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Bloc G - Infection > Apr25 M1,2,3-Virology > Flashcards

Apr25 M1,2,3-Virology Flashcards

1
Q

virus structure

A

nuclei acid core surrounded by a capsid (and some have an envelope around that)

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2
Q

how a virus infects a cell

A

attach to host cell Rs, is endocytosed, penetrates the membrane and assembles new particles. new particles released by budding or cell lysis

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3
Q

what happens during the incubation period

A

the virus replicates

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4
Q

how viruses can disseminate in the host body

A
  • using nerves, to go towards the CNS

- bloodstream

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5
Q

transmission routes of viruses

A
  • resp (droplet (big and limited distance), aerosols, saliva, nasal secretions)
  • GI (fecal-oral)
  • transcutaneous/transmucosal (arthropod borne diseases, blood-borne)
  • vertical (mother to infant in utero)
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6
Q

examples of viruses transmitted via resp route (3)

A
  • rhinovirus (droplets)
  • influenza (droplets)
  • RSV (droplets)
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7
Q

some viruses using GIT route (4)

A
  • enteroviruses (enterovirus, coxsackie, echovirus, poliovirus)
  • hep A
  • norovirus
  • rotavirus
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8
Q

common characeristic of viruses that use GI route

A
  • DON’T have an envelope

- survive stomach acid, bile, proteolytic enzymes (resp viruses don’t survive that)

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9
Q

some viruses using the transcutaneous route (animals, insects, needles)

A
  • arboviruses (Dengue, West Nile, Zika)
  • HepB
  • HIV
  • Rabies (from bat)
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10
Q

some viruses using the transmucosal route and their mode of transmission

A
  • CMV
  • HepB
  • HSV
  • HIV
  • are sexually transmitted*
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11
Q

some viruses using vertical transmission

A
  • viremia and infection of placenta = rubella (is a congenital disease), CMV, parvovirus
  • exposure in birth canal = HSV, HIV
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12
Q

4 ways to dx a virus (and main one used)

A
  • tissue culture (cell lines, embryonated eggs, suckling mice)
  • antigen detection (ELISA, immunofluorescence)
  • nuclei acid detection (in-situ hybridization, PCR)** MAIN ONE **
  • serology (IgM+, 4x rise in acute and convalescent IgG (sera)
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13
Q

how virus (resp virus for ex) is detected on tissue culture (cell lines of fibroblasts or cancer cells for ex)

A
  • inoculated on a monolayer
  • don’t see virus
  • see monolayer going from orgnized to disorganized, death, refractory nuclei = CYTOPATHIC effect
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14
Q

most common use of embryonated eggs for virus tissue culture

A
  • influenza virus (to grow in high titer)

- inject allantoic fluid with a respiratory specimen (secretion) and will check later to see if there’s a virus in there

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15
Q

monoclonal Abs (ELISA) for virus dx is used for what viruses

A
  • RSV
  • adenoviruses
  • influenza
  • rotavirus
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16
Q

PCR (main virus dx technique) method and used for what viruses mainly

A
  • take specimen (like sputum)
  • use probes of all diff viruses
  • do PCR
  • mainly for respiratory viruses*
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17
Q

serology testing for virus dx: method

A
  • acute infection is IgM+, IgG-

- weeks after infection = IgG+

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18
Q

orthomyxoviridae = what viruses

A

influenza A,B,C (C = no disease in humans)

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19
Q

paramyxoviridae = what viruses

A

parainfluenza, RSV A and B, human metapneumovirus

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20
Q

adenoviridae = what virus

A

adenovirus

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21
Q

picornaviridae = what virus and disease

A

rhinovirus (common cold)

also enterovirus including coxsackie, echovirus, enterovirus, poliovirus. hepatovirus. parechovirus

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22
Q

coronaviridae = what virus and disease

A

coronavirus (cold, SARS = severe acute resp syndrome), middle east resp syndrom)e

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23
Q

viruses with a lot of serotypes

A
  • rhinovirus (89, so recurrent infections, + immunity not lifelong)
  • adenovirus (49)
  • coronaviruses
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24
Q

(imp) RSV: 2 basic proteins

A
  • G protein (for attachment)

- F protein (for fusion, with the host cell)

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25
Q

which population is particularly affected by RSV and disease caused

A
  • children and especially newborns <6 mo
  • 75% of 1 year olds are seropositive
  • BRONCHIOLITIS
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26
Q

(imp) RSV exact transmission, symptoms and pathology

A
  • resp droplets
  • fever, coughing, wheezing, dyspnea
  • inflammation in bronchioles: edema and mucous formation. severe resp distress in infants
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27
Q

in the newborns population, who is especially vulnerable to RSV (paramyxoviridae)

A
  • premature babies (lungs less developed)

- congenital heart disease and shunting disease (have less cardiac reserve)

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28
Q

specific RSV prevention method given to vulnerable newborns

A
  • prophylaxis monoclonal Ab to the F protein
  • every month in winter time to high risk group of right age
  • IM injections, cost 1500 each
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29
Q

virus shedding meaning

A

virus exocytosis, budding out of host cells

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30
Q

rhinovirus (picornaviridae) route of transmission, incubation period, shedding time, infectivity period, if is on surfaces

A 
route = big droplets
incubation = 1-4 days
shedding = in days 1 to 3
infectivity = in first days infected
lives on surfaces = yes
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31
Q

complications of rhinovirus infections

A
  • sinusitis
  • otitits media
  • asthma
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32
Q

how immunity to rhinoviruses is maintained

A

an Ab develops to the serotype that infected you

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33
Q

adenovirus (adenoviridae) particular characteristics and route of transmission

A
  • latent (dsDNA)
  • no envelope so goes in GIT
  • transmission = aerosol and fecal-oral (is a GIT and resp virus)
  • many serotypes
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34
Q

adenovirus: diseases caused

A

URTI, LRTI, GE, keratoconjunctivitis, hemorrhagic cystitis

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35
Q

charact of adenovirus latency

A
  • no problems unless immunocompromised
  • problems in children who get BM transplant
  • recurrent, prolonged shedding (as part of the latency)
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36
Q

clinical significance of adenovirus latency

A
  • latent so vector for gene therapy
  • inject adenovirus with a missing gene
  • adenovirus multiplies and expresses this gene
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37
Q

coronavirus (coronaviridae) is like what virus

A

rhinovirus

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38
Q

coronavirus: diseases caused and important one

A
  • URTI
  • pneumonia
  • SARS** (was caused by a recombinant mammalian and avian CoV)
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39
Q

MERS-CoV (Middle East Respiratory Syndrome Coronavirus) source of the infection and mortality (related disease)

A
  • camels infected with the virus

- 40-50% mortality (severe respiratory illness)

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40
Q

influenza virus original virus

A

originates from spanish flu

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41
Q

2 glycoproteins on influenza A,B and C

A
  • hemagglutinin (H1, H2, H3)

- neuraminidases (N1, N2)

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42
Q

antigenic shift in influenza virus

A

antigenic shift = not common, when a new H and N numbered virus pops up after years of having vaccine for same strain (H1N1 before and now new H2N2 and lot more get sick

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43
Q

antigenic drift in influenza virus

A
  • common

- same H and N but different strains (like diff H1N1 strains)

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44
Q

influenza symptoms, transmission and complication

A
  • fever, myalgias, HA, cough
  • droplets
  • complication = bacterial pneumonia (associated are S pneumoniae and S aureus)
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45
Q

how influenza strains are generated

A
  • birds are a big reservoir for influenza viruses
  • birds transmit to other birds or swine (pigs)
  • reassortment (strains recombination) happens in pigs and birds (mostly pigs)
  • pigs and birds transmit reassortant virus to humans
46
Q

2 types of influenza vaccines

A
  • inactivated

- live, attenuated, cold-adapted (give live influenza that can only live in the cold as a nasal spray)

47
Q

limit of influenza vaccine

A
  • immunity (Abs) wanes over time

- a different virus circulates the next season

48
Q

main characteristic of the herpes viruses category

A

DNA viruses so are latent

49
Q

some viruses in the herpes viruses group

A
  • HSV 1,2 (1 and 2 are equal)
  • VZV (chickenpox)
  • EBV (infectious mono)
  • CMV
50
Q

HSV transmission and what it does in the body

A
  • direct inoculation of mucous membranes (mouth, eye, genital tract, etc.) (NOT skin)
  • accesses nerve cel endings in epidermis and is transported to nerve cell bodies in peripheral ganglia to establish latency there
51
Q

what does HSV do when it is reactivated

A

travels back down its route (down the peripheral nerves) and illness appears
herpes encephalitis is possible but very rare

52
Q

consequence of HSV route of transmission and how it travels in the body

A
  • destruction of epithelial cells in skin and mucous membranes
  • nerve damage causing tingling and burning (prodrome)
53
Q

HSV diseases caused

A

-ocular infection
-oral infection
-herpes keratitis
-genital herpes
-neonatal herpes
-encephalitis
-disseminated herpes
(2 last = newborns vulnerable if mom never infected)

54
Q

treatment of herpes infections and what it really does

A

acyclovic

  • reduces duration of symptoms
  • doesn’t eliminate latency
55
Q

VZV infection symptoms

A
  • generalized vesicular rash (papular vesicular lesions) (starts in stomach and goes out whereas measles starts on head and goes down)
  • fever
56
Q

complications of VZV

A
  • bacteria superinfection (GAS) (necrotizing fasciitis for ex)
  • thrombocytopenia
  • cerebellar ataxia
  • encephalitis
57
Q

clues to recognize varicella

A
  • papules start on stomach then spread

- varicella papules are at different stages at the same time

58
Q

VZV vaccine charact

A
  • live vaccine (so giving latent virus for life)

- less risk of developing shingles Zoster

59
Q

What is Zoster Shingles

A
  • reactivation of varicella virus (spread to dorsal root ganglia)
  • reactivated VZV on a dermatome
  • painful
  • happens if immunocompromised (elderly for example)
60
Q

CMV how infects you and where it resides

A
  • through epithelium

- persists in hematopoietic and epithelial cells

61
Q

main problem with CMV

A

congenital infection (when a mother gets a primary CMV infection during pregnancy): baby born with a lot of defects (liver, spleen, small head, growth retardation)

62
Q

CMV charact (when do we see symptoms and where is it when it reactivates)

A
  • usually asymptomatic, otherwise mono-like
  • immunocompromised = more significant infection (and symptoms)
  • periodic reactivation in saliva, urine, blood
63
Q

EBV enters body how and infects what cells + special charact

A
  • enters through mucosal surfaces
  • B lymphocytes and epithelial cells (viral genome persists in memory B cells)
  • has an envelope
64
Q

symptoms in most cases of EBV

A

sore throat, fever, fatigue, lymph nodes, possible whitish exudate on tonsils and big tonsils

65
Q

complications of EBV

A
  • B-cell immortalization and transformation (lymphoproliferative disease) in immunocompromised pts and posttransplant
  • Hodgkin’s disease
  • Burkitt lymphoma
  • nasopharyngeal CA
66
Q

viruses of gastroenteritis (GE) and link

A
  • rotavirus
  • enteric adenoviruses (conjunctivitis, diarrhea)
  • norovirus
  • astrovirus
  • calicivirus
  • all have similar presentations* + note all have no envelope
67
Q

tx of GE

A

supportive tx

68
Q

transmission of GE viruses

A

fecal-oral

69
Q

rotavirus charact

A
  • groups A to F. A is most common. same serotype reinfection is possible
  • severe pediatric disease
  • peak age of infection = 6 mo to 2 years
70
Q

rotavirus symptoms and pathology

A
  • fever, vomiting, watery diarrhea, dehydration

- atrophy of SI villi + carb malabsorption

71
Q

rotavirus dx

A

Ag detection by ELISA. put stool on plate with rotavirus Ab. then add Ab with fluorescein marker to the 1st Ab

72
Q

norovirus incubation and affects who

A
  • 1-2 days incubation
  • cruiseships, hospital ER staff
  • outbreaks in schools
73
Q

norovirus transmission

A

fecal-oral and aerosol (after vomiting)

74
Q

norovirus evolution of illness

A
  • acute onset of vomiting
  • diarrhea for 24 hours
  • total 48 hours feeling very bad
75
Q

norovirus tx

A

(self limited illness)

-water, rest, symptomatic tx

76
Q

viruses in the picornaviridae family

A
  • rhinovirus (human rhinovirus)
  • enterovirus (coxsackie A and B, echovirus, enterovirus, poliovirus)
  • hepatovirus (hepA virus)
  • parechovirus (human parechovirus)
77
Q

enteroviruses

A
  • enterovirus
  • coxsackie A and B
  • echovirus
  • poliovirus
78
Q

enteroviruses transmit how, spread where, replicate where

A
  • transmitted fecal-oral
  • replicate in GIT
  • spread in blood to target organs
79
Q

enteroviruses symptoms

A
  • aseptic meningitis
  • herpangina (sores in the mouth)
  • hand, foot and mouth disease (coxsackie)
  • myocarditis
  • hemorrhagic conjunctivitis
80
Q

echovirus: why called like that

A

Enteric Cytopathic (effect on tissue culture) Human Orphan (thought it caused no disease but wrong) virus

81
Q

(imp) polio (an enterovirus) serotypes

A

1,2,3

82
Q

(IMPORTANT) polio main concern

A
  • invasion of brain and spinal cord + destruction of anterior horn cells
  • get muscle INCLUDING DIAPHRAGM paralysis*
83
Q

(IMPORTANT) 2 polio vaccines

A
  • inactivated (Salk) = IPV

- Trivalent oral LIVE vaccine (Sabin) = OPV

84
Q

(IMPORTANT) IPV charact

A
  • need syringe, cold chain to keep it from degrading, someone competent to give it = in developed countries
  • enhanced formulation. >99% benefit. few adverse effects
85
Q

(IMPORTANT) OPV charact

A
  • taken by mouth, gos down GIT.
  • immune response similar to natural infection, is mucosal IgA mediated immunity
  • developing countries (cheap, easy, effective)
86
Q

(IMPORTANT) ‘‘Herd vaccination’’ in polio is what

A
  • some people got OPV
  • transmit it through fecal-oral route to people who didn’t get vaccinated
  • these people are now vaccinated
87
Q

(IMPORTANT) rare complication of polio (can happen in immunocompromised person)

A

VAPP (vaccine associated paralytic poliomyelitis)

= polio paralysis

88
Q

rabies caused by what virus and in what animals

A

lyssavirus (is in dogs, terrestrial wildlife and bats)

89
Q

how rabies is transmitted

A

-salivary contact with infected animal including breathing air (resp tract transmission) in bat caves

90
Q

inoculation time (incubation) of rabies and why

A
  • from days to years (avg 90 days) depending on infection site
  • virus has to travel in peripheral nerves to reach CNS and lead to encephalitis
91
Q

prodrome of rabies

A
  • 4-10 days
  • subtle neuro changes
  • tingling at bite site
  • headache, myalgia, flu like illness
92
Q

CNS infection (encephalitis) with rabies consequence (symptoms)

A
  1. confusion, agitation, hydrophobia, aerophobia, throat spasms
  2. in <20% cases, progressive flaccid paralysis
    * *very high mortality rate**
93
Q

treatment of rabies

A

Milwaukee protocol
-drug induced coma
-antivirals
(still very high mortality rate. used o be 100% mortality)

94
Q

rabies two ‘‘treatments’’ other than Milwaukee protocol

A

pre and post exposur prophylaxis

95
Q

pre-exposure prophylaxis in rabies

A

human diploid cell vaccine, 3 IM doses. for high risk peopel (vets, travelers, spelunkers)

96
Q

post exposure prophylaxis in rabies

A
  • immediate wound care (providone-iodine)
  • rabies Ig Ab injection in the wound
  • human diploid cell vaccine (4 doses)
97
Q

hemorrhagic fever viruses other name for these + 2 examples

A

filoviruses

  • ebola
  • Zika
98
Q

reservoir of Ebola and transmission

A
  • reservoir = fruit bats

- transmission = direct blood, secretions contact. contaminated needles

99
Q

Ebola species with the highest fatality rate

A

Zaire ebolavirus

100
Q

Ebola incubation time

A

2-21 days

101
Q

Ebola evolution of symptoms

A
  • 0-3 days: non specific illness (fever, headache, joint pain)
  • 3-10 days: diarrhea, vomiting
  • 7-12 days: shock or recovery
  • > 10 days: late complications
102
Q

hemorrhage is where in ebola

A

mouth, GIT, etc.

103
Q

important component of Ebola illness

A

large diarrhea and vomiting

  • electrolyte imbalance
  • dehydration
  • need to support, otherwise shock*
104
Q

Zika virus is in what family of viruses

A

Flavivirus (includes Dengue, yellow fever, WNF = West Nile Fever, Japanese encephalitis)
(flavivirus for yellow, bc gives hepatitis, turns you yellow)

105
Q

Zika virus previous and current locations

A

previous: Uganda, SE Asia, Pacific ilsands
current: Central and South America

106
Q

Zika virus symptoms

A

fever, rash, arthralgias, conjunctivitis

107
Q

Zika virus transmitted how

A
  • Aedes aegyptus (fly). has visible stripes

- sexual transmission

108
Q

dengue symptoms

A
  • red rash for a week

- rarely, severe hemorrhage with high mortality

109
Q

2 ways of dx Zika and Dengue and how to choose

A
  1. IgG and IgM testing (if never vaccinated for yellow fever)
  2. RT-PCR (if already got vaccinated for yellow fever, bc will test Zika positive. Zika and yellow fever are alike)
110
Q

Zika vector, how Zika is transmitted other than by the vector and what body part does it infect

A
  • Aedes aegyptus or sexual transmission

- intrauterine infections

111
Q

main worry with Zika

A

associated microcephaly in newborns (small head)

112
Q

Zika tx

A
  • no tx or vaccine right now
  • prevent mosquito bites and control mosquito breeding sites. this mosquito is active during the day. + man sperm infected so abstain for 6 months

Bloc G - Infection (39 decks)

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