the esophagus. It can also cause full thickness retinal necrosis called "pizza pie retinopathy"

CMV

What is the symptom spectrum of congenital CMV?

- Blueberry muffin rash due to thrombocytopenia - Hepatosplenomegaly jaundice - Sensorineural deafnes - Brain abnormalities: periventricular & intraventricular calicifications causing MR & seizures

A 1 year old is brought in after having a very high fever of 104 F that lasted for 4 days and had a seizure. After the fever, the Pt developed a diffuse macular body rash with a lacy appearance that does not affect the face. Labs show no bacteria or fungal infection. What is most likely diagnosis?

Roseola (HHV-6 / "The Sixth Disease")

Patient presents with violet-colored lesions on nose, extremities, and mucous membrains (especially on the hard palate). Labs show no bacteria or fungal infection. What is most likely diagnosis and mechanism of the bug? What does this predispose the patient to?

HHV-8 --> causes dysregulation of VEGF & causes angiogenesis It predisposes people to developing Kaposi's sarcoma

40 y/o HIV+ male presents with weakness, visual changes, & worsening difficulty with speech. His CD count is

JC virus (John Cunninham virus)

50 y/o Pt has fever and gross hematuria w/ bladder pain. PSH shows he had a renal transplant. Labs show no bacteria or fungal infection. What is most likely diagnosis?

BK virus --Remember: Adenovirus has same symptoms but that's in children that go swimming

What are the pathological serotypes of HPV and what do they cause? What are the virulence factors and signs of these?

HPV 6 & 11 --> cause laryngeal papillomatosis (airway tumors) & Anogenital warts (Condyloma acuminata) HPV 16 & 18 --> cause Anogenitcal CANCERS (#1 cause of cervical and anal squamous cell carcinomas) - Cervical cancer buzzword: post-coital bleeding - Koilocytes (large dense wrinkled nucleus) cells on Pap Smear Virulence factors: E6 (binds p53) & E7 (bind RB) -Bypass the G1-S checkpoint of cell cycle

Child presents with a rash prominent on both cheeks of his face that is starting to progress to a lacy reticular pattern down the body. This was preceded by a low grade fever that lasted about a week. Serology shows a single stranded DNA virus. What is the infectious agent and disease?

Parvovirus B19 --> causes Slapped-cheek Disease (aka Fifth Disease / Erythema Infectiosum)

A school teacher presents with joint pain, arthritis, and generalized edema. She claimed to be healthy until recently and noted that a few of her students had a facial rash. Labs show no bacteria or fungal infection. What is most likely diagnosis?

Parvovirus B19 --> this is adult presentation

An 8 year old child who frequently visits the local pool presents with swollen tonsils, conjunctivitis, and gross hematuria. Labs show no bacteria or fungal infection. What is most likely diagnosis?

Adenovirus

``` What do the following markers stand for in Hep B? ALT vs AST HbSAg: HBeAg: Anti-HBc: Anti-HBe: Anti-HBs: ```

ALT > AST HBsAg: surface antigen; shows if there is an active infection or not --Required for co-infection of Hep D HBeAg: shows infectivity / if a person is contagious Anti-HBc: this is + during window period Anti-HBe: shows low infectivity Anti-HBs: indicates recovery (person does not have infection)

Child comes in with barking cough and inspiratory stridor. X ray show a Steeple sign. Lab tests come back negative for bacterial and fungal culture. What does this kid have?

Parainfluenza virus --> causes Croup (Laryngotracheobronchitis)

Viruses Flashcards

(44 cards)