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Derm Micro > Pox Virus > Flashcards

Pox Virus Flashcards

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1
Q

What is the structure of pox viruses?

A

Non-icosahedral with complex structure known as “brick-shaped.” Virus can actually be seen under LM.

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2
Q

What does the intracellular pox virus contain?

A

Core and lateral bodies surrounded by an envelope.

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3
Q

What does the extracellular pox virus contain?

A

Everything that the intracellular virus has with the addition of an extra envelope.

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4
Q

What is the genome of pox viruses?

A

Large, double stranded linear DNA genomes that are complexed with proteins.

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5
Q

Replication occurs where for pox viruses?

A

Cytoplasm

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6
Q

What happens during uncoating 1 for pox viruses?

A

Virus enters cells and releases core particle into the cytoplasm

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7
Q

For pox viruses, what does the core particle contain?

A
  1. DNA-dependent RNA polymerase
  2. Capping and methylating enzymes
  3. PolyA polymerase
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8
Q

For pox viruses, what happens with the core particle upon release into the cytoplasm?

A

A round of early mRNA synthesis proceeds inside the core. mRNAs then travel to the cytoplasm and are translated.

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9
Q

What happens during uncoating 2 of pox viruses?

A

The early proteins that have been synthesized lead to complete uncoating. DNA is released into the cytoplasm and DNA replication begins.

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10
Q

For pox viruses, how and where does virus assembly take place?

A

Late transcripts and proteins (structural proteins and virion enzymes) are produced in the cytoplasm leading to virus assembly there. Known as “virus factories.”

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11
Q

How do pox virus virions attain an envelope?

A

Most virions remain intracellularly and the membrane appears to develop de novo. “Crescents” with no detectable contacts with existing membranes begin to envelope core structures. 1% derive a second envelope from the Golgi membrane and eventually are released from the cell.

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12
Q

What are the pertinent infectious agents of pox virus in the real world?

A

Extracellular enveloped viruses (EEVs)

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13
Q

What is variola virus?

A

Smallpox

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14
Q

What is vaccinia virus?

A

Used for smallpox vaccination. Essentially a lab strain. Reservoir is unknown.

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15
Q

For pox viruses, what do agents of molluscum contagiosum cause?

A

Nodular skin lesions

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16
Q

What are the 2 basic forms of smallpox?

A

Variola major and variola minor

17
Q

What does smallpox cause?

A

A systemic dz with a generalized rash

18
Q

How is smallpox spread?

A

Inhalation of virus released from ruptured mouth lesions

19
Q

What are the early symptoms of smallpox?

A

High fever, malaise, body aches, and viremia followed by small red spots in mouth and on tongue

20
Q

When is a smallpox pt most contagious?

A

When a red spot in mouth or on tongue ruptures

21
Q

What is the toxemic phase of smallpox?

A

After second viremia, infected macrophages migrate to epidermis leading to skin lesions.

22
Q

What are the skin lesions like of the toxemic phase of smallpox?

A

Initial skin lesion is a raised bump with a depression in the middle. Then become pustules that feel as if there’s a BB pellet inside. Pustules then scab over leading to pitted scars.

23
Q

How long is a smallpox pt contagious?

A

Until the last scab falls off

24
Q

How do you distinguish smallpox from chickenpox?

A
  1. Smallpox lesions are firm, well define, and develop a pit. Chickenpox lesions are superficial.
  2. Chickenpox lesions in a certain area will all be at different stages
25
Q

What are the 2 forms of molluscum contagiosum?

A
  1. Childhood

2. Young adulthood

26
Q

What are the characteristics of the childhood form of molluscum contagiosum?

A

Lesions appear on face, trunk, and limbs. Spread via direct contact from skin to skin. Mostly tropical.

27
Q

What are the characteristics of the young adulthood form of molluscum contagiosum?

A

Most lesions are on the lower abdomen. Spread via sexual transmission.

28
Q

What happens to the lesions of molluscum contagiosum?

A

Spontaneously disappear in 2-12 months

29
Q

How is molluscum contagiosum diagnosed?

A

Appearance of lesions. Confirmed by demonstration of large cytoplasmic inclusions in eosinophils of the affected area.

30
Q

Describe the vaccinia vaccine for smallpox.

A
  1. live vaccine
  2. inoculate epidermis: produces localized lesion that heals w/in 2 weeks
  3. vaccination 3 days postexposure can protect (7 days post can lessen severity)
  4. effectiveness declines after 3 years: completely gone after 20 years
31
Q

What are the 4 key features that allowed eradication of smallpox by 1977?

A
  1. humans were the only reservoir
  2. no healthy carriers
  3. no sub-clinical infxns so cases were easily identified
  4. effective vaccine available
32
Q

T or F. Vaccinia for smallpox is the safest vaccine available.

A

F: it is the least safe

33
Q

Which pts should not receive the vaccinia vaccine for smallpox?

A
  1. pregnant or breast feeding
  2. weakened immune system
  3. eczema, atopic dermatitis, severe acne
  4. non-emergency situations for those under 18
  5. heart dz
34
Q

T or F. For every 1 million people who receive the vaccinia vaccine for smallpox, 50-1000 will suffer severe adverse reactions, 15 will suffer life-threatening complications, and 1-3 will die.

A

T

35
Q

What can some adverse reactions to the vaccinia vaccine for smallpox be treated with?

A

VIG (vaccinia immune globulin). Cidofovir is a promising drug for complications.

36
Q

What are 3 non-life threatening complications to vaccinia vaccine for smallpox (in increasing order of frequency)?

A
  1. generalized vaccinia
  2. inadvertent inoculation
  3. erythema multiforme (allergic skin rash)
37
Q

What are 4 life-threatening complications to vaccinia vaccine for smallpox (in increasing order of frequency)?

A
  1. progressive vaccinia (assoc w/ CMI defects)
  2. post-vaccinial encephalitis (autoimmune response w/ 30% death rate)
  3. eczema vaccinatum (can lead to shock and death)
  4. myopericarditis or MI

Derm Micro (7 decks)

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