Herpes viruses

Question 1

What is the most common cause of viral encephalitis?

Answer 1

Herpes simplex 1 (HSV-1)

Question 2

What is the most common complication with shingles from the varicella virus?

Answer 2

Post-herpatic neuralgia

Question 3

What is the “old” method of diagnosis for HSV-2 and VZV?

Answer 3

Tzanck smear

Question 4

What types of cells are found microscopically in HSV-1 and 2?

Answer 4

Multinucleated (syncytial) giant cells

with intranuclear inclusion bodies

Question 5

What is the best mode of diagnosis for HSV-1,2 and VZV?

Answer 5

PCR

Question 6

What is the Ramsay Hunt Syndrome?

Answer 6

(AKA herpes zoster optics)
Infection of the ear (outer, middle and inner)
-can cause ipsilateral facial nerve deficiency

Question 7

What type/name of vaccine is given for VZV?

Answer 7

Live attenuated virus

- Varilrix

Question 8

What’s the other name for shingles?

Answer 8

Herpes zoster

caused by VZV (varicella zoster virus)

Question 9

In which virus do we see the “owl eye” phenomenon?

Answer 9

Cytomegalovirus (CMV)

Question 10

In which cells is CMV latent?

Answer 10

Mononuclear cells

Question 11

What is the most common viral cause of mental retardation?

Answer 11

Congenital CMV

Question 12

Possible signs and symptoms of congenital CMV infection?

Answer 12

• jaundice/hepatosplenomegaly/hepatitis
• microcephaly
• periventricular calcification
• deafness
• mental retardation
• epilepsy
• chorioretinitis
• pneumonia
• thrombocytopenia , hemolytic anemia

Question 13

Diseases caused by CMV in immunocompromised patients?

Answer 13

• pneumonia
• (chorio)retinitis
• encephalitis
• disseminated infection
• colitis
• death

Question 14

How do you diagnose mononucleosis due to the Epstein Barr virus?

Answer 14

• “Mono-spot” test AKA Paul-Bunnel test

Question 15

What is observed in a lab test for mononucleosis from CMV?

Answer 15

• elevated liver enzymes

- monocytosis

Question 16

What are the serological findings for infectious mononucleosis in a heterophiles negative patient?

Answer 16

• -> Heterophile negative indicates it is caused from EBV

- Serology: anti-CMV IgM and IgG

Question 17

What is the therapy for CMV infections?

Answer 17

• orally: valganciclovir
• parenterally: gangiclovir (usually given)
• IF ganciclivor resistant: foscarnet, cidofovir

Question 18

Modes of transmission of CMV?

Answer 18

• congenital transfusion
• sexual contact
• saliva
• urine
• transplant

Question 19

What type of cells are seen in mononucleosis in a heterophiles positive patient?

Answer 19

Heterophile (+) = pt. has EBV

• atypical/Downey cells
• -> these cells are reactive cytotoxic (CD8+) T cells

Question 20

What are the disease caused by epstein barr virus?

Answer 20

1) Infectious mononucleosis
2) Burkitt’s lymphoma (B cell lymphoma)
3) Nasopharyngeal carcinoma
4) Lymphoproliferative disease (transplant pts)
5) Oral hairy leukoplakia

Question 21

What can cause a maculopapular rash in EBV mononucleosis?

Answer 21

Treating the pt. with amoxicillin

Question 22

What test is used for diagnosis of mononucleosis caused by EBV?

Answer 22

“Mono-spot” test: showing heterophile antibodies

–> detected via Ab agglutination of sheep/horse RBCs

Question 23

What does HHV-6 cause? And what are it’s signs/symptoms?

Answer 23

Roseola infantum

• fever first
• “rosie” cheeks later
• -> diffuse macular rash develops

Question 24

How is HSV6 and 7 transmitted?

Answer 24

Via saliva (direct contact)

Question 25

What is Kaposi sarcoma and what causes it?

Answer 25

Neoplasm of endothelial cells.

Caused by human herpesvirus 8 (HHV8)

Question 26

What diseases are caused by kaposi sarcoma associated herpes virus?

Answer 26

1) Kaposi sarcoma
2) Primary effusion lymphoma
3) Multicentric Castleman’s disease

Question 27

What is the site of latency for….

1) HSV-1
2) HSV-2
3) VZV
4) EBV
5) CMV
6) HSV 6, 7,
7) HSV 8 (Kaposi associated)

Answer 27

1) HSV-1 = trigeminal nerve ggl
2) HSV-2 = sacral ggl
3) VZV = dorsal root ggl
4) EBV = B cells (B lymphocytes)
5) CMV = monocytes
6) HSV 6, 7, = monocytes
7) Kaposi associated = B lymphocytes