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D2 Summer > Microbio Week 11 - Herpesviruses and VZV (Exam 3) > Flashcards

Microbio Week 11 - Herpesviruses and VZV (Exam 3) Flashcards

1
Q

Describe herpesviruses

A

dsDNA
Linear
Icosahedral
Enveloped

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2
Q

T/F: Herpesviruses are inactivated by detergents, acid, and drying

A

True, they are enveloped

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3
Q

What are the 2 types of infections involved with herpesviruses?

A

Lytic
Latent

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4
Q

Are all herpesviruses localized or systemic/generalized?

A

Systemic/generalized

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5
Q

Name the antivirals for herpesviruses

A

Acyclovir
Valacyclovir
Famciclovir
Gangciclovir

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6
Q

What does the acyclovir class of antivirals stop?

A

Viral DNA replication

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7
Q

What is acyclovir activated by?

A

Viral thymidine kinase

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8
Q

Once acyclovir is activated by a viral
thymidine kinase, it is used by the viral DNA polymerase and causes what?

A

Viral DNA chain termination

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9
Q

T/F: The acyclovir antivirals must be activated by a protein found in an infected cell, a viral thymidine kinase

A

True

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10
Q

Acyclovir can only act on which type of cells?

A

Cells infected by the herpesvirus

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11
Q

Which antiviral is just a prodrug of acyclovir?

A

Valacyclovir

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12
Q

What is valacyclovir metabolized in the body to?

A

Acyclovir

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13
Q

Why is valacyclovir useful?

A

Has a longer 1/2 life (can take fewer pills/day)

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14
Q

Which antiviral is the oral prodrug of the topical ointment penciclovir?

A

Famciclovir

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15
Q

Which drug is often used interchangeably with acyclovir and valacyclovir?

A

Famciclovir

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16
Q

Which antiviral is used for CMV infections?

A

Ganciclovir

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17
Q

Which antiviral has a prodrug called valganciclovir that has a longer half life in the body?

A

Ganciclovir

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18
Q

Resistance to the acyclovir class of drugs usually occurs where?

A

In the viral thymidine kinase

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19
Q

What drugs can be used if resistance to acyclovir develops?

A

Drugs NOT phosphorylated by the viral thymidine kinase

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20
Q

Which forms of herpesvirus can infect mucosal epithelial cells, cause lesions, and become latent in nerve ganglia?

A

HSV 1 and 2

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21
Q

Which nerve ganglia do oral HSV 1 and 2 become latent?

A

Trigeminal ganglia

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22
Q

Which nerve ganglia do genital HSV 1 and 2 become latent?

A

Sacral ganglia

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23
Q

T/F: HSV 1 and HSV 2 are identical viruses

A

FALSE, they are similar but NOT identical

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24
Q

Can a person be infected with both HSV 1 and HSV 2?

A

Yes

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25
Q

What occurs during latency in HSV 1 and 2 infections that allows the infected cells to be hidden from the immune system?

A

Virus doesn’t express proteins

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26
Q

How do HSV and VZV go up the nerve?

A

Retrograde axial transport

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27
Q

T/F: HSV and VZV will go up the nerve via retrograde axial transport and lay dormant, latent

A

True

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28
Q

Is any virus produced in latency?

A

No

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29
Q

Can a latent virus be reactivated in order to produce the virus again?

A

Yes

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30
Q

T/F: HSV-1 causes oral herpes and HSV-2 causes genital herpes

A

FALSE, either virus can cause oral or genital herpes!

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31
Q

What is the vast majority of oral herpes caused by?

A

HSV 1

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32
Q

What is the majority of genital herpes caused by?

A

HSV 1 or HSV 2 (both!)

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33
Q

What does oral HSV 1 protect against?

A

Protects against acquiring genital HSV 1

(since you already have the ABs from the oral infection)

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34
Q

What is the name for the first infection with oral HSV?

A

Gingivostomatitis

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35
Q

What is the primary causative agent in gingivostomatitis?

A

HSV 1

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36
Q

What are the symptoms of gingivostomatitis?

A

Gingivitis
Vesicles on buccal mucosa, tongue, hard palate, gingiva, lips, face

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37
Q

Vesicles from gingivostomatitis break down into ________ and then crust over on the lips and face but usually don’t _________

A

ulcers; scar

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38
Q

How long do symptoms from gingivostomatitis last?

A

1-2 weeks

(can be painful, children can become dehydrated)

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39
Q

There is often _________ and enlarged ___________ in gingivostomatitis

A

fever; lymph nodes

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40
Q

What is the name for any reactivation/recurrent oral herpes after the primary infection?

A

Herpes labialis

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41
Q

T/F: Herpes labialis (recurrent oral herpes) is usually more severe with more lesions and appears in a different place as primary lesions

A

FALSE, it is LESS severe with LESS lesions and appears in the SAME place as primary lesions

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42
Q

Name 4 things that can trigger a recurrence (herpes labialis)

A

Stress
UV light
Menstruation
Dental procedures

43
Q

T/F: Herpes labialis is less severe, with no fever or lymph node swelling

A

True

44
Q

What is common in people who have been infected with HSV-1?

A

Oral asymptomatic shedding of HSV-1

45
Q

A large proportion of the US are seropositive for ________, almost all from genital infection. The vast majority of them do not know they are positive.

A

HSV-2

46
Q

T/F: There is an increasing amount of people infected genitally with HSV-1

A

True

47
Q

Is it common to get HSV from an asymptomatic shedding partner (meaning the person infected with HSV has no visible sores)?

A

Yes

48
Q

Are asymptomatic infections common?

A

Yes

49
Q

Where are genital herpes lesions present?

A

Genital epithelium
Upper thighs
Anal area

50
Q

T/F: As in primary oral infections, the
primary genital infection is the worst and can result in lymph node swelling, fever, and more sores than will be present in reactivation events

A

True

51
Q

HSV-2 tends to cause (more/less) recurrences and asymptomatic shedding than genital HSV-1

A

More

52
Q

For oral and genital recurrent herpes sores, which 3 drugs can be taken prophylactically or at the first signs of an outbreak?

A

Acyclovir
Valacylovir
Famciclovir

53
Q

What 3 drugs can also be taken daily to help prevent outbreaks and transmission but do not entirely stop asymptomatic shedding?

A

Acyclovir
Valacylovir
Famciclovir

54
Q

The risk of acquiring _______ is increased if genitally infected with HSV-2

A

HIV

55
Q

What is the name for herpetic lesions on the finger and was common in dentists and other health care workers?

A

Herpetic Whitlow

56
Q

T/F: Children and adults can secrete herpes in saliva without visible sores

A

True

57
Q

Herpetic Whitlow can also be caused by what?

A

Autoinoculation

58
Q

Herpetic Whitlow lesions can shed ______ and spread the virus to others

A

HSV

59
Q

Are recurrences common in Herpetic Whitlow?

A

Yes

60
Q

How do you prevent Herpetic Whitlow?

A

Gloves and handwashing

61
Q

Topical acyclovir or penciclovir, oral acyclovir, valacyclovir, or famciclovir can reduce symptoms in which type of herpes infection?

A

Herpetic Whitlow

62
Q

What is caused by reactivating oral herpes going to the eye or spread by touching the eye and contaminating it with HSV-1?

A

Ocular herpes

63
Q

Ocular herpes can cause more severe infections that scar the ___________

A

cornea

64
Q

Can ocular herpes reoccur?

A

Yes

65
Q

What is there a higher chance of if ocular herpes reoccurs?

A

Permanent vision loss

66
Q

Antiviral eye drops and/or oral acyclovir are used to treat what type of herpes infection?

A

Ocular herpes

67
Q

Almost all herpes simplex encephalitis infections are from which form of HSV?

A

HSV-1

68
Q

HSV travels up ___________ or __________ nerves to the temporal or frontal lobes of the brain in herpes simplex encephalitis.

This can happen during primary infection or from the virus’s reactivation.

A

Olfactory or trigeminal

69
Q

What causes necrosis of brain tissue in herpes simplex encephalitis?

A

Replication of the virus

70
Q

Prompt treatment is needed with herpes simplex encephalitis.

What drug is given intravenously and can drastically reduce the fatality rate?

A

Acyclovir

71
Q

T/F: Survivors of herpes simplex encephalitis can have neurological defects

A

True

72
Q

How does neonatal herpes spread?

A

Vertically (mother to baby during pregnancy)

73
Q

What form of HSV are most neonatal herpes infections caused by?

A

HSV-2

74
Q

What else can neonatal herpes be caused by?

A

Reactivation of existing infection close to labor

75
Q

The use of which drug in an infant can drastically reduce mortality in neonatal herpes infections?

A

Acyclovir

76
Q

What is VZV?

A

Varicella zoster virus/chickenpox

77
Q

Is VZV contagious?

A

Yes, it’s very contagious!!!

78
Q

How is VZV spread?

A

Respiratory droplets
Lesions

79
Q

Where are most VZV lesions found?

A

Face and trunk

80
Q

Varicella can be more severe in adults, pregnant people, and the immunocompromised, with the most common risk being ____________

A

pneumonia

81
Q

What is a defining feature of chickenpox?

A

Vesicular rash

82
Q

T/F: Lesions of VZV are present in all stages, from just erupted to crusted over

A

True

83
Q

Where is VZV latent?

A

Dorsal root and cranial nerve
Trigeminal ganglia

84
Q

T/F: You should give aspirin to children with chickenpox or influenza, it is safe

A

FALSE, you should never give aspirin to kids, it may cause Reye’s syndrome

85
Q

There is a risk for pneumonia with high mortality when pregnant and infected with ______________. The mortality can be lowered with treatment

A

Varicella

86
Q

Varicella can cause severe congenital _____________ if a pregnant woman is infected in the first trimester

A

disabilities

87
Q

If varicella symptoms occur before delivery, before a maternal ___________ response can occur and transfer to the fetus, the baby can contract ____________. The baby can have
disseminated disease

A

AB; varicella

88
Q

T/F: Congenital varicella and disseminated infection of newborns are very rare

A

True

89
Q

Reactivation of varicella virus along dermatomes causes what?

A

Herpes Zoster/Shingles

90
Q

Reactivation of varicella virus along which dermatomes causes Herpes Zoster/Shingles most commonly?

A

Thoracic
Ophthalmic
Cervical

91
Q

What is a shingles outbreak near the eye called?

A

Herpes Zoster Opthamalicus

92
Q

About 1/3 of people with shingles can develop which disease that causes mild to severe pain after the resolution of lesions?

A

Post-herpetic neuralgia (PHN)

93
Q

Shingles occur primarily in people over _____ years old when the CTL response for VZV seems to be waning

A

50

94
Q

Herpes Zoster/Shingles can be very painful; lesions can be infectious and cause the primary infection of __________

A

chickenpox

95
Q

What type of vaccine is recommended for all children to prevent chickenpox?

A

Attenuated

96
Q

How many shots are needed for the chickenpox vaccine?

A

2

97
Q

Because the varicella/chickenpox vaccine is an attenuated virus, it is contraindicated in which types of patients?

A

Immunocompromised
Pregnant

98
Q

If contraindicated for the live-attenuated vaccine, what can be given to help prevent chickenpox infection?

A

Varicella IgG

99
Q

What vaccine is approved for shingles?

A

Subunit

100
Q

The shingles vaccine is very efficacious in preventing what?

A

Shingles
Post-herpetic neuralgia

101
Q

What vaccine is recommended for all people over 50 who have had chickenpox?

A

Shingles vaccine

102
Q

In people with HIV, there can be more recurrent oral and genital outbreaks that are more severe with which viruses?

A

HSV 1 and 2

103
Q

In people with HIV, what are they more likely to get an earlier age and do worse if they contract chickenpox?

A

Shingles

D2 Summer (37 decks)

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