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FA - Micro - Virology Flashcards

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0
Q

Viral genetics - Reassortment?

A

When viruses with segmented genomes (e.g., influenza virus) exchange segments.
==> 2009 novel H1N1 influenza A pandemic ==> Complex reassortment of genes from HUMAN + SWINE + AVIAN viruses.
==> POTENTIAL FOR ANTIGENIC SHIFT.

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1
Q

Viral genetics - Recombination?

A

Exchange of genes between 2 chromosomes by crossing over within regions of significant base sequence homology.

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2
Q

Viral genetics - complementation?

A

When 1 OF 2 viruses that infect the cell has a mutation that results in a NON FUNCTIONAL PROTEIN.
==> The NON MUTATED virus “complements” the mutated one by making a functional protein that serves BOTH viruses.

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3
Q

Viral genetics - phenotypic mixing?

A
  1. Occurs with SIMULTANEOUS infection of a cell with 2 VIRUSES.
  2. Genome of virus A can be partially or completely coated (forming pseudovirion) with the surface proteins of virus B.
  3. Type B protein coat determines the tropism (infectivity) of the hybrid virus.
  4. The progeny from this infection have a type A coat that is encoded by its type A genetic material.
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4
Q

Live attenuated vaccines - mechanism?

A

Induce humoral AND cell-mediated immunity - have reverted to virulence on RARE occasions.

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5
Q

Killed/inactivate vaccines - mechanism?

A

Induce ONLY HUMORAL immunity but are stable.

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6
Q

Live attenuated vaccines - mention some?

A
  1. Smallpox
  2. Yellow fever
  3. Chickenpox (VZV)
  4. Sabin polio virus
  5. MMR
  6. Influenza (Intranasal)
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7
Q

Live attenuated vaccines - need a booster?

A

NO BOOSTER.

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8
Q

Killed vaccines - mention some?

A
  1. Rabies
  2. Influenza (injected)
  3. Salk Polio
  4. HAV vaccines
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9
Q

Recombinant vaccines - 2 examples?

A
  1. HBV (antigen= HBsAg)

2. HPV (types 6, 11, 16, 18).

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10
Q

All DNA viruses are ds, EXCEPT?

A

Parvo (Latin for small)

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11
Q

All DNA viruses are linear, EXCEPT?

A
  1. Papilloma
  2. Polyoma
  3. Hepadna
    (circular)
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12
Q

All RNA viruses are ss, EXCEPT?

A

Reo (Repeato-virus ==> ds).

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13
Q

Positive-stranded RNA viruses?

A
  1. Retro
  2. Toga
  3. Flavi
  4. Calici
  5. Picorna
  6. Corona
  7. Hepevirus
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14
Q

Naked viral genome infectivity?

A

Purified nucleic acids of most dsDNA (EXCEPT pox and HBV) and +strand ssRNA –> INFECTIOUS.

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15
Q

NON infectious naked nucleic acids?

A

Naked nucleic acids of (-)strand ssRNA and dsRNA viruses are NOT infectious –> Require polymerases contained in the complete virion.

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16
Q

DNA viruses - viral replication?

A

ALL IN THE NUCLEUS (except POX).

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17
Q

RNA viruses - viral replication?

A

ALL in the CYTOPLASM - except INFLUENZA and RETRO.

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18
Q

Viral envelopes - Naked?

A 
DNA ==> 
1. Papilloma
2. Polyoma
3. Adeno
4. Parvo
RNA ==>
5. Calici
6. Picorna
7. Reovirus
8. Herpes
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19
Q

Generally, how do enveloped viruses acquire their envelopes?

A

From plasma membrane when they exit the from cell.

EXCEPT HERPESVIRUSES ==> Acquire envelopes from nuclear membrane.

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20
Q

General rule - ALL DNA viruses are?

A
  1. HHAPPPPy –> Hepadna, Herpes, Adeno, Pox, Parvo, Polyoma, Papilloma.
  2. DOUBLE-STRANDED
  3. LINEAR GENOMES
  4. ICOSAHEDRAL –> except pox (complex)
  5. NUCLEUS for replica –> except pox (carries OWN DNA-dependent RNA poly).
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21
Q

Herpesviruses - envelope?

A

Yes.

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22
Q

Herpesviruses - DNA structure?

A

DS and linear.

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23
Q

HSV-1 - disease?

A
  1. Gingivostomatitis.
  2. Keratoconjunctivitis.
  3. Herpes labialis.
  4. Herpetic whitlow on finger.
  5. Temporal lobe encephalitis.
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24
Q

HSV-2 - disease?

A
  1. Herpes genitalis.

2. Neonatal herpes.

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25
Q

VZV (HHV-3) - disease?

A
  1. Chickenpox.
  2. Shingles.
  3. Encephalitis.
  4. Pneumonia.
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26
Q

VZV - vaccine?

A

Available

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27
Q

EBV (HHV-4) - disease?

A
  1. Mono
  2. ENDEMIC Burkitt
  3. HL.
  4. Nasopharyngeal carcinoma.
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28
Q

CMV (HHV-5) - disease?

A
  1. Mononucleosis (Monospot NEGATIVE) in IMMUNOCOMPETENT patients.
  2. PNEUMONIA in transplant patients.
  3. AIDS RETINITIS (“sightomegalovirus”) ==> Hemorrhage + Cotton-wool exudates + Vision loss.
  4. CONGENITAL CMV.
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29
Q

HHV-6 - disease?

A

Roseola - exanthem subitum ==> HIGH FEVER for several days that can cause SEIZURES, followed by diffuse macular rash.

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30
Q

HHV-7 - disease?

A

Less common cause of roseola.

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31
Q

HHV-8 - disease?

A

Kaposi ==> Neoplasm of ENDOTHELIAL cells.

  1. In HIV/AIDS patients.
  2. In transplant patients.
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32
Q

Hepadna - envelope?

A

YES

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33
Q

Hepadna - DNA structure?

A

Partially ds and circular.

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34
Q

Hepadna - disease?

A

HBV:
Acute/chronic hep.
==> NOT A RETROVIRUS, BUT HAS REVERSE TRANSCRIPTASE.

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35
Q

HBV - vaccine?

A

Available - contains HBV surface antigen.

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36
Q

HBV - reverse transcriptase?

A

YES, even if it’s not a retrovirus.

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37
Q

Adenovirus - envelope?

A

No

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38
Q

Adeno - DNA structure?

A

DS and linear.

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39
Q

Adeno - disease?

A
  1. Febrile pharyngitis - sore throat.
  2. Acute hemorrhagic cystitis.
  3. Pneumonia
  4. Conjunctivitis - “pink eye”.
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40
Q

Parvo - envelope?

A

NO

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41
Q

Parvo - DNA structure?

A

ss and linear (-) –> smallest DNA virus.

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42
Q

Parvo - disease?

A

B19:

  1. Aplastic crises in SCA.
  2. “Slapped cheeks” in children - erythema infectiosum (5th disease).
  3. RBC destruction in fetus –> hydrops fetalis and death.
  4. PURE RED CELL APLASIA + RA-like symptoms in adults.
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43
Q

Polyomavirus - envelope?

A

NO

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44
Q

Polyoma - DNA structure?

A

ds and circular.

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45
Q

Polyoma - name 2 viruses?

A

JC, BK

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46
Q

JC virus - disease?

A

Progressive multifocal leukoencephalopathy in HIV.

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47
Q

BK virus - disease?

A

Transplant patients, commonly targets KIDNEY. (BK for Bad Kidney).

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48
Q

Pox - envelope?

A

YES

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49
Q

Pox - DNA structure?

A

DS and linear - largest DNA virus.

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50
Q

Pox - disease?

A
  1. Smallpox - ERADICATED world wide by use of LIVE-ATTENUATED vaccine.
  2. Cowpox (“milkmaid blisters”)
  3. MOLLUSCUM CONTAGIOSUM - Flesh-colored dome lesions with central umbilication.
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51
Q

HSV-1 - Diseases?

A
  1. Gingivostomatitis
  2. Keratoconjunctivitis
  3. Temporal lobe encephalitis (MCC of sporadic encephalitis in the US)
  4. Herpes labialis
  5. Herpetic whitlow on finger.
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52
Q

HSV-1 - Latent where?

A

In the trigeminal ganglia.

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53
Q

HSV-1 - transmission?

A
  1. Respiratory secretions

2. Saliva

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54
Q

HSV-2 - disease?

A
  1. Herpes genitalis
  2. Neonatal herpes
    ==> Viral MENINGITIS is more common with HSV-2 than with HSV-1.
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55
Q

HSV-2 - Latent where?

A

In sacral ganglia.

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56
Q

HSV-2 - Transmission?

A
  1. Sexually

2. Perinatally

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57
Q

VZV - Diseases?

A
  1. Varicella-zoster (chickenpox, shingles).
  2. Encephalitis
  3. Pneumonia
    ==> MC complication of shingles is POST-HERPETIC NEURALGIA.
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58
Q

VZV - Latent where?

A

Dorsal root or trigeminal ganglia.

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59
Q

VZV - MC complication?

A

Post herpetic neuralgia.

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60
Q

VZV - Transmission?

A

Respiratory secretions.

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61
Q

EBV - disease?

A

Mononucleosis

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62
Q

Mono - Features?

A
  1. Fever
  2. HSM
  3. Pharyngitis
  4. Lymphadenopathy –> especially POSTERIOR CERVICAL nodes.
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63
Q

EBV - transmission?

A
  1. Respiratory secretions

2. Saliva

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64
Q

EBV - Mechanism?

A

Infects B cells THROUGH CD21.

==> Atypical lymphocytes seen on peripheral blood smear infected B cells BUT rather REACTIVE CYTOTOXIC T CELLS.

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65
Q

EBV - Monospot?

A

Heterophile antibodies detected by agglutination of sheep or horse RBCs.

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66
Q

EBV - associations?

A
  1. Hodgkin
  2. Endemic Burkitt
  3. Nasopharyngeal carcinoma
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67
Q

CMV - Diseases?

A
  1. Congenital infection
  2. Mononucleosis (Monospot (-))
  3. Pneumonia
  4. Retinitis
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68
Q

CMV - special feature?

A

Infected cells have characteristic “owl’s eye” inclusions.

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69
Q

CMV - Latent where?

A

Mononuclear cells.

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70
Q

CMV - Transmission?

A
  1. Congenitally
  2. By transfusion
  3. Sexually
  4. Saliva
  5. Urine
  6. Transplant
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71
Q

HHV-6 - disease?

A

ROSEOLA –> High fevers for several days that can cause seizures, followed by a diffuse macular rash.

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72
Q

HHV-6 transmission?

A

By saliva.

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73
Q

HHV-8 disease?

A
  1. Kaposi sarcoma - neoplasm of endothelial cells.
  2. Dark/violaceous flat and nodular skin lesions representing endothelial growths.
  3. Can ALSO affect GI/Lungs.
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74
Q

HHV-8 - target patients?

A

AIDS/transplant patients.

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75
Q

HHV-8 - transmission?

A

Sexually

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76
Q

HSV - Identification?

A
  1. Viral culture for skin/genitalia.
  2. CSF PCR for herpes encephalitis.
  3. Tzanck test (genital herpes) - a smear of an opened skin vesicle to detect multinucleated giant cells ==> COMMONLY SEEN IN HSV-1/HSV-2/VZV infections.
  4. Infected cells also have intranuclear Cowdry A inclusions ==> HSV-1/2 + VZV.
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77
Q

Reo - envelope?

A

NO

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78
Q

Reo - RNA structure?

A

DS linear.

10-12 segments.

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79
Q

Reo - Capsid symmetry?

A

Icosahedral - double.

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80
Q

Reo - Medical importance?

A
  1. Coltivirus –> Colorado tick fever.

2. Rotavirus –> #1 cause of FATAL diarrhea in CHILDREN.

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81
Q

Pircorna - envelope?

A

NO.

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82
Q

Picorna - RNA structure?

A

SS(+) linear.

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83
Q

Picorna - capsid symmetry?

A

Icosahedral.

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84
Q

Picorna - medical importance?

A
  1. Polio
  2. Echo –> ASEPTIC meningitis
  3. Rhinovirus –> “common cold”
  4. Coxsackievirus
  5. HAV
    PERCH.
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85
Q

Picorna - Coxsackievirus?

A
  1. ASEPTIC meningitis
  2. Herpangina (mouth blisters, fever)
  3. Hand, foot, and mouth disease
  4. Myocarditis
  5. Pericarditis
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86
Q

Hepevirus - Envelope?

A

NO.

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87
Q

Hepevirus - RNA structure?

A

SS(+) linear.

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88
Q

Hepevirus - Capsid symmetry?

A

Icosahedral.

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89
Q

Hepevirus - Medical importance?

A

HEV

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90
Q

Calici - envelope?

A

NO

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91
Q

Calici - RNA structure?

A

SS(+) linear.

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92
Q

Calici - Capsid symmetry?

A

Icosahedral.

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93
Q

Calici - Medical importance?

A

Norovirus - Viral gastroenteritis.

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94
Q

Flavivirus - Envelope?

A

Yes

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95
Q

Flavi - RNA structure?

A

SS(+) linear.

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96
Q

Flavivirus - capsid symmetry?

A

Icosahedral

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97
Q

Flavivirus - Medical importance?

A
  1. HCV
  2. Yellow fever
  3. Dengue
  4. St.Luis encephalitis
  5. West Nile virus
    ==> ALL ARBO.
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98
Q

Toga - Envelope?

A

YES

99
Q

Toga - RNA structure?

A

SS(+) linear.

100
Q

Toga - Capsid symmetry?

A

Icosahedral.

101
Q

Toga - Medical importance?

A
  1. Rubella
  2. Eastern equine encephalitis = ARBO
  3. Western equine encephalitis = ARBO.
102
Q

Retroviruses - Envelope?

A

Yes

103
Q

Retroviruses - RNA structures?

A

SS(+) linear

2 COPIES

104
Q

Retroviruses - Capsid symmetry?

A

Icosahedral (HTLV)

Complex and conical (HIV)

105
Q

Retroviruses - Medical importance?

A
  1. Have reverse transcriptase
  2. HIV
  3. HTLV
106
Q

Corona - envelope?

A

Yes

107
Q

Corona - RNA structure?

A

SS(+) linear.

108
Q

Corona - Capsid symmetry?

A

Helical.

109
Q

Corona - medical importance?

A
  1. Coronavirus - “common cold”.
  2. SARS.
  3. MERS = Middle East Respiratory Syndrome.
110
Q

Orthomyxo - envelope?

A

YES

111
Q

Orthomyxo - RNA structure?

A

SS(-) linear - 8 SEGMENTS.

112
Q

Orthomyxo - Capsid symmetry?

A

Helical.

113
Q

Orthomyxo - Medical importance?

A

Influenza virus.

114
Q

Paramyxo - Envelope?

A

YES

115
Q

Paramyxo - RNA structure?

A

SS(-) linear - NON SEGMENTED.

116
Q

Paramyxo - Capsid symmetry?

A

Helical.

117
Q

Paramyxo - medical importance?

A

PaRaMyxo:

  1. Parainfluenza - croup.
  2. RSV - bronchiolitis in babies; Rx-Rivabirin.
  3. Measles, Mumps
118
Q

Rhabdo - envelope?

A

YES

119
Q

Rhabdo - RNA structure?

A

SS(-) linear.

120
Q

Rhabdo - capsid symmetry?

A

Helical.

121
Q

Rhabdo - medical importance?

A

Rabies.

122
Q

Filo - envelope?

A

YES

123
Q

Filo - RNA structure?

A

SS(-) Linear.

124
Q

Filo - capsid symmetry?

A

Helical

125
Q

Filo - Medical importance?

A

Ebola/Marburg hemorrhagic fever –> often FATAL.

126
Q

Arena - envelope?

A

Yes

127
Q

Arena - RNA structure?

A

SS(+) OR SS(-) circular, 2 SEGMENTS.

128
Q

Arena - Capsid symmetry?

A

Helical.

129
Q

Arena - Medical importance?

A
  1. LCMV - Lymphocytic choriomeningitis virus.

2. Lassa fever encephalitis - spread by RODENTS.

130
Q

Bunya - envelope?

A

Yes

131
Q

Bunya - RNA structure?

A

SS(-) circular - 3 SEGMENTS.

132
Q

Bunya - Capsid symmetry?

A

Helical

133
Q

Bunya - medical importance?

A
  1. California encephalitis = ARBO
  2. Sandfly/Rift valley fevers = ARBO
  3. Crimean-Congo hemorrhagic fever = ARBO
  4. Hantavirus - hemorrhagic fever, pneumonia
134
Q

Arboviruses?

A
  1. California encephalitis
  2. Sandfly/Rift valley fevers
  3. Crimean-Congo hemorrhagic fever
135
Q

Delta - envelope?

A

Yes

136
Q

Delta - RNA structure?

A

SS(-) circular.

137
Q

Delta - Capsid symmetry?

A

UNCERTAIN.

138
Q

Delta - Medical importance?

A

HDV is a “defective” virus that requires HBV to replicate.

139
Q

Negative-stranded viruses - what must be done?

A

Must transcribe (-)strand to (+). Virion brings its own RNA-dependent RNA polymerase.

140
Q

Negative-stranded viruses - Mention them.

A
  1. Arena
  2. Bunya
  3. Paramyxo
  4. Orthomyxo
  5. Filo
  6. Rhabdo
141
Q

Segmented viruses?

A

ALL are RNA viruses:

  1. Arena
  2. Bunya
  3. Orthomyxo
  4. Reo
142
Q

Picorna - mention the viruses:

A
  1. Polio
  2. Echo
  3. Rhino
  4. Coxsackie
  5. HAV
143
Q

Picorna - Special features?

A
  1. RNA is translated into 1 large polypeptide that is cleaved by proteases into functional viral proteins.
  2. Can cause aseptic (viral) meningitis (except rhinovirus and HAV).
  3. ALL are ENTEROviruses (fecal-oral spread) except rhinovirus.
144
Q

Rhinovirus - Serologic types?

A

> 100

145
Q

Rhinovirus - acid labile?

A

YES ==> DOES NOT INFECT THE GI (unlike the other picornaviruses).

146
Q

Yellow fever virus - what type of virus?

A

Flavivirus (also an Arbovirus).

147
Q

Yellow fever virus - Transmission?

A

Aedes mosquitoes.

148
Q

Yellow fever virus - reservoir?

A

Monkey or human.

149
Q

Yellow fever virus - symptoms?

A
  1. High fever
  2. Black vomitus
  3. Jaundice
150
Q

Rotavirus - important feature?

A

Major cause of acute diarrhea in the US during winter - especially in day-care centers, kindergartens.

151
Q

Rotavirus - pathogenic mechanism?

A

Villous destruction with atrophy leads to decrr. absorption of Na and loss of K.

152
Q

Influenza virus - antigens?

A
  1. Neuraminidase (promotes progeny virion release)

2. Hemagglutinin (promotes viral entry)

153
Q

Influenza virus - 2 important features?

A
  1. Risk for FATAL bacterial superinfection ==> S.aureus + S.pneumo + H.flu.
  2. Rapid genetic changes.
154
Q

Influenza virus - Reformulated vaccine (the flu shot)?

A

Containing viral strains most likely to appear during the flu season, due to virus’ rapid genetic change.

155
Q

Influenza virus - killed viral vaccine?

A

Most frequently used.

156
Q

Influenza virus - live attenuated (temperature-sensitive mutant) vaccine?

A

Replicates in the nose BUT NOT IN THE LUNG ==> Administered intranasally.

157
Q

Genetic shift/antigenic shifts?

A

Cause PANdemics.
Reassortment of viral genome segments undergo high-frequency recombination, such as when human flu A virus recombines with swine flu A virus.

158
Q

Genetic drift?

A

Causes EPIdemics.

Minor (antigenic drift) changes based on random mutation in hemagglutinin OR neuraminidase genes.

159
Q

Rubella virus - what virus?

A

Toga

160
Q

Another name for rubella?

A

German (3day) measles.

161
Q

Rubella virus - disease features?

A
  1. Fever
  2. Post-auricular and other lymphadenopathy
  3. Arthralgias
  4. Fine, confluent rash ==> Starts on face and spreads centrifugally to invovle trunk and extremities.
    Mild disease in children but serious congenital disease (ToRCHeS).
162
Q

Congenital rubella features?

A

Blueberry muffin appearance ==> DERMAL extramedullary hematopoiesis.

163
Q

Croup cough?

A

Seal-like barking cough.

164
Q

Paramyxo (parainfluenza, mumps, measles, RSV) contain?

A

Fusion protein (F protein) –> Causes respiratory epithelial cells to fuse and form multinucleated cells.

165
Q

Palivizumab ?

A

Monoclonal antibody against F protein –> prevents pneumonia caused by RSV infection in premature infants.

166
Q

Measles - Usual presentation:

A
  1. Prodromal fever with COUGH + CORYZA + CONJUNCTIVITIS.
  2. Then, Koplik spots on buccal mucosa.
  3. Followed by 1-2 days later by maculopapular rash ==> Head towards toe.
167
Q

Measles virus - Possible sequelae?

A
  1. SSPE - subacute sclerosing panencephalitis, occurring YEARS later.
  2. Encephalitis (1:2000).
  3. Giant cell pneumonia (rarely, in immunosuppressed).
168
Q

3C’s of measles:

A

Cough
Coryza
Conjunctivitis

169
Q

VitA used for what in malnourished children?

A

Can REDUCE MORTALITY + MORBIDITY from measles.

170
Q

Rash of measles:

A

Discrete erythematous rash, presents late, and includes limbs (vs rubella) as it spreads downward.

171
Q

Mumps virus - Diseases?

A
  1. Parotitis
  2. Orchitis
  3. Aseptic meningitis
  4. PANCREATITIS
    ==> Can cause sterility especially AFTER puberty.
172
Q

Rabies virus - characteristic shape?

A

Bullet-shaped.

173
Q

Rabies virus - characteristic bodies?

A

Negri bodies (CYTOPLASMIC inclusions) –> Commonly found in Purkinje cells of cerebellum and in hippocampal neurons.

174
Q

Rabies incubation period?

A

LONG - Weeks to months before symptom onset.

175
Q

Rabies - Postexposure treatment?

A

Wound cleansing and vaccination +/- rabies immune globulin.

==> Example of PASSIVE-ACTIVE IMMUNITY.

176
Q

Rabies - mechanism?

A

Travels to the CNS by migrating in a retrograde fashion up nerve axons ==> Binding to ACh RECEPTORS.

177
Q

Rabies - Progression of disease?

A

Fever, malaise –> Agitation, photophobia, hydrophobia, hypersalivation –> Paralysis, coma –> Death.

178
Q

Rabies - Transmission?

A
  1. Bat bites
  2. Raccoon bites
  3. Skunk bites
    than dog bites in US.
    ==> AEROSOL TRANSMISSION (eg bat caves) ALSO POSSIBLE.
179
Q

HAV - Virus?

A

Picorna

180
Q

HAV - incubation?

A

Short - weeks.

181
Q

HBV - Virus?

A

DNA hepadna

182
Q

HBV - incubation?

A

LONG - months.

183
Q

HCV - virus?

A

Flavi

184
Q

HDV - virus?

A

Delta virus

185
Q

HDV - incubation?

A

Superinfection with HBV - Short.

Co-infection with HBV - Long.

186
Q

HEV - virus?

A

Hepevirus.

187
Q

Signs/symptoms of all hepatitis viruses:

A
  1. Episodes of Fever
  2. Jaundice
  3. UP AST/ALT
188
Q

Best test to detect active hep A?

A

Anti-HAV IgM.

189
Q

Anti-HBc?

A

Antibody to HBcAg:
IgM = acute/recent infection
IgG = prior exposure or chronic infection.
POSITIVE during window period.

190
Q

HBeAg?

A

A second different antigenic determinant in the HBV core.

–> Indicates active viral replication + HIGH TRANSMISSIBILITY.

191
Q

Anti-HBe?

A

Antibody to HBeAg - indicates low transmissibility.

192
Q

HBsAg(+)
HBeAg(+)
Anti-HBc = IgM

A

Acute HBV

193
Q

Anti-HBe (+)

Anti-HBc = IgM

A

Window

194
Q

HBsAg(+)
HBeAg(+)
Anti-HBc = IgG

A

Chronic HBV - High infectivity.

195
Q

HBsAg (+)
Anti-HBe (+)
Anti-HBc =IgG

A

Chronic HBV - Low infectivity.

196
Q

Anti-HBs (+)
Anti-HBe (+)
Anti-HBc = IgG

A

Recovery

197
Q

Anti-HBs (+)

A

Immunized

198
Q

HIV genome?

A

DIPLOID - 2 molecules of RNA.

199
Q

HIV 3 structural genes?

A

Env, gag, pol

200
Q

env encodes?

A

gp120

gp41

201
Q

env protein formation?

A

Formed from cleavage of gp160 to form envelope glycoproteins.

202
Q

gp120 role?

A

Attachment to host CD4+ T cell.

203
Q

gp41 role?

A

Fusion and entry.

204
Q

gag encodes?

A
  1. p24 CAPSID PROTEIN.

2. p17 MATRIX PROTEIN.

205
Q

gp41 role?

A

Capsid protein.

206
Q

pol encodes?

A
  1. Reverse transcriptase
  2. Aspartate protease
  3. Integrase
207
Q

HIV binds which receptors on T cells?

A

CCR5 (early)
CXCR4 (late)
CD4

208
Q

HIV binds which receptors on macrophages?

A

CCR5

CD4

209
Q

Homozygous CCR5 mutation?

A

Immunity

210
Q

Heterozygous CCR5 mutation?

A

Slower course

211
Q

HIV diagnosis - which lab tests?

A
  1. Presumptive diagnosis made with ELISA - sensitive, high false-positive rate and low threshold –> RULE OUT test.
  2. (+) Results are then CONFIRMED with Western blot assay - specific, high false-negative rate and high threshold –> RULE IN test.
212
Q

AIDS diagnosis?

A
  1. Under 2 hundred CD4/mm^3.
  2. HIV (+) with AIDS-defining condition.
  3. CD4 PERCENTAGE UNDER 14%.
213
Q

ELISA/Western blot tests look for what?

A
  1. Antibodies to viral proteins.
  2. Often FALSE(-) in the first 2 MONTHS of HIV infection.
  3. FALSE(+) initially in BABIES born to infected mothers –> Anti-gp120 crosses placenta.
214
Q

Four stages of untreated infection:

A
  1. Flu-like (acute)
  2. Feeling fine (latent)
  3. Falling count
  4. Final crisis
215
Q

Common diseases of HIV(+) - Systemic - Clinical presentation?

A
  1. Low-grade fever
  2. Cough
  3. HSM
  4. Tongue ulcer
216
Q

Common diseases of HIV (+) - Systemic - Lab findings?

A

Oval yeast cells within macrophages, CD4<100cells/mm3.

217
Q

Common diseases of HIV(+) - Systemic - Pathogen?

A

Histoplasma capsulatum (Causes only pulmonary symptoms in immunocompetent hosts).

218
Q

Common diseases of HIV(+) - Dermatologic - Clinical presentation?

A
  1. Fluffy white cottage-cheese lesions –> C.albicans
  2. Hairy leukoplakia –> EBV.
  3. Superficial vascular proliferation –> B.henselae
219
Q

HIV (+) diseases - lab findings - Pseudohyphae, commonly oral if CD4<100?

A

C.albicans –> causes oral thrush and esophagitis.

220
Q

HIV(+) diseases - findings - hairy leukoplakia often on LATERAL TONGUE?

A

EBV

221
Q

Bartonella henselae causes?

A

Bacillary angiomatosis.

222
Q

HIV(+) disease - GI presentation?

A

Chronic, watery diarrhea - Cryptosporidium spp.

223
Q

Cryptosporidium diarrhea - findings?

A
  1. Acid-fast cysts seen in stool.

2. Especially when CD4<200cells/mm3.

224
Q

HIV(+) diseases - T.gondii?

A

Abscesses –> many ring-enhancing lesions on imaging.

225
Q

CD4 for T.gondii?

A

CD4<100

226
Q

HIV(+) dementia?

A

Directly associated with HIV - Must differentiate from other causes.

227
Q

HIV(+) encephalopathy?

A

JC virus reactivation (cause of PML) –> Due to reactivation of latent virus.
Results in demyelination.

228
Q

CD4 for JC reactivation?

A

CD4<200

229
Q

C.neoformans meningitis in HIV(+) - Findings?

A

India ink stain reveals yeast with narrow-based budding and large capsule.

230
Q

CD4 for C.neoformans?

A

CD4<50.

231
Q

HIV(+) CMV retinitis - findings?

A

Cotton-wool spots on fundoscopic exam and may also occur with esophagitis.

232
Q

CD4 for CMV retinitis?

A

CD4<50.

233
Q

HIV(+) NHL (large cell type) ?

A

Often on oropharynx (Waldeyer ring) - May be associated with EBV.

234
Q

HIV(+) primary CNS lymphoma?

A
  1. Focal or multiple, differentiate from toxoplasmosis.

2. May be associated with EBV.

235
Q

HIV(+) SCC?

A

HPV - Often in anus (gays) or cervix.

236
Q

HIV(+) superficial neoplastic proliferation of vasculature?

A

HHV-8 - Biopsy reveals LYMPHOCYTIC INFLAMMATION.

Do not confuse with bacillary angiomatosis caused by B.henselae (neutrophils).

237
Q

HIV(+) interstitial pneumonia CMV?

A

Biopsy reveals cells with intranuclear (owl eye) inclusion bodies.

238
Q

Invasive aspergillosis - HIV(+)?

A

Aspergillus fumigatus - Pleuritic pain, hemoptysis, infiltrates on imaging.

239
Q

PCP ?

A
  1. Especially when CD4<200.
  2. Ground-glass appearance on imaging.
  3. P.jirovecii
240
Q

Pneumonia in HIV(+)?

A
  1. Generally when CD4>200.

2. S.pneumoniae

241
Q

TB-like disease in HIV(+)?

A
  1. Especially with CD4<50.

2. M.avium-intracellulare - also known as MAC.

242
Q

Prion diseases - etiology?

A

Conversion of a normal (predominantly alpha-helical) protein termed prion protein (PrPc) to a β-pleated form (PrPsc), which is transmissible:

  1. CNS-related tissue –> Iatrogenic CJD
  2. Food contaminated by BSE-infected animal products (variant CJD)
243
Q

PrPsc does what?

A

Resists PROTEASE DEGRADATION and facilitates the conversion of still more PrPc to PrPsc.

244
Q

Accumulation of PrPsc results in what?

A
  1. Spongiform encephalopathy
  2. Dementia
  3. Ataxia
  4. Death
245
Q

Types of spongiform encephalopathy?

A
  1. CJD ==> Rapidly progressive dementia, typically sporadic (some familial forms).
  2. Bovine spongiform encephalopathy (BSE) ==> “Mad cow disease”.
  3. Kuru ==> Acquired prion disease noted in tribal populations practicing human cannibalism.

Microbiology (46 decks)

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