Exam 3 Flashcards
Viruses differ from bacteria in that viruses:
A. Do not have any nucleic acid
B. Are obligate intracellular parasites
C. Are filterable
D. Are not composed of cells
D. Are not composed of cells
How is a persistent viral infection different from a latent viral infection?
A. It remains in equilibrium with the host
B. It can be reactivated by immunosuppressive therapy
C. The infectious virus appears suddenly
D. The infectious virus gradually builds up over a long period of time
D. The infectious virus gradually builds up over a long period of time
What is the function of viral spikes?
Attachment; which contributes to specificity (tropism)
The envelope of viruses often serves as protection because it contains spikes that are antigenic. What does the envelope mean in terms of treating viruses?
Envelopes are often more susceptible to disinfectants, which may mean that enveloped viruses are easier to treat
What are the steps of viral replication?
Attachment, penetration, uncoating, biosynthesis, maturation and release
What are two ways for viruses to attach and penetrate the host cell?
Pinocytosis (after attaching with spikes)
Fusion (requires viral envelope)
What enzyme helps a retrovirus integrate into the host cell genome?
Integrase
Why is HIV an exception to viral maturation and release?
HIV does not mature until after budding has occurred. Maturation involves cleavage of protein units with proteases
What type of virus is described as remaining in asymptomatic host cell for long periods of time, such as cold sores or shingles?
Latent
What type of virus is described as a disease process occurring over a long period of time and is generally fatal such as measles?
Persistent (chronic)
How is HIV transmitted and how is its transmission unique?
HIV is transmitted when infected blood, semen, or vaginal secretions come in contact with broken skin or mucous membranes
Unique because sexual transmission is 100,000x more virulent than other transmission methods due to high number of dendritic cells in mucous membranes and dendritic cells have CCR5 receptors
What receptors are important for HIV attachment?
HIV has a Gp120 spike that attaches to CD4 cells and requires co-receptors CCR5 and CXCR-4
What phase of HIV begins 2-8 weeks after initial infection and patients experience brief flu-like illness followed by rapid multiplication and dissemination of virus throughout the body and stimulation of the immune response?
Acute phase
What phase of HIV may last from 6 months to 10 years, at which time levels of detectable HIV in blood decrease, although viral replication continues (particularly in lymphoid tissue)
Asymptomatic (latent)
What phase of HIV can last for months to years, at which time viral replication continues and numbers of CD4+ cells in blood significantly decrease (resulting in patients developing a variety of illnesses often caused by opportunistic pathogens and AIDS related cancers)
Chronic symptomatic
What stage of HIV is represented when the immune system is no longer able to defend against the virus
AIDS (fourth and final stage)
How is HIV diagnosed? (Most common way, and most sensitive way)
Most common: detection of specific anti-HIV antibodies in the blood by ELISA assay followed by confirmation with Western blot technique
Most sensitive: using polymerase chain reaction
The treatment of HIV/AIDS is directed at reducing the viral load, disease symptoms, and treating disease and malignancies. The most successful treatment involves a combination of what types of drugs?
Nucleoside RT inhibitors (AZT) Nonnucleoside RT inhibitors (delavirdine) Protease inhibitors (indinavir) Fusion inhibitors (enfuvirtide)
Why is HIV/AIDS treated with a combination of drugs?
Reverse transcriptase is very prone to errors due to poor proofreading mechanisms, this makes it very easy for HIV to develop resistance to treatment very quickly due to viral evolution
What is the biggest issue with trying to develop an HIV vaccine?
Envelope proteins of virus continually change their antigenic properties
What is the largest group of known viruses?
Double-stranded DNA viruses
Where is the herpesvirus virion envelope derived from?
The host’s golgi apparatus membrane
Where is the herpesvirus latent infection taking place if the viral protein VP16 and host cell factor (HCF) enter the nucleus with the viral genome?
epithelial cells
Where is the herpesvirus latent infection taking place if VP16 and HCF do not enter the nucleus, resulting in decreased early gene expression and microRNA production?
neurons
What are the different types of Herpes Simplex presentation?
Cold sores aka Fever blisters
Herpes gladiatorum - vesicles on skin
Herpes whitlow - vesicles on fingers
Herpes encephalitis
What are all possible names for HHV-1?
HSV-1, herpes simplex 1, oral herpes
What is the cell target for HHV-1?
epithelial cells and nerve cells
Where does HHV-1 remain latent?
Typically in the trigeminal nerve, but it can also remain latent in the vagus nerve
What are some unique features of HHV-1 in terms of signs/symptoms, cell features, and treatment options?
Signs/symptoms: cold sores, gingivostomatitis, herpetic keratitis (cornea)
Cell features: multinucleated (used in diagnosis)
Treatment: Acyclovir, education for prevention
What are all possible names for HHV-2?
HSV-2, herpes simplex 2, genital herpes
What is the cell target for HHV-2?
epithelial cells and nerve cells
Where does HHV-2 remain latent?
Sacral nerves
What are some unique features of HHV-2 in terms of transmission, signs/symptoms, cell features, and treatment options?
Transmission: STD or congenital (associated with high mortality rate)
Signs/symptoms: fever, burning sensation, genital soreness, blisters
Cell features: multinucleated (used in diagnosis)
Treatment: Acyclovir, education for prevention
What are all possible names of HHV-3?
Human herpesvirus 3, Chicken Pox (Varicella), Shingles
What is the cell target of HHV-3?
epithelial cells and nerve cells
Where does HHV-3 remain latent?
dorsal root ganglia of cranial/sensory nerves
What are some unique features of HHV-3 in terms of reservoir, signs/symptoms, and treatment options?
Reservoir: humans
Signs/symptoms: varies from Varicella to Shingles, may have viremia - bloodstream infection
Treatment: vaccination for Varicella, Acyclovir for Shingles
What are all possible names for HHV-4?
Ebstein Barr virus (EBV), Infectious mononucleosis
What is the cell target of HHV-4?
B cells and epithelial cells
What are some unique features of HHV4 in terms of cell features, complications, and signs/symptoms?
Cell features: mononucleated (proliferation of monocytes)
Complications: Oncogenic -> Burkitt’s Lymphoma or nasopharyngeal carcinoma
Signs/symptoms: Often asymptomatic in children, swollen lymph nodes, spleen enlargement
What are all possible names of HHV-5?
Human cytomegalovirus (HCMV), Inclusion disease
What is the cell target of HHV-5?
CMV can infect any cell!
Where does HHV-5 remain latent?
White blood cells
What are some unique features of HHV-5 in terms of cytopathic effects, treatment options, and risk of transmission?
Cytopathic effects: causes formation of inclusion bodies in cytoplasm or nucleus of cells
Treatment options: Antiviral therapy
Transmission risks with organ transplants or blood transfusions, can also cross placenta
What are all possible names of HHV-8?
Human herpesvirus-8, Kaposi’s Sarcoma
What is the cell target of HHV-8?
Lymphocytes and other cells
What are some unique features of HHV-8 in terms of signs/symptoms and complications?
Complications: causes Kaposi’s Sarcoma (oncogenic) which is indicated by skin lesion, KS is common in AIDS patients
Which herpes viruses may lead to hepatitis?
HHV-4 (EBV) and HHV-5 (CMV)
Almost all forms of Hepatitis have an RNA genome, what type did we learn has a DNA genome?
Hepatitis B
Which type of Hepatitis is a current epidemic?
Hepatitis C
Which types of Hepatitis are thought to be carcinogenic?
Hepatitis B and Hepatitis C
Which types of Hepatitis exist as co-infections?
Hep D (with Hep B) and Hep E (with Hep A)
Which types of Hepatitis cause chronic liver disease?
B, C, and D
Which types of Hepatitis have vaccines and what type of vaccines are they?
Hep A (also covers Hep E) - inactivated HAV
Hep B (also covers Hep D) - recombinant HBV
Which type of hepatitis is characterized by DANE particles as its infectious form?
Hep B
What do Hep B, C, and D have in common in terms of transmission?
Parenteral transmission possible!
What type of genome is seen with the influenza virus?
RNA with segmented genome
What is the reservoir for influenza?
numerous animal reservoirs, i.e., swine, birds
What is the difference between hemagglutinin (HA) and neuraminidase (NA) spikes found on influenza virus?
HA spikes = attachment
NA spikes = release
Spikes determine influenza subtype
Why is there a new version of the flu vaccine each year?
Antigenic shift and antigenic drift
Describe antigenic drift
occurs due to accumulation of mutations in a strain within a geographic area (more local)
may involve only 1 amino acid
allows virus to avoid mucosal IgA antibodies
Describe antigenic shift
Changes in HA and NA spikes due to reassortment of genomes when two different strains of flu virus (from humans and animals) infect the same cell and are incorporated into a single new capsid
For example: H1N1 - swine flu, H5N1 - bird flu
Koplik’s spots are diagnostic for:
A. Rubella
B. Measles
C. Herpes simplex
D. Chickenpox
B. Measles
Shingles is caused by the reactivation of the latent organism:
A. Human parvovirus B19
B. Human herpesvirus 3
C. Rubella virus
D. Human herpesvirus 6
B. Human herpesvirus 3
Which virus infects pregnant women and causes birth defects?
A. Ebstein-Barr virus
B. Cytomegalovirus
C. Hantavirus
D. Marburg virus
B. Cytomegalovirus
Ebola virus is transmitted from human to human by:
A. Contact with blood
B. Inhalation
C. Arthropod vector
D. Ingestion
A. Contact with blood
Describe Measles (Rubeola) virus in terms of genome, transmission, signs/symptoms, and treatment/prevention
Enveloped RNA virus transmitted through respiratory tract
Signs/symptoms: initial cough followed by macular rash and Koplik’s spots in the mouth
Treatment/prevention: Symptomatic/supportive therapy, prevention by live-attenuated MMR vaccine
Describe the Mumps virus in terms of genome, clinical manifestations (signs/symptoms), and treatment/prevention
Enveloped RNA virus with 16-18 day incubation period
Signs/symptoms: fever and swelling/tenderness of salivary glands (possible complication = meningitis or orchitis)
Treatment/prevention: symptomatic/supportive therapy; live-attenuated MMR vaccine
Describe Rubella (German Measles) virus in terms of genome, transmission, symptoms, complications, and prevention
Enveloped RNA virus transmitted through respiratory droplets
Symptoms: mild, brief rash
Complications: Congenital rubella syndrome leading to fetal death, premature delivery, or congenital defects
Prevention: live-attenuated MMR vaccine
Describe Human Papillomavirus in terms of genome, characteristics, transmission, and treatment
DNA virus that causes verrucae (horny projections on skin)
Infects epithelium and mucous membranes causing benign epithelial tumors or certain cancers (cervical, pharyngeal)
Transmitted by direct contact and autoinoculation
Treatment: physical destruction (activates immune response), topical medications, or injection of IFN-alpha
Which type of HPV do we have a vaccine for?
HPV 16, which should protect against 80-100% of cervical cancers and other cancers (pharyngeal)
18 is also carcinogenic
Describe Polio virus in terms of genome, characteristics, and clinical signs/symptoms
Plus(+) strand RNA enterovirus with 3 subtypes offering no cross-immunity
Very stable in food and water; multiplies in throat and intestinal mucosa
Usually asymptomatic or brief, mild illness. Viremia sometimes occurs and persists as virus enters CNS causing paralytic polio (rare)
Describe preventative measures against Polio
Two types of vaccine:
IPV is dead strain and injected (U.S.)
OPV is live-attenuated and taken orally - high risk of reversion leading to active polio infection. It is cheaper to make and administer and is used in developing countries
Describe Ebola in terms of genome, reservoir, transmission, characteristics, and potential treatment
Negative(-) strand RNA virus with ~80% mortality rate
Reservoir: fruit bats
Transmission: direct-contact with Ebola victim, body fluids, or clinical samples
Characteristics: internal hemorrhage
No treatment available; potential treatment could be antibodies from survivors of Ebola
What are symptoms and complications of Zika?
Fever, rash, joint pain, conjunctivitis
Complications: GBS, microcephaly
Describe modes of transmission for Zika
Primarily through Aedes mosquitoes, the same kind that spread dengue and chikungunya
Also spread from mother-to-child, through sexual contact, or through blood transfusions
Prions are misfolded and highly stable; their mode of disease production is still not well understood. What is the current accepted model of disease production by prions?
PrP(sc) causes PrP(c) to CHANGE ITS CONFORMATION to the abnormal form; newly produced PrP(sc) molecules convert other normal molecules to abnormal forms, causing NEURODEGENERATIVE DISEASE
What is the most common form of TSE in humans?
CJD
Generally, in an infection caused by a DNA-containing virus, the host animal cell supplies all of the following except:
A. RNA polymerase
B. Nucleotides
C. DNA polymerase
D. tRNA
C. DNA polymerase
True or false: co-infection with HIV and HHV-8 can greatly promote the development of cancer in AIDS patients
True
True or false: hepatitis can be caused by cytomegalovirus and Ebstein-Barr virus
True
Women of childbearing age should be vaccinated against:
A. Cytomegalovirus
B. Varicella virus
C. Rubella virus
D. Ebstein-Barr virus
C. Rubella virus
*We do not have a vaccine for Cytomegalovirus or EBV. Varicella in pregnancy would be treated with Acyclovir
Which of the following is a prion disease of humans associated with cannibalism?
A. CJD
B. Kuru
C. CJD and Kuru
D. None of the above
B. Kuru
Using a homemade saline solution for contact lenses can result in:
A. Acanthamoeba keratitis
B. Trachoma
C. Ophthalmia neonatorum
D. Inclusion conjunctivitis
A. Acanthamoeba keratitis
Trypanosoma brucei is transmitted by:
A. Tsetse fly
B. Body lice
C. Houseflies
D. Head lice
A. Tsetse fly
Chaga’s disease is caused by:
A. Toxoplasma gondii
B. Trypanosomiasis cruzi
C. Plasmodium vivax
D. Leishmania donovani
B. Trypanosomiasis cruzi
Anopheles is the vector for the disease:
A. Babesiosis
B. Schistosomiasis
C. Malaria
D. Swimmer’s itch
C. Malaria
Which organism is a flagellate protozoan that is able to attach firmly to a human’s intestinal wall?
A. Giardiasis lamblia
B. Entamoeba histolytica
C. Cyclospora cayetanensis
D. Cryptosporidium hominis
A. Giardia lamblia
What organism produces cysts that contaminate food and water and cause dysentary?
A. Cyclospora cayetanensis
B. Giardia lamblia
C. Entamoeba histolytica
D. Asergillus flavus
C. Entamoeba histolytica
The only protozoan that causes an STI, which affects mostly women is:
A. Trichomonas vaginalis
B. Gardnerella vaginalis
C. Mycoplasma hominis
D. Haemophilus ducreyi
A. Trichomonas vaginalis
Which stage of the plasmodium protozoan infects the RBCs of humans?
A. Schizont
B. Merozoite
C. Sporozoite
D. Gametocyte
B. Merozoite
Currently the most promising method to control malaria is:
A. Antibiotics
B. Vaccine
C. Bed nets
D. Chloroquine
C. Bed nets
Why are protists considered difficult to treat?
They are eukaryotic, so differentiating treatments between animal cells and their cells is difficult
Euglenozoa are hemoflagellates associated with which two protozoan diseases?
Trypanosoma cruzi: Chaga’s disease
Trypanosoma gambiense and Trypanosoma rhodesiense: African sleeping sickness
Trypanosomes have a unique appearance under the microscope; they are large and move in a spiral-twisting motion using flagella. What is an important virulence factor of trypanosomes?
They have the ability to undergo antigenic variation by changing their protein coat (thick glycoproteins layer coating cell wall) which allows them to evade the immunologic response and we cannot develop a vaccine
What are the vectors for african sleeping sickness and chaga’s disease?
African sleeping sickness: tsetse fly
Chaga’s disease: kissing bug
Reservoirs include cattle and other animals
Involvement of what system makes the treatment of African trypanosomiasis difficult?
CNS, because arsenic must be used to allow compounds across the blood brain barrier
What is the difference between transmission of African sleeping sickness and Chaga’s disease?
African sleeping sickness is caused by the bite of the tsetse fly (metacyclic trypanomastigotes present in salivary glands of fly)
Chaga’s disease is caused by the kissing bug defecating into its bite, where the trypanosome moves through the bloodstream, enters cells, and becomes obligate intracellular parasite
Leishmaniasis is caused by flagellated protists and can be transmitted by what means?
Sand flies or Parentaral route - blood transfusions causing cutaneous infection
Reservoir is mammals
What is unique about the life cycle of Leishmania parasite?
Injected by sandfly as promastigote which is then phagocytized by host macrophages where it transforms into amastigote and multiplies
Sandfly picks up these macrophages with blood meal; amastigotes transform into promastigotes in midgut of fly
How do Entamoeba and acanthamoeba move?
Pseudopods, or false feet typical of amoeba
What organ system gets damaged by Entamoeba histolytica?
Small intestines
What mode of transmission is used by Entamoeba histolytica?
Fecal/oral, typically vehicle involved
Entamoeba histolytica is an obligate intracellular parasite causing what?
Amoebic dysentary (bloody diarrhea)
Amebic dysentary infection is caused by what?
Ingestion of mature cysts from fecally contaminated food, water, or hands; or from fecal exposure during sexual contact
What is the etiological agent of malaria?
Plasmodium (four species - each cause different degree of severity)
What is the method of transmission for malaria?
Female anopheles mosquitos
What protozoan disease is associated with transmission from animal reservoirs, recreational water, and daycares by ingestion of cysts?
Cryptosporidiosis
Cryptosporidium is concerning for what population?
Immunocompromised; AIDs and HIV patients
What method of movement does Giardia lamblia use?
Multiple flagella found on the end of the organism
How do people become infected with giardiasis?
Drinking fresh water that has become contaminated
Describe the motility of toxoplasma Gondi
Apicomplexan (nonmotile)