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Clinical Pathology > CP7 viral and prion pathogens > Flashcards

CP7 viral and prion pathogens Flashcards

1
Q

How many significant herpes viruses are there?

A

5

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2
Q

How many significant respiratory viruses are there?

A

4

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3
Q

What is needed for virsuses to replicate?

A

A host

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4
Q

What are the 3 main components of a virus structure?

A

A genome (RNA or DNA)
A capsid (a protein coat)
An envelope (sometimes) - formed of a lipid bilayer)

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5
Q

What is the basic virus life cycle?

A

Absorption
Penetration
Uncoating
Synthesis
Assembly
Release

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6
Q

How are viruses classified?

A

By their genetic material and the presence of absence of an envelope

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7
Q

What are general properties of herpes viruses?

A

Double stranded DNA
enveloped
Establish latency and reactivate

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8
Q

What disease is caused by heroes simplex 1?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

Cold sores (HSV-1)

Worldwide - 80% of UK population

Spread by direct contact with vesicular fluid from legions. Latency in sensory trigeminal nerve ganglion with periodic reactivation down nerve

Can cause encephalitis (brain inflammation)

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9
Q

What disease is caused by herpes simplex 2?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

Genital herpes (HSV-2)

Worldwide and 10-20% of UK population

Direct contact with vesicular fluid from lesions. Latency in sacral ganglia which causes periodic reactivation

Can cause meningitis and neonatal herpes via vertical transmission

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10
Q

What disease is caused by varicella zoster virus?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

Chicken pox - reactivatated form called herpes zoster or shingles

95% have chicken pox in UK before age 20, 50% in the tropics

Respiratory droplet from infected individual, direct contact with vesicle fluid.latency established in dorsal root ganglia of whole CNS

Shingles causes unilateral vesicles in a dermatologist distribution unlike widespread rash in chicken pox

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11
Q

What disease is caused by Epstein barr virus?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

Glandular fever/mono

90% in UK are affected by age 25, 50% of these infections occur before age 5

Saliva and genital secretions. Establishes latency in B cells

Causes infectious mononucleosis (aka mono) as primary infection - tonsillitis, fever, lymphadenopathy and hepatosplenomegaly). Can also lead to malignant B cell lymphoproliferative disorders in the immunosuppressed.

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12
Q

What disease is caused by CMV?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

CMV (cytomegalovirus)

In UK prevalence = age e.g. 20% of 20 year olds

Saliva and genital secretions, donated blood, stem cells and organs. Latency in myeloid progenitors/monocytes/dendritic cells

Can cause infectious mononucleosis (primary), congenital CMV (infants born to mothers with CMV) and reactivation in immunosupressed patients.

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13
Q

What disease is caused by rhinoviruses?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

Common cold

Worldwide distribution more common in autumn winter and spring

Aerosolised respiratory secretions and droplets from the nose and eyes

Most common cause of common cold

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14
Q

What disease is caused by coronaviruses?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

Common colds and covid, SARS and MERS

Worldwide distribution infecting both humans and animals

Aerosolised respiratory secretions

Covid 19 causes severe pneumonitis and respiratory failure

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15
Q

What disease is caused by influenza?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

Flu

Infects humans and animals and can spread between species. Peaks at winter

Aerosolised respiratory secretions

3 types - A, B, C - with 2 important surface proteins H and N
A mutates regularly.
Can also cause post-influenza secondary bacterial lung infections

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16
Q

What disease is caused by RSV?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

Bronchiolitis

Worldwide commonly in winter months. Commonest amongst children

Aerosolised respiratory secretions

Not really

17
Q

What disease is caused by HIV?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

AIDS (rise in viral load and fall in CD4 count)

38.4 million living globally with HIV- 67% in sub Saharan Africa

Bodily fluids e.g. blood, genital secretions and breast milk and vertically and sexually transmitted

Targets helper t lympocytes. 2-6 weeks after transmission can cause a seroconversion illness and then there is asymptomatic chronic infection.
AIDS defining illnesses (illnesses more common in people with AIDS) include pneumocystis pneumonia, cryptococcal meningitis and kaposi’s sarcoma

18
Q

What disease is caused by hepatitis A?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

Hepatitis A

More common in lower income nations with contaminated water. 10-50% in Europe.

Faeco-orally

Asymptomatic in children and 50% of infected adults are symptomatic.

19
Q

What disease is caused by hepatitis E?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

Hepatitis E

In Western Europe and North America associated with undercooked pork - 95% of cases are asymptomatic

Faeco-oral in contaminated food and water

High mortality in infected pregnant women (25%)

20
Q

What disease is caused by hepatitis B?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

Hepatitis B

248 million people worldwide are chronically infected

Vertical, sexual and needle sharing

Causes acute clinical hepatitis after transmission (often asymptomatic), can then become chronic - younger you are when infected, more likely it is to become chronic infection. Chronic hepatitis leads to cirrhosis which can then cause hepatocellular carcinomas.

21
Q

What disease is caused by hepatitis C?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

Hepatitis c

170 million people are infected globally, in UK 50% of people who inject drugs have hep C

Blood (predominantly), vertical and sexual transmission

After transmission, 25% develop acute clinical hepatitis, 15% clear the virus but 85% will become chronically infected.

22
Q

What disease is caused by norovirus?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

Norwalk virus

90% of adults at some point over their life.

Aerosolised vomit particles

Vomiting is the dominant symptom

23
Q

What disease is caused by rotavirus?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

Rotavirus

80-100% of children in first 3 years of life without vaccination. Seasonally peaks in winter.

Faeco-orally in contaminated food, water and aerosolised faeces and vomit

Large cause of infant mortality in lower income nations. Presents with a fever, vomiting and watery diarrhoea

24
Q

What are common enteroviruses that cause disease?

What disease is caused by enterovirus?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

Polio, echoviruses, and coxsackie A and B

Hand foot and mouth, 50% of viral meningitis in UK, severe disseminated disease in neonates and poliomyelitis.

Worldwide distribution and peak in summer and autumn in the UK with 75% of cases in under 15 year olds

Faeco-orally by contaminated food and water

Replicates in gut but doesn’t cause GI symptoms. Viruses moves from gut to the lymph nodes and into the blood and sometimes the CNS

25
Q

What disease is caused by mumps virus?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

Mumps leading to acute parotitis, orchitis and meningitis

Endemic childhood infection worldwide peaking in winter.

Saliva and respiratory secretions

Vaccinated for in MMR vaccine

26
Q

What disease is caused by measles virus?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

Measles primarily. Can also cause acute post infectious measles encephalitis and subacute sclerosing pan-encephalitis (SSPE)

Occurs in clusters in the unvaccinated in the UK

Respiratory droplets transmission (environment still infectious after 2 hours)

Symptoms of primary measles infection include fever, coryza, cough, conjunctivitis and koplik’s spots on inside of the cheek.

27
Q

What disease is caused by rubella virus?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

Rubella

Very rare in the UK due to vaccine

Respiratory droplets

Can be primary rubella or congenital rubella. Primary rubella in adults can cause arthritis.

28
Q

What disease is caused by parovirus B19?

What is its epidemiology?

How does it spread?

Any distinguishing factors?

A

Parvovirus also known as Fifth disease and slapped cheek syndrome

50% infected by 15 and 90% by aged 90. Peaks in spring

Respiratory droplets

Causes transient anaemia by infecting and killing erythrocyte progenitor cells. Can cause erythema infectiosum, transient aplastic crisis and hydrops fetalis in unborn feature if individual infected whilst pregnant.

29
Q

What do prions not have?

A

Nucleic acid

30
Q

How to prions cause disease in the host?

A
  1. a gene mutation causes a change in folding pattern of the prion protein
  2. This abnormal folding makes it resistant to protease enzymes
  3. Prion accumulates abnormally in the cell
  4. Prions promote host proteins to also abnormally fold

I.e accumulation of abnormally folded prion protein in the cell results in the host proteins also abnormally folding

31
Q

What properties are shared by human prion disease?

A

Effect CNS
Produce spongiform change in the brain tissue
Long incubation times - can take 30 years for clinical disease to manifest
Highly fatal

32
Q

How is prion disease acquired?

A

Either through inheriting a genetic defect or transmission via consumption or direct exposure

33
Q

What is an example of a very rare prion disease? What symptoms does it cause and what is the prognosis?

A

Sporadic creutzfeld-jacob disease

A random gene mutation leading to progressive ataxia, depression, dementia and then death (usually within a year)

34
Q

What causes new variant CJD ?

A

Prions from contaminated beef from cows with BSE

Clinical Pathology (65 decks)

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