DD Common viral pathogens

Question 1

List what type of virus they are: DNA vs RNA
	Herpes simplex type 1 (HSV1)
	Herpes simplex type 2 (HSV2)
	Varicella zoster virus (VZV)
	Cytomegalovirus (CMV)

Answer 1

All are DS DNA!

Question 2

Which virus targets Mucosal epithelium and

Est. latency in sensory ganglia?

Answer 2

Herpes simplex type 1 (HSV1)
Herpes simplex type 2 (HSV2)
Varicella zoster virus (VZV)

Question 3

CMV cellular target for primary infection and latency

Answer 3

Epithelia, monocytes, lymphocytes, others

Question 4

EBV cellular target for primary infection and latency

Answer 4

B lymphocyte, epithelia

Question 5

Transmission of:

CMV

Answer 5

Contact, blood transfusions, transplantation, congenital

Question 6

Transmission of:

EBV

Answer 6

Saliva

Question 7

Clinical presentation of HSV1 and 2

Answer 7

Orofacial lesions and 
Genital lesions,
Encephalitis, 
Herpes Whitlow, 
Herpes keratitis, 
Neonatal herpes

Question 8

For immunocompromised indiv with CMV what treatment would you use?

Answer 8

ganciclovir

Question 9

When virus enters host, it brings with it Immediate Early (IE) genes, which are required for expression of Early (E) and Late (L) genes.
What are the functions of E and L genes?

Answer 9

□ E genes encode proteins involved in DNA replication, such as viral DNA polymerase, thymidine kinase (TK), helicase, etc.

□ L genes encode structural proteins, such as capsid and glycoproteins.

Question 10

Describe the differences in disease manifestation for HSV-1 vs HSV-2 when you know that they both result in the development of painful mucocutaneous ulcers

Answer 10

® HSV-1 is primarily responsible for orofacial and ocular lesions

® HSV-2 generally is transmitted sexually and causes genital disease

Question 11

Assume skin vesicles in neonate less than 1 month of age is due to?

Answer 11

HSV

Question 12

Chickenpox aka _______________
Shingles aka __________________

What do they have in common?

Answer 12

• Chickenpox, which is called varicella.
§ Chickenpox is the result of a primary infection with VZV.

• Shingles, which is sometimes called herpes zoster or “zoster”.
§ Shingles is caused by reactivation of VZV.

Question 13

serious complications of chickenpox

Answer 13

1. Secondary infection or cellulitis
2. Pneumonia
3. Necrotizing fasciitis
4. Encephalitis or encephalomyelitis
5. Hepatitis
6. Congenital varicella syndrome

• Typically in immunocompromised indivs.

Question 14

Which chicken pox complication is most common? Second most common?

Answer 14

1. Secondary infection or cellulitis

2. Pneumonia

Question 15

What bacteria is associated with:

1. Secondary infection or cellulitis
2. Pneumonia
3. Necrotizing fasciitis

Answer 15

1. Secondary infection or cellulitis
   - Group A Strep
2. Pneumonia
   - GAP
   - Staph aureus
3. Necrotizing fasciitis
   - Group A Strep

Question 16

Chance that preggo Mom can pass CMV to her baby

Answer 16

Via reactivation or primary infection (more common)

She develops primary infection → gets viremia → baby is infected ⅓ of the time, of those, 10-15% will have symptoms at birth = 3-5% (Math is hard) have congenital CMV

Question 17

how can CMV can be diagnosed histologically in infected tissue?

Answer 17

□ CMV-infected cells will have a characteristic “owl’s eye” appearance
® The owl’s eye is a dense, dark nuclear body surrounded by a halo. These represent intranuclear inclusions (accumulation of viral proteins or virions). There may also be smaller intracytoplasmic inclusions noted.

Question 18

Importance of serology in diagnosing CMV

Answer 18

In primary CMV disease, serology can establish the diagnosis.
AND
can distinguish between primary and recurrent infection.

Question 19

Interpret Serology:
Negative IgG
Negative IgM

Answer 19

Never had CMV

IgM indicates recent disease
(IgG remains for life)

Question 20

Interpret Serology:
Positive IgG
Negative IgM

Answer 20

Had previous infxn of cmv

IgM indicates recent disease
(IgG remains for life)

Question 21

Interpret Serology:
Positive IgG
Positive IgM

Answer 21

Recent reactivation of cmv

IgM indicates recent disease
(IgG remains for life)

Question 22

Interpret Serology:
Negative IgG
Positive IgM

Answer 22

Primary CMV

IgM indicates recent disease
(IgG remains for life)