Epstein-Barr Virus Flashcards

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1
Q

What is the family?

A

Herpesvirus

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2
Q

Where does it replicate in? What does this cause?

A

Replicates in B lymphocytes and epithelial cells in oropharyngeal secretions, causing polyclonal growth stimulation and lymphoid hyperplasia

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3
Q

What does it cause in normal lymphocytes?

A

Immortalisation (continuously dividing cell line)
Expression of nuclear neoantigens (EB nuclear antigen)

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4
Q

What are the clinical features?

A
  1. Infectious mononucleosis
  2. Burkitt’s lymphoma
  3. Nasopharyngeal carcinoma
  4. Immunoblastic lymphoma
  5. Chronic fatigue syndrome
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5
Q

What are the clinical presentations of infectious mononucleosis?

A
  • Glandular fever
  • Lethargy
  • Anorexia
  • Pharyngitis
  • Hepatosplenomegaly
  • Lymphadenopathy
  • Exudative tonsillitis
  • Rash exacerbated by ampicillin
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6
Q

How long is the incubation period of infectious mononucleosis?

A

4 - 7 weeks

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7
Q

How is EBV transmitted?

A

Close-contact - “kissing disease”

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8
Q

Who is EBV most prevalent in?

A

Seronegative children and young adults

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9
Q

What are the complications of infectious mononucleosis?

A
  1. Hepatitis (may have jaundice, abnormal LFT)
  2. Pneumonitis
  3. Neurological (aseptic meningitis, encephalitis, myelitis, optic neuritis, acute cerebellar ataxia, Guillain-Barré syndrome, peripheral neuropathy, Bell’s palsy)
  4. Haematological (haemolytic anaemia, thrombocytopaenia, splenic rupture)
  5. Myocarditis, pericarditis
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10
Q

What do Burkitt’s Lymphoma cells express? Which chromosomal translocation is involved? Which areas does it occur?

A
  • EBV markers (e.g. EBNA)
  • 8;14 or 2;22 (deregulation of c-myc oncogene)
  • Occurs in. holoendemic malaria in tropical Africa
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11
Q

Who is at risk for immunoblastic lymphoma?

A

Lymphoproliferative disorder in patients with impaired cell-mediated immunity (AIDS, iatragenically induced in organ transplant recipients)

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12
Q

How does chronic fatigue syndrome present?

A

Extreme fatigue, fever, sore throat, painful lymphadenopathy, muscle weakness, memory loss

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13
Q

How to diagnose?

A
  1. Atypical lymphocytosis and mononuclear cells (at least 10%)
  2. Paul-Bunnell Test - Heterophile antibodies (present in 90%)
    - monospot screening test
    - haemagglutinating Ab to sheep RBCs -> Ab removed by adsorption with ox RBC but not with guinea pig kidney
  3. 90% of healthy adults have EBV Ab so EBV IgM useful confirmation for IM
    - viral capsid antigen Ab
    - EB nuclear antigen Ab
    - early antigen Ab
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14
Q

How to treat?

A

Treat the symptoms
Avoid penicillin

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15
Q

Is there EBV vaccine?

A

Undergoing clinical trials

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