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female presents with the recent onset of vaginal discharge. Physical examination reveals multiple clear vesicles on her vulva and vagina. A smear of material obtained from one of these vesicles reveals several multinucleated giant cells with intranuclear inclusions and groundglass nuclei. These vesicles are most likely the result of an infection with
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*Ground-glass nuclei(Nuclear homogenization),Cowdry inclusions(INTRAnuclear inclusins) with mutltinucleated giant cells is cahracteristic of HSV <Double stranded LINEAR DNA virus which is Enveloped, baby can acquire this virus from mom during delivery>TORCHES in baby.*Patient more likely had HSV2 which is transmitted trough sexual contact,perinatal in contrast with saliva, respiratory secretions which serve as transmission channels for HSV1(associated with KERATOCONJUCTIVITIS,Herpetic withlow on finger=painful infection of nail,GINGIVOSTOMATITIS and TEMPORAL Lobe encephalitis), if you get HSV1 on boards they are most likely to describe patient with acute onset of Seizures,Mental status change/aphasia as HSV1 is MC cause of Sporadic encephalitis, or with uncomplicated herpes labialis while if you get HSV2 it is most likely in the context of herpes genitalis,neonatal herpes.*they LOVE to ask about latent sites, HSV1 usually hides in trigeminal ganglia while HSV 2 usually hides in SACRAL ganglia.*Also don't confuse Viral encephalitis(Can present with grand mal seizure+Lesion in Temporal lobe +Multinucleated giant cells with intranuclear inclusins on brain biopsy) ass. with HSV1 with Viral Meningitis(it is inflammation of meninges around brai/spinal cord instead of inflammation of brain itself whcih is the case with encephalitis) which is more associated with HSV2.
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*NONcardiogenic pulmonary edema resulting from increased permeability of the pulmonary capillaries..*Hypotension with fever and Myalgia(ESP: in Lower legs)*leukocytosis, atypical lymphocytes, thrombocytopenia, coagulopathy, and decreased serum protein concentrations.*Abdominal pain that mimics acute abdomen.*Causative virus belongs to ?
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*This is HANTAVIRUS(transmitted from rodents) which belongs to Bunyaviridae<Negative Sense SS,ENVELOPED,RNA virus with Circular RNA structure with 3 segments and with Helical caspid symmetry,*CLASSICALLY hantavirus is associated with Hemorrhagic fever with renal syndrome which presents with hematologic abnormalities,abdominal pain and renal failure with minimal pulmonary involvement however it CAN present with Hantavirus pulmonary syndrome too..dude LISTEN you have to know that it has 3 segments and you should know every detail of its structure .....i've heard that it showed up as Acute repsiratory distress syndrome in young patient from New Mexico who was exposed to rodent excreta.
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*Virus that started with influenza like symptoms progressed to rash, muscle pain, joint pain, and bone pain.It can produce a potentially fatal hemorrhagic disorder and is known as Breakbone fever..virus?
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*patient has DENGUE fever(Breakbone fever), it is caused by FLAVIVIRUS which is SS+,LINEAR,Enveloped RNA virus with Icosahedral caspid symmetry.*You should know that Aedes mosquito can transmit it as prevention can be done by using Insect repellent(No vaccine or drug is available)
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*Guy who vomits DARK blood, is jaundiced, on liver biopsy you see councilman bodies(Represent apoptosis of hepatocytes), virus ?
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*YELLOW FEVER is caused by yellow fever virus which is FLAVIVIRUS(SS+,Linear ,Enveloped RNA,Icosahedral) is ARBO virus and is transmitted by aedes mosquito(But humans and monkeys are reserviors) we have KILLED vaccine for yellow fever.(Give to someone who goes to South America and Africa), LOOK they can make you choose between Mosquito netting and Vaccine and BEST choice is KILLED VACCINE.,HOWEVER if the patient has WEST NILE VIRUS(targets elderly),St.Louis encephalitis or DENGUE fever then PICK management of VECTOR(Mosquitos) as a way of prevention because vaccine is NOT available.*This virus can cause coagulative necrosis of acinar zone2(Midzonal necrosis)*Liver failure leads to jaundice(YELLOW FEVER:) and vomit of clotted blood(DARK).*Culex mosquito transmits St.louis encephalitis>(Stupor,fever,joint pain,neck,stiffnes,HEADACHE)*West-Nile encephalitis LOVES ELDERLY and can present with stiff neck,sleepiness,disorientation,headache,swollen lymph nodes, can progress to convulsions,coma,paralysis)*HCV will have lot's of cards, for now know that it is SS+ linear,icosahedral,enveloped RNA virus common in IV Drug abusers and has tendency to go chronic.
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6-year-old boy develops a facial rash that has the appearance of a slap to the face. The rash, which is composed of small red spots, subsequently involves the upper and lower extremities. This boy also has arthralgia and suddenly develops a life-threatening aplastic crisis of the bone marrow. The most likely infectious agent causing these symptoms is
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Parvovirus
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*Why should you know that rota virus is NON-enveloped?
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*Because they will ask you which of the following is Not likely to be killed by Ethanol, and will give you bunch of RNA, DNA viruses that are Enveloped, but the answer would be rota or other Non-enveloped viruses like Picornaviruses.
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*Eclipse is?
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*Time between onset of infection and appearance of INTRAcellular virus.<Not Super HY for boards but you never know...
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Medical student on the Caribbean island of Dominica presents at the Student Health Clinic complaining of an increasingly severe headache and back and bone pain. Yesterday she was nauseated and vomited several times during the night. She has a 39.5°C/103°F fever, which appeared suddenly, and a generalized rash that blanches under pressure. She had been hiking in the rainforest 1 week earlier and was particularly bothered by mosquitoes at that time. The most likely infectious agent causing her symptoms is
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*DENGUE Virus-causing "BreakBone fever"*This virus can be transmitted by mosquito bites and is present in Caribbean.
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*Which hepatitis have vaccine?
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*Hep B(SUBUNIT vaccine, involves HbsAg)and HepA(Killed vaccine)
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*After adopting child from Southeast Asia, mother developes jaundice,increased AST,ALT(AST more),Mixed hyperbillirubinemia, virus?
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*HepA is very common in Southeast Asia, so it is a good idea to give them HepA vaccine(killed), before they adopt child from this area,or travel there.*Note think of HepA in jaundiced baby in Daycare center, or traveler and remember that transmission if Fecal oral for this Non-enveloped,SS+,icosahedral RNA virus.*Diagnosis is made by serologic tests rather than culturing of the virus.
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*16 year old teen presents with Posterior cervical lymphadenopathy, fever,hepatosplenomegaly, pharyngitis, you suspect that he got the disease by respiratory droplets(In his case by KISSING),Monospot test you performed was (sheep RBCs were agglutinated by heterotrophil antibodies).*Atypical lymphocytes on blood smear are?
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*CYTOTOXIC T LYMPHOCYTES.*Yes EBV is DS,Linear,enveloped,icosahedral DNA virus(Herpes virus 4) which is famous for the fact that it can infect B lymphocytes by binding to CD21,yet Atypical lymphocytes on blood smear are reactive cytotoxic CD8+T lymphocytes.*Don't forget association of EBV with Burkitt's lymphoma(endemic form,patient will likely be young African child) and more importantly with nasopharyngeal carcinoma(most likely patient will be Asian)*Most clinically relevant fact:Even if it is young Conor Mcgregor, he has to quit sport for a while <as he can die from splenic rupture ...
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*Why could we eradicate smallpox(Caused by poxvirus)?
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*Because Poxvirus has single stable serotype, so new formulations of vaccine every year aren't needed,so 1 live(attenuated) vaccine was enough to eradicate this fcker.*Note Poxvirus is Largest DNA virus and it is DS,Linear,Enveloped,Non-icosahedral virus that is so bad ass that it can replicate in the cytoplasm(Contrast this with other DNA viruses which replicate inside nucleus, Pox carries Own DNA dependent RNA plymerase).*They are more likely to ask about Molluscum contagiosum which manifests as Flesh-colored papule with central umbilication Large eosinophilic cytoplasmic inclusions are present in the affected epithelia.(Rash can be pruritic and can be transmitted trough skin-skin contact)
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*Female with HbsAg+,is AntiHbsAg Ab-she is also HbeAg+,AntiHbeAgAb-,Anti Hbc Ab+(igG)*She is pregnant, what do you do to baby?
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*she has Chronic Active HBV(Acute would have igM for Hbc, but we have igG)+She has Highly infective state as HbeAg is present while Ab for it is absent .*Babies infected with HBV have 90% chance to progress to chronic hepatitis.(Contrast this with adults which mostly develop acute infection)*You need to give baby Vaccine(Subunit vaccine for HBV)+HBIG(as mom can transmit HBV to baby)*Perinatal transmission is MC in developing countries like Southeast Asia, in U.S sexual contact is most common cause.
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*Genome of virus which is Not retrovirus and has Reverse transcriptase(enzyme Synthesizes cDNA from RNA ) in it?
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*Partially double-stranded,circular,enveloped DNA Hepandavirus>Sex,From blood,(parenteral)or from Mom(perinatal)*Patient initially can present with Arthralgia,Fever,Rash(Like serum sickness*Cytotoxic T cells mediate the damage to liver and on biopsy you would see granular eosinophilic"Ground Glass" appearance.*Note Just like HCV and HDV it can increase your risk of HCC.*Note HDV produces same histological manifestations is transmitted in same ways as HBV but is Defective RNA virus that needs envelope from HBV and with Co-infection>Severe prognosis esp.in pregnant patients.
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*Pregnant Female developed fulminant hepatitis and died , Liver biopsy shows Patchy Necrosis.she most likely got virus from?
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*From water, food<Transmission of HEV(RNA hepevirus) is Fecal-Oral.>VERY Severe in pregnant patients <Can kill them, Patchy necrosis is characteristic on liver biopsy and just like HAV it has NO CARRIER STATE.*HAV and HEV are much like each other as we see both have fecal-oral transmission, without carrier state and Non of them increase risk of HCC,however HAV is picornavirus which has good prognosis and on liver biopsy you would see Hepatocyte swelling,MONOCYTE INFILTRATION,councilman bodies(indicate apoptosis)
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