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56 Cards in this Set
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What are the general features of viral hemorrhagic fever? (3 general)
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fever, uncontrolled external and internal bleeding, caused by specific RNA viruses
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What are the four families that cause viral hemorrhagic fever (VHF)?
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Bunyaviridae (CA encephalitis, Hantavirus) , Arenaviridae (LCMV, Lassa virus, Machupo virus), Filoviridae (Ebola virus), Flaviviridae (Dengue, St. Louis, Yellow, Hep C). Note just dengue and yellow of flavi can cause VHF.
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Which viral hemorrhagic fever causing virus does this describe:
First identified in two outbrekas in 1976: Zaire Ebola virus (90% fatal), Sudan Ebola virus (50% fatal) Outbreaks mainly occur in Africa, though some in US have occurred in Reston Virginia and Texas due to importation of infected animals. A. Ebola B. Marburg C. Hanta D. Crimean Congo Fever E. Rift Valley Fever F. Lassa |
A. Ebola
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Which viral hemorrhagic fever causing virus does this describe: Onset of illness is abrupt. Includes; Fever, HA, joint and muscle aches, sore throat, weakness. Then diarrhea, vomiting and stomach pain. Sometimes a rash, red eyes, hiccups and internal and external bleeding may be seen in some patients.
A. Ebola B. Marburg C. Hanta D. Crimean Congo Fever E. Rift Valley Fever F. Lassa |
A. Ebola
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Which viral hemorrhagic fever causing virus does this describe:
nset abrupt. HA, high fever, back pain, joint pain, stomach pain, vomiting. Red eyes, flushed face, red throat, petechiae on palate common too. Jaundice and changes in mood and sensory perception is also possible. As illness progresses, large areas of severe bruising, severe nosebleeds and uncontrolled bleeding at injection sites can be seen from 4th day of illness to 2 weeks later. A. Ebola B. Marburg C. Hanta D. Crimean Congo Fever E. Rift Valley Fever F. Lassa |
D. Crimean Congo Fever
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Which viral hemorrhagic fever causing virus does this describe:
Onset abrupt. Intense HA, back and abdominal pain, fever, chills, nausea, blurred vision. Can also have flushed face, inflammation or redness of the eyes, or rash. Later symptoms include: low BP, acute shock, vascular leakage, acute kidney failure. A. Ebola B. Marburg C. Hanta D. Crimean Congo Fever E. Rift Valley Fever F. Lassa |
C. Hanta
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Which viral hemorrhagic fever causing virus does this describe:
Asymptomatic OR mild illness associated with fever and liver abnormalities. Mild fever, generalized weakness, back pain, dizzziness, weight loss at onset. In some patients, illness can progress to hemorrhagic fever, encephalitis, or ocular disease. A. Ebola B. Marburg C. Hanta D. Crimean Congo Fever E. Rift Valley Fever F. Lassa |
E. Rift Valley Fever
The other VHF-causing virus that can be asymptomatic sometimes if Lassa fever virus. |
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Which viral hemorrhagic fever causing virus does this describe:
80% of infections are mild or asymptomatic but remaining 20% have severe multisystem disease. Onset gradual. Mailaise, fever, HA, sore throat, cough, nasuea, vomiting, diarrhea, myalgia, chest and abdominal pain, fever is persistent or spikes. In severe cases, shock, pleural effusion, hemorrhage, seizures, encephalopathy and edema of the face and neck are common. Bleeding occurs from mucous membranes of orifices and renal failure may occur. A. Ebola B. Marburg C. Hanta D. Crimean Congo Fever E. Rift Valley Fever F. Lassa |
F. Lassa
The other VHF-causing virus that can be asymptomatic or mild if not full blown is Rift Valley fever virus |
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Which viral hemorrhagic fever causing virus does this describe:
Greatest prevention measure is rodent control and proper safety measures when cleaning rodent-infested areas. A. Ebola B. Marburg C. Hanta D. Crimean Congo Fever E. Rift Valley Fever F. Lassa |
C. Hanta
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Which viral hemorrhagic fever causing virus does this describe:
Transmission: Ixodid ticks are reservoir and vector, domesticated animals serve as amplifying hosts. Transmission to humans occur through contact with infected animal blood or ticks. Human-human spread via blood or body fluids. A. Ebola B. Marburg C. Hanta D. Crimean Congo Fever E. Rift Valley Fever F. Lassa |
D. Crimean Congo Fever
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Which two Hanta virus strains are associated with more severe symptoms and which two are associated with moderate symptoms?
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Severe: Hantaan and Dobrava
Moderate: Seoul and Puumala |
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What virus does this describe:
Transmission: oral-fecal, close contact. Worldwide, NOT seasonal. Responsible for 5-10% of respiratory diseases in children; 15% of gastoenteritis At particular risk of infection is: Children < 14 y/o , people in crowded areas (students, military) A. Adenoviruses B. Human Papillomavirus C. Polyoma viruses (JC, BK, Merkel cell) D. Variola E. Molluscum Contagiosum |
A. Adenoviruses
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What virus does this describe:
> 150 strains, 15 are classified as high risk for cancer. Most cause benign papillomas or warts. A. Adenoviruses B. Human Papillomavirus C. Polyoma viruses (JC, BK, Merkel cell) D. Variola E. Molluscum Contagiosum |
B. Human Papillomavirus
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What virus does this describe:
Cause mild respiratory infections. Were also discussed in slow viruses lecture as they can result in multifocal leukoencephalopathy, can affect kidneys, and can be a strong causer of a certain carcinoma. A. Adenoviruses B. Human Papillomavirus C. Polyoma viruses (JC, BK, Merkel cell) D. Variola E. Molluscum Contagiosum |
C. Polyoma viruses (JC, BK, Merkel cell)
JC infection: of the brain can result in progressive multifocal leukoencephalopathy, generally fatal. During immunosuppression, BK virus can affect the kidneys. Merkel cell: Detected in 80% of cases of Merkel cell carcinoma, a rare form of skin cancer. |
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What virus does this describe:
Transmission: aerosol, VERY CONTAGIOUS, or through direct contact through skin. Flu-like symptoms, then in 2 days rash on face, arms, legs. Initially flat, then fill lesions with pus. Then crust and scabs fall off. Survivors were very disfigured with scars. A. Adenoviruses B. Human Papillomavirus C. Polyoma viruses (JC, BK, Merkel cell) D. Variola E. Molluscum Contagiosum |
D. Variola (aka SMALLPOX
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What virus does this describe:
benign viral infection of the skin. Common viral infection in children (Type 1) and AIDs patients(Type 2). Appearance of lesions that are firm papules and nodules with central depressions. Core may be expressed, producing white, cheesy material. Usually painless, though may become red and swollen. Prognosis is good as cases are self-limitng. A. Adenoviruses B. Human Papillomavirus C. Polyoma viruses (JC, BK, Merkel cell) D. Variola E. Molluscum Contagiosum |
E. Molluscum Contagiosum
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Which two Hanta virus strains are associated with more severe symptoms and which two are associated with moderate symptoms?
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Severe: Hantaan and Dobrava
Moderate: Seoul and Puumala |
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What virus does this describe:
Transmission: oral-fecal, close contact. Worldwide, NOT seasonal. Responsible for 5-10% of respiratory diseases in children; 15% of gastoenteritis At particular risk of infection is: Children < 14 y/o , people in crowded areas (students, military) A. Adenoviruses B. Human Papillomavirus C. Polyoma viruses (JC, BK, Merkel cell) D. Variola E. Molluscum Contagiosum |
A. Adenoviruses
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What virus does this describe:
> 150 strains, 15 are classified as high risk for cancer. Most cause benign papillomas or warts. A. Adenoviruses B. Human Papillomavirus C. Polyoma viruses (JC, BK, Merkel cell) D. Variola E. Molluscum Contagiosum |
B. Human Papillomavirus
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What virus does this describe:
Cause mild respiratory infections. Were also discussed in slow viruses lecture as they can result in multifocal leukoencephalopathy, can affect kidneys, and can be a strong causer of a certain carcinoma. A. Adenoviruses B. Human Papillomavirus C. Polyoma viruses (JC, BK, Merkel cell) D. Variola E. Molluscum Contagiosum |
C. Polyoma viruses (JC, BK, Merkel cell)
JC infection: of the brain can result in progressive multifocal leukoencephalopathy, generally fatal. During immunosuppression, BK virus can affect the kidneys. Merkel cell: Detected in 80% of cases of Merkel cell carcinoma, a rare form of skin cancer. |
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What virus does this describe:
Transmission: aerosol, VERY CONTAGIOUS, or through direct contact through skin. Flu-like symptoms, then in 2 days rash on face, arms, legs. Initially flat, then fill lesions with pus. Then crust and scabs fall off. Survivors were very disfigured with scars. A. Adenoviruses B. Human Papillomavirus C. Polyoma viruses (JC, BK, Merkel cell) D. Variola E. Molluscum Contagiosum |
D. Variola (aka SMALLPOX
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What virus does this describe:
benign viral infection of the skin. Common viral infection in children (Type 1) and AIDs patients(Type 2). Appearance of lesions that are firm papules and nodules with central depressions. Core may be expressed, producing white, cheesy material. Usually painless, though may become red and swollen. Prognosis is good as cases are self-limitng. A. Adenoviruses B. Human Papillomavirus C. Polyoma viruses (JC, BK, Merkel cell) D. Variola E. Molluscum Contagiosum |
E. Molluscum Contagiosum
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Regarding HPV, differentiate between the various types of warts : common skin warts, butcher warts, plane warts, plantar warts. Detail the HPV type causative of each and where each is stationed.
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1. WARTS: Common skin warts (caused by HPV type 2 or 4) in children and most commonly found on hands and knees, butcher warts (HPV Type 7), plane warts (HPV 3 and 10) are small, flat smooth and numerous common on arms, face and knees of children, plantar warts (HPV Type 1) are painful, deep, endophytic warts found on weight bearing regions of heel and sole of foot.
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Of the various warts one can acquire from HPV, which is painful, deep, endophytic warts found on weight bearing regions of the heel and sole of the foot?
A. Common skin warts (Type 2, 4) B. butcher warts (Type 7) C. Plane warts (Type 3, 10) D. Plantar warts (Type 1) |
D. Plantar warts (Type 1)
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Regarding HPV genital infections, which two HPV types cause 90% of genital papillomas? Most are subclinical and do not present a risk of cancer. Genital warts associated with 70% of cervical cancers are what two HPV types?
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3. GENITAL INFECTIONS: HPV types 6 and 11 cause 90% of genital papillomas. Most are subclinical and do not present a risk of cancer. Genital warts associated with 70% of cervical cancers are HPV types 16 and 18.
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What are the viruses that are the polyoma viruses (3)? What condition do they cause?
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JC virus, BK virus, Merkel cell polyoma virus. Initial infection yields mild respiratory infection. But these viruses are also slow viruses. JC infection of the brain can result in progressive multifocal leukoencephalopathy. BK with immune suppression can have adverse kidney effects. Merkel cell virus is detected in Merkel cell carcinomas, a rare form of skin cancer.
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Name the families and their viruses that belong to the viral hemorrhagic fever designation. (hint: 4 families)
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Filoviruses - Ebola and Marburg
Bunyaviruses - Hanta, Rift Valley, Crimean Congo Arena - Lassa Flaviv - Dengue, Yellow |
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HPV is transmitted via direct contact with abrasions. More specifically where or how are the following acquired:
A. Plantar warts B. Genital warts C. Oral papillomas |
A. Plantar warts - wet floors of public swimming pools and showers
B. Genital warts - sexual intercourse C. Oral papillomas - can be from sexual intercourse |
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Arboviruses are not specific to a family or genus of viruses. They include viruses in which four families?
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the Togaviridae, Flaviviridae, Bunyaviridae and Reoviridae families
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Arboviruses usually present/manifest itself in three different ways. What are they?
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3 major ways these present:
1. Systemic febrile illness: HA, arthralgia, myalgia, rash. Some viruses cause more severe symptoms like jaundice. 2. Neuroinvasive disease: aseptic meningitis, encephalitis, acute flaccid paralysis 3. Hemorrhagic fever |
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Which of the following are arboviral encephalitises of North America?
A. Colorado Tick Fever B. Eastern Equine Encephalitis C. Japanese Encephalitis D. La crosse / CA encephalitis E. Murray Valley Encephalitis F. St. Louis Encephalitis G. Tick-Borne Encephalitis H. Western Equine Encephalitis I. West Nile Encephalitis J. West Nile Virus K. Venezuelan Equine Encephalitis |
NORTH AMERICAN:
A. Colorado Tick Fever B. Eastern Equine Encephalitis D. La crosse / CA encephalitis F. St. Louis Encephalitis H. Western Equine Encephalitis I. West Nile Encephalitis all others are outside of North America |
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Which of the following are arboviral encephalitises OUTSIDE of North America?
A. Colorado Tick Fever B. Eastern Equine Encephalitis C. Japanese Encephalitis D. La crosse / CA encephalitis E. Murray Valley Encephalitis F. St. Louis Encephalitis G. Tick-Borne Encephalitis H. Western Equine Encephalitis I. West Nile Encephalitis J. West Nile Virus K. Venezuelan Equine Encephalitis |
C. Japanese Encephalitis
E. Murray Valley Encephalitis G. Tick-Borne Encephalitis J. West Nile Virus K. Venezuelan Equine Encephalitis all others are within North America |
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Name the six Arboviral encephalitides of North America and the family each belongs to, as well as stem.
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Eastern Equine Encephalitis - Togaviridae family (ssRNA+, linear, icos, enveloped sensitive)
Western Equine Encephalitis - same as Eastern Equine Enceph La Crosse / CA Encephalitis - Bunyaviridae family (-ssNRA, helical, enveloped, sensitive, segmented, circular) West Nile Encephalitis - Flaviviridae family (same stem as Togaviridae) Colorado Tick Fever - Reoviridae (dsRNA+/- , icos, naked, partially resistant) St. Louis Encephalitis - Flaviviridae family (same stem as togaviridae) |
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Which is the most severe and potentially fatal of the North American arboviral encephalitids?
A. Colorado Tick Fever B. Eastern Equine Encephalitis C. Japanese Encephalitis D. La crosse / CA encephalitis E. Murray Valley Encephalitis F. St. Louis Encephalitis G. Tick-Borne Encephalitis H. Western Equine Encephalitis I. West Nile Encephalitis J. West Nile Virus K. Venezuelan Equine Encephalitis |
B. Eastern Equine Encephalitis
Low incidence (3 cases per year), but highly fatal. Occurs mainly along Atlantic Gulf and coasts of US. |
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Match each North American encephalitis to its endemic location:
A. freshwater swamps along Atlantic and Gulf Coast B. reported in all US states, though highest in Gulf and central states. Epidemics occur in both urban and suburban areas clustered where there is groundwater or septic systems. C. Mainly in central and eastern US D. In all contiguous states E. Higher elevation areas of states from central plains to Pacific coast F. contiguous in all states |
A. Eastern Equine Encephalitis
B. St. Louis Enceph C. La Cross / CA Enceph D. Colorado Tick Fever E. West Nile Encephalitis |
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What arboviral encephalitis of North America is described:
Outcome: 2% infected adults, 6% children develop encephalitis. Mortality is 30%. Survivors have frequent neurologic sequelae. Complete recovery is uncommon! |
Eastern Equine Enceph
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What arboviral encephalitis of North America is described: Most patients have self-limited febrile illness. Risk of neuro-invasive infetion increases with age, especially > 60 y/o. Includes aseptic meningitis, encephalitis and flaccid paralysis. Mortality: 9% adults, 1% children. Contiguous in all states.
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West Nile Encephalitis.
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Name the aboviral encephalitis OUTSIDE of North America and the families they belong to. (5)
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Venezuelan Equine Encephalitis - Togaviridae family
Japanese Encephalitis - Flaviviridae family TIck-borne Encephalitis - Flaviviridae West Nile Virus - ? Murray Valley Encephalitis - Flaviviridae |
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Of the Encephalitises in both North America, which is transmitted via Culex mostquitos? Aedes mosquitos? Ticks?
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Culex mosquitoes: a lot - EEE, WEE, St. Louis, West Nile.
Aedes - CA / La Cross Encephalitis Ticks- Colorado Tick Fever and Powassan Virus |
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Which is endemic to Australia, New Guinea, eastern parts of Indonesian archipelago?
A. Venezuelan Equine Encephalitis B. Japanese Encephalitis C. Tick borne Encephalitis West Nile Virus D. Murray Valley Encephalitis |
D. Murray Valley Encephalitis
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Which is the most important cause of global arboviral encephalitis?
A. Venezuelan Equine Encephalitis B. Japanese Encephalitis C. Tick borne Encephalitis West Nile Virus D. Murray Valley Encephalitis |
B. Japanese Encephalitis
Formalin-inactivated vaccine is used internationally. VACCINE RECOMMENDED FOR TRAVELERS TO ENDEMIC COUNTRIES STAYING 1+ MONTH IN RURAL AREAS OR DURING PERIODS OF ENDEMIC TRANSMISSION |
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Which of the arboviral encephalitises OUTSIDE of North America does this describe?
Causes mild febrile illness to frank encephalitis. Can also cause acute flaccid paralysis primarily in children. Outcome: mortality in hospitalized patients is 30%. Acute flaccid paralysis rarely recovers. A. Venezuelan Equine Encephalitis B. Japanese Encephalitis C. Tick borne Encephalitis West Nile Virus D. Murray Valley Encephalitis |
B. Japanese Encephalitis
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What are encephalitis' early symptoms, progressive symptoms and what can eventually occur?
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Typical early symptoms: fever, HA, anorexia, nausea/vomiting, myalgias. Progression to: encephalitis - altered mental status (confusion, disorientation, larthargy), photobia, severe HA
Can progress to seizures and coma. |
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What are encephalitis' early symptoms, progressive symptoms and what can eventually occur?
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Typical early symptoms: fever, HA, anorexia, nausea/vomiting, myalgias. Progression to: encephalitis - altered mental status (confusion, disorientation, larthargy), photobia, severe HA
Can progress to seizures and coma. |
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What are encephalitis' early symptoms, progressive symptoms and what can eventually occur?
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Typical early symptoms: fever, HA, anorexia, nausea/vomiting, myalgias. Progression to: encephalitis - altered mental status (confusion, disorientation, larthargy), photobia, severe HA
Can progress to seizures and coma. |
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How is dengue virus transmitted?
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Transmission: human-mosquito-human cycles via Aedes aegypti mosquitos, which are daytime feeders that prefer to bite humans. These breed in or close to houses and lay eggs in both manmade and natural water containers. Flight distance is relatively short. Thus, spread of siease occurs mainly through viremic humans and follows main lines of transportation.
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Which signifcant arbovirus is transmitted by Aedes aegypti mosquitoes which are unique as daytime feeders preferentially feeding on humans?
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Dengue viruses
Flaviviridae family (ssRNA+, linear, icosahedral, enveloped, sensitive) Transmission: human-mosquito-human cycles via Aedes aegypti mosquitos, which are daytime feeders that prefer to bite humans. These breed in or close to houses and lay eggs in both manmade and natural water containers. Flight distance is relatively short. Thus, spread of siease occurs mainly through viremic humans and follows main lines of transportation. Endemic to tropical South America and Asia |
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What are the 2 clinical syndromes related to dengue fever and where is it endemic to?
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Dengue fever and Dengue hemorrhagic fever.
Endemic to tropical South America and Asia. |
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What condition is described:
Incubation period 7 days. Sudden onset of high fever with frontal or retro-orbital pain. Severe back pain may also precede fever. Then transient generalized rash in first 24-48 hours. Fever remits after 6 days and then recurs in 1-2 days (biphasic fever pattern). Thus: biphasic fever, myalgia, arthralgia, rash , leukopenia, lymphadenopathy. |
Dengue fever.
Dengue fever is self-limited and complete recovery expected. Infection with serotype 3 has been associated with more severe illness. |
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Patient comes in with history of recent travel outside the country. He returned about a week ago. He experienced a fever that lasted a few days and went away but now returned 2 days later. He also has frontal HA and complained of backache and transient rash as well. What does he have?
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Dengue fever!
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True or False:
Dengue hemorrhagic fever (DHF) seems to have an immunopathologic basis - occurs in invidiuals who have had previous dengue infection. |
TRUE
Outcome is that 20-30% of DHF are complicated by dengue hemorrhagic shock syndrome. Mortality is as high as 40-50% if proceeds to DHSS. |
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What arboviral disease is described: Transmission: mosquito-borne viral hemorrhagic fever characterized by hepatic, renal and myocardial injury. Primary transmission includes cycle of monkeys and daytime biting mosquitoes. Can also be human-vector-human. Endemic to South America and
Sub-Saharan Africa. |
Yellow Fever viruses
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Yellow fever viral infection proceeding to hemorrhagic fever is characterized by injury to what three bodily sites?
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hepatic, renal and mycoardial injury!
Subclinical infection, abortive, and life-threatening disease with fever, jaundice, renal failure and hemorrhage. CLASSICAL ILLNESS HAS 3 STAGES: 1. Period of infeciton: viremia present, sudden onset fever, HA, myalgia, anorexia, lumosacral pain, flushing of face, neck 2. Period of remission: fever and symptoms abate/ resolve for 48 hours. Patients with abortive infection recover; 15% will enter third stage. 3. Period of intoxication: viremia resolves and antibodies appear. Return of fever, nausea, vomiting epigastric pain with jaundice, oliguria and hemorrhage. Hepatic and renal dysfunction. Hemorrhage prominent. Myocardial injury and CNS dysfunction sometimes present too. OUTCOME: 20-30% of patients who enter 3rd stage expire. |
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What are the three classical stages of Yellow Fever classical illness?
1. Period of infection 2. Period of remission 3. Period of intoxication |
1. Period of infeciton: viremia present, sudden onset fever, HA, myalgia, anorexia, lumosacral pain, flushing of face, neck
2. Period of remission: fever and symptoms abate/ resolve for 48 hours. Patients with abortive infection recover; 15% will enter third stage. 3. Period of intoxication: viremia resolves and antibodies appear. Return of fever, nausea, vomiting epigastric pain with jaundice, oliguria and hemorrhage. Hepatic and renal dysfunction. Hemorrhage prominent. Myocardial injury and CNS dysfunction sometimes present too. |
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What is the most important arthropod borne virus worldwide?
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Dengue viruses
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What are each of the following "Most important cause" of?
1.Dengue virus 2. Japanese encephalitis 3. Eastern Equine Encephalitis |
1. Dengue virus - MOST IMPORTANT ARTHROPOD BORNE VIRUS WOLDWIDE
2. Japanese Enceph - MOST IMPORTANT GLOBAL CAUSE OF ARBOVIRAL ENCEPHALITIS 3. EEE - MOST SEVERE AND POTENTIALLY FATAL OF THE NORTH AMERICAN ARBOVIRAL ENCEPHALITIDE |
