Class: Papilloma, Polyoma, Parvo

Question 1

What kinds of cancer are caused by HPV (6)

Answer 1

99% cervical cancers
Anal cancers
vuvlar, vaginal, penile
oropharyngeal cancers

Question 2

What are the high risk HPV types most assocuated with cancers

Answer 2

16, 18

Question 3

What does a low risk E6 viral protein do vs high risk

Answer 3

low = does not inactivate p53
high = inactivates p53

Question 4

What does a high risk E7 viral protein do vs low risk?

Answer 4

low = weakly binds and does not degrade Rb
high = binds and degrades Rb

Question 5

What is the AIDs defining cancer in HIV+ woman

Answer 5

cervical

Question 6

The incidence of what cancers are higher in the HIV+ population

Answer 6

anal and oropharyngeal

Question 7

What HPV type causes common warts (verrucus vulgaris)

Answer 7

types 1,2,4

Question 8

What HPV type causes Plane warts or flat warts (verrucae plana)

Answer 8

types 3, 10

Question 9

What HPV type causes Plantar warts (verrucae plantaris)-

Answer 9

types 1, 2

Question 10

what is epidermodysplasia verruciform? Inheritance pattern?

Answer 10

AR - chronic infection of cutaneous HPV

Question 11

What HPV types are assc with epidermodysplasia verruciform

Answer 11

types 3, 10

Question 12

what is recurrent respiratory papillomatosis ?

Answer 12

warts that appear in larynx and spread to lung

Question 13

How does recurrent respiratory papillomatosis present? (3)

Answer 13

warts in resp tract
hoarseness is first sx
difficulty swallowing or breathing while sleeping

Question 14

What HPV types causerecurrent respiratory papillomatosis

Answer 14

types 6, 11

Question 15

how is recurrent respiratory papillomatosis transmitted in Juvenile and adult

Answer 15

juvenile = birth
adult = oral sex

Question 16

3 treatments of recurrent respiratory papillomatosis

Answer 16

frequent surgeries
IFN or cidofovir to reduce time between surgeries
Indole-3 carbinol

Question 17

in Cervarix vaccine what HPV virus types are present?

Answer 17

Bivalent-16,18 only

Question 18

Gardasil: quadrivalent, vaccine what virus types are present?

Answer 18

HPV 6, 11, 16, 18

Question 19

Gardasil 9: 9-valent, what types are repsent?

Answer 19

HPV 6, 11, 16, 18 and 10% of other high risk HPV’s

Question 20

What is the optimal age of HPV vaccination?

Answer 20

11-12

Question 21

How many shots do the following age groups get?
9
11-14
15- 21 (boys), -26 (girls)

Answer 21

9 = 2 doses

11-14 = 2 doses

15-21 get 3 doses

Question 22

cervarix only approved for who

Answer 22

girls

Question 23

Gardasil bi- and quadrivalent approved for what pop?

Answer 23

boys and girls

Question 24

who is at risk for PML? (3)

Answer 24

1. AIDs pts
2. Immunosuppressed -dt transplant, hematologic malignancies
3. Those on immunosuppressive thx: Crohn’s, MS, rheumatoid arthritis, psoriasis, SLE

Question 25

What virus (and family) causes PML?

Answer 25

JC virus (polyoma family)

Question 26

Why such a small incidence of PML even in the immune suppressed?

Answer 26

Several steps are needed to get to PML from a JC infection:

Question 27

What are the 3 steps needed to cause PML

Answer 27

1. virus needs to change to infect glial cells 2. needs to get to brain 3. needs to evade immune surveillance in brain

Question 28

What cells does PML infect?

Answer 28

infects oligodendrocytes and astrocytes

Question 29

How does PML cuase it's sx?

Answer 29

causes a multifocal demyelination of the white mater

Question 30

What does IRIS stand for

Answer 30

(Immune Reconstitution Inflammatory Syndrome)

Question 31

What is IRIS associated with and what increases risk?

Answer 31

associated with use of immunosuppressant Natalizumab | increased risk with increased time on drug

Question 32

tx for IRIS

Answer 32

corticosteroid

Question 33

What 2 problems does BK virus cause in kidney transplant pts

Answer 33

some develop BK-associated nephropathy | of those 50% reject the trasnplant

Question 34

What problems arise in Bk- infected allogenic hematopoietic stem cell transplant pts

Answer 34

increased risk for hemorrhagic cystitis

Question 35

What cell is found in urine of BK pt

Answer 35

decoy cells

Question 36

what virus causes erythema infectiosum

Answer 36

Parvovirus B-19

Question 37

How is parvovirus B-19 transmitted. (2)

Answer 37

respiratory droplets | TORCHES = congential

Question 38

What is parvovirus B-19 receptor?

Answer 38

globoside (also known as blood group P antigen).

Question 39

How is erythema infectiosum transmitted.

Answer 39

resp droplets and fomites

Question 40

wHAT CELL TYPE IS TARGET FOR parvovirus? why?

Answer 40

erythroid precursor cells | In order to replicate needs to infect cells that are actively dividing

Question 41

How does erythema infectiosum presetn in children

Answer 41

fever--> slapped cheek rash --> recovery

Question 42

How does erythema infectiosum presetn in adults

Answer 42

arthritis/arthralgia in small joints in hands, and feet (also knee)

Question 43

What can erythema infectiosum be mistaken for in adults?

Answer 43

Rheumatoid arthritis

Question 44

Two main complications of erythema infectiosum

Answer 44

Transient aplastic crisis (TAC) | Pure Red Cell Aplasia

Question 45

In what pop does Pure Red Cell Aplasia occur

Answer 45

immunosuppressed

Question 46

In what pop does Transient aplastic crisis (TAC) occur

Answer 46

people with hemoglobinopathies: MC = SSD, but also | thalassemia, hereditary spherocytosis, red cell enzymopathies, and autoimmune hemolytic anemia.

Question 47

what the outcome can be for pregnant women infected with B19.

Answer 47

high output cardiac failure and non-immune hydrops fetalis.

Question 48

When during gestation does parvo B-19 infx becomes most problematic

Answer 48

Highest risk is in first 20 weeks of pregnancy

Question 49

What is major complication of fetal B-19 infx and MOA

Answer 49

B19 infects fetal myocytes expressing the P-antigen --> myocarditis--> hydrops fetalis