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Immuno mikro eng > Viral Respiratory Infections - DNA Viruses > Flashcards

Viral Respiratory Infections - DNA Viruses Flashcards

1
Q

How is mucous protective of the URT?

A

Contains mucins which are high viscosity tot rap viral particles, and contain decoy sialic acid receptors for agglutinating the virus

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2
Q

What virus subfamilies are EBV, VZV, and CMV in?

A

All Herpesviruses

VZV = alpha herpesvirus
CMV = beta herpesvirus
EBV = gamma herpesvirus
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3
Q

Is EBV common?

A

Yes, in US about 50% are seropositive before age 5, with another wave in adolescents and young adults

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4
Q

What does EBV usually cause in young children:

A

Sore throat and fever

Much less commonly otitis media, GI symptoms, and mono

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5
Q

What are the symptoms of EBV infectious mono-nucleosis? How long does it last?

A

Common in adolescents and adults

Fatigue, fever, sore throat (pharyngitis, copious)

Specific: Lymphadenopathy (cervical, could be generalized), splenomegaly (due to T cell proliferation), lymphocytosis, and heterophile antibodies

Lasts 2-4 weeks acutely, with fatigue lasting longer

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6
Q

What are heterophile antibodies?

A

Antibodies recognizing unusual antigens, caused by nonspecific B cell activation by EBV infection, even though the B cells never encountered those antibodies.

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7
Q

How is EBV transmitted and what is its cell tropism?

A

Transmitted via saliva
Tropism: infection begins in epithelial cells of upper respiratory tract, and spreads to B cells

Up to 10% of peripheral B cells become infected -> heterophile antibodies

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8
Q

What causes lymphocytosis in EBV?

A

T cells responding to infection proliferate

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9
Q

Why can EBV be transmitted even after infection resolution?

A

About 1 in 1,000,000 B cells remain latently infected -> potential for subclinical virus shedding

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10
Q

What cancers and lymphomas is EBV associated with?

A

Burkitt’s lymphoma (Africans, bar kid, swelling cheeks), Nasopharyngeal carcinoma (asians), Hodgkin’s Lymphoma (Owl sitting in Reeds), Lymphomas / Lymphoproliferative tumors in AIDS

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11
Q

What is Hairy Oral Leukoplakia? How can this be distinguished from Candida?

A

White, wart-like lesions typically found on the side of the tongue, which are sites of active EBV replication

Difference from Candida: cannot be wiped off

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12
Q

What clinical features distinguish CMV mononucleosis vs EBV mononucleosis?

A

CMV mono-nucleosis will be heterophile antibody negative, but will still show hepatosplenomegaly

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13
Q

How is CMV transmitted?

A

Direct contact, sexual contact, transfusion, transplantation, breast milk, or transplacentally

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14
Q

What is the structure of adenoviruses and where do they replicate?

A

Like all DNA viruses except poxviruses, they replicate in the nucleus.

Linear, dsDNA genome, non-enveloped icosahedral

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15
Q

What major CMV complications are immunocompromised patients at risk for?

A

CMV pneumonia and retinitis

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16
Q

What is the cell tropism of adenoviruses?

A

Mucosal epithelial cells - so primarily a respiratory pathogen

Respiratory tract, small intestine, epithelial tissue of eye

17
Q

What are the modes of transmission for adenoviruses?

A

Respiratory spread, especially GI pathogens subtype 40 and 41 can spread fecal-oral.

However, even in respiratory subtypes, the virus spreads to the GI tract and is spread in the feces (poor hygiene)

18
Q

What acute respiratory infection can adenovirus cause and what is its primary complication?

A

Acute febrile pharyngitis -> fever, sore throat, cough, nasal congestion with possible tonsillitis (pretty nonspecific for viral pathogens)

It is highly infectious and can lead to pneumonia as a complication.

19
Q

What is Acute Respiratory Disease (ARD)?

A

Respiratory infection commonly found in military recruits, transmission facilitate by stress and crowing.

Can cause mild URI to pneumonia

Only military has a vaccine

20
Q

What is pharyngoconjunctival fever? How is it uncommonly spread?

A

Adenovirus infection uncommonly spread through swimming pools, but also aerosols and fomites

Pharyngo: URI
Conjunctival: Pink eye

21
Q

What is epidemic keratoconjunctivitis and how is it typically spread?

A

Adenovirus causing highly contagious corneal and conjunctival infection which can cause permanent corneal damage, especially among those with corneal abrasion.

Typically spread via healthcare workers contamined eyedrops

22
Q

What do Adenovirus types 40 and 41 cause?

A

Infant gastroenteritis

Most adenoviruses replicate in GI tract, but do not cause GI disease

23
Q

What are two super uncommon adenovirus infections?

A

Urethritis and cystitis

24
Q

What are the two subfamilies of Parvoviruses, and what are the general features of each?

A

Very small ssDNA genomes

  1. Parvovirinae - autonomously replicate, includes Parvovirus B19
  2. Dependovirinae - requires helper viruses to replicate (adenovirus or herpesvirus), not associated with any disease and are being looked at for gene vector therapies
25
Q

What disease does Parvovirus B19 cause? Who gets it?

A

Erythema Infectiosum (Fifth Disease)

Typically school age children, rarely adults

26
Q

Who is at greatest risk of severe disease from Parvovirus B19?

A

Immunocompromised
Fetuses
Hemolytic anemia (due to associated reticulocyte suppression)

27
Q

What is the first stage of Parvovirus B19 infection / where does it replicate / shed?

A

Nonspecific flu-like symptoms and suppression of reticulocytes (RBCs)

Replicates in bone marrow and sheds in Upper Respiratory Tract (probably URT transmission)

Parvoviruses are inactivated by protective IgM response

28
Q

What is the second phase of Parvovirus infection?

A

Deposition of immune complexes leads to erythematous rash + arthritis symptoms

29
Q

What does Parvovirus B19 infection cause in patients with hemolytic anemia?

A

Transient Aplastic Crisis -> low number of RBCs until the infection is cleared

30
Q

How are patients with hemolytic anemia and immunocompromization with Parvovirus B19 treated?

A

Hemolytic Anemia - Blood Transfusions

Immunocompromised - Immunoglobulin therapy

31
Q

What is the risk in pregnancy of Parvovirus B19 infection?

A

Hydrops fetalis

  • fatal anemia of the fetus
  • condition caused by anemias which force the fetal heart to pump much more blood volume for the same amount of oxygen

Immuno mikro eng (56 decks)

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