(P2) Infect dis (cytomegalic inclusion disease- the Kidney)

Question 1

Name this slide:

1. Name the smaller darker structure
2. Name the larger tructure in the center

Answer 1

Cytomegalic Inclusion Disease (the Kidney)

1. Glomeruli endothelial cells
2. Affected renal tubule

Question 2

Name this slide:

Name the infected:

1. large center structure
2. LARGE CELLS?
3. small cells cells ?

Answer 2

Cytomegalic Inclusion Disease (the Kidney)

• 1. Infected Renal Tubule*
• 2. Intranucleor basophilic inclusions surrounded by a clear halo (owl’s eye)*
• 3. Renal Tubular epithelial cells*

Question 3

Name this slide

1. Name the large dark structure

Answer 3

• Cytomegalic Inclusion Disease (the Kidney)*
  1. I**ntranucleor basophilic inclusions

surrounded by a clear halo

(owl’s eye)

Question 4

Cytomegalic Inclusion Disease (the Kidney)

1. Virus type?
2. Route of transmission?
3. What cells does it infect?

Answer 4

1. -CMV beta-group herpes virus
2. -saliva, urine, breast milk, placenta
3. -brain: neurons
   - lungs: alveolar macrophages, epithelial cells, endothelial cells

-kidney: tubular epithelial cells and glomeruli endothelial cells

Question 5

Cytomegalic Inclusion Disease (the Kidney)

Name some other organisms

in the herpes group?

Answer 5

1. herpes simplex
2. varicella-zoster

Question 6

CMV is known as ?

Describe the Pathogen

&

its effects

Answer 6

• Cycomegalovirus CMV*
• is congenital and opportunistic pathogen that usually produces asymptomatic infection
• In neonates & immunocompromised patients leads to a devastating systemic infection

Question 7

• (CMV)*
• Transmission mechanism*

Answer 7

1. Fetus – across the placenta (congenital CMV)
2. Through cervical or vaginal secretions at birth, breast milk (perinatal CMV)
3. Saliva – usually during preschool years
4. urine
5. Genetal route – adolescents & adults
6. Iatrogenic – organ transplants, blood transfusion
7. Respiratory secretions

Question 8

CMV

Morphology

Answer 8

1. Enlargement of infected cells
2. Epithelial cells, lymphocytes, monocytes & establishes latency in WBC’s
3. Cellular and nuclear pleomorphism
4. Small asophilic intracytoplasmic inclusions
5. Intranuclear basophilic inclusions surrouned by a clear halo (OWL’S EYE)
6. Affected cells are:

Question 9

Microscopy of CMV

Answer 9

Cytomegalo virus

1. Marked cellular and nuclear enlargement
2. Giant nucleus which is usually solitary – contains a large central inclusion surrounded by a clear zone (halo)
3. Intranuclear viral inclusions (owl’s eye) in the tubular epithelial cells

Question 10

Describe microscopy of the cell affected by the Cytomegalovirus (CMV)

Answer 10

Enlarged infected cells w/basophilic intranuclear inclusions surrounded by clear halo (owl’s eye) (alveolar macrophages, epithelial and endothelial cells

Question 11

Is Disseminated CMV life threatening?

What orgarns are affected

and

name the condition?

Answer 11

YES

1. Lungs (pneumonitis)
2. GIT (Colititis)
3. Retina (Retinitis)

Question 12

Cytomegalic inclusion disease (the kidney)

Congenital infections:

Answer 12

1. Acquired in utero
2. Permanent deficits (hearing loss-neurologic impairments- intellectual disability)
3. 95 % asymptomatic
4. Intrauterine growth retardation
5. Jaundice- hepatospleenomegaly-

anemia-bleeding

encephalitis-microcephaly, calcifications

Question 13

CMV

INFECTED CELLS:

Answer 13

• -Brain* – neurons
• -Lungs* – alveolar macrophages, epithelial and endothelial cells

-Kidney – tubular epithelial & glomeruli endothelial cells

-Gladular organs - parenchymal epithelial cells

Question 14

Cytomegalovirus Mononucleosis

• Describe S/S*
• Diagnosis*
• Infected individuals remain ____ for life.*

Answer 14

S/S:

Fever, atypical lymphocytosis, lymphadenopathy,

hepatitis

Diagnosis:

Serology

Infected in indiv. remain Seropositive for life