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PLE > Microbiology: Virology > Flashcards

Microbiology: Virology Flashcards

1
Q

All viruses have this structure

A

Capsid (protein coat) made up of capsomeres

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2
Q

What is a matrix protein or tegument (viral structure)?

A

Interstitial space between nucleocapsid and the envelope

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3
Q

Viral lipid membrane derived from the host cell

A

Envelope

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4
Q

All viral envelopes are acquired through budding from the plasma membrane except

A

Herpes virus (from nuclear membrane)

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5
Q

Enveloped viruses are ___ stable and ___ easily activated

A

less stable, more easily activated

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6
Q

Compared to enveloped viruses, naked viruses

A

tend to be more resistant to damage

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7
Q

Viral symmetric: spherical (icosahedral) or helical

Which is enveloped?

A

Both may be enveloped, but icosahedral viruses can also be naked

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8
Q

What viruses are naked?

A 
Naked Viruses: Naked CPR and PAPP smear
Calici
Picorna
Reo
Parvo
Adeno
Papilloma
Polyoma
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9
Q

All viruses are haploid, T or F?

A

False, Retroviruses are not haploid

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10
Q

RNA viruses have a segmented genome which contributes to

A

Genetic diversity

Better for mixing with other viral genomes

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11
Q

Segmented Genome Viruses

A 
BOAR
Bunyaviruses
Orthomyxoviruses (influenza)
Arenaviruses
Reoviruses
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12
Q

This type of virus brings its own RNA-dependent RNA polymerase

A

Negative Strand RNA Viruses

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13
Q

Negative Strant RNA Viruses

A 
Always Bring Polymerase Or Fail Replication
Arenaviruses
Bunyaviruses
Paramyxoviruses
Filoviruses
Rhabdoviruses
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14
Q 
Drug class and stage affected in viral life cycle:
Enfuvirtide (T-20)
A

Fusion inhibitor

Adsorption/attachment

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15
Q 
Drug class and stage affected in viral life cycle:
Amantadine
A

Penetration and uncoating

For influenza, Type A only

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16
Q 
Drug class and stage affected in viral life cycle:
Acyclovir, Ribavirin
A

Viral DNA/RNA synthesis

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17
Q

Drug class and stage affected in viral life cycle:
Lamivudine
Zidovudine
Nevirapine

A

Viral DNA/RNA synthesis

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18
Q 
Drug class and stage affected in viral life cycle:
Interferon
A

Viral protein synthesis

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19
Q 
Drug class and stage affected in viral life cycle:
Protease inhibitors
A

Assembly and re-assembly

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20
Q

What property of viruses enables them to cause epidemics?

A

Genomic reassortment

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21
Q

One virus produces a protein that can also be used by another virus, give an example

A

Complementation

You can only have HepD if you have HepB

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22
Q

Phenotypic mixing

A

Two different viruses infect the same cell, leading to production of new strains

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23
Q

Outcomes of viral infection: Cytopathic effect

A

Visual or functional change in infected cells

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24
Q

Outcomes of viral infection: Malignant transformation

A

Oncogenic viruses induce transformation and unrestrained growth

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25
Q

Outcomes of viral infection: Commensal symbiosis

A

Infected cells appear normal, but are producing large numbers of progeny viruses

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26
Q

3 virulence factors and their description

A

Antigenic variants of surface proteins - change the “face” of the virus
Cytokine decoys - bind cytokines and block their ability to interact with receptors on their intended targets
Virokines - reduce the expression of antigen presenting cells and inactivate complement

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27
Q

States of persistent viral infections: HepB, HepC, HIV

A

Carrier state

Produce virus for long periods of time, serve as a source of infection

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28
Q

States of persistent viral infections: Herpes zoster (VZV)

A

Latent infections

No active viral reproduction, but can be reactivated at a subsequent time

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29
Q

States of persistent viral infections: HIV, Rabies

A

Slow virus infections

Long incubation period, often measured in years

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30
Q

Finding an antibody to a virus in a patient who previously had no antibodies to that specific virus

A

Seroconversion

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31
Q

7 diagnostic techniques for viral infections

A 
ELISA
RIA
Hemagglutination inhibition
Complement fixation
Neutralization
FAA
PCR
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32
Q

Gold standard in viral diagnosis?

A

Presence of viral DNA or RNA in the sample

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33
Q

Which viruses have p24?

A

HIV, HepB

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34
Q

What is the first vaccine produced that prevents human cancer?

A

HepB (decreased HCC)

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35
Q

ssDNA naked virus, icosahedral, linear

A

Parvovirus B19

The only DNA virus that is not double-stranded
Only has one serotype

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36
Q

dsDNA naked virus, icosahedral, linear

A

Adenovirus

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37
Q

dsDNA enveloped virus, icosahedral, circular

A

Hepadnavirus B (HepB)

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38
Q

DNA Viruses

A

DNA Viruses are HHAPPPPy viruses! (if not one of these, the virus is an RNA virus)

Hepadna
Herpes
Adeno
Papilloma
Parvo
Polyoma
Pox
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39
Q

All DNA viruses have linear DNA except

A

Hepadna
Papilloma
Polyoma

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40
Q

All DNA viruses are icosahedral and replicate in the nucleus except

A

Poxvirus

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41
Q

Where is the inclusion body in DNA viruses?

A

Nucleus

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42
Q

Where is the inclusion body in RNA viruses?

A

Cytoplasm

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43
Q

Naked virus: Parvovirus B19
Mode of transmission
Oncogenic?
Vaccine?

A

Naked virus: Parvovirus B19
Mode of transmission: respiratory, transplacental
Oncogenic? No
Vaccine? No

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44
Q

Naked virus: Adenovirus
Mode of transmission
Oncogenic?
Vaccine?

A

Naked virus: Adenovirus
Mode of transmission: respiratory, fecal-oral
Oncogenic? No
Vaccine? Yes

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45
Q

Naked virus: Human papillomavirus
Mode of transmission
Oncogenic?
Vaccine?

A

Naked virus: Human papillomavirus
Mode of transmission: sexual, skin contact
Oncogenic? Yes
Vaccine? Yes

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46
Q

Slapped cheek and other signs of erythema infectiosum, fifth disease

A

Parvovirus B19

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47
Q

Parvovirus B19 causes what in the second trimester?

A

Hydrops fetalis

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48
Q

Chronic Parvovirus B19 infection in immunodeficient patients

A

Pancytopenia

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49
Q

Has penton fibers and 41 antigenic types

A

Adenovirus

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50
Q

Cowdry Type A intranuclear inclusions

Cowdry Type B intranuclear inclusions

A

Type A: herpes simplex, VZV, CMV infections and Yellow fever

Type B: Adenovirus, Poliovirus

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51
Q

Virus that causes hemorrhagic cystitis and conjunctivitis

A

Adenoviridae

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52
Q

Three strains of Papovaviridae

A

Human papilloma virus
JC polyoma virus
BK polyoma virus

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53
Q

BK polyoma virus disease manifestation

A

Only in immunocompromised

BK (bone and kidney) transplant patients may develop hemorrhagic cystitis and nephropathy

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54
Q

JC polyoma virus disease manifestation

A

Only in immunocompromised
Progressive multifocal leukoencephalopathy in patients with AIDS
DDx: Multiple sclerosis

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55
Q

HPV Vaccines

A

Bivalent - Cervarix - 16 and 18

Quadrivalent - Gardasil - 6, 11, 16, 18

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56
Q

Koilocytes are a pathological finding in this viral infection

A

HPV

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57
Q

Functions of genes E6 and E7 in HPV pathogenesis

A

Inactivation of TSG
E6- inhibits p53
E7 - inhibits Rb

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58
Q

HPV 1 to 4
Common name
Location

A

HPV 1 to 4
Common name: verruca vulgaris
Location: skin and plantar area (liquid nitrogen and salicylic acid)

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59
Q

HPV 6 and 11
Common name
Location

A

HPV 6 and 11
Common name: genital warts/ condyloma accuminata
Location: genital area (podophyllin), respiratory tract
Most common viral STD!

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60
Q

HPV 16, 18, 31, 33

Location

A

16 and 18 are high risk strains

Carcinomas of: penis, anus, vulva, cervix

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61
Q 
Diseases caused by Herpesviridae:
HHV 6
HHV 8
HSV 1
HSV 2
VZV
EBV
CMV
A 
Diseases caused by Herpesviridae:
HHV 6: roseola infantum
HHV 8: Kaposi sarcoma
HSV 1: oral herpes (gingivostomatitis, labialis, keratoconjunctivitis, temporal lobe encephalitis, herpetic whitlow - fingers, herpes gladiatorum - trunk)
HSV 2: genital, neonatal, aseptic meningitis
VZV: varicella zoster
EBV: infectious mononucleosis
CMV: congenital mononucleosis
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62
Q

Site of HSV latency:
HSV 1
HSV 2

A

Site of HSV latency:
HSV 1: trigeminal ganglia
HSV 2: lumbosacral ganglia

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63
Q

DOC for HSV?

A

Acyclovir

Shortens duration of the lesions
Reduces extent of shedding
No effect on latent state (not actively replicating, no viral kinase produced)

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64
Q

DOC for VZV

A

Moderate to severe is Acyclovir

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65
Q

Ramsay Hunt syndrome

A

VZV: Zoster
Dermatomal, postherpetic neuralgia

Hutchinson sign
Herpes zoster otticus
Herpes zoster ophthalmicus

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66
Q

Reye syndrome, vesicular, centrifugal rash, “dewdrop on a rose”

A

VZV: Varicella

Hides in dorsal root ganglia until it reactivates as zoster

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67
Q

Multinucleated giant cells with intranuclear inclusions

A

VZV

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68
Q

Negative heterophil test, giant cells with owl’s eye intranuclear inclusions

A

CMV

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69
Q

DOC for CMV

A

Ganciclovir

70
Q

Most common cause of congenital abnormalities

A

CMV

71
Q

Diseases that cause “Blueberry muffin lesions”

A

Congenital CMV: microcephaly, seizures, deafness, jaundice, purpura, 1st trimester
Congenital rubella
Congenital/disseminated neuroblastoma

72
Q

HHV 4, “kissing disease”, rare complication is splenic rupture

A

EBV

73
Q

Positive heterophil test, affects B lymphocytes (B cell lymphomas)

A

EBV

74
Q

Oral hairy leukoplakia in immunocompromised patients is seen in those infected with

A

EBV

75
Q

EBV-infected African boy with facial asymmetry

A

Burkitt lymphoma

76
Q

Nasopharyngeal carcinoma in Chinese

A

EBV

77
Q

DDx: Bartonella (cat scratch disease) basillary angiomatosis

A

Kaposi Sarcoma - malignancy of vascular endothelial cells, an AIDS-defining illness

78
Q

Guarnieri bodies on histopathology, intracytoplasmic eosinophilic inclusions

A

Smallpox/Variola

79
Q

Largest virus, has been eradicated

A

Smallpox/Variola

80
Q

DOC if Cifodovir, Henderson-Peterson bodies (intracytoplasmic eosinophilic inclusions) on histopathology, skin lesion with umbilicated center

A

Molluscum contagiosum virus

81
Q

Enveloped virus with incomplete circular dsDNA

A

Hepatitis B

82
Q

Hepatitides and their characteristics

A 
The VOWELS (A and E) his your BOWELS. 
Hep A and E cause enteric infections

Hep A = Asymptomatic (Picornaviridae)
Hep B = Blood-borne (Hepadnaviridae)
Hep C = Chronic, cirrhosis, carcinoma, carriers (Flaviviridae)
Hep E = Enteric, expectant mothers, epidemics (Caliciviridae)

83
Q

Virulence factors of HepB

A 
Surface antigen (HBsAg)
Core antigen (HBcAg)
e antigen (HBeAg) - seen in blood if virus is actively replicating
84
Q

Only DNA virus that produces DNA by reverse transcription, with mRNA as template, targeted by Lamivudine

A

HepB

85
Q

Interpret HepB profile: IgM anti-HBcAg (+)

A

New infection
Most specific marker for diagnosis of acute HBV infection because it persists during the window period

Recall: HepB profile interpretation

86
Q

Presence of HBeAg connotes

A

“e” = “enfectivity”(high activity of DNA replication)

87
Q

This HepB antigen describes whether the patient is diseased or immune

A

Surface antigen

88
Q

These HepB antigens tell us how long the infection has been present

A

Core antigens

89
Q

DOC for HepB

A

Interferon alpha

Lamivudine

90
Q

Reverse transcriptase functions as

A

RNA-dependent DNA polymerase

91
Q

Lamivudine is an anti-retroviral drug which inhibits reverse transcriptase. It is useful in the treatment of which 2 viral infections?

A

HIV

HepB

92
Q

All RNA viruses have single-stranded DNA except

A

Reovirus

Rotavirus

93
Q

All RNA viruses replicate in the cytoplasm except

A

Influenza

Retrovirus

94
Q

Picornaviridae viruses

A

PERCHed on a PIC

Poliovirus
Echovirus
Rhinovirus
Coxsackie virus
Hepatitis A virus
Picornaviridae
95
Q

Difference between the 2 polio vaccines

A

Killed - Salk - IPV

Live attenuated - Sabin - OPV (antigenically superior)

96
Q

This virus replicates in the motor neurons of the anterior horn of the spinal cord causing paralysis

A

Poliovirus

97
Q

Group A Coxsackie spectrum of disease

A

Herpangina
Hemorrhagic conjunctivitis
Hand-foot-and-mouth disease

98
Q

Group B Coxsackie spectrum of disease

A

Pleurodynia

Myocarditis and pericarditis

99
Q

Group A and B Coxsackie spectrum of disease

A

Aseptic or viral meningitis (along with Polio and Echo)

100
Q

What does ECHOvirus stand for?

A

Enteric Cytopathic Human Orphan

101
Q

Only non-enteric virus of Picorna

A

Rhinovirus
They are acid-labile, killed by gastric acid when swallowed

The real “colds”: RHINO has a runny nose.

102
Q

Children are most frequently infected, a.k.a. Enterovirus 72

A

Hepatitis A

103
Q

Caliciviridae virus that has high mortality in pregnant women

A

Hepatitis E

104
Q

Most common cause of nonbacterial diarrhea in adults, viral gastroenteritis

A

Norwalk Virus or Norovirus

Caliciviridae

105
Q

Most common cause of childhood diarrhea, viral gastroenteritis

A

Rotavirus (Right Out the Anus)

Reoviridae

106
Q

Ensures genetic diversity in influenza

A

Envelope

Contains the 2 antigens: Hemagglutinin and Neuraminidase

107
Q

Influenza strain exclusive to humans, causes major outbreaks

A

Influenza B

108
Q

Influenza strain causing worldwide epidemics (pandemics)

A

Influenza A

109
Q

Antigen in influenza responsible for binding, the target of neutralizing antibody, 16 types

A

Hemagglutinin

110
Q

Influenza antigen for entry and release, cleaves neuraminic acid (sialic acid) to release progeny virus from the infected cell, 9 types

A

Neuraminidase

111
Q

Reason that there is a new vaccine yearly for influenza, causes epidemics

A

Influenza B antigenic drift

Sudden Shift is more deadly than graDual Drifts.

112
Q

Major changes based on the reassortment of segments of the genome RNA, causes pandemics

A

Antigenic shift

113
Q

DOC for inluenza

A

Oseltamivir
Zanamivir
Amantadine is for Influenza A only

114
Q

Strain combination in yearly flu vaccine

A

2 A strains

1 B strain

115
Q

Envelope spikes that may be present in Paramyxoviridae

A 
Hemagglutinin (only RSV does not have this)
Neuraminidase (Mumps and Parainfluenza only)
Fusion protein (all have this)
116
Q

Paramyxoviruses

A 
PaRaMyxoviruses
Parainfluenza virus
RSV
Measles
Mumps
117
Q

Histopathologic finding of Warthin-Finkeldey bodies (multinucleated giant cells)

A

Measles Virus

118
Q

Maculopapular rash progression in measles

A

face - trunk - extremities - palms and soles

119
Q

Complications of measles virus infection

A

Encephalitis
Pneumonia
Subacute sclerosing panencephalitis (SSPE)

120
Q

Cardinal manifestations of measles

A

Cough, Coryza, Conjunctivitis, Koplik spots

121
Q

Vitamin A supplementation reduces the severity of this disease

A

Measles

122
Q

Mumps spectrum of disease

A

Mumps make your parotids and testes as big as POM-poms.
Parotitis
Orchitis
Meningitis (aseptic)

123
Q

Surface spikes are fusion proteins forming multinucleated giant cells, humans are natural hosts

A

Respiratory syncytial (multinucleated giant cells) virus

124
Q

DOC for RSV, also given in HepC

A

Ribavirin

125
Q

MABs and their respective diseases

A

Palivizumab - RSV
Sevirumab - CMV
Omalizumab - Asthma
Ibalizumab - HIV

126
Q

In infants, causes pneumonia and bronchiolitis, with severe disease due to immunologic cross reaction with maternal antibodies

A

RSV

127
Q

Causes laryngotracheobronchitis (croup) - inspiratory stridor, cough, hoarseness, steeple sign on x-ray (subglottic stenosis)

A

Parainfluenza Virus 1 and 2

128
Q

Moves by axonal transport to CNS, histopathologic finding of Negri bodies

A

Rabies

129
Q

Phase in rabies where there are periods of mental aberration but with lucid intervals, eventual prominent brainstem dysfunction

A

Encephalitic phase

130
Q

Diagnostic tests for rabies

A

Fluorescent Ab testing for CSF (late, cannot be from vaccine since these do not cross the BBB)
RT-PCR on fresh saliva
Skin biopsy sample (brain is ideal)
Absence of negri bodies does not rule out rabies

131
Q

Only vaccine that is routinely used post-exposure

A

Rabies vaccine

Recall: WHO Guidelines for PEP for Rabies

132
Q

Caused by Corona virus, binds to ACE-2 receptor, non-cavitary “ground glass” infiltrates on x-ray, atypical pneumonia rapidly progressing to ARDS

A

Severe Acute Respiratory Syndrome (SARS)

133
Q

5 serotypes, gold standard for diagnosis is PCR, breakbone fever, hemorrhagic shock due to cross-reacting antibodies during second infection

A

Dengue Virus

134
Q

Most prevalent blood-borne pathogen

A

Hepatitis C

135
Q

Most common indication for liver transplantation

A

Hepatitis C

136
Q

DOC for chronic Hep C

A

Peginterferon

Ribavarin

137
Q

DOC for acute Hep C

A

Interferon

138
Q

Main cause of essential mixed cryoglobulinemia

A

Hepatitis C

139
Q

Responsible for autoimmune reactions such as thyroiditis, autoantibodies, MPGN, porphyria cutanea tarda, and DM

A

Hepatitis C

140
Q

Togaviridae, 3-day maculopapular rash and posterior LAD

A

Rubella

141
Q

Rubella causes 2 disease entities

A

German Measles

Congenital Rubella Syndrome

142
Q

5 Bs of Congenital Rubella Syndrome

A 
Bulag (cataracts)
Bingi (sensorineural deafness)
Bobo (mental retardation)
Butas ng puso (PDA)
Blueberry muffin baby
143
Q

Diploid retrovirus

A

HIV

144
Q

Proteins and their respective functions as encoded by HIV gene: gag

A

p24, p7 - nucleocapsid

p17 - matrix

145
Q

Proteins and their respective functions as encoded by HIV gene: pol

A

reverse transcriptase - transcription of RNA genome into DNA (RNA-dependent DNA polymerase)
protease - cleaves precursor polypeptides
integrase - integrates viral DNA into host cell DNA

146
Q

Proteins and their respective functions as encoded by HIV gene: env

A

gp 120 - attachment to CD4 protein, antigenicity changes rapidly
gp 41 - fusion with host cell

147
Q

Group-specific antigen that is located in the core, therefore conserved and is an important marker for serologic HIV testing

A

p24

148
Q

Most immunogenic region of gp120

A

V3 loop

149
Q

High mutation rate in HIV is due something that is lacking in reverse transcriptase

A

Lacks proofreading mechanism

150
Q

Phase of HIV infection where there is rapid viral replication but HIV test is negative

A

Phase 1 - Window Period

151
Q

Phase of HIV infection where there is peak in viral load, positive HIV test, mild flu-like illness lasting 1 to 2 weeks

A

Phase 2- Seroconversion

152
Q

Phase of HIV infection where patient is asymptomatic, CD4 goes down, lasts up to 15 years

A

Phase 3 - Latent Period

153
Q

HIV is acquired

A

Phase 0 - Infection

154
Q

CD4 count in Phase 4 - Early Symptomatic

A

500 to 200

Lasts 5 years, mild mucocutaneous, dermatologic and hematologic illness

155
Q

CD4 count is less than 200, AIDS-defining illnesses develop

A

Phase 5 - AIDS

156
Q

AIDS-Defining Illnesses

CD4 Count < 500

A

M. tuberculosis - Disseminated TB
HSV - HSV Esophagitis
C. albicans - Esophageal candidiasis
HHV 8 - Kaposi sarcoma

157
Q

AIDS-Defining Illnesses

CD4 Count < 200

A 
P. jiroveci - PCP
T. gondii - Cerebral toxoplasmosis
C. neoformans - Meningoencephalitis
C. immitis - Coccidiodomycocis
C. parvum - Chronic diarrhea
EBV - Burkitt's, HL, NPCA
158
Q

AIDS-Defining Illnesses

CD4 Count < 50

A

M. avium - invasive pulmonary disease
H. capsulatum - histoplasmosis
CMV - CMV retinitis

159
Q

Basis of prognostication in HIV

A

Plasma viral load through PCR

160
Q

Test for definitive diagnosis for HIV

A

Western blot analysis

Antibodies will bind to gp 41 or p24 protein

161
Q

Test for presumptive diagnosis for HIV

A

ELISA

162
Q

Components of HAART

A

2 Nucleoside inhibitors = Zidovudine and Lamivudine

1 Protease inhibitor = Indinavir

163
Q

What sometimes happens to HIV patients started on HAART with co-infection of HepB, HepC and MAC/MAI?

A

Immune Reconstitution Inflammatory Syndrome (IRIS)

Synonym(s): Immune Reconstitution Syndrome, Immune Restoration Disease

In HIV infection, an exaggerated inflammatory reaction to a disease-causing microorganism that sometimes occurs when the immune system begins to recover following treatment with antiretroviral (ARV) drugs. Immune reconstitution inflammatory syndrome (IRIS) occurs in two forms: “unmasking” IRIS refers to the flare-up of an underlying, previously undiagnosed infection soon after antiretroviral therapy (ART) is started; “paradoxical” IRIS refers to the worsening of a previously treated infection after ART is started. IRIS can be mild or life-threatening.

164
Q

Mutation in this gene interferes with the function of gp 120 viral protein in HIV

A

CCR 5

Patient with the mutation is found to be immune to HIV.

165
Q

DOC for prophylaxis agains mycobacterium avium intracellulare complex

A

Azithromycin + Ethambutol

166
Q

Patient previously had PCP, now has ring-enhancing lesions on brain CT. What organism is responsible?

A

T. gondii

167
Q

The only live vaccine that can be given to HIV patients

A

MMR vaccine

168
Q

Histopathologic finding of malignant T cells with flower-shaped nucleus

A

Human T-Cell Lymphotrophic Virus (HTLV)

169
Q

Zika and Ebola virus origins

A

Zika - Uganda (1947 in monkeys, 1952 in humans)

Ebola - Zaire (1976)

170
Q

Thalamic infarcts on CT scan, vector is Culex, most common cause of epidemic encephalitis

A

Japanese encephalitis

PLE (14 decks)

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