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Human Herpesviruses- Exam IV Flashcards

1
Q

Describe the genome and structure of human herpesviruses:

A

double-stranded DNA genome; enveloped

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2
Q

How big is the genome of human herpesviruses?

A

125,000-236,000 base pairs

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3
Q

Herpesviridae family members share four significant biological properties including:

A
  1. encode a large array of enzymes
  2. synthesis of viral DNAs and capsid assembly occur in the nucleus, while final processing of virions occur in the cytoplasm
  3. production of virus results in destruction of the infected cell
  4. able to exist in a latent state in their natural hosts while retaining the capacity to replicate and reactivate
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4
Q

Herpesviridae family members encode a large array of enzymes involved in:

A
  1. nucleic acid metabolism (thymidine kinase)
  2. DNA synthesis (DNA polymerase)
  3. protein processing (protein kinases)
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5
Q

The nucleic acid metabolism enzymes produced by herpesviridae family members include:

A

thymidine kinase

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6
Q

Human herpes viruses can broadly be categorized as:

A
  1. alpha herpesviruses
  2. beta herpesviruses
  3. gamma herpesviruses
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7
Q

Alpha herpesviruses include:

A
  1. HSV-1 (HHV-1)
  2. HSV-2 (HHV-2)
  3. VZV (HHV-3)
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8
Q

herpes virus responsible for fever blisters:

A

HSV-1 (alpha)

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9
Q

herpes virus responsible sexually transmitted genital lesions:

A

HSV-2 (alpha)

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10
Q

herpes virus responsible chicken pox and shingles:

A

VZV (alpha)

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11
Q

herpes virus responsible for roseola:

A

HHV-6 and HHV-7 (beta)

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12
Q

List the beta human herpesviruses:

A
  1. cytomegalovirus (CMV)
  2. HHV-6
  3. HHV-7
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13
Q

List the gamma herpesviruses:

A
  1. epstein-barr virus (EBV) (HHV-4)
  2. kaposi’s sarcoma (HHV-8)
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14
Q

herpes virus responsible for infectious mononucleosis:

A

Epstein-Barr Virus (EBV)

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15
Q

Transmission of HSV-1 and HSV-2 occur through:

A

direct contact

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16
Q

Transmission of VZV occurs through:

A

inhalation & direct contact

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17
Q

Transmission of CMV and EBV occur through:

A

saliva & blood

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18
Q

The portal of entry for HSV-1 and HSV-2 is:

A

mucous membranes & skin

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19
Q

The portal of entry for VZV is:

A

respiratory tract and mucous membranes

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20
Q

The portal of entry for CMV & EBV is:

A

blood stream and mucous membranes

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21
Q

Herpes viruses are fragile, susceptible to heat & detergent & drying due to:

A

envelope

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22
Q

To become infected with a herpes virus, it generally requires:

A

direct inoculation

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23
Q

____ is more susceptible to herpes virus infection than ___.

A

mucous membranes; skin

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24
Q

CMV and EBV can be transmitted through:

A

infected leukocytes

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25
Q

VZV is mostly transmitted through:

A

aerosols

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26
Q

Similarly to the adenovirus, gene expression of herpes viruses occurs through:

A

a cascade

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27
Q

What happens upon release of herpes viruses:

A

attach to and infect adjacent cells

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28
Q

What involves in a local spread of herpes virus?

A

budding directly onto and into adjacent cells

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29
Q

Budding onto and into adjacent cells results in the local spread of herpes virus as well as:

A

syncytia formation (characteristic of herpesvirus)

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30
Q

Herpes viruses replicate and assemble in the:

A

cell nucleus

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31
Q

Because the herpes virus replicates and assembles in the nucleus, this causes some very severe changes in nuclear structures including:

A
  1. chromatin shifted to margins of nucleus
  2. Cowdry type A acidophilic intranuclear inclusion bodies
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32
Q

Under a microscope, stained cells infected with herpes virus show formation of:

A

syncytia

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33
Q

Multi-nucleated cells seen when viewing stained herpes virus:

A

Tzanck cells

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34
Q

Scraping from the base of a herpes lesion=

A

Tzanck smear

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35
Q

In addition to the Tzanck cells seen under a microscope, what else can be seen?

A

intranuclear inclusion bodies (darkly staining nuclear region)

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36
Q

Anti-herpesvirus antibodies play ___ in recovery from primary disease and on recurrent disease

BUT anti-herpesvirus antibodies can help prevent ____.

A

minor role; primary disease

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37
Q

What plays the major role in recovery in response to alpha-herpesvirus infections?

A

cell-mediated immune mechanisms

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38
Q

In the immune response to an alpha-herpes infection, MHC class I and II proteins displaying viral antigens on surface of infected cell activate:

A

T-lymphocytes

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39
Q

The T-lymphocytes activated by MHC class I and II proteins displaying viral antigens on surface of infected cell ultimately function to:

A
  1. directly all the infection cell
  2. secrete cytokines and chemokine to attract macrophages
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40
Q

The cell-mediated response to alpha-herpes viruses varies:

A

with age

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41
Q

Who is at most risk for problems associated with HSV infections? Who is most at risk for problems associated with VZV infections

A

neonates; elderly

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42
Q

HSV-1, HSV-2, and VZV evade the host immune response through:

A

envelope glycoproteins bind Fc domain of antibodies and complement components

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43
Q

HSV-1, HSV-2, and VZV evade the host immune response through envelope glycoproteins bind Fc domain of antibodies and complement components:

A

blocking their ability to promote an antiviral response

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44
Q

In order to evade the immune response, HSV proteins reduce ___ production and its downstream signaling pathway.

A

Type I interferon production

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45
Q

In order to evade the immune response, HSV proteins can prevent ____ from being expressed on the surface of infected cells

A

MHC Class I and II proteins

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46
Q

Results in no expression of viral proteins and therefore no peptides for MHC proteins to display:

A

Latency

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47
Q

facial or genital herpes, stomatitis, or keratitis, localized can all be described as:

A

acute disease of herpes simplex

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48
Q

How does the herpes virus gain entry into the host?

A

exposure of skin, mucosa, or cornea to secretions containing virus

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49
Q

What happens once herpes virus gains entry into host?

A

replication of virus in epithelial cells

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50
Q

The replication of herpes virus in epithelial cells causes:

A

vescular mucocutaneous lesions, stomatitis, or keratitis

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51
Q

What occurs after the replication of herpes virus in epithelial cells causing lesions?

A

spread to peripheral sensory or autonomic nerve endings and ganglia

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52
Q
  • Herpes virus that is acquired very early in life
  • 2/3 of adults are Ab positive
A

HSV-1

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53
Q
  • Herpes virus mostly transmitted by genital contact
  • Uncommon before adolescence
  • 1/5 of adults are Ab positive
A

HSV-2

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54
Q

Most HSV-1 and HSV-2 infections :

A

asymptomatic

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55
Q

around ___ HSV infections have recognizable symptoms

A

1/3

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56
Q

Following the acute disease of herpes virus, what is the next phase?

57
Q

Describe the recovery phase of herpes virus:

A

Healing of lesions and establishment of latent infections in neurons

58
Q

Following the recovery phase of herpes virus, what is the next phase?

59
Q

Describe the latency phase of herpes virus:

A

Maintenance of latent infections of neurons

60
Q

Usual course of herpes simplex virus infection and disease includes:

A
  1. acute disease
  2. recovery
  3. latency
  4. recurrent disease
61
Q

Reactivation of latent herpes simplex virus and distal spread:

A

recurrent disease

62
Q

Recurrent phase of herpes disease can be characterized by:

A

cold sores, fever blisters, keratitis, or genital lesions localized

63
Q

Recurrent herpes lesions are caused by:

A

virus replication in epithelial cells

64
Q

Reactivation of various herpes viruses can be induced by:

A
  1. local trauma
  2. mental tension (stress)
  3. fatigue
  4. menstruation
  5. exposure to bright light
  6. aging effects
65
Q

Infections associated with HSV include:

A
  1. ocular herpes
  2. oral herpes
  3. genital herpes
66
Q

Describe the predominant virus type, frequency, age group, usual outcome and recurrence for ocular herpes:

A

HSV-1
Common
All
Resolution, visual impairment
Yes

67
Q

Describe the predominant virus type, frequency, age group, usual outcome and recurrence oral herpes:

A

HSV-1 (sometimes HSV-2)
Very common
All
Resolution
Yes

68
Q

Describe the predominant virus type, frequency, age group, usual outcome and recurrence genital herpes:

A

HSV-2 (sometimes HSV-1)
Common
Adolescents & Adults
Resoluation
Yes

69
Q

Condition caused by herpes simplex virus that can lead to scarring/ blindness:

A

Herpes Keratitis - Eye

70
Q

Most common viral infection of the mouth:

A

Herpetic stomatitis

71
Q

Herpetic stomatitis is caused by:

A

primary infection by HSV-1 or HSV-2

72
Q

Herpetic stomatitis is characterized by:

A

vesicles on oral mucosa, tongue, or gingivae

73
Q

Herpetic stomatitis can often be confused with:

A

acute necrotizing ulcerative gingivitis (ANUG) when gingival is inflamed

74
Q

Herpes labials (cold sore) is a result of:

A

reactivation of latent HSV-1 or HSV-2

75
Q

Herpetic dermatitis and herpetic whitlow is a result of HSV-1 and HSV-2 infections that appears on the:

A

skin and fingers

76
Q

Varicella-zoster virus (VZV) (HHV-3) is the cause of:

A

chicken pox and shingles

77
Q

Transmission of VZV can be:

A

Aerosol (inhalation) and direct contact

78
Q

____ % of adults have VZV antibody (from time before vaccination)

79
Q

Local VZV replication occurs in the:

A

respiratory tract

80
Q

For VZV infections, local replication replication occurs in the respiratory tract and the virus then progresses to:

A

phagocytic cells via the bloodstream and lymphatic system

81
Q

Following VZV progressing to phagocytic cells via the bloodstream and lymphatic system, ___ occurs and spreads the virus throughout the body

A

secondary viremia

82
Q

Secondary viremia following VZV infection, spreads the virus throughout the body including the:

83
Q

When does secondary viremia following VZV infection occur?

A

11-13 days post infection

84
Q

Where do the skin lesions appear from secondary viremia during VZV infection?

A

entire body

85
Q

Compare the spread of VZV to the spread of HSV:

A

systemic spread for VZV (unlike herpes simplex virus)

86
Q

Similarly to HSV, once the VZV is replicating in cells, it will spread:

A

cell-to-cell

87
Q

VZV will spread cell-to-cell except for:

A

epithelial cells of lung keratinocytes and skin lesions, which can release virus

88
Q

VZVs replication is similar to HSVs but:

89
Q

The smaller genome of HHVs:

A

VZV (~125,000 base pairs)

90
Q

Where does the latent infection of VZV establish itself?

A

neurons, dorsal root ganglia, cranial nerve ganglia

91
Q

VZV is often reactivated in older adults, why?

A

impaired cell-mediated immunity

92
Q

When VZV is reactivated in older adults, the virus is released along:

A

entire neural pathway to infect the skin

93
Q

Because VZV reactivation in older adults releases the virus along the entire neural pathway, this clinically presents as:

A

vesicular rash along the entire dermatome

94
Q

VZV reactivation creates a vesicular rash along the entire dermatome =

A

herpes zoster or shingles

95
Q

Post-herpetic neuralgia occurs in 30% of older patients and causes:

A

pain for months to years after zoster

96
Q

Why is the entire dermatome affected by VZV reactivation?

A

because the dermatome is an area of skin innervated by fibers from a single dorsal root spinal nerve

97
Q

What promotes recovery from primary VZV disease?

A

Host defenses

98
Q

Anti-VZV antibodies play a ____ role in recovery from primary disease and on recurrent disease.

However, anti-VZV antibodies can help:

A

minor role; prevent primary disease

99
Q

Is there a VZV vaccine? Is it effective?

100
Q

Anti-VZV antibodies limit:

A

viremic spread of virus

101
Q

What plays the major role in recovery as for VZVs & HSVs?

A

Cell-mediated immune mechanisms

102
Q

Childhood infection of VZV =

A

chicken pox

103
Q

Primary infection of VZV in adults is ____ and can cause ____ in 30% of adults and can be fatal

A

more severe; interstitial pneumonia

104
Q

Epstein-Barr VIrus (EBV; HHV-4) infects:

A

B lymphocytes and epithelial cells

105
Q

Cytomegalovirus (CMV; HHV-5) infects:

A

a wide variety of cells

106
Q

EBV and CMV replication within host cells is very similar to the replication of:

107
Q

Establishment of CMV results in:

A

persistent/chronic infection (not a true latent infection)

108
Q

Establishment of EBV results in:

A

latent infection

109
Q

The establishment of a latent infection by EBC occurs in:

A

memory B cells

110
Q

The EBV viral proteins produced during latency promote:

A

B-cell proliferation

111
Q

CBV and EBV infections are very:

112
Q

What percent of adults in the developing world are infected with CMV or EBV? What percent of adults in the United States are infected with CMV or EBV?

A

95%; 50-60%

113
Q

When EBV and CMV are acquired early:

A

usually asymptomatic

114
Q

EBV and CMV are acquired similarly. what is the difference?

A

Breast milk is NOT an important route of virus spread in EBV

115
Q

When EBV is acquired after childhood, it results in:

A

infectious mononucleosis (infectious)

116
Q

Most common viral infection of the fetus in humans:

A

congenital CMV

117
Q

Congenital CMV leads to ___ and ___ including ___ and ___

A

severe disease; permanent neurological damage; hearing loss; learning disabilities

118
Q

Persistant CMV and EBV infections are associated with:

A

chronic inflammatory diseases and cancer

119
Q

Persistent EBV is specifically associated with:

A
  1. Hodgkin disease
  2. African Burkitt lymphoma
  3. Nasopharyngeal carcinoma
120
Q

CMV have very characteristic cell changes including:

A

large inclusions in tissue specimens (Owl eye inclusions)

121
Q

What test is used to determine EBV infection?

A

Heterophile antibody or monospot test (PCR test)

122
Q

EBV infection induces production of large numbers of antibodies that recognize ___ of others species called ____.

A

RBC antigens; heterophiles antibodies

123
Q

Agglutination of horse RBCs by heterophiles antibody in patients serum:

A

Monospot test

124
Q

The syndromes associated with cytomegalovirus include:

A

congenital infection & mononucleosis

125
Q

The syndrome associated with Epstein-barr virus include:

A

mononucleosis

126
Q

The syndrome associated with herpesvirus type 6 include:

127
Q

The syndrome associated herpesvirus type 7 include:

128
Q

The syndrome associated with Kaposi’s sarcoma associated virus (HHV8) include:

A

Kaposi’s sarcoma

129
Q

The oral manifestation of ____ includes lesions that may be found n both before skin rash develops:

130
Q

VZV reactivation is associated with:

131
Q

What is affected in 15% of shingles cases?

A

trigeminal nerve

132
Q

What types of lesions are often involved in shingles (list them in order of occurrence)

A

ophthalmic –> maxillary –> mandibular

133
Q

With ____, oral pain often precedes rash and mimics toothache pain

134
Q

The most common intramural sites affected by shingles include:

A
  1. anterior half of tongue
  2. soft palate
  3. cheek
135
Q

The cause of infectious mononucleosis:

136
Q
  • Painful sore throat at onset of infection
  • Rash may be present at junction of hard and soft palates (fine petechial hemorrhages)
  • White pseudomembrane may develop on tonsils and other parts of oral mucosa
A

infectious mononucleosis

137
Q

Describe Kaposi’s Sarcoma associated virus oral manifestation:

A

Kaposi’s sarcoma lesions (endothelial tumor)

138
Q

What viruses are present in majority of advanced periodontal lesions:

139
Q

Possible roles for herpesviruses in periodontal disease:

  1. Viruses may cause DIRECT ___
  2. Gingival viruses may promote ___
  3. CMV and EBV can infect ___, ___, & ___, in lesions and impair cell function
  4. Viruses induce a pro inflammatory response that can result in ____
  5. Viruses can suppress host defenses ___ & ____
A
  1. cytopathic effects
  2. bacterial attachment/colonization
  3. monocytes, macrophages, & lymphocytes
  4. tissue destruction
  5. locally & systemically

microbiology (24 decks)

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