Mon Test week 4 day 1 - Viruses

Question 2

What is the Reservoir of Ebola virus? How is it spread?

Answer 2

Fruit bat is probably the natural reservoir May also be spread by non-human primates - blood, body fluids and tissues

Question 3

Characteristics of Ebola Virus? What is a similar disease?

Answer 3

1) Virus undergoes massive replication in endothelial cells, phagocytes, hepatocytes 2) Necrosis of liver, kidneys, gonads, spleen, lymph nodes 3) Hemorrhage of lungs 4) Severe - 80-90% fatality Marburg Hemorrhagic Fever is similar

Question 4

What are the symptoms of ebola?

Answer 4

• hemorrhagic rash appears over entire body - bleeding from mucous membranes - mouth nose eyes and rectum

Question 5

Do we see Hantavirus in the US?

Answer 5

Yes unlike Ebola. Mostly North America

Question 6

reservoir of Hantavirus?

Answer 6

Rodents appear to be the natural reservoir, especially deer mouse’s urine, droppings, and saliva

Question 7

Characteristics of Hantavirus?

Answer 7

Fatigue, fever and muscle aches initially Later coughing, shortness of breath, fluid-filled lungs Death in ~40%

Question 8

What percentage of oral cancers come from HPV? Do all HPV cause cancer?

Answer 8

10-15% No, mostly HPV 16 and HPV 18

Question 9

What are the high risk HPV? How are they transmitted?

Answer 9

HIGH-RISK HPV TYPES #16 & #18 are sexually transmitted

Question 10

What do low risk HPV cause?

Answer 10

Papillomas and warts

Question 11

How common is HPV?

Answer 11

Very. Every sexually active person will get it at some point without the vaccine

Question 12

What are HPV 16 and 18 particularly involved in?

Answer 12

Oropharyngeal cancer -> 70% due to HPV

Question 13

What is the main cause of oral cancer?

Answer 13

80% smoking

Question 14

Why should we continue screening for cancer for those who are vaxxed against HPV?

Answer 14

Maybe dysplasia before got vaccinated Maybe infected with other oncogenic strain Maybe they smoke Maybe they’d have developed cancer anyway

Question 15

Whats the most likely cancer in men caused by HPV? Women?

Answer 15

Men: Oropharyngeal ~ 77% Women: Cervix ~ 59%

Question 16

What is the pathogenesis of HPV? How does it infect?

Answer 16

Papillomaviruses are small, non-enveloped, circular double-stranded DNA viruses Trophic for squamous epithelial cells Enter into basal cells Transported to the nucleus. Once in the nucleus turn off different suppressor genes. E6 and E7 are suppressors, so like a car without the breaks. Proliferation.

Question 17

Name two genes of HPV and the three host things they are targeting? their role in carcinogenesis?

Answer 17

• HPV’s E7 gene can bind to Rb - gatekeeper off duty! uncontrolled cell reproduction - HPV’s E6 protein can bind to p53 Repeated replication of cells with incorrect DNA information No apoptosis of mutated cells HPV’s E6 can also activate telomerase so it confers immortality maintains a repeated cell cycle that continues to produce viral cells. mutant cells continue to reproduce out of control.

Question 18

What are the two ways an HPV disease can progress after HPV infection?

Answer 18

1. HPV infects the cell and can cause a latent phase, so cell looks normal and sits quietly. HPV makes cells reproduce crazy. Immune system notices and starts attacking and killing off the viral cells. No HPV.
2. Sometimes HPV E6 and E 7 bind to p53 and Rb and keep on replicating. Smoking or other infections like HIV help viruses. Sometimes develop malignancy, but that’s a minority.

Question 19

What is the disease associated with HPV 2, 4, 40? Clinical manifestations?

Answer 19

Verruca vulgaris, common wart. It is also seen in oral cavity.

• Its white - more keratin than papilloma
• Elevated with crisp borders
• Flat verrucous or warty top (Jughead’s hat)

Question 20

What are the treatments for papillomas and Verrucas?

Answer 20

• On skin:
  
  • Surgical excision, liquid nitrogen, or keratinolytic agents.
• Intraoral:
  
  • Surgical excision, cryotherapy or electrosurgery

Question 21

What is the causative agent for Condyloma acuminatum? How does it look like? Tx?

Answer 21

HPV 6, 11, 42, 43, 44, 55

Genital or venerial warts.

Not high risk HPV. Infectious! Can spread from sites to sites.

papillary proliferation, cauliflower shape

Larger than papilloma and often multiple

Treatment: Surgical or medical. No laser bc particles can spread

Question 22

general differences in shapes of pappiloma, verruca and condyloma?

Answer 22

papilloma - Pendunculates like P, no definite HPV causes it

Verruca Vulgaris - common wart, fingers are the common site, serrated top - HPV 2, 4, 40

Condyloma Acuminatum - Venerial wart, common genitals flat and scalloped top - HPV 6 & 11

Question 23

What viruses cause Hecks disease? Manifestations? Risk?

Answer 23

HPV 13, 32

Focal Epithelial hyperplasia, oral

Not high risk

• Flat, smooth, soft, papules
• Same color as surrounding mucosa usually
• No ulceration
• No malignant transformation potential
• Usually a self-limiting viral infection

Question 24

whats some sensitive info about Hecks disease?

Answer 24

Its mostly in endogenous populations, and in Children. Can mimic condyloma acuminatum. You can send it off to histo to make sure its not a sexual abuse in kids.

Question 25

What is causing plantar wart? Where does it appear?

Answer 25

HPV 1, 2, 4

sole of foot

Question 26

Viruses that cause cancer? What kind of cancer?

Answer 26

16, 18 mostly

Cervix, pharynx, oral (some)