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95 Cards in this Set
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Orthomyxo A, B, C
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IA: Humans and animals strains, Pandemics
B: Human, major influenza C: Human, mild respiratory track infections no influenza Respiratory, Flu Like |
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Orthomyx general features
*Winter months! |
-ssRNA, segmented 8, lipid containing envelope, replicates in nucleus!, Respiratory airborne droplets
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Orthomyxo virulence factors
HA, NA |
1. Hemagglutin HA: binds to RBCs to initiate infection
2. Neuraminidase NA: breaks down neuraminic acid to release progeny into infected cell |
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Antigenic Shifts
Antigenic Drifts |
Shift: major change, reassortment, pandemics
Drift: minor changes, mutations, epidemics (Influenza A) |
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Ortho Pathogenesis
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Inhaled, NA degrades mucous layers, upper lower resp tract, cytokines, IgA
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Do you see vomit and diarrhea in Ortho Influenza?
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NO!
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What syndrome is associated with ASPIRIN therapy and Orthomyx?
*like VZV |
Reye's Syndrome in children
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Symptoms associated with Orthomyx
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headache, body pain, sore throat, cough SUDDENLY
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Should Ortho vaccine be given with egg allergies?
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No.
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Orthomyx treatment
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Amantadine- prevents viral uncoating of influenza A and symtoms
NA inhibitors: shorten duration Zanamivir (inhaled!) Oseltamivir (oral) |
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What Syndrome is a side effect of Vaccine use in Orthomyx? Old vaccine, with swine infuenza strain
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Guillian Barre- ascending paralysis
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What makes Orthomyx different from Paramyxo?
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Ortho is:
Segmented Smaller Ha and Na are on DIFFERENT spikes No giant cell formation No fusion M protein |
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What four pathogens come from Paramyxo?
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Measeles, Mumps, RSV, Parainfluenza
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Paramyx general features...
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ssRNA, genome is not infectious, Ha Na, Fusion protein
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How is measles spread?
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Respiratory droplets
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What does syncytia mean?
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Cell to Cell fusion, evades antibodies!
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Measles Rubeola, epidemics in?
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Children, highly contagious
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Does Measles have HA and NA?
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Ha but no Na!
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What are the 3c&p of measles?
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Hacking cough, coryza, conjuctivitis, photophobia
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What are Koplik Spots and where are they seen?
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mucous membrane lesions on day 2-3, gray dots on red base near Stensen duct of oral cavitity ‘grains of salt’
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When is the patient sickest in Measles?
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The day rash appears
Maculopapular rash just below ears then spreads |
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Measles Pneumonia
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60% death
Warthin Finkeldey Giant cells in lung |
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Encephalitis with Measles
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1/200 15% die
7-10 days after acute disease Headache, Seizures, Coma, Demyelination of neurons |
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Giant Cell Pneumonia in Measles
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NO RASH!!
Immunocompramised Kids |
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Subacute Sclerosing Panencephalitis in Measles
SSPE |
late neurologic complication, kids less than 2, 5-10 yrs later manifests
-Personality/behavior changes: loss of memory, muscle spasm, spacticity, blindness, hi levels of antibody in serum/CSF |
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Lab diagnosis of Measles
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Koplik Spots, Multinucleated Giant Cells
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Major cause of upper respiratory disease in kids?
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Parainfluenza Virus
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Steeple Sign
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Subglottic narrowing in Parainfluenza
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Parainfluenza Virus
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1,2,3,4a,4b
Mild Upper Resp Infections Droplet Nuclei 50% Otitis media 15% Croup |
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Croup
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Barking cough, hoarse voice, stridor, steeple sign
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Mumps/Parotits
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acute benign viral swelling of parotid glands, lifelong natural immunity, droplet nuclei, often asymptomatic, Bilateral parotitis with fever, Sterility from Orchitis/testicles
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I say Bilateral Parotitis with a fever
you say? |
Mumps!
(late winter, early spring) |
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When and what do you culture for mumps?
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Saliva- 5 days after onset
Urine- 14 days after onset |
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What vaccine should be given and when?
Mumps, Measles, Rubella |
MMR 15 months
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Respiratory Syncytial Virus, RSV
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Epidemic winter resp tract infections in infants/young, kids before 4, droplet nuc/fomites/fingers, Bronchiolitis, *scared patient, low fever, increased breathing, fatal in immunocomp
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What test should be done for RSV?
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Antigen test
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What is the Rx for RSV?
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Aerosol Ribavirin
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Scared patient with increased breathing, low fever, Bronchiolitis, comes to you in the winter
You say? |
RSV
*MCC of pneumonia is <6mo Bronchiolitis: low fever, tachypnea, tachycardia, cyanosis, wheezing, scared patient |
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What is the second most common cause of the common cold?
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Coronavirus, not affiliated with the beer. haha
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Cornonavirus
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Atypical pneumonia, Common cold, SARS
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Coronavirus features
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Nonsegmented, ssRNA+, enveloped, helical CLUB shaped spikes
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Severe Acute Respiratory Syndrome
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Atypical pneumonia, fever 38 deg, nonprod cough, hypoxia, Xray shows ground glass infiltrates intersititially but do not cavitate
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Togavirus- Alpha virus
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Western Equine Encephalitis WEE
Eastern Equine Encephalitis EEE -Venezuelan equine |
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Togavirus general features
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ssRNA, no segments, replicates in cytoplasm, enveloped, placental spread, or respiratory droplets
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Togavirus:Rubella
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Blueberry Muffin, TORCH, Respiratory virus
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Where does Togavirus replicate?
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nasopharynx and lymph nodes
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Rubella
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14-21 incubation period
Fever, Malaise Maculopapular rash on face then extremities Posterior Auricular lymphadenopathy |
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Older women with Rubella get?
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Polyarthritis
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You see a deaf, jaundice, Patent Ductos Arterial, Small head, Cataract'ed baby you say?
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CONGENITAL RUBELLA SYNDROME!
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Why is a Rubella infected baby a public hazard? *this is not a joke haha
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Baby infected in utero can continue to excrete rubella for months
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The presence of what virus is needed to culture Rubella?
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Echovirus
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Tell me again when MMR is given!? Should everyone get it?
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15 months
Not pregnant women or immunocomped |
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You see a baby with Posterior Auricular Lymph swelling and a Maculopapular rash you say?
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RUBELLA, ELLA, ELLA
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Is Rubella Teratogenic? If yes, haha what does that mean?
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YES.
Disturbs normal mitosis, growth and chromosomal structure in fetus. |
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TORCH Rubella
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Maternal infection first 8 wks
Hearing loss Congenital Heart Defect= PDA Cataracts Small head |
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Rubella Lab Diagnosis
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IgM= current
IgG= immunity/old |
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Reovirus, what does REO stand for?
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Respiratory Enteric Orphan Virus
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Reovirus features
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Nonenveloped RNA, double stranded!!, Segmented, Rotavirus, Fecal Oral, Winter time
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Most common cause of infantile nonbloody diarrhea is? (viral gasterenteritis in young children)
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Reovirus/Rotavirus, then E Coli
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How can Rota be distinguished from bacterial diarrhea?
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No Leukocytes in stool
ELISA |
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Colorado Tick Fever
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Wood Tick Borne
Western USA, South West Canada |
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Patient with fever, chills, photophobia, lethargy, leukopenia, profound prostration and weakness has...
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Colorado Tick Fever
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Calcivirus
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Norwalk agent, ssRNA, naked, fecal oral, HepE
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Patient with explosive self-limited viral gasteroenteritis, fever, abdominal pain, vomit, diarrhea with or without pus/blood has?
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Calicivirus
*give intravenous fluids *Infants could die with this! |
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Filovirus
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Marburg and Ebola virus
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Filovirus features
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ssRNA, nonsegmented, enveloped, humans and monkies in SubSaharan Africa, hi mortality,
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Acute viral hemorrhagic fever from medical instruments
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Filovirus
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Somnolence is seen in?
*sleepy/drowsy |
Filovirus Acute Viral Hemorrhagic Fever
(fever, headache, myalgia, abdominal pain, diarrhea, pharyngitis, hiccups, cough) |
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Arenavirus features
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ssRNA, segmented, enveloped, zoonotic
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How is Arenavirus spread
*GROSS |
Rodent Urine, inhalation, ingestion of fomites
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Lymphocytic Choriomeningitis is seen in
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Arenavirus
Influenza like, sometimes viral meningitis |
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Arena: Lassa fever
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fever, sore throat, ab pain, intractable vomiting, hypotension, fatal!
Rx: Ribavirin |
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What is Kuru?
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New Guinea tribes
Laughing, Dementia, Spastic jerky, Confusion, Memory Loss, Headache, Apathy |
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Bornavirus
*first detected in horses *Schizo * |
Enveloped, Rna virus, spreads via CNS, loss of memory/learning, contributes to: Autism, Shizo, Depresson, Bipolar
Rx: Ribavirin |
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What does Flavivirus cause?
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Yellow fever, Dengue fever, St. Louis Encephalitis, Japanese encephalitis
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Flavivirus features
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ssRNA, nonsegmental
Vector: Mosquitoes |
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Yellow Fever
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Hepatomegaly with Jaundice!
Fever, Backache, Black Vomit |
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What is the vector for Yellow Fever and Dengue Fever?
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Aedes
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You see black vomit you "yell"?
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Yellow Fever
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Dengue Fever = Break Bone Fever
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Painful fever, headache, muscle/joint aches, hemorrhage, shock, thrombocytopenia
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West Nile Fever
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FLACID paralysis
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Bunyavirus general features
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ssRNA, segmented
Vector: Arthropod, except Hanta California Encephalitis Virus Lacrosse Virus Hantavirus Sandfly fever Rift Valley Fever |
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You see fever and encephalopathy in summer with recent bite
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California Encephalitis Virus
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Bleeding gums, Hemorrhage, Petechie, Fever
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Rift Valley Fever
*vaccine |
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Hantavirus
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Pulmonary infections
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Picornavirus general features
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ssRNA, naked, tissue tropism, fecal/oral, resistant to harsh, 5 families
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What are the 5 families of Picornavirus
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Enterovirus= Polio, Coxsac, Echovirus
Rhinovirus Cardiovirus Apthovirus Heparnavirus-HepA |
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Poliovirus- types
*lower motor neurons |
Asymptomatic
Abortive Nonparalytic Paralytic |
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Polio Vaccine drama
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Sabin vaccine given to kids, fecal/oral transmission of infection thru bloody stools
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Is there sensory loss in Polio?
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No.
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Coxsackie A Disease
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Hand Foot Mouth
Ulcer in mouth, rash on palms and soles Cutaneous lesions w/ erythema |
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Coxsackie B
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Muscle disease
Pleurodynia |
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Abrupt onset of painful spasm in lower rib cage or upper abs
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Coxsacie B
*complete recovery |
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Rhinovirus= common cold
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Can't replicate in GIT track
Temperature sensitive Liable to acidic pH |
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What is released during the common cold
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Bradykinin and Histamine
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