FA virology

Question 1

Which viruses have live attenuated vaccines?

Answer 1

smallpox, yellow fever, chicken pox, sabin’s polio virus, MMR, influenza

Question 2

Which viruses have killed vaccines?

Answer 2

RIP Always

Rabies, influenza (injected), Salk Polio virus, HAV vaccine

Question 3

Which virus has a recombinant vaccine?

Answer 3

HBV

Question 4

What are the DNA viruses?

Answer 4

HHAPPPPy viruses

hepadna, Herpes, adeno, pox, parvo, papilloma, polyoma

Question 5

What are the picornaviruses?

Answer 5

PERCH
Poliovirus: polio, Salk vaccine=IPV; Sabin vaccine=OPV
-Echovirus: aseptic meningitis
-Rhinovirus: common cold
-Coxsackie virus: aseptic meningitis; herpangina (mouth blisters, fever); hand, foot and mouth diseases; myocarditis
-HAV: acute viral hepatitis

Question 6

What are the paramyxoviruses?

Answer 6

PaRaMyxovirus:

• parainfluenza: croup
• RSV: bronchiolitis in babies (Rx with ribavirin)
• Measles, Mumps

Question 7

Which viruses are naked (no envelope)?

Answer 7

Give PAPP smears and CPR to naked Heppy

Papillomavirus, adenovirusm parvovirus, polyomavirus, calcivirus, picornavirus, reovirus, Hepevirus

Question 8

positive stranded RNA viruses

Answer 8

can replicate w/o RNA dependent RNA polymerase

• retrovirus
• togavirus
• flavivirus
• coronavirus
• hepevirus
• calicivirus
• picornavirus

Question 9

What are the negative stranded RNA viruses?

Answer 9

Arenaviruses, Bunyaviruses, Paramyxoviruses, Orthomyxoviruses, filovirus, rhabdovirus

Always Bring Polymerase Or Fail Replication

Question 10

Which viruses are segmented?

Answer 10

BOAR

Bunyavirus, orthomyxovirus (influenza), arenavirus, Reoviruses

Question 11

zanamivir, oseltmivir

Answer 11

inhibit influenza neuradminidase, dec. release of viral progeny
-tx and prevention of influenza A and B

Question 12

ribavirin

Answer 12

inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase

• Tx of RSV and chronic HCV
• Tox: hemolytic anemia, severe teratogen

Question 13

acyclovir and valacyclovir

Answer 13

valacyclovir is prodrug with better oral bioavailablity

• MOA: monophosphorylated by HSV/VZV thymidine kinase. Guanine analog. Triphosphate formed by cellular enzymes. Preferentially inhibits viral DNA polymeraze by chain termination
• Use: HSV and VZV (weak against EBV, no activity against CMV)
• resistance gained thru mutated viral thymidine kinase

Question 14

tx of herpes zoster

Answer 14

famciclovir (related to acyclovir)

Question 15

ganciclovir

Answer 15

valganciclovir is prodrug with better oral bioavailability
MOA: guanosine analog. monophosphate added by CMV viral kinase. Inhibits DNA polymerase
-Use in CMV (esp immunocompromised patients)
-tox: leukopenia, neutropenia, thrombocytopenia, renal toxicity

Question 16

foscarnet

Answer 16

MOA: pyrophosphate analog binds and blocks DNA polymerase *does not require activation by viral kinase
Use: 2nd line if tx fails (CMV retinitis in immunocompromised when ganciclovir fails; acyclovir resistant HSV)
Tox: nephrotoxicity

Question 17

Cidofovir

Answer 17

MOA: inhibits viral DNA pol *does not require activation by viral kinase
Use: 2nd line when others fail
tox: nephrotoxicity (give with probenecid and IV saline to reduce toxicity)

Question 18

What is HAART therapy?

Answer 18

highly active antiretroviral therapy: initiated when patients present with AIDS defining illness, low CD4<500, or high viral load
-regimen of 3 drugs: 2 NRTIs + NNRTI or PI or II

Question 19

What are the protease inhibitors? MOA? Toxicities?

Answer 19

all end in –navir (lopinavir, atazanavir, darunavir, fosamprenavir, squinavir, ritonavir, indinavir)

-block HIV protease (which cleaves polypeptide into it’s functional parts)–>prevents maturation of new viruses

• Tox: hyperglycemia, GI intolerance (N/V/D), lipodystrophy
  indinavir: nephropathy, hematuria

Question 20

what are the nucleoside reverse transcriptase inhibitors (NRTIs)? MOA? Toxicities?

Answer 20

• tenofovir, emtricitabine, abacavir, lamivudine, zidovudine, didanosine, stavudine
• MOA: nucleoside analogs that competitively inhibit viral reverse transcriptase
• all need to be phosphorylated to become activated except tenofovir
• tox: bone marrow suppression (reverse with G-CSF and Epo), peripheral neuropathy, lactic acidosis (nucleosides), rash (non-nucleosides), anemia (ZDV)

Question 21

What are the non-nucleoside reverse transcriptase inhibitors (NNRTIs)? MOA? Toxicities?

Answer 21

• nevirapine, efavirenz, delavirdine
• MOA: inactivate reverse transcriptase *do not require phosphorylation to be active or compete with nucleotides
• Tox: same as NRTI; bone marrow suppression (reverse with G-CSF and Epo), peripheral neuropathy, lactic acidosis (nucleosides), rash (non-nucleosides), anemia (ZDV)

Question 22

What is the integrase inhibitor? MOA? Toxicities?

Answer 22

• raltegravir
• inhibits HIV genome intergration into host cell chromosome by reversibly inhibiting HIV integrase
• Tox: hypercholesterolemia

Question 23

Interferon alpha can be used to treat what?

Answer 23

chronic HBV or HCV

kaposi’s sarcoma

Question 24

Interferon Beta can be used to treat what?

Answer 24

MS

Question 25

interferon gamma can be used to treat what?

Answer 25

NADPH oxidase deficiency