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33 Cards in this Set

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What are three ways damage can occur for congenital diseases?
1. Cytopathic effect (CPE)
- direct infection of cells interfere with normal development (e.g. - Rubella)

2. Inflammatory reaction
(e.g.-CMV, toxoplasmosis)

3. Placental infection resulting in placental insufficiencies.
What does TORCHS stand for?
Toxoplasmosis gondii

Other (HIV, HepB, VZV, entero..)

Rubella virus

CMV

Herpes Simplex virus

Syphillis (Treponema pallidum)
CMV:

- family
- major cause of?
- symptoms? x2
Herpesviridae

Congenital defects

90% asymptomatic at birth,
but 20% develop signs later

10% of infected newborns have CMV-related symptoms at birth
(4000/yr)
CMV -> Common defects x8
Jaundice
Mental Retardation
Deafness
Microencephaly
Anemia
Thrombocytopenia
Chorio-retinitis
Hepatosplenomegaly
CMV:

- Diagnose x2
PCR

Grow virus in cell culture
(combined with immunofluorescence for early antigens in 2 days)
(4-6 weeks for CPE to develop)
HSV:

- Usually what type for congenital infections?

- prevalence for congenital infection?

- prevalence for natal/neonatal infection

- Transmission?
HSV-2

1 in 200,000

>1 in 5,000

Transplacental or ascending
Congenital diseases associated with HSV-2. x4
Undeveloped cellular immune response

Skin, eye, mouth infection

Encephalitis
(50% dies)

Disseminated infection
(multi-organ disease)
(80% have vesicular rash)
(80% die if untreated)
HSV-2:

- Diagnosis x3
Detect DNA in TISSUE sample
(PCR, Hybridization)

Isolate virus

Detect viral antigen
(immunofluorescence, immnuohistochemistry)
HIV:

- transmission x2
- type of infection?
- symptoms x3
In utero
Mother milk

Chronic

Encephalopathy
Lymphadenopathy
Failure to thrive
What are the outcomes to Parvovirus B19? x5
Erythema infectiosum - fifth's dz
(RASH - slapped cheek appearance)

Arthropathy
(in females, hands and wrists)

Aplastic crisis
(due to block in erythropoiesis)

Fetal loss
(due to infection of pregnant women)

No birth defects
Parvovirus B19:

- transmission:
Respiratory
Parvovirus B19:

- how does it spread?
- starting from when?
- spread in what?
Viremia

Day 7

Erythroid precursors
Parvovirus B19:

- What happens 2wks post infection in children?

- What happens 2wks post infection in women?

- What happens to mothers that become infected?
Rash to face, then to trunk, then to limbs

Arthropathy to hands / wrists

In 4-6 weeks, fetal loss (fetal hydrops), with no defects.
Toxoplasmosis:

- organism name?
- organism type?
- host?
- symptoms?
Toxoplasma gondii

Obligate intracellular sporozoan

CAT

Asymptomatic in immunocompetent patients.
Toxoplasmosis:

- transmission x3
Oocysts via CAT fecal/oral

Cysts via poorly cooked meat

Asexual tachyzoite in congenital from acutely infected mother.
How can you reduce the congenital infection of toxoplasmosis by 60%?
Treat mother
What would you see clinically in severe cases of Toxoplasmosis gondii? x5
Hydorcephaly
Encephalitis

Pneumonitis
Psychomotor retardation

Chorioretinitis
Lab Dx for toxoplasmosis gondii. x4
PCR
IgM
EIA - 4x rise in IgG
Wright or Giemsa stain lymph tissue shows trophozoite
Toxoplasmosis treatment? x2
Pyrimethamine + Sulfadiazine
Herpes and VSV have what common rash associated with them?

What families do they belong to?
Vesicular Exanthema

Both Alphaherpesvirinae
Acantholysis:

- define:
- caused by:
Disruption of
intracellular j(x)
btw
epidermal keratinocytes

Lysis of cellular cement substance, leading to degeneration.
T/F - You can notice acantholysis in Mid stage of HSV-1 only.
False. You can see acantholysis in mid and full stage of HSV-1.
What is the general manifestion of HSV skin infections called?

- in patients with associated condition?

- describe lesions
Eczema herpeticum

with underlying atopic dermatitis

can be localized or disseminated.
What is herpetic whitlow?

- responsible virus?
- symptoms x3
- location
- duration with symptoms
- prognosis?
HSV infection of the digits

HIV-1 (sometime HIV-2)

Pain, itching, then deep vesicle

Usually at terminus of 1 digit

10 day process with constant pain

After 10 days, lesion dries up, pain subsides.
VZV vesicular exanthems

- type/progression of lesions

- Herpes zoster distribution is mostly where?
Umbilicated, eliptical early lesion

Mulitiple stages or "crops" of lesions appear simultaneously

Thoracic distribution
Genital HSV infections display what type of skin lesion?
Ulcers
HSV-2 infections usually occur after what major life event?
Sexual maturity
HSV-2:

- probability of transmission with # of sexual partner
- # of cases per year
- What is the significant source of transmission?
- When does the virus shed?
- What is the largest reservoir of HSV-2?
1P -> 10%
2-10P -> 40%
>10P -> 62%

40-60M

Asymptomatic shedding

During primary & recurrent infections, with or without symptoms

Recurrent genital infections
Bulla(e) is associated with:

- what disease
- what virus
- lesions initially where
- lesion progression?
- associated symptoms x2
- prognosis
Hand-foot-mouth disease

Coxsackievirus A16

In the mouth

In one day, will move to hand palms and foot soles.

Painful lesions
Mildly febrile

Subsides in a few days.
Petechia(e) is what kind of lesion?

- Name three viruses that cause this.
Hemorrhagic lesion

Rickettsia Rickettsii
(Rocky Mountain spotted fever)

Ebola virus

Dengue virus
During Meningococcal sepsis, what skin lesions would you expect to see?
Ecchymoses
Poxviridae is associated with what type of skin lesion?
Nodules
Poxviridae:

- List two skin lesion diseases
- Compare the two in terms of symptoms, durations, and prognosis
PSEUDOCOWPOX (Milker's nodule)

Papular lesions on hand & fingers
Increase in size over 1-2 weeks
Painless with NO vesiculation
Heals without scars

MOLLUSCUM CONTAGIOSUM

Painless, but may be itchy
Appears alone or in groups,
anywhere on body
Regress within 6 to 12 months