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35 Cards in this Set

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classification and spread of rubella?
togaviridae in genus rubivirus, only one in the family not spread by mosquito, human is the only natural host
tissues infected?
all kinds - pantropic
describe postnatal rubella
sx begin with lymphadenopathy, then prodrome of flu like with sore throat and coryza, then faint maculopapular exanthem on face or trunk, lasts 3 days and note it may not appear at all. complications are polyarthritis and arthralgia, rare encephalitis by 7 days, pt is infectious before prodrome until 14 days after rash (2 weeks before and 2 weeks after). IgM is diagnostic, immunity is permanent. infection may be asymptomatic, symptomatic Rx, very low mortality, reinfection produces no viremia thus no hazard to fetus if mom gets reinfected.
how often do rubella outbreaks appear, who do they infect and what time of year do they usually outbreak?
6 to 8 year intervals, usually in spring, in children 5 to college age.
describe the rubella vaccine and when it is given.
live-attenuated vaccine, MMR! given at 15 months and then a booster bw 4 and 6
incubation period of rubella?
16 to 25 days
what causes the rash in rubella?
it is immune mediated
describe rubella infection in adults.
usually more severe, arthralgia and arthritis, rare thrombocytopenia, postinfectious encephalopathy (rare)
how many serotypes of rubella exist?
1
what is the preffered assay for rubella detection?
hemagglutination inhibition assay (if 1/8 of titer will inhibit then the person is immune)
should pregnant women get MMR?
nope, this is still live virus and potentially dangerous to the fetus
what are the cytological effects in congenital rubella?
not lysis but affects growth, mitosis, chromosomal structure
severity of outcomes of congenital rubella infection as well as times during pregnancy compared to severity of thess outcomes.
congenital rubella syndrome with severe defects or stillbirth. 1st month over 80% pathology and all fetuses infected, 1st trimester 70 to 85% pathology, 2nd trimester 25 to 35% infected, last ten weeks, few will have severe defects
describe the transient manifestations of congenital rubella syndrome (note these may disapear).
LBW, thrombocytopenia purpura (blueberry muffin), hepatosplenomegaly, meningoencephalitis and large anterior fontanelle, bone lesions. uncommon manifestations: adenopathy, hepatitis, cloudy cornea, hemolytic anemia, pneumonia, myocarditis.
describe the permanent manifestations of CRS.
uni or bilateral deafness due to screw up with organ of corti, congenital heart disease, central language defects, MR, cataracts and microphthalmia, glaucoma, permanent retinopathy
describe the late manifestations of CRS.
usually due to CNS infection, behavior DOs, MR, IDDM, autoimmune disease in some HLA types. Very rare: progressive rubella panencephalitis (can appear 20 yrs after birth), behavior changes (ataxia and intellectual decline), spasticity (fatal within 8 yrs, lose white matter and then demyelinate), perivascular cuffing
how do you diagnose an infant with rubella?
IgM in cord blood or serum
describe all the agents that can cause congenital infections.
TORCHS. toxoplasma gondii, other (HIV, Hep B, VZV, enterovirus, etc.), rubella, CMV, HSV, syphilis
congenital CMV stats
0.5 to 2.5% of newborns excrete CMV at birth, 90% normal at birth but 20 % develop sx later, 10% of infected newborns have CMV related sxs at birth
common defects in congenital CMV?
microenceph, anemia, deafness, jaundice, MR, chorioretinits, thrombocytopenia, hepatosplenomegaly... hard to tell dif bw CMV and rubella
diagnosis of CMV?
culture virus and look for CPE, combine with IF for early antigens after 2 days, PCR
how do newborns get HSV2?
natally usually, some neonatal
diseases of HSV seen in newborns?
skine, eye and mouth. disseminated infection ( most common killer if not treated), encephalitis (half die, survivors can have neurological impact)
HSV diagnosis?
DNA detection via PCR, etc. detection of viral antigen
describe newborn HIV transmission and results of it.
in utero or mom's milk, chronic infection that leads to lymphadenopathy, failure to thrive, encephalopathy.
describe toxoplasma infections in neonates including transmission and treatment.
obligate intracellular sporozoan, usually asympto in immuno compentent. transmission is oocysts via cat fecal oral, environment. congenital infection is from the asexual tachyzoite infecting the fetus. treating mom reduces congenital infection by 60%, severe cases can have encephalitis, pneumonitis, chorioretinitis, hydrpencephaly, psychomotor retardation. diagnosis is by PCR, IgM, EIA 4 fold rise in IgG titer, write or giemsa stain lymph tissue to show trophozoites. Treat with pyrimethamine and sulfadiazine
define macule, papule, vesicle, bullae, ulcer, petechiae, nodule, and wart.
red spot on skin that is not elevated. circumscribed elevated area that is less than 1 cm. circumscribed elevated area on skin containing clear fluid. large vesicles over 5mm containing serous or seropurulent fluid. excavation of tissue (sloughing of inflammatory necrotic tissue). pinpoint non raised, round, purplish red spot caused by intradermal or submucous hemorrhage. small node that is round and defined by touch. lobulated hyperplastic epidermal lesion with a horny surface and several morphological types
viruses that cause a maculopapular exanthem?
measles, rubella, HHV6, EBV, HIV1, enteroviruses, CMV, hep B, dengue, chikungunya
viruses that cause vesicular exanthema.
VZV, HSV, enterovirus
viruses that cause hemorrhagic exanthema?
dengue, yellow fever
viruses that cause a pustular exanthema?
vaccinia, monkeypox, cowpox.
viruses that cause a nodular exanthema?
papilloma, molluscum contagiosum, pseudocowpox
describe hand, foot, and mouth disease
bullae caused by coxsackievirus A16, lesions initially in oral cavity, move to hand palms, and foot soles. mildly febrile, subsides in a few days, painful lesions
what causes a milkers nodule?
pseudocowpox
whats an ecchymosis?
hemorrhagic rash that looks like massive bruises