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Foundations of Disease and Therapy > DNA Viruses > Flashcards

DNA Viruses Flashcards

1
Q

What’s the only SS DNA virus?

A

Parvovirus

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2
Q

What is the important Parvovirus?

A

B19

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3
Q

Describe the proteins expressed by DNA viruses and the order they are expressed in

A

1) Interferons and proteins involved in immune evasion
2) Proteins that induce cell cycle progression (exception: Pox because it’s in cytoplasm and Parvo because it’s too small)
3) Structural proteins necessary to build new viral particles

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4
Q

Primary Herpes Infection

A

Usually the worst disease attack (if it’s symptomatic); instead of a single lesion there will be multiple

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5
Q

Treatment for CMV

A

Gancyclovir

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6
Q

Name the naked DNA viruses

A

PAPP Parvovirus Adenovirus Papillomavirus Polyomavirus

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7
Q

Tropism for adenovirus

A

mucosal epithelium (primary), lymphoid, mesenchymal

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8
Q

Second Line Antiviral drugs

A

These drugs do not require phosphorylation; they carry higher toxicity to host however. They include Cidofovir and Foscarnet

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9
Q

Describe the stability of Enveloped vs Naked viruses

A

Naked viruses are more capable of persisting in the environment and are resistant to chemical inactivation - more likely to lead to epidemic outbreaks

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10
Q

How can HSV-1 lead to Corneal Blindness and Encephaly?

A

Virus is latent in Trigeminal Ganglia, so if virus goes down V1 it can reach the eye. Alternatively, if the virus goes backwards along the nerve it can reach the Temporal Lobe of brain (usually only occurs in people who get many outbreaks a year)

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11
Q

Describe prevalence of CMV

A

CMV is widely dispursed throughout the population, and the vast majority of people are infected but remain asymptomatic. Most people get it during perinatal period or during reproductive years.

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12
Q

Molluscum Bodies

A

Acidophilic inclusions seen in epidermis due to an accumulation of virons of Pox virus

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13
Q

The worse disease associated with Gamma Herpes viruses is what?

A

Their latency phase - Cancer

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14
Q

Polyoma Viruses

A
  1. SV 40
  2. JC Virus
  3. BK Virus
  4. Merkel Cell Virus
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15
Q

Where do JC and BK viruses remain latent?

A

Kidney, lymphocytes, and brain

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16
Q

How Alpha herpes viruses evade immune system during latency phase

A

They produce NO PROTEIN during latency phase; only a small intron of RNA is expressed called the LAT Transcript

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17
Q

Name the Alpha Herpes Viruses

A

HSV 1, HSV 2, VZV

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18
Q

Diseases associated with HSV-2

A
  1. Genital infection
  2. Oral infection
  3. Congenital Herpes in Neonate (bad)
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19
Q

What DNA Viruses have circular DNA?

A

Papilloma Polyoma Hepadna

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20
Q

Replication Machinery encoded by DNA viruses

A

1) DNA-Dependent-DNA Polymerase
2) Thymidine Kinase

Hepadna encodes Reverse Transcriptase

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21
Q

Why do we care about the site of viral replication?

A

We know that if we see intranuclear inclusions it’s likely a DNA virus (exception: Pox), and if we see cytoplasmic inclusions it’s likely an RNA virus (exception: Influenza and Retroviruses)

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22
Q

Trophism of Varicella Zoster Virus

A

Immune Cells and Neurons, epithelial cells, T cells

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23
Q

Diagnostic important of Syncytia

A

If multi-nucleated giant cells are present it indicates the virus is enveloped

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24
Q

Name the Gamma Herpes viruses

A

EBV, HHV 8

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25
Q

Drugs that target DNA-Dependent-DNA-Polymerase

A

Foscarnet and Cidofivir

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26
Q

What do Alpha and Beta Herpes viruses have in common?

A

Their active replication stage is associated with disease

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27
Q

What DNA virus has a pleomorphic/filamentous shape?

A

Hepadnavirus

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28
Q

Transmission of adenovirus and incubation time

A

Mainly fecal-oral, also Respiratory

incubation of 5-9 days

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29
Q

Complications of congenital CMV

A
  1. Number one cause of viral birth defects
  2. Microcephaly and Hearing loss are main problems
  3. Periventricular calcifications
  4. Also Jaundice, retinitis, blueberry muffin rash, CNS damage
  5. Hydrops fetalis
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30
Q

Transmission of Parvovirus

A

Aerosol or Transplacental

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31
Q

Herpes Gladiatorum

A

Herpes infection that’s common on the neck of wrestlers

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32
Q

Describe Monkey B Virus

A

It’s an alpha herpes virus that typically infects monkeys but is asymptomatic in them. When it infects humans due to scratches or bites, it leads to early flu-like symptoms, then progresses to neurological symtoms such as paresthesia, disorentiation, dysphagia, ascending paralysis, encephomyelitis, coma, and DEATH

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33
Q

Do antiviral drugs work on latent viruses?

A

NO - they require ACTIVE viral replication

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34
Q

What is the significance of the extremely high prevalence rate of DNA viruses in terms of diagnosis?

A

Serology testing is useless; must test for viral proteins

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35
Q

Name the Beta Herpes Viruses

A

CMV, HHV 6, HHV 7

36
Q

Diseases associated with HSV-1

A
  1. Cold Sores
  2. Ocular Infections - leading cause of ocular blindness
  3. HSV Temporal Lobe Encephalitis
37
Q

Main difference between HSV-1 and HSV-2 inections

A

HSV-1 infections typically recur about once a year; HSV-2 infections recur multiple times a year

38
Q

How are HSV-1 and HSV-2 diagnosed?

A
  1. HSV-1 and HSV-2 are distinguished by ELISA antibody type specific assays against Glycoprotein G (most rapid method, especially for possible encephalitis case)
  2. Tzank Test is the old method
39
Q

Reactivation Phase of Herpes Virus

A
  1. Recrudescent Disease - single cold sore (because only one neuron reactivated)
  2. Asymptomatic Shedding - the virus is active but the patient sees no symptoms; this is how most transmission occurs
40
Q

Disease caused by BK virus

A

Hemorrhagic Cystitis in organ transplant patients

41
Q

Where does HHV-2 remain latent

A

Sacral Ganglia

42
Q

Diseases caused by CMV

A
  1. Mononucleosis (adolescents)
  2. Severe Congenital Infections (hearing loss, periventricular calcifications, blueberry muffin rash, hydrops fetalis)
  3. Esophagitis with linear ulcerations
  4. CMV Colitis with ulcerated walls
  5. CMV Retinitis (CD4 Count < 50)
  6. CMV Pneumonia/ severe systemic infection (recent organ transplant)
43
Q

Guarnieri Bodies

A

Basophilic sites of DNA replication within cytoplasm of cells infected with a Pox virus

44
Q

Diseases caused by HHV-6 and HHV-7

A
  1. Roseola Infantum (Sixth Disease)
  2. Can cause febrile seizures and encephalitis
    3.
45
Q

Tzank Test

A

Looks for multi-nucleated giant cells (Syncytia) which indicates the virus has an envelope. This can be coupled with intranuclear/cytoplasmic inclusion tests to further narrow down which virus you might be dealing with. Most important for new viruses nowadays since we have more specific tests for current ones

46
Q

Generalized Vaccinia

A

Because Smallpox vaccine is a live-attenuated virus, 1:5000 may get vaccinia. This is only a problem for neonates and immunocompromised. Right now, only CDC workers and Military are at risk. The CDC has immunoglobins to treat this

47
Q

Diseases caused by adenovirus

A

1) Acute Respiratory Disease (ARD) - seen in military recruits
2) Pneumonia
3) Sporadic follicular Conjunctivitis - benign conjunctivitis and most common eye infection
4) Epidemic keratoconjunctivitis - pink eye; can spread in public pools
5) Gastroenteritis - second most common cause of infantile viral diarrhea; people can shed this virus in stool months after infection

48
Q

Cancerous protein made Polyoma viruses

A

Large T (LgT)

49
Q

Define Syncytia

A

Property of enveloped viruses that allows them to merge neighboring cells together to form multi-nucleated giant cells

50
Q

Herpes Virus pathogenesis

A
  1. Primary Lyctic Infection occurs because virus gains access to body through mucosal breaks
  2. During latent infection, virus persists in ganglia (immunoprivileged)
  3. If a stress occurs, the virus reactivates - only ONE neuron gets activated, so you usually only get one cold sore
51
Q

Describe vaccines availble for VZV

A
  1. Live-attenuated VZV vaccine given to children to prevent chicken pox
  2. Zostavax - Live-attenuated vaccine with 10x more concentrated dose given to adults over age 60 to invoke a stronger T Cell response in order to prevent shingles/neuralgia
52
Q

Tropism of Parvovirus

A

Epithelial cells in S Phase of cell cycle, Erythroid progenitor cells, Endothelial cells of Blood vessels

53
Q

Diagnosis of JC virus/PML

A

Multiple non-ring-enhancing lesions in brain of immunocompromised patient

54
Q

How are HHV-6 (a and b) and HHV-7 transmitted?

A
  • HHV-6b is transmitted in saliva
  • HHV-6a is transmitted sexually
  • HHV-7 is transmitted in breast milk
55
Q

Disease caused by JC Virus

A

Progressive Multifocal Leukoencephalopathy

56
Q

What DNA virus lacks an icosahedral structure?

A

Poxvirus; it is a multi-enveloped Ovoid Block (complex)

57
Q

Trophism of Herpes Simplex Virus

A

Neurons and epithelial cells

58
Q

Where do EBV and HHV-8 (Kaposi’s Sarcoma) remain latent?

A

B cells

59
Q

Hemorrhagic Cystitis

A

Caused by BK virus; diffuse inflammation of the bladder leading to dysuria, hematuria, and hemorrhage. Associated with bone marrow transplant patients

60
Q

Molluscum Contagiosum

A

Only Pox virus we have to worry about; usually only occurs in immunocompromised

61
Q

Transmissibility of VZV

A

Aerosol transmission so highly contageous

62
Q

What enzyme activates nucleoside derivatives in Alpha Herpes Viruses? CMV?

A
  • Alpha Herpes Viruses: Thymadine Kinase
  • CMV: Phosphotransferase
63
Q

Where do HHV-6 and HHV-7 remain latent?

A

T cells

64
Q

Trophism of Cytomealovirus

A

Monocytes

65
Q

What is a potential problem with immune-modulating monoclonal antibodies?

A

They can lead to a reactivation of JC virus which results in Progressive Multifocal Leukoencephalopathy

66
Q

Does B19 have a vaccine?

A

No, but most people have had it and have antibodies for it

67
Q

Cancerous proteins made by papilloma viruses

A

E6 and E7 transforming proteins

68
Q

What is unique about HHV-6?

A

It can be integrated chromosomally and inherited genetically

69
Q

Envelope of Pox viruses

A

Pox viruses have two envelopes associated with one virus. Both forms are infectious. The body has to neutralize both versions of envelopes, and vaccines must target both forms

70
Q

Pathogenicity of Parvovirus and special requirements

A

Direct cell damage by viremia as well as humoral immune response.

Must invade actively dividing cells since it does not encode proteins that encourage cell division; Alternatively it can co-infect with another DNA virus that has this machinery

71
Q

What are the only Herpes viruses that do not infect a majority of the population

A

Kaposi’s Sarcoma (HHV 8) and HSV-2

72
Q

Other diseases/co-infections associated with Herpes infections

A
  1. HSV-2 is associated with HIV infection
  2. HSV-1 is associated with Alzheimer’s
73
Q

Complication of Shingles

A

Post Herpetic Neuralgia - extremely painful due to death of neurons. Unlike HSV, when VZV reactivates many neurons are affected and you can get a lot of neuronal death

74
Q

Diagnosis of BK Nephropathy

A

Characteristic viral inclusions in biopsy materials; nuclear enlargement with “smudgy” or “ground glass” appearance

75
Q

Where does VZV remain latent

A

Dorsal Root Ganglia

76
Q

How to nucleoside antivirals work?

A

They must be phosphorylated in the cell, and this only happens in actively dividing cells. Then they have very high affinity for Viral Polymerase

77
Q

Diagnosis of CMV

A
  1. Cytomegaly on histology with “owl-eyes” appearance
  2. Monospot test if patient presents with mono; if test is negative the virus causing mono is CMV
  3. IgM antibodies indicate primary acute infection
78
Q

Pathogenicity of adenovirus

A

Very stable in the environment and resistant to chemical/physical agents (including chlorinated pools) as well as adverse pH. Causes direct cell damage via replication with strong cellular immune response

79
Q

Periventricular Calcifications on neonate indicate what?

A

Congenital CMV infection

80
Q

Where does HHV-1 remain latent

A

Trigeminal Ganglia

81
Q

Where does CMV remain latent

A

hematopoietic progenitor cells/monocytes

82
Q

Main mechanisms of viral drug resistance

A
  1. Alteration in Thymidine Kinase/Phosphotransferase (valacyclovir and famciclovir)
  2. Alteration in DNA Polymerase (valacyclovir, famiciclovir, acyclovir, adn foscarnet)
83
Q

What do Beta and Gamma herpes viruses have in common?

A

Their latencey stage is in leukocytic immune cells

84
Q

Herpes Whitlow

A

Usually occurs on doctors and dentists from treating patients’ mouths who have an active Herpes infection without wearing gloves; they get a Herpes infection on their thumb

85
Q

Diseases caused by B19

A

Mneumonic: PARvo

Pregnancy-associated hydrops fetalis

Aplastic anemia and Arthritis

Rash (erythema infectiosum)

1) Fifth disease (Erythema infectiosum) - “slapped cheek rash”
2) Hydrops fetalis - causes severe hypoxia in fetus due to anemia
3) Persistent infection in Immunocompromised
4) Aplastic Crisis and Relapsing Chronic Anemia in those with RBC disorders like Sickle Cell

Foundations of Disease and Therapy (12 decks)

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