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125 Cards in this Set
- Front
- Back
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What is HHV5?
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Cytomeglovirus
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How many people have CMV by 40?
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85%
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What is the MC S&S of CMV?
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None, asymptomatic usually
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How do you get CMV (mode of transmission)?
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Sexual, congenital, through blood products or transplantation, and person-to-person
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Who gets serious CMV?
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AIDS people, transplant people
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A baby walks in with Jaundice, hepatosplenomegaly, thrombocytopenia, periventricular CNS calcifications, MR, motor disability, and purpura. What is the diagnosis?
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CMV
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A baby walks in with no symptoms at birth but by 10 has hearing loss and vision loss. What does the baby have?
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CMV
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Can you transmit HHV6 through breast milk?
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Yes
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An AIDS guy walks in with Fever, malaise, myalgias, arthralgias
Splenomegaly, atypical lymphocytes, and abn. LFTs Leukopenia followed by leukocytosis. What does he have? |
CMV
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What are four complications of CMV?
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Mucosal GI damage, encephalitis, Guillain-Barre syndrome, pericarditis, myocarditis
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What is the risk in days that a bone marrow suppressed person could get CMV?
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100 days
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What's the CD4 threshold for getting CMV?
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< 100
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What is the CD4 threshold for CMV retinitis?
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< 50
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You have a pt. who has IBD-like symptoms, but you know it is a virus. Which?
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CMV - GI
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You have a patient with a viral odynaphagia. What could it be?
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CMV in the esphogus
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A patient walks in with diarrhea, hematochezia, abdominal pain, fever, and weight loss. Mucal biopsy shows virus. Which?
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CMV
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You have a patient with polyradiculopathy, transverse myelitis, encephalitis. You know it is a virus. Which?
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CMV
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How do you test for a CMV?
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Virus isolation, tissue confirmation
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How do you prevent CMV? What can you do with AIDS people?
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antiviral agents and CMV IG and Valganciclovir. HAART.
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What are the treatments for CMV?
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Ganciclovir, valganciclovir, foscarnet, cidofovir
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What is HHV4?
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EBV
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What causes Mono?
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EBV
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What is the incubation of EBV?
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4-6 weeks
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A teen patient walks in with Fever, sore throat, lymphadenopathy, hepto/splenomegally, fatigue,h/a, myalgias, nausea, and abdominal pain. What do they have?
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EBV
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How do you detect EBV?
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IgM, IgG antibody testing
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What labs are indicated for EBV?
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CBC, LFT, CT if suspect spleen rupture
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What is the treatment for EBV/mono?
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Treatment : symptomatic, no sports for at least 4-8 weeks
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What is a common way to get a rash after misdiagnosing mono?
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If amoxil or ampicillin given with misdx of strept patient will present with rash
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What causes Erythema Infectiosum
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Childhood exanthem associated with parovirus B19(HPV B19)
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What is another name for Erythema Infectiousum
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fifth's dz
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A drunk woman walks in with edematous erythematous plaques on the cheeks (slapped cheek appearance) and erythematous lacy eruption on the trunk and extremities. What is it?
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5ths or deal gone bad
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What is the MC person that you see 5ths in?
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adult women
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How do you transmit 5ths?
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respiratory droplets
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What is the incubation for 5ths.
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4-14 days
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What % is symptomatic with 5ths?
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20-60% symptomatic
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Child walks into clinic with fever, malaise, h/a, coryza 2 days before rash. H/a sore throat, cough typically coincide with rash. +-pruritus. What do you think?
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5ths
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Woman walks in with constitutional symptoms more severe with fever, adenopathy, arthralgias, +- pruritis
and a typically abscent rash. What iz it? |
5ths
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In 5ths when does the face rash go away?
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Edematous, confluent plaques on malar face which fade 1-4 days
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Do you have body rash with 5ths?
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Body lesions appears after facial lesions and are erythematous macules and papules which become confluent and have a lacy or reticulated appearance
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How long can a rash last with 5ths?
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Rash typically lasts 5-9 days but can last much longer
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How do you treat 5ths?
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Diagnosis and treatment
IgM, IgG antibodies to B19 Symptomatic |
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What causes AIDS?
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Human immunodeficiency virus
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What type of virus is AIDS
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Family: Retroviridae
Genus: Lentivirus |
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How many species of HIV are there?
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2
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What are three major routes of AIDS?
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: blood, semen, vaginal fluid (unprotected sexual intercourse, contaminated needles and via breast milk to infant are three major routes)
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What does HIV infect?
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Infects helper T cells (CD4 T cells) and macrophages leading to low CD4 counts
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When did we first see HIV?
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1959 in a monkey scientist
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A john comes in 6 weeks after hanging out at a sleezy hotel with Fever, h/a, sore throat, lymphadenopathy and rash – resembles mono. What U think?
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HIV - early
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This guy comes in with lymphadenopathy, diarrhea, wt loss, fever, cough, SOB. You ask about needle sharing. He says not for years. You say _______?
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AIDS - 2nd stage
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If an AIDS guy walks in with an oportunistic infection and CD4 < 200, what is his prognosis.
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He will die soon. He is in last phase.
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What are the phases of AIDS?
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asymptomatic, 1st, 2nd, and last
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A guy walks in that has Soaking night sweats
Shaking chills or fever for several weeks Dry cough h/a Blurred vision Wt loss Persistent unexplained fatigue Chronic diarrhea and Kaposis sarcoma, and lymphoma. What do you think? |
AIDS
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What virus family causes flu?
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: Orthomyxoviridae
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How important do you think a topic is when there is two slides dedicated to it?
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Me too. AIDS must be pretty rarer than Cushings.
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Can you vaccinate for flu?
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Yes. Two types.
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What virus is responsible for seasonal epidemics in the US?
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flu
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How long can flu live on surfaces?
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a long time.
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When do people get flu?
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Winter months, October – May
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A person walks in with Abrupt onset of fever, chills, rigors, h/a, myalgia and malaise, dry cough, nasal discharge, sore throat. They may have what virus?
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flu
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What are two complications of flu?
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pneumonia (viral and bacterial) Reyes syndrome(esp B) and aspirin
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How can you detect flu?
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Diagnosis and Treatment
Nasal or throat viral culture |
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When can you give antivirals?
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Antivirals if given within 72 hours of onset
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What family causes mumps?
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Paramyxovirus
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How do you transmit mumps?
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saliva droplets
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What is incubation for mumps?
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18-21 days
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A guy walks in with Painful swelling of salivary glands(parotid) and fever
and possibly Orchitis Oophoritis Meningitis Pancreatitis. What do you suspect. |
mumpsH
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How do you dx mumps?
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Clinical or isolating virus from saliva or CSF
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What do labs for mumps show?
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Lymphocytosis
Elevated serum amylase |
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What is the tx for mumps?
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Symptomatic
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What do you avoid when treating mumps?
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Avoid acidic foods that stimulate the glands
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What virus causes encephalitis in mammals?
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Rabies
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What dz might you run into a Lyssavirus?
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Rabies
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How do you get Rabies? (2 ways)
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Transmission: bite of infected animal and aerosol through mucous membranes (cave explorers)
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What is the incubation on Rabies?
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3-12 weeks
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Someone comes in with cerebral dysfunction, anxiety, insomnia, agitation, abnormal behavior, paranoia, delirium, and death. What does the autopsy show?
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Rabies
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You see a kid with a bite from a rapid jackalope. What do you do for him?
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Postexposure prophylaxis - must administer within 14 days of exposure
Wound should be washed with soap and water One dose of immunoglobulin(1/2 injected into wound) Five doses of vaccine asap, day three, seven, fourteen and twenty-eight. |
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What is HHV6 or HHV7 responsible for?
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Roseola
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You have a Roseola suseciptible child, what age are they?
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6-24 mo
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What is the Roseola incubation?
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5-15 days
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Your illegitimate child has a high fever that remains consistent until day 4 when it returns to normal and then the rash appears. What would you think it is?
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Roseola
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You see small blanchable pink macules and papules on trunk and neck of an infant. What do you think?
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Roseola
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How do you treat Roseola?
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symptomatic
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What is another name for Rubella?
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German measles or 3 day measles
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What type of virus is German measles or 3 day measles?
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Rubivirus
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What age group(s) are susceptible to Rubivirus?
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adult and child
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How do you get Rubella?
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: inhalation of droplets
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What is the incubation of Rubella?
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Incubation period 14-21 days
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I am an older woman with anorexia, myalgias, conjunctivitis, h/a, fever, URI and arthralgia. What might this be a pandrome for?
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Rubella
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A guy walks in with a big 70s 'stache and pink macules and papules on forehead initially spreading to face, trunk and extremities during first day, with fading of face on second and complete fading by day three. What does he have?
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Rubella
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How do you dx rubella?
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Clinical (rubella titer)
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Treatment is symptomatic for Rubella but if a pregnant women gets infected what might happen?
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chance of spreading to fetus with fetal infection and malformation
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Rubeola is also called what?
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Measles
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What is a common highly contagious childhood viral exanthem?
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Measles
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What are the spots called before you get measles?
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Koplik spots which are pathnomonic and appear before exanthem
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How do you transmit measles?
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respiratory droplets
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What is the incubation period of measles?
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10-15 days
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I have fever, malaise, coryza, hacking barklike cough, photophobia, conjunctivitis, periorbital edema and will probably die. What do I have?
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Measles
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How do you prevent measles?
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vaccinate
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How do you treat my accute measles?
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symptomatic
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How do you dx measles?
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Clinical, confirmed with serology
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Herpes 1 or 2 is less gross?
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HSV-1
Mucocutaneous disease of mouth and oral cavity |
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If you have Herpes labialis do you turn off guys?
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No. It's not on the VJJ
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I have herpes on my hands, what might that be called?
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Herpetic whitlows
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What causes herpes to reoccur?
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Recurrences induced by stress, fever, infection, sunlight, chemotherapy
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HSV2 occurs where?
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HSV-2
Genital tract Virus remains latent in presacral ganglia |
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A call girl comes in with Lesions are multiple, painful, small, grouped, and vesicular. Primary infection may manifest as aseptic meningitis. What's up?
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HSV2
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How do you dx herpes?
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Clinically
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Tzank stain good for what?
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Herpes
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How can you tell herpes simplex?
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Viral cultures of vesicular fluid or direct fluorescent antibody staining of scraped lesions
Polymerase chain reaction (PCR) Intranuclear inclusion bodies and multinucleated giant cells on a Tzanck preparation |
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An old guy comes in with keratitis, blepharitis, keratoconjunctivitis
Unilateral, impaired visual acuity. What U say? |
Herpes
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How can you tell herpes is in your eye?
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Diagnosed by dendritic ulcer that stain with fluorescein
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So your herpes baby is going to be born. Where did s/he get the infection?
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Transmission during delivery MC than intrauterine infection
Maternal infection during 3rd trimester – highest risk of neonatal transmission |
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You have herpes up your encephalitis and recurrent meningitis. What are your sx. Especially why herpes and not Mono or Claymidia in your neck?
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You got nonspecific symptoms
Flu-like prodrome, headache, fever, behavioral and speech disturbances, seizures |
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Why would you have disseminated herpes?
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b/c you got problems with your immune system
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What virus can cause Stevie Johnson Syndrome?
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Herpes -- Erythema Multiforme
Along with drugs, the leading association and with Stevens-Johnson syndrome |
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What do you use to treat keratitis in herpes people?
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Trifluridine – keratitis
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You have a bone marrow transplant guy with resistant herpes.
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Foscarnet – resistant strains in immunocompromised persons
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What is the most common STD in the US?
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Human Papillomavirus
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What causes genital warts?
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Human Papillomavirus
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What causes cervical cancer?
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Human Papillomavirus
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What are the bad strains of Human Papillomavirus for cancer?
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16 & 18
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So you are a woman that wants to go on gaurdicsil. What strains of HPV will you find yourself protected from?
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6 and 11 (low risk strains)
Types 18 and 18 |
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So you are a woman that wants to go on gaurdicsil. How old are you?
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9 - 26
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What is the dosing reommendation for the gaurdicil?
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Vaccination recommended for females 11-12 years with 3 IM doses; 2nd and 3rd doses given 2 and 6 months after the first
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Do you like "Jennifer Pack" or "JPack" better, for a moniker.
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JPack sounds so much more legit
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