DNA Enveloped (EBV,KSHV, CMV, HHV6, HHV7) Flashcards
what is the biology of EBV?
envelped double stranded DNA
what cells does EBV target for primary infection?
muco-epithelial and B cells
what cells does EBV select to remain latent and for secondary infection?
B cells
what does EBV use to immortalize b cells?
EBNA (epstein bar nuclear antigen)
how do you treat EBV?
no vaccine, no treatment
how do you diagnose EBV?
fever
hepato-splenomegaly
swollen lymp nodes
white patches in the tonsils
macular rash
how do you confirm a diagnosis of EBV?
Atypical Downey cells
how do you know if an infection of EBV is current or re-current?
current = anti-VCA IgM
recurrent = anti-EBNA IgG
what is this?
Atypical Downey cell in EBV
what non-histological test can be used to confirm diagnosis of EBV?
heterophile monospot test
what complications can occur with EBV?
1) Ora hairy leukoplakia
2) Hodgkins lymphoma
3) Burkitt’s lymphoma
4) nasopharyngeal lymphoma
how is EBV transmitted?
by saliva
when is EBV mostly seen?
as infectious mononucleosis in college era (15-20’s)
what is needed to contain an infection of EBV? and what is the consequence?
cell mediated response is needed but in will cause damage to our cells leading to inflammation
why does EBV cause sore throat?
because of the destruction of epithelial cells
why do atypical downey cells appear?
due to T cell activation and proliferation having atypical appearance
infectious mononucleosis is another name for what?
EBV
infectious mononucleosis macular rash is seen in what part of the body?
from the trunk to head and forearms
what do you not give to infectious mononucleosis patients with macular rash?
antibiotics because it exacerbates the rash (hypersensitivity)
when EBV infects B cells, what gets secreted?
heterophile antibodies
what test can be used to confirm presence of heterophile antibodies?
monospot test
monospot test can differentiate between what 2 viruses?
CMV or EBV
anti-EBNA is indicative of what?
past infection and not active infection
what is anti-VCA a definitive of?
definitive infection of EBV
what is this?
oral hairy leukoplakia
what is this?
hodgkins lymphoma
what is this?
burkitts lymphoma
in what patients is Kaposi sarcoma most common?
AIDS patients
HHV-8 is what?
kaposi sarcoma
what symptom is mostly seen in kaposi sarcoma?
Red or violet or salmon pink to silver grey macules or nodules
what does the kaposi sarcoma virus lytic infection do?
it releases viral proteins, activate the vascular G protein causes angiogenesis and tumor formation
what is this? what virus?
red papules in kaposi sarcoma, HHV-8
how is kaposi sarcoma treated?
no treatment, no vaccine, no control
what is the biology of cytomegalovirus?
it is a enveloped double stranded DNA virus
how is CMV transmitted?
mom to fetus
transplants
body fluids
what cells does CMV target?
mononuclear cells like T cells or macrophages
what cell does CMV target to remain latent?
Hematopoetic stem cells
what is the treatment for CMV?
Gancyclovir
what is the clinical presentation of CMV?
fever
swollen lymph nodes
hepato-splenomegaly
how do you confirm a diagnosis of CMV?
histological owl eye intracnuclear inclusion
what is this?
owl eye intranuclear inclusion
what complications can occur with CMV?
cytomegalo-inclusion disease
keratitis
which are normal, which are CMV?
CMV are huge cells
what cell will CMV impair?
T cells
do you have heterophile immune cells with CMV?
no, B cells are unaffected
what is curious about CMV?
we all get it and it remains latent
what can trigger CMV activation?
immuno-compromised individuals
infection
pregnancy
when is cytomegalo-inclusion disease most commonly seen?
neonates, because they lack cell mediated immunity
when does CMV cause multisite symptomatic disease?
in transplant or AIDS patients
how does CMV evade the hosts defense mechanism?
Blocks NK recognition
Blocks NK activation
Blocks TAP (MHC Class I)
Encodes IL-10 analog thus preventing Th1 activity
what is the most common in-utero infection in the US?
CMV
what symptoms are seen in neonates with CID from CMV?
petachiae
jaundice
hepato-splenomegaly
thrombocytopenia (blue-berry muffin baby)
what symptoms are seen in AIDS or transplant patients with CMV?
pneumonia
gastritis/colitis
retinitis
how is CMV detected?
direct immuno-florescence
what does HHV-6 cause?
roseola infantum
what is HHV-7?
exanthem subitum
who is susceptible to develop roseola or exanthem subitum?
kids less than 2 y/o
what is the treatment for HHV-6/7?
none, it goes away alone
what is the clinical presentation for HHV-6/7?
sudden high fever and lacy rose-red maculo-papular rash 2 after fever goes away
