Neoplasia/Hematology - Sketchy - Coronaviruses, HIV, Filoviruses, Arenaviruses, EBV

Question 1

Coronaviridae are a family of ______-sense ______ viruses.

Answer 1

Coronaviridae are a family of positive-sense RNA viruses.

Question 2

Coronaviruses _________ (are/are not) enveloped and are ________ (helical/icosahedral/complex).

Answer 2

Coronaviruses are enveloped and are helical.

Question 3

Name a few viruses that can cause the common cold:

_______viruses

_______viruses

RSV

Parainfluenza viruses

Adenoviruses

Answer 3

Name a few viruses that can cause the common cold:

Rhinoviruses

Coronaviruses

RSV

Parainfluenza viruses

Adenoviruses

Question 4

__________ can cause upper respiratory infections that can lead to SARS or MERS (and even acute respiratory failure).

Answer 4

Coronaviruses can cause upper respiratory infections that can lead to SARS or MERS (and even acute respiratory failure).

Question 5

Human immunodeficiency virus (HIV) is a ________-sense ______ virus in the ______viridae family.

Answer 5

Human immunodeficiency virus (HIV) is a positive-sense RNA virus in the _Retro_viridae family.

Question 6

Is HIV enveloped?

Answer 6

Yes.

Question 7

HIV is a ___ploid virus; each HIV virion is composed of ____ copy(ies) of positive-sense RNA.

Answer 7

HIV is a diploid virus; each HIV virion is composed of 2 copies of positive-sense RNA.

Question 8

The ____ gene of HIV encodes the p24 protein (thousands of p24 protein products comprise the conical ______ of HIV).

Answer 8

The gag gene of HIV encodes the p24protein (thousands ofp24protein products comprise the conical capsid of HIV).

Question 9

The gag gene of HIV encodes the ____ protein (thousands of ____ protein products comprise the conical ______ of HIV).

Answer 9

The gag gene of HIV encodes the p24** protein (thousands of **p24 protein products comprise the conical capsid of HIV).

Question 10

The ____ gene of HIV encodes the gp41 and gp120 ________ proteins.

Answer 10

The env gene of HIV encodes the gp41 and gp120 envelope proteins.

Question 11

The env gene of HIV encodes the ______ and ______ envelope proteins.

Answer 11

The env gene of HIV encodes the gp41 and gp120 envelope proteins.

Question 12

The ____ gene of HIV encodes a reverse transcriptase (an ____-dependent ____ polymerase), which converts RNA to DNA.

Answer 12

The pol gene of HIV encodes a reverse transcriptase (an RNA-dependent DNA polymerase), which converts RNA to DNA.

Question 13

The pol gene of HIV encodes a _______ _______, which converts _____ to _____.

Answer 13

The pol gene of HIV encodes a reverse transcriptase (an RNA-dependent DNA polymerase), which converts RNA to DNA.

Question 14

HIV initially infects what cell type in particular?

It later infects what cell type in particular?

Answer 14

Macrophages;

CD4+ T cells

Question 15

In general HIV infects what category of cells?

Answer 15

Reticuloepithelial cells

(e.g. macrophages, CD4+ T cells, dendritic cells, microglia, etc.)

Question 16

Acute HIV infection (or HIV prodrome) frequently presents with _____- or _____-like symptoms such as cervical lymphadenopathy and pharyngitis.

Answer 16

Acute HIV infection (or HIV prodrome) frequently presents with flu- or mono-like symptoms such as fever, cervical lymphadenopathy, and pharyngitis.

Question 17

What are some of the generic S/Sy associated with acute HIV infection (or HIV prodrome)?

Answer 17

Fever, cervical lymphadenopathy, and pharyngitis

(flu- or mono-like symptoms)

Question 18

HIV undergoes a clinical latent period (or incubation period or chronic period) that can last up to how long?

Answer 18

10 years

Question 19

A CD4+ count 3) is the diagnostic marker of AIDS.

Answer 19

A CD4+ count <200 (per mm³​) is the diagnostic marker of AIDS.

Question 20

Patients with HIV are at a higher risk of some lymphoid malignancies, such as what?

Answer 20

Diffuse large B cell lymphoma

Question 21

In early stages of infection, HIV gains entry into host cells via the _____ receptor.

Answer 21

In early stages of infection, HIV gains entry into host cells via the CCR5 receptor.

Question 22

In later stages of infection, HIV gains entry into host cells via the _____ receptor.

Answer 22

In later stages of infection, HIV gains entry into host cells via the CXCR4 receptor.

Question 23

In ______ stages of infection, HIV gains entry into host cells via the CXCR4 receptor.

Answer 23

In later stages of infection, HIV gains entry into host cells via the CXCR4 receptor.

Question 24

In _____ stages of infection, HIV gains entry into host cells via the CCR5 receptor.

Answer 24

In early stages of infection, HIV gains entry into host cells via the CCR5 receptor.

Question 25

What test detects the presence of anti-HIV antibodies? (used to screen for HIV)

Answer 25

**Enzyme-linked immunosorbent assay (ELISA)**

Question 26

A _______ \_\_\_\_\_\_\_ (which detects the ____ antigen) is done to confirm HIV infection in patients who tested positive on an ELISA screening test.

Answer 26

A **_western_ _blot_** (which detects the **_p24_** antigen) is done to confirm HIV infection in patients who tested positive on an ELISA screening test.

Question 27

What test is used to screen for HIV by detecting antibodies? What test is used as a confirmatory test by detecting p24 antigen?

Answer 27

ELISA western blot

Question 28

Western blotting is used as a confirmatory test for HIV by detecting what? ELISA is used to screen for HIV by detecting what?

Answer 28

p24 antigen anti-HIV antibodies

Question 29

\_\_\_\_\_\_\_\_\_ reverse transcriptase inhibitors (**NRTIs**) are non-functional _________ analogs that prevent the elongation of DNA molecules synthesized by HIV’s **reverse** **transcriptase** (NRTIs are incorporated into the DNA chain).

Answer 29

**_Nucleotide_** reverse transcriptase inhibitors (**NRTIs**) are non-functional **_nucleotide_** analogs that prevent the elongation of DNA molecules synthesized by HIV’s **reverse** **transcriptase** (NRTIs are incorporated into the DNA chain).

Question 30

What medication should be administered to pregnant HIV patients to reduce the risk of transmitting HIV to the fetus?

Answer 30

**Zidovudine**

Question 31

What is the general mechanism of action of NRTIs and NNRTIs in treating HIV infection?

Answer 31

**Blocking reverse transcriptase** (nucleoside and non-nucleoside analogs that get incorporated into the DNA chain, thus disrupting elongation)

Question 32

**True/False**. NRTIs and NNRTIs are integrase inhibitors.

Answer 32

**False**. NRTIs and NNRTIs are ***reverse*** ***transcriptase*** inhibitors

Question 33

Protease inhibitors block _________ of HIV by binding proteases and preventing cleavage of proteins that are vital for what?

Answer 33

Protease inhibitors block **_replication_** of HIV by binding proteases and preventing cleavage of proteins that are vital for **producing infectious forms of the virus**.

Question 34

What medication type blocks the **CCR5** host cell membrane protein, preventing HIV from fusing with the host cell?

Answer 34

**Maraviroc**

Question 35

**Maraviroc** blocks the _______ host cell membrane protein, preventing HIV from ______ the host cell.

Answer 35

**Maraviroc** blocks the **_CCR5_** host cell membrane protein, preventing HIV from **_fusing with_** the host cell.

Question 36

*Ebolavirus* and *Marburgvirus* belong to what family of RNA viruses?

Answer 36

*Filoviridae*

Question 37

Filoviruses (i.e. *Ebolavirus*, *Marburgvirus*) are \_\_\_\_\_\_\_\_\_\_-sense _____ viruses.

Answer 37

Filoviruses (i.e. *Ebolavirus*, *Marburgvirus*) are **_negative_**-sense **_RNA_** viruses.

Question 38

The capsids of filoviruses (i.e. *Ebolavirus*, *Marburgvirus*) are \_\_\_\_\_\_\_\_\_\_.

Answer 38

The capsids of filoviruses (i.e. *Ebolavirus*, *Marburgvirus*) are **_helical_**.

Question 39

Are filoviruses enveloped?

Answer 39

Yes.

Question 40

Marburg virus and Ebola virus infections may present with ________ \_\_\_\_\_\_\_\_ and \_\_\_\_\_\_\_\_.

Answer 40

Marburg virus and Ebola virus infections may present with **_petechial_** **_rash_** and **_fever_**.

Question 41

Severe cases of Marburg virus and Ebola virus can cause ___________ \_\_\_\_\_\_\_.

Answer 41

Severe cases of Marburg virus and Ebola virus can cause **_hemorrhagic_** **_fever_**.

Question 42

Hemorrhagic fever caused by Marburg virus or Ebola virus can result in widespread \_\_\_\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_\_, and end-\_\_\_\_\_\_ failure.

Answer 42

Hemorrhagic fever caused by Marburg virus or Ebola virus can result in widespread **_bleeding_**, **_shock_**, and end-**_organ_** failure.

Question 43

Marburg virus and Ebola virus are likely transmitted via \_\_\_\_\_\_\_\_\_, with _________ as a reservoir.

Answer 43

Marburg virus and Ebola virus are likely transmitted via **_primates_**, with **_bats_** as a reservoir.

Question 44

Among U.S. citizens, what population is most at-risk for infection with Marburg virus or Ebola virus?

Answer 44

**Healthcare workers** who care for infected patients

Question 45

*Arenaviridae* (e.g. lymphocytic choriomeningitis virus) are ______ viruses.

Answer 45

*Arenaviridae* (e.g. lymphocytic choriomeningitis virus) are **_RNA_** viruses.

Question 46

Are arenaviruses (i.e. lymphocytic choriomeningitis virus) negative-sense RNA viruses?

Answer 46

Sort of, they are **ambi-sense**. They are classified as negative-sense, but they also harbor sections of positive-sense RNA.

Question 47

**True/False**. Arenaviruses (i.e. lymphocytic choriomeningitis virus) are naked.

Answer 47

**False**. Arenaviruses (i.e. lymphocytic choriomeningitis virus) are ***enveloped***.

Question 48

**True/False**. Arenaviruses (i.e. lymphocytic choriomeningitis virus) possess both positive and negative-sense RNA sections, making them ambisense.

Answer 48

True.

Question 49

What shape is the capsid making up arenaviruses?

Answer 49

Helical

Question 50

The arenavirus genome is __________ and contains _____ RNA segments.

Answer 50

The arenavirus genome is **_segmented_** and contains **_two_** RNA segments.

Question 51

How do arenaviruses (i.e. lymphocytic choriomeningitis virus) appear when visualized by electron microscopy?

Answer 51

'Grainy'

Question 52

What is the reservoir for arenaviruses (i.e. lymphocytic choriomeningitis virus)?

Answer 52

Rodents

Question 53

What is the most relevant virus of *Arenaviridae* to know?

Answer 53

Lymphocytic choriomeningitis virus

Question 54

Lymphocytic choriomeningitis virus infection may lead to **aseptic** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**itis**, manifesting with fever.

Answer 54

Lymphocytic choriomeningitis virus infection may lead to **aseptic** **_meningoencephal_****itis**, manifesting with fever.

Question 55

Arenaviruses can be inactivated by ______ and \_\_\_\_\_\_.

Answer 55

Arenaviruses can be inactivated by **_heat_** and **_irradiation_** (e.g. **light**).

Question 56

The Epstein-Barr virus is a ____ virus in the *\_\_\_\_\_\_\_viridae* family.

Answer 56

The Epstein-Barr virus is a **_DNA_** virus in the ***_herpes_**viridae* family.

Question 57

Epstein-Barr virus is primarily transmitted through what?

Answer 57

Saliva

Question 58

\_\_\_\_\_\_\_\_ + **painful** **lymphadenopathy** in the ________ \_\_\_\_\_\_\_\_ region + **splenomegaly** + **pharyngitis** are some of the classic features of Epstein-Barr virus-induced mononucleosis.

Answer 58

**_Fever_** + **painful** **lymphadenopathy** in the **_posterior_** **_cervical_** region + **splenomegaly** + **pharyngitis** are some of the classic features of Epstein-Barr virus-induced mononucleosis.

Question 59

**Fever** + __________ \_\_\_\_\_\_\_\_\_\_ in the **posterior cervical** region + __________ + **pharyngitis** are some of the classic features of Epstein-Barr virus-induced mononucleosis.

Answer 59

**Fever** + **_painful_** **_lymphadenopathy_** in the **posterior cervical** region + **_splenomegaly_** + **pharyngitis** are some of the classic features of Epstein-Barr virus-induced mononucleosis.

Question 60

Epstein-Barr virus infection causes peripheral lymphocytosis and the presence of atypical lymphocytes (abnormally large reactive CD\_\_\_+ T-cells with abundant cytoplasm) and _________ cells (atypical lymphocytes with strongly **basophilic** cytoplasm pathognomonic of EBV infection).

Answer 60

Epstein-Barr virus infection causes peripheral lymphocytosis and the presence of atypical lymphocytes (abnormally large reactive CD**_8_**+ T-cells with abundant cytoplasm) and **_Downey_** cells (atypical lymphocytes with strongly **basophilic** cytoplasm pathognomonic of EBV infection).

Question 61

Epstein-Barr virus remains latent in what cell type?

Answer 61

B cells

Question 62

To initiate infection, the Epstein-Barr virus envelope glycoprotein binds to the _____ membrane protein of _____ cells.

Answer 62

To initiate infection, the Epstein-Barr virus envelope glycoprotein binds to the **_CD21_** membrane protein of **_B_** cells.

Question 63

The four basic S/Sy of EBV mononucleosis are:

Answer 63

The four basic S/Sy of EBV mononucleosis are: **Fever** **Pharyngitis** **Painful lymphadenopathy** (posterior cervical) **Splenomegaly**

Question 64

Pharyngitis with production of _________ \_\_\_\_\_\_\_\_\_ is a common feature of Epstein-Barr virus-induced mononucleosis.

Answer 64

pharyngitis with production of **_tonsillar_** **_exudate_** is a common feature of Epstein-Barr virus-induced mononucleosis.

Question 65

Patients with Epstein-Barr virus infections who are mistakenly treated with ________ or ________ (due to suspicion of streptococcal pharyngitis) can develop a maculopapular rash.

Answer 65

patients with Epstein-Barr virus infections who are mistakenly treated with **_penicillin_** or **_amoxicillin_** (due to suspicion of streptococcal pharyngitis) can develop a maculopapular rash.

Question 66

Patients with Epstein-Barr virus infections who are mistakenly treated with penicillin or amoxicillin (due to suspicion of streptococcal pharyngitis) can develop what?

Answer 66

A maculopapular rash

Question 67

EBV is associated with what malignancies?

Answer 67

**B cell** malignancies (Hodgkin's + non-Hodgkin's + Burkitt lymphomas)

Question 68

EBV is associated with what B cell malignancies?

Answer 68

**Hodgkin's**, **non-Hodgkin's**, and **Burkitt lymphomas**

Question 69

EBV infection may be associated with the development of Hodgkin's lymphoma, which is characterized by what characteristic cells?

Answer 69

**Reed-Sternberg** cells (classically described as having an “owl eye” appearance)

Question 70

EBV is associated with which form of Burkitt lymphoma?

Answer 70

**African** (or **endemic**) Burkitt lymphoma (often presents with a large jaw lesion and/or jaw swelling)

Question 71

EBV is associated with a higher risk for development of __________ carcinoma, which is more commonly seen in patients with Asian ancestry.

Answer 71

EBV is associated with a higher risk for development of **_nasopharyngeal_** carcinoma, which is more commonly seen in patients with Asian ancestry.

Question 72

Epstein-Barr virus is associated with a higher risk for development of what oral lesion that occurs most commonly in HIV patients?

Answer 72

Hairy leukoplakia

Question 73

What can be used to rapidly diagnose acute Epstein-Barr virus infection?

Answer 73

The **monospot** test ## Footnote *(utilizes horse or sheep RBCs, which will agglutinate when mixed with patient serum due to production of anti-horse/sheep blood IgM antibodies induced by the presence of Epstein-Barr virus)*

Question 74

How does the monospot test identify acute cases of EBV?

Answer 74

It utilizes horse or sheep RBCs, which will **agglutinate** when mixed with patient serum due to production of **anti-horse/sheep blood IgM antibodies** induced by the presence of Epstein-Barr virus.

Question 75

Patients with what viral infection should avoid contact sports due to risk of splenic rupture?

Answer 75

Infectious mononucleosis

Question 76

Patients with what viral infection should avoid contact sports due to risk of what?

Answer 76

Splenic rupture

Question 77

What test is more expensive than ELISA or Western blot for HIV, but is more accurate?

Answer 77

NAAT

Question 78

**True/False** Individuals infected with HIV should be started on ART **as soon as possible**.

Answer 78

True.

Question 79

All of the following are risk factors for poor ART adherence except: ## Footnote **Low SES** **Active EtOH abuse** **Depression** **Poor patient education by MD** **Low literacy** **Pill burden**

Answer 79

**Low SES**

Question 80

What is the best method of determining a patient's adherence to HIV ART?

Answer 80

Monitoring viral load

Question 81

HIV is at an untransmissable level when the viral load is at what level?

Answer 81

\< 200 copies / mL

Question 82

What medication is the most commonly used pre-exposure prophylaxis for HIV infection? ## Footnote **PrEP**

Answer 82

**Tenofovir**/**emtricitabine** | (Truvada)

Question 83

What is the difference between the medication give for HIV pre-exposure prophylaxis (PrEP) and HIV post-exposure prophylaxis (PEP)?

Answer 83

No difference

Question 84

What percentage of HIV cases are made up of homo- or bisexual men?

Answer 84

50%

Question 85

Which of the following has the highest rate of HIV transmission? (I.e. infected fluids/tissues from which of the following is most likely to lead to seroconversion?) **1. Anal intercourse** **2. Blood product transfusion** **3. Kidney transplant** **4. Transplacental transmission**

Answer 85

**2. Blood product transfusion** (higher direct viral load transmission as viral load is highest in the blood)

Question 86

Which HIV protein binds CCR5 on macrophage surfaces?

Answer 86

gp 120

Question 87

Which HIV protein is responsible for HIV penetration through the host lipid bilayer?

Answer 87

gp 41

Question 88

What part(s) of the HIV virion actually make it into the cell?

Answer 88

The RNA | (+ enzymes?)

Question 89

What are the phases of HIV infection?

Answer 89

1. Acute (initial infection) 2. Chronic (latent period) 3. Crisis

Question 90

Homozygous mutation of what protein can lead to immunity to HIV infection?

Answer 90

CCR5

Question 91

How can HIV lead to increased likelihood of lymphoproliferative diseases?

Answer 91

Decreased T cell immunosurveillance

Question 92

Non-hodgkin's B cell lymphomas resulting from HIV infection are most often associated with translocations involving what chromosome?

Answer 92

8

Question 93

What two neoplasias are most associated with HHV-8 infection?

Answer 93

Kaposi sarcoma; primary effusion lymphoma