FA - Micro - Virology (2016) Flashcards

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1
Q

Envelope protein of HDV?

A

HBsAg.

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2
Q

Live attenuated vaccine that can be given to HIV(+) patients?

A

MMR ==> IN PATIENTS who do NOT show signs of immunodeficiency.

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3
Q

All DNA viruses are double stranded EXCEPT:

A

PARVO (ss negative).

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4
Q

All DNA viruses have LINEAR GENOMES EXCEPT:

A
  1. Papilloma + Polyoma ==> CIRCULAR and SUPERCOILED.

2. Hepadna ==> Circular, incomplete.

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5
Q

HSV-1 - Notes:

A

MCC of sporadic encephalitis. Can present as:

  1. Altered mental status.
  2. Seizures.
  3. +/- APHASIA.
  4. KLUVER-BUCY !!!
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6
Q

Receptors used by viruses - CMV:

A

INTEGRINS ==> HEPARAN SULFATE.

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7
Q

Receptors used by viruses - EBV:

A

CD21.

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8
Q

Receptors used by viruses - HIV:

A

CD4
CCR5
CXCR4.

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9
Q

Receptors used by viruses - Rabies:

A

Nicotinic AChR.

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10
Q

Receptors used by viruses - Rhinovirus:

A

ICAM-1.

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11
Q

Yellow fever virus - Liver biopsy?

A

May see COUNCILMAN BODIES = EOSINOPHILIC APOPTOTIC GLOBULES.

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12
Q

Most important GLOBAL CAUSE OF INFANTILE GASTROENTERITIS:

A

ROTAVIRUS = SEGMENTED dsRNA virus (Reovirus).

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13
Q

What does CDC recommends about rotavirus?

A

ROUTINE VACCINATION OF ALL INFANTS.

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14
Q

Croup is …?

A

ACUTE LARYNGOTRACHEOBRONCHITIS.

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15
Q

Croup is caused by …?

A

Parainfluenza viruses (paramyxovirus).

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16
Q

Croup (acute laryngotracheobronchitis) - Features:

A
  1. “Seal-like” barking cough.

2. Inspiratory stridor.

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17
Q

Croup - Sign on X-ray:

A

Narrowing of upper trachea + subglottis leads to …

STEEPLE SIGN ON X-RAY.

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18
Q

Severe croup can result in …?

A

PULSUS PARADOXUS 2o to UPPER AIRWAY OBSTRUCTION.

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19
Q

Measles (rubeola) virus - Lymphadenitis with …?

A

WARTHIN-FINKELDEY GIANT CELLS (fused lymphocytes) in a background of PARACORTICAL HYPERPLASIA.

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20
Q

Ebola virus - What genus?

A

FILOVIRUS.

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21
Q

Ebola virus - Targets:

A
  1. Endothelial cells.
  2. Phagocytes.
  3. Hepatocytes.
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22
Q

Ebola - Incubation of …?

A

21 days.

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23
Q

Ebola virus - Presents with …?

A

Abrupt onset of:

  1. Flu-like symptoms.
  2. Diarrhea/vomiting.
  3. High fever.
  4. Myalgia.
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24
Q

Ebola virus - Can progress to …?

A
  1. DIC.
  2. DIFFUSE HEMORRHAGE.
  3. SHOCK.
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25
Q

Ebola virus - Diagnosed with …?

A

RT-PCR within 48h of SYMPTOM ONSET.

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26
Q

Ebola virus - Mortality:

A

HIGH.

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27
Q

Ebola virus - Transmission requires …?

A

DIRECT CONTACT WITH:

  1. Bodily fluids.
  2. Fomites (including dead bodies).
  3. Infected bats or primates (apes/monkeys).
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28
Q

Ebola virus - Incidence of nosocomial infection:

A

HIGH INCIDENCE OF NOSOCOMIAL INFECTION.

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29
Q

Ebola virus - Tx:

A

SUPPORTIVE - No definitive treatment.

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30
Q

Ebola virus - Preventing transmission …?

A
  1. STRICT ISOLATION of infected individual.

2. BARRIER PRACTICES of health care workers.

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31
Q

HAV - Liver biopsy:

A
  1. Hepatocyte SWELLING.
  2. Monocyte infiltration.
  3. Councilman bodies.
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32
Q

HBV - Liver biopsy:

A
  1. Granular + eosinophilic “GROUND GLASS” appearance.

2. Cytotoxic T cells mediate damage.

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33
Q

HCV - Liver biopsy:

A

Lymphoid aggregates with focal areas of MACROVESICULAR STEATOSIS.

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34
Q

HDV - Liver biopsy:

A

HBV.

35
Q

HEV - Liver biopsy:

A

PATCHY NECROSIS.

36
Q

Anti-HAV IgM:

A

IgM antibody to HAV.

==> BEST TEST to detect ACUTE Hep A.

37
Q

Anti-HAV IgG:

A

IgG antibody indicates PRIOR HAV infection and/or prior vaccination.
==> PROTECTS AGAINST REINFECTION.

38
Q

HBsAg:

A

Antigen found on surface of HBV ==> INDICATES HBV INFECTION.

39
Q

Anti-HBs:

A

Antibody to HBsAg ==> INDICATES IMMUNITY TO Hep B.

40
Q

HBcAg:

A

Antigen associated with CORE of HBV.

41
Q

Anti-HBc IgM:

A

Acute/recent infection.

42
Q

Anti-HBc IgG:

A

Prior exposure or chronic infection.

43
Q

IgM anti-HBc may be the …?

A

SOLE POSITIVE marker of infection during window period.

44
Q

HBeAg - Secreted by …?

A

INFECTED HEPATOCYTE INTO CIRCULATION.

45
Q

HBeAg is NOT …?

A

NOT PART OF MATURE HBV VIRION.

46
Q

HBeAg indicates …?

A

ACTIVE VIRAL REPLICATION ==> HIGH TRANSMISSIBILITY.

47
Q

Anti-HBe:

A

Antibody to HBeAg.

48
Q

Anti-HBe indicates …?

A

LOW TRANSMISSIBILITY.

49
Q

Common diseases of HIV-positive adults - General picture:

A

As CD4 cell count decreases ==>

  1. Incr. risk for REACTIVATION of past infections = TB, HSV, shingles.
  2. DISSEMINATION of bacterial/fungal infections (eg coccidioidomycosis).
  3. NHLs.
50
Q

CD4 UNDER 5 HUNDRED - 6 major pathogens:

A
  1. C.albicans.
  2. EBV.
  3. B.henselae.
  4. HHV-8.
  5. Cryptosporidium spp.
  6. HPV.
51
Q

C.albicans - Presentation:

A

ORAL THRUSH.

52
Q

C.albicans - Findings:

A
  1. Scrabable white plaque.

2. Pseudohyphae on microscopy.

53
Q

EBV - Presentation:

A

ORAL HAIRY LEUKOPLAKIA.

54
Q

EBV - Findings:

A

UNSCRAPABLE white plaque on lateral tongue.

55
Q

B.henselae - Presentation:

A

Bacillary angiomatosis.

56
Q

B.henselae - Findings:

A

BIOPSY WITH NEUTROPHILIC INFLAMMATION.

57
Q

HHV-8 - Findings:

A

BIOPSY WITH LYMPHOCYTIC INFLAMMATION.

58
Q

Cryptosporidium spp. - Presentation:

A

Chronic, watery diarrhea.

59
Q

Cryptosporidium spp. - Findings:

A

ACID-FAST OOCYSTS in stool.

60
Q

HPV - Presentation:

A

SCC ==>

  1. Anus (MSM).
  2. Cervix (women).
61
Q

CD4 cell count UNDER 2 HUNDRED - 3 major pathogens:

A
  1. HIV.
  2. JC (reactivation).
  3. P.jirovecii.
62
Q

HIV - Presentation:

A

DEMENTIA.

63
Q

JC - Presentation:

A

PML.

64
Q

JC - Findings:

A

NON ENHANCING AREAS OF DEMYELINATION ON MRI.

65
Q

P.jirovecii - Presentation:

A

PCP.

66
Q

P.jirovecii - Findings:

A

Ground-glass opacities on CXR.

67
Q

CD4 cell count UNDER 1 HUNDRED - 8 major pathogens:

A
  1. A.fumigatus.
  2. C.neoformans.
  3. C.albicans.
  4. CMV.
  5. EBV.
  6. H.capsulatum.
  7. Mycobacterium avium-intracellulare, MAC.
  8. Toxoplasma gondii.
68
Q

A.fumigatus - Presentation:

A
  1. Hemoptysis.

2. Pleuritic pain.

69
Q

C.neoformans - Presentation:

A

Meningitis.

70
Q

C.neoformans - Findings:

A
  1. Encapsulated yeast on India ink stain.

2. Capsular antigen (+).

71
Q

C.albicans - Presentation:

A

ESOPHAGITIS.

72
Q

C.albicans - Findings:

A
  1. White plaques on endoscopy.

2. Yeast + Pseudohyphae on biopsy.

73
Q

CMV - Presentation:

A
  1. Retinitis.
  2. Esophagitis.
  3. Colitis.
  4. Pneumonitis.
  5. Encephalitis.
74
Q

CMV - Findings:

A
  1. LINEAR ULCERS on endoscopy.
  2. Cotton-wool spots on fundoscopy.
  3. Biopsy ==> INTRANUCLEAR (owl eye) inclusion bodies.
75
Q

EBV - Presentation:

A

B-cell lymphoma ==> NHL, or 1o CNS lymphoma.

76
Q

EBV - Findings:

A

CNS lymphoma ==> Ring, enhancing, may be SOLITARY (vs TOXOPLASMA).

77
Q

H.capsulatum - Presentation:

A
  1. Fever.
  2. Weight loss.
  3. Fatigue.
  4. Cough.
  5. Dyspnea.
  6. Nausea.
  7. Vomiting.
  8. Diarrhea.
78
Q

H.capsulatum - Findings:

A

Oval yeast cells WITHIN MACROS.

79
Q

Mycobacterium avium-intracellulare, MAC - Presentation:

A
  1. Non specific systemic symptoms (fever, night sweats, weight loss).
  2. Focal lymphadenitis.
80
Q

Toxoplasma gondii - Presentation:

A

Brain abscessES.

81
Q

Toxo - Findings:

A

MULTIPLE ring-enhancing lesions on MRI.

82
Q

Prions are resistant to …?

A

Standard sterilizing procedures, INCLUDING STANDARD AUTOCLAVING.

83
Q

Viral genetics - Complementation - Example:

A

HDV requires the presence of replicating HBV to supply HBsAg ==> THE ENVELOPE PROTEIN OF HDV.