DNA enveloped Viruses - Verma Flashcards

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1
Q

What are the three classes of enveloped DNA viruses?

A

Pox, Herpes, and Hepadna

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2
Q

What viral groups are included in the Herpes family?

A

alpha, beta, and gamma

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3
Q

what are the alpha herpes virues?

A

VZV, HSV1, HSV 2

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4
Q

What are the beta herpes viruses?

A

CMV, HHV6/7 (Roseola virus)

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5
Q

What are the gamma herpes viruses?

A

Kaposi’s Sarcoma, EBV

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6
Q

T/F: the hallmark of herpesvirus is a severe acute infection

A

false; latent or persistent

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7
Q

when is reactivation most likely to take place with herpesviruses?

A

during immune suppresion

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8
Q

Herpesviruses encode their own (DNA/RNA) Pol

A

DNA; since it is a DNA virus!

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9
Q

What is the antiviral target for herpes virus?

A

the viral DNA dep DNA pol

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10
Q

by what method is herpesvirus brought into the cell?

A

receptor mediated endocytosis

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11
Q

Where is viral DNA replicated in herpesvirus/

A

in the nucleus

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12
Q

What class of proteins are made by the immediate early genes?

A

regulatory

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13
Q

What class of proteins are made by the early genes?

A

enzymes for DNA rep

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14
Q

what class of proteins are made by the late genes?

A

structural

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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

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16
Q

HSV 1 and 2 are latent in what cell types?

A

neurons

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17
Q

HOw are HSV 1 and 2 distinguished?

A

by antigenicity and location of hte lesions

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18
Q

Where do you normally find HSV 1 lesions?

A

mouth and eyes

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19
Q

In the mouth, HSV 1 presents as:

A

gingivostomatitis

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20
Q

In the eye, HSV 1 presents as:

A

keratoconjunctivitis

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21
Q

How do HSV 1 and 2 differ in their presentation to the CNS?

A

HSV1: encephalitis

HSV 2: meningitis

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22
Q

Does HSV 1 or 2 cause disease in the neonate?

A

HSV 2

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23
Q

Does HSV 1 or 2 cause dissemination to the viscera in immunocompromised pts?

A

HSV 1

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24
Q

cold sores are recurrent forms of (blank)

A

gingivostomatitis

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25
Q

cold sores are caused by crops of vesicles at the (blank) of the lips and nose

A

mucocutaneous junctions

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26
Q

What lobe of the brain does HSV 1 attack with encephalitis?

A

temporal lobe

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27
Q

T/F: in both HSV 1 and 2, recurrent lesions are worse than primary lesions

A

false; primary lesions are worse

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28
Q

T/F: you can have the Ab to HSV 2 but have never have shown clinical disease

A

true

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29
Q

How does a neonate get HSV 2?

A

contact with vesicular lesions within the birth canal

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30
Q

T/F: neonatal herpes can be anything from asymptomatic to severe encephalitis

A

true

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31
Q

HSV (1/2) is transmitted via saliva while (1/2) is transmitted via sex

A

1 for saliva, 2 for sex

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32
Q

How do you get HSV1 on the genitals and HSV 2 in the mouth?

A

oral-genital sex

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33
Q

what percent of people in the US have HSV 1?

A

50-60%

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34
Q

When do Abs appear for HSV 1? For HSV 2?

A

1: childhood
2: age of sexual activity

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35
Q

What is the most definitive method to diagnose HSV?

A

viral isolation and culture growth

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36
Q

HSV encephalitis can be done by rapid PCR of (blank) from the spinal fluid

A

viral DNA

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37
Q

When is the only time you use serology to diagnose HSV infection

A

primary infection

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38
Q

A Tzanck smear shows a base of vesicles stained with (blank) during HSV infection

A

Giemsa stain

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39
Q

What types of cells show upon the Tzanck smear for HSV?

A

multinucleated giant

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40
Q

T/f: some HSV 1 is resistant to acyclovir

A

true (Foscarnet: HSV 1)

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41
Q

Valcyclovir and Famciclovir are used to treat HSV (1/2)

A

HSV 2

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42
Q

What is recommneded to pregnant women with HSV 2?

A

C -section

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43
Q

T/F: HSV 2 acute infection will show with lymphadenopathy

A

true

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44
Q

T/F: individuals can shed the HSV virus without symtpoms

A

true

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45
Q

What is the acute and the latent forms of VZV?

A

chicken pox and shingles

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46
Q

Where does the latent infection of VZV hang out?

A

in the neurons

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47
Q

What is the incubation period of VZV?

A

14-21 days

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48
Q

Describe the rash in VZV?

A

vesicular

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49
Q

Describe the rash in HSV ?

A

vesicular

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50
Q

VZV complications include viral pneumonia, encephalitis, and hemorrhagic chicken pox in what types of patients?

A

immunocompromised

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51
Q

Where SPECIFICALLY does the latent VZV reactivate?

A

SENSORY GANGLION, like trigeminal and then tracks down that nerve

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52
Q

What is the most sensitive method for diagnosing VZV? What is the other method?

A

Direct IFA most sensitive; PCR also available

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53
Q

Is theVZV virus easy or hard to isolate?

A

hard to isolate

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54
Q

T/F: Ab titers for VZV are normally very high

A

false; they are low

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55
Q

Do you give antiviral therapy for a childhood infection of VZV?

A

nope; everyone gets chickenpox!

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56
Q

(x)cyclovir antivrals will (prevent/shorten) adult VZV infections

A

shorten

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57
Q

Which VZV vaccine do you give to kids and which do you give to adults?

A

Varivax to kids and Zostavax to adults. V before Z

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58
Q

At what age do you adminster the Zostavax vaccine?

A

over 60

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59
Q

What is in the VZV vaccine?

A

live attenuated virus

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60
Q

What is the numerical name for VZV?

A

HHV3

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61
Q

(blank) causes infectious mononucleosis, B cell lymphoma, and nasopharyngeal carcinoma

A

EBV

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62
Q

What is the numerical name for EBV?

A

HHV 4

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63
Q

What is the most important antigens in EBV?

A

viral capsid antigen VCA, early antigens EA, and nuclear antigen EBNA
VCA
EA
EBNA

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64
Q

T/F: kids with mono normally have severe symptoms

A

nope; asymptomatic or just fever, fatigue, sore throat

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65
Q

African Burkitt’s lyphoma , oral hairy leukoplakia, and post-transplant lymphoproliferative disease (PTLD) is caused by (blank)

A

EBV

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66
Q

How is EBV transmitted?

A

saliva

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67
Q

What percent of people shed eBV for life?

A

greater than 90%

68
Q

What percent of the US population is infected with EBV by age 30?

A

70%

69
Q

(blank) and immunocompromised patients are at high risk of lymphoproliferative disorders caused by eBV?

A

AIDS pts

70
Q

Where is the initial infection of EBV?

A

oropharynx

71
Q

What is the target cell of EBV?

A

B cells

72
Q

IgM Ab is produced in response to which ag from EBV?

A

VCA

73
Q

IgG Ab persist for life to which ag from EBV?

A

VCA

74
Q

IgM detects (blank) infection and IgG detects (blank) infection of EBV?

A

IgM: acute
IgG: past infection

75
Q

In a productive infection of eBV, in what order do we produce Abs to which ags? When is Ab produced against EBNA?

A

VCA to MA to EA

EBNA produced during cell lysis

76
Q

What are the hemotological criteria needed to diagnose EBV?

A

30% of lymphocytes must be atypicla with an ENLARGED NUCLEUS and VACUOLATED CYTOPLASM

77
Q

What are the two criteria necessary to diagnose EBV from an immunologic approach?

A

need to see HETEROPHILE Abs and EBV specific Abs

78
Q

Presence of heterophile Ab is an early diagnosis of (blank)

A

infectious mononucleosis

79
Q

T/F: acyclovir is very active against mono

A

false; limited activity only!

80
Q

Is there a vaccine against EBV?

A

nope

81
Q

What is the common name for the heterophile Ab test?

A

monospot

82
Q

What organ becomes enlarged during mono? Why does this make sense?

A

Splenomegaly; atypical blood cells!!!

83
Q

T/F: mono symptoms are self limiting but can last for fucking months

A

very true dude

84
Q

T/F: EBV can immortalize lymphocytes

A

yes, B cells, that’s how you get Burkitt’s lymphoma

85
Q

What is the numerical name of CMV?

A

HHV5

86
Q

T/F: CMV infects in a similar manner to EBV

A

false; it is an opportunistic infection in immunocompromised patients

87
Q

Bone marrow recipients who show pneumonia, retinitis, hepatitis and colitis likely have a (blank) infection

A

CMV

88
Q

IN what cells does CMV go latent?

A

stromal cells of bone marrow

89
Q

What risks are involved in vertical passage of CMV?

A

serious birth defects

90
Q

In immune COMPETENT adults with a NEGATIVE heterophile mono fever and the presence of atypical lymphoctyes, we suspect what bug?

A

CMV

91
Q

How is CMV transmitted in children? How is it transmitted in adults?

A

kids; saliva.; adults: sexually

92
Q

A histology sample showing a CYTOLOMEGALIC VIRUS suggest what infection?

A

CMV

93
Q

Is it easy or hard to culture CMV?

A

easy

94
Q

What is the primary method of Dx for CMV?

A

Abs, think monospot

95
Q

how do we treat CMV infection?

A

Ganciclovir and Foscarnet

96
Q

Cytogam, a high titer Ig, is used to prevent (blank) in organ transplant patients

A

disseminated CMV infections

97
Q

Roseola infection is what two numbers?

A

HHV6 and 7

98
Q

What is the target cell of Roseola infection?

A

T cells;

99
Q

Can all lymphocytes be infected with Roseola virus or just T cells?

A

both B and T cells

100
Q

T/F: HHV6/7 share LIMITED nucleotide homology and antigenic cross reactivity

A

true

101
Q

WHere is HHV6/7 found?

A

UBIQUITOUS WORLDWIDE

102
Q

HOw is Roseola virus transmitted?

A

saliva and breast feeding

103
Q

Why do you acquire Roseola AFTER four months?

A

maternal IgG is degraded

104
Q

what stunning percent of the pop is infected with HHV6 AND 7?

A

90-99%

105
Q

Is 6 or 7 associated with roseola infantum?

A

6

106
Q

A SPIKING FEVER and mild maculopapular rash suggest what HHV infection?

A

Roseola

107
Q

How do you diagnose HHV infection?

A

IgM and IgG

108
Q

How does the rash spread in roseola infection?

A

from trunk to extremities

109
Q

Kaposi’s Sarcoma is what number?

A

HHV 8

110
Q

Castleman’s disease and primary effusion lymphomas are associated with what AIDS related disease?

A

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
Q

T/F: most pts with Kaposi’s have anitbodies against HHV8

A

true

112
Q

In what group is seroprevalence of HHV8 high?

A

gays

113
Q

bluish-purple spots on chest and thighs, generalized lympadenopathy, and being gay probably indicates that you have?

A

Kaposi’s sarcoma from HHV 8

114
Q

T/F: variola virus causing smallpox has been completely eradicated

A

true

115
Q

What category is smallpox?

A

cat A

116
Q

What is contained within the pox virion particle?

A

dsDNA genome and DNA dep RNA pol!

117
Q

Where does the pox virus replicate? why is this strange?

A

in the cytoplasm; it is a DNA virues

118
Q

How many serotypes of smallpox are there?

A

only one, that’s why we have a vaccine and it is eradicated

119
Q

What are the two methods of transmitting smallpox?

A

resp. aerosol or direct contact

120
Q

Does smallpox infect the upper or lower respiratory tract?

A

upper

121
Q

What are the locations of primary viremia of smallpox?

A

upper resp. tract, lymph nodes, and blood vessels

122
Q

What are the targets of secondary viremia in smallpox?

A

internal organs and skin

123
Q

Why do you get the pox with smallpox>?

A

secondary viremia in the skin

124
Q

What is the incubation period for small pox?

A

7-14 days

125
Q

Where are the pox the worst on the body?

A

face and extremities

126
Q

What is contained within the smallpox vaccine?

A

live attenuated, it’s variolation!!!

127
Q

Is there an animal reservoir of pox?

A

nope, that’s why its gone

128
Q

Can you culture pox?

A

yes, viral Ags are also used for Dx

129
Q

How long after exposure can you be immunized and still be protected against small pox?

A

4 days

130
Q

Vaccinia immune globulins are given to treat what?

A

complications due to small pox infection

131
Q

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:

A

molluscum contagiosum

132
Q

What is the incubation period of molluscum contagiosum and can you culture it?

A

2-8 weeks; no

133
Q

Since you can’t culture molluscum contagiosum, how do you Dx it?

A

clinically

134
Q

What viral family does molluscum contagiosum belong to?

A

pox virus, it is a papule after all

135
Q

How is MCV transmitted?

A

direct body contact or genital lesions sexually

136
Q

How do we treat MCV?

A

no specific therapy, let it resolve on its own over time

137
Q

Is Hep B virus large or small?

A

small

138
Q

Hep (B/C) viral particles are resistant to low pH, freezing, and moderate heating

A

Hep B

139
Q

HBsAg is what and what is it used for?

A

Hep B surface Ag, used for Dx

140
Q

What are the two other important Ags for Hep B antigens?

A

HBcAg and HBeAg

141
Q

What is the only natural host of Hep B infection?

A

Humans

142
Q

What are the three modes of Hep B transmission?

A

blood, sexual, and vertical

143
Q

HBV is common in what demographic?

A

IVDU

144
Q

Where in the world is HBV the most prevalent?

A

Asia; high prevalence of hepatocellular carcinoma

145
Q

What vaccine is the first to prevent human cancer?

A

Hep B

146
Q

What are the symptoms of acute hepatitis?

A

fever, fatigue, nausea, pain from hepatosplenogmegaly

147
Q

In what percent of people suffer from chronic hepatitis B?

A

only 5-10%

148
Q

What fraction of pts with chronic Hep B will develop cirrhosis and liver failure?

A

one third

149
Q

8-% of cases of primary hepatocellular carcinoma are due to (blank)

A

chronic hep B

150
Q

How do you diagnose Hep B?

A

liver enzymes and serology

151
Q

IgM to HBcAG indicates an (acute/chronic) infection

A

acute

152
Q

HBsAg is assoicated with an (acute/chronic) infection

A

chronic

153
Q

Is there treatment for ACUTE hep B?

A

nope

154
Q

How do we treat chronic hep B?

A

IFN-a, lamivudine, adefovir, or entecavir

155
Q

What is in the vaccine for Hep B?

A

recombinant HBsAg

156
Q

What do you give neonates that are born to mothers that are HBsAg positive?

A

HBV IgG

157
Q

Jaundice, dark urine, and elevated liver enzymes suggest what type of infection?

A

Hep B

158
Q

What is the genome of Hep D?

A

small circular enveloped RNA

159
Q

(blank) is a subviral satellite that only propagates in the presence of Hep B

A

Hep D

160
Q

T/F: Hep B and D are transmitted through the same route

A

true

161
Q

Hep D codes for (blank) agent that surrounds the genome and is found in blood, semen, and vaginal secretions

A

delta agent

162
Q

Replication of delta agent leads to (blank)

A

liver damage

163
Q

How do you diagnose Hep D?

A

detecting RNA genome, delta ag, or anti-HDV antibodies

164
Q

Clay colored stools, dark urine, large liver, and travel to NEPAL would indicate what type of infection?

A

Hep E

165
Q

What is the mode of transmission of Hep E?

A

fecal oral route

166
Q

T/F: Hep E does NOT establish a chronic infection

A

true