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Microbiology > DNA Virus - Herpesviridae > Flashcards

DNA Virus - Herpesviridae Flashcards

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1
Q

Classification of Herpesviridae

A

HHV 1-8
HHV 1 and 2 - Cause HSV 1 and 2
HHV 3 - HZV/Varicella zoster
HHV 4 - EBV
HHV 5 - CMV
HHV6
HHV7
HHV8

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2
Q

General properties of Herpesviridae family

A

150-200nm size (Second largest)
Icosahedral Symmetry
dsDNA

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3
Q

Subfamilies of Herpesviridae family

A

Alpha
Beta
Gamma

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4
Q

Alpha subfamily of Herpesviridae family includes which species and site of latency

A

Species - HHV 1, 2 and 3
Site of latency - Neurons

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5
Q

Beta subfamily of Herpesviridae family includes which species and site of latency

A

Species - HHV5, 6, 7
Site of latency - Glands and T cells

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6
Q

Gamma subfamily of Herpesviridae family includes which species and site of latency

A

Species - HHV4 (EBV), HHV8
Site of latency - B cells

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7
Q

Transmission ways of HSV 1 And HSV 2

A

HSV 1 - Mucosa/Abraded skin
HSV 2 - Sexual/vertical

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8
Q

Latency sites of HSV 1 And 2

A

HSV 1 - Trigeminal ganglia
HSV 2 - Sacral ganglia

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9
Q

Age group more commonly affected in case of HSV 1 and 2

A

HSV 1 - Children
HSV 2 - Adults

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10
Q

Clinical features seen in case of HSV 1

A

Orofacial mucosal lesions
Skin lesions above waist
Encephalitis
Meningitis
Ocular lesions

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11
Q

Clinical features seen in HSV 2

A

Genital lesions - B/L painful vesicles with painful Inguinal Lymphadenopathy
Below waist
Neonatal herpes( mother to child)

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12
Q

Which HSV grows well on Chick embryo fibroblast

A

HSV 2 - Grows well
HSV 1 - doesn’t grows well

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13
Q

Which HSV shows more Neurovirulence and drug resistance

A

HSV 2

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14
Q

Most common site of Orofacial mucosal lesions

A

HSV 1 M/C
Buccal mucosa

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15
Q

Most common primary lesion in HSV 1

A

Gingivostomatitis

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16
Q

Most common recurrent lesion in HSV 1

A

Herpes labialis

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17
Q

CNS Infections are more Common in which HSV

A

HSV 1&raquo_space; HSV 2

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18
Q

HSV 1 is most common cause of which type of encephalitis

A

Acute sporadic viral Encephalitis (temporal lobe is affected)

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19
Q

Mollaret meningitis/Recurrent lymphocytic Meningitis is most commonly seen in which HSV

A

HSV 2

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20
Q

Ocular lesions are most commonly seen in which HSV

A

HSV 1 > HSV 2
Dendritic corneal ulcers

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21
Q

Genital lesions are most commonly seen in which HSV

A

HSV 2&raquo_space; HSV 1
Bilateral painful vesicles with Painful Inguinal Lymphadenopathy

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22
Q

Other clinical features seen in HSV

A

Herpetic whitlow (seen in healthcare workers)
Herpes gladiatorum (Wrestlers herpes)
Eczema herpeticum
Erythema multiforme

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23
Q

Tzanck smear is done for diagnosis of

A

Done for HSV 1 and 2
Low sensitivity
Can’t differentiate between HSV 1,2 And HZV

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24
Q

Sample taken in case of HSV and are stained by

A

Lesion - unroof vesicle, Scrap base
Stain with Giemsa nd Wright stain (Romanowsky stain), Toluidine stain

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25
Q

Cytopathic effect seen in case of HSV Infection

A

3M phenomenon
Multinucleated, Moulding and Margination of Chromatin
+
Cowdry Type A - Lipchultz bodies

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26
Q

Which is most definitive diagnosis exam in case of HSV

A

Virus isolation - Cell lines

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27
Q

DNA studies and Serology methods of HSV Infection

A

PCR - Sensitive, can’t differentiate
ELISA - 4 fold increase in antibodies suggestive of HSV

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28
Q

Drug of choice in HSV Infection

A

Acyclovir - inhibits DNA Polymerase
If Resistance - Foscarnet

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29
Q

HHV 3/Herpes Zoster/Varicella Zoster virus causes which diseases in Children and Adults

A

Child - Chickenpox
Adults - Herpes Zoster/Shingles

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30
Q

Incubation period of Chickenpox

A

2-3 weeks

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31
Q

Characteristic rash features in Chickenpox

A

Versicle surrounded by an erythematous halo (Dew drop on a rose petal)
If in adults - More severe hemorrhagic and bullous lesions

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32
Q

Rash distribution in case of Chickenpox

A

Bilateral, diffuse, Centripetal distribution (starts on trunk) - then centrifugal spread (flexor surface)
Comes on crops (fever with each crops)

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33
Q

Period of infectivity in case of Chickenpox

A

2 days before and 5 days after rash

34
Q

Reservoir, source and Carrier in case of Chickenpox

A

Reservoir - Humans
Source - patient’s
Carrier - None

35
Q

Most common Complication of Chickenpox

A

Secondary bacterial infection

36
Q

Most common extracutaneous Complication of Chickenpox

A

CNS Involvement - Benign cerebellar ataxia

37
Q

Most serious Complication of Chickenpox

A

Varicella Pneumonia (especially in pregnancy)

38
Q

Fetal/Congenital Varicella Syndrome timeline and clinical features

A

Infection within 20 wks of intrauterine life
Cicatricial skin lesions
Limb hypoplasia
Microcephaly
Cortical atrophy

39
Q

Neonatal Varicella Syndrome causes and max chance of transmission

A

Mother has varicella in late pregnancy
Max chance of Transmission - 5 days before to 2 days after delivery
Disseminated disease

40
Q

Treatment of Neonatal Varicella Syndrome

A

Acyclovir (Prophylactically)
If skin lesion appears - Varicella zoster Immunoglobulin (<94 hrs of exposure)

41
Q

Vaccine for Neonatal Varicella Syndrome

A

OKA Strain (2 doses)

42
Q

Herpes zoster/ Shingles occurs due to

A

Reactivation - in elderly or immunocompromised patients

43
Q

Rash distribution in Herpes Zoster/Shingles

A

Along dermatomes (M/C - D3 to L2)
Unilateral, segmental and Painful

44
Q

Zoster sine herpete means

A

Dermatomal pain without skin lesions

45
Q

Complications of Herpes Zoster/Shingles

A

Post herpetic Neuralgia (M/C);- Pain at local site
Zoster opthalmicus - trigeminal ganglion, dendritic ulcer
Ramsay hunt Syndrome

46
Q

Ramsay hunt Syndrome

A

Involvement of Geniculate ganglion of CN VII
Facial N palsy
Vesicles in EAM, otalgia
Loss of taste sensation on ant. 2/3rd of tongue

47
Q

Vaccines used in case of Varicella zoster/Shingles

A

To enhance the immunity
Live attenuated vaccine - Zostavax
Recombinant vaccine - Shingrix

48
Q

Transmission of Epstein Barr virus (HHV4)

A

Close contact
Kissing
Sexual intercourse
Blood Transfusion
BM Transplantation

49
Q

EBV entry via which receptors and acts on which cells

A

Receptors - CD21/CR2
Leads to activation of Polyclonal B cell

50
Q

Regulation Proteins for Esptein barr

A

LMP 1(Latent membrane protein 1) - acts on CD4 Pathway
EBNA 2 ( Epstein barr nuclear antigen 2) - Activates SRC Protooncogenes
VIL10 (Viral interleukin 10) - Antiinflammatory

51
Q

Epstein barr virus Causes

A

1) Infectious mononucleosis/Kissing disease - Aka Glandular fever
2) Malignancy
3) Other condition - Duncan Syndrome (Lymphoproliferative Syndrome)
- Hairy cell leukoplakia/oral cell leukoplakia
- Hemophagocytic Lymphohistiocytosis (HLH)

52
Q

Clinical features and incubation period of Infectious mononucleosis

A

IP - 4-8 weeks
SHE Feels Shy LAL
Splenomegaly
Hepatitis
Encephalitis
Fever
Sore throat
Lymph node enlargement
Arthralgia
Lethargy

53
Q

Malignancies caused by Epstein Barr virus

A

Carcinoma
Lymphoma
Sarcoma

54
Q

Carcinoma associated with EBV infection

A

Most common - Gastric Carcinoma
Nasopharyngeal Carcinoma

55
Q

Lymphoma associated with EBV

A

Hodgkin’s - mixed cellularity
NHL - Burkitts Lymphoma, DLBL, Post transplant Lymphoma, T/NK cell Lymphoma

56
Q

Sarcoma associated with EBV infection

A

Leiomyosarcoma

57
Q

CBC Microscopic finding in case of EBV

A

Atypical Lymphocytes (Downy cells) - AKA - Ballurina skirt appearance

58
Q

Heterophile Antibody detection test done in case of EBV

A

Paul Bunell test - A/b react with sheep RBCs
Monospot test (Now) - A/b react with horse RBC

59
Q

Specific antibody test done in case of EBV

A

Antibody to viral capsid antigen
Antibody to early antigen - Early diagnosis
Antibody to EBNA

60
Q

Most sensitive and specific test for EBV

A

Nucleic acid hybridization test

61
Q

Treatment of EBV

A

Acyclovir - oral hairy cell leukoplakia
Rituximab

62
Q

Which is the largest of Herpesviridae

A

Cytomegalovirus (HHV5)

63
Q

Transmission of Cytomegalovirus

A

M/C - Oral, respiratory, body secretions
Less common - Transplacental, sexual

64
Q

Cytomegalovirus multiplies in which organs

A

SRK - Mannat(Sleep)
Salivary gland (M/C)
Respiratory tract
Kidney

65
Q

CMV remains latent in which Organ

A

Monocytes

66
Q

Clinical signs of CMV are classified into

A

Congenital
Perinatal
Immunocompetent
Immunocompromised

67
Q

Most common infection associated with Congenital defects

A

Congenital CMV Infection

68
Q

Clinical features of Congenital CMV Infection

A

More common - Hepatosplenomegaly, Jaundice, Petechia/Purpuric rashee
Less common - Microcephaly, Chorioretinitis, Cerebral calcification, deafness

69
Q

Perinatal CMV clinical features

A

Usually asymptomatic - later on can see complications

70
Q

CMV clinical features in Immunocompetent pt.

A

Infectious mononucleosis like Syndrome - Fever, sore throat, No Lymphadenopathy, no heterophile Antibodies

71
Q

CMV clinical features in Immunocompromised pt.

A

In HIV , transplant patients
CMV Chorioretinitis
CMV is most common opportunistic infection or virus in HIV and transplant

72
Q

Cytopathic effect or Inclusion bodies seen in case of CMV Infection

A

Owl eye appearance (both I/n and I/c inclusions)

73
Q

CMV virus isolation is done on which cell line

A

Human Fibroblast cell line (2° cell line)

74
Q

Antigen found in case of CMV Infection

A

PP65

75
Q

Treatment of CMV infection

A

DOC - Ganciclovir
If Resistance - Foscarnet

76
Q

HHV 6 Variants

A

6A
6B

77
Q

Mode of infection in HHV 6

A

Oral Secretions

78
Q

HHV 6 in children causes

A

Sixth disease/Roseola infantum/Exanthem subitum

79
Q

Clinical features of Sixth disease/Roseola infantum/Exanthem subitum

A

Fever
Nagayama spots - erythematous spots on soft palate and uvula
Rash after fever - Rose pink non pruritus papules

80
Q

HHV 6 known to cause in adults

A

Mononucleosis like Syndrome

81
Q

HHV 8 is associated with which diseases

A

Kaposi sarcoma
Primary Effusion Lymphoma
Castlemann disease (LN)

82
Q

Kaposi sarcoma

A

Vascular tumor
M/C associated with immunocompromised status
M/C site - Skin of lower limb
2nd M/C - Lymph node

Microbiology (37 decks)

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