Viral STI continued Flashcards
When are neonates at highest risk for contracting HSV?
Neonates are at highest risk at birth from infected mothers when compared to after birth.
What are three compliations with dermal neonatal herpes infections?
Blindness
Microcephaly
Spastic quadriplegia
What percentage of neonates will develop encephalitis?
1/3 of neonate infections will develop into encephalitis often causing neurological impairment. Has 50% mortality in untreated patients.
What percentage of neonates with visceral HSV will undergo mortality?
80% in untreated, when treated the rate dissipates to 20%.
What are some of the complications with disseminated HSV?
HSV pneumotis and Disseminated intravascular coagulation.
What treatment are neonates of HSV infected mothers given following birth?
IV administration of antivirals for all neonate herpes cases.
What sort of virus is HSV?
HSV is an enveloped dsDNA virus that encodes many of its own enzymes including HSV polymerase.
What sort of neurons does HSV like to hide in?
Sensory type neurons.
HSV1 is most common with
Where as HSV2 is more common with….
HSV1 is more common with oral lesions where as HSV2 is most common with genital lesions.
What sort of smear is important for diagnosis of HSV?
Tzanck smear.
What can be used to determine between HSV1 and HSV2?
PCR can be used to detect the genome where as immunocytochemistry is used to detect antigens.
Primary Genital herpes is treated with what?
Oral antiviral treatment.
Recurrent genital herpes is treated with what?
Treated with long term oral antiviral treatment.
What are the treatment goals of Anti-herpetic drugs?
Shorten time to lesion healing and increase time between outbreaks.
Acyclovir and famciclovir work to treat what condition?
These work through similar mechanisms to treat HSV acting as nucleoside analogues for interuption of viral thymidine kinase.
What is Foscarnet and how does it work?
Foscarnet is a nonnucleoside inhibitor of HSV used in acyclovir resistant HSV infections.
It acts by blocking viral DNA polymerases.
What family is HPV a family member of?
Papovaviridae
What type of virus is Human papillomavirus?
Non enveloped ds DNA genome
Which two HPV strains increase risk of cervical cancer the most?
HPV-16 and HPV-18
Upregulation of E6 and E7 are most closely tied to what infection?
HPV
If E6 and E7 go unchecked by E2 it can lead to excessive protein production leading to cancer.
What does HPV E7 and HPV E6 block specifically?
HPV E6 blocks P53
HPV E7 blocks Rb
Both Rb and P53 normally stop the cell from entering S phase from G1.
Rising levels of E6 and E7 indicate risk of cancer.
Appearance of Koilocytes in a pap smear are indicative of what pathology?
Koilocytes are seen in HPV infections and can help in the diagnosis of HPV.
Koilocytes are enlarged keratinocytes containing hyperchromatic nuclei surrounded by characteristic halo.
At what age should YSPSTF HPV testing start and how often should the tests be done/ when should you stop?
The patient should be tested first at 21 years old.
Q3y paps costesting when older than 30 years old.
Stop at 65 if adequate prior screens.
What sort of cervical smear helps to diagnose HPV?
Papanicolaou stained cervical smears.
What prevention is there for HPV?
Guardisil and Ceravix.
What sort of vaccine is guardasil?
Guardasil is a quadrivalent test that protects against HPV 6,11,16, and 18.
Prepared from viral capsid proteins (L1)
What sort of vaccine is Ceravix?
A bivalent HPV vaccine protecting against HPV 16 and 18.
Which HPV vaccines are recommended to women and at what age?
Either the bivalent (ceravix) or quadrivalent (guardasil) is recommended for women at ages 11-12.
Which HPV vaccines are recommended to men and at what age?
Only the quadrivalent vaccine (guardasil) is recommended for boys at ages 11-12.
