Micro - Virology Part 1 Flashcards
A recent renal transplant recipient has fever, malaise, allograft dysfunction, and cells with “owl’s eye” inclusions. Diagnosis?
CMV infection
What are the two components of the naked icosahedral virus structure?
Nucleocapsid and nucleic acid
What are the four components of an enveloped icosahedral virus structure?
Surface protein, lipid bilayer, capsid, and nucleic acid
What are the four components of the enveloped helical virus structure?
Surface protein; matrix or core protein; lipid bilayer; and nucleic acid and
nucleocapsid protein
Structurally, what are the three main classes of viruses?
Naked icosahedral, enveloped icosahedreal, enveloped helical
In viral genetics, what is recombination?
It is the exchange of genes between two chromosomes by crossing over within
regions of significant base sequence homology
In viral genetics, what is reassortment?
It is the exchange of segments among viruses with segmented genomes (eg,
influenza virus)
Which type of viral genetic event can cause worldwide pandemics?
Reassortment, which happens when viruses with segmented genomes (eg,
influenza virus) exchange segments
In viral genetics, when does complementation occur?
Complementation occurs when one of two viruses that infect the cell has a mutation that results in a nonfunctional protein and the nonmutated virus makes a functional protein that serves both viruses (the nonmutated virus “complements” the mutated one)
In viral genetics, when does phenotype mixing occur?
Phenotype mixing occurs when the genome of virus A is coated with the surface
proteins of virus B and infectivity is determined by the virus B protein coat, but the
progeny is encoded by virus A generic material and will have the virus A coat
Viral genome reassortment occurs in viruses with what type of genomic structure?
Segmented genomes
What is a pseudovirion?
The genetic material of one virus coated by the surface proteins of a different virus
What is the difference between the immunity induced by a live, attenuated virus
and that of killed virus vaccines?
Live, attenuated vaccines induce humoral and cell-mediated immunity whereas
killed vaccines induce only humoral immunity
What is the advantage of killed vaccines over live, attenuated vaccines?
Killed vaccines are more stable, whereas live, attenuated vaccines have reverted to
virulence on very rare occasions
Live vaccines are dangerous to give to which populations?
Immunocompromised patients or their contacts
Name five live, attenuated vaccines.
MMR (measles, mumps, rubella), Sabin polio, varicella zoster virus, yellow fever,
smallpox (remember: “Live! One night only! See small yellow chickens get
vaccinated with Sabins and MMR”)
Name four killed virus vaccines.
Rabies, Influenza, Salk Polio, and hepatitis A virus (remember: RIP Always, and
SalK= Killed)
Name two recombinant vaccines.
Hepatitis B virus and human papilloma virus vaccines
What is the antigen that is present in the hepatitis B virus vaccine?
Recombinant hepatitis B surface antigen
Which human papillomavirus types does the human papillomavirus vaccine protect
against?
Types 6, 11, 16, and 18; the types most likely to cause cervical cancer and genital
warts
What is the only live, attenuated vaccine that can be given to HIV-positive
individuals?
MMR (measles, mumps, rubella)
All DNA viruses contain double-stranded DNA, except for which family?
Parvoviridae, which has single-stranded DNA (remember: part-of-a-virus)
Which three DNA viruses contain nonlinear DNA?
Papilloma, polyoma, and hepadna viruses, which contain circular DNA
All RNA viruses contain single-stranded RNA, except for which family?
Reoviridae (remember: all are single-strand RNA except “repeatovirus” [reovirus]
is double-stranded RNA])
Purified nucleic acids from which viruses are considered infectious?
Most double-stranded DNA viruses and positive-strand single-stranded RNA
viruses
Why are negative-strand single-stranded RNA and double-stranded RNA viruses
not infectious?
They require enzymes found in the complete virion to become infectious
The purified nucleic acids of what two double-stranded DNA viruses are not
considered infectious?
Poxviruses and hepatitis B virus; both require enzymes not found in human cells
for replication
Are most viruses haploid or diploid?
Most are haploid (one copy of genetic material)
What is the only virus that is not haploid?
Retroviruses (2 copies of single-stranded RNA)
With one exception, all DNA viruses replicate in what part of the host cell?
Nucleus
All DNA viruses replicate in the nucleus of the host cell, except for which virus?
Poxvirus
Do most RNA viruses replicate in the cytoplasm or the nucleus of the host cell?
Cytoplasm
Which two RNA viruses replicate in the host cell nucleus?
The influenza virus and retroviruses
What are the seven naked (nonenveloped) viruses?
Calicivirus, Picornavirus, Reovirus, Parvovirus, Adenovirus, Papillomavirus, and Polyomavirus (remember: naked CPR and PAPP smear)
From what structure are most viral envelopes derived?
Plasma membrane
The herpesviruses acquire their envelopes from which component of the host cell?
Nuclear membrane
Name three enveloped DNA viruses.
Herpesviruses, hepatitis B virus, smallpox virus
Herpesviruses are _____ (DNA/RNA) _____ (enveloped/nucleocapsid) viruses.
DNA; enveloped
Hepatitis B is a _____ (DNA/RNA) _____ (enveloped/nucleocapsid) virus.
DNA; enveloped
Smallpox is a _____ (DNA/RNA) _____ (enveloped/nucleocapsid) virus.
DNA; enveloped
Name three DNA nucleocapsid viruses.
Adenovirus, papillomaviruses, parvovirus
Adenovirus is a _____ (DNA/RNA) _____ (enveloped/nucleocapsid) virus.
DNA; nucleocapsid
Papillomavirus is a _____ (DNA/RNA) _____ (enveloped/nucleocapsid) virus.
DNA; nucleocapsid
Parvovirus is a _____ (DNA/RNA) _____ (enveloped/nucleocapsid) virus.
DNA; nucleocapsid
Influenza virus is a _____ (DNA/RNA) _____ (enveloped/nucleocapsid) virus.
RNA; enveloped
Parainfluenza is a _____ (DNA/RNA) _____ (enveloped/nucleocapsid) virus.
RNA; enveloped
Respiratory syncytial virus is a _____ (DNA/RNA) _____
(enveloped/nucleocapsid) virus.
RNA; enveloped
Measles virus is a _____ (DNA/RNA) _____ (enveloped/nucleocapsid) virus.
RNA; enveloped
Mumps virus is a _____ (DNA/RNA) _____ (enveloped/nucleocapsid) virus.
RNA; enveloped
Rubella virus is a _____ (DNA/RNA) _____ (enveloped/nucleocapsid) virus.
RNA; enveloped
Rabies is a _____ (DNA/RNA) _____ (enveloped/nucleocapsid) virus.
RNA; enveloped
Human T-lymphotropic virus is a _____ (DNA/RNA) _____
(enveloped/nucleocapsid) virus.
RNA; enveloped
HIV is a _____ (DNA/RNA) _____ (enveloped/nucleocapsid) virus.
RNA; enveloped
Enteroviruses are _____ (DNA/RNA) _____ (enveloped/nucleocapsid) viruses.
RNA; nucleocapsid
Rhinovirus is a _____ (DNA/RNA) _____ (enveloped/nucleocapsid) virus.
RNA; nucleocapsid
Reovirus (rotavirus) is a _____ (DNA/RNA) _____ (enveloped/nucleocapsid)
virus.
RNA; nucleocapsid
Name the three types of RNA nucleocapsid viruses.
Enteroviruses, rhinovirus, and reovirus (rotavirus)
Name the seven DNA viruses.
Hepadnavirus, Herpesvirus, Adenovirus, Poxvirus, Parvovirus, Papillomavirus, and Polyomavirus (remember the mnemonic: HHAPPPPy viruses)
All DNA viruses are linear except what three DNA viruses?
Hepadnavirus (circular, incomplete) and papillomavirus/polyomavirus (circular,
supercoiled)
All DNA viruses are icosahedral except which one?
Poxvirus; it is complex
Which DNA virus does not replicate in the nucleus?
Poxvirus; it has a DNA-dependent RNA polymerase and can replicate without nuclear enzymes
In general, DNA viruses are _____ (single/double) stranded, _____
(linear/circular), icosahedral, and replicate in the _____ (nucleus/cytoplasm).
Double stranded; linear; nucleus
Name seven medically important herpesviruses.
Herpes simplex virus type 1, herpes simplex virus type 2, varicella zoster virus,
Epstein-Barr virus, cytomegalovirus, human herpesvirus type 6, and human
herpesvirus type 8 (human herpesvirus 7 is not clinically significant)
Which herpesvirus most often causes oral lesions as well as keratoconjunctivitis?
Herpes simplex virus type 1
Which herpesvirus most often causes genital lesions in humans?
Herpes simplex virus type 2
Chickenpox, zoster, and shingles are caused by what DNA virus?
Varicella zoster virus
Which types of patients are particularly vulnerable to significant cytomegalovirus infection?
Immunosuppressed patients (especially transplant recipients) and the fetuses of infected mothers
Which childhood illness is caused by human herpesvirus type 6?
Roseola (exanthem subitum)
Which DNA virus is associated with Kaposi sarcoma?
Human herpesvirus type 8 (Kaposi’s sarcoma-associated herpesvirus)
To what viral family does hepatitis B virus belong?
Hepadnavirus
Which enzyme does hepatitis B virus have in common with retrovirus?
Reverse transcriptase
Adenovirus is most commonly responsible for what three conditions?
Febrile pharyngitis (sore throat), pneumonia, and conjunctivitis
What is the smallest DNA virus?
Parvovirus
What skin exanthem does parvovirus B19 cause in children?
Erythema infectiosum (“slapped-cheek” rash)
Parvovirus B19 causes what condition in patients with sickle cell disease?
Aplastic crisis
What severe complication is seen in the fetuses of pregnant women who are
exposed to parvovirus B19?
Hydrops fetalis (due to red blood cell destruction)
What two DNA virus families were originally categorized together as
papovavirus?
Papillomavirus and polyomavirus
What type of disease does papillomavirus cause?
Genital warts, cervical intraepithelial neoplasia, and cervical cancer
JC virus is the causative agent of what condition in HIV-positive patients?
Progressive multifocal leukoencephalopathy
Which viral family is responsible for smallpox, cowpox, and molluscum
contagiosum?
Poxvirus
What is the largest DNA virus?
Poxvirus
Which disease caused by a poxvirus has been eradicated but could possibly be used
in germ warfare?
Smallpox
Vaccinia virus causes what condition?
Cowpox (“milkmaids blisters”)
Which is the only hepatitis-causing virus that is a DNA virus?
Hepatitis B virus
Name six medically important herpesviruses.
Cytomegalovirus, Herpes simplex virus types 1 and 2, Human herpesvirus type
8, Epstein-Barr virus, Varicella zoster virus (remember: get herpes in
a CHEVrolet)
Which herpesvirus causes gingivostomatitis, keratoconjunctivitis, temporal lobe
encephalitis, and herpes labialis?
Herpes simplex virus type 1
Herpes encephalitis usually affects which lobe of the brain?
The temporal lobe
Herpes genitalis and neonatal herpes are most commonly caused by what herpes virus?
Herpes simplex virus type 2
Shingles, encephalitis and pneumonia can be caused by which herpesvirus?
Varicella zoster virus
Epstein-Barr virus causes what conditions?
Infectious mononucleosis, Burkitts lymphoma and nasopharyngeal carcinoma
Cytomegalovirus causes what conditions?
Congenital infection, mononucleosis, and pneumonia
What is the most likely etiology for a mononucleosis-like presentation that is
monospot test negative?
Cytomegalovirus
Human herpesvirus type 8 can cause what disease in HIV-positive patients?
Kaposi sarcoma
What is the primary route of transmission of herpes simplex virus type 1?
Respiratory secretions and saliva
How is herpes simplex virus type 2 primarily transmitted?
Via sexual contact and perinatally
How is varicella zoster virus transmitted?
Respiratory secretions
What are the modes of cytomegalovirus transmission?
Congenital, transfusion, sexual contact, saliva, urine, and organ transplantation
Human herpesvirus type 8 is primarily transmitted via what route?
Sexual contact
What histologic finding is characteristic of cells infected with cytomegalovirus?
“Owls eye” intranuclear inclusions
How is Epstein-Barr virus transmitted?
Respiratory secretions and saliva
Where does varicella zoster virus remain dormant in the body after primary
infection?
In the dorsal root and trigeminal ganglia
Describe the clinical presentation of human herpesvirus type 6 infection.
Roseola: high fevers followed by a diffuse macular rash; human herpesvirus type 6
is one of the most common causes of febrile seizures in children
What is the Tzanck test?
A test to detect multinucleated giant cells in opened skin vesicles of herpes simplex
virus type 1 and 2 and varicella zoster virus
HSV-infected cells contain inclusion bodies known as what?
Cowdry A intranuclear inclusions
Which herpesvirus is the most common cause of mononucleosis?
Epstein-Barr virus
Epstein-Barr virus causes mononucleosis by infecting which cells?
B cells
A college student presents to the emergency department with fever,
hepatosplenomegaly, pharyngitis and lymphadenopathy (especially posterior
cervical nodes). Which viral infection should be suspected?
Epstein-Barr virus can cause mononucleosis, also known as the “kissing disease”
because its peak incidence is 15-20 years old (peak “kissing years”); transmission
is through saliva
What laboratory test can be used to diagnose mononucleosis?
Monospot test: heterophil antibodies detected by agglutination of sheep red blood cells
A complete blood count of a patient with infectious mononucleosis would show
what abnormalities?
Atypical lymphocytes (circulating cytotoxic T cells)
Epstein-Barr virus is associated with the development of which three types of
malignancy?
Hodgkins and endemic Burkitts lymphoma and nasopharyngeal carcinoma
What vaccines exist against poliovirus?
Salk (inactivated polio vaccine) and Sabin (oral polio vaccine)
Which two picornaviruses commonly cause aseptic meningitis?
Echovirus and coxsackievirus
Which two RNA viruses cause the common cold?
Rhinovirus and coronavirus
Aseptic meningitis; myocarditis; herpangina; and hand, foot, and mouth disease are
caused by which picornavirus?
Coxsackieviruses
Name a medically important calicivirus.
Norwalk virus
Norwalk virus causes what condition?
Viral gastroenteritis
Rotavirus belongs to which viral family?
Reoviruses
Reovirus causes what condition?
Colorado tick fever
The structure of the genome of reovirus is unique among RNA viruses in what
respect?
It has double-stranded RNA with 10-12 strands, whereas all other RNA viruses are
single stranded
Flaviviruses are responsible for what five diseases?
Hepatitis C virus, yellow fever, dengue, St. Louis encephalitis, and West Nile virus
Togaviruses cause what three diseases?
Rubella (German measles), Eastern equine encephalitis, and Western equine
encephalitis
Name two RNA viruses that have reverse transcriptase.
HIV (a retrovirus), and human T-lymphotropic virus
Human T-lymphotropic virus causes what disease?
T-lymphocyte leukemia
Coronaviruses are the causative agents of what two diseases?
The common cold and severe acute respiratory syndrome (SARS)
Which medically important RNA virus belongs to the orthomyxovirus family?
Influenza
Name four medically important paramyxoviruses.
Parainfluenza, Respiratory syncytial virus, Measles (rubeola), and Mumps;
remember: PaRaMyxoviruses
What disease does parainfluenza virus cause?
Croup
What disease does respiratory syncytial virus cause in babies?
Bronchiolitis
Rabies virus is what type of virus?
Rhabdovirus
Filoviruses are the causative agents of what two diseases?
Ebola hemorrhagic fever and Marburg hemorrhagic fever; both are frequently fatal
Arenaviruses are the causative agents of what two diseases?
Lymphocytic choriomeningitis and Lassa fever encephalitis
Bunyaviruses are the causative agents of what four diseases?
California encephalitis, Sandfly/Rift Valley fevers, Crimean-Congo hemorrhagic
fever and hantavirus
Hepatitis D virus belongs to which viral family?
Deltavirus
The viruses that cause viral hepatitis A-E in humans belong to which families?
Picornavirus (hepatitis A), hepadnavirus (hepatitis B), flavivirus (hepatitis C),
deltavirus (hepatitis D), hepevirus (hepatitis E)
Name six viral families that are single-strand, positive-sense, linear RNA viruses
with icosahedral capsids.
Picornavirus, hepevirus, calicivirus, flavivirus, togavirus, and retrovirus
Name the viral family that is made up of double-stranded RNA viruses with a
double icosahedral capsid.
Reovirus
All negative-sense RNA viruses have what type of capsid?
Helical
Which clinically significant virus has a segmented linear RNA?
Influenza (an orthomyxovirus)
What are the three viral families with circular RNA?
Arenaviruses, bunyaviruses, and deltavirus
What is the only positive-sense RNA virus with a helical capsid?
Coronavirus
True or False? All helical viruses are enveloped.
True
Which diseases are caused by arboviruses?
Yellow fever, dengue, St. Louis encephalitis, West Nile virus, Eastern equine
encephalitis and Western equine encephalitis, California encephalitis, Crimean-
Congo hemorrhagic fever
Name the four families of RNA viruses that have no envelope.
Reoviruses, picornaviruses, hepevirus and caliciviruses
What must a negative-stranded DNA virus do to replicate within a human cell?
Transcribe its negative strand to a positive strand; it does this by carrying an RNA-
dependent RNA polymerase
Name the six negative-stranded virus families.
Arenaviruses, Bunyaviruses, Paramyxoviruses, Orthomyxoviruses, Filoviruses, and Rhabdoviruses (remember: Always Bring Polymerase Or Fail Replication)
All segmented viruses are ____ (RNA/DNA) viruses.
RNA
Name four segmented RNA viruses.
Bunyaviruses, Orthomyxoviruses (influenza), Arenaviruses, and Reoviruses
(remember: BOAR)
How many segments of RNA make up the influenza virus genome?
Eight
The reassortment of influenza virus RNA segments results in antigenic _____
(shift/drift) and is a cause of _____ (pandemics/epidemics).
Shift; pandemics
What five RNA viruses are picornaviruses?
Poliovirus, Echovirus, Rhinovirus, Coxsackievirus, and Hepatitis A virus
(remember: PERCH on a “peak” = Pico)
Picornaviruses (except rhinovirus and hepatitis A virus) can cause what condition
in humans?
Aseptic meningitis
Picornaviruses are (small/large) _____, (RNA/DNA) _____ viruses.
Small, RNA (remember: PicoRNAvirus = RNA virus)
What type of virus is rhinovirus?
A nonenveloped RNA virus that belongs to the picornavirus family
Why are humans susceptible to multiple recurrent infections with rhinovirus
causing cold-like symptoms?
Because there are more than 100 serologic types of rhinovirus
Yellow fever is caused by a virus that belongs to what viral family?
Flavivirus, which is an arbovirus (flavi = yellow)
How is yellow fever transmitted?
By Aedes mosquitoes
A 30-year-old man presents to the emergency room with a high fever, black
vomitus, and a yellow discoloration to his skin. What is the most likely etiology?
Yellow fever
What histologic finding on liver biopsy is seen in patients with yellow fever?
Councilman bodies (acidophilic inclusion bodies)
Globally, what is the most important cause of infantile gastroenteritis?
Rotavirus
During what season is rotavirus the major cause of acute diarrhea in the United
States?
Winter, although a new vaccine is significantly reducing cases of rotavirus
What is the pathophysiology of the diarrhea caused by rotavirus?
Atrophy and destruction of intestinal villi lead to decreased absorption of sodium
and water; remember: ROTA = Right Out The Anus
In what settings are rotavirus diarrhea commonly seen?
Daycare centers and kindergartens
Influenza virus is _____ (enveloped/nonenveloped), with _____-_____ (single-
stranded/double-stranded), _____ (segmented/nonsegmented) RNA.
Enveloped; single-stranded; segmented
Name the two major antigens of the influenza virus.
Hemagglutinin and neuraminidase
If influenza results in fatal illness, which complication is usually responsible?
Pneumonia caused by bacterial superinfection
What is the major mode of protection against influenza virus?
Killed virus vaccine; the vaccine is reformulated each year
What are the functions of hemagglutinin and neuraminidase?
Hemagglutinin promotes viral entry and neuraminidase promotes the release of
viral progeny
The recombination of human flu A virus with swine flu A virus is an example of
what?
Genetic shift, the reassortment of viral genome, which can cause worldwide
pandemics
Random mutations leading to minor genetic changes in the human flu A virus is an
example of what?
Genetic drift (antigenic drift)
Genetic shift causes (epidemics/pandemics) _____ while genetic drift causes
(epidemics/pandemics) _____.
Pandemics, epidemics; remember: Sudden Shift is more deadly than graDual Drift
An unvaccinated 4-year-old boy presents with fever, lymphadenopathy, arthralgias
and a fine truncal rash. The rash persists for only 3 days. Which viral infection
should be suspected?
Rubella
Rubella is a relatively benign illness in most cases, but when can serious sequelae
result?
When it infects fetuses (it is one of the T0RCH infections)
What diseases are caused by paramyxoviruses?
Mumps, measles, croup and respiratory syncytial virus bronchiolitis
Paramyxoviruses cause disease predominantly in what age group?
Children
What is the typical clinical presentation of croup?
A seal-like barking cough
What surface protein is common to all paramyxoviruses? What is its role?
Surface F (fusion) protein, which causes respiratory epithelial cells to fuse and form multinucleated cells
Injections of which monoclonal antibody are given to children at high risk of
severe respiratory syncytial virus bronchiolitis?
Palivizumab
Describe the progression of disease in rabies.
It begins with fever and malaise, develops into agitation, hydrophobia,
photophobia, and then paralysis, coma, and death
How does rabies virus invade the central nervous system?
By migrating in a retrograde fashion up the nerve axons
What animal bites are most likely to result in rabies infection in the United States?
Bat, raccoon, and skunk bites
What is the importance of postexposure vaccination in rabies?
The disease is universally fatal after symptoms have developed
What are arboviruses?
Viruses transmitted by arthropods (remember: ARBOvirus: ARthropod-BOrne
virus)
Arboviruses include members of which viral families?
Flavivirus, Togavirus, and Bunyavirus (remember: Fever Transmitted by Bites)
The hepatitis A virus is primarily transmitted via what route?
The fecal-oral route
The hepatitis E virus is primarily transmitted via what route?
The enteric route (causing water-borne epidemics)
The clinical course of hepatitis E infection resembles that of what other hepatitis
virus?
Hepatitis A
How is the hepatitis E virus different from the hepatitis A virus?
The hepatitis E virus can cause waterborne epidemics and has a high mortality rate
among pregnant women (remember: Hep E: Enteric, Expectant
mothers, Epidemics)
How does the number of people with serologic evidence of prior hepatitis A
infection compare to the number who have had clinically significant infection?
Most infections are clinically insignificant (remember:
Hep A: Asymptomatic, Acute, Alone [no carriers])
Does hepatitis A virus have a short or long incubation period?
Short (3 weeks); there are no chronic carriers of the infection
How is the hepatitis B virus transmitted?
By parenteral, sexual, or maternal-fetal routes (remember: Hepatitis B: Blood
borne)
Which hepatitis virus has a reverse transcription capability?
Hepatitis B virus; reverse transcription occurs (DNA from an RNA
intermediate) but the virion enzyme is a DNA-dependent DNA polymerase