Class: Herpes Virus: CMV, EBV, HHV6-8 Flashcards

1
Q

How is EBV associated infectious mononucleosis transmitted?

A

saliva

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2
Q

What is incubation time for EBV associated infectious mononucleosis

A

30-50 days

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3
Q

What are the 3 major sxs of EBV associated infectious mononucleosis

A

Triad for IM-lymphadenopathy, fever, pharyngitis

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4
Q

major complications of EBV associated infectious mononucleosis (4)

A

i. Hemolytic anemia- dt auto-antibodies
ii. Thrombocytopenia- unclear etiology
iii. Neutropenia- mild, self-limiting
4. Neurologic complications <1% (85% recover completely)

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5
Q

What happens to 80-90% of IM patients who take ampicillin for EBV IM?

A

rash from a hypersensitivity reaction

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6
Q

X-linked lymphoproliferative disease is marked by increased what?

A

abnormally high numbers B cells, T cells and macrophages

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7
Q

What can be result of X-linked lymphoproliferative disease (2)

A

fulminant hepatitis, or develop hemophagocytic lymphohistiocytosis.

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8
Q

What causes X-linked lymphoproliferative disease?

A

inability of the body to effectively control EBV replication

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9
Q

How is EBV IM diagnosed?

A

monospot test

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10
Q

What does the monospot test detect?

A

heterophile antibodies

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11
Q

If monospot test is negative what is the cuase of IM

A

CMV

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12
Q

WHat oral infx is caused by EBV

A

oral hairy leukoplakia

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13
Q

What distinguishes Oral Hairy Leukoplakia from candidiasis

A

OHL can’t be scraped off tongue

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14
Q

how is CMV is transmitted

A
Saliva, urine, semen, cervical secretions
breast milk
trasnplants
Stem cells
sexual
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15
Q

What disease doe CMV cause in normal immune people

A

heterophile (-) infectious mononucleosis

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16
Q

how is congenital CMV is transmitted.

A

32% risk of congenital transmission if there is a primary infection of CMV during pregnancy
if already seropositive - 1% risk of congenital infection

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17
Q

How it cCMV diagnosed and in what time frame? (2 ways)

A

Saliva (1 hour after nursing) and/or urine PCR test within 3 weeks of life.

18
Q

What percent of cCMV infants show symptoms at birth?

A

10%

19
Q

common sx of cCMV? (5)

A
petechiae
jaundice
hepatosplenomegaly
microcephaly
hearing loss
20
Q

if symptomatic at birth, what are sequelae (3)

A

higher risk of long term sequelae

1) Sensorineural hearing loss = #1 sequelae
2) Cognitive defect/intellectual defect
3) Vision loss

21
Q

if symptomatic at birth, what are sequelae (3)

A

1) Sensorineural hearing loss = #1 sequelae
2) Cognitive defect/intellectual defect
3) Vision loss

22
Q

What is the most serious complication of CMV infx in SOT and HSCT pts?

A

Pneumonitis - has a very high mortality (84%) rate

23
Q

How to manage CMV infx in highly susceptible groups

A

Prophylaxis -ganciclovir or valganciclovir

24
Q

What are two things serology detects in CMV test and problem with one of them

A

IgA - can last several months so can’t show acute infx

IgM

25
Q

PCR is used to dx CMV in what populations (3)

A

acute infx only
newborns
CNS pts

26
Q

Antigenemia assay detects only what type of CMV infection? how?

A

only detects active infx by detecting neutrophils which are only infected in active infx

27
Q

What are th emajor complications of CMV infx in AIDS (3)

A

end-organ disease
retinitis
IRIS (Immune Reconstitution Inflammatory Syndrome)

28
Q

When does CMV retinitis occur?

A

usually in patients presenting with AIDS or treatment failure

29
Q

When does CMV diseases occur in AIDS pts

A

When CD4 count <50

30
Q

What is rule in treating CMV retinitis

A

don’t just treat unilateral eye–> disease in other eye or other organs

31
Q

what ages are infected with HHV6 and 7

A

6- younger < 2yo

7 older > 2yo

32
Q

What diseases can HHV6 cause?

A

Encephalitis
Roseola infantum (exanthem subitum, sixth disease)
Febrile seizures
Febrile seizures epilepticus

33
Q

What diseases can HHV7 cause?

A

Febrile seizures and

Febrile seizures epilepticus but HHV6&raquo_space;»7

34
Q

What is complication of Febrile seizures epilepticus

A

epilepsy

35
Q

What is a general complication of HHV-6 infx

A

Integrated chromosomal HHV-6 (icHHV-6)- every cell in body has HHV-6 integrated into their teleomeres

36
Q

What causes Kaposi’s sarcoma?

A

HHV-8

37
Q

what population gets classical KS

A

elderly men of Mediterranean or Eastern European descent.

38
Q

what population gets endemic KS

A

male, African adults

39
Q

What pop gets Iatrogenic KS

A

transplant recipients

40
Q

What is strongest risk factor for KS?

A

Strongest risk factor is low CD4 cell count (if HHV8 positive)