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DEN 7108 Micro and Immuno Concepts Part II > 1/30 Nguyen Microbiology and Immunology Concepts II > Flashcards

1/30 Nguyen Microbiology and Immunology Concepts II Flashcards

1
Q

Herpesviruses are part of what family?

A

Herpesviridae

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2
Q

What viruses are part of herpesviridae?

A
  • HSV 1 and 2
  • Varicella-zoster virus
  • Epstein-Barr virus
  • Cytomegalovirus
  • Human herpesviruses 6, 7, 8
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3
Q

Herpesviridae: three subfamilies

A
  • alpha herpesviruses
  • beta herpesviruses
  • gamma herpesviruses
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4
Q

Alpha herpes viruses

A
  • HSV 1 and 2
  • Varicella zoster virus
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5
Q

Varicella zoster virus is also known as:

A

Human herpesvirus 3

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6
Q

Gamma herpes viruses

A
  • Epstein-Barr virus
  • Kaposi’s sarcoma-related virus
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7
Q

Epstein-Barr virus is also known as:

A

human herpesvirus 4

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8
Q

Kaposi’s sarcoma-related virus is also known as:

A

Human herpesvirus 8

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9
Q

Beta herpes viruses

A
  • Cytomegalovirus
  • Human herpes virus 6 and 7
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10
Q

Cytomegalovirus is also known as:

A

Human herpesvirus 5

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11
Q

Herpesviruses structure

A
  • Enveloped
  • icosahedral (equilateral triangles)
  • large dsDNA
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12
Q

Herpesviruses encode:

A

Viral DNA polymerase

as opposed to host dna polymerase

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13
Q

All herpesviruses are _____ following initial primary infection

A

Latent

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14
Q

Herpesviruses are mostly ____, but problematic for ____ patients

A

Benign; immunocompromised (HIV/AIDS)

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15
Q

HSV-1 and HSV-2 spread by _____

A

Contact

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16
Q

HSV-1 and HSV-2 shed in:

A

Secretions (saliva, tears, genitals)

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17
Q

How long are HSV-1 and 2 shed in secretions?

A

For years after primary infection

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18
Q

HSV-1 and HSV-2 can be spread by ____ but are most contagious during ____

A

Asymptomatic transmission; outbreak

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19
Q

True or false: antibodies towards HSV-1 and HSV-2 are generally protective

A

False - can get infected over and over

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20
Q

Majority of HSV-1 infections are _____; a proportion are ____

A

Oral-facial herpes; genital-anal

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21
Q

HSV-2 is almost exclusively _____ transmitted

A

Sexually

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22
Q

True or false: HSV-2 infection is lifelong and incurable

A

True

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23
Q

____ is the most common infection in people living with HIV

A

HSV-2

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24
Q

Those with HIV and HSV-2 coinfection have:

A
  • more severe clinical presentation
  • more frequent recurrences
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25
Q

Some herpesviruses may recombine within genome, such as:

A
  • Varicella zoster
  • Herpes simplex (HSV)
  • CMV (Cytomegalovirus)
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26
Q

Number of isomeric forms of VZV

A

2

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27
Q

Number of isomeric forms of HSV-1 and HSV-2

A

4

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28
Q

Number of isomeric forms of CMV

A

4

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29
Q

HSV vaccine: ____ approved yet

A

None

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30
Q

HSV RNA-based vaccines are being tested to:

A

Prevent viral attachment to host cells

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31
Q

HSV-1 site of viral latency

A

Trigeminal ganglia

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32
Q

HSV-1 and HSV-2 establish latency in:

A

Innervating sensory neuron

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33
Q

HSV-2 site of viral latency

A

Sacral ganglia

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34
Q

HSV infection - triggers for recurrence

A
  • stress
  • fever
  • infection
  • menstruation
  • sunlight (UVB)
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35
Q

HSV can spread during:

A

Recurrence

viral replication in neuron, recurrent lesions in same location

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36
Q

HSV-1 recurrence %

A

45%

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37
Q

HSV-2 recurrence

A

60%

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38
Q

HSV clinical manifestations

A
  • acute gingivostomatitis
  • herpes labialis (cold sore)
  • herpes genitalis
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39
Q

HSV-1 and 2 can both cause _____ infections

A

Oral and genital

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40
Q

What is acute gingivostomatitis?

A
  • Inflamed oral mucosa and gingiva
  • causes gingival pain and bleeding
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41
Q

Most common manifestation of primary herpetic infection (age 1-3 years)

A

acute gingivostomatitis

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42
Q

HSV-1 can have a co-infection with:

A

Candidiasis

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43
Q

Primary herpetic gingivitis may cause a risk of ____ because it is painful to drink

A

Dehydration

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44
Q

_____ can occur as a form of oral-facial herpes and can be very severe in children

A

Peri-oral herpes simplex

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45
Q

After the primary infection, oral-facial herpes is mostly:

A

Asymptomatic

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46
Q

Most common recurrent form of HSV-1 disease

A

Herpes labialis (cold sore, blisters, or ulcers)

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47
Q

Herpes labialis can be found on:

A
  • vermillion border/edge of lips
  • gingiva
  • hard and soft palate
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48
Q

Herpes gladiatorum is also known as:

A

Mat herpes

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49
Q

Herpes gladiatorum is nearly always:

A

HSV-1

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50
Q

Cutaneous herpes can be caused by:

A

HSV-1 and HSV-2

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51
Q

Cutaneous herpes can occur:

A

Anywhere on the skin

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52
Q

What is herpetic whitlow?

A

Herpes lesions on fingernail; common from bare-handed dentistry

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53
Q

Cutaneous herpes recurrence tracks back to:

A

Nerve

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54
Q

True or false: you can autoinnoculate yourself in other parts of your body with cutaneous herpes

A

True

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55
Q

Patients with eczema or atopic dermatitis can develop:

A

Eczema herpeticum

HSV vesicles superimposed upon dermatitis

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56
Q

_____ most common cause of corneal blindness in the US

A

Ocular HSV-1

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57
Q

___ is associated with ocular herpes

A

Dendritic ulcer (scars when healing)

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58
Q

Herpes keratitis

A

HSV-1 infection of the eye due to autoinnoculation

59
Q

Herpes keratitis is commonly limited to:

A

One eye

60
Q

Genital herpes symptoms

A

Painful, burning, vestibular ulcers (1-8mm)

61
Q

Herpes can spread to other areas and cause other infections such as:

A
  • meningitis
  • encephalitis
  • neonatal (perinatal infection)
62
Q

True or false: Herpes meningitis is usually benign and mostly self-limiting

A

True

63
Q

Herpes encephalitis has a ____ mortality

A

High

64
Q

Herpes encephalitis is usually caused by:

A

HSV-1

65
Q

Herpes meningitis is usually caused by:

A

HSV-2 (more than HSV-1)

66
Q

Herpes encephalitis treatment

A

Acyclovir IV

67
Q

Perinatal infection, caused by HSV ____, can cause:

A

HSV-2; dissemination, encephalitis, and high mortality in the newborn

68
Q

HSV laboratory diagnosis methods

A
  • immunofluorescence microscopy (IFM)
  • Tzanck preparation (herpes skin test/smear)
  • PCR
69
Q

Gold standard for herpes lab diagnosis

A

PCR

70
Q

HSV treatment

A
  • Multiple forms of acyclovir (topical, oral, IV, ointment)
  • Valacyclovir (HSV-2)
71
Q

Valacyclovir is used to treat _____. It is a derivative of ____. Its function is to ____

A

Genital herpes; Acyclovir; shorten infection severity, length, and shedding

72
Q

Guanosine components

A

Guanine with ribose

73
Q

Acyclovir is _____ nucleoside analog

A

Guanosine

74
Q

Acyclovir treatment: mechanism of action

A
  1. ACV inert unless HSV is present
  2. HSV produces thymidine kinase to add a phosphate to ACV
  3. host completes phosphorylation to make active form of acyclovir (ACV-triphosphate)
  4. viral DNA incorporates ACV-TP
  5. ACV-TP competes, inhibits, inactivated HSV-specified DNA polymerase
  6. terminates viral DNA synthesis
75
Q

HSV can also be treated with laser treatment in order to:

A

Stimulate ATP synthesis to increase cellular energy levels and promote tissue repair

76
Q

True or false: HSV laser treatment can be done in a dental office

A

True

77
Q

Varicella Zoster virus can establish:

A

Latent infection

78
Q

Varicella causes:

A

Chicken pox

79
Q

VZV spreads via:

A

Respiratory routes

80
Q

VZV stages of infection

A
  • primary infection in mucosa of respiratory tract
  • secondary viremia (lesions may cover entire body)
  • latency in neurons, recurrence
81
Q

VZV chickenpox is spread through ____ and _____ contagious

A

Respiratory; highly

82
Q

VZV causes a maculopapular rash which show up as:

A

Successive crops (varying stages)

83
Q

Varying stages of chickenpox

A
  • papule
  • blister
  • ulcer
  • scabbing
84
Q

True or false: chickenpox can be intraoral

A

True

85
Q

VZV establishes latency in:

A

Cerebral or posterior root ganglia

86
Q

VZV is ____ severe in older adults

A

More

87
Q

VZV diagnosis - cytopathology

A
  • Syncytia (giant, multinucleated cells)
  • intranuclear inclusions
88
Q

VZV clinical diagnosis

A

Several stages of rash at one time (papule, vesicle, pustule, scab)

89
Q

Chickenpox is usually located on:

A

Torso

90
Q

What are Shingles?

A

Recurrence of latent varicella

91
Q

Symptom of latent varicella

A
  • post herpetic neuralgia
  • intense lasting pain
  • pain worse in older patients
92
Q

Latent varicella usually affects:

A

Single dermatome, does not cross midline

93
Q

DOC for latent varicella

A
  • Acyclovir
  • Valacyclovir
94
Q

Varicella vaccine is _____. It is administered in the ____ vaccine for _____

A
  • live & attenuated
  • part pf MMRV vaccine
  • children 4-6 years old
95
Q

Epstein Barr virus site of latency

A

B cell

96
Q

Kaposi’s sarcoma-related virus site of latency

A

B cell

97
Q

Cytomegalovirus site of latency

A

Monocyte, lymphocyte

Myeloid cells

98
Q

Human herpesvirus 6/7 site of latency

A

T cells

99
Q

EBV structure

A
  • enveloped
  • icosahedral
  • dsDNA
100
Q

EBV is transmitted mainly by:

A

Saliva (toothbrush, eating utensils, blood, semen)

101
Q

EBV latency occurs in _____ and are reactivated by ____ to become active again

A

B cells; Th2 cells (Th2 response)

102
Q

EBV associated diseases

A
  • Infectious mononucleosis (mono)
  • nasopharyngeal carcinoma
  • lymphoma (Burkitt’s lymphoma)
  • Hodgkin’s lymphoma
  • gastric adenocarcinoma
103
Q

EBV sheds in saliva, so it is termed the:

A

“Kissing disease” or “mono”

104
Q

Infectious mononucleosis can lead to:

A
  • lymphadenopathy (swollen glands)
  • exudative pharyngitis (tonsillar membrane)
  • palatal petechiae (soft palate)
105
Q

HIV/AIDS patients who acquire EBV can get:

A

Hairy leukoplakia

106
Q

True or false: hairy leukoplakia can rub off like candidiasis

A

False - cannot be rubbed off (differs from candidiasis)

107
Q

____ can cause Burkitt’s lymphoma

A

EBV

108
Q

What is Burkitt’s lymphoma?

A

Monoclonal B-cell tumor

109
Q

Burkitt’s lymphoma is endemic in:

A

Malarial regions of Africa

110
Q

Burkitt’s lymphoma involves chromosomal ____ which has sporadic occurrence in ____ patients

A

Translocations; HIV/AIDS

111
Q

_____ can be a co-factor in Burkitt’s lymphoma

A

Malaria (co-infection with EBV)

112
Q

What is Hodgkin’s lymphoma?

A

Cancer of lymphocytes; lymph node cancer

113
Q

Hodgkin’s lymphoma is mostly attributed to ____ infection

A

EBV

114
Q

EBV causes 2 types of lymphatic cancer:

A
  • non-Hodgkin’s lymphoma
  • Hodgkin’s lymphoma
115
Q

Diagnosis of Hodgkin’s lymphoma involves identifying presence of:

A

Reed-Sternberg cells

116
Q

What are Reed-Sternberg cells?

A

Multi-nucleated, bilobular malignant B-cell

117
Q

Hodgkin’s lymphoma can affect _____ patients

A

Transplant and HIV/AIDS

118
Q

Why are transplant patients more prone to developing Hodgkin’s lymphoma with EBV infection?

A

They are on immunosuppression therapy; infection of B cells

119
Q

EBV can infect _____ to cause nasopharyngeal carcinoma

A

oropharyngeal and nasopharyngeal epithelia

120
Q

Nasopharyngeal carcinoma is endemic in:

A

Southern China

121
Q

EBV may activate genes that can affect risks for developing:

A

Autoimmune diseases

more research needed for links between other conditions

122
Q

EBV clinical diagnosis

A
  • Self-limiting
  • splenomegaly (enlarged spleen)
123
Q

EBV treatment

A

Supportive therapy

124
Q

EBV laboratory diagnosis

A
  • lab tests usually unnecessary
  • can look for atypical lymphocytes (Downey cell)
  • serology
125
Q

What is Kaposi’s sarcoma?

A
  • lymph or blood vessels cancer
  • cancer then causes skin or mucosal tumors usually on mouth/palate
126
Q

Kaposi’s sarcoma can be found in what locations?

A

Usually mouth and palate, also trachea

127
Q

Kaposi’s sarcoma tumors can be:

A

Flat or raised

128
Q

Kaposi’s sarcoma is caused by ____ which infects and establishes latency in _____

A

Kaposi’s sarcoma-associated herpesvirus (KSHV); B-cells

129
Q

Phases of infection by Kaposi’s sarcoma-associated herpesvirus

A

Latent and lytic/productive phases

130
Q

What happens during the lytic/productive phase of KSHV infection?

A

MHC Class I downregulation on the surface of infected cells

131
Q

_____ immortalizes cells

A

KSHV (latent and lytic phase promotes cell cycle and growth, prevents apoptosis)

132
Q

Kaposi’s sarcoma has characteristic ____ disease in HIV/AIDS patients

A

Opportunistic

133
Q

True or false: CMV is a common human pathogen, infection 70-90% of people

A

True

134
Q

CMV infection is usually:

A

Asymptomatic

135
Q

CMV is transmitted via:

A

Secretions

136
Q

CMV is an important opportunistic pathogens in:

A

Immunocompromised patients (HIV/AIDS, transplants, Pneumonia)

137
Q

CMV forms nuclear and cytoplasmic inclusion bodies, such as:

A
  • CMV Owl’s eye
  • Marginated chromatin
  • enlarged cell (cytomegaly)
138
Q

CMV diagnosis

A

PCR

139
Q

____ is the most common viral cause of congenital defects

A

CMV

140
Q

Congenital defects associated with CMV

A

Loss of hearing, microencephaly

141
Q

CMV DOC

A

Ganciclovir

142
Q

HHV-6 and HHV-7 are:

A

genetically related

143
Q

HHV-6-and HHV-7 are part of the ____ subfamily

A

Roseolovirus
“Roseola infantum”
“Exanthem subitum”

144
Q

Symptoms of HHV-6 and 7

A

Fever and rash in infants for 1-5 days

DEN 7108 Micro and Immuno Concepts Part II (27 decks)

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