DNA Viruses Flashcards
What is the common classification among herpes family of viruses?
dsDNA enveloped
What is the most common cause of intraoral inflammation of the gingiva and mucosa in a young newborn?
HSV-1 (typically from the mother)
What virus is responsible for a 25 year old with fever, headache, personality change, and hallucinations?
Desiminated HSV-1
– temporal lobe inflammation and hemorrhages
Where do HSV-1 and HSV-2 reside latently?
HSV-1 – usually trigeminal ganglia
HSV-2 – sacral ganglia
What test would you need to perform after you have aspired at vessicular lesion on a patient’s groin to identify?
Tzank Smear – look for multinucleated giant cells and intracellular inclusions – Cowdry Bodies
What is characteristics of HSV-2 infection?
painful groin vesiscular lesions with inguinal lymphadepathy
What family and characteristics is EBV?
Herpesfamily
dsDNA with envelope
What are unique pathology associated with EBV?
Infects B-cells via CD21 Receptor
- Infectious Mono
Immunocompromised
- Hodgkin’s Lymphoma – Reed-Sternburg Cells
- Burkitt Lymphoma – jaw/mandible lesions
- Nasopharyngeal Carcinoma (Asians)
- leukoplakia of the lateral tongue (HIV)
How can you tell strep pharyngitis/tonsillitis from infectious mononucleosis?
Strep – usually young children and resolves with amoxicillin/ampicillin
EBV – older children (teens) and will have posterior LAD and if started on amox/amp will develop macular rash
What are the diagnostic tests for EBV / Infectious Mononucleosis?
Monospot Test – heterophile antibodies that bind to horse RBC (REMEMBER B-CELLS)
What is a unique microscopic identifier of Infectious mononucleosis?
- Downey Cells, mostly CD8+ cells with indented nucleus
What family is CMV in and how is it classified?
Herpesfamily, dsDNA virus with envelop
What are the buzz words for congenital CMV infection?
- sensorineural HEARING LOSS in children
- “blue berry muffin rash” – petechiae rash
- intraventrical calcifications
- Hydrops Fetalis
- – its the most common congenital viral infection
What kind of symptoms in a patient that has a CD4 count below 50, if infected with CMV?
- CMV Retinitis
- Linear Ulcerations of esophagitis
- CMV Colitis
What is the causative agent if a 15 year old gets pharyngitis with posterior LAD, but negative Monospot Test?
- Strep
- - CMV (Owl’s Eye Appearance)
What family is varicella zoster in and classification?
Herpesfamily – dsDNA with evelope
What is unique characteristic of varicella in children?
“Dew drops on a rose” – type of rash
- Different stages of healing (KEY)
- fever/sweat
What are the pathologic factors in varicella?
- Latent in dorsal root ganglia
Immunocompromised
– dermatomal distribution
– postherpetic neurologia (painful area with or without rash several weeks/months)
Complication – varicella pneumonia (mortality)
What kind of vaccine is used for varicella?
Live Attenuated Virus
What is congenital Varicella consist of?
TORCH Infection
- blindness
- limb development inhibition (stubby)
- cutaneous scarring?
What families are HHV-6 and HHV-8 virus in and their classificiations?
Herpesfamily
dsDNA virus with envelope
What is the virus that affects young children (6m-2years) with a high fever followed by a rash that spares the face?
HHV-6 Roseola
– KEY – LACEY RASH, Spares the Face
Who is most commonly affected by HHV-8?
Immunosuppressed individuals
- elderly russian men
- african adults
What is the unique attribute of HHV-8 to look for clinically?
Immunosuppressed individuals
- Violacious Lesions of nose, extremities, and mucous membranes (hard palatte)
- Causes increased VEGF/vasculature
- Primary Effusion lymphoma
What two etiologies cause highly vascularized lesions on the body who are immunocompromised?
- HHV-8
- Bartonella Hensleae (cat scratches)
How do you classify Pox Virus?
dsDNA that is linear with envelope
- also the largest genome of any virus
- makes it own envelope, does not use the cell’s membrane
How can you tell between small pox and varicella?
Varicella – different aged lesions on the skin
Small Pox – all the lesions are the same age
What are the unique characteristics of Molluseum Catagiosum?
– Flesh colored lesion that is dome shaped with a central dimple
How do you classify Polyomavirus?
Naked, circular dsDNA virus
What happens if a person who is immunocompromised gets polyomavirus?
JC Virus – progressive multifocal leukoencephalopathy when CD4+ count is less than 200, non-enhancing white matter lesions
What are patients who have transplants at risk of developing? (On top of being immunocompromised)
- -BK Virus (bad kidney) damages kidney and causes hemorrhagic cystitis (can be isolated in urine)
- usually only transplant patients
- -CMV Pneumonia
How is Parvovirus unique in its characteristic?
Only DNA Virus – ssDNA, naked, smallest genome
What adults are most suspectible to harmful affects of Parvovirus B19?
Sickle Cell – causes aplastic anemia, due to infecting the bone marrow
If a child develops a fever, then after the fever subsides develops a rash on their face that spreads downwards in a lacey pattern, what is the infectious agent?
Parvovirus B19
- Slapped Cheek Disease // Fifths Disease
- **STARTS on FACE (Unique)
What virus mostly affects military personnel and others in close quarters?
- Adenovirus – dsDNA, linear, naked
A recent military recruit presents with sore throat, injected sclera, and occasional hematuria, what might be the causative agent?
- Adenovirus
- tonsillitis
- viral conjunctivitis
- hemorrhagic cystitis
What strands of HPV are common verruca vulgaris?
HPV1, 2, 3, 4
How do you classify HPV stains?
dsDNA, circular, and naked
What papillomavirus stains cause laryngeal papillomatosis on vocal cords and anogenital warts/condro accumulata?
HPV6, 11 (low risk stains for cancer)
What stains are the high risk HPV stains for squamous cell carcinoma?
HPV16 / HPV18 + HPV31/33
– cervical cancer: post intercourse painless bleeding
How does HPV cause cancer?
Produce E6/E7
- -E6: proteolysis of p53 allowing cycle progression to S
- -E7: inhibits Rb, allowing into S-phase
How do you prevent cervical cancer?
Pap smear – looking at transition zone - kiolocytes
– Vaccine with high risk strains 16,18
What makes Hep B unique in classification?
partial dsDNA virus, circular, enveloped
- replicates both in the cytoplasm and nucleus, most others are in cytoplasm
What is the difference in prognosis of Hep B with children and adults becoming infected?
Children – the younger the higher risk of chronic infection
Adults – limited risk of chronic infection due to intact immune system
What are common clinical manifestations of Hep B?
- hepatitis
- polyartheritis nodosa (small medium arteries), looks like beads on a string
- membranoproliferative glomerulonephritis – train track appearance in the glomeruli
What is commonly co-infected with Hep B?
Hep D – can only infect if Hep B is present or at the same time. Worsens prognosis.
Treatment – Lamivudine + RT inhibitors + IF-Alpha
What is the risk with chronic Hep B infection?
- Hepatocellular Carcinoma
- - Fibrosis from chronic inflammation
