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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
diagnosis of EBV
1. symptoms 2. CBC: hyperplasia, atypical lymphocytes 3. heterophile antibody (transient) 4. EBV Ag-specific antibody
26
HHV6
roseola aka 6th disease (exanthem subitum) | HHV7: less common cause of roseola
27
HHV8
Kaposi sarcoma
28
NO antivirals for which virus
EBV
29
what fraction of US population is infected w HSV1/2?
1/4 quarter, 25%
30
what enzyme is required for HSV viral DNA replication?
thymidine kinase
31
HSV keratitis
inflammation of the cornea only infects SINGLE eye
32
live-attenuated vaccines c/i for
immunocompromised pts, taking immunosuppressive meds (steroids, prednisone), hematologic malignancies (leukemia, lymphoma), preg
33
if there's zoster/shingles on the tip of the nose, where else is it also going to go to?
eyes
34
Zostavax
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
CMV retinitis (cotton wool spots)
blurred vision (esp in HIV pts)
36
HA and NA undergo mutation
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
what is the leading cause of vaccine preventable death in US
influenza
38
what host specificity do humans have to influenza A virus
(a 2,6) sialic acid linkage in URT
39
Hemagglutinin
binds sialic acid on cell surfaces and induces endocytosis
40
Neuraminadase
cleaves sialic acid on virions way out of host cell; also disrupts mucin barrier to expose sialic acid Igs to NA are protective
41
PB1-F2 (influenza)
``` 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
influenza antiviral ASAP for any pt w/ confirmed or suspected influenza
hospitalized severe, complicated, progressive illness high risk for influenza complication (immunocompromised, COPD, diabetes, preg)
43
s/s acute hepatitis
jaundice, abdominal pain, dark urine, itching fever (typical virus infection) liver enzyme in the blood
44
Hepatitis viruses are cytolytic or not
not cytolytic
45
HBV Replication
cccDNA VIRAL DNA polymerase & VIRAL reverse transcriptase (like HIV)
46
HepD
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
____ is the sole (+) marker of infection during WINDOW period (HBV)
IgM anti-HBc
48
Hep E
Fecal-oral transmission | esp DEADLY in PREGNANCY
49
HCV
~50% extrahepatic manifestations cryoglobulinemia (abnormal high protein in blood - immune complexes): Raynaud, glomerulonephritis
50
factors associated w/ progression of chronic HCV (~20% of all HCV infection)
age, alcohol HIV, HBV male > F
51
what is EQUAL to amount of HCV disease?
[HCV mRNA] need to test twice several weeks apart
52
Entecavir
HBV antiviral nucleotide analogue that is phosphorylated by CELLULAR enzyme to inhibit viral DNA poly doesn't work if Lamivudine resistant HBV
53
Tenofovir
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
Simeprevir
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
Sofosbuvir
HCV antiviral NS 5B polymerase inhibitor
56
HIV is carried/latent within with immune cells?
Mac and DCs
57
HIV: decreases which immunities
humoral AND CMI | CD4s -> B cells for Ig produciton
58
people who are deficient in ____ receptor are resistant to HIV infection
CCR5 (chemokine receptors on macs)
59
how does HIV evade Ig detection?
antigenic drift of the gp120 | heavy glycosylation of gp120
60
drugs that need intracellular phosphorylation
Acyclovir (3) | NRTIs (3)
61
SARS coronavirus
zoonotic agent resp. & GI tract attach to host using Spike (s) protein
62
Paramyxo viral entry & fusion of cell membrane using what protien what's hallmark of Parmyxo
F(usion) protein syncytia formation: giant-multi nucleated cell
63
what's seen in histology of affected neurons (Rabies, Rhabdo)
Negri bodies
64
which antigen on (progenitor endothelial, placental cells, fetal liver/heart) does ParvoB19 binds to?
P antigen
65
biphasic disease (erythemia infectiosum and arthropathy of parvob19)
``` initial phase (viremia): flu-like, lytic - viral shedding later phase (immune response): immune complex -> rash, arthralgia, arthritis - non-infectious ```
66
Rubella
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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