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Viral STIs II Flashcards

1
Q

What is the progression of symptoms for Herpes?

A

Macules, papules, vesicles, pustules, ulcers

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2
Q

How long do the herpes lesions last for?

A

about 3 weeks

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3
Q

In which sex are symptoms more severe for herpes?

A

Women

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4
Q

What is the prodrome for Herpes recurrent lesions?

A

tingling, pain

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5
Q

How long does it take for herpes lesions to heal?

A

7-10 days

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6
Q

True or false: neonatal herpes infections are usually fatal, but asymptomatic

A

False,

Lethal yes, but rarely asymptomatic

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7
Q

What is the primary infection of herpes?

A

First time ever exposed

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8
Q

Is herpes painful? Pruritic?

A

Yes, and yes

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9
Q

What are the associated symptoms of herpes?

A

Fever
Inguinal lymph nodes
Malaise

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10
Q

Are recurrent lesions of herpes more or less severe than the initial infection?

A

Less

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11
Q

What is herpetic whitlow?

A

Infection in the digits

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12
Q

What is herpetic labialis?

A

Cold sores

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13
Q

What are the two scary herpes infections?

A

keratitis

Encephalitis

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14
Q

Who is usually infection with herpetic whitlow?

A

Healthcare workers

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15
Q

What infants are at the highest risk of developing neonatal herpes?

A

in infants born to mothers experiencing a primary infection during delivery

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16
Q

Can herpes pass through the placenta?

A

No

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17
Q

What is the least severe neonatal herpes infection?

A

Disease localized to skin, eyes, mouth

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18
Q

What are the serious consequences of babies not treated for herpes?

A

Blindness
Microcephaly
Spastic quadraplegia

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19
Q

What are the symptoms of encephalitis neonatal herpes infection?

A

Szs
poor feeding
Bulging fontanelle

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20
Q

What fraction of neonate infections with herpes develop microcephaly? What is the mortality rate?

A

1/3

50% mortality

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21
Q

What are the symptoms of disseminated neonatal herpes infections? What is the mortality rate?

A

Depends on organs involved

80% mortality rate

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22
Q

Are c-section indicated for herpes?

A

Yes

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23
Q

What is the family of herpes virus? Enveloped? Genome?

A

Herpesviridae family
Enveloped
dsDNA genome

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24
Q

What is the target of antivirals for herpes?

A

HSV pol

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25
Where does herpes establish a latent infection?
Sensory neurons
26
Which nerve is responsible for holding cold sore herpes on the face? Genitalia?
CN V Sacral plexus
27
What are the two types of HSV? Which are each associated with?
1= oral lesions 2= genitalia
28
How is HSV transmitted?
Saliva Sex Lesion contact
29
What are people usually exposed to HSV 1 and 2?
``` 1= <4 yo 2 = sexual activity ```
30
How do you diagnose HSV?
Lesion appearances PCR/serology Tzanck smear
31
What is the Tzanck smear? Which HSV viruses will this be positive for?
Seeing large, multinucleated cells HSV 1 and 2
32
How can you detect a dendritic lesion in the eye d/t HSV?
Fluorescent dye
33
What is the treatment for oral lesions of HSV?
Not treated with antivirals
34
What is the treatment for genital herpes?
Oral antivirals
35
What is the treatment for neonatal herpes?
IV antivirals
36
What is the treatment for ocular HSV infections?
Topical antivirals
37
What are the treatment goals for HSV?
Shorten time | Increase recurrence time
38
Do antiherpetic drugs work in the latent stage of HSV infection?
No
39
What is the MOA of nucleoside analogues like acyclovir?
Viral DNA pol inhibitor by guanosine analogue
40
Are there many side effects of acyclovir? Why?
No, because it needs to be activated by a viral enzyme
41
What is the viral enzyme that is needed to activate acyclovir?
Viral thymidine kinase
42
What are the non-nucleoside inhibitors for HSV? MOA?Is an enzyme needed? How is it administered?
Foscarnet Inhibitors of viral DNA pol no enzyme needed, but more side effects IV administration
43
What is the viral cause of genital warts?
HPV
44
What are the lesions associated with genital warts?
Hyperkerotitic , firm, exophilic papules
45
What are the symptoms of genital warts
Asymptomatic to itching, burning painfil
46
What are the three way cervical warts present?
Exophilic Endophilic Flat
47
How can you identify cervical warts?
Add acetic acid
48
What are the symptoms of respiratory papollomatisis of HPV?
Hoarseness Stridor Respiratory distress
49
What is the treatment for respiratory papillomatosis/laryngeal papillomas caused by HPV?
surgical removal
50
Is c-section helpful to prevent respiratory papillomatosis/laryngeal papillomas caused by HPV?
no
51
What is the family of HPV? Enveloped? genome?
Papvaviridae Non-enveloped dsDNA genome
52
Replication of HPV is closely associated with what property of the epithelial cells that it infects?
The differentiation status
53
What is the MOA of increased CA risk of HPV?
Increased expression of E6 and E7 via genome integration into host genome
54
What is E2?
Gene that regulates the expression of E6 and E7 (decreases)
55
What happens when E2 binds to E2BS? What happens in CA?
inhibits E6/E7 production | Integration into host cell genome, thus no regulation
56
What is the MOA of E6 and E7?
Inhibiting p53 and Rb respectively
57
What is the MOA of p53 and Rb?
Control cell cycle from G1 to S phase
58
When do precancerous lesions appear (what age)?
around 30 years
59
What age do cancerous HPV infections usually develop?
40ish yo
60
What is the progression of the histology of HPV?
CIN 1, CIN2, CIN3
61
What is the cytology progression of HPV?
LSIL, HSIL
62
How is HPV transmitted?
Sexually | Cuts/abrasions
63
What is the incubation period for genital warts?
3-4 months
64
How do you diagnose HPV?
Clinical appearance of warts PCR if necessary
65
What are koilocytes?
Enlarged keratinocytes that contain irregular hyperchromatic nuclei surrounded by a halo in a pap smear
66
Which serotypes of HPV have PCR dection?
16, 18, and 12
67
What is the treatment for gential warts caused by HPV?
cryotherapy | CO2 laser
68
What is the treatment for low grade neoplasms caused by HPV?
get wart off
69
What is the treatment for high grade neoplasms caused by HPV?
Hysterectomy Radiation Chemo
70
What are the prevention techniques for HPV?
Pap smears | HPV vaccine
71
What are the two vaccines for HPV?
Gardasil | Cervarix
72
What are the serotypes that Gardasil protects against? Cervarix?
``` Gardasil = 6, 11, 16, 18 Cervarix = 16, 18 ```
73
Which HPV vaccine should males get?
Gardasil
74
Which HPV serotypes cause laryngeal papillomas?
6 and 11
75
Which HPV serotypes cause anogenital warts?
6, 11, 16, 18, 31, 33,
76
Which HPV serotypes cause common warts?
2, 3, 10
77
Which HPV serotypes cause plantar warts?
1, 4
78
Which HPV serotypes cause carry a high risk of CA development?
16, 18, 31, 33
79
Which HPV serotypes cause carry a lower risk for CA development?
6, 11
80
What is an "initial genital infection" with herpes? Primary infection?
Initial genital = had before, but not in genitalia Primary = first time exposure
81
What are the three types of neonatal infections of herpes?
1. Localization to skin, eyes, mouth 2. Encephalitis 3. Disseminated
82
Are neonatal Herpes infection localized to the skin, eyes, and mouth lethal?
No
83
What is the mortality rate for disseminated neonatal herpes infection? Complications?
80% HSV pneumonitis Disseminated intravascular coagulation
84
Can HSV cross the placenta?
No
85
What part of the epithelium does cervical neoplasia have to breach to be considered invasive squamous cell carcinoma?
Basal membrane
86
What do the HPV vaccines contain as the active compound? How is this produced?
L1 capsid Produced through yeast

Microbio (50 decks)

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