what are the picorno viruses
hepatitis: hsm, fecal oral
enterovirus--
echovirus: no1 cause of aseptic meningitis for kids
rhinovirus: only one not fecal oral
poliovirus: ant horn, lmn defecit, live and killed vaccine
coxsackie: A--hand, foot, mouth, aseptic men, esp summer months mos
which one of the picorno viruses are not fecal oral
rhinovirus--respiratory droplets, hands (fomites)
what are characteristics of picornovirus
no envelope, SS+ RNA linear icosahedral
what is one of the causes of death in polio?
respiratory insufficiency
during the summer months infection this disease that causes aseptic meningitis and hand and foot mouth disease
coxsackie a, SS RNA picorno fecal oral naked
what causes dilated CM and devils grip?
coxsackie B picornovirus ss+RNA, fecal oral naked
why haven't we had a vaccine for rhinovirus
many serotypes
what is main route of transmission in developing countries for a picornovirus that causes jaundice, hsm, fever?
hep a--fecal oral in unfiltered water esp southern hemisphere. needs to be chlorinated and get a vaccine!
what kind of vaccine is hep a
killed
virus that causes explosive watery diarrhea on a cruiseship, how get it and characteristics of virus
norovirus from the calicivirus family +ssRNA linear that is activated when cut into pieces ssrna, naked
what is part of flavivirus
hep c, dengue, yellow fever, west nile
enveloped +ssRNA
jaundice, backpain, ades egyptei, bloody diarrhea and vomiting
yellow fever
flavivirus
vaccine live attenuated
mosquito, encephalitis, myelitis (meningitis with flaccid paralysis and seizures/coma)
west nile
flavivirus
serology and pcr on csf
blood transfusion before 1990 is now having RUQ pain, hsm, increased AST more than ALT. what is causing this and what virus
hep C. if it was alcoholic hep c then ALT> AST
togavirus
envelope sslinear + icosahedral
rubella= german measles
arbovirus: eastern and western encephalitis
is there a treatment for encephalitis caused by togavirus
no. need just netting and bedding and spray
blueberry mufin rash, radiolucent bones lesions, pda, mental retardation, pulm stenosis, microcephaly.
measles virus, rubella
togavirus
which toga virus is a TORCH disease and what is the congenital symptoms
cataracts, sensoneural deafness and PDA--rubella
what is childhood and adults presentation of rubella and transmission. how can prevent this
respiratory droplets childhood exanthema, posturicular and occipital lymphadenopathy, descending maculopapular rash
adults: Adulthood: lymphadenopathy and
live vaccine: MMR vaccine, don't give to pregnant women or HIV CD4 count less than 200
coronavirus
and tx
encapsulated, helical, ssRNA
MERS, SARS and common cold---corona can seem innocent but turn bad real quick
tx: ribivarin, broad spectrum ab, corticosteroids
what combination therapy for hiv, can everyone have the same cocktail?
no, need to do genotyping bc several strains. NRTI + NNRTI + ccr5 inhibitor in early stage--maraviroc
when should test for hiv
6mo after exposure, early will give false negative
what tests for hiv
1. elisa 2. confirm with western blot = gel electrophoriesis
what is pathology of how hiv enters cells
ccr5 ad cxcr4 (early and late) corrector enter and uncut. reverse transcriptase--> insert in host dan and make new virions
how does hiv present
promodome flu like symptoms. latent up to 10 yrs then drop in cd4+. once below 200 then considered AIDS
a patient comes in with fever, headache, mental status change personality change, olfactory hallucination. on CT see necrosis and hemorrhage of temporal lobes.
herpes 1 virus no. 1 cause of sporadic encephalitis (vs. herpes 2 causes aseptic meningitis)
which nerve is herpes 1 latent in and where is herpes 2
trigeminal nerve for 1 and 2 is sacral ganglia
herpes whitlow
herpes on fingers --dentists
a patient has a cold sore on their mouth has a cc of red eyes and pain, you decide to a eye exam, what would expect to see on slit lamp
keratoconjuctivits- serpinginous corneal ulcers --herpes 1. cold sore is herpes labialis
painful inguinal lymphadenopathy with clusters of vesicles with red base and vesicular. what is diagnostic test
PCR of CSF for herpes meningitis(hsv2 is more common for enceph than 1). tzank smear and see multinucleate giant cells for vesicles (get it at base of vesicle)
what can give to prevent breakout in pt with herpes
acyclovir or valcyclovir
what is first sign of herpes 1 and what is followed by after
gingivostomatits--inflamed lips and gums. then cn have erythema multiform, target rash 1-2wks after infection
which herpes can pass vertical transmission
herpes 2
a teenager with tonsillar exudates, fever, and generalized lymphadenopathy esp posterior cervical comes in you treat with amoxicillin. they come back not feeling better and now they have a maculopapular rash. you decide to do a pbs and what other test?
monospot test: heterophile antibodies agglutinate to sheep blood rbc.
pbs: atypical lymphocytes on pbs. reactive t cells. but ebv does infect b cells via cd21
avoid sports
a patient comes in with white lesion on tongue that can't be scraped off
hiv patients, oral hairy leukoplaqua. EBV
an asian with ebv
africacn ebv
nasopharyngeocarcinoma-asian
jaw lesion-burkits lymphoma
if an hiv + pregnant woman comes in and gets cmv esp in 2nd trimester. what are we worried for baby
hydrops fetalis
if baby contracts cmv through mothers breast milk or saliva then how will neonate presetn
blueberry muffin rash (petechia from thrombocytopenia), hsM, jaundice, seizures **sensineural deafness. can see intracranial calcificatins and ventriculomegaly
if AIDS patient <50 for cd4, what disease can get with cmv
cmv retinitis: cotton woot spots, vision loss, linear and deep ulcerations in esophagus
a patient with sore throat, lymphadenopathy and fatigue and negative mono spot test. suspect cmv what test?
get buffy coat with cow and platelets and incubate with anti-cmv ab to detect virus
blindness, limb hypoplasia, cutaneous dermatomal scarring
congenital varicella syndrome
a patient comes in with a vesicular rash and is painful. he had chickenpox as a child. the rash crosses the midline you notice. the patient has never been on chemo and is not using any corticosteroids or immunosuppressed agents. what are concerned for
hiv. anyone with hiv, immunosuppression with disseminated rash (cross midline)
give shingles vaccine if cd4 over 200
why is it worse for adults to get chickenpox
bc at risk for fatal pneumonia and encephalitis (esp if immunocomp)
what can reduce mortality of measles
vit A
a patient had a history of measles as a child 5-15 years ago has myoclonus, coma, death, seizures, personality changes, coma, death. what test
anti-measles ab of CSF.
parotid gland swollen and orchitis unilateral, what are virulence factors
mump
for the virus that causes mumps, what else can it cause
paroxymovirus is ss-RNA. parainfluenza= croup, mumps, measles, RSV (bronchiolitis and pneumo on infants, #1). F fusion proteins to make respiratory epithelial cells stick together and make multinucleated cells
laryngeotracheobronchitis and see staple sign on x ray, cough and inspiratory stridor
narrowing of subglottis= rev. give paviluzumab against F protein (mab).
a patient comes in with hematuria, flank pain, watery red eyes, blurry vision, and tonsils are enlarged
adenovirus: hemorrhagic cystisttis, viral conjuctivitis, TONSILLITIS