Viral infections of blood and tissues I Flashcards
Does EBV have an envelope?
Yes
What is the EBV genome?
dsDNA
How does EBV gain attachment and entry?
C3d
Where does EBV replicate?
Epithelial cells and B cells
What is the virology of EBV?
- Infected B cells induced to proliferate 2. Heterophile Abs produced 3. T cells clear infection but some B cells remain (memory)
What are the genes involved in EBV carciogenesis?
Latent membrane protein 1 (LMP1), latent membrane protein 2 (LMP2), Epstein Barr viral nuclear antigen 1 (EBNA1)
What is the function of LMP1 in EBV?
Increased growth and suppressed apoptosis
What is the function of LMP2 in EBV?
Increased growth of B cells
What is the function of EBNA1 in EBV?
Controls expression of LMP1 and LMP2
When is a rash seen in infectious mononucleosis?
Following ampicillin treatment
What is the course of appearance of antibodies in infectious mononucleosis?
- Anti-EA / Anti-VCA 2. IgM 3. Anti-EBNA / IgG
What is the diagnosis for infectious mononucleosis?
- Mono spot test - heterophile Abs 2. Antibodies to EBV - IgM to viral capsule antigen (VCA) demonstrates primary infection 3. Downey cells
What are Downey cells?
Atypical T cell with vacuoles, altered nucleus, and indented cell margins
What are cofactors associated with Burkitt’s lymphoma?
Chronic malaria and immune suppression
What are the clinical symptoms of Hodgkin’s lymphoma?
Enlarged mediastinal lymph nodes, fever, night sweats, weight loss
What is the key cytological finding in Hodkin’s lymphoma?
Reed Sternberg cell - large cell with two or more nuclei or nuclear lobes - each of which contains an eosinophilic nucleus
What are the symptoms of nasopharyngeal carcinoma?
Facial pain, fullness in sinuses and throat, hearing loss
What is the treatment for post-transplantation lymphoproliferative disorder?
- Reduce immunosuppression 2. Treat with rituximab 3. Conventional chemotherapy
Is CMV enveloped?
Yes
What is the CMV genome?
dsDNA
Where does latency occur in CMV infection?
Monocyte
What are the primary antiviral therapies used for CMV?
Gancyclovir (IV / oral), valganciclovir (oral)
What is the method of action of gancyclovir?
Converted to polymerase inhibitor by CMV enzymes
What is the method of action of valganciclovir?
Converted to gancyclovir within the body
What drugs are used for resistant CMV?
Cidofovir, Foscarnet
How does CMV infectious mononucleosis-like illness differ from actual mononucleosis?
No heterophile antibodies, seen in infections of non-immunocompromised adults
What are the main symptoms of cytomegalic inclusion body disease?
Hepatosplenomegaly, jaundice, petechiae / rash
What is the risk of transmission from primary CMV infection during pregnancy?
33%
CMV retinitis is usually seen in what patient population?
AIDS patients
