Term
| Where are the important hepadnaviruses? |
|
Definition
-Hep B
-See previous cards |
|
|
Term
| What are the medically important types of herpesviruses and abbreviations? |
|
Definition
1. Herpes simplex virus 1 & 2 (HSV)
2. Varicella-zoster virus (VZV)
3. Epstein-Barr virus (EBV)
4. Cytomegalovirus (CMV)
5. Human herpes virus 6 (HHV-6)
6. Human herpes virus 8 (HHV-8) |
|
|
Term
| What is the genome, shape, and size of herpesviruses? |
|
Definition
-dsDNA
-Icosahedral and enveloped (from nuclear membrane)
-Large |
|
|
Term
| What will a cell look like that has the virus? |
|
Definition
| -There will be *intranuclear inclusion bodies |
|
|
Term
| What is a distinguishing feature of infections with herpesviruses? |
|
Definition
| -It is the main family to go latent |
|
|
Term
| Where do we see HSV-1 & 2? |
|
Definition
-HSV-1 is above the waist
-HSV-2 is below the waist |
|
|
Term
| What is the reservoir for HSV infections? How about the transmission? |
|
Definition
-Human mucosa and *ganglia (like in shingles)
-Contact transmission (kissing & sex) |
|
|
Term
| What is the pathogenesis for HSVs? |
|
Definition
-It infects the epithelial tissue and causes the typical vesicle formation (bumps on skin, not intracellular)
-They describe them sometimes as a dewdrop on a rose, with the rose being the ring of erythema
http://o.quizlet.com/L17UzDK.gx.kRMM.pcm46Q_m.jpg
-Also causes latent lifelong infection in ganglion cells |
|
|
Term
| What are the disease (5) that HSV cause and info on them? |
|
Definition
1. Gingivostomatitis and cold sores
-From HSV-1 latent in *trigeminal ganglia
2. Keratoconjunctivitis
-Lid swells and there is vesicle formation
-Also get *dendritic ulcers (corneal ulcers)
-Often from spread from mouth to eye (from rubbing)
3. Meningoencephalitis/encephalitis
-**HSV-1 is the leading cause of viral encephalitis**
-Get fever, headache, confusion
-Esp. associated with focal temporal lesions
-Very high mortality rate if untreated 70%
4. Genital infectoins
-HSV-2 latent in *sacral nerve ganglia
5. Neonatal herpies
-From mothers with genital herpes
-Is often severe and fatal
-Can have liver involvement, encephalitis, or be on skin, eyes, and mouth |
|
|
Term
| How do we diagnose the genital infections? |
|
Definition
-We can use a *Tzank smear to show **multinucleated giant cells (syncytia) and *nuclear inclusions
-More commonly, we now use immunofluorescence which can distinguish the two HSV types |
|
|
Term
| What is treatment for HSV-1 and HSV-2? |
|
Definition
-We use all the -clovir drugs to treat it; mostly **Acyclovir
-These are nucleoside analog antivirals that are inactive until activated by *viral thymidine kinase |
|
|
Term
| What is the reservoir and transmission for varicella zoster virus? |
|
Definition
-Reservoir is the human mucosa and nerves
-The transmission is via respiratory droplets (can get from direct contact, but is much less likely) |
|
|
Term
| What is the pathogenesis in terms of where the virus is? |
|
Definition
| -The VZV enters the respiratory tract--> replicates in nodes--> primary viremia--> spleen and liver--> secondary viremia--> skin (rash)--> latent in *dorsal root ganglia |
|
|
Term
| What are the diseases associated with VZV? |
|
Definition
Chicken pox
-Flu-like symptoms and rash
-Rash is **asynchronous
-1/5 classic childhood exanthems (skin rashes)
Shingles
-Reactivated from dorsal ganglia, usually late in life
-Is along one dermatome, on one side |
|
|
Term
| How do we distinguish chicken pox from small pox? |
|
Definition
| -Small pox vesicles all come at once and are in the same stage of appearance (all ulcers, all scabs, etc.) |
|
|
Term
| How do we diagnose VZV? How do we treat? How do we not treat? |
|
Definition
-We can do the Tzanck smear and should see the multinucleated giant cells and nuclear inclusions
-We usually just let it run its course, but we can give *acyclovir if they are immunocompromised
-*Aspirin is contraindicated due to association with *Reye syndrome (many bad effects, poorly understood) |
|
|
Term
| What is the vaccine for VZV? |
|
Definition
-We use a live, attenuated vaccine
-Rem; Mrr. VZ Mapsy
-This means we will likely see "non-vaccinated" in a stem
-Can also give VZIG (VZ immunoglobulin) as a prophylactic treatment for exposed immunocompromised patients |
|
|
Term
| What is the reservoir and transmission for EBV? |
|
Definition
-Humans
-Saliva
-90% of adults are seropositive |
|
|
Term
| What is the pathogenesis of EBV? Where does it go latent and what do we see that gives it away? |
|
Definition
-Effects nasopharyngeal epith. cells, and also B cells
-It binds to the CD21 receptor of B cells and acts as a mitogen, where it goes **latent
-We get the massive lymph nodes and spleen bc the white cells are fighting the B cells
-The B cells will then cause **heterophile antibodies |
|
|
Term
| What are the diseases associated with EBV? |
|
Definition
Heterophile-positive mononucleosis, "kissing disease"
-Fatigue, fever, sore throat, *lymphadenopathy, splenomegaly
Lymphoproliferative disease
-In immunocompromised patients (T cells can't control)
-Will look like B-cell lymphoma
Hairy Oral Leukoplakia
-Hyperproliferation of oral epith.
-Typical in AIDS patients |
|
|
Term
| What are the cancers associated with EBV? |
|
Definition
-*Burkitt lymphoma (mandible, Africa)
-Nasopharygeal carcinoma (Chinese men)
-*Hodgkin lymphoma |
|
|
Term
|
Definition
-We look for **heterophile antibody
-Also see atypical reactive T cells (react to blood cells); can make up 70% of white blood cells
-MONOcytes will also be elevated (Mac precursor) |
|
|
Term
| What is associated with transformed cells? |
|
Definition
|
|
Term
|
Definition
| -Usually symptomatic but can give acyclovir to immunocompromised patients |
|
|
Term
| What is the reservoir and transmission for CMV? |
|
Definition
-Humans
-Saliva, sexual, parenteral, in **utero |
|
|
Term
| What is the pathogenesis for CMV? Latency? |
|
Definition
-It infects the salivary epith. cells
-It has a latency in the **mononuclear cells |
|
|
Term
| What are the diseases (4) associated with CMV? |
|
Definition
Cytomegalic inclusion disease
-**Most common in utero infection in US**
-Jaundice, hepatosplenomegaly, thromocytic purpura (*"blueberry Mufin baby"), CNS damage and death
Mononucleosis
-Same symptoms as before, but now it is **heterophile negative mononucleosis
Interstitial pneumonitis to severe systemic infection
-From reactivation in **transplant or AIDS patients
CMV retinitis
-Common in AIDS patients |
|
|
Term
| How do we diagnose CMV? How do we treat? How do we prevent? |
|
Definition
-Owl's eye inclusion (sight-o-MV)
-Supportive care for health, a -clovir for immunocompromised
-There is no CMV vaccine, so all we can do is practice safe sex and screen for organ donors |
|
|
Term
| What is that transmission for HHV-6? Where does it replicate? Site of latency? What disease does it cause? Do we have a vaccine? |
|
Definition
-It is transmitted by respiratory droplets
-Replicates in the peripheral blood mononuclear cells, which also serve as the site of latency
**Roseola; fever for 3-5 days and THEN lacy body rash
-Fever will be very high; **afebrile during rash
-There is no vaccine |
|
|
Term
| What do we have to know about HHV-8? |
|
Definition
-Sexual transmission or in saliva
-Infects the dermis
-Can cause **Kaposi sarcoma because HHV-8 turns on VEGF (vascular endothelial growth factor)
-There is no treatment
-We don't know what the site of latency is |
|
|
Term
| OK. Now on to POXVIRUSES! |
|
Definition
| __________________________________________________________ |
|
|
Term
| What's the genome, shape, replication site, and size of poxviruses? |
|
Definition
-dsDNA
-Complex shape* (odd)
-Replicates in the cytoplasm* (odd)
-It is the *largest family of viruses
-The different things about it are because poxviruses takes all the things it needs in the capsid (over packs like a typical female lol) |
|
|
Term
| What are the viruses in the poxvirus family? |
|
Definition
-*Variola
-Vaccinia (vacine strain)
-Molluscum contagiosum
Less common;
-Orf
-Monkey pox |
|
|
Term
| What is variola? How many serotypes does it have? How is it transmitted? |
|
Definition
-It is the virus that caused small pox
-It only has one serotype, which is why were able to eradicate it in 1977 |
|
|
Term
| What is the pathogenesis? What is the timing? |
|
Definition
-It is similar to chicken pox in that it starts by inhalation, goes to viremia, and infects some organs on the way to the dermal tissue
-It has an incubation of 5-17 days, then you get flu-like symptoms for a few days, and finally the pocks, which can cover the entire body in just 24 hours |
|
|
Term
| How do we differentiate it clinically from chicken pox? |
|
Definition
-It starts at the mouth and then spreads *all over the body in a synchronous rash (all vesicles are in same stage of development)
-Also we find *Guarnieri bodies in cytoplasms |
|
|
Term
| What is the variola vaccine? |
|
Definition
-Live attenuated (it's the P in Mapsy)
-It is called vaccinia
-No longer vaccine for it because it has been eradicate |
|
|
Term
| How is molluscum contagiosum transmitted? Where does it replicate? |
|
Definition
-It is transmitted by contact or by fomites
-Replicates in the dermis |
|
|
Term
| What does it look like? How about on a microscopic level? |
|
Definition
-You have little clusters of **umbilicated wart-like lesions (have central depression);
http://warts212.com/images/molluscum.jpg
-We will see eosinophilic cytoplasmic inclusion bodies |
|
|
Term
| How do we treat molluscum contagiosum? |
|
Definition
-We normally don't
-As always with theses DNA viruses, in immunocompromised we may want to treat with one of the antivirals; this time, ritonavir, or cidofovir (still has -vir) |
|
|
