V-Viral Infections

Question 1

symptoms of infectious mononucleosis

Answer 1

fever + malaise + exudative pharyngitis + splenomegaly + tender lymphadentis + rash (if treated with ampicilin)

Question 2

pathogenesis of mono

Answer 2

EBV infected B cells are targeted by immune system
transmit via saliva

Question 3

serology of mono

Answer 3

-IgM to viral capsid antigen if primary infection
-downey cells (atypical T cells)
-heterophile antibodies (mono-like illnesses from CMV will not have)

Question 4

burkitt’s lymphoma

Answer 4

from latent EBV in jaw of children of central Africa

translocation of chromos 8 and 14

Question 5

hodgkins disease presentation

Answer 5

lymphadenopathy in supraclavicular or axilla regions+ enlarged lymph nodes deep in chest + fever + night sweats + weight loss

Question 6

hodgkin’s disease pathology

Answer 6

latent EBV
reed-sternberg cells

Question 7

nasopharyngeal carcinoma presentation

Answer 7

facial pain + fullness in sinuses and throat + hearing loss

Question 8

nasopharyngeal carcinoma pathology

Answer 8

latent EBV in southeast Asia and China
not B cell related - epithelial cells instead

Question 9

PTLD presentation

Answer 9

abnormal prolif of lymphoid cells + fever + fatigue + weight loss + progressive encephalopathy

benign or malignant

Question 10

PTLD pathology

Answer 10

latent EBV in transplant patients so treat by reducing immunosup first then rituximab and chemo

Question 11

oral hairy leukoplakia presentation

Answer 11

nonpainful lesions/warts on lateral tongue

Question 12

oral hairy leukoplakia pathology

Answer 12

lytic/active EBV in adolescents and adults esp if immunocomp

since lytic can treat with antiherpetic drugs

Question 13

cytomegalic inclusion presentation

Answer 13

neonates show hepatosplenomegaly + jaundice + petechiae/rash + hearing loss

can develop later in life too

Question 14

cytomegalic inclusion pathology

Answer 14

pregnant women exposed to CMV

Question 15

CMV on transplant recipients

Answer 15

1. CMV pneumonitis - fever + hypoxia + interstitial lung infiltrates
2. GI problems - nausea, diarrhea, abdom pain, vomit

Question 16

CMV on AIDS patients

Answer 16

1. CMV retinitis- blurred vision, floaters, white lesions
2. GI problems
3. CMV pneumonitis

Question 17

ganciclovir

Answer 17

aka GCV antiviral that targets DNA polymerase
-gets converted to oral polymerase inhibitor by CMV enzymes

can also use valganciclovir that gets converted to GCV

Question 18

cidofovir

Answer 18

aka CDV antiviral that targets DNA polymerase
-gets converted to viral polymerase inhibitor by cellular enzymes

Question 19

foscarnet

Answer 19

aka FOS antiviral that directly inhibits CMV DNA polymerase

Question 20

viral myocarditis symptoms

Answer 20

SOB + exercise intolerance + fatigue + chest pain + abdom pain in adult men

Question 21

cause of viral myocarditis

Answer 21

lots of stuff
-adenovirus, enterovirus, parvovirus, HHV-6

Question 22

diagnosing viral myocarditis

Answer 22

chest radiography and ECG esp if congestive heart failure

Question 23

presentation of Kaposi sarcoma

Answer 23

cutaneous lesions (purple, brown) + weight loss + fever + spindle morphology of cells from HHV-8

endothelial cell origin

Question 24

classic Kaposi sarcoma

Answer 24

rare and rarely life threatening
-middle eastern or mediterranean
-few lesions

Question 25

endemic Kaposi sarcoma

Answer 25

either classic presenting OR aggressive and fatal in equatorial Africa pre-pubescent kids

Question 26

transplant related Kaposi sarcoma is from

Answer 26

due to immunosupp from transplant so once discontinued lesions resolve

Question 27

AIDS related Kaposi sarcoma

Answer 27

widespread lesions + lymph node swelling + fever + weight loss + fatal if reaches lungs

Question 28

adult T cell lymphoma presentation

Answer 28

papules/plaques/tumors/ulcers from skin infiltration of tumor cells + hypercalcemia + lymphadenopathy + h/smegaly in Japan, Caribbean, central Africa

flower cell histology

Question 29

HTLV-1 associated myelopathy presentation

Answer 29

stiff gait > LE weakness > back pain > incontinence > beridden

from demyelination of neurons from autoimmune dz