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29 Cards in this Set
- Front
- Back
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When are viruses highly contagious? * a common theme among viruses.
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asymptomatic stage
prodrome (minimal sx) |
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Case: infant, lethargic, difficulty breathing, fever:
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RSV
infants and elderly aerosol transmission |
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Case: college student, fever, cough, sore throat, myalgia
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Test: HIV
Influenza |
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What is the accuracy of the rapid influenza test?
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50%
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When is the ONLY time you treat influenza?
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first 48 hours
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Case: HS student, mild upper respiratory infection, sore throat, runny nose, fever:
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Rhinovirus
Differential: no runny nose --> EBV, CMV barking cough: parainfluenza |
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Can viral dx be made on symptoms and presentation?
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no! not alone, must confirm
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Case: air force cadet, sore throat, tiredness, white patchy exudates in throat, feeling of sand in eyes:
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Adenovirus
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Case: HS swimmer, sore throat, tiredness, white patchy exudates in throat, feeling of sand in eyes:
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Adenovirus
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Case: Koplik spots (oral mucosa), rash, infant returning from abroad: (parents admit no vaccinations)
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Rubeola - red measles (Paramyxovirus)
*Not: Rubella - Togavirus |
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Case: immigrant infant, severe dehydration, fever, diarrhea, lethargic:
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Rotavirus (Reoviridae)
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Case: cruise ship, buffet, nausea, vomiting, diarrhea:
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Norovirus (Calciviridae)
fecal-oral |
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Case: elevated bilirubin and liver enzymes, recently ate shellfish, nausea, vomiting:
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Hepatitis A (think liver)
(Picornavirus) |
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Case: slapped cheek, no distress, child
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Parvovirus B19 (DNA)
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Reactivated VZV?
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Shingles: extremely painful, single dermatome
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Does HSV 1 or 2 cause oral and genital lesions?
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both do
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Case: dewdrop on a rose petal:
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HSV
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Case: dentist with lesions on fingers:
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Herpetic whitlow
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Does HSV 1 or 2 tend to be more recurrent?
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HSV 2
90% of youth have HSV 1 Av, HSV 2 more from sexual activity |
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How do you dx HSV?
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direct smear, scrape base of vesicle
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Which two viruses commonly cause mononucleosis?
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EBV or CMV
red blood smear will show atypical lymphocytes |
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In an advanced case of what viral disease would you find negri bodies in the cerebellum?
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Rabies (Rhabdovirus)
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[TEST]
5 y/o admitted with fever and possible meningitis. Stable and hydrated. CSF is taken and antibiotics started. CSF comes back negative for gram stain bacteria and positive for Enterovirus by PCR. What is the appropriate action? A. Get PCR for Lyme disease on the CSF B. Continue antibiotics for 72 hrs C. Recommend camp be closed D. Discontinue antibiotics and send home E. Treat siblings for meningitis |
D
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[TEST]
12 y/o child presents with bilateral red eyes, sore throat and fever after a field trip to a water park. GAS (group A strep) antigen test and monospot negative. What is the most likely cause of infection? A. Group A streptococcus B. Enteric Adenovirus 40/41 C. Enterovirus D. EBV E. Respiratory Adenovirus type |
E
swimming pool = Resp. adenovirus |
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[TEST]
40 y/o presents with HA, fever, difficulty breathing and sore throat. Rapid antigen test for influenza is negative. Pt is admitted for severe respiratory distress. Of the etiologies below, which would you want to rule out by molecular testing? A. Adenovirus B. Influenza C. Rhinovirus/enterovirus D. None – treat symptoms with Tylenol and fluids E. None – treat with antibiotics |
B
Influenza can be treated and will reduce spread |
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[TEST]
3 m/o presents wth interstitial pneumonia and bronchiolitis on CXR and wheezing for 2 days. Rapid antigen RSV is negative. What is the likely virus? A. RSV B. Influenza C. Adenovirus D. Enterovirus E. Rhinovirus |
A
RSV: 3 m/o, pneumonia |
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[TEST]
8 y/o presents with a single vesicle lesion on an erythematous base on her forearm. Which test will clarify the possible dx of HSV vs. VZV? A. Tzanck prep by derm B. H and E stain from the lesion biopsy C. Culture lesion for viruses D. DFA (direct fluorescence) for HSV and VZV E. PCR for HSV |
D
Direct plate |
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[TEST]
22 y/o in January with flu-like symptoms and no travel hx. Which of the etiologies is possible? A. HIV B. Influenza A C. Influenza B D. Rhinovirus E. Any of the above |
E
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[TEST]: match
1. Infects red cell lineage 2. Potential sever reactivated disease in immunocompromised patients 3. Common cause of otitis media 4. Acquired by fecal-oral route, short duration diarrhea 5. Respiratory virus that may occur in non-vaccinated A. Parvovirus B. Measles C. CMV D. Metapneumovirus E. Norovirus |
1 = A
2 = C 3 = D 4 = E 5 = B |
