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ID1 Flashcards

1
Q

heterophile (+) mono

  1. what type of herpes virus?
  2. what type of antibody?
A
  1. EBV

2. IgM, agglutinates animal cells

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2
Q

heterophile (-) mono

A

CMV

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3
Q

chicken pox: mono or polymorphic lesions?

A

polymorphic

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4
Q

How many people in the US are infected w/ HSV?

A

1 out of 4 US population

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5
Q

naked capsid is environmentally stable to the following

A

acid, detergent, drying, proteases, tempt

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6
Q

what’s a DNA virus that doesn’t reside/replicate in the nucleus? doesn’t have to interact w/ host transcription machinery

A

pox virus (in the cytoplasm)

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7
Q

DNApolymerase requires what to replicate the viral genome

A

primer

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8
Q

RNA viruses replicate in the cytoplasm. which two viruses don’t?

A

retrovirus, influenzae virus

replicated in the nucleus

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9
Q

RNA viruses w/ what type of genome don’t have to carry RNA-dependent RNA poly?

A

(+)RNA genome

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10
Q

which DNA virus assembles in the nucleus (not in the cytoplasm)

A

herpes

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11
Q

how does Herpes virus mature?

A

by budding through the INNER LAMELLA of the nuclear membrane

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12
Q

in which main sensory ganglion cell are the HSV-1 latent in?

A

trigeminal ganglion

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13
Q

what is seen under the microscope of HSV1/2/3 lesion?

what smear?

A

Tzanck smear
multi-nucleated giant cells
Cowdry type A inclusion bodies

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14
Q

what kind of lesions (monomorphic vs polymorphic) do chicken pox show?

A

polymorphic lesions

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15
Q

where does VZV establish latency?

A

neurons: dorsal root, cranial nerve ganglia

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16
Q

x% of people who live to 85yo will develop shingles

A

50%

w/o vaccine

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17
Q

____ is the most prevalent viral cause of BIRTH DEFECTS

A

CMV

most serious during 1st trim
only during PRIMARY infection -> abortion or cytomegalic inclusion disease
serology tells u primary or not

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18
Q

CMV&HHV6 vs EBV(HHV4)

heterophile (antibody) +/- mononucleosis

A

EBV: + (only in adults, not in infants/children)
- IgM agglutinate RBCs, but not guinea pig’s; result back in 2 wks
- transient antibody
CMV&HHV6: (-)

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19
Q

Atypical lymphocytes

A

in infectious mononucleosis (EBV)

large cells w/ lobulated nuclei

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20
Q

CMV: what kind of inclusion body?

A

“owl’s eye”

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21
Q

presence of ________ is diagnostic of congenital CMV infection

A

fetal IgM

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22
Q

EBV: attack rate of college roommates w/ EBV are of no greater risk than the general population

A

.

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23
Q

EBV -> causes these diseases

A

mono, Burkitt lymphoma (non-hogkin: immortalized B cells), Hodgkin lymphoma, nasopharyngeal carcinoma

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24
Q

Triad of s/s (EBV)

A

lymphadenopathy
splenomegaly
exudative pharyngitis

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25
Q

diagnosis of EBV

A
  1. symptoms
  2. CBC: hyperplasia, atypical lymphocytes
  3. heterophile antibody (transient)
  4. EBV Ag-specific antibody
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26
Q

HHV6

A

roseola aka 6th disease (exanthem subitum)

HHV7: less common cause of roseola

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27
Q

HHV8

A

Kaposi sarcoma

28
Q

NO antivirals for which virus

A

EBV

29
Q

what fraction of US population is infected w HSV1/2?

A

1/4 quarter, 25%

30
Q

what enzyme is required for HSV viral DNA replication?

A

thymidine kinase

31
Q

HSV keratitis

A

inflammation of the cornea

only infects SINGLE eye

32
Q

live-attenuated vaccines c/i for

A

immunocompromised pts, taking immunosuppressive meds (steroids, prednisone), hematologic malignancies (leukemia, lymphoma), preg

33
Q

if there’s zoster/shingles on the tip of the nose, where else is it also going to go to?

A

eyes

34
Q

Zostavax

A

zoster vaccine (live)

reduce incidence of zoster
younger, more effective
even if get zoster, LESS severe post-herpetic neuralgia (which isn’t prevented in antivirals)

> 60yo

35
Q

CMV retinitis (cotton wool spots)

A

blurred vision (esp in HIV pts)

36
Q

HA and NA undergo mutation

A

drift (minor mutation)-> seasonal influenza:
minor ANTIGENIC change

shift (major reassortment) -> pandemic influenza
genetic change -> NEW viruses to which the population has no immunity and thus herald a pandemic

37
Q

what is the leading cause of vaccine preventable death in US

A

influenza

38
Q

what host specificity do humans have to influenza A virus

A

(a 2,6) sialic acid linkage in URT

39
Q

Hemagglutinin

A

binds sialic acid on cell surfaces and induces endocytosis

40
Q

Neuraminadase

A

cleaves sialic acid on virions way out of host cell; also disrupts mucin barrier to expose sialic acid

Igs to NA are protective

41
Q

PB1-F2 (influenza)

A 
polymerase component 
funtional alternate translation product 
produced when reading frame changes 
in pathogenic virus (1997 avian H5N1) that has increased virulence 
kills alveolar macrophages
42
Q

influenza antiviral ASAP for any pt w/ confirmed or suspected influenza

A

hospitalized
severe, complicated, progressive illness
high risk for influenza complication (immunocompromised, COPD, diabetes, preg)

43
Q

s/s acute hepatitis

A

jaundice, abdominal pain, dark urine, itching
fever (typical virus infection)

liver enzyme in the blood

44
Q

Hepatitis viruses are cytolytic or not

A

not cytolytic

45
Q

HBV Replication

A

cccDNA

VIRAL DNA polymerase & VIRAL reverse transcriptase (like HIV)

46
Q

HepD

A

D for dependent virus
can only exist in the setting of HBV infection
needs HBsAg to form its envelope
contract either 1. simultaneously w HBV (coinfection) or via superinfection w/ previous HBV

superinfection: worse prognosis

makes HBV harder to treat

47
Q

____ is the sole (+) marker of infection during WINDOW period (HBV)

A

IgM anti-HBc

48
Q

Hep E

A

Fecal-oral transmission

esp DEADLY in PREGNANCY

49
Q

HCV

A

~50% extrahepatic manifestations

cryoglobulinemia (abnormal high protein in blood - immune complexes): Raynaud, glomerulonephritis

50
Q

factors associated w/ progression of chronic HCV (~20% of all HCV infection)

A

age, alcohol
HIV, HBV
male > F

51
Q

what is EQUAL to amount of HCV disease?

A

[HCV mRNA] need to test twice several weeks apart

52
Q

Entecavir

A

HBV antiviral

nucleotide analogue that is phosphorylated by CELLULAR enzyme to inhibit viral DNA poly

doesn’t work if Lamivudine resistant HBV

53
Q

Tenofovir

A

HBV antiviral

nucleotide developed to tx HIV
s/e: renal toxicity, Fanconi-like syndrome - need to monitor serum creatinine and phosphorus regularly
screen for HIV before use (if not, causes HIV resistance)

works for Lamivudine resistant HBV

54
Q

Simeprevir

A

HCV antiviral

NS3-4A protease inhibitor

TRANSIENT bilirubin increase
rash (and/or photosensitivity reactions)
pruritis (itching)
nausea

metabolized by CYP 3A4 (drug-drug interaction)

quickly become resisnt, low genetic barrier to resistance

55
Q

Sofosbuvir

A

HCV antiviral

NS 5B polymerase inhibitor

56
Q

HIV is carried/latent within with immune cells?

A

Mac and DCs

57
Q

HIV: decreases which immunities

A

humoral AND CMI

CD4s -> B cells for Ig produciton

58
Q

people who are deficient in ____ receptor are resistant to HIV infection

A

CCR5 (chemokine receptors on macs)

59
Q

how does HIV evade Ig detection?

A

antigenic drift of the gp120

heavy glycosylation of gp120

60
Q

drugs that need intracellular phosphorylation

A

Acyclovir (3)

NRTIs (3)

61
Q

SARS coronavirus

A

zoonotic agent

resp. & GI tract
attach to host using Spike (s) protein

62
Q

Paramyxo viral entry & fusion of cell membrane using what protien

what’s hallmark of Parmyxo

A

F(usion) protein

syncytia formation: giant-multi nucleated cell

63
Q

what’s seen in histology of affected neurons (Rabies, Rhabdo)

A

Negri bodies

64
Q

which antigen on (progenitor endothelial, placental cells, fetal liver/heart) does ParvoB19 binds to?

A

P antigen

65
Q

biphasic disease (erythemia infectiosum and arthropathy of parvob19)

A 
initial phase (viremia): flu-like, lytic - viral shedding
later phase (immune response): immune complex -> rash, arthralgia, arthritis 
- non-infectious
66
Q

Rubella

A

acquired s/s: *postauricular lymphadenopathy, rash, arthritis
congenital: PDA (pulmonary artery hypoplasia), cataracts, deafness, “blueberry muffin” baby

don’t give mom vaccine until after baby is born since it’s a live vaccine

Q1 (7 decks)

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