Herpes Flashcards by Jess Fazekas

all herpes are what kind of virus

DNA

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herpes simplex virus is composed of

herpes 1 and herpes 2

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herpes 1 takes place

over the waist

seen in 80% of the population

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herpes 2 takes place

below the waist

20% infected with this
common genital STD

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how is herpes spread

contaminated secretions

liquid in lesions contain live virus

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herpes 1 is also called

herpes labialis

-oral herpes (cold sores, fever blisters)

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in children herpes 1 can cause

pharnygitis

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where can oral lesions be seen

inside the mouth, on lips

associated with stress, fever

sunlight can cause fever blisters

-can be found in genital area but not STD

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herpes 2 is found where on men and females

female- anywhere genital
male- around the penis

-may be asymptomatic for years

last 10-14 days and can be painful

possibly in the urethra

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can herpes 2 be transmitted when asymptomatic

yes

not curable, treat the symptoms

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neonatal herpes

pass from mother to baby and be infectious/deadly

during birth 60% mortality rate if baby not treated within first 12 hours

C section suggested

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herpes encephalitis

follows herpe 1 infection

takes place in the brain
-leaves people disabled

normal glucose levels
protein normal to slightly increased
-lymphs increased

to diagnose need brain tissue

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ocular herpes

latent

may infect cornea and cause destruction of it

lead to partial or complete blindness

herpes 1

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gold standard for diagnosis of herpes

looking for CPE on viral cultures

-no calcium alginate swabs will kill virus

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can you look for antibody for herpes

not that useful because so many people have herpes 1

-IgM is better

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antibodies for herpes 1 and 2 will

cross react= give positive

diagnosis via lesions and symptoms

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varicella zoster

chickenpox – kids

infections are worse the older you get and can lead to complications

infectious until all lesions are healed

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chicken pox transmission

highly contagious

direct contact with person
respiratory droplets
open lesions

not associated with congenital infections

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to see if someone had chicken pox vaccine

antibody titers

IgG are good

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latent chickenpox can turn into

shingles

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shingles can be activated by

stress
immunocompromising disease

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shingles affects

nerve ganglia and outbreak be anywhere

follows a nerve -can lose feeling

starts as hives, lesions with fluid and become black
(infectious until all gone)

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shingles on the face called

Bell’s palsy

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prevention of shingles

vaccine for shingles recommended for people over 50

-once you have had shingles you should not get the vaccine for 3-6 months once gone

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if you are near someone who has not have chickenpox or shingles you can transmit to them and give them

chicken pox

herpes 8

more seen in AIDs patients blister red outbreak in HIV + people turn into black and blue

kaposi sarcoma

tumor of the blood -viral rarely seen in healthy people

#1 route of transmission for kaposi sarcoma

sexual contact

how is kaposi sarcoma detected

PCR no treatment

by the time you are a teenager you have antibodies to

EBV

EBV is called mono because

atypical lymphs used to be called monocytes

how is EBV transmitted

-oral secretions -blood transfusions -mother to baby

what cancers EBV associated

-Burkitt's Lymphoma -Hodgkin's Lymphoma -Nasopharyngeal cancer -gastric cancer

EBV does not cause

hepatitis -but associated with inflammation of the liver

Reye's syndrome

inflammation of liver (children taking aspirin during a viral infection)

what is increased with liver involvement (analyte)

ammonia liver involvement= also spleen involvement (enlarged)

treatment for mono

supportive treatment -most prominent population is young adults

B cells are infected through what marker

CD21

how long are people infectious with mono

6 weeks

testing for EBV- screen

heterophile antibodies

what is heterophile antibodies

antibody like substance that is known to cross react with antigens that were not part of inducement -different species -agglutinates cow RBC -mono not the only one like this (also lupus)

infectious mono antibodies are

NOT absorbed out/ neutralized by guinea pig antigen -other heterophile antibodies are

screen procedure for mono

1) mix serum with guinea pig antigen -will neutralize out other heterophile antibodies leaving infectious mono 2)infectious mono antibodies can agglutinate sheep RBCs now mix with sheep RBC and if agglutinates= mono now if mix patient serum with bovine RBC membrane antigen will only react with infectious mono antibodies

does negative screen rule out mono

no -children under 3 rarely produce heterophile antibodies -70% of adult population will produce them -now test for antibodies specific for mono

antibodies we can also test for EBV

viral capsid antigen early antigen EBV nuclear antigen

viral capsid antigen

most common of antigens that we test for antibody production -best to test for IgM -IgG rises slightly after

if only doing IgG have to look for

4 fold rise in titer between acute and convalescent

early antigen

rises a little after viral capsid and wan 4-5 months -Appears during late acute or early convalescence stage

EBV nuclear antigen

heighten 5-6 months after primary infection and only last 2-3 months -indicates recent past infection

know mono chart

notes

EBV and transplants

causes illness in transplants -if put on immunosuppresents and EBV can be a risk factor for these cancers

CMV

cytomegalovirus -causes illness like mono -can be misdiagnosed as EBV

why CMV called that

causes enlargement of cells it infects

organs CMV involves

involves the spleen more than EBV -some liver involvement -high rate through transplanted organs

how is CMV transmitted

same as mono can in body fluids -semen, breast milk

does CMV produce heterophile antibodies

CMV one of the most common

congenital infections -if you are born with CMV -leading cause of children are born deaf -associated with heart and liver anomalies

when doctors suspect CMV what profile is done

torch

TORCH stands for

toxoplasmosis, other (IgM titers), rubella, CMV, herpes 2

when giving infant's RBC's need pedi pak to be

CMV - blood (iridate), Leuko reduced

do adults have antibody titers to CMV

yes -CMV antibodies will cross react with EBV antibodies -test IgM because doesn't cross react as much as IgG

when testing infant for CMV

test the urine for presence of the antigen

CMV forms what when infects a cell

inclusion -CPE -formed in B cells (dumbbells) -transplanted tissues also check for CMV

testing for CMV

DNA testing - PCR