viruses

Question 1

HSV lives in the ?

Answer 1

dorsal root ganglion, reactivates with stress, trauma

Question 2

HSV 3 (zoster/Chicken pox) diag?

Answer 2

Clinical - dew drops in different stages of healing. Small pox is all 1 stage of healing

Question 3

How can you tx or prevent varicella?

Answer 3

vaccination, Tx is supportive

Question 4

Dermatome pattern, unilateral

Answer 4

Shingles

Question 5

Trigeminal nerve Dermatome pattern

Answer 5

Herpes Ophthalmicus

Question 6

Hutchinson sign

Answer 6

herpetic lesion to tip of nose

Question 7

After zoster has resolved and has painful neuralgia

Answer 7

Post-herpetic neuralgia - TX: steroids, gabapentin

Question 8

TRIAD: Pharyngitis, posterior lymphadenopathy, fever is?

Answer 8

mononucleosis - Burkitt lymphoma

Question 9

maculopapular/petechial rash (will definitely appear if you treat with amoxicillin –
happens when misdiagnosed as strep throat)

Answer 9

mononucleosis

Question 10

mononucleosis Complications

Answer 10

splenic rupture, pericarditis,

Question 11

mononucleosis Dx

Answer 11

Heterophil antibodies ( false + RPR) T spot, clinical diagnosis

Question 12

mononucleosis tx?

Answer 12

supportive (do not give ASA b/c of concern for Reyes syndrome), No contact sports

Question 13

Cytomegalovirus tx?

Answer 13

Ganciclovir, Foscarnet

Question 14

Severe CMV in what 2 populations?

Answer 14

Congenital (micrcephaly, rash) or HIV (retinitis”pizza pie lesion)

Question 15

Sudden high fevers then days later rash starts as the child is getting better. Rash starts on Trunk and moves to head and neck

Answer 15

Roseola/“Sixth disease” “Exanthem subitum”

Question 16

What do you not give Roseola?

Answer 16

No ASA, give tylenol

Question 17

congenital rubella lead to what 3 things?

Answer 17

Microcephaly
PDA (patent ductus arteriosus)
Cataracts

Question 18

Fever, cough, coryza, conjunctivitis
● Koplik spots (not always seen)
● Rash starts on head and spreads
● Rash “stains” (turns brown)

Answer 18

Measles - rash from head and M spreads

Question 19

Parvo B19 causes

Answer 19

Erythema Infectiosum:“Fifth Disease” Slap cheek

Question 20

Genetic drift and shift leads to mutation in what virus?

Answer 20

Flu - shift is more violent and major mutations

Question 21

Sudden onset fever, sore throat, headache, myalgias, nonproductive cough

Answer 21

flu

Question 22

Most common cause of death is secondary pneumonia (often staph)

Answer 22

flu - secondary pneumonia

Question 23

Flu tx?

Answer 23

oseltamivir, zanamivir <48 hrs/

Question 24

Pain/paresthesia at site, restless, seizures, thick saliva - dog,bats, foxes, raccons, coyotes

Answer 24

Rabies

Question 25

does Rabies have hydrophobia?

Answer 25

yes

Question 26

if bitten what do you do?

Answer 26

post-ex vax with rabies immunoglobulin. & HDCV (4 days)

Question 27

Cauliflower, genital warts is? Tx/

Answer 27

HPV. Gardesil 9

Question 28

retrovirus that requires reverse transcriptase

Answer 28

HIV

Question 29

Macrophages serve as reservoir of virus

Answer 29

HIV

Question 30

HIV <200 CD4

Answer 30

AIDS dementia, PCP, HIV encephalopathy, candida

Question 31

HIV <100 CD4

Answer 31

toxo, histo, cryto, cocci

Question 32

HIV <50 CD4

Answer 32

PML, MAC, CMV

Question 33

SE of NRTI?

Answer 33

peripheral neurpathy, hepatits, rash

Question 34

SE of NNRTI

Answer 34

Rash

Question 35

Post-exposure prophylaxis i shoudl be given within ?

Answer 35

72 hours

Question 36

HIV infection at any time?

Answer 36

TB, Zoster, Kaposis

Question 37

``` oxacillin minimum inhibitory concentration (MIC) ≥ 4 µg/mL is what bacteria ```

Answer 37

MRSA

Question 38

prolonged hospitalization, admission to ICU or nursing home, recent antibiotic use can lead to?

Answer 38

MRSA

Question 39

Necrotizing pneumonia following influenza infection is due to?

Answer 39

MRSA

Question 40

MRSA Diag?

Answer 40

gram stain, PCR

Question 41

MRSA tx?

Answer 41

Bactrum, Clinda - Oral | Vanco, Daptomycin - IV

Question 42

flavivirus, in CSF, Blood, Urine, Semen

Answer 42

Zika

Question 43

S/Sx: acute onset low-grade fever, maculopapular pruritic rash, arthralgia & conjunctivitis; fetal loss may occur during pregnancy

Answer 43

Zika;

Question 44

Zika Dx

Answer 44

NAT

Question 45

Zika Tx

Answer 45

symptomatic, Prevention: mosquito protection

Question 46

congenital Zika syndrome

Answer 46

microcephaly, facial disproportion, irritability, hypertonia/spasticity, hyperreflexia, seizures, sensorineural hearing loss, limb & ocular

Question 47

Most common pathogens isolated are gram-positive bacteria. multiple organ dysfunction syndrome & death

Answer 47

SIRS/Sepsis

Question 48

Risk Factors: ICU admission, nosocomial infection, bacteremia, ↑ age, immunosuppression, previous hospitalization, CAP

Answer 48

SIRS/Sepsis

Question 49

hypotension, tachycardia, | tachypnea, fever, leukocytosis, left shift, organ dysfunction

Answer 49

Sepsis

Question 50

requirement of vasopressors despite adequate fluid resuscitation, ↑ LACTATE, multiple organ dysfunction syndrome

Answer 50

Sepsis

Question 51

Sepsis tx?

Answer 51

aggressive fluid resuscitation, vasopressor agents

Question 52

Septic shock needs vasopressor despite IVF.

Answer 52

Yes