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Step 1 2019 First Aid Flashcards > Micro FA Virology p162 - 178 > Flashcards

Micro FA Virology p162 - 178 Flashcards

1
Q

What is recombination

A

Exchange of genes between 2 chromosomes by crossing over within regions of significant base sequence homology.

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2
Q

What quality of virus genomes has potential to cause antigenic shift?

A

Viruses with segmented genomes can go through reassortment to create new antigens.

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3
Q

Ex of segmented viruses

A

They include Bunyaviruses (3 segments), Orthomyxoviruses (influenza viruses) (8 segments), Arenaviruses (2 segments), and Reoviruses (10-12 segments).

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4
Q

Hepatitis D virus requires the presence of hepatitis B for what? What is that process called?

A

Hepatitis D virus requires the presence of replicating hepatitis B virus to supply HBsAg, the envelope protein for HDV. Called complementation

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5
Q

Define complementation

A

When 1 of 2 viruses that infect the cell has a mutation that results in a nonfunctional protein, the nonmutated virus “complements” the mutated one by making a functional protein that serves both viruses.

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6
Q

Which DNA virus has ssDNA?

A

Parvo

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7
Q

Which 3 DNA viruses have circular genomes?

A

Papilloma, Polyoma, Hepadna

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8
Q

Which RNA virus is double stranded?

A

Reo

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9
Q

⊕ stranded RNA viruses?

A

I went to a retro (retrovirus) toga (togavirus) party, where I drank flavored (flavivirus) Corona (coronavirus) and ate hippie (hepevirus) California (calicivirus) pickles (picornavirus).

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10
Q

Purified nucleic acids of most ____ viruses and _______ (≈ mRNA) viruses are infectious.

Which virus’ naked dsDNA are not infectious?

A

Purified nucleic acids of most dsDNA viruses (except poxviruses and HBV) and ⊕ strand ssRNA (≈ mRNA) viruses are infectious.

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11
Q

Naked nucleic acids of ⊝ strand ssRNA and dsRNA viruses are not infectious. why?

A

They require polymerases contained in the complete virion.

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12
Q

DNA viruses tend to have what shape? except?

A

icosahedral, except pox

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13
Q

Which DNA virus does not replicate in the nucleus

A

Pox - carries its own DNA-dep RNA polymerase

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14
Q

flesh colored papule with central umbilication - disease? virus?

A

Molluscum contagiousum - Pox virus

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15
Q

Which hepatitis virus has DNA?

A

HBV - Hepadna family

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16
Q

Adenovirus causes?

A

Febrile pharyngitis —sore throat
Acute hemorrhagic cystitis
Pneumonia
Conjunctivitis—“pink eye”
Gastroenteritis
Myocarditis

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17
Q

Which serotypes of HPV assoc with cervical cancer?

A

16,18 (31,35)

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18
Q

Pathomech of warts?

A

hyperkeratosis

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19
Q

Which viruses are DS and circular?

A

Papilloma & Polyoma (JC/BK)

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20
Q

What do JC/BK viruses cause?

A

JC virus—progressive multifocal leukoencephalopathy (PML) in HIV
BK virus—transplant patients, commonly targets kidney
JC: Junky Cerebrum; BK: Bad Kidney

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21
Q

what cell type does Parvovirus infect? consequences?

A

RBC precursors and endothelial cells; RBC destruction in fetus leads to hydrops fetalis and death, in adults leads to pure RBC aplasia and rheumatoid arthritis–like symptoms

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22
Q

Issue with parvovirus and sickle cell?

A

Aplastic crises

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23
Q

B19 causes what in children?

A

Fifth disease/erythema infectiosum - slapped cheek rash, lacy reticular rash on body

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24
Q

How does B19 infect RBC precursors?

A

by binding P antigen on RBCs

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25
Q

Properties of Herpes family of viruses

A

dsDNA, linear, enveloped

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26
Q

Encephalitis of HSV1 is localized to what area?

A

temporal lobe NOTE - Most common cause of sporadic encephalitis, can present as altered mental status, seizures, and/or aphasia.

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27
Q

HSV1 causes?

A

Gingivostomatitis, keratoconjunctivitis , herpes labialis , herpetic whitlow on finger, temporal lobe encephalitis, esophagitis, erythema multiforme.

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28
Q

Where does HSV1 & HSV2 lie latent?

A

HSV1 - trigeminal ganglia HSV2 - sacral ggl

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29
Q

T or F Viral meningitis more common with HSV1 vs HSV2

A

F - HSV2 is the more common viral meningitis

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30
Q

The Vaccine for papilloma virus contains which serotyes

A

capsid proteins from serotypes 6,11,16,18

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31
Q

How does papilloma virus –> cancer?

A

Viral oncoproteins E6 & E7 –> cell cycle dysregulation
E6 - binds to and promotes degradation of p53
E7 - binds and (-) p105Rb (retinoblastoma)

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32
Q

Virulence factors of Adenovirus (not in FA)

A

Penton fibers - a hemagglutinin, cytotoxic
E3 prot - (-) MHC1 expression
E1A prot - makes cells susceptible to TNF

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33
Q

Most common complication of shingles?

A

post-herpetic neuralgia

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34
Q

What does HHV3/VZV cause?

A

Varicella-zoster (chickenpox, shingles), encephalitis, pneumonia

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35
Q

For VZV, _____ branch involvement can cause herpes zoster _________.

A

CN V1 branch involvement can cause herpes zoster ophthalmicus.

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36
Q

Where does VZV lie latent?

A

dorsal root or trigeminal ggl

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37
Q

EBV/HHV4 is connected with which neoplasias?

A

Lymphoma (esp endemic Burkitt lymphoma) and nasopharyngeal carcinoma (Asians)

Nasopharyngeal CA - presents with nasal stuffiness and hearing loss bc blocks Eustachian tube. cytokeratin (+)

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38
Q

A pt diagnosed with EBV - the blood smear shows atypical lymphoctes - what type of cells are these?

A

Atypical lymphocytes on peripheral blood smear G—not infected B cells but reactive cytotoxic T cells. aka Downey cells

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39
Q

What cell does EBV infect? and how?

A

Infects B cells thru CD21 - “Must be 21 to drink Beer in a Barr.”

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40
Q

Sx of Mono

A

—fever, hepatosplenomegaly , pharyngitis, and lymphadenopathy

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41
Q

Which lymph nodes most commonly enlarged in Mono

A

posterior cervical nodes

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42
Q

A pos Dx for Mono involves a Monospot test - how does it work?

A

heterophile antibodies detected by agglutination of sheep or horse RBCs.

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43
Q

What drug, if used with Mono, leads to a maculopapular rash?

A

amoxicillin

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44
Q

EBV is assoc with what in AIDS pts?

A

hairy oral leukoplakia (hyperproliferation of oral epithelium)

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45
Q

1 in utero infection in US?

A

CMV

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46
Q

How does Congenital CMV/HHV5 present?

A

microcephaly,
sensorineural deafness
thrombocytic purpura (blueberry muffin baby - also in Rubella, but that’s not commonly seen in US unless unvaccinated)
periventricular brain calcification hepatosplenomegaly

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47
Q

How does CMV present in immunocompetent vs immunocompromised?

A

(-) Monospot Mono in immunocompetent

infection in immunocompromised -

Esp pneumonia in transplant pt

esophagitis

AIDS retinitis: hemorrhage, cotton wool exudates, vision loss

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48
Q

Where does CMV lie latent?

A

mononuclear cells

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49
Q

Major histo finding of CMV?

A

Owls eye inclusions in infected cells (SIGHT-omegalovirus - also good to remember AIDS retinitis)

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50
Q

What does HHV6 & 7 cause?

A

Roseola infantum (exanthem subitum): high fevers for several days that can cause seizures, followed by diffuse macular rash (starts on trunk then spreads to extremities ROSeoLA: fever first, ROSy (rash) LAter

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51
Q

Is HHV6 or 7 a more common cause of Roseola infantum?

A

HHV6

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52
Q

Dark/violaceous plaques or nodules representing vascular proliferations? What is it? virus and pt pop?

A

HHV8 - Kaposi sarcoma, a neoplasm of endothelial cells Seen in AIDS/transplant pt

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53
Q

HHV8 can also affect which other areas?

A

GI and Lungs

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54
Q

Tx of HHV8

A

IFN alpha

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55
Q

Lung sx caused by HHV8 (not in FA, Uworldq)

A

Primary effusion lymphoma - large malignant lymphocytes in pleura effusion, B cell markers

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56
Q

Another disease caused by HHV8?

A

Multicentric Castleman disease - lymphoproliferative disease

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57
Q

Dx of Herpes encephalitis?

A

CSF PCR for herpes encephalitis.

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58
Q

What is a Tzanck test?

A

—a smear of an opened skin vesicle to detect multinucleated giant cells commonly seen in HSV-1, HSV-2, and VZV infection.

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59
Q

Test of choice for herpetic skin lesions?

A

PCR

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60
Q

What histo characteristic is seen in HSV1,HSV2, and VZV?

A

Intranuclear eosinophilic Cowdry A inclusions

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61
Q

Receptor used by CMV?

A

Integrins - heparan sulfate

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62
Q

Receptor used by EBV?

A

CD21

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63
Q

Receptor used by HIV?

A

CD4, CXCR4, CCR5

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64
Q

Receptor used by Parvovirus B19?

A

P Ag on RBCs

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65
Q

Receptor used by Rabies virus?

A

Nicotinic AchR

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66
Q

Receptor used by Rhinovirus?

A

ICAM-1

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67
Q

Which RNA virus is double stranded?

A

Reo

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68
Q

Which RNA viruses are naked?

A

Picorna, Hepe, Calici, Reo (Picture a Hepe (happy) naked Calici in Reo)

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69
Q

T or F there are no naked helical RNA viruses

A

True! Helical viruses must be enveloped

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70
Q

Which RNA viruses are + sense?

A

Picorna
Hepe
Calici
Flavi
Corona
Retro
Toga

Picture a Positively Hepe Calici drinking a Flavorful Corona at a Retro Toga party!

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71
Q

Diseases caused by Reovirus?

A

COLTIvirus—COLorado TIck fever

Rotavirus—cause of fatal diarrhea in children

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72
Q

Picorna virus family causes?

A

Poliovirus—polio-Salk/Sabin vaccines—IPV/OPV Echovirus—aseptic meningitis
Rhinovirus—“common cold”
Coxsackievirus—aseptic meningitis; herpangina (mouth blisters, fever); hand, foot, and mouth disease; myocarditis; pericarditis
HAV—acute viral hepatitis

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73
Q

1 cause of aseptic meningitis and viral myocarditis?

A

Picorna - Echovirus/Coxsackie

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74
Q

1 viral cause of infection necessitating a heart transplant?

A

Coxsackie (myo/pericariditis)

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75
Q

1 cause of noninflammatory gastroenteritis in US? what family?

A

Norovirus (cruise ships); Calici

76
Q

Viruses and diseases caused by flavi virus family?

A

HCV
Yellow fever
Dengue
St. Louis encephalitis
West Nile virus—meningoencephalitis, flaccid paralysis
Zika virus

77
Q

Diseases caused by Toga virus family?

A

Toga CREW—Chikungunya virusa (co-infection with dengue virus can occur), Rubella, Eastern and Western equine encephalitis

78
Q

What does the capsid look like for HIV virus?

A

complex and conical

79
Q

Where do retroviruses replicate and how?

A

In the nucleus, w/ rev transcriptase

80
Q

What neoplasia is assoc with retroviruses?

A

HTLV - T cell leukemia

81
Q

What is caused by corono viruses?

A

“Common cold”, SARS, MERS

82
Q

Difference between onset of common cold of Rhino v Corona viruses?

A

Rhino - summer/fall

Corona - winter/sprin

83
Q

ss-linear helical 8 segmented RNA, w/ envelope - what family? major virus?

A

Orthomyxovirus; Influenza

84
Q

Which RNA viruses are neg sense?

A

They include Arenaviruses, Bunyaviruses, Paramyxoviruses, Orthomyxoviruses, Filoviruses, and Rhabdoviruses.
Always Bring Polymerase Or Fail Replication.

85
Q

Diseases caused by Paramyxo viruses?

A

PaRaMyxovirus:

Parainfluenza—croup

RSV—bronchiolitis in babies

Measles, Mumps

86
Q

Diseases caused by ss- 3 segmented circular helical capsid virus family?

A

Bunya

California encephalitis
Sandfly/Rift Valley fevers
Crimean-Congo hemorrhagic fever
Hantavirus—hemorrhagic fever, pneumonia

87
Q

Diseases caused by 2 segmented circular helical capsid RNA viruses? family?

A

Arena viridae

LCMV—lymphocytic choriomeningitis virus

Lassa fever encephalitis—spread by rodents

88
Q

Filo virus - what diseases?

A

Ebola/Marburg hemorrhagic fever—often fatal.

89
Q

Which RNA viruses are segmented?

A

All are RNA viruses. They include Bunyaviruses (3 segments), Orthomyxoviruses (influenza viruses) (8 segments), Arenaviruses (2 segments), and Reoviruses (10-12 segments).

ABOR - (2,3,8,10-12)

This Segment is A-BORing!!

90
Q

How do Picorna viruses make viral proteins?

A

RNA is translated into 1 large polypeptide that is cleaved by virus-encoded proteases into functional viral proteins.

91
Q

Which picorna viruses cause meningitis? Which are enteroviruses?

A

All are enteroviruses, that cause aseptic (viral) meningitis (except rhinovirus and HAV).

92
Q

Why is Rhino virus not an enterovirus?

A

Acid labile—destroyed by stomach acid; therefore, does not infect the GI tract

93
Q

Reservoir and vector of Yellow fever? what virus family?

A

A flavivirus transmitted by Aedes mosquitoes. Virus has a monkey or human reservoir

94
Q

Sx of yellow fever?

A

high fever, black vomitus, and jaundice.

95
Q

eosinophilic apoptotic globules seen on liver biopsy? - what are they? what disease

A

Councilman bodies

Seen in yellow fever, most famously. but also in other viral hemorrhagic fever/acute viral hepatitis

96
Q

segmented dsRNA virus?

A

Reovirus

97
Q

Major cause of acute diarrhea in children, esp in winter

A

Rota virus

98
Q

The villous destruction and atrophy in GI by rota virus leads to?

A

dec absorption of Na+ and loss of K+

99
Q

Virulence factors of influenza viruses? how do they work?

A

Contain hemagglutinin (binds sialic acid and promotes viral entry) and neuraminidase (promotes progeny virion release) antigens.

100
Q

Patients with influenza are at risk for what infections

A

Patients at risk for fatal bacterial superinfection, most commonly S aureus, S pneumoniae, and H influenzae.

101
Q

Explain genetic shift vs drift

A

Genetic shift
Causes pandemics. Reassortment of viral genome segments, such as when segments of human flu A virus reassort with swine flu A virus.

Genetic/antigenic drift
Causes epidemics. Minor (antigenic drift) changes based on random mutation in hemagglutinin or neuraminidase genes.

102
Q

Explain two types of influenza vaccine

A

Killed viral vaccine is most frequently used.

Live attenuated vaccine contains temperaturesensitive mutant that replicates in the nose but not in the lung; administered intranasally.

103
Q

Sx of Rubella - what virus family?

A

Toga;

Fever, postauricular and other lymphadenopathy, arthralgias, and fine, maculopapular rash that starts on face and spreads centrifugally to involve trunk and extremities

104
Q

Congenital Rubella looks like what?

A

Congenital rubella findings include “blueberry muffin” appearance due to dermal extramedullary hematopoiesis.

105
Q

parainfluenza (croup), mumps, measles, RSV are all from what family? what do they all cause?

A

Paramyxoviridae;

all cause resp tract infections (bronchiolitis, pneumonia) in children/infants

106
Q

Virulence factor of Paramyxovirus - what does it cause? Name a drug that targets it?

A

All contain surface F (fusion) protein, which causes respiratory epithelial cells to fuse and form multinucleated cells.

Palivizumab (monoclonal antibody against F protein) prevents pneumonia caused by RSV infection in premature infants. Palivizumab for Paramyxovirus (RSV) Prophylaxis in Preemies.

107
Q

Acute laryngotracheobronchitis is caused by what virus?

A

parainfluenza virus - croup

108
Q

Virulence factors of Parainfluenza virus and fxn?

A

Virus membrane contains hemagglutinin (binds sialic acid and promotes viral entry) and neuraminidase (promotes progeny virion release) antigens

109
Q

Severe croup can lead to what circulatory issue? why?

A

Severe croup can result in pulsus paradoxus 2° to upper airway obstruction.

110
Q

Xray finding of croup?

A

Narrowing of upper trachea and subglottis leads to characteristic steeple sign on x-ray

111
Q

Sx of parainfluenza?

A

“seal-like” barking cough and inspiratory stridor.

112
Q

4 Cs of Measles?

A

4 C’s of measles: Cough Coryza Conjunctivitis “C”oplik spots

113
Q

Administration of this vitamin can help reduce mortality from measles

A

Vitamin A; esp in malnourished children

114
Q

Sx of measles

A

Usual presentation involves prodromal fever with cough, coryza, and conjunctivitis, then eventually Koplik spots followed 1–2 days later by a maculopapular rash that starts at the head/neck and spreads downward.

115
Q

Diff in rash in Measles vs Rubella

A

Measles - maculopapular rash B that starts at the head/neck and spreads downwards

Rubella - maculopapular rash that starts on face (day 1) and spreads centrifugally to involve trunk and extremities (day 3)

116
Q

Describe a Koplik spot

A

bright red spots with blue-white center on buccal mucosa

117
Q

Patho signs of Measles

A

Lymphadenitis with Warthin-Finkeldey giant cells (fused lymphocytes) in a background of paracortical hyperplasia.

118
Q

Sequelae of Measles

A

ƒ SSPE (subacute sclerosing panencephalitis, occurring years later)
ƒ Encephalitis (1:2000)
ƒ Giant cell pneumonia (rare except in immunosuppressed)

119
Q

Patho signs of Measles

A

Lymphadenitis with Warthin-Finkeldey giant cells (fused lymphocytes) in a background of paracortical hyperplasia

120
Q

Most common cause of death in childhood measles?

A

Pneumonia

121
Q

Sx of Mumps

A

Parotitis A, Orchitis (inflammation of testes), aseptic Meningitis, and Pancreatitis
Can cause sterility (especially after puberty)

122
Q

What are the cytoplasmic inclusions in Rabies virus called, and what cells do they infect?

A

Negri bodies commonly found in Purkinje cells of cerebellum and in hippocampal neurons.

123
Q

Postexposure prophylaxis of Rabies? What type of immunity is this?

A

Postexposure prophylaxis is wound cleaning plus immunization with killed vaccine and rabies immunoglobulin.
passive-active immunity.

124
Q

How does the rabies virus infect the CNS?

A

Travels to the CNS by migrating in a retrograde fashion (via dynein motors) up nerve axons after binding to ACh receptors.

125
Q

Progression of Rabies disease?

A

Progression of disease: fever, malaise –> agitation, photophobia, hydrophobia, hypersalivation –> paralysis, coma –> death.

126
Q

Common transmission of rabies in US?

A

Infection more commonly from bat, raccoon, and skunk bites than from dog bites in the United States;

Raccoon - Eastern US; Skunk - Western US

aerosol transmission (eg, bat caves) also possible.

127
Q

Ebola virus - what virus family? what cell types does it infect?

A

A filovirus that targets endothelial cells, phagocytes, hepatocytes.

128
Q

Sx of Ebola virus

A

Following an incubation period of up to 21 days, presents with abrupt onset of flu-like symptoms, diarrhea/vomiting, high fever, myalgia. Can progress to DIC, diffuse hemorrhage, shock.

129
Q

Transmission of Rabies

A

Transmission requires direct contact with bodily fluids, fomites (including dead bodies), infected bats or primates (apes/monkeys);

130
Q

Zika virus - what virus family? transmitted by?

A

A flavivirus most commonly transmitted by Aedes mosquito bites

131
Q

If transmitted in utero - consequences of Zika?

A

Can lead to congenital microcephaly or miscarriage if transmitted in utero.

132
Q

Sx of Zika virus?

A

conjunctivitis, low-grade pyrexia, and itchy rash in 20% of cases.

133
Q

Sx same for all hepatitis viruses?

A

episodes of fever, jaundice, Inc ALT and AST.

134
Q

Which hepatitis viruses are naked ?

A

HAV, HEV

Naked viruses are usually stronger, and can last through gastric acid

135
Q

Which Hepatitis virus has DNA ?

A

HBV

136
Q

How does HBV reproduce?

A

HBV DNA polymerase has DNA- and RNA-dependent activities. Upon entry into nucleus, the polymerase completes the partial dsDNA. Host RNA polymerase transcribes mRNA from viral DNA to make viral proteins. The DNA polymerase then reverse transcribes viral RNA to DNA, which is the genome of the progeny virus.

137
Q

What leads to the antigenic variation of HCV?

A

HCV lacks 3′-5′ exonuclease activity –> no proofreading ability –> antigenic variation of HCV envelope proteins

138
Q

Which Hepatitis viruses are ss+ linear RNA with an icosahedral capsid? Which one is not naked?

A

HAV, HEV, HCV - HCV has an envelope

139
Q

Which Hepatitis virus is ss- circular?

A

HDV

140
Q

Which two hepatitis viruses can lead to carcinoma?

A

HBV HCV

141
Q

Liver biopsy in HAV shows?

A

Hepatocyte swelling, monocyte infiltration, Councilman bodies

142
Q

Liver biopsy in HBV shows?

A

Granular eosinophilic “ground glass” appearance; cytotoxic T cells mediate damage

143
Q

Liver biopsy in HCV shows?

A

Lymphoid aggregates with focal areas of macrovesicular steatosis

144
Q

Which two hepatitis viruses can result in a carrier state?

A

HBV, HCV

145
Q

Hematological/Vascular issues assoc of HBV vs HVC

A

HBV - assoc w/ PAN

HCV - Essential mixed cryoglobulinemia, Inc risk B-cell NHL, ITP, autoimmune hemolytic anemia

146
Q

Which types of glomerulonephritis are common with HBV vs HCV?

A

Membranous > membranoprolif with HBV

Membranoproliferative >membranous with HCV

147
Q

Which Hepatitis induced GN is seen with subepithelial deposits and which with subendothelial deposits? Which has GBM thickening vs GBM splitting?

A

Membranous nephropathy (HBV>HCV) – spike and dome subepithelial deposits, GBM thick

Membranoproliferative (HCV>HBV) – subendothelial deposits with granular IF, GBM split

148
Q

Vascular manifestations of HBV vs HCV?

A

HBV - PAN

HCV - Leukocytoclastic vasculitis

149
Q

Which Hepatitis virus has derm manifestations?

A

HCV - porphyria cutanea tarda, lichen planus

HBV - serum sickness like rash

150
Q

Endocrine risks with HCV

A

Inc risk of DB, Autoimmune hypothyroidism

151
Q
A
152
Q
A
153
Q

Is HIV diploid or haploid? RNA or DNA?

A

a diploid RNA virus

154
Q

Best test to detect acute Hep A infection

A

IgM vs Hep A

155
Q

What protects against HAV reinfection?

A

IgG vs HAV

156
Q

List the 3 Ag of HBV and what they indicate

A

HBsAg - surface Ag, indicates active infection

HBcAg - core HBV Ag

HBeAg - secreted by infected hepatocyte into circulation. indicates active viral replication, high tramissibility

157
Q

Sign of actue/recent HBV infection

A

Igm vs HBcAg

158
Q

What is the only marker of HBV infection in the window period?

A

IgM vs HBcAg

159
Q

What does Anti-HBe indicate?

A

low transmissibility

160
Q

What, on its own, indicates vaccination of HBV

A

Anti-HBs with no other markers

161
Q

A pt who has recovered from HBV has what markers?

A

Anti-HBs IgG and Anti-HBe IgG

162
Q

Which HBV Antibody rises first?

A

Anti-HBc

163
Q

What does the HBV window mean?

A

The time between the dec in HBsAg and the appearence of Anti-HBs

164
Q

Where are HIV envelope proteins acquired from?

A

from budding off host cell plasma membrane

165
Q

Where are gp120 and gp41 of HIV derived from?

A

Formed from cleavage of gp160 to form envelope glycoproteins

166
Q

Which HIV protein mediates attachment to host CD4 T cell?

A

gp120

167
Q

Which HIV protein enables viral fusion and entry?

A

gp41

168
Q

What gene codes for HIV capsid and matrix proteins? what are those proteins

A

gag gene; capsid prot = p24

matrix prot = p17

169
Q

What does HIV pol gene code for?

A

pol—Reverse transcriptase, Integrase, Protease; RIP “Pol” (Paul)

170
Q

How does HIV integrate its genes into the host genome?

A

Reverse transcriptase synthesizes dsDNA from genomic RNA; dsDNA integrates into host genome.

171
Q

What does HIV bind to on T cells? What’s the co-receptor?

A

CD4 and CXCR4 on T cells

172
Q

Where/When does HIV bind to CCR5?

A

It binds to CCR5 on macrophages in early infection

173
Q

What could lead to HIV immunity or slower course of infection?

A

Homozygous CCR5 mutation = immunity. Heterozygous CCR5 mutation = slower course.

174
Q

What do we use to detect HIV in babies?

A

HIV-1/2 Ag/Ab testing is not recommended in babies with suspected HIV due to maternally transferred antibody. Use HIV viral load instead.

175
Q

What test do we use Dx HIV and what are we testing for?

A

Presumptive diagnosis made with HIV-1/2 Ag/ Ab immunoassays. These immunoassays detect viral p24 Ag capsid protein and IgG Abs to HIV-1/2.

176
Q

What do we use to monitor effect of drug therapy in HIV? what does it test for?

A

Viral load; Viral load tests determine the amount of viral RNA in the plasma.

177
Q

What determines someone has AIDS?

A

AIDS diagnosis ≤ 200 CD4+ cells/mm3 (normal: 500–1500 cells/mm3).

HIV ⊕ with AIDS-defining condition (eg, Pneumocystis pneumonia) or CD4+ percentage < 14%.

178
Q
A
179
Q

What is HIV virus doing during latency period

A

replicating in lymph nodes

180
Q

What infections do we watch out for when CD4 count drops below <500? How do they present?

A
181
Q

AIDS diseases w/ CD <200

A
182
Q

AIDS disease assoc w/ CD# <100 - fungi/parasites. How does it present?

A
183
Q

AIDS diseases CD# < 100 - bact/viruses; Presentation

A
184
Q

Prion diseases caused by?

A

Prion diseases are caused by the conversion of a normal (predominantly α-helical) protein termed prion protein (PrPc) to a β-pleated form (PrPsc), which is transmissible via CNS-related tissue (iatrogenic CJD) or food contaminated by BSE-infected animal products (variant CJD)

185
Q

Accumulation of PrPsc results in ?

A

Accumulation of PrPsc results in spongiform encephalopathy and dementia, ataxia, and death.

186
Q

PrPsc resists ______ ________ and facilitates the conversion of still more PrPc to PrPsc. Resistant to standard sterilizing procedures, including standard ___________.

A

PrPsc resists protease degradation and facilitates the conversion of still more PrPc to PrPsc. Resistant to standard sterilizing procedures, including standard autoclaving.

187
Q
A

Step 1 2019 First Aid Flashcards (63 decks)

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