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FA - Micro - Virology Flashcards

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
HSV-2 - disease?
1. Herpes genitalis. | 2. Neonatal herpes.
25
VZV (HHV-3) - disease?
1. Chickenpox. 2. Shingles. 3. Encephalitis. 4. Pneumonia.
26
VZV - vaccine?
Available
27
EBV (HHV-4) - disease?
1. Mono 2. ENDEMIC Burkitt 3. HL. 4. Nasopharyngeal carcinoma.
28
CMV (HHV-5) - disease?
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.
29
HHV-6 - disease?
Roseola - exanthem subitum ==> HIGH FEVER for several days that can cause SEIZURES, followed by diffuse macular rash.
30
HHV-7 - disease?
Less common cause of roseola.
31
HHV-8 - disease?
Kaposi ==> Neoplasm of ENDOTHELIAL cells. 1. In HIV/AIDS patients. 2. In transplant patients.
32
Hepadna - envelope?
YES
33
Hepadna - DNA structure?
Partially ds and circular.
34
Hepadna - disease?
HBV: Acute/chronic hep. ==> NOT A RETROVIRUS, BUT HAS REVERSE TRANSCRIPTASE.
35
HBV - vaccine?
Available - contains HBV surface antigen.
36
HBV - reverse transcriptase?
YES, even if it's not a retrovirus.
37
Adenovirus - envelope?
No
38
Adeno - DNA structure?
DS and linear.
39
Adeno - disease?
1. Febrile pharyngitis - sore throat. 2. Acute hemorrhagic cystitis. 3. Pneumonia 4. Conjunctivitis - "pink eye".
40
Parvo - envelope?
NO
41
Parvo - DNA structure?
ss and linear (-) --> smallest DNA virus.
42
Parvo - disease?
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.
43
Polyomavirus - envelope?
NO
44
Polyoma - DNA structure?
ds and circular.
45
Polyoma - name 2 viruses?
JC, BK
46
JC virus - disease?
Progressive multifocal leukoencephalopathy in HIV.
47
BK virus - disease?
Transplant patients, commonly targets KIDNEY. (BK for Bad Kidney).
48
Pox - envelope?
YES
49
Pox - DNA structure?
DS and linear - largest DNA virus.
50
Pox - disease?
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.
51
HSV-1 - Diseases?
1. Gingivostomatitis 2. Keratoconjunctivitis 3. Temporal lobe encephalitis (MCC of sporadic encephalitis in the US) 4. Herpes labialis 5. Herpetic whitlow on finger.
52
HSV-1 - Latent where?
In the trigeminal ganglia.
53
HSV-1 - transmission?
1. Respiratory secretions | 2. Saliva
54
HSV-2 - disease?
1. Herpes genitalis 2. Neonatal herpes ==> Viral MENINGITIS is more common with HSV-2 than with HSV-1.
55
HSV-2 - Latent where?
In sacral ganglia.
56
HSV-2 - Transmission?
1. Sexually | 2. Perinatally
57
VZV - Diseases?
1. Varicella-zoster (chickenpox, shingles). 2. Encephalitis 3. Pneumonia ==> MC complication of shingles is POST-HERPETIC NEURALGIA.
58
VZV - Latent where?
Dorsal root or trigeminal ganglia.
59
VZV - MC complication?
Post herpetic neuralgia.
60
VZV - Transmission?
Respiratory secretions.
61
EBV - disease?
Mononucleosis
62
Mono - Features?
1. Fever 2. HSM 3. Pharyngitis 4. Lymphadenopathy --> especially POSTERIOR CERVICAL nodes.
63
EBV - transmission?
1. Respiratory secretions | 2. Saliva
64
EBV - Mechanism?
Infects B cells THROUGH CD21. | ==> Atypical lymphocytes seen on peripheral blood smear infected B cells BUT rather REACTIVE CYTOTOXIC T CELLS.
65
EBV - Monospot?
Heterophile antibodies detected by agglutination of sheep or horse RBCs.
66
EBV - associations?
1. Hodgkin 2. Endemic Burkitt 3. Nasopharyngeal carcinoma
67
CMV - Diseases?
1. Congenital infection 2. Mononucleosis (Monospot (-)) 3. Pneumonia 4. Retinitis
68
CMV - special feature?
Infected cells have characteristic "owl's eye" inclusions.
69
CMV - Latent where?
Mononuclear cells.
70
CMV - Transmission?
1. Congenitally 2. By transfusion 3. Sexually 4. Saliva 5. Urine 6. Transplant
71
HHV-6 - disease?
ROSEOLA --> High fevers for several days that can cause seizures, followed by a diffuse macular rash.
72
HHV-6 transmission?
By saliva.
73
HHV-8 disease?
1. Kaposi sarcoma - neoplasm of endothelial cells. 2. Dark/violaceous flat and nodular skin lesions representing endothelial growths. 3. Can ALSO affect GI/Lungs.
74
HHV-8 - target patients?
AIDS/transplant patients.
75
HHV-8 - transmission?
Sexually
76
HSV - Identification?
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.
77
Reo - envelope?
NO
78
Reo - RNA structure?
DS linear. | 10-12 segments.
79
Reo - Capsid symmetry?
Icosahedral - double.
80
Reo - Medical importance?
1. Coltivirus --> Colorado tick fever. | 2. Rotavirus --> #1 cause of FATAL diarrhea in CHILDREN.
81
Pircorna - envelope?
NO.
82
Picorna - RNA structure?
SS(+) linear.
83
Picorna - capsid symmetry?
Icosahedral.
84
Picorna - medical importance?
1. Polio 2. Echo --> ASEPTIC meningitis 3. Rhinovirus --> "common cold" 4. Coxsackievirus 5. HAV PERCH.
85
Picorna - Coxsackievirus?
1. ASEPTIC meningitis 2. Herpangina (mouth blisters, fever) 3. Hand, foot, and mouth disease 4. Myocarditis 5. Pericarditis
86
Hepevirus - Envelope?
NO.
87
Hepevirus - RNA structure?
SS(+) linear.
88
Hepevirus - Capsid symmetry?
Icosahedral.
89
Hepevirus - Medical importance?
HEV
90
Calici - envelope?
NO
91
Calici - RNA structure?
SS(+) linear.
92
Calici - Capsid symmetry?
Icosahedral.
93
Calici - Medical importance?
Norovirus - Viral gastroenteritis.
94
Flavivirus - Envelope?
Yes
95
Flavi - RNA structure?
SS(+) linear.
96
Flavivirus - capsid symmetry?
Icosahedral
97
Flavivirus - Medical importance?
1. HCV 2. Yellow fever 3. Dengue 4. St.Luis encephalitis 5. West Nile virus ==> ALL ARBO.
98
Toga - Envelope?
YES
99
Toga - RNA structure?
SS(+) linear.
100
Toga - Capsid symmetry?
Icosahedral.
101
Toga - Medical importance?
1. Rubella 2. Eastern equine encephalitis = ARBO 3. Western equine encephalitis = ARBO.
102
Retroviruses - Envelope?
Yes
103
Retroviruses - RNA structures?
SS(+) linear | 2 COPIES
104
Retroviruses - Capsid symmetry?
Icosahedral (HTLV) | Complex and conical (HIV)
105
Retroviruses - Medical importance?
1. Have reverse transcriptase 2. HIV 3. HTLV
106
Corona - envelope?
Yes
107
Corona - RNA structure?
SS(+) linear.
108
Corona - Capsid symmetry?
Helical.
109
Corona - medical importance?
1. Coronavirus - "common cold". 2. SARS. 3. MERS = Middle East Respiratory Syndrome.
110
Orthomyxo - envelope?
YES
111
Orthomyxo - RNA structure?
SS(-) linear - 8 SEGMENTS.
112
Orthomyxo - Capsid symmetry?
Helical.
113
Orthomyxo - Medical importance?
Influenza virus.
114
Paramyxo - Envelope?
YES
115
Paramyxo - RNA structure?
SS(-) linear - NON SEGMENTED.
116
Paramyxo - Capsid symmetry?
Helical.
117
Paramyxo - medical importance?
PaRaMyxo: 1. Parainfluenza - croup. 2. RSV - bronchiolitis in babies; Rx-Rivabirin. 3. Measles, Mumps
118
Rhabdo - envelope?
YES
119
Rhabdo - RNA structure?
SS(-) linear.
120
Rhabdo - capsid symmetry?
Helical.
121
Rhabdo - medical importance?
Rabies.
122
Filo - envelope?
YES
123
Filo - RNA structure?
SS(-) Linear.
124
Filo - capsid symmetry?
Helical
125
Filo - Medical importance?
Ebola/Marburg hemorrhagic fever --> often FATAL.
126
Arena - envelope?
Yes
127
Arena - RNA structure?
SS(+) OR SS(-) circular, 2 SEGMENTS.
128
Arena - Capsid symmetry?
Helical.
129
Arena - Medical importance?
1. LCMV - Lymphocytic choriomeningitis virus. | 2. Lassa fever encephalitis - spread by RODENTS.
130
Bunya - envelope?
Yes
131
Bunya - RNA structure?
SS(-) circular - 3 SEGMENTS.
132
Bunya - Capsid symmetry?
Helical
133
Bunya - medical importance?
1. California encephalitis = ARBO 2. Sandfly/Rift valley fevers = ARBO 3. Crimean-Congo hemorrhagic fever = ARBO 4. Hantavirus - hemorrhagic fever, pneumonia
134
Arboviruses?
1. California encephalitis 2. Sandfly/Rift valley fevers 3. Crimean-Congo hemorrhagic fever
135
Delta - envelope?
Yes
136
Delta - RNA structure?
SS(-) circular.
137
Delta - Capsid symmetry?
UNCERTAIN.
138
Delta - Medical importance?
HDV is a "defective" virus that requires HBV to replicate.
139
Negative-stranded viruses - what must be done?
Must transcribe (-)strand to (+). Virion brings its own RNA-dependent RNA polymerase.
140
Negative-stranded viruses - Mention them.
1. Arena 2. Bunya 3. Paramyxo 4. Orthomyxo 5. Filo 6. Rhabdo
141
Segmented viruses?
ALL are RNA viruses: 1. Arena 2. Bunya 3. Orthomyxo 4. Reo
142
Picorna - mention the viruses:
1. Polio 2. Echo 3. Rhino 4. Coxsackie 5. HAV
143
Picorna - Special features?
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
Rhinovirus - Serologic types?
>100
145
Rhinovirus - acid labile?
YES ==> DOES NOT INFECT THE GI (unlike the other picornaviruses).
146
Yellow fever virus - what type of virus?
Flavivirus (also an Arbovirus).
147
Yellow fever virus - Transmission?
Aedes mosquitoes.
148
Yellow fever virus - reservoir?
Monkey or human.
149
Yellow fever virus - symptoms?
1. High fever 2. Black vomitus 3. Jaundice
150
Rotavirus - important feature?
Major cause of acute diarrhea in the US during winter - especially in day-care centers, kindergartens.
151
Rotavirus - pathogenic mechanism?
Villous destruction with atrophy leads to decrr. absorption of Na and loss of K.
152
Influenza virus - antigens?
1. Neuraminidase (promotes progeny virion release) | 2. Hemagglutinin (promotes viral entry)
153
Influenza virus - 2 important features?
1. Risk for FATAL bacterial superinfection ==> S.aureus + S.pneumo + H.flu. 2. Rapid genetic changes.
154
Influenza virus - Reformulated vaccine (the flu shot)?
Containing viral strains most likely to appear during the flu season, due to virus' rapid genetic change.
155
Influenza virus - killed viral vaccine?
Most frequently used.
156
Influenza virus - live attenuated (temperature-sensitive mutant) vaccine?
Replicates in the nose BUT NOT IN THE LUNG ==> Administered intranasally.
157
Genetic shift/antigenic shifts?
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
Genetic drift?
Causes EPIdemics. | Minor (antigenic drift) changes based on random mutation in hemagglutinin OR neuraminidase genes.
159
Rubella virus - what virus?
Toga
160
Another name for rubella?
German (3day) measles.
161
Rubella virus - disease features?
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
Congenital rubella features?
Blueberry muffin appearance ==> DERMAL extramedullary hematopoiesis.
163
Croup cough?
Seal-like barking cough.
164
Paramyxo (parainfluenza, mumps, measles, RSV) contain?
Fusion protein (F protein) --> Causes respiratory epithelial cells to fuse and form multinucleated cells.
165
Palivizumab ?
Monoclonal antibody against F protein --> prevents pneumonia caused by RSV infection in premature infants.
166
Measles - Usual presentation:
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
Measles virus - Possible sequelae?
1. SSPE - subacute sclerosing panencephalitis, occurring YEARS later. 2. Encephalitis (1:2000). 3. Giant cell pneumonia (rarely, in immunosuppressed).
168
3C's of measles:
Cough Coryza Conjunctivitis
169
VitA used for what in malnourished children?
Can REDUCE MORTALITY + MORBIDITY from measles.
170
Rash of measles:
Discrete erythematous rash, presents late, and includes limbs (vs rubella) as it spreads downward.
171
Mumps virus - Diseases?
1. Parotitis 2. Orchitis 3. Aseptic meningitis 4. PANCREATITIS ==> Can cause sterility especially AFTER puberty.
172
Rabies virus - characteristic shape?
Bullet-shaped.
173
Rabies virus - characteristic bodies?
Negri bodies (CYTOPLASMIC inclusions) --> Commonly found in Purkinje cells of cerebellum and in hippocampal neurons.
174
Rabies incubation period?
LONG - Weeks to months before symptom onset.
175
Rabies - Postexposure treatment?
Wound cleansing and vaccination +/- rabies immune globulin. | ==> Example of PASSIVE-ACTIVE IMMUNITY.
176
Rabies - mechanism?
Travels to the CNS by migrating in a retrograde fashion up nerve axons ==> Binding to ACh RECEPTORS.
177
Rabies - Progression of disease?
Fever, malaise --> Agitation, photophobia, hydrophobia, hypersalivation --> Paralysis, coma --> Death.
178
Rabies - Transmission?
1. Bat bites 2. Raccoon bites 3. Skunk bites than dog bites in US. ==> AEROSOL TRANSMISSION (eg bat caves) ALSO POSSIBLE.
179
HAV - Virus?
Picorna
180
HAV - incubation?
Short - weeks.
181
HBV - Virus?
DNA hepadna
182
HBV - incubation?
LONG - months.
183
HCV - virus?
Flavi
184
HDV - virus?
Delta virus
185
HDV - incubation?
Superinfection with HBV - Short. | Co-infection with HBV - Long.
186
HEV - virus?
Hepevirus.
187
Signs/symptoms of all hepatitis viruses:
1. Episodes of Fever 2. Jaundice 3. UP AST/ALT
188
Best test to detect active hep A?
Anti-HAV IgM.
189
Anti-HBc?
Antibody to HBcAg: IgM = acute/recent infection IgG = prior exposure or chronic infection. POSITIVE during window period.
190
HBeAg?
A second different antigenic determinant in the HBV core. | --> Indicates active viral replication + HIGH TRANSMISSIBILITY.
191
Anti-HBe?
Antibody to HBeAg - indicates low transmissibility.
192
HBsAg(+) HBeAg(+) Anti-HBc = IgM
Acute HBV
193
Anti-HBe (+) | Anti-HBc = IgM
Window
194
HBsAg(+) HBeAg(+) Anti-HBc = IgG
Chronic HBV - High infectivity.
195
HBsAg (+) Anti-HBe (+) Anti-HBc =IgG
Chronic HBV - Low infectivity.
196
Anti-HBs (+) Anti-HBe (+) Anti-HBc = IgG
Recovery
197
Anti-HBs (+)
Immunized
198
HIV genome?
DIPLOID - 2 molecules of RNA.
199
HIV 3 structural genes?
Env, gag, pol
200
env encodes?
gp120 | gp41
201
env protein formation?
Formed from cleavage of gp160 to form envelope glycoproteins.
202
gp120 role?
Attachment to host CD4+ T cell.
203
gp41 role?
Fusion and entry.
204
gag encodes?
1. p24 CAPSID PROTEIN. | 2. p17 MATRIX PROTEIN.
205
gp41 role?
Capsid protein.
206
pol encodes?
1. Reverse transcriptase 2. Aspartate protease 3. Integrase
207
HIV binds which receptors on T cells?
CCR5 (early) CXCR4 (late) CD4
208
HIV binds which receptors on macrophages?
CCR5 | CD4
209
Homozygous CCR5 mutation?
Immunity
210
Heterozygous CCR5 mutation?
Slower course
211
HIV diagnosis - which lab tests?
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
AIDS diagnosis?
1. Under 2 hundred CD4/mm^3. 2. HIV (+) with AIDS-defining condition. 3. CD4 PERCENTAGE UNDER 14%.
213
ELISA/Western blot tests look for what?
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
Four stages of untreated infection:
1. Flu-like (acute) 2. Feeling fine (latent) 3. Falling count 4. Final crisis
215
Common diseases of HIV(+) - Systemic - Clinical presentation?
1. Low-grade fever 2. Cough 3. HSM 4. Tongue ulcer
216
Common diseases of HIV (+) - Systemic - Lab findings?
Oval yeast cells within macrophages, CD4<100cells/mm3.
217
Common diseases of HIV(+) - Systemic - Pathogen?
Histoplasma capsulatum (Causes only pulmonary symptoms in immunocompetent hosts).
218
Common diseases of HIV(+) - Dermatologic - Clinical presentation?
1. Fluffy white cottage-cheese lesions --> C.albicans 2. Hairy leukoplakia --> EBV. 3. Superficial vascular proliferation --> B.henselae
219
HIV (+) diseases - lab findings - Pseudohyphae, commonly oral if CD4<100?
C.albicans --> causes oral thrush and esophagitis.
220
HIV(+) diseases - findings - hairy leukoplakia often on LATERAL TONGUE?
EBV
221
Bartonella henselae causes?
Bacillary angiomatosis.
222
HIV(+) disease - GI presentation?
Chronic, watery diarrhea - Cryptosporidium spp.
223
Cryptosporidium diarrhea - findings?
1. Acid-fast cysts seen in stool. | 2. Especially when CD4<200cells/mm3.
224
HIV(+) diseases - T.gondii?
Abscesses --> many ring-enhancing lesions on imaging.
225
CD4 for T.gondii?
CD4<100
226
HIV(+) dementia?
Directly associated with HIV - Must differentiate from other causes.
227
HIV(+) encephalopathy?
JC virus reactivation (cause of PML) --> Due to reactivation of latent virus. Results in demyelination.
228
CD4 for JC reactivation?
CD4<200
229
C.neoformans meningitis in HIV(+) - Findings?
India ink stain reveals yeast with narrow-based budding and large capsule.
230
CD4 for C.neoformans?
CD4<50.
231
HIV(+) CMV retinitis - findings?
Cotton-wool spots on fundoscopic exam and may also occur with esophagitis.
232
CD4 for CMV retinitis?
CD4<50.
233
HIV(+) NHL (large cell type) ?
Often on oropharynx (Waldeyer ring) - May be associated with EBV.
234
HIV(+) primary CNS lymphoma?
1. Focal or multiple, differentiate from toxoplasmosis. | 2. May be associated with EBV.
235
HIV(+) SCC?
HPV - Often in anus (gays) or cervix.
236
HIV(+) superficial neoplastic proliferation of vasculature?
HHV-8 - Biopsy reveals LYMPHOCYTIC INFLAMMATION. | Do not confuse with bacillary angiomatosis caused by B.henselae (neutrophils).
237
HIV(+) interstitial pneumonia CMV?
Biopsy reveals cells with intranuclear (owl eye) inclusion bodies.
238
Invasive aspergillosis - HIV(+)?
Aspergillus fumigatus - Pleuritic pain, hemoptysis, infiltrates on imaging.
239
PCP ?
1. Especially when CD4<200. 2. Ground-glass appearance on imaging. 3. P.jirovecii
240
Pneumonia in HIV(+)?
1. Generally when CD4>200. | 2. S.pneumoniae
241
TB-like disease in HIV(+)?
1. Especially with CD4<50. | 2. M.avium-intracellulare - also known as MAC.
242
Prion diseases - etiology?
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
PrPsc does what?
Resists PROTEASE DEGRADATION and facilitates the conversion of still more PrPc to PrPsc.
244
Accumulation of PrPsc results in what?
1. Spongiform encephalopathy 2. Dementia 3. Ataxia 4. Death
245
Types of spongiform encephalopathy?
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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