Bafl Exam 3: Other Viral

Front 1

Coxsackie A virus is mostly responsible for...

Back 1

A16

HFM Disease

Front 2

Coxsackie B virus is mostly responsible for...

Back 2

myocarditis, pericarditis, meningitis

Front 3

Cause?

Back 3

Coxsackie A and B

painful vesicles and erosions on the soft palate, uvula, tonsils, pharynx, buccal mucosa

Front 4

Progression/characteristics of measles? Incubation period?

Back 4

paramyxoviridae virus

incubation about 2 weeks prior to development of exanthem

3-4 days prior to exanthem, prodrome of cough, coryza, conjunctivitis, photophobia, high fever, malaise, swelling of eyelids

1-2 days prior to exanthem, development of koplik's spots

erythematous macules and papules in a cephalocaudad spread

Front 5

Koplik's spots are pathomneumonic of...

Back 5

measles

Front 6

Forcheimer's spots are pathomneumonic for...

Back 6

Rubella (Togaviridae)

petechial macules on the soft palate

Front 7

Difference between rubeola and rubella?

Back 7

Rubeola --> measles --> paramyxoviridae

Rubella --> German measles --> togaviridae

Rubella has tender LAN and Forcheimer's spots, Rubeola has Koplik's spots

Front 8

Specific complications of Rubella?

Back 8

Arthralgias and arthritis in postpubertal girls, women

Less often- hepatitis, myocarditis, pericarditis, hemolytic anemia, thrombocytopenia, encephalitis

Front 9

Triad of congenital rubella?

Back 9

MC from infection during first 16 weeks of pregnancy, about 20% chance of damage to the fetus

Triad of: cataracts, deafness, congenital heart defects (PDA, VSD)

Front 10

Progression of the exanthem of Erythema Infectiosum?

Back 10

Erythema Infectiosum --> Fifth's Disease

Human parvovirus B19

Parvoviridae (ssDNA)

1. Bright red macular erythema of cheeks (1-4d)

2. Lacy reticular rash on trunk, neck, extensor extremities (7-10d)

3. Periodic recurence of lacy rash with heat, sunlight, activity

Front 11

Complications of Fifths disease?

Back 11

1. Patients with decreased RBC survival time ---> (hemoglobinopathies, hemolytic disease) --> aplastic crisis, prolonged viral shedding

2. Immunocompromised --> severe chronic anemia, viral shedding

3. Pregnant --> fetal infection, anemia, miscarriage/stillbirth, hydrops fetalis (greatest risk of infection acquired before 20 weeks)

Front 12

Human parvovirus B19 structure? Causes what?

Back 12

single stranded DNA

Erythema infectiosum (fifth disease), papular purpuric gloves and socks syndrome

Front 13

Smallpox/variola, cause? Characteristics?

Back 13

Smallpox (variola), d/t orthopoxvirus of poxviridae family

high fever for 1-4 days prior to rash onset, plus malaise, HA, backache, lesions consentrated on face and limbs (somewhat spare trunk)

SYNCHRONOUS LESIONS ie all the lesions are in the same stage of development

Patients are contagious until the last crust falls off

Front 14

What is vaccinia? What is variola?

Back 14

Vaccinia is an orthoposxvirus used as a vaccine for smallpox in humans --> papules at vaccination site --> vesiculates --> crust

Variola is small pox

Front 15

Not only is the smallpox vaccine effective against smallpox, it can also protect against...

Back 15

monkey pox

primarily in Africa (rodents and monkeys)

Front 16

Disease? Who is at risk?

Back 16

Orf (ecthyma contagiosum, sore mouth, scabby mouth)

shepherds, vets, butchers at risk --> typically on hands following contact with infected animal: will get a papule --> nodule --> ulcerates/crusts

Heals in 4-8 weeks

Front 17

this guy is a dairy farmer.

Back 17

Milkers nodule

pseudocowpox

lesions on hands virtually identical to ORF

Front 18

Most common molluscum contagiosum in kids? HIV?

Back 18

Kids: MCV 1

HIV: MCV 2

Front 19

Vector for disease in South America? Phases of disease?

Back 19

Dengue Fever!

Aedes aegypti can also transmit Chikungunya (Africa)

Acute phase- fever 2-7 days, HA, muscle/bone pain, vomiting, epistaxis, gingival bleeding

Critical phase- defervescence, abd pain, vomiting, mucosal bleeding, increase in HCT with decrease in platelets

Convalescent phase- white isles in sea of red, hypervolemia

Front 20

Patient from Caribbean presents with a high fever, gingival bleeding, pulmonary edema

Back 20

Dengue fever

Classic convalescent phase of 'white isles in a sea of red'

Front 21

Clinical presentation of Chikungunya? Vector?

Back 21

Togaviridae, transmitted by aedes aegypti (same as dengue fever)

fever, HA, myalgias, arthralgias, acral edema and erythema, genital ulcers, PIH

Front 22

Diagnosis of Rabies in animals?

Back 22

brain tissue from two locations

Front 23

Skin biopsies looking for rabies should be taken from where?

Back 23

posterior neck

Front 24

Post exposure prophylaxis for rabies?

Back 24

Wound cleaning

RIG

Vaccine (days 1, 3, 7, 14)

Front 25

Forchheimer's spots?

Koplik spots?

Back 25

Forchheimer's spots- petechiae on soft palate in Rubella

Koplik spots- gray-white papules on buccal mucosa in Measles

Front 26

Adjunctive treatment for measles?

Back 26

high dose vit A 200,000 IU x 2, 24 hours apart

Front 27

Pathogenesis of parvovirus?

Back 27

ssDNA

globoside (P antigen) on RBC is the receptor, parvo virus infects them and lyses them

some people lack the P antigen, and thus are not susceptible

Front 28

Diseases related to HHV6?

Back 28

PR

DRESS **

Rosai-Dorfman (sinus histiocytosis with massive lymphadenopathy)

Accelerates progression of HIVv

MS

Chronic fatigue syndrome

Front 29

What is Eczema vaccinatum?

Back 29

Vaccinia (small pox) virus superimposed on dermatitic skin (AD, dariers, nethertons) --> systemic illness with 30-40% mortality rate in untreated patients

Front 30

On the BX of Orf, what is secreted to cause the vascular proliferation?

Back 30

VEGF

Front 31

Dengue fever is also known as 'break bone fever', why?

Back 31

Severe back pain!

remember, Grandpa had this!!

remember, white isles in a sea of red

Front 32

How do we diagnose dengue fever?

Back 32

Lab triad: increased LFT, thrombocytopenia, leukopenia

Will see evidence of plasma leakage, hematocrit will be more than 20% of normal with a more than 20% drop in hct after fluid replacement

positive tourniquet test, petechiae, ecchymoses, purpura, bleeding mucosa

will see white isles in a sea of red

Front 33

Chikungunya fever also has severe myalgias and arthralgias, just like Dengue fever... pathogenesis difference?

Back 33

Chikungunya has actual VIRAL infection of the synovium