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HEME Micro & Immuno > Mononucleosis syndromes > Flashcards

Mononucleosis syndromes Flashcards

1
Q

immunocompromised pt with CMV: Latently infected 1) contact activated T cells and differentiate into macrophages that produce infectious virus

A

1) monocytes

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2
Q

microcephaly, chorioretinitis

A

CMV manifestations in infants:

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3
Q

EBV pathogenesis–>Once B-cells are infected, three things can happen: 1) where the virus replicates in B-cells; ends up in the 2);

A

1) Lytic infection 2) SALIVA

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4
Q

Seroconversion and presence of IgM

A

CMV in immunocompetent

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5
Q

Symptomatic illness = hepatosplenomegaly, jaundice, anemia, thrombocytopenia, low birth weight, microcephaly, chorioretinitis

A

CMV manifestations in infants:

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6
Q

Lymphomas in immunocompromised patients: s/s

A

Persistent fever, lymphadenopathy, hepatosplenomegaly

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7
Q

infects macrophages

A

CMV

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8
Q

CMV manifestations in infants: Fetal damage most likely in 1)

A

1) 1st trimester

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9
Q

Latent CMV in:

A

Monocytes

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10
Q

Diagnosis of CMV in Immunocompromised

A

• Viral antigen or DNA in blood • Inclusions or viral antigen in diseased tissue

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11
Q

EBV and Immunity: Capacity to limit proliferation of EBV-infected B cells

A

Memory T cells

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12
Q

EBV Not good correlation between titer and disease severity

A

Heterophile antibodies

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13
Q

African Burkitt Lymphoma genetics:

A

Translocations in B cells = c-myc oncogene and Ig heavy or light loci

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14
Q

protein-filled region; houses Enzymes and proteins required immediately for viral replication

A

Tegument; refers to EBV

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15
Q

EBV and Immunity: 1)–> Inc. circulating T-cells b/c activated in response to virus-infected B cells

A

1) Atypical lymphocytosis

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16
Q

Teenagers and young adults

A

EBV

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17
Q

Cytomegalovirus family and subfamily:

A

herpesvirus family β-herpesvirus subfamily

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18
Q

Diagnosis of CMV in Congenital infection Culture or 1) positive at birth or within 1-2 weeks

A

1) viral DNA assay

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19
Q

EBV–> Outside of viral particle covered by 1)

A

1) lipoprotein envelope

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20
Q

Perinuclear cytoplasmic inclusions

A

CMV

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21
Q

EBV and Lymphoproliferative Disease: Endemic in southern China

A

Nasopharyngeal carcinoma

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22
Q

CMV in bone marrow transplants:

A

interstitial pneumonia leading cause of death

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23
Q

Only used in heterophile antibody negative cases

A

Serologic tests

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24
Q

Large viral genome = 125-240 kb encoding 75 viral proteins

A

EBV

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25
Q

 Close personal contact  Sexual contact  Congenital infections  Isolated from saliva, cervical secretions, semen, urine, WBCs for months to years after infection

A

CMV

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26
Q

heterophile antibody–> Sera from 1) agglutinate RBCs from 2)

A

1) patients 2) sheep and horses

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27
Q

CMV in immunocompetent vs. immunocompromised

A

Immunocompetent = clinical disease from primary infection, if at all; mostly asymptomatic; Immunocompromised = primary infection and reactivation symptomatic

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28
Q

CMV on histo hallmark

A

Nuclear inclusions = owl eye cells

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29
Q

Not contained in immunocompromised organ transplant recipients

A

Memory T cells

30
Q

Simple slide agglutination tests using animal erythrocytes; Present by end of 1st week of illness o May persist for many months

A

Heterophile antibodies

31
Q

Screening for increased IgA to VCA and early EBV Ags used for early diagnostic purposes

A

African Burkitt Lymphoma

32
Q

EBV pathogenesis: -Initially infects 1) -Subsequent infection of 2) activation and proliferation -Virus enters B cells by binding 3)

A

1) epithelial cells 2) B cells and polyclonal B cell 3) CR2

33
Q

1)detectable in nucleus of infected cells;

A

1) 18-24h EBNA (Epstein Barr Nuclear antigen)

34
Q

immunocompromised pt with CMV: Infection of monocytes causes 1)

A

1) increasing predisposition to fungal and bacterial infections

35
Q

EBV and Lymphoproliferative Disease: Lymphomas in 1) patients, such as post-renal or lung transplant;

A

1) immunocompromised

36
Q

CMV transmission

A

Close personal contact, sexual contact and congenital infections

37
Q

EBV Can be used as diagnostic test, but 15% of adults fail to induce detectable levels

A

Heterophile antibodies

38
Q

Infects vascular endothelial cells and leukocytes

A

CMV

39
Q

Mononucleosis Syndrome clinical feature:

A

fever and reactive lymphocytes

40
Q

EBV and Immunity: Heterophile antibodies–> 1) antibodies against antigens on sheep and horse RBCs

A

1) IgM

41
Q

CMV has a latent infection; how may this be significant:

A

it may be transmitted in transfusion and organ transplant

42
Q

Suggested infectious cofactor, such as malaria that causes immunosuppression and predisposes to EBV-related malignancy such as 1)

A

African Burkitt Lymphoma

43
Q

what is CR2;

A

EBV enters B-cell by binding to CR2

44
Q

CMV Neonatal infections during or shortly after birth: transmission via 1); not associated with adverse outcome

A

1) breast milk

45
Q

10-15% of children infected in 1st 5 years of life

A

CMV

46
Q

CMV manifestations: 1)–> 90% normal or asymptomatic but long term 10-20% develop sensory hearing loss, psychomotor mental retardation, or both

A

1) infants

47
Q

Febrile prodrome 3-7 days

A

Mononucleosis Syndrome

48
Q

Requires multiple contacts between shedding and susceptible persons

A

EBV

49
Q

EBV Envelope = 1) protrude like spikes

A

1) 9 glycoprotein

50
Q

why do immunocompromised organ transplant recipients have a higher risk of EBV associated malignancies

A

immunocompromised organ transplant recipients do not have MEMORY T-cells;

51
Q

In AIDS patients, EBV is associated with:

A

• Hairy leukoplakia • Interstitial lymphocytic pneumonia • Lymphoma

52
Q

EBV and Lymphoproliferative Disease: Most common malignancy in young children

A

African Burkitt Lymphoma

53
Q

 Expression of viral genome associated with immortalization and proliferation  Infected B cells produce Ig and express a membrane Ag that is target of host cellular immune reponses

A

EBV pathogenesis

54
Q

Two strains circulate widely, both can coinfect a single individual

A

EBV

55
Q

Mononuclear leukocytosis–> key feature of Mono syndrome: 1) = greater than 50% of blood cells; At least 10% = 2)

A

1) Lymphocytes 2) reactive lymphocytes

56
Q

Clinical manifestations due to vigorous host response to viral infection

A

Mononucleosis Syndrome

57
Q

EBV family and subfamily:

A

Herpesviridae family; γ- herpesvirus subfamily

58
Q

Diagnosis of CMV in immunocompetent

A

Seroconversion and presence of IgM

59
Q

CMV Childhood and adulthood: Usually asymptomatic; may cause 1) In immunocompromised: 2)

A

1) mono syndrome 2) primary infection and reactivation is severe

60
Q

Larger than normal with vacuolated cytoplasm, lobulated, and eccentrically placed nucleus

A

reactive lymphocytes

61
Q

Environmental carcinogens create precancerous lesions

A

Nasopharyngeal carcinoma

62
Q

CMV in AIDS patients:

A

disseminates to visceral organs causing chorioretinitis, gastroenteritis, and neurologic disorders

63
Q

EBV: Present at onset of symptoms and disappear with resolution of disease

A

Atypical lymphocytes

64
Q

EBV pathogenesis–>Once B-cells are infected, three things can happen: -Priming of the immune response -> production of 1)

A

1) EBV cytotoxic t-cells or memory t-cells.

65
Q

Infects B cells

A

EBV

66
Q

Adults 30-60 years of age

A

CMV

67
Q

Diagnosis of CMV in Perinatal infection: Culture 1) at birth but positive at 2)

A

1) negative 2) 4 weeks or more after birth

68
Q

EBV pathogenesis–>Once B-cells are infected, three things can happen: 1) from resting B cell that harbors the virus inside them;

A

1) Persistent infection

69
Q

reactive lymphocytes: Larger than normal with vacuolated cytoplasm,1) nucleus

A

1) lobulated, and eccentrically placed

70
Q

EBV and Diagnosis: Demonstration of 1) and 2)

A

1) atypical lymphocytes 2) heterophile antibodies

HEME Micro & Immuno (11 decks)

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