Tips and tricks to pass the cardiovascular station for PACES exam
Reorhabdogit
1. Reovirus, Rhabdovirus and Gastrointestinal Viruses FE A. BARTOLOME, MD, FPASMAP Department of Microbiology & Parasitology Our Lady of Fatima University
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5. Reoviridae REPLICATION : Ingestion Proteolytic cleavage of outer capsid in GIT Formation of intermediate/infectious viral particle (ISVP) ISVP release core into cytoplasm Enzymes in core initiate mRNA production using + strand as template
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10. A 6-month-old boy was seen in the emergency room after two days of persistent watery diarrhea and vomiting accompanied by a low-grade fever and mild cough. The infant appeared dehydrated and required hospitalization.
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18. A 24-year old mountaineering student developed fever, chills, and headache 4 days after hiking in the forest. He also complained of photophobia, muscle pain, joint pains and lethargy. P.E. showed redness of conjunctiva, (+) LAD, and palpable liver margins. Maculopapular rashes were noted. Laboratory exam revealed leukopenia with neutropenia and lymphopenia. He remembers being bitten by an insect during the hike.
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30. An 11-year old boy was brought to the hospital after falling. His bruises were treated and he was released afterwards. The following day, he refused to drink water with his medicine, and he became more anxious. That night, he began to act up and hallucinate. He was also salivating and had difficulty breathing. Two days later, he had high grade fever and experienced two episodes of cardiac arrest. His condition continued to deteriorate, and he died 11 days later. When the parents were questioned, it was learned that the boy had been bitten on the finger by a dog 6 months earlier.
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37. Rhabdovirus Wks to mos Afferent neurons Incubation phase Prodrome phase Neurologic phase MOT Bind to nicotinic Ach or ganglioside receptors of neurons Muscle at site of inoculation Replicate at site of bite Skin of head & neck, salivary glands, retina, cornea, nasal mucosa, adrenal medulla, renal parenchyma, pancreatic acinar cells CNS (hippocampus, brainstem, ganglionic cells of pontine nuclei, Purkinje cells of cerebellum) Travel by retrograde axoplasmic transport to DRG & to SC
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39. Rhabdovirus PROGRESSION OF RABIES DISEASE Disease Phase Symptoms Time (days) Viral Status Immunologic status Incubation Asymptomatic 60 – 365 after bite Low titer, virus in muscle Prodrome Fever, n & v, anorexia, headache, lethargy, pain at bite site 2 – 10 Low titer, virus in CNS and brain Neurologic Hydrophobia, pharyngeal spasms, hyperactivity, anxiety, depression CNS: loss of coordination, paralysis, confusion 2 – 7 High titer, virus in brain and other sites Detectable antibody in serum & CNS Coma Coma: cardiac arrest, hypotension, hypoventilation, secondary infections 0 – 14 High titer, virus in brain and other sites Death
