Viral infections of blood and tissues I

Question 1

Does EBV have an envelope?

Answer 1

Yes

Question 2

What is the EBV genome?

Answer 2

dsDNA

Question 3

How does EBV gain attachment and entry?

Answer 3

C3d

Question 4

Where does EBV replicate?

Answer 4

Epithelial cells and B cells

Question 5

What is the virology of EBV?

Answer 5

1. Infected B cells induced to proliferate 2. Heterophile Abs produced 3. T cells clear infection but some B cells remain (memory)

Question 6

What are the genes involved in EBV carciogenesis?

Answer 6

Latent membrane protein 1 (LMP1), latent membrane protein 2 (LMP2), Epstein Barr viral nuclear antigen 1 (EBNA1)

Question 7

What is the function of LMP1 in EBV?

Answer 7

Increased growth and suppressed apoptosis

Question 8

What is the function of LMP2 in EBV?

Answer 8

Increased growth of B cells

Question 9

What is the function of EBNA1 in EBV?

Answer 9

Controls expression of LMP1 and LMP2

Question 10

When is a rash seen in infectious mononucleosis?

Answer 10

Following ampicillin treatment

Question 11

What is the course of appearance of antibodies in infectious mononucleosis?

Answer 11

1. Anti-EA / Anti-VCA 2. IgM 3. Anti-EBNA / IgG

Question 12

What is the diagnosis for infectious mononucleosis?

Answer 12

1. Mono spot test - heterophile Abs 2. Antibodies to EBV - IgM to viral capsule antigen (VCA) demonstrates primary infection 3. Downey cells

Question 13

What are Downey cells?

Answer 13

Atypical T cell with vacuoles, altered nucleus, and indented cell margins

Question 14

What are cofactors associated with Burkitt’s lymphoma?

Answer 14

Chronic malaria and immune suppression

Question 15

What are the clinical symptoms of Hodgkin’s lymphoma?

Answer 15

Enlarged mediastinal lymph nodes, fever, night sweats, weight loss

Question 16

What is the key cytological finding in Hodkin’s lymphoma?

Answer 16

Reed Sternberg cell - large cell with two or more nuclei or nuclear lobes - each of which contains an eosinophilic nucleus

Question 17

What are the symptoms of nasopharyngeal carcinoma?

Answer 17

Facial pain, fullness in sinuses and throat, hearing loss

Question 18

What is the treatment for post-transplantation lymphoproliferative disorder?

Answer 18

1. Reduce immunosuppression 2. Treat with rituximab 3. Conventional chemotherapy

Question 19

Is CMV enveloped?

Answer 19

Yes

Question 20

What is the CMV genome?

Answer 20

dsDNA

Question 21

Where does latency occur in CMV infection?

Answer 21

Monocyte

Question 22

What are the primary antiviral therapies used for CMV?

Answer 22

Gancyclovir (IV / oral), valganciclovir (oral)

Question 23

What is the method of action of gancyclovir?

Answer 23

Converted to polymerase inhibitor by CMV enzymes

Question 24

What is the method of action of valganciclovir?

Answer 24

Converted to gancyclovir within the body

Question 25

What drugs are used for resistant CMV?

Answer 25

Cidofovir, Foscarnet

Question 26

How does CMV infectious mononucleosis-like illness differ from actual mononucleosis?

Answer 26

No heterophile antibodies, seen in infections of non-immunocompromised adults

Question 27

What are the main symptoms of cytomegalic inclusion body disease?

Answer 27

Hepatosplenomegaly, jaundice, petechiae / rash

Question 28

What is the risk of transmission from primary CMV infection during pregnancy?

Answer 28

33%

Question 29

CMV retinitis is usually seen in what patient population?

Answer 29

AIDS patients