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LAST EXAMMMMMM Year I > Chap8- Viral Infections > Flashcards

Chap8- Viral Infections Flashcards

1
Q

What viruses attack upper respiratory tract

A

adenovirus
rhinovirus
influenza viruses A B
Respiratory syncytial virus

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2
Q

What viruses affect the digestive tract

A 
mumps
rotavirus- childhood
norovirus
Hep A
Hep B
Hep D
Hep C
Hep E
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3
Q

What viruses cause systemic with skin eruptions

A 
measles
rubella
varicella zoster
Herpes simplex virus 1
Herpes simplex virus 2
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4
Q

What viruses cause systemic with hematopoietic disorders

A

CMV
EBV
HIV 1 and 2

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5
Q

What are the arboviral and hemorhhagic fever viruses

A

dengue virus1-4

yellow fever

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6
Q

what virus causes skin warts

A

papillomavirus

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7
Q

What viruses affect CNS

A

polio and JC

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8
Q

How do you confirm a measles Dx

A

detection of viral antigen in nasal exudate or urinary sediment

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9
Q

What type of virus is measles

A

ss RNA of the paramyxovirus family

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10
Q

What virus causes croup

A

parainfluenza virus

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11
Q

What cell R are associated with measles

A

CD46- C’ regulatroy protein that inactivates C3 converses

SLAM- involved in T cell activation

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12
Q

How does measles spread

A

respiratory droplets and from there can multuply in epithelial cells, endothelial, monocytes, macrophages, dendritic cells and lymphocytes

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13
Q

What does measles cause clinically

A

croup, pneumonia, diarrhea with protein-losing enteropathy, keratitis with scarring and blindness, encephalitis and hemorrhagic rashes in malnourished children

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14
Q

Most people develope what type immunity to measles

A

T cell, with hypersensitivity rash

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15
Q

What is the cause of measles morbiditiy and mortality rates

A

its immunosuppression resulting in secondary bacterial and viral infection

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16
Q

What are some of the late complications of measeles

A

subacute sclerosing panencephalitis and inclusion body encephalitis

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17
Q

What does the rash to measles look like and what causes it

A

blotchy reddish, brown rash on face, trunk and proximal extremities
from dilated skin vessels, edema and mononuclear perivascular infiltrate

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18
Q

What are the pathonomonic findings in measles

A

Koplik spots, ulcerated mucosal lesions in oral cavity near opening
Warthin-Finkeldey cells- multinucleate giant cells in lymphoid tissue

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19
Q

What are the 2 types of glycoproteins on the mumps virus

A

one with hemagglutinin and one with neuraminidase activities

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20
Q

Where does mump replicate

A

preferentially in activate T cells

travel in drained lymph

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21
Q

What are common signs of mumps

A

salivary gland pain and aseptic meningitis

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22
Q

Describe morphology of the parotitis in mumps

A

moist, glistening and reddish brown
diffusely infiltrated by macrophages, lymph and plasma cells which compress acini and ducts
some neutrophils and necrotic debris

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23
Q

Describe morphology mumps orchitis

A

swelling from edema and mononuclear cell infiltration with focal hemorrhages
can have ares of infarction leading to sterility

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24
Q

What does mumps look like in pancreas

A

fat necrosis and neutrophil rich inflammation

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25
describe mumps encephalitis
causes perivenous demylination and perivascular mononuclear cuffing
26
What type of virus is polio
unencapsulated RNA from the enterovirus genus
27
What are the enteroviruses
coxsackievirus A and B, enterovirus 70, echovirus
28
How many strains are there of polio and what vaccines are available
3 strains | the salk formalin(killed) and sabin oral (attenuated live) have all 3
29
how is polio transmitted
oral fecal route | multipling in intestinal mucosa and lymph nodes
30
Why does polio only affect humans
uses human CD155 to gain entry
31
What group of viruses does west nile belong to
arbovirus of flavivirus group
32
Where does west nile replicate
in dendritic cells then migrating to lymph nodes where it can enter blood stream and potentially cross bbb
33
What is the double edge about CCR5
without it more prone to west nile | with it- can be affect by HIV
34
What are the symptoms of west nile if any
short lived febrile illness with HA and myalgia | maculopapular rash in some
35
What is found in brains of those who died of West nile
perivascular and leptomeningeal chronic inflammation with microglial nodes and neronophagia in temporal lobes and brain stem
36
what is the best way to confirm Dx of west nile
usually serology but viral culture and PCR used too
37
what type of viruses cause viral hemorrhagic fevers and what are the 4 families
enveloped RNA viruses | arenaviruses, filoviruses, bunyaviruses and falviviruses
38
what are the mild acute diseases cause by viral hemorrhagic fevers VHF
fever, HA, myalgia, rash, neutropenia and thrombocytopenia
39
what are the severe diseases cause by VHF
hemodynamic deterioration and schock
40
What immune response contributes to VHF
innate because activation of macrophages leads to release of mediators that modify vascular function
41
What type of DNA is herpes
ds DNA
42
what are the categories of herpes and types of cells they each infect
alpha group: HSV 1 and 2, VZV infecting epithelial cells and latency in neurons lymphotropic beta group: CMV, herpes-6 and herpes-7 infect a variety of cells -group: EBV KSHV-8 latent infections in lymphoid cells
43
Where do HIV 1 and 2 replicate
in the skin and mucous membranes at site of entrance where they cause vesicular lesions
44
What occurs during latency in HSV
viral DNA remains in nucleus and viral RNA trancripts are synthesized no viral proteins are produced
45
how do HSV evade CTLs
inhibit class I MHC and elude humoral immune defenses by producing R for the Fc domain of Ig and inhibitors of C'
46
Where in the brain does HSV attack first
temporal lobes, orbital gyri of frontal lobes
47
what do HSV cells looks like
large with inclusions that have intact disrupted virions with stained host cell chromatin pushed to edges of nucleus
48
what is gingivostomatitis
children with HSV-1 that have a vesicular eruption extending from tongue to retropharynx casing cervical lymphadenopathy
49
What does HSV-2 look like in neonate
mild, more commonly with generalized lymphadenopathy, splenomegaly and necrotic foci throughout lungs, liver, adrenals and CNS
50
What type of corneal lesions does Herpes cause
herpes epithelial keratitis- cytolysis of superficial epithelium herpes stromal keratitis- infiltrates of mononuclear cells around keratinocytes and endothelial cells-->neovascularization, scarring, opacificaiton of cornea and eventual blindness
51
What is kaposi varicelliform eruption
generalized vesiculating involvement of skin
52
what is eczema herpeticum
confluent pustular or hermorrhagic blisters with bacterial superinfection and viral dissemination to internal viscera
53
how does herpes affect resp tract
herpes esophagitis and bronchopneumonia
54
what conditions are caused by varicella zoster virus
chicken pox and shingles
55
how is VZV transferred
aerosols, and causes widespread vesicular skin lesions
56
Describe the recurrence of VZV
painful in dermatomes innervated by trigem ganglia
57
How is VZV Dx confirmed
viral culture or detection of viral Ag in cells from superficial lesions
58
what do chicken pox vesicles have in them
intranuclear inclusions in epithelial cells like that of HSV-1
59
What is shingles
when VZV has been latent a long time, after having chicken pox will infect keratinocytes that have vesicular lesions assoc with itching, burning or sharp pain
60
What can VZV cause in immunocompromised patients
interstitial pneumonia, encephalitis, transverse myelitis, necrotizing visceral lesions
61
What type of cells does CMV attack latently
monocytes and their bone marrow progenitors
62
What does CMV cause in healthy patients? neonateS? immunocompromised?
asymptomatic or mononucleosis like infection with fever and lymphadenopathy, hepatomegaly intrauterine: cytomegalic inclusion disease- growth retardation, jaundice, HSM, anemia, encephalitis, microcephaly, deafness perinatal: interstitial pneumonitis, skin rash, hepatitis, failure to thrive immunocompromised pneumonitis, colitis, ARDS, intestinal necrosis with formation of pseudomembranes and diarrhea
63
What cells does CMV acutely affect
dendritic cells and impair their maturation and ability to stimulate T cells
64
how does CMV elude immune system
downmodulates Class I and II MHC and produces homologues to TNF R, IL 10 and MHC I
65
how does CMV affect NK cells
activate and evade NK cells by inducing ligands for activating R
66
What do CMV cells look like morpho
enlarged | intranuclear basophillic inclusions spanning half the nuclear diameter
67
what tissues and components are affected by CMV
glands- parenchymal epithelium brain- neurons lungs- alveolar macrophages kidneys- tubular epithelium and glomerular endothelial
68
What is the most common opportunistic viral pathogen in AIDS
cytomegalovirus
69
What does HBV (HepB) cause
acute and chronic liver disease
70
how is HBV transmitted
drug IV, blood, perinatally, sexually
71
The cellular injury of liver from HBV occurs how
from immune response to infected liver cells | when the rate of infection overcomes rate that CTL can clear virus
72
Patients with HBV are at increased for developing what
hepatocellular carcinoma
73
What does EBV cause
infectious mononucleosis, self limited lymphoproliferative disorder assoc with developing neoplasms like lymphomas and nasopharyngeal carcinoma
74
What are the symptoms of EBV
fever, generalized lymphadenopaty, splenomegaly, sore throat and blood of atypical T lymphocytes
75
How is EBV transmitted
saliva, kissing
76
What type of proteins are on EBV
CD21 (CR2) whicis the R for C'3d on B cells
77
what are the ways that B cells are infected
lysis of infected cells releasing virions that can infect other cells majority just establish latent infection
78
What type of disease is protective for EBV
X- agamaglobulinemia because don't have B cells
79
What are the gene products of EBV latency
EBNA1 which mediates maintenance | EBNA2 and latent membrane protein1 LMP1 that dirve proliferation
80
What type of R does the LMP1 from EBV bind
TNFR activating pathways that mimic B cell activation by CD40
81
What is used Dx for EBV
detection of heterophile anti-sheep red blood cell Ab
82
What cells are most important against EBV
CD8 CTLs and NK cells
83
What type of lymphomas does EBV contribute to in immunocompromised patients
B cell lymphomas | Burkitt lymphoma with the 8:14 translocation amplifying c-myc
84
what is characteristic of EBV in peripheral smear
lymphocytosis with >60% WBC and many of them being atypical huge with many clear vacillations and oval indented nucleus with scattered granules
85
where are lymph nodes enlarged first in EBV
groin, axillary and posterior cervical
86
What areas of lymph nodes are expanded in EBV
paracortical by activated T cells
87
The Dx of EBV depends on what
lymphocytosis with characteristic atypical lymphocytes in peripheral blood + heterophile Ab rxn specific Ab for EBV Ag
88
what disease if concurrent with EBV infection is fatal in 1/3 patients
X linked lymphoproliferation syndrome "Duncan disease"

LAST EXAMMMMMM Year I (24 decks)

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