(1) Herpes, and Poxvirus Flashcards by Geno Alinsub

large group of virus that contains several important human viral pathogens

Herpesviridae

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characteristic of HERPESVIRUSES

Double stranded DNA
Enveloped
Icosahedral symmetry
Linear

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One outstanding property of herpesviruses

ability to establish lifelong persistent infections in their hosts

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TOF

Herpesviridae undergo periodic reactivation

True

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Herpesviridae reactivation happnes mostly to?

Already affected persons of Herpesviridae:
* elderly
* immunosuppressed individual

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Herpesviridae

what is the second reactivation from latency of the virus called?

secondary infection or latent infection–latency

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TOF

NOT ALL HERPESVIRIDAE have latency site

F (All)

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HERPESVIRIDAE

once infected, they will remain ____ on that specific latency site

dormant

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HERPESVIRIDAE

oh no i have a herpesviridae but its dormant, but i have low immunity now what will happen to me > __< uwu

REACTIVATED

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Herpesviridae

TOF
Infect both warm and cold blooded animals

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Infections of herpesviridae

mucocutaneous infection and even lifethreatening cancers

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herpesviridae have become successful pathogens due to

latency and reactivation

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Classification (herpesviridae)

Classification are mainly based on its?

biologic property

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what are the subfamillies under herpesviridae

Alphaherpesviridae
Betaherpesviridae
Gammaherpesviridae

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Herpesviridae: Subfamilies

Fast-growing virus (when tried to culture)

Alphaherpesviridae

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Herpesviridae: Subfamilies

Slow growing virus (on culture)

Betaherpesviridae

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Herpesviridae: Subfamilies

what infection does alphaherpesviridae have?

Cytolytic virus

causes lysis on the cell (damage the cell)

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Herpesviridae: Subfamilies - Alpha

causes lysis on the cell (damage the cell)

Cytolytic virus

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Herpesviridae: Alphaherpesviridae

site of latency

Neuron (CNS)

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Herpesviridae: Subfamilies

enumerate the members of alphaherpesviridae

mnemonic: HeHeVading(ka)

Herpes simplex virus type 1
Herpes simplex virus type 2
Varicella-zoster virus

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Herpesviridae: Subfamilies

what infection does betaherpesviridae harbor?

Cytomegalic virus

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Herpesviridae: Subfamilies - Beta

enlargement of cell

Cytomegalic virus

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Herpesviridae: Subfamilies - Beta

Site of latency

SECRETORY GLANDS and KIDNEYS

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Herpesviridae: Subfamilies - Beta

enumerate the members

Cytomegalovirus
Human herpesvirus type 6
Human herpesvirus type 7

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# Herpesviridae: Subfamilies what infection does gammaherpesviridae harbors?

Lymphoproliferative virus

# Herpesviridae: Subfamilies - Beta spread on lymphoid organs

Lymphoproliferative virus

# Herpesviridae: Subfamilies - Gamma Site of Latency

lymphoid tissues

# Herpesviridae: Subfamilies - gamma enumerate the members

- Epstein- Barr virus - Kaposis sarcoma associated herpesvirus

# Herpes Simplex Virus Type 1 (HSV-1) Official name

Human Herpes Virus 1

# Herpes Simplex Virus Type 1 (HSV-1) Causes an infection to the?

UPPER PART OF THE BODY MOSTLY THE FACE AND MOUTH

# Herpes Simplex Virus Type 1 (HSV-1) Mode of transmission

Thru contact, usually involving **infected saliva**, **skin lesions** and **oropharyngeal lesions**

# HSV-1: Pathogenesis Transmitted by contact of a susceptible person with an ____ ____ | Primary infection

excreting virus

# HSV-1: Pathogenesis - Primary Infection virus enter via?

broken skin or mucous membrane

# HSV-1: Pathogenesis - Primary Infection TOF Viral replication occurs first at the site of infection

True

# HSV-1: Pathogenesis - Primary Infection location of the initial lesion

Site of infection, characteristic lesion can be seen (produced during primary infeciton)

# HSV-1: Pathogenesis - Primary Infection The virus then spreads locally and short- termed ____ occurs.

Viremia

# HSV-1: Pathogenesis - Primary Infection during the period of viremis, what happens to the virus?

disseminated in the body

# HSV-1: Pathogenesis - Primary Infection virus invades the? and this is where the latency is established

local nerve endings

# HSV-1: Pathogenesis Site of letency

Trigeminal Nerve Root Ganglion

# HSV-1: Pathogenesis TOF Viral persistence in the infected ganglia lasts for the quarter of life Of the host

False (last for the lifetime of the host) | Reactivates when immunocompromised

# HSV-1: Clinical Manifestation enumerate all clinical manifestation

* Oropharyngeal disease * Keratoconjunctivitis * Genital Herpes * Skin infection

# HSV-1: Clinical Manifestation enumerate the disease under oropharyngeal disease

* Gingivostomatitis * Herpes labialis

# HSV-1: Clinical Manifestation common manifestation of Gingivostomatitis

Gingivitis | "singaw"

# HSV-1: Clinical Manifestation signs for Gingivitis are noticed when?

immune system lowers and stressed

# HSV-1: Clinical Manifestation Adult manifestations for Gingivostomatitis

Pharyngitis and tonsilitis

# HSV-1: Clinical Manifestation TOF gingivostomatitis is asymptomatic?

F (nakita mong may mga lesions sa mouth)

# HSV-1: Clinical Manifestation Gingivostomatitis occurs commonly on?

young children (ages 1-5)

# HSV-1: Clinical Manifestation Gingivostomatitis involves the?

- Mouth area - Mucal (or buccal-check trans) cavity - gingival mucosa

# HSV-1: Clinical Manifestation Recurrent lesion of the eyes

Keratoconjunctivitis

# HSV-1: Clinical Manifestation keratoconjunctivitis appears as?

dendritic keratitis or corneal ulcer

# HSV-1: Clinical Manifestation TOF Vesicle on the labia can also be seen

F (eyelids) | hindi eyelids ng puthy

# HSV-1: Clinical Manifestation what are produced with keratoconjunctivitis?

pus

# HSV-1: Clinical Manifestation TOF there is no recurrent issue for keratoconjunctivitis

F there is, it can result to permanent impairment or blindness

# HSV-1: Clinical Manifestation genital herpes are characteriz by?

**vesiculo-ulcerative lesion** for male and female | The sores and lesions are very painful

# HSV-1: Clinical Manifestation Skin infection manifestation virus portal of entry are?

Broken skin

# HSV-1: Clinical Manifestation signs and symptoms for skin infection

**Herpetic Whitlow** - can be seen on fingers

# HSV-1: Clinical Manifestation herpetic whitlow are common with?

healthcare personnel handling the patient without wearing proper PPE

# HSV-1: Clinical Manifestation other variation for skin infection

- Herpes gladiatorum (wrestler) - Eczema herpeticum (eczema) - CNS (meningitis and encephalitis) - Neonatal herpes

Herpes Simplex Virus Type 2 (HSV-2) are also called as?

Genital herpes and Neonatal herpes

# Herpes Simplex Virus Type 2 (HSV-2) may also cause

aseptic meningitis

# Herpes Simplex Virus Type 2 (HSV-2) TOF can also cause Cervical cancer

T (but most common with papilloma virus)

# Herpes Simplex Virus Type 2 (HSV-2) Latency site

sacral ganglion

# Herpes Simplex Virus Type 2 (HSV-2) official name

Human Herpesvirus 2

# Herpes Simplex Virus Type 2 (HSV-2) Causes an infection to what part of the body

LOWER PART OF THE BODY, MOSTLY IN THE GENITALS, also causes VIRAL STD

# Herpes Simplex Virus Type 2 (HSV-2) mode of transmission

sexually or from a maternal genital infection to a newborn

# Herpes Simplex Virus Type 2 (HSV-2) primary infection

Same with HSV-1 just recall sa trans

# Lab Diagnosis: HSV-1 and HSV-2 specimens used

- Aspirate from Vesicle - Scraping from base of ulcer - Respiratory samples - Serum/CSF for antibody

# Lab Diagnosis: HSV-1 and HSV-2 enumerate the lab diagnosis

1. Direct Micrscopic Examination 2. Cell culture 3. Serology 4. Molecular Assay

# Lab Diagnosis: HSV-1 and HSV-2 what smear is used for Direct microscopic examination

Tzanck Smear

# Lab Diagnosis: HSV-1 and HSV-2 scraping from the base (the lesion) of the vesicles stained with **giemsa**

Tzanck Smear | Screening method

# Lab Diagnosis: HSV-1 and HSV-2 After staining you can observe inclusion under direct microscopic examination

Multinucleated giant cell with **cowdry inclusion**

# Lab Diagnosis: HSV-1 and HSV-2 what is the disadvantage of direct microscopic

Cannot distinguish between Herpes simplex virus type (HSV -1 & -2) and Varicella-zoster virus ## Footnote inclusion can be seen from these 3 members

# Lab Diagnosis: HSV-1 and HSV-2 what if tzank smear was only ordered by the physician, what other basis can be used for diagnosis

signs and symptoms

# Lab Diagnosis: HSV-1 and HSV-2 TOF HSV is easy to cultivate and Inoculation of tissue cultures is used for viral isolation.

Ture

# Lab Diagnosis: HSV-1 and HSV-2 what is used for cell culture?

SHELL VIAL CULTURE

# Lab Diagnosis: HSV-1 and HSV-2 - Replication of virus occurs after 24 hours of incubation with fluorescent antibodies - incubated with fluorescent antibodies - will be observed with fluorescent microscope

Cell culture: shell vial culture

# Lab Diagnosis: HSV-1 and HSV-2 what will be the cytopathic effect under cell culture?

GIANT CELLS.BALLOONING OF CELLS

# Lab Diagnosis: HSV-1 and HSV-2 for serology how many days are before it the infection of antibodies start to appear

4 to 7

# Lab Diagnosis: HSV-1 and HSV-2 in serology the infection peak after?

2 to 4 weeks of infection

# Lab Diagnosis: HSV-1 and HSV-2 Detection methods under serology:

- neutralization - immunofluorescence - enzyme-linked immunosorbent assay (ELISA)

# Lab Diagnosis: HSV-1 and HSV-2 disadvantage of serology

Diagnostic value is limited due to antigen sharing Of HSV - 1 and HSV -2 | little to no differentiation

# Lab Diagnosis: HSV-1 and HSV-2 most sensitive

Molecular assay

# Lab Diagnosis: HSV-1 and HSV-2 what molecular assay technique can be used?

PCR - Sensitive and Specific

# Management: HSV-2 this the drug of choice for most situations at present. It is available in a number of formulations:

Acyclovir

# Management: HSV-2 oral only, more expensive than acyclovir.

Famciclovir and valacyclovir

# Management: HSV-2 idoxuridine, trifluorothymidine, Vidarabine (ara-A). is an example of?

Other older viral agents ## Footnote highly toxic and is suitable for topical use for opthalmic infection only

# Varicella-Zoster Virus (VZV) Official name?

Human Herpesvirus 3

# Varicella-Zoster Virus (VZV) TOF morphologically identical to HSV with no known animal host

# Varicella-Zoster Virus (VZV) mode of transmission

Spread by airborne droplets and by direct contact with infected individual

# Varicella-Zoster Virus (VZV) Pathogenesis 1. inhaled and infected in mucosal cell in the nose and throat

Droplets

# Varicella-Zoster Virus (VZV) Pathogenesis Droplets →

Respiratory tract (Upper)

# Varicella-Zoster Virus (VZV) Pathogenesis Respiratory tract →

**Lymphatics** - will have a viremia and will spread and infect in the lymphatic (lymph nodes)

# Varicella-Zoster Virus (VZV) Pathogenesis Lymphatics →

Liver, Spleen, Reticuloendothelial system

# Varicella-Zoster Virus (VZV) Pathogenesis where does it reac the secondary viremia?

Liver, Spleen, Reticuloendothelial system

# Varicella-Zoster Virus (VZV) Pathogenesis after the secondary viremia what will happen

sign and symptoms will occur: - Fever - malaise - Headached - Sore throat

# Varicella-Zoster Virus (VZV) Pathogenesis and with the period of second viremia which records a virus on blood, what formation can be seen?

Vesicle progression (formation) – SKIN LESIONS

# Varicella-Zoster Virus (VZV) Pathogenesis what involves with the skin lesions?

- Macules - Papules - Vesicles - Pustules - Crusts

# Varicella-Zoster Virus (VZV) Pathogenesis And when the immune system is strong enough, what happens

infection will be eliminated and the "tirang" virus will be dormant or latent in the Dorsal root of ganglia

# Varicella-Zoster Virus (VZV) Pathogenesis site of latency?

Dorsal root of ganglia

# VZV Clinical manifestation (findings) Enumerate the disease manifestation

1. Varicella 2. Herpes Zoster

# VZV Clinical manifestation (findings) Commonly called as CHICKENPOX “bulotong”

Varicella

# VZV Clinical manifestation (findings) Varicella's Incubation period is between

10-21 days

# VZV Clinical manifestation (findings) what are the earliest symptoms of varicella

- malaise and fever (occurs in 2nd viremia) - quickly followed by Rash on trunk, face, limbs, buccal, and pharyngeal mucosa

# VZV Clinical manifestation (findings) Varicella's successive fresh vesicles appear in

crops

# VZV Clinical manifestation (findings) TOF Successive fresh vesicles appear in crops, so that all stages of macules, papules, vesicles, and crusts may be seen at one time

True

# VZV Clinical manifestation (findings) complications

- Rare in normal children - Varicella pneumonia

# VZV Clinical manifestation (findings) Commonly called as SHINGLES

Herpes Zoste ## Footnote VZV Clinical manifestation (findings)

# VZV Clinical manifestation (findings) Herpes zoster is characterized by

skin vesicles,**often on one side of the body (characteristic)**with severe pain around the skin lesions

# VZV Clinical manifestation (findings) complication may include:

- CNS disorders - eye problems (ophthalmic zoster) - facial paralysis

# VZV Clinical manifestation (findings) Immunity to Varicella Zoster Virus, can be acuqired by?

- Previous infection confers lifelong immunity to varicella - if Vaccinated

# Lab Diagnosis: VZV specimens

- Aspirate from Vesicle - Scraping from base of ulcer

# Lab Diagnosis: VZV Same method like HSV-1 & -2

check direct micrscopic and cell culture ty

# Lab Diagnosis: VZV what is the main difference for Cytopathic effect of VZV from HSV-1 and -2

HAIR LIKE PROJECTIONS/ THREAD LIKE on the ballooning parts

# Lab Diagnosis: VZV (Serology) - recent primary infection - first antibody produced during primary infections

VZV IgM

# Lab Diagnosis: VZV (Serology) - past infection and immunity

VZV IgG

# Lab Diagnosis: VZV (Serology) Rise in specific antibody titer is detected by either

- fluorescent antibody - enzyme immunoassay

# Lab Diagnosis: VZV (Serology) preferred methoid for diagnosis of VZV encephalitis

PCR - molecular assay

# VZV: Treatment, Prevention and Control TOF Vaccination is possible?

T (live attenuated varicella vaccine) ## Footnote Antibodies induced after vaccination persist for at least 20 years

# VZV: Treatment, Prevention and Control DRUG OF CHOICE

Acyclovir

# Epstein - Barr Virus (EBV) Official name

Human Herpesvirus 4

# Epstein - Barr Virus (EBV) discovered by?

Epstein & colleagues

# Epstein - Barr Virus (EBV) TOF Common in almost all parts of the world with more than 69% of adults are seropositive

F (90%)

# Epstein - Barr Virus (EBV) Mode of transmission

Contact with oropharyngeal secretions (respiratory secretion)

# Epstein - Barr Virus (EBV) Infects what cell

B cells (C3)

# Epstein - Barr Virus (EBV) Site of latency

B-Cells/ B-lymphocytes

# Epstein - Barr Virus (EBV) pls check the process of pathogenesis

,/,

# EBV: Clinical manifestation enumerate the disease

- Infections mononucleosis (IM) - Malignancies

# EBV: Clinical manifestation Also called as: Kissing disease or Glandular fever

Infections Mononucleosis (IM)

# EBV: Clinical manifestation common in?

adolescence and adults (15 to 25 years of age)

# EBV: Clinical manifestation Infections mononucleosis are usually a ____ disease with flu-like signs and symptoms

Self limiting

# EBV: Clinical manifestation TOF Complications are not rare

F (rare) but may be serious if present such as: splenic rupture, meningoencephalitis, pharyngeal obstruction and neurological complications

# EBV: Clinical manifestation what are the way to diagnose IM

Hematology — blood smear and staining

# EBV: Clinical manifestation Diagnosis of IM using hematolgy, what presence should be on the peripheral blood smear

Atypical Lymphocytes of ‘DOWNEY CELLS’ ## Footnote (activated b-cells “skirt like” or “fried egg like cytoplasm)

# EBV: Clinical manifestation Diagnosis of IM: TOF Positive on HETEROPHILE ANTIBODIES

# EBV: Clinical manifestation what is being detected for antibodies with IM?

EBV antibodies

# EBV: Clinical manifestation what are the malignancies

- Burkitt’s lymphoma - Nasopharyngeal carcinoma - Hodgkin's disease - Non - Hodgkin's disease - Chronic interstitial pneumonitis - Gastric carcinoma

# Lab Diagnosis: EBV (isolation) EBV may bve isolate from the

saliva, peripheral blood, or lymphoid tissue

# Lab Diagnosis: EBV (isolation) how are the isolate can be retrieved

by immortalization of normal human lymphocyes commonly obtained from **umblical cord blood**

# Lab Diagnosis: EBV (isolation) TOF this technique is seldom performed due to the time consuming process

# Lab Diagnosis: EBV (Serology) Detects?

EBV antibodies

# Lab Diagnosis: EBV (Serology) Detects EBV antibodies thru

- ELISA - Immunoblot assays - Indirect immunofluorescence tests

# Lab Diagnosis: EBV (Serology) if u see this card check

check the typical pattern of the antibody response with primary EBV infection

# Lab Diagnosis: EBV (Serology) Early acute infection: Rise in the VCA (viral capsid antigen)

VCA IgM

# Lab Diagnosis: EBV (Serology) weeks after early infection:

VCA IgG

# Lab Diagnosis: EBV (Serology) Approx. 1 month of infection

Antibodies against Early antinges (EA)

# Lab Diagnosis: EBV (Serology) Approx. months after early acute infection:

EBNA (epstein barr nuclear antigens) IgG

# Lab Diagnosis: EBV (agglutination) During Infectious mononucleosis infection most patients develop transient ____ ____ that agglutinate sheep cells.

heterophil antibodies

# Lab Diagnosis: EBV (agglutination) Main disadvantage

presence Of heterophil antibodies is not specific to Infectious mononucleosis cause Other diseases such as serum sickness also produces heterophil antibodies.

# Lab Diagnosis: EBV (agglutination) TOF DEFINITIVE, not specific with infection mononucleos

F (Not definitive)

# Lab Diagnosis: EBV what molecular assay can be used

Quantitative PCR - determine viral progession

# EBV: Treatment, Prevention and Control Drug of Choice

Acylovir

# EBV: Treatment, Prevention and Control vaccine?

walang Avail