4th Semester - Micro - Viral Hemorrhagic Fevers
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| What is a common characteristic of all viruses that cause hemorrhagic fever? | They are all enveloped RNA viruses.
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| Describe the structure of flaviviruses | Small, single stranded, postive sense enveloped RNA viruses
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| Flaviviruses are responsible for what disesaes primarily | Yellow fever and dengue
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| Yellow fever and dengue are caused by what virus? | Flavivirus
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| Approx size of flavivirus? | 50nm in diameter
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| What type of mosquito transmits jungle yellow fever to humans | Aedes spp. mosquito
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| What type of mosquito transmits urban yellow fever to human? | A. aegypti
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| What is the incubation period of yellow fever? | 3 to 6 days
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| What is the duration of yellow fever? | 6-10 days.
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| What is faget's sign? | The unusual combination of fever and bradycardia. Seen in yellow fever, among other dz's
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| What are the lab findings of yellow fever? | Leukopenia with relative neutropenia
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| Clinical presentation of yellow fever in viremic stage | high fever, malaise, chills, ha. myalgia, CONGESTION OF CONJUNCTIVA AND **REDDENING OF THE EDGES OF TONGUE**
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| Clinical presentation of yellow fever in late stage? | **EPIGASTRIC PAIN AND JAUNDICE**, rena dysfunction / oliguria, Increase AST and ALT levels. Global reduction in clotting factors / prolonged PT and bleeding time.
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| How is yellow fever diagnosed? | Often clinical and epidemiologic. Otherwise, Mostly ELISA.
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| ddx of yellow fever? | Viral hepatitis, leptospirosis, dengue, etc
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| what liver cells are first infected? | Kupffer cells.
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| Can people get yellow fever twice? | No. Being infected once provides life long immunity in the form of neutralizing ABs
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| What are the two types of dengue? | Classical dengue fever and Dengue hemorrhagic fever / dengue shock syndrome ( mostly in children)
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| Lab findings of classical dengue? | Leukopenia with absolute neutropenia and elevated AST/ALT
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| Clinical presentation of dengue? | Abrupt onset of high fever, arthralgia / deep bone pain, CONGESTION OF CONJUNCTIVA, puffy eyelids and RELATIVE BRADYCARDIA, May complain of a metallic taste sensation and epitaxis
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| Lab findings of dengue hemorrhagic fever. | Same as classical dengue ** but with elevated hct and throbocytopenia**
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| Likely cause of leukopenia in dengue fever? | BM suppression.
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| Can you get dengue fever more than once? | Yes. Although long last immunity is achieved through neutralizing antibodies. 2nd infxon is possible from a virus of heterologous sertotype, in which case it is usually the more severe form.
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| describe structure of FILOviruses. | filamentous, pleomorphic, (-) SSRNA viruses.
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| What are the two main species of filovirus? | Ebola and Marburg
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| What is the incubation period of filoviruses? | 4 days to 6 weeks
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| What are the lab findings of filovirus infection (marburg or ebola) | lymphopenia, netropenia, marked thrombocytopenia, elevated AST and ALT with elvated CREATININE AND BUN
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| Filoviruses infect what cell type? | Mononuclear phagocytes.
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| rift valley fever is caused by what virus? | phlebovirus
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| Phlebovirus causes.... | rift valley fever
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| Bunyaviradar consists of what viruses | Bunyavirus, phlebovirus, nairovirus, and hantavirus
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| Describe structure and size of phleboviirus | segmented (3) (-) SSRNA, enveloped. ~100nm in diameter
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| Aedes mcintoshi is responsible for transmitting what virus? | phlebovirus. Rift valley fever.
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| Possible complication of rift valley fever? | Usually benign self limiting disease resolving in 2-5 days. Possible cx include encephalitis, retinitis, and unveitis, likely immune mediated.
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| Crimean-congo-hemorrhagic fever is caused by what virus | Nairovirus
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| What is the structure of nairovirus | enveloped, segmented (3) (-)SSRNA (same structure and size [100nm] as phlebovirus)
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| How is nairo virus transmitted? | Hyalomma ticks. (causes Crimean-congo-hemorrhagic fever)
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| What virus / dz combo features vomitting, hepatomegally, and neurologic manifestation of somnolence. | Crimean-congo-hemorrhagic fever
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| Describe structure of hantavirus | same as phlebovirus and nairovirus. (100nm in diameter, segmented (3) (-)SSRNA
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| How is hantavirus transmitted | rodent urine and feces
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| Unique clinical manifestations of hemmorhagic fever with renal symptoms. | Febrile stage : Hematuria and proteinurea with conunctival hemorrhage. Hypotension and shock in the hypotensive phase, then progressing to oligouric stage
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| lassa fever is a finding of what viral infxon | arenavirus
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| describe arenavirus structure | 60-300nm, (-) ssrna
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| Possible complications if arenavirus infxon | hearing impairments and bacterial superinfection
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| What is the treatment for lassa fever | Ribavirin
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| Ribavirin can be used to tx what viral hemorrhagic disease | lassa fever (arenovirus)
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| What are the main targets for most hemorrhagic fevers causing viruses | Dendritic cells and macrophages
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| ****What cytokine is commonly implicated in hemorrhagic fever?**** | TNA-a --> increased endothelial permeability
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| Innate viral immunity is mediated via,...? cellular immunity? | Innate = INF-alpha, Cellular immunity = CTLs mostly, Humoral = neutralizing antibodies
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| How do neutralizing antibodies mediate response against viruses that cause hemorrhagic fever? | They mediat oxidation of the viral envelope by compliment
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| A person with a hemorrhagic fever who recently traveled to Asia is most likely infected with hat virus? | DENV-1,2,3 or 4 (dengue)
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| A person with a hemorrhagic fever who recently traveled to Arica or South America is most likely infected with what virus? | Yellow Fever Virus (flaviviridae)
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