Major DNA Viruses

Question 1

Describe the characteristics of Parvovirus: B19.

Answer 1

ss
linear DNA
naked
icosahedral

Question 2

How is parvovirus transmitted?

Answer 2

respiratory

oral secretions

Question 3

What is the pathogenesis of parvovirus B19?

Answer 3

infects mitotically active erythroid precursor cells in bone marrow

2-phase disease

1. lytic: viremia, flu-like symptoms, viral shedding
2. non-infectious immune response

Question 4

What are the clinical manifestations of parvo?

Answer 4

“slap cheek”
erythematous
lacy reticular maculopapular rash

Question 5

What are complications of parvovirus B19?

Answer 5

intrauterine infection may lead to hydrops fetalis

Question 6

Describe the characteristics of Adenovirus.

Answer 6

ds
non-enveloped
linear
DNA

Question 7

How are adenoviruses transmitted?

Answer 7

*Respiratory
- inhalation of respiratory droplets
- across eye by direct contact
GI
-fecal-oral route

Question 8

What is the pathogenesis of adenoviruses?

Answer 8

• infect mucoepithelium in tissues

- infect adenoids, tonsils, respiratory epithelium, Peyer’s patches, intestinal epitheia

Question 9

Which Ig is involved to resolve adenovirus?

Answer 9

IgG

Question 10

Adenovirus proteins interfere with immune defenses by blocking ?

Answer 10

IFN

T-cells

Question 11

Adenovirus has what oncogenes?

Answer 11

promote cell growth
EIA &raquo_space; inactivates pRB (retinoblastoma)
E1B» inactivates p53

Question 12

What are the clinical syndromes of Adenovirus infection?

Answer 12

Acute Febrile Pharyngitis 
Pharyngoconjunctival fever
Acute respiratory disease
Other: laryngitis, croup, brionchiolitis
Epidemic karatoconjunctivitis "shipyard eye"
cervititis, urethritis
Acute gastroenteritis (infants)

Question 13

What are the characteristics of papillomaviridae (HPV)?

Answer 13

ds
non-enveloped
circular
small

Question 14

What is the incubation period for papillomaviridae (HPV)?

Answer 14

2 weeks to 1+ years

Question 15

What are common diseases of papillomaviridae (HPV)?

Answer 15

plantar warts
anogenital warts (HPV 6/11)
Cervical cancer (HPV16/18)

Question 16

What layer of the skin does papillomaviridae (HPV) develop?

Answer 16

basal cells of the dermal layer via L1 VAP/integrins

Question 17

What are epithelial spikes referred to as?

Answer 17

papillomatosis

Question 18

In what layer are prickle cells present? prickle layer?

Answer 18

stratum spinosum

stratum granulosum

Question 19

In papillomaviridae (HPV), E6 binds to ___________ and activates ___________ and suppresses ____________.

Answer 19

p53
activates telomerase
suppresses apoptosis

Question 20

in papillomaviridae (HPV) E7 binds to ___.

Answer 20

p105RB

Question 21

What laboratory tests would you use to diagnose papillomaviridae (HPV)?

Answer 21

Cytology: Koilocytotic cells
In situ DNA probe analysis
PCR

Question 22

What is the treatment of papillomaviridae (HPV)?

Answer 22

removal

• cryotherapy, electrocautery
• interferon, imiquimod or stripping with duct tape

Question 23

What vaccinations are available for papillomaviridae (HPV)?

Answer 23

Gardasil (tetravalent HPV6,11,16,18)
Cervarix (divalent HPV16,18)
9-26 years of age
3 doses (initial, 2 mos, 6 mos)

Question 24

What are the characteristics of herpesvirus (HSV, VZV)?

Answer 24

ds
enveloped
linear
large

Question 25

How is herpesvirus (HSV, VZV) transmitted?

Answer 25

requires inoculation of virus-containing body fluids | sites: oral, ocular, genital, mucosa, respiratory tract, blood stream

Question 26

What are the clinical presentations of HSV-1?

Answer 26

lesions on oropharynx cold sores fever blisters

Question 27

What are the clinical presentation of HSV-2?

Answer 27

lesions on genitalia | can be spread without genital lesions

Question 28

Where do herpesvirus (HSV, VZV) go latent?

Answer 28

nerve ganglia

Question 29

How are HSV 1/2 transmitted?

Answer 29

close contact | STD

Question 30

How is VZV transmitted?

Answer 30

respiratory | close contact

Question 31

What are primary manifestation of HSV-1?

Answer 31

gingiovostomatitis - children(fever, malaise, lesions) pharyngitis or tonsillitis - adults

Question 32

What are secondary/recurrent manifestations of HSV-1?

Answer 32

cold sore keratoconjunctivitis (eye) Herpetic Gladiatorium Herpatic Whitlow (fingers)

Question 33

What are 3 separate phases of HSV?

Answer 33

establishment maintenance reactivation

Question 34

What triggers can reactivate HSV?

Answer 34

``` stress UV light infection menstruation decreased immunity ```

Question 35

How is recurrence suppressed for HSV?

Answer 35

strong cellular immune response

Question 36

HSV-1 can be responsible for (encephalitis/meningitis)?

Answer 36

encephalitis

Question 37

What are some HSV complications?

Answer 37

perinatal transmission encephalitis meningitis (if immune suppressed - pneumonia, mucocutaneous lesions)

Question 38

How would you diagnose HSV 1/2?

Answer 38

clinical appearance | PCR of CSF for HSV encephalitis

Question 39

Why is HSV difficult to prevent?

Answer 39

many people shed asymptomatically

Question 40

What is the treatment for HSV?

Answer 40

valacyclovir acyclovir famciclovir

Question 41

In what form is VZV reactivated?

Answer 41

shingles

Question 42

What can trigger VZV reactivation?

Answer 42

old age decreased immunity local injury

Question 43

How would shingles present?

Answer 43

acute pain redness of dermatome rash post-herpatic neuralgia (PHN) can be prolonged

Question 44

How would you diagnose VZV?

Answer 44

``` clinical presentation 3 types of lesions simultaneously - maculopapular - vesicular - scabs ```

Question 45

What treatments are available for VZV?

Answer 45

chicken pox - symptomatic Zoster rash - acyclovir Zoster PHN - tricycle antidepressant

Question 46

What are the characteristics of poxviridae?

Answer 46

ds DNA linear complex symmetry cytoplasmic replication

Question 47

How is poxviridae transmitted?

Answer 47

respiratory droplets | fomites

Question 48

How does poxviridae present?

Answer 48

basophilic inclusion bodies

Question 49

What treatments are available for poxviridae?

Answer 49

freezing electric cautery chemical agents

Question 50

What are the characteristics of Hepadnaviridae (HBV)?

Answer 50

ds (partially) enveloped circular DNA

Question 51

How is Hepadnaviridae (HBV) transmitted?

Answer 51

``` ***minute amount can transmit*** blood bodily fluids perinatal (during birth or through milk) (once it enters bloodstream it travels to the liver to infect hepatocytes) ```

Question 52

Describe replication of Hepadnaviridae (HBV)?

Answer 52

DNA virus but includes RNA intermediate | encodes reverse transcriptase (RNAd-DNA pol)

Question 53

What are the clinical manifestations of Hepadnaviridae (HBV)?

Answer 53

hepatitis excretion of bile pigments -bilirubin accumulation (Jaundice)

Question 54

During which phase of chronic HBV would treatment be an option?

Answer 54

immune active | not indicated during immune tolerant or inactive phase

Question 55

What are the treatment options for Hepadnaviridae (HBV)?

Answer 55

Active vaccine (0,1,6 mos) ``` Post: supportive HBV immunoglobin (HBIG) IFNa Lamivudine ```

Question 56

How would you diagnose Hepadnaviridae (HBV)?

Answer 56

liver function test (ALT>AST) Jaundice (30%) RUG discomfort Antibody detection