West Nile Encephalitis: Review Questions Sajan Thomas, MD and Hema Azad, MD Dr. Azad is a resident in internal medicine and Dr. Thomas is assistant program director of the internal medicine residency program, Westlake Hospital, Melrose Park, IL. The questions below are based on the May 2004 cover article, “West Nile Encephalitis” Choose the single best answer for each question.
	1. What is the incubation period of West Nile virus infection in human beings? 6-24 hours 1-2 days 2-14 days 2-4 weeks 4-8 weeks Click here to compare your answer. 2. What percentage of West Nile virus-infected persons develop severe illness with central nervous system involvement? 0.33% 0.67% 1.3% 3.1% 5.1% Click here to compare your answer. 3. Which of the following clinical features is uncommon in West Nile encephalitis? Altered mental status Fever Headache Nuchal rigidity Optic neuritis Click here to compare your answer.		4. All of the following clues raise the index of suspicion for a diagnosis of West Nile encephalitis EXCEPT: Mosquito season Unexplained bird death in the region Age less than 50 years Hyporeflexia Muscle weakness and/or flaccid paralysis Click here to compare your answer. 5. In patients with West Nile encephalitis, what percent of patients have leptomeningeal or periventricular enhancement on magnetic resonance imaging? 10% 30% 50% 70% 90% Click here to compare your answer. 6. What is the best option available currently for the treatment of West Nile virus infection? Corticosteroids Interferon alfa-2b Osmotic agents Ribavirin Supportive management Click here to compare your answer.
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