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DD/BL Final > Herpesviridae > Flashcards

Herpesviridae Flashcards

1
Q

Transmission of HSV-1/HSV-2?

A
  1. Direct contact
  2. Sexually transmitted (HSV-2)
  3. Sensory nerve –> sensory nerve ganglia –> sensory nerve –> skin lesions
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2
Q

Alpha-subfamily?

A
  1. HSV1/HSV2
  2. Varicella-zoster (VZV)
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3
Q

Beta-subfamily?

A
  1. CMV
  2. HHV (6 & 7)
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4
Q

Gamma-subfamily?

A
  1. EBV
  2. KSHV
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5
Q

Alpha-subfamily latency location?

A

Sensory nerve ganglia

  1. HSV1 (cold sore) : trigeminal ganglion
  2. HSV2 (genital herpes) : sacral ganglion
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6
Q

Beta-subfamily latency location?

A

Monocyte & lymphocyte

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7
Q

Gamma-subfamily latency location?

A

B cells

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8
Q

HSV1/HSV2 clinical?

A
  1. Gingivostomatitis (cold sore)
  2. Herpetic keratitis of eye –> corneal blindness
  3. Encephalitis
  4. Genital herpes
  5. Neonatal herpes
  6. Herpetic whitlow
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9
Q

Which Herpes virus cause Encephalitis?

A
  1. HSV1/2
  2. CMV
  3. VZV
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10
Q

Neonatal herpes?

A

Passage fetus through infected birth canal

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11
Q

TORCHES cross blood-placenta barrier

A

TO-Toxoplasmosis

R-Rubella

C-Cytomegalovirus

HE-Herpes, HIV

S-Syphilis

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12
Q

Treatment HS1/HS2?

A
  1. Acyclovir 2. Valacyclovir 3. Famciclovir 4. Trifluridine eye drops (HSV1) –> corneal infection 5. Condom use (HSV2)
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13
Q

HS1/HS2 Diagnostics?

A
  1. Tzanck prep 2. Viral culture 3. PCR 4. Serology 5. Direct Fluorescent Antibodies
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14
Q

Tzanck prep?

A

Reveals multinucleated giant cells & intranuclear inclusion bodies

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15
Q

Direct Fluorescent Antibodies?

A

Ulcer base scrapings tested with antibodies against HSV. –> Antibodies attach HSV if present & fluoresce

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16
Q

VZV transmission?

A
  1. Highly contagious * Aerosolized respiratory secretion (coughing, sneezing) * Contact ruptured vesicles 2. Zoster: reactivation from sensory ganglion
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17
Q

VZV clinical (incubation, signs & symptoms, course of infection)

A
  1. 10-21 days incubation period
  2. Fever, headache, malaise
  3. Rash: trunk & face –> then entire body (including mucous membrane)
  4. Crops eruption (one forms one scabs over)
  5. Last 7 days
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18
Q

Other complications of immunocompromised pt with VZV?

A

Pneumonia & encephalitis

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19
Q

VZV treatment?

A
  1. Acyclovir (48-72 hours)
  2. Chickenpox vaccine
  3. Zoster immune globulin –> reducing severity high risk individuals (4 days after)
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20
Q

VZV diagnostic

A
  1. Dew drops on rose petal
  2. Tzanck prep –> multinucleated giant cells
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21
Q

Zoster (Shingles) clinical (reactivation VZV infection)

A

Painful eruption vesicles isolated to single dermatome –> Not crossing mid-line –> vesicles dry up and form crust –> painful in elderly

22
Q

Herpes Zoster opthalmicus

A
  1. one-sided forehead
  2. Blindness –> corneal involvment
23
Q

Chicken pox vaccine?

A
  1. Live attenuated 2. Two-dose series, subcutaneously * 12-15 months * 4-6 year age
24
Q

VZV unique in comparison with other herpesvirus?

A
  1. NO asymptomatic viral shedding –> Only shed from shingles lesions
  2. Occurs in waves (crop) –> multiple stages at once
25
Q

Post-herpetic neuralgia

A
  1. Chronic burning, itching, shooting pain –> sensitivity to touch
  2. Elderly
26
Q

Distinguish shingles & herpes?

A
  1. Direct fluorescent antibody
  2. VZV & HSV PCR
  3. Viral culture

* VZV grows slowly vs. HSV grows readily

27
Q

Treatment of Shingles and its complications

A
  1. Shingles: acyclovir (48-72 hours)
  2. Zoster/Shingles vaccine (age > 60): live attenuated vaccine
  3. PHN: ibuprofen and/or corticosteroids –> pain control
28
Q

CMV transmission

A
  1. Infected body fulid:

* Milk, saliva, urine & tears

* Blood & organ transplant

* Mother to child

  1. Prolonged exposure (eg: children in day care)
  2. Sexual tranmission
29
Q

CMV Primary infection Symptoms?

A
  1. Asymptomatic (latent phase)
  2. Congenital disease (TORCHES) –> cross placenta
30
Q

CMV complication in immunocompromised pt?

A

CMV can infect most organs

  1. Pneumonia
  2. Retinitis
  3. Esophagitis
  4. Disseminated disease
31
Q

CMV complication in AIDS vs. transplant pt?

A

Marrow Transplant = CMV pneumonitis

AIDS = CMV retinitis

32
Q

Congenital CMV syndrome

A
  1. Skin rash –> blueberry muffin spots
  2. Hepatomegaly
  3. Jaundice
  4. Chorioretinitis
  5. Mental impair
33
Q

CMV Diagnosis-Serology (IgG & IgM)

A

IgG & IgM

  • /- : never had CMV
  • /+ : primary CMV

+/- : previous infection (dormant)

+/+ : recurrent CMV

34
Q

CMV Diagnosis

A
  1. Serology (IgG & IgM)
  2. Viral culture

* easy to grow BUT several days

  1. PCR
  2. Direct fluorescence test
35
Q

CMV Diagnosis-Tissue Histology

A

Owl eye

* Intranuclear inclusion bodies

* Intracytoplasmic inclusions (smaller, multiple)

36
Q

CMV treatment (immunocompromised pt)

A
  1. Gancyclovir for CMV retinitis and infants
  2. CMV-IG for pregnant women
  3. No vaccine available
37
Q

When should we use Gancyclovir as treatment?

  1. Which disease?
  2. List two targeting populations
A
  1. Gancyclovir for CMV
  2. Patients with retinitis and infants
38
Q

When should we use CMV-IG?

A

To treat pregnant women

39
Q

Why there is currently no protection against CMV?

A

There is no vaccine available

40
Q

Compare viral culture of CMV, HSV and VZV?

A
  1. HSV: readily grow
  2. CMV: will grow but take some time
  3. VZV: take a long time to grow
41
Q

Which herpes virus target mucosal epithelium?

A
  1. HSV 1/2
  2. VZV
42
Q

Which herpes virus target B lymphocyte epithelia? (1)

A
  1. EBV
43
Q

Which herpes virus resides in B-cell during its latency period? (2)

A
  1. EBV
  2. KSHV
44
Q

Which herpes virus transmits through contacts? (5)

A
  1. HSV 1
  2. HSV 2
  3. VZV
  4. CMV
  5. HHV 6
45
Q

Which herpes virus results into central nervous system lymphoma in immunodeficiency pt? (1)

A

EBV

46
Q

How herpes encephalitis occurs? (2)

A
  1. blood-borne (hematogenous) spread
  2. neuronal transmission
47
Q

Which diseases rarely seen in HSV2? (3)

A
  1. Encephalitis
  2. Herpetic Whitlow
  3. Herpes Keratitis
48
Q

Compare & Contrast HSV1 vs. HSV2 clinical manifestations

A
49
Q

List 3 groups of HSV infections that should be treated with IV acyclovir

A
  1. Patients with neonatal herpes
  2. Herpes infection in immunocompromised host
  3. Pts with encephalitis or meningoencephalitis
50
Q

When should oral antiviral suppressive therapy is used to treat HSV Prophylaxis?

A
  1. Pts with frequent painful oral/genital herpes recurrences
  2. Pts with genital herpes: sexually active with uninfected partner
51
Q

For pt suffering genital herpes, who has multiple partners, which treatment is recommended to prevent future complication?

A

Oral antiviral suppressive therapy

52
Q

Which is the most common secondary complication seen in chicken pox?

A

Cellulitis

DD/BL Final (11 decks)

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