DNA enveloped Viruses - Verma Flashcards
1
Q
What are the three classes of enveloped DNA viruses?
A
Pox, Herpes, and Hepadna
2
Q
What viral groups are included in the Herpes family?
A
alpha, beta, and gamma
3
Q
what are the alpha herpes virues?
A
VZV, HSV1, HSV 2
4
Q
What are the beta herpes viruses?
A
CMV, HHV6/7 (Roseola virus)
5
Q
What are the gamma herpes viruses?
A
Kaposi’s Sarcoma, EBV
6
Q
T/F: the hallmark of herpesvirus is a severe acute infection
A
false; latent or persistent
7
Q
when is reactivation most likely to take place with herpesviruses?
A
during immune suppresion
8
Q
Herpesviruses encode their own (DNA/RNA) Pol
A
DNA; since it is a DNA virus!
9
Q
What is the antiviral target for herpes virus?
A
the viral DNA dep DNA pol
10
Q
by what method is herpesvirus brought into the cell?
A
receptor mediated endocytosis
11
Q
Where is viral DNA replicated in herpesvirus/
A
in the nucleus
12
Q
What class of proteins are made by the immediate early genes?
A
regulatory
13
Q
What class of proteins are made by the early genes?
A
enzymes for DNA rep
14
Q
what class of proteins are made by the late genes?
A
structural
15
Q
heparan sulfate modified glycoprotein, PILRalpha, HVEM, and Nectin1/2 are host cell protiens that have what function in herpes virus infection?
A
attachment proteins for viral entry
16
Q
HSV 1 and 2 are latent in what cell types?
A
neurons
17
Q
HOw are HSV 1 and 2 distinguished?
A
by antigenicity and location of hte lesions
18
Q
Where do you normally find HSV 1 lesions?
A
mouth and eyes
19
Q
In the mouth, HSV 1 presents as:
A
gingivostomatitis
20
Q
In the eye, HSV 1 presents as:
A
keratoconjunctivitis
21
Q
How do HSV 1 and 2 differ in their presentation to the CNS?
A
HSV1: encephalitis
HSV 2: meningitis
22
Q
Does HSV 1 or 2 cause disease in the neonate?
A
HSV 2
23
Q
Does HSV 1 or 2 cause dissemination to the viscera in immunocompromised pts?
A
HSV 1
24
Q
cold sores are recurrent forms of (blank)
A
gingivostomatitis
25
cold sores are caused by crops of vesicles at the (blank) of the lips and nose
mucocutaneous junctions
26
What lobe of the brain does HSV 1 attack with encephalitis?
temporal lobe
27
T/F: in both HSV 1 and 2, recurrent lesions are worse than primary lesions
false; primary lesions are worse
28
T/F: you can have the Ab to HSV 2 but have never have shown clinical disease
true
29
How does a neonate get HSV 2?
contact with vesicular lesions within the birth canal
30
T/F: neonatal herpes can be anything from asymptomatic to severe encephalitis
true
31
HSV (1/2) is transmitted via saliva while (1/2) is transmitted via sex
1 for saliva, 2 for sex
32
How do you get HSV1 on the genitals and HSV 2 in the mouth?
oral-genital sex
33
what percent of people in the US have HSV 1?
50-60%
34
When do Abs appear for HSV 1? For HSV 2?
1: childhood
2: age of sexual activity
35
What is the most definitive method to diagnose HSV?
viral isolation and culture growth
36
HSV encephalitis can be done by rapid PCR of (blank) from the spinal fluid
viral DNA
37
When is the only time you use serology to diagnose HSV infection
primary infection
38
A Tzanck smear shows a base of vesicles stained with (blank) during HSV infection
Giemsa stain
39
What types of cells show upon the Tzanck smear for HSV?
multinucleated giant
40
T/f: some HSV 1 is resistant to acyclovir
true (Foscarnet: HSV 1)
41
Valcyclovir and Famciclovir are used to treat HSV (1/2)
HSV 2
42
What is recommneded to pregnant women with HSV 2?
C -section
43
T/F: HSV 2 acute infection will show with lymphadenopathy
true
44
T/F: individuals can shed the HSV virus without symtpoms
true
45
What is the acute and the latent forms of VZV?
chicken pox and shingles
46
Where does the latent infection of VZV hang out?
in the neurons
47
What is the incubation period of VZV?
14-21 days
48
Describe the rash in VZV?
vesicular
49
Describe the rash in HSV ?
vesicular
50
VZV complications include viral pneumonia, encephalitis, and hemorrhagic chicken pox in what types of patients?
immunocompromised
51
Where SPECIFICALLY does the latent VZV reactivate?
SENSORY GANGLION, like trigeminal and then tracks down that nerve
52
What is the most sensitive method for diagnosing VZV? What is the other method?
Direct IFA most sensitive; PCR also available
53
Is theVZV virus easy or hard to isolate?
hard to isolate
54
T/F: Ab titers for VZV are normally very high
false; they are low
55
Do you give antiviral therapy for a childhood infection of VZV?
nope; everyone gets chickenpox!
56
(x)cyclovir antivrals will (prevent/shorten) adult VZV infections
shorten
57
Which VZV vaccine do you give to kids and which do you give to adults?
Varivax to kids and Zostavax to adults. V before Z
58
At what age do you adminster the Zostavax vaccine?
over 60
59
What is in the VZV vaccine?
live attenuated virus
60
What is the numerical name for VZV?
HHV3
61
(blank) causes infectious mononucleosis, B cell lymphoma, and nasopharyngeal carcinoma
EBV
62
What is the numerical name for EBV?
HHV 4
63
What is the most important antigens in EBV?
viral capsid antigen VCA, early antigens EA, and nuclear antigen EBNA
VCA
EA
EBNA
64
T/F: kids with mono normally have severe symptoms
nope; asymptomatic or just fever, fatigue, sore throat
65
African Burkitt's lyphoma , oral hairy leukoplakia, and post-transplant lymphoproliferative disease (PTLD) is caused by (blank)
EBV
66
How is EBV transmitted?
saliva
67
What percent of people shed eBV for life?
greater than 90%
68
What percent of the US population is infected with EBV by age 30?
70%
69
(blank) and immunocompromised patients are at high risk of lymphoproliferative disorders caused by eBV?
AIDS pts
70
Where is the initial infection of EBV?
oropharynx
71
What is the target cell of EBV?
B cells
72
IgM Ab is produced in response to which ag from EBV?
VCA
73
IgG Ab persist for life to which ag from EBV?
VCA
74
IgM detects (blank) infection and IgG detects (blank) infection of EBV?
IgM: acute
IgG: past infection
75
In a productive infection of eBV, in what order do we produce Abs to which ags? When is Ab produced against EBNA?
VCA to MA to EA
| EBNA produced during cell lysis
76
What are the hemotological criteria needed to diagnose EBV?
30% of lymphocytes must be atypicla with an ENLARGED NUCLEUS and VACUOLATED CYTOPLASM
77
What are the two criteria necessary to diagnose EBV from an immunologic approach?
need to see HETEROPHILE Abs and EBV specific Abs
78
Presence of heterophile Ab is an early diagnosis of (blank)
infectious mononucleosis
79
T/F: acyclovir is very active against mono
false; limited activity only!
80
Is there a vaccine against EBV?
nope
81
What is the common name for the heterophile Ab test?
monospot
82
What organ becomes enlarged during mono? Why does this make sense?
Splenomegaly; atypical blood cells!!!
83
T/F: mono symptoms are self limiting but can last for fucking months
very true dude
84
T/F: EBV can immortalize lymphocytes
yes, B cells, that's how you get Burkitt's lymphoma
85
What is the numerical name of CMV?
HHV5
86
T/F: CMV infects in a similar manner to EBV
false; it is an opportunistic infection in immunocompromised patients
87
Bone marrow recipients who show pneumonia, retinitis, hepatitis and colitis likely have a (blank) infection
CMV
88
IN what cells does CMV go latent?
stromal cells of bone marrow
89
What risks are involved in vertical passage of CMV?
serious birth defects
90
In immune COMPETENT adults with a NEGATIVE heterophile mono fever and the presence of atypical lymphoctyes, we suspect what bug?
CMV
91
How is CMV transmitted in children? How is it transmitted in adults?
kids; saliva.; adults: sexually
92
A histology sample showing a CYTOLOMEGALIC VIRUS suggest what infection?
CMV
93
Is it easy or hard to culture CMV?
easy
94
What is the primary method of Dx for CMV?
Abs, think monospot
95
how do we treat CMV infection?
Ganciclovir and Foscarnet
96
Cytogam, a high titer Ig, is used to prevent (blank) in organ transplant patients
disseminated CMV infections
97
Roseola infection is what two numbers?
HHV6 and 7
98
What is the target cell of Roseola infection?
T cells;
99
Can all lymphocytes be infected with Roseola virus or just T cells?
both B and T cells
100
T/F: HHV6/7 share LIMITED nucleotide homology and antigenic cross reactivity
true
101
WHere is HHV6/7 found?
UBIQUITOUS WORLDWIDE
102
HOw is Roseola virus transmitted?
saliva and breast feeding
103
Why do you acquire Roseola AFTER four months?
maternal IgG is degraded
104
what stunning percent of the pop is infected with HHV6 AND 7?
90-99%
105
Is 6 or 7 associated with roseola infantum?
6
106
A SPIKING FEVER and mild maculopapular rash suggest what HHV infection?
Roseola
107
How do you diagnose HHV infection?
IgM and IgG
108
How does the rash spread in roseola infection?
from trunk to extremities
109
Kaposi's Sarcoma is what number?
HHV 8
110
Castleman's disease and primary effusion lymphomas are associated with what AIDS related disease?
Kaposi's Sarcoma; Castleman--Rook can only move in one direction; When you have AIDS you can't do anything but treat or die
111
T/F: most pts with Kaposi's have anitbodies against HHV8
true
112
In what group is seroprevalence of HHV8 high?
gays
113
bluish-purple spots on chest and thighs, generalized lympadenopathy, and being gay probably indicates that you have?
Kaposi's sarcoma from HHV 8
114
T/F: variola virus causing smallpox has been completely eradicated
true
115
What category is smallpox?
cat A
116
What is contained within the pox virion particle?
dsDNA genome and DNA dep RNA pol!
117
Where does the pox virus replicate? why is this strange?
in the cytoplasm; it is a DNA virues
118
How many serotypes of smallpox are there?
only one, that's why we have a vaccine and it is eradicated
119
What are the two methods of transmitting smallpox?
resp. aerosol or direct contact
120
Does smallpox infect the upper or lower respiratory tract?
upper
121
What are the locations of primary viremia of smallpox?
upper resp. tract, lymph nodes, and blood vessels
122
What are the targets of secondary viremia in smallpox?
internal organs and skin
123
Why do you get the pox with smallpox>?
secondary viremia in the skin
124
What is the incubation period for small pox?
7-14 days
125
Where are the pox the worst on the body?
face and extremities
126
What is contained within the smallpox vaccine?
live attenuated, it's variolation!!!
127
Is there an animal reservoir of pox?
nope, that's why its gone
128
Can you culture pox?
yes, viral Ags are also used for Dx
129
How long after exposure can you be immunized and still be protected against small pox?
4 days
130
Vaccinia immune globulins are given to treat what?
complications due to small pox infection
131
A painless, non-itchy, non-inflamed, small papule of the skin or mucous membrane found on the trunk, genitalia, or proximal extremities, usually found in clusters is most likely:
molluscum contagiosum
132
What is the incubation period of molluscum contagiosum and can you culture it?
2-8 weeks; no
133
Since you can't culture molluscum contagiosum, how do you Dx it?
clinically
134
What viral family does molluscum contagiosum belong to?
pox virus, it is a papule after all
135
How is MCV transmitted?
direct body contact or genital lesions sexually
136
How do we treat MCV?
no specific therapy, let it resolve on its own over time
137
Is Hep B virus large or small?
small
138
Hep (B/C) viral particles are resistant to low pH, freezing, and moderate heating
Hep B
139
HBsAg is what and what is it used for?
Hep B surface Ag, used for Dx
140
What are the two other important Ags for Hep B antigens?
HBcAg and HBeAg
141
What is the only natural host of Hep B infection?
Humans
142
What are the three modes of Hep B transmission?
blood, sexual, and vertical
143
HBV is common in what demographic?
IVDU
144
Where in the world is HBV the most prevalent?
Asia; high prevalence of hepatocellular carcinoma
145
What vaccine is the first to prevent human cancer?
Hep B
146
What are the symptoms of acute hepatitis?
fever, fatigue, nausea, pain from hepatosplenogmegaly
147
In what percent of people suffer from chronic hepatitis B?
only 5-10%
148
What fraction of pts with chronic Hep B will develop cirrhosis and liver failure?
one third
149
8-% of cases of primary hepatocellular carcinoma are due to (blank)
chronic hep B
150
How do you diagnose Hep B?
liver enzymes and serology
151
IgM to HBcAG indicates an (acute/chronic) infection
acute
152
HBsAg is assoicated with an (acute/chronic) infection
chronic
153
Is there treatment for ACUTE hep B?
nope
154
How do we treat chronic hep B?
IFN-a, lamivudine, adefovir, or entecavir
155
What is in the vaccine for Hep B?
recombinant HBsAg
156
What do you give neonates that are born to mothers that are HBsAg positive?
HBV IgG
157
Jaundice, dark urine, and elevated liver enzymes suggest what type of infection?
Hep B
158
What is the genome of Hep D?
small circular enveloped RNA
159
(blank) is a subviral satellite that only propagates in the presence of Hep B
Hep D
160
T/F: Hep B and D are transmitted through the same route
true
161
Hep D codes for (blank) agent that surrounds the genome and is found in blood, semen, and vaginal secretions
delta agent
162
Replication of delta agent leads to (blank)
liver damage
163
How do you diagnose Hep D?
detecting RNA genome, delta ag, or anti-HDV antibodies
164
Clay colored stools, dark urine, large liver, and travel to NEPAL would indicate what type of infection?
Hep E
165
What is the mode of transmission of Hep E?
fecal oral route
166
T/F: Hep E does NOT establish a chronic infection
true
