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Viral Diseases - Patho Flashcards | StudBud
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Viral Diseases - Patho
Viral Diseases - Patho
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1
Rubella Peds - "German measles", "3-day measles"
False
True
2
MAC Treatment in AIDS:
For prevention of MAC in AIDS pts with CD4+ <50 **Clarithromycin**
1) Clarithromycin 500 mg PO BID or Azizthromycin 600 mg QD
2) Plus Ethambutol
3
How is HIV transmitted?
Sexual intercourse
Sharing needles or needle stick injury
Blood or blood product transfusion
Breastfeeding and through placenta
4
A patient is dx with AIDS when the CD4+ count falls below 200 and/or pt contracts any AIDs-defining illnesses (CDC)
False
True
5
Progression to AIDS from HIV:
CD4+ cell levels fall below 200/mL
Severe wasting in AIDS
Neurologic symptoms when infected macrophages cross Blood Brain Barrier
6
Influenza Diagnosis (Dx):
Monospot
Rapid tests for influenza antigens from nasal or throat swabs
COVID PCR test
7
What does HIV replication target?
Dendritic cells
HIV targets the CD4+ cells (helper T-cells), monocytes, macrophages
Eosinophils
Red blood cells
8
What cases of Hepatitis should be reported to the CDC?
Only E
A,B,C
None because of HIPAA
9
Influenza Treatment (Tx):
Main Tx: *Oseltamivir (Tamiflu)* dose 75mg PO BID. If renal impair: 75mg PO
Ribaviran (mist) for A&B and Amantradine/ Rimantadine for A only
Acetaminophen for fever and aches
Symptomatic treatment is required: Saline nasal spray, analgesic gargle
10
Cytomegalovirus (CMV) Diagnosis (DX):
Pathologic hallmark enlarged cell with viral inclusion bodies "owls eye"
Dx: Can be early manifestation of HIV and AIDS, Def. Dx rarely required
Quantitative PCR assays are preferred method for viral detection
*Gold Standard*: Histopathological Diagnosis
11
Hepatitis B (HBV) Spherical, double-shelled structure:
3) Viral-double stranded DNA genome - HBV DNA
2) Inner core/ nucleocaspid = HBcAg
1) A lipid envelope (antigen) = HBeAg
Hepatitis B surface particles are antigens = HBsAG
12
Epstein-Barr Virus (EBV) Dx, Tx and Education:
Confirming Dx: Positive heterophile antibody test & Monospot
Dx: Lymphocytosis with differential count exceeding 50%
Education: Avoid contact sports due to possible splenic trauma/rupture
Tx: Supportive care - plenty of fluids & rest, Acetaminophen & NSAIDS
13
Hepatitis B (HBV): HBV viral load (DNA):
Direct measure of Hep B DNA
Indirect measure of Hep B DNA
14
Influenza (seasonal)
Infection caused by 1 of 3 basic types: A,B,C - A is most common
Spread by respiratory route
15
Hepatitis C (HCV) - Transmission is primarily through percutaneous exposures to infection blood & IV drug use
True
False
16
Treatment of HIV-AIDS:
HAART Treatment 3-4 drugs in combination to inhibit viral enzymes, fusion
No vaccine
17
Hepatitis C (HCV) Most common chronic bloodborne infection in the USA; Testing of donated blood reduced risk of trans.
False
True
18
Hepatitis C (HCV) can also spread through....?
Sex with HCV infected person
Sharing personal items (razors, toothbrushes)
19
Algorithm for HIV testing:
If Western blot is (+) CD4+ count and viral load
ELISA screening
Western Blot to confirm
20
Hepatitis B (HBV): HBcAg (core antigen): no tests available. HBcAb (antibody to core) does what?
HBcAb declines over several years and presents in pts with chronic hep.
Appears 1 month after infection with HBsAg
21
Influenza complications:
Bloody urine
Reyes syndrome - young children aspirin use do not give if they have fever
22
Rabies replicates in the brain then spreads to eyes, heart, skin & oral cavity ---> sheds in saliva. Human-Human trans.
True
False
23
Hepatitis B (HBV): HBeAg (envelope antigen): is this person still infective?
**Correlates with early and active disease and high infectivity **
Low infectivity
24
Hepatitis D (HDV) tends to accelerate progress of liver disease associated with HBV infection (Hepatitis B)
True
False
25
Hepatitis B (HBV): Worldwide healthcare problem. Spherical, double-shelled structure (2 facts):
Mother may transmit HBV to neonate
90% risk of chronic infection
26
Hepatitis E (HEV) in endemic and nonendemic areas. Dx: Detection of anti-HEV(IgM). Tx: supportive if symptomatic
True
False
27
What Hepatitis is Chronic Viral?
Hepatitis B,C,D - occurs frequency in Hepatitis C
Hepatitis E only
28
Zika virus first case of human to human transmission from an insect borne virus was via sexual transmission
False
True
29
Clinical stages of Rabies:
Phase paralytic: Flaccid paralysis
Phase prodrome: Fever, paresthesias (tingling at site)
Coma phase: Coma, Death
Phase Encephalitic: Anxiety, agressive, combativeness, hydrophobia
30
Complications of HZV "shingles" includes pain and Zoster ophthalmicus. What is Zoster opthalmicus and why is it imp.?
STAT Ophthalmology consult!!
Vesicles ontop of nose or side precedes development opthalmic herpes zoster
Ophthalmologic emergency! Loss of vision is permanent!
31
Cases of HIV (Human Immunodeficiency virus) should be reported to the CDC
True
False
32
What is HAART Treatment in HIV?
Highly Aerobic anti-retroviral therapy
Highly active anti-retroviral therapy
33
Varicella zoster virus (VZV) is the pathogen. Primary infection (1st) - called "chicken pox"
False
True
34
Hepatitis B (HBV) Treatment & Diagnosis:
Tx: Supportive care, Fulminant disease- aggressive Tx
Dx: Hepatitis panel, HBsAg indicative of active HBV disease (s antigen)
LFTS - high lvls of (ALT) &(AST) within a range of 1000-2000 - acute HBV
Chronic cases- anti-viral therapy (Tenfovir, Entecavir) ends with -vir
35
Tx of Rabies:
Passive immunizations: Human Rabies Immune Globulin (HRIG), 20 IU
Active immunization: Rabies vaccine - human diploid cell vaccine
Start before symptoms
HRIG given after antibody titers, same time HRIG given HDVC given (vaccine)
36
Dx of rabies:
Dx: Serum & Spinal fluid tested for antibodies to rabies virus
A clinical Dx: live observation and inspection of infected mammal
Postmortem testing: immunoflurescence staining viral antigens *Negri bodies
37
Influenza prevention:
Vaccine
**HAND WASHING, HYGIENE**
38
If newly diagnosed HIV pt: obtain baseline studies for other infections. Suggest starting HAART regardless of CD4+ Count
False
True
39
The rate of progression to AIDS & Death is related to the viral load
False
True
40
Hepatitis B (HBV) Complications:
Chronic hepatitis- Increased risk of cirrhosis and/or hepatocellular cancer
Fuilminant hepatitis- urgent/emergent care
41
AIDS defining illnesses Clinical Manifestations (MAC):
MAC - Dx Confirmed by positive blood cultures
Culture includes: aspirate of affected lymph node, identified via PCR
PCR distinguishes MAC from TB
42
Dx and Tx of HZV "Shingles":
Clinical Dx: Pain & Rash - unilateral and dermatomal
Tx: must be started early, oral corticosteroids if given within 48 hrs
Tx: Acyclovir, valacylovir, famciclovir - all vir = anti-viral drug
43
Aids-Defining Illnesses continued: Kaposi sarcoma: flat purple tumors in any tissue
True
False
44
HSV I & II: Derm, GYN - difference: location, location, location
False
True
45
Influenza clinical presentation:
Abrupt onset of chills, fever, malaise, myalgias, cough
Bloody diarrhea
46
Erythema infectiosum - Peds Fifth disease, "slapped cheek"
True
False
47
Most common Hepatitis culprits are hepatotropic viruses (termed A-E)
True
False
48
Clinical presentations of HIV:
Initial infection: due to lytic phase (lysis of cells) mild & dissappears
Constant terrible symptoms
49
Hepatitis C (HCV) education:
Avoid sharing personal items
Transmission w/ sex partners
Not spread by sneezing,hugging, cooughing or through food & water
Donating blood can spread HCV to others
50
Rabies is caused by the pathogen Rhabdoviridae. Caused by bats.
False
True
51
Mumps Peds- a type of parotitis (most common viral cause)
True
False
52
Hepatitis C (HCV) Treatment:
Sofosbuvir (sovaldi) & Simeprevir
Successful hep. C treatment results in: Sustained virologic response (SVR)
53
Hepatitis Clinical Presentation (General):
Aversion to smoking
Significant transaminase elevations early in course
Prondrome of viral like symptoms: Fever, Jaundice
54
Hepatitis A (HAV) Treatment (Tx) & Prevention:
Tx: Supportive treatment
Tx: Avoid all hepatotoxins: alcohol, Tylenol
Prevention: Hand washing and good hygiene
Tx: Active immunization (vaccine) is reccomended
55
Secondary Infection it is called Herpes zoster virus (HZV) = Shingles Clinical Presentation:
Severe pain and paresthesia are common
Present on dermatomes; unilateral
Single/associated group of doral root ganglia; present along nerve pathways
56
Cytomegalovirus (CMV) Treatment (TX):
Ganciclovir - mainstay treatment for CMV disease
Valganciclovir - Treatment of choice for prophylaxis in transplant pts.
57
Shingles needs early aggressive Tx to reduce pain & severity. Tx: with capsaicin ointment, amitrityline & gabapentin
True
False
58
Hepatitis C (HCV) Clinical presentation:
Symptoms similar to HBV (Fever, Fatigue)
Waxing and waning LFT elevations
59
Hepatitis B (HBV) HBsAg (surface protein is the antigen) - first test to becomme abnormal.
Returns to normal when Jaundice subsides
If HBsAg persists >6 months in blood carrier or chronic active hepatitis
HBsAg rises before onset of clinical symptoms; peaks during 1st week
If HBsAg is elevated indicates active infection
60
Hepatitis C (HCV) Diagnosis:
Screening tests for antibody to HCV (anti-HCV)
Qualitative & Quantitative (titer) tests confirm
*** ALWAYS confiirm the Dx with + HCV & Viral load **
61
Zika virus- member of Flaviviridae. Transferrable by mosquitoes. Transmitted from person->mosquito->person
True
False
62
Hepatitis includes Acute Hepatitis (short time), Chronic Hepatitis (lasts >6 months), Fulminant hepatic failure
True
False
63
Chronic Hepatitis: Liver inflammation lasting > 6 months from any cause. Dx: Based upon abnormal LFTS and liver biopsy
True
False
64
Hepatitis D (HDV) Clinical presentation & Dx and Tx:
Tx: Primarily supportive care
Dx: ELISA (screening and HDV RNA by RT-PCR to confirm
90% of pts asymptomatic
65
Hepatitis B (HBV): HBsAb (antibody to surface protein):
Signifies end of acute infection phase
Appears 4 weeks after disappearance of surface antigen
Denotes immunity after administration of Hep B vaccine
66
Measles - Peds rubeola "English measles" "red measles"
False
True
67
Rabies clinical presentation:
Paresthesias radiating proximally from site of a known would - suggestive
Greater the proximity of the site of injury to the brain, shorter the time
68
AIDS Defining Illnesses:
(PCP) - most common opportunistic infection with AIDS
Pneumocytis jiroveci Pneumonia (PCP)- an atypical fungus via airborne route
PCP-diffuse bilateral, interstitial. or perihilar infiltrates on CXR
69
Who should we test for HIV?
Screening should be performed for all pts aged 13-64 years old
All persons at high risk
Only for pts under 5 years old
70
Hepatitis D (HDV) is transmissed through intimate personal contact, IV drug use and hemophiliacs
False
True
71
What is Hepatitis?
Viral/Infectious
Inflammation of liver cells
72
Hepatitis B (HBV): HBeAb (antibody to envelope) - indicates active phase of HBV is over or almost over
True
False
73
HPV (Human Papillomavirus Infection) - GYN
True
False
74
Roseola Peds- sixth disease
True
False
75
Cytomegalovirus (CMV): Most severe form occurs in infants (Congenital CMV). Dx in newborn: isolating virus from urine
False
True
76
How do we test for HIV?
** If positive ELISA result - confirm with Western Blot **
** High sensitivity enzyme-linked immunoabsorbent assay (ELISA)**
77
HIV risk factors:
Heterosexual partners of HIV carriers
Medical & Dental personnel
Homosexual or bisexual males
Intravenous drug users
78
Hepatitis B (HBV) Risk Factors & Clinical Presentation:
Clinical presentation: Insidious onset (can't see it coming
Clay-colored bowel movements (decrease in bile salts)
Risk factors: Correctional facilities, nursing homes
79
Dense paraplegia with loss of sphincter control and paralysis of muscles of deglutition & respiration lead to death
Clinical presentation of Rabies
Clinical presentation of mumps
80
Epstein-Barr Virus (EBV) is the Most common cause of infectious mononucleosis. What is EBV's clinical presentation?
Lymphadenopathy & prolonged recovery several weeks - 3 months
Fatigue (90-100%)
Fever in 80-95% of cases
Severe sore throat
81
Zika Clinical Presentation and Tx:
Pregnancy associated complications: microcephaly
Asthenia (abnormal physical weakness or lack of energy)
Dx: Supportive treatment: fever/pain control, bedrest, fluids
82
HIV is:
Results in development of opportunistic infections and neoplastic processes
Characterized by the depletion of helper T lymphocytes (CD4+ cells)
83
Hepatitis A (HAV): First antibody to appear is IGM 3-4 weeks after exposure; returns to normal in 8 weeks. Lasts 9 weeks
True
False
84
Hepatitis D (HDV): Needs presence of HBV for replication. Pt must have HBV from a past or synchronously occuring infec.
True
False
