Term
|
Definition
| Via direct contact with infected secretions (saliva, sexual etc.) |
|
|
Term
| How does CMV primary infection present? |
|
Definition
| Usually asymptomatic. Occasionally glandular fever like picture. |
|
|
Term
| What happens when CMV virus reactivates? |
|
Definition
| It is aasymptomatic but the virus is excreted in the urine and saliva. |
|
|
Term
| What is the greatest risk for CMV infection for solid organ donation? |
|
Definition
| Donor positive, recipient negative. Results in primary infection in the recipient. |
|
|
Term
| What is the greatest risk for CMV infection for HSCT (bone marrow transplant)? |
|
Definition
| Donor negative, recipient positive. CMV present but no T cells. |
|
|
Term
| What can CMV in the immunocompromised cause? |
|
Definition
CMV syndrome: fever, neutropoenia
Organ invasive disease. |
|
|
Term
| How do you diagnose CMV in the immunocompetent and immunocompromised? |
|
Definition
Immunocompetent: CMV IgM (prone to false +ves)
Immunocompromised: PCR. |
|
|
Term
| How is ganciclovir activated and how does it work? |
|
Definition
| It is activated by a viral enzyme and inhibits DNA viral polymerase. |
|
|
Term
| What is the difference between ganciclovir and valganciclovir? |
|
Definition
| Valganciclovir has better bioavailability but is myelosuppressive and nephrotoxic. |
|
|
Term
| How do you prevent CMV in the immunosuppressed after a transplant? |
|
Definition
1) Prophylaxis
2) Pre-emptive monitoring. |
|
|
Term
| Where is epstein barr virus latent? |
|
Definition
|
|
Term
| How does primary EBV present in adolescence? |
|
Definition
| Maybe asymptomatic. Infectious mononucleosis (glandular fever). |
|
|
Term
| What are the symptoms of infectious mononucleosis? |
|
Definition
Triad of:
1) Low grade fever
2) Lymphadenopathy
3) Sore throat
- Abnormal liver function
- Splenomegaly
- Malaise, anorexia, tiredness
- Maculopapular rash if given amoxycillin (immune-mediated). |
|
|
Term
| How does a monospot test work? |
|
Definition
| It detects heterophile antibodies which appear in acute primary EBV infection. |
|
|
Term
| Which antibodies are measured in serology testing? |
|
Definition
1) EBV IgM
2) EBV IgG
3) EBV EBNA IgG. |
|
|
Term
| Which human cancers is EBV mainly associated with? |
|
Definition
1) Burkitt's lymphoma
2) Nasopharyngeal carcinoma
3) Post-transplant lymphoproliferative disorder (PTLD). |
|
|
Term
| What happens in EBV reactivation? |
|
Definition
| Normally asymptomatic in the immunocompetent; virus secreted in the saliva. |
|
|
Term
| What is Burkitt's lymphoma? |
|
Definition
| A highly malignant B cell tumour which arises most commonly in the jaw. Seen mostly in Africa. |
|
|
Term
| What is nasopharyngeal carcinoma? |
|
Definition
| An EBV associated tumour of the head and neck. Geographically seen in Asia and parts of Africa. |
|
|
Term
|
Definition
| Reduced T cell immunity- Uncontrolled EBV replication- E cell proliferation- PTLD. |
|
|
Term
|
Definition
1) Reduce immunosuppression
2) Rituximab- anti B cell antibody
3) Chemotherapy. |
|
|
Term
| How are human herpes virus 6 & 7 transmitted? |
|
Definition
| Via direct contact with infected secretions. |
|
|
Term
| What can HHV6 & 7 cause in a primary infection in children? |
|
Definition
|
|
Term
| What are the complications of HHV 6 & 7? |
|
Definition
1) Febrile convulsions (primary infection)
2) Encephalitis (primary infection)
-Immunocompromised
1) Generalised infection
2) Organ specific disease including encephalitis. |
|
|
Term
| What kind of cancer is HHV8 associated with? |
|
Definition
|
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