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Viral infection ´ëÀå°æ Á¤¸®

1. HSV I : ¾ÆÀÌ, oral cavity·Î °¨¿° ¹× ÀüÆÄ, trigeminal ganglion¿¡ Àẹ

HSV II: ¼ºÀÎ, genital tractÀ¸·Î °¨¿°, sexual contactÀ¸·Î ÀüÆÄ, lumbosacral ganglion¿¡

Àẹ

2. HSV encephalitis: viral encephalitisÁß most common

fever, focal neurologic sx(+),ƯÈ÷ temporal lobe

Ãʱ⿡ °¡Àå ¹Î°¨ÇÏ°í ºñħ½ÀÀûÀÎ °Ë»ç: CSF¿¡¼­ HSV DNA PCRÁõ¸í

3. VZV¿¡ ÀÇÇØ ¹ß»ýÇÏ´Â varicella(chickenpox)¿Í herpes zosterÀÇ Â÷ÀÌ

Varicella: air-borne infection

herpes zoster: reactivation of latent infection

4. Varicella = chickenpox

°¨¿°±â°£: ¹ßÁøÀÌ »ý±â±â 2ÀÏÀüºÎÅÍ ¼öÆ÷°¡ Çü¼ºµÉ¶§±îÁö(º¸Åë 4-5ÀÏ)

24½Ã°£³»¿¡ PO acyclovirÅõ¿©°¡ ÃßõµÈ´Ù. 5-7ÀÏ

5. foscarnet: acyclovir resistant HSV or VZV

ganciclovir resistant CMV¿¡ Åõ¿©

6. Infectious mononucleosis

°¡Àå Æ¯Â¡ÀûÀÎ ÁõÈÄ´Â pharyngitisÀÌ´Ù.

ù 2ÁÖ¿¡ lymphadenopathy, pharyngitis, fever -> 2-3ÁÖ¿¡ splenomegaly

Àẹ±â´Â 4-6ÁÖ

heterophil Ab´Â acute illnessÈÄ titer°¡ Á¡Â÷ °¨¼ÒÇÏ¿© 3°³¿ù Áö¼ÓÇϸç 1³â±îÁö Áö¼ÓÇÒ ¼öµµ

ÀÖ´Ù.

atypical lymphocyte´Â activated T lymphocyte(CD8+)ÀÌ´Ù.

7. CMV pneumonitis Áø´Ü

lung biopsy or BAL

8. CMVÀüÆÄ: sexual contact, breast feeding, tranfusion µî

9. HSV I esophagitis´Â ¸é¿ª±â´ÉÀÌ Á¤»óÀÎ »ç¶÷¿¡¼­µµ ¹ß»ýÇÒ ¼ö ÀÖ´Ù.

CMV esophagitisÀÇ biopsy: large fibroblast & endothelial cell¿¡ intranuclear & small

intracytoplasmic inclusions

10. CMV infectionÀ» cultureº¸´Ù ´õ »¡¸® Áø´ÜÇÒ¼ö ÀÖ´Â ¹æ¹ý

i) CMV immediate-early antigen(pp65) in PB leukocyte

ii) CMV DNA PCR

iii) shell vial assay

11. BMTȯÀÚ¿¡¼­ CMV pneumoniaÀÇ Ä¡·á´Â ganciclovir´Üµ¶À¸·Î´Â È¿°ú°¡ ¾ø°í

ganciclovir¿Í immunoglobulinÀÇ º´ÇÕ¿ä¹ýÀ» ÇÑ´Ù.

12. allogeneic BMTÈÄ urine/sputum culture¾ç¼ºÀº carrier»óŸ¦ ÀǹÌÇϱâ´Â Çϳª CMV

disease¸¦ ÀǹÌÇÏÁö´Â ¾Ê´Â´Ù. ±×·¯¹Ç·Î Ä¡·á´ë»óÀÌ ¾Æ´Ï´Ù.

13. ÃÖ±Ù Àå±âÀ̽ÄÈÄ ganciclovirÀÇ Á¶±â ¿¹¹æÀû Åõ¿©ÀÇ È¿°ú

Á¶±â CMV°¨¿°À¸·Î ÀÎÇÑ »ç¸Á·ü, ÀÌȯÀ²À» °¨¼Ò½ÃÄ×´Ù.

³»¼º CMV±î »ó´ëÀûÀ¸·Î ±ÞÁõÇϰí ÀÖ´Ù.

Èıâ CMV°¨¿°ÀÇ ¹ß»ý¿¡´Â È¿°ú°¡ ¾ø´Ù.

14. Adenovirus°¨¿°ÀÇ ÀÓ»óÇü

i) acute respiratory disease

ii) childhood pneumonia

iii) pharyngoconjunctival fever

iv) keratoconjuntivitis

v) febrile pharyngitis

vi) acute hemorrhagic cystitis

vii) pertussis syndrome

15. asthma acute exacerbation½ÃŰ´Â °¡Àå ÈçÇÑ °¨¿°¿øÀÎ(virus)

young children : RSV, parainfluenza virus

older children, adult: rhinovirus, adenovirus

16. influenza AÄ¡·á¿¡¸¸ ÀÌ¿ëµÇ´Â Ç×¹ÙÀÌ·¯½º ¾àÁ¦: amantadine, rimantadine

17. influenza A, B¿¡ ¸ðµÎ È¿°ú°¡ ÀÖ´Â ¾à: zanamivir

18. influenzaÀ¯ÇàÁö¿ª¿¡¼­ ¿¹¹æÁ¢Á¾À» ÇÏÁö ¾ÊÀº °íÀ§Ç豺¿¡ ¿¹¹æÀûÀ¸·Î Åõ¿©ÇÒ¼ö ÀÖ´Â ¾à?

amantadine and rimantadine

19. viral gastroenteritisÀÇ most common cause? Norwalk virus

20. È«¿ªÀ» ¾Î°í ³­ÈÄ ¼ö³âÈÄ¿¡ ³ªÅ¸³¯ ¼ö ÀÖ´Â Áúȯ? SSPE(subacute sclerosing

panencephalitis)

21. È«¿ª(measles= rubeola)

Àü±¸±â¿¡ Àü¿°·ÂÀÌ °¡Àå °­Çϰí, È£Èí±â ºÐºñ¹°À̳ª Á÷Á¢ Á¢ÃËÀ» ÅëÇØ¼­ Àü¿°µÈ´Ù.

¼ºÀο¡¼­ ¹ßº´½Ã¿¡´Â Áõ»óÀÌ ´õ ½ÉÇÏ´Ù.

22. È«¿ª ¹é½ÅÀÇ ±Ý±â

ÀÓ½Å, immunodeficiency, leukemia, other systemic malignant disease

active Tb

23. dzÁø(rubella) ÀӽŽà exposureµÈ °æ¿ì

Ab(+)À̸é žƿ¡°Ô ¹®Á¦ ¾ø´Ù.

Ab(-)À̸é 3ÁÖÈÄ¿¡ ÃßÀû°Ë»çÇÏ¿© Ab titer°¡ 4¹èÀÌ»ó Áõ°¡ÇÏ¸é °¨¿° -> À¯»ê

24. Hantavirus infectionÀÇ ÀÓ»ó¾ç»ó

HFRS, HPS(hantavirus pulmonary syndrome)

25. À¯Ç༺ ÃâÇ÷¿­, ÀúÇ÷¾Ð±â¿¡ °¡Àå ÁÁÀº Ä¡·á? albumin, vasopressor

26. HFRSº´¸®: arterilolar dilatation, congestion,

plasma, RBCÀÇ extravasation

27. Rabies

active immunization: HDCV(human diploid cell vaccine)À̳ª RVA(rabies vaccine

adsorbed)´Â 5ȸ ¸Â¾Æ¾ß ÇÑ´Ù.