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Path - Microbiology > Opportunistic Viral Infections > Flashcards

Opportunistic Viral Infections Flashcards

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Biology 101 flashcards
1
Q

primary cause of immunocompromised?

A

Primary
§ UNC93B deficiency and TLR3 deficiency
□ Associated with predisposition to herpes simplex encephalitis

§ Epidermodysplasia verruciformis

§ SCID

perforin deficiency in Familial Hemophagocytic Lymphohistiocytosis

§ HHV8 is associated with a STIM1 mutation

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2
Q

acquired cause of immunocompromised?

A 
§ Solid organ transplantation 
			§ Bone marrow transplantation HSCT
			§ Immunosuppressive drugs 
			§ Advanced HIV infection 
				□ NOTE: measles also causes a prolonged immunodeficient state after the infection
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3
Q

what is the Baltimore class-action?

A

is a virus classification system that groups viruses into families, depending on their type of genome (DNA, RNA, single-stranded (ss), double-stranded (ds), etc..)

and their method of replication.

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4
Q

are these DNA/RNA viruses:

Herpesvirus (HSV, VZV, EBV, CMV)
Adenovirus
Polyomavirus (BK, JC)
Papillomavirus

A

ds DNA viruses

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5
Q

are these DNA/RNA viruses:

Parvovirus

A

ss DNA virus

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6
Q

are these DNA/RNA viruses:

Norovirus
Coronavirus
Picornavirus (entero, echo, polio, coxsackie)
Flavivirus (Dengue, JapEnceph, West Nile)
Toga (Rubella, Chik)

A

ss+ RNA

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7
Q

Ebola, Marburg, Lassa, Hantavirus, CCHF
Influenza, Parainfluenza
Mumps, Measles

A

ss- RNA

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8
Q

what type of viruses are :

Hep B (DNA)
HIV (RNA)
A

retroviruses

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9
Q

what is a retrovirus?

A

A retrovirus is a type of RNA virus that inserts a copy of its genome into the DNA of a host cell that it invades, thus changing the genome of that cell.

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10
Q

both HEP B and HIV are retroviruses but what is the difference?

A

Hep B - ds dna virus

HIV - RNA

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11
Q

if you’re looking for infection which viral diagnostics to do?

A

PCR

NAAT - for neiserria

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12
Q

if you’re looking for evidence of previous infection which viral diagnostics to do?

A

serology

usually via ELISA

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13
Q

which virus can cause cancer in immunocompromised?

A

hhv8

karposi sarcomi

associated with STIM1 mutation

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14
Q

3 procedures needing immunosuppression?

A

SOT (solid organ transplant)

HSCT (human stem cell transplant)

HIV/AIDS

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15
Q

name a lentivirus and its condition?

A

HIV - causes AIDs

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16
Q

which virus causes Progressive multifocal leukoencephalopathy PML?

A

JC virus

John Cunningham virus, is a germ so common that the majority of adults have been exposed to it.

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17
Q

which virus causes Cervical cancer?

A

HPV

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18
Q

which virus causes chronic ulcer(s), pneumonitis, esophagitis…

A

HHV1

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19
Q

which virus causes Lymphoma, Burkitt’s

A

HHV4 (EBV)

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20
Q

which virus causes retinitis, other disease

A

HHV5 - CMV

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21
Q

which virus causes Encephalopathy

A

HIV

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22
Q

2 Types of HSCT?

A

Allo-graft

Auto-graft

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23
Q

Classes of immunosuppressive Drugs

A
  • Steroids
  • Calcineurin inhibitors (T-Cell) i.e. tacrolimus
  • Anti-proliferative agents eg azathioprine & Mycophenolate mofetil
  • Anti-bodies
  • T-cell Depleting / non-depleting
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24
Q

What must you remember in Bone marrow transplants?

A

if patient had immunity and is replaced with donor who did not have immunity, reactivation risk is BIG

espesh for opportunistic infections i.e. CMV

25
Q

when do viruses reactivate after SOtransplants ?

A

over a month after their transplant

26
Q

when do viruses reactivate after Bone marrow transplant?

A

within a month!

espesh herpes viruses

so faster!

27
Q

sources of infection in post transplant infections?

A

○ Viruses acquired from the graft (e.g. HBV)

○ Viral reactivation from the host (e.g. HSV)
- assess 1+2 via serology

○ Novel infection from infected individual (e.g. VZV)

28
Q

what to do for HSV prophylaxis?

A

HSV igG test

if its low (poor immunity) …

Prophylaxis:
acyclovir
1 month until HSCT
3-6 for SOT

29
Q

hsv and vzv which causes encephalitis?

A

vzv

hsv - can if TLR3 UNC93B deficiency (primary immunodeficiency)

30
Q

what to do for VSV prophylaxis?

A

Antiviral - acyclovir. Or Give them VZV IgG

31
Q

how to treat varicella? in immunosuppressed ofc

chicken pox

A

Anti-viral for 7-10 days
IV until no new lesions;
PO until all crusted

32
Q

how to treat zoster? in immunosuppressed off

shingles

A

Anti-viral (IV if disseminated) + analgesia

If Ramsay-Hunt: add steroids

33
Q

EBV can cause which 2 things?

A

B-cell lymphoma

PTLD - post-transplant lympho-proliferative disorder

34
Q

how to treat EBV?

A

Rx: ?Rituximab - antiCD20 - Removes the B cells

35
Q

you see Inclusion bodies on histology for which opportunistic infection in HIV?

A

CMV

36
Q

Ocular (retinitis) is a presentation of which infection?

A

CMV

remeber inclusion bodies - owls yes

37
Q

what viral infection happens when CD4<50

A

CMV

around 6 months

38
Q

what viral infection happens when CD4 approx 500

A

HSViruses

39
Q

treatment of CMV?

A

Bone marrow transplant:
- measure viral load treat if reactivation (pre-emptive)
IV Ganciclovir

SOT:
Prophylaxis - valganciclovir (PO) 100 days

40
Q

in SOT what is the risk with CMV?

A

directly threatens the graft - allograft disease

and damages endothelial cells

41
Q

what Presents with brownish/purplish vascular lesions that can be cutaneous or visceral ?

A

kaposi sarcoma

42
Q

diagnosis of KP sarcoma?

A

biopsy

43
Q

treatment of KP sarcoma?

A

§ Chemotherapy

§ Antiretroviral therapy

44
Q

Main pathological feature is demyelination of white matter

in which condition

A

JC virus - PML

45
Q

diagnosis of JC virus - PML?

A

MRI and PCR of CSF

46
Q

what is the investigation of choice in respiratory Viruses in the Immunocompromised?

A

• Multiplex PCR

47
Q

which Hepatitis viruses should get a vaccine before procedure?

A

Hep A

48
Q

core antibody cAb and surface antibody sAb

which is a marker of immunity?

A

sAb

49
Q

which antibody is marker of immunity?

A

IgG

50
Q

how to prevent hep b reactivation?

A

Nucleoside/nucleotide analogue Prophylaxis i.e.

TENOFOVIR

51
Q

which virus:

• In developed countries, it is a zoonosis caused by genotype 3 virus
In developing countries, it is mainly caused by genotype 1 virus

A

hep E

52
Q

who gets chronic hep b infections?

A

neonates

53
Q

NAME 2 POLYOMA VIRUSES?

A

JC virus

BK virus

54
Q

which virus Causes chronic anaemia in the immunocompromised ?

A

parvovirus B19

55
Q

Which virus can cause hydrops faetalis?

A

parvovirus B19

56
Q

what is the difficulty with CMV infection as opposed to EBV in immunosuppresed?

A

CMV - big issue with end organ damage

EBV - no end organ damage, but is Oncogenic!

57
Q

In hep B serology, what are the markers of infection?

A

sAg+
Circulating virus

cAb+ (IgM)
Acute immune response

eAg+
Circulating virus

58
Q

In hep B serology, what are the markers of immunity?

A

sAb+
Generated from:
sAg (virus)
sAg (vaccine)

cAb+ (IgG/total)
Generated from cAg (virus)

eAb+
Generated from eAg (virus)

59
Q

the presence of the following indicates?

Anti-hbs – surface antibody
Antihbc – core antibody

A

Anti-hbs – surface antibody (immunity)

Antihbc – core antibody (immunity)

Path - Microbiology (27 decks)

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