Surgical notes

🤔 Molliscum contagiosm and Human Papilloma warts Molliscum contagiosm:- ❗️ Caused by MCV , Poxviruse ❗️ one genotype ❗️ Umblicated cheesy Papules ❗️ soft ❗️ called Human soft warts Human Papilloma wart : - ❗️ Caused by HPV , Papovaviruses ❗️>100 serotypes ❗️ cauliflower shaped ( Verruca Vuligaris) ❗️ rough ❗️called warts ( Verruca) #مايكرو #فيروسات

🤔🤔 Small pox and Chickenpox: Both are transmitted by droplets and contact .. Small pox ❗️Caused by small pox viruse ❗️Rash :- centrifugal ❗️Starts : macule , papule , vesicle , pustules, ends forming crust ❗️Scar formation .. And Fetal Chicken pox : ❕ caused by VZV ❕ rash : Centripetal ❕ polymorphic ( all in same time ) Characterized by Umblicated lesion ❕ healed without scar Not fetal #فيروسات #مايكرو

🍃Why small pox is eridicated:- 1- it has only one stable stereotype. 2- The man is the only host 3- no reservoir host 4- no carrier 5- was the first to be controlled by vaccine 6- produce long lasting memory #فيروسات #مايكرو

🛑 Lymphocytosis is suspected lymphoma utill proven otherwise .. 🛑 Lymphocytosis with Atypical T lymphocytes ..." feel safe " It is infectioue Mononucleosis 🛑 to Differentiate between infectioue Mononucleosis, and Infectious mononucleosis like syndrome Infectious mononucleosis, With heterophills Antibodys in EBV Infectious mononucleosis like, without Hetrophills antibodies in CMV Both shows symptoms of: Sore throat, fever , fatigue, lymphadenopathy , enlarged spleen , Hepatitis #فيروسات #مايكرو

🤔For EBV : Anti - VCA IgM / IgG :- Anti viral capsid IgM :- Acute infection then disappears IgG ; may be Occurs in Acute infection, remains in convalescent anti-EBNA IgG ( EB nuclear antigen) Only occur in convalescent and indicates previous infection #فيروسات #مايكرو

🤕 common skin rashes :- 1- macule : small ,flat 2- papule : small ,raised ( solid) Maculopapule Both^ 3- vesicle : small , elevated ( with clear fluid) 4- pastule : vesicle filled with pus 5- Nodule: large , raised, Solid 🤕 Differences between Droplets / Airborne :- Droplets : Large >5 microns Surface contamination Removed by hand wash Airborne:- smaller ( Droplet nuclei ) <5 microns Still in the air ( more dangerous) #فيروسات #مايكرو

Most commonly: Laboratory diagnosis methods used :- 1) PCR 2) Viral atigens by DIF #فيروسات #مايكرو

🙂🙂🙂 For HSV-1 HSV-2 VZV Direct virus demonstration: By scrapping the ulcer of from Vesicular fluids Under light microscope:- Tzanck smear Shows ( Multinucleated Gaint cells ) Stained by Geimsa stain #فيروسات #مايكرو

🛑 Note for the DNA viruses we have vaccines for 4 Viruses only :- 1- VZV 2- Adenoviruses ( Stopped ) 3- human Papilloma virus 4- Parvovirus And for EBV ,CMV :- Vaccines under trail #فيروسات #مايكرو

💉 Summary of DNA viruses prevention :- 🌺 Herpsviridae:- 1- HSV-1 :- a) Avoid contact with herpetic lesions b) Avoid kissing c) hand washes d) personal purposes 2- HSV-2 :- a) Avoid Adultery b) Cesarean section for new born 2- VZV :- ( Active / Passive immunization) 🍃a) Active:- ❗️For Vericella: 1995 children Varivax >> Live attenuated >> 2Doses ❗️ For Zoster : old age a) Zostavax (2006 ) >> live attenuated >> single ... over 60y b) Shingrix ( 2017 ) >> recombinant 🍃 Passive:- ( VZIG ) Immunoglobulin for Immunocompromized , mother before delivery , neonatel 3) EBV : a) Avoid kissing b) vaccine under trail 4) CMV :- a) blood transfusion free of CMV b) Donor and recipient of organ Transplant free of CMV c) vaccine under trial 2018 positive phase1 🌺 Poxviruses : no vaccine 🌺 Adenoviruses: a) Avoid overcrowded b) hand washing C) chorination of Swimming pool d) vaccne type 3,4&7 which was ceased ( Stopped ) 1999 🌺 Papovavirus:- 1- human Papilloma virus prevention: a) Quadrivalent (6,11,16,18 ) for female ( 0 , 2 & 6 months ) b) Bivalent ( Cervarix) for Type 16,18 ( Recombinant) 🌺 Parvovirus B19:- a) Screening of Blood transfusion for patients with chronic anemia , AIDS , anemic pregnant women b) Vaccine ( 0 ,1 &6 ) recombinant #فيروسات #مايكرو

📛 Exanthematic Diseses: 6 ( MS.VRPR) 1- M : measles by Rubeloa virus 2-S : scarlet fever by erythrogenic toxins of Streptococcus pyogens 3-V: Vericella by VSV 4- R: rubella 5- P: Parvovirus b19 , slapped Cheek appearance ( fifth disease) 6-R: Roseola Infantum ( Sixth disease) by HHV-6/7 #فيروسات #مايكرو

🛑 Note : ❗️DNA viruses may be Oncogenic 🛑Cervical cancer may be due to :- 1- HSV-2 2- HPV ( 16,18,6,11 ) 🛑 Keratoconjunctivitis:- By :- 1- HSV-1 2- Adenoviruses #فيروسات #مايكرو

🌼Diseases caused by DNA viruses :- 🌼 Herpsviridae:- 1- HSV-1 :- ( OroFacial) 💥 1- Herps Labialis 💥 2- Keratoconjunctivitis >> dendritic ulcer >> Bindness 💥 3- Gingivostomatitis 💥4- Herpetic Whitlow on Finger 💥 5- complication : Ecephalitis , Aseptic meningitis 2- HSV-2 :- ( Urogenital) 💥1- Genital Herps 💥2- Neonatal herps through Birth canal 💥3- Cervical cancer 3- VZV:- 💥1- Primary infection:- Vericella ( Chickenpox) generalized rash 💥2- Reactivated infection: Zoster or Shingles ( A belt roses from hell ) 4- EBV 💥1- most cases Subclinical 💥2- infectioue Mononucleosis ( Glandular fever ) making B- cell immortal producing Hetrophill antibodies , lymphosytosis with Atypical lymphocytes 💥 Infectious mononucleosis:- may cause Hepatitis ( Viral Hepatitis) 💥 3- Oral hairy Leukoplakia in AIDS patients 💥4- Burkitt's Lymphoma in Negroes 💥5- Nasopharyngeal carcinoma 5- CMV :- 💥1- in normal host :- a) Asymptomatic, latent b) Infectious mononucleosis like syndrome including Hepatitis c) Restenosis of Coronary angioplasty 💥2- In immunecompramised a ) Retinitis ( Blindness) b) Pnemonia 💥3- Congenital infection :- <24 w Abortion > 24 w Stll birth * Cytomegalic Inclusion Disese :- a) Blindness b) Diffness c) Mental retardation d) Hepato- spleenomegaly 6- HHV- 6 :- 💥 Roseola Infantum ( Subitem) >> Sixth disease of Exanthematic Diseses [ Rose Rash ] 7- HHV-7 :- 💥Roseola Infantum like 8- HHV-8 :- 💥 Kaposi's Sarcoma in patients with AIDS .. ( Endothelial cell tumor ) Multiple vascular nodules 🌼 Poxviruses:- ☄1- Orthopoxvirus :- eridicated 💥a) Smallpox ( variola ) virus 💥b ) cowpox 💥c) vaccine virus ☄ molluscum contagiosm :- Human soft Warts ( Benign skin nodules) >> Umblicated Papules 🌼 Adenoviruses:- more than 50 antigenic type Effects epithelial cells :- ☄1- upper respiratory tract + Eye :- 💥 a) Febrile respiratory disease (4,7,14,21) : Rhinitis , pharyngitis, bronciolitis , croup [ larynx , trachea ,Bronchi) >military recruits 💥b) pharyngeo- conjunctival fever (3,7) > Swimming pool 💥 Keratoconjunctivitis ( second +HSV-1) ☄ GIT :- 💥Gastroenteritis ( 40,41 ) Diarrhea, vomiting, fever >> infantile Gastroenteritis > Intussusception ☄ UT :- ( 11,21) 💥 Heamorrhagic Cystitis Dysuria , Frequency, Heamaturia ☄immunecompramised:- 💥Fetal Pnemonia, Gastroenteritis 🌼 Papovavirus:- ☄pa :- Papilloma >> rapid growth of cells ( Warts ) 💥1) Skin warts .. ( Verruca Vuligaris) 1,2,3,4,10 💥 2) Genital warts ... ( Condyloma accuminta ) 6,11,18,33 💥3 ) Cervical carcinoma ( 16,18) 6,11 ☄ po : polyoma 💥1) JC : John Cunningham Heamorrhagic Cystitis, Nephropathy 💥2) Bk : Brennan Korhn Progressive multifocal Luekoencephalopathy 🌼 Parvovirus B19 :- 1- slapped Cheek appearance ..fifth Exanthematic Diseses 2- Arthritis Due to deposition of Immune complexes 3- Transient Aplastic crisis in patients with severe Anemia ( ex :sickle cell anemia) 4- Hydrops fetalis #فيروسات #مايكرو

💊 Summary of DNA viruses Treatment:- 🌺 Herpsviridae:- 1- HSV-1 :- Acyclovir, avoid Steroids 2- HSV-2 :- Acyclovir , if Pregnant ( cesarean section) 2- VZV :- a) Acyclovir or Valacyclovir or New version ( Fscavir ) .. Foscarnet ( doesn't require Kinase) . b) calamine lotion c) Antihistamine d) Antibiotics for secondary infection e) Avoid [ Aspirin ] , Cut nails 3) EBV : ❗️ No treatment 4) CMV :- Ganciclovir 🌺 Poxviruses: eridicated : No treatment 🌺 Adenoviruses: No treatment 🌺 Papovavirus:- 1- For skin Warts ( Verruca Vuligaris ) :- liquid Nitrogen 2- Electrocautery 3- Podophyllin , Trichloroacetic Acid ,Bichloroacetic Acid 🌺 Parvovirus B19:- transfusion of packd red Blood cells #فيروسات #مايكرو

⭐️ DNA viruses Characters:- ( ALL , Except ) 1- All DNA viuses are( Double stranded) DNA except : ❗️Parvovirus B19 ; (single stranded ) 2- All DNA viruses are (linear )except ❗️Papovavirus ;( Circular) 3- All DNA viuses are ( Ichosahedral ) except ❗️ Poxviruses ; ( Complex: Brick shaped) 4- All DNA viruses or All Viruses is small and seem by( Electron microscope) except ❗️ Poxviruses is large ,seen by ( light Microscope) 5- All DNA viruses replicate innside the nucleus and therefore, Have ( intranuclear ) Inclusion Bodies Except; ❗️Poxviruses ; replicate in the cytoplasm because it has its own Transcriptase [ DNA dependent RNA polymerase] and therefore has ( Intracytoplasmic ) Inclusion Bodies. 6- All DNA viruses are (Enveloped) except ❗️ Adenoviruses , Papovaviruses , Parvovirus b19 are ( Naked).. 7- HSV-2 is transmitted vertically during labour through the Birth canal not transplacentally .. can by Avoided by Cesarean .. 🛑Note:- Poxviruses have 3 Exceptions #فيروسات #مايكرو

🌸 One of the herpsviridae characters is Latency ; 🌸Virus latency is the ability of a pathogenic virus to lie dormant within a cell. Until There is an endogenous Reactavation like Stress , ..etc ... it Shows secondary infection Where it remains Dormant ?! ✨ HSV-1 :- Trigminal Ganglia ( OroFacial) ✨ HSV - 2 :- Sacral Ganglia ( Urogenital) ✨VSV :- Dorsal roat Ganglia ✨ EBV :- B- cells ( 3Bs) ✨ CMV :- Leukocytes and kidney ( organ Transplant ) ✨ HHV-6 / HHV-7 :- T Lymphocytes ✨ HHV -8 :- Endothelial cells ( Kaposi's Sarcoma ) #فيروسات #مايكرو

Owl's eye appearance of inclusion bodies, which is highly specific for cytomegalovirus infection #فيروسات

🐾🐾Several vertically transmitted infections are included in the (TORCH) complex, which stands for: T – Toxoplasmosis / Toxoplasma gondii. O – Other infections (see below) R – Rubella C – Cytomegalovirus H – Herpes simplex virus-2 or neonatal herpes simplex "Other infections" include: Parvovirus B19 Coxsackievirus Chickenpox (caused by varicella zoster virus) Chlamydia HIV #فيروسات #مايكرو

Mucinous & serous tumors of the ovary