EBV

Question 1

EBV presents with on a slide with; in clinic with:

Answer 1

atypical lymphocytes, lymphadenopathy, hepatosplenomegaly

Question 2

after detecting EBV on a slide, the next step is:

Answer 2

heterophil test (monospot test)

Question 3

infectious mononucleosis patients develop antibodies called:

Answer 3

heterophil antibodies

Question 4

a positive ______ test has:

Answer 4

heterophil, red agglutinations on a blue backgound

Question 5

a negative _____ test has_____

Answer 5

heterophil, homogenous and purple suspension

Question 6

in a ____ test, you mix ___ with ____

Answer 6

heterophil monospot test, patient serum, horse or sheep RBC

Question 7

a ______ is unique and a diagnostic indicator of EBV

Answer 7

heterophil antibody

Question 8

the heterophil test is both ___ and ____, but is _____ for younger patients

Answer 8

sensitive and specific, less (more false negatives)

Question 9

after a heterophil test, you _____

Answer 9

serologic test for capsid antigen of EBV

Question 10

a EBV serologic test indicates levels of:

Answer 10

VCA-IgM, VCA-IgG,, EA, EBNA

Question 11

in an acute infection, the ebv serologic test is:

Answer 11

VCA-IgM +, VCA-IgG +, EA +/-, ,EBNA-,

Question 12

in a past infection, the ebv serologic test is:

Answer 12

VCA-IgM - , VCA-IgG+, EA-, EBNA+

Question 13

EBV induces proliferation of _____ in the _____ which resemble____

Answer 13

malignant lymphocytes (B cells)

Question 14

EBV infects_____ in the _____, but the atypical cells you see in patient’s blood are _____

Answer 14

B cells, lymph nodes, cytotoxic T cells (which are not infected but rather are responding to the infection)

Question 15

EBV initially infects___ then spreads to _____

Answer 15

oropharyngeal epithelial cells, underlying lymphoid tissue (tonsils and adenoids where mature B cells are infected)

Question 16

what is the B cell receptor that allows it to bind EBV?

Answer 16

CD21

Question 17

2 phases of EBV infection?

Answer 17

lytic (proliferation/replication, infection, and lysis of B cells) latency (most exist as an extrachromosomal episome)

Question 18

the EBV genes are associated with:

Answer 18

the pathogenesis of latency

Question 19

the EBV genes we need to know are:

Answer 19

EBNA1, 2, LMP1, vIL-10

Question 20

EBNA stands for____ and what does it do?

Answer 20

Epstein-Barr nuclear antigen 1, 2, bind the EBV genome to the host cell chromosomes during mitosis, promotes B cell replication

Question 21

LMP1 stands for___ and what does it do?

Answer 21

latent membrane protein, dries b-cell activation, prevents apoptosis

Question 22

what does vIL-10 do?

Answer 22

suppresses cell-mediated responses

Question 23

disease process of EBV?

Answer 23

Infectious Mononucleousis, primary disease process off EBV, and is less severe the younger the patient is (may present as a head cold or stuffy nose)

Question 24

b cells activated by EBV secrete _____ antibodies

Answer 24

heterophile antibodies (autobodies that recognize sheep or horse rbcs), or autoantibodies (anti-platelets of your own cells leading to thrombocytopenia)

Question 25

What 2 cellular responses occur in response to EBV

Answer 25

B cells: secrete heterophile antibodies that recognize sheep or horse RBCs, autoantibodies that opsonize platelets
T cells: CD8+ cytotoxic and NK cells control proliferation lymphocytes (these are NOT infected with EBV but are responding to the infected B cells)

Question 26

clinically, EBV resembles (overlaps with), need to be careful of _____ injury

Answer 26

malignancy, splenic rupture (fatal)

Question 27

atypical lymphocytosis are ___ cells that are _____:

Answer 27

CD8 cytotoxic Tcells and NK cells, not infected with EBV

Question 28

3 groups of herpes viruses

Answer 28

alpha (hsv-1, 2, VZV) neurons, beta (CMV, HHV6), gamma EBV, HHV8-Kaposi’s) latency in lymphoid cells

Question 29

CMV histologically is known for____ and can disseminate causing

Answer 29

large inclusions surrounded by a clear halo “owl’s eyes”; “looks like an alien looking at you”; disseminate PNU,

Question 30

acute transient viral infection:

Answer 30

elicit effective immune responses that eliminate the pathogens, limiting the durations of the infections

Question 31

measles (rubeola) presents with:

Answer 31

koplik spots (blue bumps inside cheek), “warthin-Finkeldey” multi-nucleated cells in lung and sputum

Question 32

warthin-finkeldey cells signal:

Answer 32

measles (rubeola)

Question 33

Poliovirus is:

Answer 33

acute transient viral infection, enterovirus transmitted via the fecal-oral route, infects anterior horn of spinal cord

Question 34

in the serology of an EBV reactivation, what two levels are elevated?

Answer 34

VCA-IgG, ENBA IgG

Question 35

immunosenescence:

Answer 35

gradual deterioration of the immune system brought on by natural age advancement; decreased cell-mediated immunity (T-cell functino) can cause reactivation of EBV, major increase in age related mortality