HPV Flashcards

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1
Q

Describe HPV ?

A

Ds DNA
Non enveloped icosahedral capsid

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2
Q

HPV target ?

A

Basal keratinocytes

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3
Q

Mention HPV GENES ?

A

1- L1-L2 (late)
2- E1-E7 (early)

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4
Q

What HPV genes are responsible for DNA replication and what are the first to be expressed??

A

E1-7

E1 & E2

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5
Q

What is responsible for cytokeratin disruption (koilocytosis)?

A

E4

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6
Q

What controles transcription and replication of viral DNA ?

A

E1 E2

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7
Q

What allows viral replication over s.basale (amplification) ?

A

E5,6,7

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8
Q

What decreases host immunity response? And through what?

A

E6, E7
Decrease TLR-9 and IL-8

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9
Q

What are the oncoproteins ?

A

E6 E7

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10
Q

What are fxns of E6 and E7 ?

A

E6: ubiquitin mediated p53 destruction
E7: binds to RB= increase of E2F transcription

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11
Q

More superficial epidermis has higher levels of ??

A

L1 L2

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12
Q

In which layer you see the complete virus ??

A

S. Granulosum

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13
Q

Which genus is responsible for EV ??

A

Beta and the other cutaneous conditions by alpha

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14
Q

Treatment of most warts ?

A

Resolve spontaneously in 1-2 years

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15
Q

Types of warts ??

A

5
(Common, palmoplantar, flat, ridged, butchers)

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16
Q

What are the black dots of common warts ?

A

Thrombosed capillaries

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17
Q

What causes 10 nail dystrophy ??

A

HPV -57

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18
Q

What causes common warts ?

A

HPV1,2,4,27,57

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19
Q

What causes palmoplantar warts ?

A

HPV1,2,4,27,57

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20
Q

Myrmecia ??

A

Palmoplantar wart with anthill appearance

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21
Q

Types of palmoplantar warts appearance??

A

Mytmecia
Mosaic

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22
Q

What is mosaic palmplantar wart ??

A

Coalescence of several warts

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23
Q

Histology of palmoantar wart ??

A

Church spires paplillomatosis
Hyperkeratosis, acanthodis with elongated rete ridges, hypergranulosis, koilocytosis and increased dermal vessels.

24
Q

What causes flat warts ??

A

HPV3,10,28,29

25
Q

Histology of flat warts ??

A

Birds eyes ( koilocytosis of granular layer), alternating ortho/parakeratosis, mild papillomatosis, hypergranulosis, acanthosis

26
Q

What causes butchers warts ??

A

HPV 2,7

27
Q

What causes ridged warts ??
And what are its varients ??

A

HPV-60
Pigmented variants in Japanese

28
Q

What causes EV ??

A

HPV 5,8

29
Q

Mode of inheritance in EV ?

A

Autosomal recessive inheritance and acquired in HIV

30
Q

What are the mutations in EV?

A

Ever 1,2 (TMC6,8)

31
Q

What is affected in EV ??

A

Transmembrane proteins in endoplasmic reticulum that interacts with zinc transporter,leading to decrease of intracellular zinc

32
Q

Histology of EV?

A

Flat wart like architecture plus large cells with Peri nuclear halos and blue gray granular cytoplasm.

33
Q

WHIM syndrome?
Mode of inheritance?
Mutation?
Symptoms?

A

AD, cxcr4
Wart+ hypogammaglobulinemia+ infections (bacteria) + myelokathexis (neutropenia)

34
Q

What is myelokathexia ?

A

bone marrow sequestration of mature neutrophils

35
Q

WILD syndrome?
Mode of inheritance?
Mutation?
Symptoms?

A

Sporadic (variant of EV- AR)
Wart, immunodeficiency (CD4 lymphopenia), lymphedema, defect(anogenital)

36
Q

Tt of warts and EV:

A

1- destructive (cryo, electrodissecation, shave/scissors removal)
2- topicals (salicylic acids 17%, codofovir gel, 5-fu)
3- intralesional (mmr, candida, bleomycin)
4- laser (co2, pdl)

37
Q

Types of genital warts ::

A

1- condylomata acuminata
2- condylomata plana (seen with acetic acid)

38
Q

HPV subtypes of genital warts ?

A

6,11,16,18,31,33,45

39
Q

Treatment of genital warts ?

A

1- destructive (cryo, high concentration of TCA, electrosurgery, shave removal )
2- topical (imiquimod, podophyllotoxin, cidofovir gel)
3- intralesional cidofovir
4- laser (co2, PDT)

40
Q

Types of HPV Vaccines?
At which age FDA approved

A

Bivalent (gardasil)
Quadrivalent (cervarix)
9-valent (gardasil)

After 9 years up to 45
It’s killed vaccine

41
Q

HPV vaccine caontains which viral proteins??

A

L1

42
Q

Contraindications of HPV vaccine )

A

Yeast allergy
Pregnancy (but not breastfeeding)

43
Q

What is bowenoid papulosis ??

A

high-grade squamous intraepithelial lesion (HSIL) or SCC in situ

44
Q

Describe bowenoid papulosis ??

A

pigmented genital papules on anogenital area

45
Q

Erythroplasia if queyrat ?

A

Red smooth sharply defined plaque on glabrous penis/vulva
Its either HSIL OR SCC

46
Q

Risk factors of erythrplasia of queryat ?

A

-Lack of circumcision
-Chronic irritation,
-infection: herpes simplex viral infection, bacteria, heat, friction, trauma
-Zoon balanitis
-(HPV) types 8 and 16
-Immunosuppression
-UV light
-Phimosis
-Multiple sexual partners
-Smoking
-Chronic underlying diseases (lichen sclerosis, lichen planus)

47
Q

Buscke lowenstein tumor variants ?
And what HPV subtypes?

A

1- oral florid papillomatosis (akerman tumor) over expression of cyclin B1
2- epithelioma caniculatum
3- papillomatosis cutis carcinoides

6,11

48
Q

Subtypes causing erythroplasia of qyerat ??

A

Premalignant subtypes

49
Q

Describe epithelioma cuniculatum
And what subtypes HPV ??

A

solitary, slow growing, warty, papillomatous plaque.

It usually develops on the foot, oral cavity, nails, or genitals.

2,11,16

50
Q

Histology of buscke lowenstein tumor?

A

Papillomatous acanthotic epidermis with bulbous downward extending rete ridges

51
Q

Tt of buscke lowenstein tumor ??

A

Excision with clear margins

52
Q

Variant of oral wart ??

A

Focal epithelial hyperplasia (hecks disease)

53
Q

Hecks disease HPV subtypes??

A

13,32

54
Q

Recurrent respiratory papillomatosis HPV subtypes??

A

6,11

55
Q

1 benign laryngeal tumor??

A

Recurring respiratory papillomatosis

56
Q

Triad of Recurring respiratory papillomatosis

A

Stridor + hoarseness + respiratory distress