Circulatory, RES & Lymphatics-Viral I Flashcards

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1
Q

Epstein Barr Virus Associated Diseases

A

Infectious mononucleosis, oral hairy leukoplakia, burkitt’s lymphoma, Hodgkin’s Disease, Nasopharyngeal Carcinoma, PTLD

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2
Q

Commonly afflicts adolescents and adults

A

infectious mononucleosis

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3
Q

Epstein Barr associated disease that commonly afflicts immunocompromised individuals

A

Oral Hairy Leukoplakia

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4
Q

Epstein Barr-Oral Hairy Leukoplakia state of viral infection

A

productive

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5
Q

Epstein Barr-Infectious mononucleosis state of viral infection

A

productive, but disease due to immunopathology

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6
Q

Epstein Barr-Burkitt’s lymphoma commonly afflicts

A

Children in central Africa

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7
Q

Epstein Barr associated disease whose viral infections are in the latent state

A

Hodgkin’s disease, Nasopharyngeal carcinoma, PTLD

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8
Q

Commonly afflicts transplant patients (Epstein-barr associated)

A

PTLD

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9
Q

Commonly affects individuals living in southeast Asia and China

A

Nasopharyngeal Carcinoma

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10
Q

Epstein Barr Virus family

A

Herpesviridae

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11
Q

dsDNA virus, uses C3d component of complement system for attachment and entry, replicates in epithelial and B-cells

A

Epstein Barr Virus

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12
Q

EBV triggers what to proliferate and produce antibodies ?

A

B Cells

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13
Q

type of antibodies commonly produced in EBV infection

A

heterophile antibodies

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14
Q

Latency phase of EBV occurs when

A

infected B cells survive immune response and become memory B cells

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15
Q

reactivation from latency

A

usually asymptomatic

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16
Q

CD40 homologue, constitutively active

A

Latent Membrane Protein 1

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17
Q

increases growth of B cells

A

Latent Membrane Protein 2

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18
Q

transactivation of EBV transforming genes (LMP1/LMP2), and inhibits apoptosis

A

Epstein Barr Virus Nuclear Antigen 1 (EBNA1)

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19
Q

Genes involved in EBV carcinogenesis

A

LMP1, LMP2, EBNA1

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20
Q

transmission through saliva

A

Epstein-Barr Virus

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21
Q

percent of seropositive adults in the world

A

90%

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22
Q

Symptoms of mononucleosis

A

fever, malaise, exudative pharyngitis, splenomegaly, tender lymphadenitis

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23
Q

biochemical marker of infectious mononucleosis

A

heterophile antibodies

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24
Q

most common in young adulthood in industrialized countries

A

infectious mononucleosis

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25
Q

pathogenesis of infectious mononucleosis

A

immune targeting of the infected B cells

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26
Q

EBV and ampicillin treatment may cause

A

a characteristic rash-immune complexes

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27
Q

Serological markers of Infectious Mononucleosis marking lytic phase-primary infection

A

EA= EBV Early Antigen, VCA=EBV Viral Capsid Antigen

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28
Q

Serological markers of Infectious Mononucleosis marking latent phase-indicates a past infection

A

EBNA=Epstein Barr Nuclear Antigen

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29
Q

test that looks for heterophile antibodies: agglutinate if positive

A

Mono Spot test

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30
Q

In addition to the mono spot test you may test for primary EBV infection

A

antibodies to EBV (IgM to Viral Capsid Antigen)

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31
Q

atypical monocytes (T cells) found in infectious mononucleosis that have an altered nucleus and indented cell margin-prevalent in EBV infection

A

Downey Cells

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32
Q

Tx: infectiouis mononucleosis

A

no vaccines, rest and rehydrate, avoid strenous activity to avoid splenic rupture

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33
Q

plaque like lesion on lateral surface of the tongue due to EBV replicating in the epithelial cells

A

oral hairy leukoplakia

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34
Q

Can be treated with antiherpetic drugs, podophyllin resin

A

Oral Hairy Leukoplakia (EBV)

35
Q

associated with a translocation 8 to 14 of myc gene-causes overexpression of myc (transcriptional activator for pushing cells from G1 to S)

A

Burkitt’s Lymphoma

36
Q

most rapidly progressing human tumor

A

Burkitt’s Lymphoma

37
Q

% of cases of Burkitt’s lymphoma associated with EBV

A

20%

38
Q

co-factors associated with Burkitt’s Lymphoma

A

chronic malaria (endemic), immune suppression

39
Q

clinical symptoms of Hodgkin’s Disease

A

nontender, palpable, lymphadenopathy in neck, supraclavicular, and/or axilla, medistinal adenopathy (1/3 present with fever, night sweats, and weight loss)

40
Q

hallmark of Hodgkin’s Disease

A

Reed-Sternberg cell

41
Q

Large cell with two or more nuclei or nuclear lobes, each of which contains a large eosinophilic nucleolus

A

Reed-Sternberg cell

42
Q

Hodgkin’s Disease Tx:

A

radiotherapy/chemotherapy

43
Q

% Hodgkin’s disease associated with EBV

A

20-24%

44
Q

orginates in the nasopharynx, epithelial cell cancer, and symptoms of facial pain, fullness in sunuses and throat and hearing loss

A

Nasopharyngeal Carcinoma

45
Q

Cofactors for EBV neoplasms

A

genetics and diet

46
Q

Tx: of nasopharyngeal carcinomas

A

chemotherapy/radiation

47
Q

abnormal proliferation of lymphoid cells in a transplant patient

A

PTLD

48
Q

PTLD clinical symptoms

A

fever, fatigue, weight loss, or progressive encephalopathy, benign or malignant tumor

49
Q

major risk factor for PTLD

A

EBV infection at time of transplant

50
Q

Dx: of PTLD

A

histological analysis of tissue, detection of EBV genomes

51
Q

Tx: of PTLD

A

Reduce immunosuppression, treat w/ Rituximab (anti-CD20 antibody), convential chemotherapy

52
Q

Cytomegalovirus causes a mononucleosis that is

A

heterophile Ab negative

53
Q

babies born to seronegative mothers (CMV) can develop

A

cytomegalic inclusion disease

54
Q

enveloped, dsDNA, latency in monocyte, viral replication in mucosal epithelium and viremia

A

Cytomegalovirus (CMV)

55
Q

Cytomegalovirus family

A

Herpesviridae

56
Q

greatest time of transmission from birth mother to baby

A

viremia

57
Q

Are reactivations symptomatic in CMV in healthy individuals

A

rarely

58
Q

Transmission of CMV

A

saliva, breast milk, urine, fomites (short term), sexual contact

59
Q

Dx: of CMV

A

viral DNA or virus culture from diseased tissue, seroconversion

60
Q

1st CMV Tx:

A

gancyclovir, valganciclovir

61
Q

converted to viral polylmerase inhibitor by CMV enzymes (iv or oral)

A

gancyclovir

62
Q

converted to gancyclovir within the body, increased bioavailability (oral)

A

valganciclovir

63
Q

toxicity of gancyclovir/valganciclovir

A

bone marrow toxicity, drug-related neutropenia

64
Q

2nd line of defense CMV Tx:

A

cidofovir, foscarnet

65
Q

direct inhibitor of the CMV polymerase

A

foscarnet (IV) (renal toxicity)

66
Q

converted to viral polymerase inhibitor by cellular enzymes-more toxic than gancyclovir, given by IV

A

Cidofovir

67
Q

incubation period of CMV infectious mononucleosis-like illness

A

20-60 days

68
Q

Symptoms of CMV infectious mononucleosis-like illness

A

fever, fatigue, pharyngitis, abnormal T cells, no heterophile antibody production

69
Q

5% of congenital CMV infections lead to

A

Cytomegalic Inclusion Body Disease

70
Q

symptoms of cytomegalic inclusion body disease

A

hepatosplenomegaly, jaundice, petechiae/rash, microcephaly, growth retardation, inguinal hernias, chorioretinitis

71
Q

most common congenital infection in the us

A

CMV

72
Q

this age group is known for shedding CMV

A

children

73
Q

Tx: for CMV cytomegalic inclusion disease

A

maternal treatment with CMV immunoglobulin (under investigation)

74
Q

most common viral pathogen complicating organ transplant

A

CMV

75
Q

sources of CMV in immunosuppressed populations

A

transplanted organ, reactivation of latent CMV

76
Q

CMV in immunosuppressed populations is associated with this symptom

A

spiking fever (100-104F)

77
Q

Transplant recipients usually present with this type of CMV

A

CMV pneumonitis (fever, hypoxia, interstitial lung infiltrates), GI tract (diarrhea, abdominal pain, nausea, vomiting)

78
Q

increased graft-vs-host rejection is associated with

A

EBV infection

79
Q

AIDS patients present with this type of CMV

A

CMV retinitis (blurred vision, floaters, white lesions with irregular necrotic border) (sometimes associated with GI tract/CMV pneumonitis)

80
Q

Dx: CMV retinitis

A

pupil dilation and opthalmoscope examination

81
Q

Prevention of CMV in AIDS patients

A

antivirals when reaching a threshold level of CD4+ T-cells (gancyclovir)

82
Q

severe CMV infection in the immunosuppressed Tx:

A

IV antivirals

83
Q

CMV vaccine will have the greatest impact on CMV morbidity in immunocompetent in

A

neonates