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.