SketchyMed - Viruses
How do we diagnose mumps?
Clinical
How do we diagnose Rhabdovirus?
Clinical, biopsy (autopsy)
A newborn in your clinic has jaundice, hepatomegaly, a blue/purple rash, periventricular calcification, ventriculomegaly, and sensorineural deafness. Most likely, what disease does the baby have?
Congenital Cytomegalovirus (child covering ear, mom yelling at her child)
If a pregnant women contracts Varicella zoster during the first 2 trimesters, what can occur?
Congenital Varicella Syndrome
Besides rhinovirus, what else can cause the common cold?
Coronavirus
What causes MERS?
Coronavirus
What causes SARS?
Coronavirus
A toddler comes into your clinic with a red, vesicular rash on this hands, feet, and around his mouth. What is your diagnosis?
Coxsackievirus
If a patient has a very sharp, unilateral pain on the lower chest, what virus might they have?
Coxsackievirus
What causes Hand, Foot, and Mouth disease?
Coxsackievirus
Which virus is associated with "Devil's grip"?
Coxsackievirus (type B)
You view a CXR with a "steeple sign". What is your diagnosis?
Croup (Parainfluenza virus)
Norovirus outbreaks often occur where?
Cruise ships, daycare
igG-HBsAG present = ?
Cured (vaccinated, takes 6 months from infection)
A liver transplant patient presents to your clinic with pneumonia, retinitis, colitis, and esophagitis. What virus do they likely have?
Cytomegalovirus
A teenager presents to your clinic with fever, lethargy, malaise, myalgia, splenomegaly, and arthralgia. You run a Monospot test and it is negative. Which virus do they likely have?
Cytomegalovirus
What is the most common fetal viral infection?
Cytomegalovirus
What is the number 1 cause of sensorineural hearing loss in children?
Cytomegalovirus
A baby in your clinic has a "Blueberry muffin rash". What virus are they likely infected with?
Cytomegalovirus (blueberry muffins on floor)
A patient of yours has "Pizza pie retinopathy". What virus is associated with this?
Cytomegalovirus (old man with pizza box)
Hydrops fetalis is associated with which viruses?
Cytomegalovirus, Parvovirus (small ballon bears)
All (+) RNA viruses replicate in __ and outside __
Cytoplasm and outside nucleus "scene taking place outside nucleus"
What type of virus is Herpes Simplex?
DNA virus (dark hues)
What is a major complication of prion disease?
Death
This is also known as "Break bone fever".
Dengue
A patient presents to your clinic with fever, epistaxis, bleeding gums, rash, arthralgia, myalgia, and hepatosplenomegaly. What is your diagnosis?
Dengue fever
Which population is most likely to contract herpetic whitlow?
Dentists
HIV directly causes what illness?
Diffuse large B cell lymphoma
What is a major complication of Coxsackievirus B?
Dilated cardiomyopathy
How does HPV 1-4 get transmitted?
Direct contact
Once in the body, Rhabdovirus travels to where before entering the brain?
Dorsal root ganglia (dorsal tree roots)
Varicella zoster lies latent in what nerve(s)?
Dorsal root ganglia (guy sleeping in the background tree roots)
How does the rash of Parvovirus travel?
Downward (from face to feet)
What does Lymphocytic Choriomeningitis cause?
Encephalitis, fever
Which group of viruses is the main cause of aseptic meningitis?
Enteroviruses
How does Epstein-Barr virus infect B cells?
Envelope glycoprotein binds CD21 (sign "must B 21")
A 14 year old girl presents to your clinic with fever, tender lymphadenopathy in the posterior cervical lymph nodes, extreme fatigue, and splenomegaly. Which virus is likely?
Epstein-Barr virus
A teenage boy presents to your clinic complaining of sore throat, fever, posterior lymphadenopathy, and splenomegaly. What do you suspect?
Epstein-Barr virus
This virus is the Human Herpes virus 4.
Epstein-Barr virus
What virus causes infectious mononucleosis?
Epstein-Barr virus
Which virus causes the "Kissing Disease"?
Epstein-Barr virus
A teenage patient presents to the clinic complaining of severe pharyngitis. You prescribe amoxicillin. The patient calls in a panic to let you know he has a maculopapular rash all over his body. What does he have?
Epstein-Barr virus (guy next to sleeping guy with a red pen)
An HIV+ patient presents with oral hairy leukoplakia. Which virus causes this?
Epstein-Barr virus (old man with white beard)
Which virus do we associate with "Owl's Eyes"?
Epstein-Barr virus, Cytomegalovirus
1 - 2 weeks after infection with HSV, what rash might appear?
Erythema multiform
A patient presents to your clinic with Herpes Zoster Ophthalmicus. You observe vesicles on the tip of the nose. What is this called?
Hutchinson sign
First immune response to Hep B?
IgM-HBcAG
Since Roseola (HHV6) infects CD4 cells, what can this cause?
Immunosuppresion
Typically, what causes reactivation of Cytomegalovirus?
Immunosuppresion (old man with cane)
How does Rotavirus cause diarrhea?
Increase chloride permeability ("cho-rider" boat:)
How is vCJD transmitted? (variant Creutzfeldt-Jakob)
Infected meat
Which type of Influenza causes worldwide epidemics?
Influenza A
Which type of Influenza causes major outbreaks?
Influenza B
Which type of Influenza causes mild respiratory tract infections?
Influenza C
A 70 year old women presents to your clinic. She has fever, myalgia, and fatigue that started about 5 days ago. She started to feel a bit better, but now she has a productive cough and is looking pretty bad. What has just occurred?
Influenza followed by bacterial pneumonia
What is a common symptom associated with HSV2?
Inguinal lymphadenopathy (bottom of herpes hermes' dress)
How to we inactivate Lymphocytic Choriomeningitis?
Irradiation, heat,
Which virus is associated with Progressive multifocal leukoencephalopathy (PML)?
JC virus
How does HSV1 affect the eyes?
Keratoconjunctivitis (hermes red eyes)
Which occurs first? Koplik spots or rash in Measles?
Koplik spots
This is a transmissible prion disease from New Guinea.
Kuru
What is another name for croup?
Laryngotracheobronchitis
What is unique about the rash of Varicella zoster?
Lesions in different stages of healing (sign says "all ages welcome")
RSV is most often seen in children of what age?
Less than 6 months
What lab values are common in patients with measles?
Leukopenia, thrombocytopenia, IgM antibodies
What kind of vaccine do we have for Paramyxovirus?
Live attenuated (live muppet show)
What kind of vaccine is the Varicella zoster vaccine?
Live attenuated (sign formed as a syringe says "Live show")
What kind of vaccine is the Shingles vaccine?
Live attenuated (sign says "live show)
You perform a blood smear on a patient with Epstein-Barr virus. What do you expect to see?
Lymphocytosis
Where does Poliovirus replicate?
Lymphoid tissue (tonsils, Peyer's patches (pathes of eggs lining the pool)
Vaccine for Rubella?
MMR vaccine live, attenuated for humoral and cell-mediated immunity
What about rash on rubella?
Maculopapular and begins on face and spreads downward ("Rubies start on crown and are falling down")
If you administer amoxicillin to patients with Epstein-Barr virus, what happens?
Maculopapular rash (guy next to sleeping guy with a red pen)
A patient who immigrated to the US 10 years ago comes to your clinic. You note personality changes, seizures, myoclonus, and ataxia. What is your diagnosis?
Measles (SSPE, Subacute sclerosing panencephalitis, can occur years later, "tales of SSPEMICE")
You find small blueish-white spots on a red base on the buccal mucosa. What is your diagnosis?
Measles (koplik spots)
What are examples of Paramyxovirus?
Measles (measel weasle), mumps, RSV
What are the main complications of mumps?
Meningitis, orchitis, parotitis, pancreatitis (Pom-Poms)
Who is the only group of people to get the Adenovirus vaccine?
Military recruits
This virus causes flesh-colored papules with umbilicated center with white core.
Molluscum contagiosum virus
Cytomegalovirus lies latent in which cells?
Mononuclear cells (lymphocytes, monocytes, macrophages, sleeping guy)
How do we diagnose Epstein-Barr virus?
Monospot test (dartboard, dots clumped and star shaped= IgM molecules)
What transmits Dengue fever?
Mosquito
How is Zika transmitted?
Mosquitos
A patient presents to your clinic with parotitis. What virus should you immediately think of?
Mumps
What is the leading cause of pancreatitis in children?
Mumps
Another virus in Paramyxovirus family is __ (mummy), which replicates in the __ and can cause __
Mumps replicates in Parotid salivary glands and can cause parotitis.("Big cheeks""Mumps mummy")
A patient presents to your clinic with Herpes Zoster Ophthalmicus. You observe vesicles on the tip of the nose. This indicates an involvement of which nerve?
Nasociliary branch
If a patient has Cytomegalovirus mononucleosis, what result will you get on the Monospot test?
Negative
In order to diagnose Rhabdovirus from a biopsy, what are we looking for in the sample?
Negri bodies in hippocampus, Purkinje cells (iNtEGRIty on boat, seahorse on boat=hippocampus, pink leaves in trees)
Which virulence factor does measles NOT have?
Neuraminidase (NA)
Can we cure Herpes Simplex?
No
Do we always need to treat Varicella Zoster with antivirals?
No
Does Colorado Tick Fever cause rash?
No
Does Rubella have a prodrome?
No
Is hairy leukoplakia cancer?
No
Is Poliovirus enveloped?
No (naked statue of david)
Can we use acicylovir to treat Cytomegalovirus?
No (resistant)
A patient presents to the clinic complaining of acute explosive watery diarrhea, low-grade fever, vomiting, and abdominal cramping. What is your diagnosis?
Norovirus
This virus is also called Norwalk virus.
Norovirus
HIV treatment?
Nucloside/nucleotide reverse transcriptase inhibitor - backbone of antiviral therapy; pose as nucleotide, get incorporated into growing DNA and then halt synthesis. (weapon with chain, standing on "reverso transcriptum" spellbook:)
In Herpes Zoster Opthalmicus, the distribution of the rash usually runs along which nerve branch?
Ophthalmic branch of CN V
Influenza is in what family?
Orthomyxovirus
How do we diagnose Herpes Simplex?
PCR, Tzank smear (The kid has a tank-model)
How do we diagnose Influenza?
PCR, rapid tests, nasal swab
How do we diagnose Cytomegalovirus?
PCR, tissue staining (Owl's Eyes)
What is the order of lesion progression for Varicella zoster?
Papules, vesicles, pustules, crusts
A 3 year old presents to your clinic with a "seal bark" cough and inspiratory stridor. What is your diagnosis?
Parainfluenza virus
What causes croup?
Parainfluenza virus
What virus causes bronchiolitis?
Parainfluenza virus
Where do mumps viruses like to hang out?
Parotid glands, testes, CSF
If a school aged child has a "lacy" rash over her body, including her palms and soles of her feet, which virus does she have?
Parvovirus
This is also known as 5th disease.
Parvovirus
What is one of the most common causes of myocarditis in children?
Parvovirus
What virus causes erythema infectiosum (slapped cheek)?
Parvovirus
A school teacher complains of joint pain, arthritis, and edema. What is the likely viral disease?
Parvovirus (guy on his knee)
This causes "Slapped Cheek" syndrome.
Parvovirus (kid with slapped cheek)
How do we treat Rhabdovirus?
Passive immunization (post exposure), active immunization (killed vaccine = syringe gun/skull antibodies keys on turban guy)
Enteroviruses are in what family of viruses?
Picornavirus
Poliovirus is a member of which virus family?
Picornavirus (baby polio flamingo)
What is the major complication of Influenza?
Pneumonia (s. aureus)
What causes Polio?
Poliovirus (flamingo)
A girl is brought into your clinic by her mom because she has been walking funny. You note paralysis in her right leg (left leg is NL) and respiratory insufficiency. What virus do you suspect?
Poliovirus (typically asymmteric paralysis, flamingo standing on one leg)
What are 3 examples of enteroviruses?
Poliovirus, Coxsackie, echovirus
Once the rash from reactivated Varicella zoster subsides, will there still be pain?
Possibly
Where does Rhabdovirus replicate?
Post-synaptic motor end plate of nicotinic ACh receptors.
This is the name for pain after the rash from reactivated Varicella zoster subsides.
Postherpetic neuralgia
What causes smallpox?
Poxvirus
Which patient populations should you not give live attenuated vaccines to?
Pregnancy, immunocompromised, cancer
Progression of HIV disease..?
Prodrome: flu or mono-like symptom with cervical lympahadenopathy, fever, pharyngitis; (neck ruffles/open mouth, red face-fever) Latent: up to 10 years; virus replicating in the lymph nodes. (CD4-guys sleeping) AIDS after 10 years: steep decline in CD4 + cells to < 200. (CD4-helper guys falling down in the "200ft drop)
If an immunocompromised patient comes in with AMS, aphasia, ataxia, hemiparesis or hemiplegia, and visual field defects, which virus should you think of?
Progressive multifocal leukoencephalopathy (PML)
This is a rare, demyelinating CNS disorder that is caused by the reactivation of the JC virus.
Progressive multifocal leukoencephalopathy (PML)
What causes the violet color in Kaposi's sarcoma?
Proliferation of vasculature
Is the rhabdovirus a RNA or DNA virus?
RNA (negative sense, sketch at night)
Is Polio a RNA or a DNA based virus?
RNA (warm colors)
Is the rhinovirus a DNA or RNA cirus?
RNA, positive sense (warm hues and sketch in daylight)
A 3 month old baby presents to your clinic with cough, runny nose, SOB, and bronchitis. What virus do you suspect?
RSV
What is the most common cause of pneumonia and bronchiolitis in infants?
RSV
A patient presents to your clinic with left sided facial paralysis and left sided ear pain. You examine the ears and note clear vesicles in the left ear. What do you suspect?
Ramsey-Hunt syndrome
Diff b/w rash on Rubella and Measels?
Rash in Rubella moves faster than measels and is only present for 3 days and it doesn't darken/coalesce (doesn't come together to make one big rash)
You perform a blood smear to test for Epstein-Barr virus. Which cells will you note if there is an EBV infection?
Reactive cytotoxic CD8+ T cells (Downey cells, atypical cells, knight thas reacting, Nr 8 on his SWord) )
How is Influenza transmitted?
Respiratory droplets
How is Rhinovirus transmitted?
Respiratory droplets
How is mumps spread?
Respiratory droplets
How are Paramyxovirus transmitted?
Respiratory droplets (sprinkler system going off)
How is Varicella zoster transmitted?
Respiratory droplets, contact with vesicles, placenta (guy with turban coughs, torches)
How is Adenovirus transmitted?
Respiratory droplets, fecal-oral
How is Parvovirus transmitted?
Respiratory droplets, placenta
Congenital Rubella causes (except the classic triad)?
Retardation microcephaly jaundice (many more)
The Rhabdovirus travels in which direction?
Retrograde
What type of virus is Human T-Cell Lymphotropic virus?
Retrovirus (causing HIV)
A mother brings her young son to the clinic. You diagnose him with chicken pox. She asks if she can give her son aspirin to help alleviate his symptoms. You tell her no. Why?
Reye's syndrome
A mother gives her son an aspirin after a flu diagnosis. She brings him in with fever, rash, vomiting, fatty liver, liver failure, and encephalitis. What does he have?
Reye's syndrome
Which virus is associated with hydrophobia?
Rhabdovirus
This virus is bullet-shaped.
Rhabdovirus (bullet collar on dog)
A fox hunter presents to your clinic with a fever, neurological symptoms (encephalitis), and increased salivation. What virus do you suspect?
Rhabdovirus (guy with encephalitis turban, drooling and sweating)
What causes the common cold?
Rhinovirus
How do we treat RSV in adults?
Ribavirin
Tx for RSV? What other virus treated?
Ribavirin. Hep C
How do we treat Arenavirus?
Ribivirin
Hantavirus is transmitted by what?
Rodents
What transmits Arenavirus?
Rodents
This virus is a major cause of infantile seizures.
Roseola (HHV6)
An 18 month old baby presents to your clinic with a high fever, macular "lacy" rash on the body, and seizures. What is your diagnosis?
Roseola (HHV6) (lady with a pink dress)
What virus is the number 1 cause of viral gastroenteritis in young children?
Rotavirus
What causes toxin-mediated (NSP4) secretory watery diarrhea?
Rotavirus (Nine SPeed 4 stroke":)
What is another name for measles?
Rubeola (measle weasle in red spanish dress rubeHOLA)
This vaccine for Poliovirus is a live attenuated vaccine.
Sabin (flamingo sign "Sabin" A Life")
HSV2 lies latent in which nerve?
Sacral ganglia (metal badge hermes scroch)
How is Epstein-Barr virus transmitted?
Saliva (lady trues to kiss)
This vaccine for Poliovirus is a killed vaccine.
Salk vaccine (sulking kid)
HIV: diagnosis?
Screening: ELISA (done multiple times up to 6 months after exposure); A positive ELISA calls for a Confirmation test: Western blot (detects the p24 antigen) (blots behind ELISA) (ELISA is guarding the tapestry)
HHV7 infects which cells?
T cells
How do we treat post-herpetic neuralgia?
TCA, gabapentin, pregabalin
Congenital Rubella is a __ infection? What other organisms?
TORCHeS infection mean it can cross placenta and enter fetus in utero and baby can get congenital pathology TOxoplasma gondii Rubella Cmv Hiv Hsv Syphilis varicella zoster & parvovirus
How can you treat Influenza?
Tamiflu, Ralenza
In immunocompetent patients, a shingles rash usually presents in what area of the body?
Thorax
"Blueberry muffin rash" caused by Cytomegalovirus is a result of what?
Thrombocytopenia
What are the 3 major disease processes caused by Adenovirus?
Tonsilitis, hemorrhagic cystitis, pink eye
How does the measles rash travel?
Top to bottom (head to everywhere else)
HSV1 typically lies latent in which nerve?
Trigeminal nerve (three gems on helmut. Usually confined to the face)
Lesions of Varicella zoster typically start where?
Trunk
How do you diagnose Varicella zoster?
Tzank smear, PCR, clinical (kid plays with his model tank)
How is HPV6 and HPV 11 transmitted?
Vaginal delivery (potentially), sexual transmission
A 5 year old presents to your clinic with a pruritic rash over her body. She also has fever and malaise. You examine the rash. You note pustules and crusts on the trunk and papules and vesicles on her arms and legs. What is your diagnosis?
Varicella (chicken pox)
Especially in immunocompromised patients and adults, these rare complications from Varicella zoster can cause fever, cough, confusion, and death.
Varicella pneumonia, encephalitis (guy with red turban (has a cane) and coughin)
An HIV+ patient presents to your clinic with vesicles on the right side of the face along with blindness in that eye. What is your diagnosis?
Varicella zoster
An elderly patient presents to your clinic with general prodromal symptoms - fever, malaise, and aches. He points to an area on his ribs where he feels pain. You perform a thorough examination and find no abnormalities. Although it is early, what virus should you keep on your differential?
Varicella zoster
Ramsey-Hunt syndrome is a polycranial neuropathy that is caused by what virus?
Varicella zoster
This virus is known for a dermatomal distribution.
Varicella zoster
What causes Chicken pox?
Varicella zoster (chickens)
What is a complication from reactivated Varicella zoster in the Trigeminal nerve?
Varicella zoster opthalmicus
Which viruses can cause Reye's syndrome?
Varicella zoster, influenza A, influenza B
What are some of the major complications of Poliovirus?
Viral meningitis (kid with helmet), respiratory paralysis (puff of air from flamingo), Flaccid paralysis (flamingo on one leg)
Which vitamin reduces measles morbidity and mortality?
Vitamin A
What causes sCJD (Creutzfeldt-Jakob disease)?
We have no idea (prions?)
Ebola is endemic to where?
West Africa
The symptoms of this virus is often confused with Guillan-Barre syndrome.
West Nile Virus
What is the leading cause of arboviral disease in the US?
West Nile Virus
Where is Hantavirus endemic?
Western US
When do Rotavirus outbreaks occur?
Winter
Are HSV2 vesicles painful?
Yes
Can Varicella zoster occur despite Varicella immunity?
Yes
Can mumps cause fertility issues?
Yes
Can we see lesions from Human Herpes Virus 8 in the intestines?
Yes
Do we have a vaccine for HPV?
Yes
Do we have a vaccine for Rotavirus?
Yes
Do we have a vaccine for Varicella zoster?
Yes
Is measles itchy?
Yes
Is there a Shingles vaccine?
Yes
Is there a vaccine for Adenovirus?
Yes
Will the measles rash spread to the palms and soles of the feet?
Yes
Is there a vaccine for Poliovirus?
Yes (2)
Is Herpes Simplex enveloped?
Yes (Hermes has clothes)
Is the shingles rash painful?
Yes (angry guy with a rash on chest)
Is Poliovirus acid stable?
Yes (birds standing on rocks in acid pool)
Is Rhabdovirus (rabies) enveloped?
Yes (clothes on)
Is Roseola (HHV6) enveloped?
Yes (clothes on)
Do we have a vaccine for Paramyxovirus?
Yes (live muppet show)
Is Cytomegalovirus enveloped?
Yes (no naked person in sketch)
Is Epstein-Barr Virus enveloped?
Yes (no naked person in sketch)
Is Varicella zoster an enveloped virus?
Yes (the guys has clothes)
Are Paramyxovirus enveloped?
Yes (wearing clothes)
HIV treatment pregnat women ("Z"/ pregnant elf)?
Zidovudine
possible reservoir for filovirus (ebola, marburg)?
bats (bat hangin from crossbar)
Does filovirus (ebola, marburg) hav a capsule or naked?
capsule (soccer jerseys)
If both IgG-HBcAG and igG-HBsAG is present?
cured from previous infection
Whats special about the rotavirus causing colorado tick fever?
double stranded RNA virus
filovirus sketch: "gooooooal", reminds you of..?
ebola (eboooooola)
Is toga virus naked or enveloped?
enveloped
Retrovirus (HIV), naked or enveloped?
enveloped (white HIV wizard is wearing a robe)
Which type of Creutzfeldt-Jakob disease is hereditary?
fCJD
bunyaviruses(i.e. hantavirus, california encephalitis virus, rift valley fever virus) obtain their envelopes from the...?
golgi apparatus (gold robe)
Flavivirus can cause hemorrhagic fever, sketchy?
guy in kidney boat surriunded by erythrocytes
Whats special about Hep B replication (except DNA-RNA-DNA)?
hepatitis B virus undergoes both intranuclear and cytoplasmic replication (hippies inside and outside of dome)
Effective treatment hep B?
lamivudine (lamb on poster)
HIV initially infects what cells..?
macrophages (macro-cages)
Rhinovirus, naked or enveloped?
naked (naked statue of David)
What type of virus is the rotavirus
naked (naked statue of David) +RNA (warm hues, daylight)
What type of virus is the Polyomavirus (JC and BK) virus?
naked DNA (warm hues, naked statue of david)
What kind of virus is papilloma?
naked, DNA
What type of virus is the filovirus (ebola)
negative (at night) sense RNA (warm hues)
What type of virus is the bunyaviruses (i.e. hantavirus, california encephalitis virus, rift valley fever virus)?
negative sense RNA (warm hues, at night)
Whats special about hepatitis B DNA?
partially double-stranded DNA virus (kumbaya circle/half circle:
A child presents to your clinic with a fever, pneumonia, cough, coryza (rhinitis), conjunctivitis, and Koplik spots. What is your diagnosis?
pink bowl =koplik, measel with party hat = red eyes, coughing, sweating)
What type of virus is the Retrovirus (HIV)?
positive sense RNA (warm hues, daylight)
What type of virus is the Togavirus?
positive sense RNA (warm/orange hues, daylight in sketch)
Rubella Vaccine contraindicated in who?
pregnant or Immunocompromised people ("Pregnant women trying to run away from person holding vaccine needle")
marburg virus and ebola virus are likely transmitted via....?
primates (monkeys)
The ribs in the hep sea (C) video, meaning?
ribavirin is used in combination therapy with interferon alpha to treat hepatitis C virus infections
"41" and "120" golden pipes in robe (white HIV wizard)?
the ENV-gene of HIV encodes the gp41 and gp120 envelope proteins
Conical wizard hat (the white HIV wizard)?
the gag gene of HIV encodes the p24 protein( thousands of p24 protein products comprise the conical capsid of HIV
The white HIV wizard holds the "reverso transcriptum" spellbook, what does that mean?
the pol gene of HIV encodes a reverse transcriptase (an RNA-dependent DNA polymerase), which converts RNA to DNA
"reverso transcriptum" spellbook in hep B?
the reverse transcriptase of hepatitis B virus is an RNA-dependent DNA polymerase, which converst RNA to DNA
he genomes of bunyaviruses (i.e. hantavirus, california encephalitis virus, rift valley fever virus) are comprised of.....?
three circular RNA segments (3 tree stumps)
Window period HEP B?
time period where one can think that the patient is cured. But, when IgM-HBcAG is fighting off the virus so the particles become so few, and the production of IgG-HBsAG is still low
This is also known as "mad cow".
vCJD (variant Creutzfeldt-Jakob)
Is hepatitis B virus an enveloped virus?
yes (hippies in clothes)
Is Parvovirus a naked virus?
yes (naked statue of David)
Classic triad of Congenital Rubella?
-Congenital cataracts "Blanks staring blind baby sculptures" -Patent Ductus Arteriosis "Open sign over aqueductus arteriosis" -Sensory-neural deafness "Baby sculpture covering ears"
The 4 C's prodromal (early symptoms) of Measles?
-Cough "mouse coughing" -Coryza "drippy nose" -Conjunctivitis "red eyes" -Koplik spots (pink bowl with blueish candy)
Potential virulence factors of Paramyxovirus viruses?
-Hemagluttinin: RBC stick together "tentacles in RBC bowl" -Neuraminidase -Fusion proteins "forms multinucleated giant cells in lymphoid tissue"
x3 types of Arbovirus that causes __
-Western equine encephalitis-Eastern equine encephalitis-Venezuelan equine encephalitis
Incubation period Hep B?
1 month
What symptoms does Coronavirus cause?
Acute bronchitis
How do we treat Shingles?
Acyclovir, Famcyclovir, Valcyclovir (recycling)
How do we treat Varicella zoster?
Acyclovir, supportive (recycling)
How do we treat Herpes Simplex?
Acyclovir, valcyclovir (recycle can)
What causes pink eye?
Adenovirus
What is the most common cause of inflammation in the adenoids?
Adenovirus
What is the most common cause of tonsilitis?
Adenovirus
Which virus causes hemorrhagic cystitis?
Adenovirus (naked statue of david)
Where is Kapsoi's sarcoma (Human Herpes Virus 8) endemic?
Africa
In Roseola (HHV6), when does the rash appear?
After fever
Where does Poliovirus attack and cause damage?
Anterior horn of the spinal cord (big horn on the black bird)
Parvovirus causes what disease in sickle cell patients?
Aplastic anemia (transient, sickle/plastic bone)
x2 types of Togavirus?
Arborvirus Rubella
What causes West Nile?
Arbovirus encephalitis
A patient has head ache, fever, vomiting, and diarrhea. Soon, he develops symptoms in his lungs, heart, kidney, and brain. Finally, he develops petechial rash and GI tract hemorrhage before dying of vascular collapse. What virus did he have?
Arenavirus
What causes Lassa fever?
Arenavirus
Arbovirus stands for a __
Arthoropod bourne virus vector, so inside ticks/ mosquitos "Guy hitting his head on an ARBOR = arbovirus, and mosquitos flying around him"
What is a major complication of Coxsackievirus A?
Aseptic meningitis
You suspect your patient has meningitis. You perform a spinal tap to analyze the results. You note an absence of glucose, aseptic, and elevated protein. What kind of meningitis does the patient have?
Aseptic meningitis
What does Echovirus cause?
Aseptic meningitis (also myocarditis)
Is Cytomegalovirus symptomatic or asymptomatic in immunocompetent adults?
Asymptomatic
How does RSV infect respiratory cells?
Attaches to G protein
In patients recovering from Epstein-Barr virus, what patient education do we need to make sure we do?
Avoid contact sports
in sketchy video hep B, a kid is holding a deflective ALT volleyball, meaning?
ALT levels is often normal in neonatal hep B
Which form of poliomyelitis is a minor illness?
Abortive poliomyelitis
What are the 3 types of poliomyelitis caused by Poliovirus?
Abortive, non-paralytic, paralytic
In patients with decreased immune system, Epstein-Barr virus can predispose them to getting what cancers?
B cell lymphoma (Hodgkin's, Burkitt's), nasopharyngeal carcinoma (cancer crab biting on chinese guys nose)
Epstein-Barr virus remains latent in which cells?
B cells (sleeping guy under dartboard)
The rash from Human Herpes Virus 8 looks very similar to which bacteria?
Bartonella henslae
What is the most common carrier of Rhabdovirus in the US?
Bats (flying in sketch)
What are some common carriers of Rhabdovirus?
Bats, fox, squirrel, skunk
Where does the measles rash usually start?
Behind the ears
How does HIV infect the host?
Binds to two receptors on the T helper cells: CCR5 receptor in early stages; CXCR4 in late stages
How do we most often get Avian flu?
Bird droppings, infected poultry
How is Cytomegalovirus transmitted?
Blood, sexual contact, breast milk, saliva, food (spilled milk, guy in butcher shoop saliva, megalo-mall)
Togavirus Encephalitis represented how? Symptoms x4?
By red TURBAN: Red, inflamed head with symptoms like head ache, fever, AMS, focal neuro deficits
How do we diagnose West Nile Virus?
CBC, CSF
Roseola (HHV6) infects which cells?
CD4 (the boy has a belt with nr 4)
Mumps can also replicate in __ and can cause __Can also cause inflammation in what other organ? Acronym for all symptoms caused by Mumps?
CNS. aseptic Meningitis Pancreatitis. POM-Poms: Parotitis, Orchitis, Meningitis, Pancreatitis
Fusion protein in measles cause__ which is what?
Causes Lymphadenitis AKA Warthin-Finkeldey giant cells found in lymphoid tissue (fused lymphocytes in background of paracortical hyperplasia)
Which patients are susceptible to Rotavirus?
Children (especially in day care)
Roseola (HHV6) typically affects which population?
Children 6 months-2 years
What virulence factors does Parainfluenza virus have?
Hemagluttinin (HA), neuraminidase (NA), fusion protein
What does Ebola cause?
Hemorrhagic fever
What does Marburg cause?
Hemorrhagic fever
In sketchy video aHep B, woman with henna tatoos, meaning?
Hep b infection can present with a rash
This virus causes a rash that is often described as "Dewdrops on a rose petal".
Herpes Simplex (hermes holds roses)
You are examining a slide and note intranuclear inclusion bodies (Cowdrey bodies). Which virus is present?
Herpes Simplex (spots on hermes clothes)
Eventually, the gingivostomatitis from HSV1 will develop into what?
Herpes labialis (cold sores)
Cytomegalovirus is a member of what viral family?
Herpes virus family (herpes hermes toy"
Varicella zoster is in what family of viruses?
Herpes virus family (small hermes guy)
What do we call it when herpes infects the hand/fingers?
Herpetic whitlow (on hermes fingers)
Reed-Sternberg cells are diagnostic for what?
Hodgkin's lymphoma
You take a blood smear and note "Owl Eyes". What disease does your patient have?
Hodgkin's lymphoma (OWL painting)
What causes Roseola?
Human Herpes Virus 6 (herpes hermes painting on horse)
An HIV+ patient presents to the clinic with violacious lesions on her nose, extremities, and mucous membranes. What virus do you suspect?
Human Herpes Virus 8
Primary Effusion Lymphoma is associated with which virus?
Human Herpes Virus 8
What causes Kaposi's sarcoma?
Human Herpes Virus 8
This virus causes dysregulation of VEG-F.
Human Herpes Virus 8 (VEG-F food bag)
Reactivation of Varicella zoster is often triggered by what?
Stress, aging, immunocompromised (old people in the background, guy with cane)
What time of year is Coxsackievirus common?
Summer
How do we treat Epstein-Barr virus?
Supportive
How do we treat Poliovirus?
Supportive
How do we treat West Nile?
Supportive
How do we treat measles?
Supportive
How do we treat mumps?
Supportive
A patient presents to your clinic with symptoms of Rhabdovirus. How do we treat them?
Supportive (vaccine is no longer effective)
How do we treat Rotavirus?
Supportive, rehydration
Out of all the newborns infected with Cytomegalovirus, how many are symptomatic?
10%
Treatment of the flu is most important when given within how many days of illness?
2 days
How long does it take for Poliovirus to replicate?
2-3 weeks (sign says "breeding season 2-3 weeks)
The Varicella zoster vaccine can be given to patients who are HIV+ if their CD4 count is over what?
200 (on shingles roof, maximum capacity 200)
How long does the fever last in Roseola (HHV6)?
4 days (nr 4 on boys belt)
HIV/AIDS patients are especially vulnerable to Cytomegalovirus when their CD4 count drops below what?
50
What is the mortality rate of Avian flu?
50%
The Shingles vaccine is recommended for people over what age?
60 (only for people above 60 =sign)
What is another name for Roseola (HHV6)?
6th disease
What are the virulence factors for measles?
Hemagluttinin (HA), fusion protein (not neuroamidase)
If HSV1 has many recurrent episodes, what complications can arise?
Eye scarring, blindness
Where does the rash of Parvovirus start?
Face
How is Poliovirus transmitted?
Fecal-oral
How is Rotavirus transmitted?
Fecal-oral
Childhood Rubella presents with what? Characteristic?
Fever, lymphadenopathy, fatigue, RASH Characteristic: Causes tender postauricular and occipital lymphadenopathy ("Guy has rubies going down back of neck, and is grabbing neck as if it is sore")
In regards to Herpes Simplex, which episodes are most severe? First or subsequent?
First
What causes viral hemorrhagic fever?
Flavi, bunya, flavi, lassavirus
What causes Yellow fever?
Flavivirus
What causes Zika?
Flavivirus
What causes Dengue fever?
Flavivirus (Dingy floating in water)
How can we view the serpiginous corneal ulcers from HSV1?
Fluorescein slit lamp
Lesions of Varicella zoster typically migrate how?
From trunk outward
What virulence factor does RSV have?
Fusion protein
How do we treat Cytomegalovirus?
Ganciclovir, Foscarnet (UL97 mutation, cart with on the side UL97)
You perform a Tzank smear to check for Herpes Simplex. What are you looking for to indicate a positive infection?
Giant multinucleated cells (On tank model)
You are using a Tzank smear to diagnose Varicella zoster. What are you looking for to identify a positive result?
Giant multinucleated cells (cells on tank)
What is the first sign of HSV1?
Gingovostomatitis
How do we treat Parainfluenza virus?
Glucocorticoids, nebulized epinephrine
What are the virulence factors for mumps?
Hemagluttinin (HA), neuraminidase (NA), fusion protein
What are the 2 major complications of Zika?
Guillan-Barre syndrome, microcephaly
Hep B vaccin contains only what?
HBsAG
You note disseminated Varicella zoster rash on a individual with no PMH of cancer or any major illness. This patient is not taking any medications. What should you test this individual for?
HIV
The white HIV wizard has two orange dragons painted on his hat, what does that remind you of?
HIV is a diploid virus; each HIV virion is composed of two copies of positive-sense RNA
Hairy leukoplakia is associated with which population?
HIV/AIDS
Which population is at increased risk for Progressive multifocal leukoencephalopathy (PML)?
HIV/AIDS
Which population is typically affected by Human Herpes Virus 8?
HIV/AIDS, elderly Russian men, certain areas in Africa
Which patient populations are at risk for developing Cytomegalovirus pneumonia?
HIV/AIDS, organ transplant
What is the most common sexually transmitted disease?
HPV
What strains of HPV cause verruca vulgaris (skin warts)?
HPV 1-4
Which HPV types cause cervical, penile, and anal cancer?
HPV 16, HPV 18
What strain of HPV causes anogenital cancer?
HPV16, HPV18, HPB31, HPV33
Condyloma acuminata is caused by what?
HPV6, HPV 11
What strains of HPV cause laryngeal papillomatosis (recurrent respiratory papillomatosis) and anogenital warts?
HPV6, HPV 11
Gardisil covers which strains of HPV?
HPV6, HPV11, HPV16, HPV18
This is the most common infection of the mouth.
HSV1
What is the most common cause of sporadic encephalitis in the US?
HSV1
Which type of Herpes Simplex is considered "above the waist"?
HSV1
Which virus is associated with temporal lobe encephalitis?
HSV1 (hermes helmet)
This virus causes serpiginous corneal ulcers on the eyes.
HSV1 (snakes around torch)
A patient presents to your clinic with fever, irritability, white vesicular oral lesions, keratoconjunctivitis, Head aches, vomiting, and seizures. What do you suspect the patient has?
HSV1 (temporal lobe encephalitisu)
Which type of Herpes Simplex is considered "below the waist"?
HSV2
Which virus should you associate with aseptic meningitis in adolescents and adults?
HSV2
The very high fevers (over 104) from Roseola (HHV6) can cause what?
Seizures
The intracranial calcifications caused by Cytomegalovirus can cause what?
Seizures (guy slipping)
How is Human Herpes Virus 8 transmitted?
Sexual contact, saliva
How is Herpes Simplex transmitted?
Sexual contact, saliva, placenta (TORCH)
How is Norovirus transmitted?
Shellfish, fecal-oral, vomit
What is the name we use to indicate the reactivation of Varicella zoster?
Shingles (shingle roof)
Who is most susceptible to Adenovirus?
Small children, military recruits, public pool users
What is the only disease to be eradicated due to a vaccine.
Smallpox
Transmission of rubella?
Spreads via respiratory droplets "people fanning droplets off guy"
What bacteria most often causes bacterial pneumonia associated with Influenza?
Staph aureus