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STEP1 > Herpes Viruses > Flashcards

Herpes Viruses Flashcards

1
Q

What is the structure of the herpes virus?

A

enveloped
dsDNA
linear

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2
Q

What are the herpes viruses?

A 
HHV1/HSV1-Oral herpes
HHV2/HSV2-Genital Herpes
VZV
EBV
CMV
HHV6/7
HHV8-Kaposi's Sarcoma
HHVECHKO
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3
Q

What are some things that can be caused by HSV1? treatment?

A

cold sores
temporal lobe encephalitis
keratoconjunctivitis
gingivostomatitis

acyclovir or valacyclovir

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4
Q

Where does HSV1 lie dormant?

A

sensory neurons, trigeminal ganglion

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5
Q

What does HSV2 cause? treatment?

A

genital and some oral lesions
get multiple painful vesicles
acyclovir or valacyclovir

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6
Q

What is the transmission of HSV2?

A

sexual contact
birth vaginal
or in utero if primary infection

**lies dormant in sacral nerve root ganglion

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7
Q

What does HHV3 cause?

A

VZV
primary: chickenpox-transmitted via resp secretions
secondary shingles. single dermatome, does not cross midline, transmitted via direct contact

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8
Q

What is the treatment for VZV? Where does it lie dormant?

A

lies dormant in sacral nerve root ganglion

treatment: famicyclovir

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9
Q

What’s the deal with EBV?

A

mono
increased risk for lymphomas, nasopharyngeal carcinoma, oral hairy leukoplakia
**infects B cells via CD21

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10
Q

What is the usual presentation of EBV?

A

fever, HSM, pharyngitis (looks like strep, exudative), LAD, esp posterior cervical nodes

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11
Q

What is the important histo feature of EBV?

A

atypical lymphocytes (T cells)–>Downy cells: foamy w/ basophilic cytoplasm

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12
Q

How do you test for Mono?

A

monospot test, checks for heterophils antibodies to RBCs of sheep, horse, beef

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13
Q

If mono is misdiagnosed as strep throat, what could happen?

A

given amoxicillin for strep throat
get maculopapular rash
think allergic to pencillins when NOT

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14
Q

With heterophile - mono, what could it be?

A 
CMV
HIV
Acute toxoplasmosis
viral hepatitis
strep throat
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15
Q

How is CMV passed on?

A

congenitally (TORCH)
sexual contact
saliva, breast milk, urine
transplant

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16
Q

What does CMV do in patients who have received bone marrow transplants?
IN patients with AIDS?

A

bone marrow transplants: life-threatening pneumonia

AIDS: retinitis, GI ulcers, Candida esophagitis (won’t respond to antifungals)

17
Q

What is the histo feature w/ CMV?

A

Owl eye inclusion

18
Q

Where does CMV remain latent?

A

in mononuclear and polymorphonuclear cells

19
Q

What’s the deal with HHV6/7 infections?

A

Produce Roseola (6th disease)
high fevers
then diffuse macular rash
febrile seizures possible

20
Q

What’s the deal with HHV8 infection?

A 
Kaposi's sarcoma
neoplasm of endothelial cells, spindle cells lining lymphatic and vascular vessels
classic: slow growing
HIV type
immunocompromised, transplant patients
dark/violaceous plaques or nodules

**treat w/ HAART, alitretinoin, vinblastine, daunorubicin, doxorubicin

21
Q

Kaposi’s can also affect which things?

A

lungs-hemoptysis

GI tract

22
Q

What is the tzanck smear?

A

multinucleated giant cells: HSV1, HSV2, VZV

23
Q

What are the intranuclear inclusions you see w/ HSV?

A

Intranuclear Eosinophilic Inclusions
Type A Cowdry Bodies
Type 1 Cowdry Inclusions

24
Q

Describe acyclovir and valacyclovir?

A

guanosine analog
it is activated inside HSV/VZV thymidine kinase
inhibits viral DNA pol

25
Q

What does famiciclovir?

A

used for VZV preferentially, also guanosine analog and is activated by thymidine kinase

26
Q

Ganciclovir?

A

guanosine analog
activated by CMV viral kinase
inhibits viral DNA pol

SE: bone marrow suppression and renal toxicity

**Treats CMV infections

27
Q

Foscarnet?

A

doesn’t need to be activated
DNApol inhibitor AND HIV reverse transcriptase inhibitor

**good for resistant bugs

**can cause nephrototoxicity, anemia

STEP1 (54 decks)

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