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Step 1 AB > Virology > Flashcards

Virology Flashcards

1
Q

a. What are the Picornaviruses?

b. What kind of virus are they?

A

a. HAV, Enteroviruses (Polio, Coxsackie A/B, Echovirus) and Rhinovirus
b. ss naked + linear RNA virus

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2
Q

How are Picornaviruses spread?

A

Fecal oral (Except Rhinovirus)

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3
Q

a. What is the pathology of Poliovirus?

b. What is the clinical course of Poliovirus?

A

a. Enters GI tract, replicates in lymphoid tissues like Peyer’s patches, spread to anterior horn of LMN bodies (2-3 weeks after infection)
b. Causes asymmetric paralysis, myalgia, decreased deep tendon reflexes, respiratory insufficiency

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4
Q

What are the two vaccines available for Poliovirus?

A
  1. Salk - inactivated vaccine given parenterally (only forms IgG)
  2. Sabin - live attenuated given orally (forms IgG AND IgA Abs)
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5
Q

What diseases do Coxsackie virus A cause?

A
  1. Hand, foot, mouth disease (red vesicular rash)

2. Aseptic meningitis infection in summer

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6
Q

What diseases do Coxsackie virus B cause?

A
  1. Dilated cardiomyopathy

2. Devil’s grip, pleurodynia, Bornholm’s disease

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7
Q

Which viruses are SS + linear?

a. naked
b. enveloped

A

a. picornaviruses (echo, coxsackie, polio, rhino, HAV), hepevirus, calicivirus
b. flavivirus, togaviruses, retroviruses, coronaviruses

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8
Q

Where do + RNA viruses replicate?

A

In the cytoplasm

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9
Q

What Calicivirus causes gastroenteritis?

A

Norovirus

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10
Q

Norovirus

a. Where are infections common?
b. Causes?

A

a. Outbreaks with lots of people in close quarters (cruises, young kids in daycare), consumption of shellfish/buffets
b. Causes explosive diarrheal illness

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11
Q

What are the Flavivirus viruses?

A

HCV
Yellow fever
Dengue fever - break bone fever, thrombocytopenia, renal failure
West Nile virus - encephalitis, flaccid paralysis, seizures, coma

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12
Q

a. What kind of virus is Togavirus?

b. What are examples of Togaviruses?

A

a. ss + RNA virus, enveloped

b. Rubella, Western/Eastern Equine Encephalitis

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13
Q

What is the clinical disease caused by Rubella

A
  • Postauricular and occipital lymphadenopathy
  • Arthralgia and arthritis (adults)
  • Descending maculopapular rash that starts on face; 3 days (kids)
  • Congenital Rubella
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14
Q

What are symptoms of congenital Rubella?

A

Sensorineural deafness
Congenital cataracts
PDA
(Jaundice, blueberry muffin rash)

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15
Q

a. What is Coronavirus?

b. What illnesses does it cause?

A

a. SS + RNA, enveloped (helical)

b. SARS, MERS, common cold

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16
Q

What are the 3 structural genes of HIV and what do they code for?

A
  1. env (gp120 and gp41) - formed from cleavage of gp160 to form envelope glycoproteins; gp120 mediates attachment to CD4 T cells and gp41 mediates fusion and entry
  2. gag (p24) - capsid protein
  3. pol - reverse transcriptase, aspartate protease, integrase
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17
Q

a. What kind of virus is HIV?

b. How does it enter host?

A

a. Retrovirus; ss + RNA virus, enveloped (reverse transcriptase synthesizes dsDNA from genomic RNA and ds DNA integrates into host)
b. Virus binds CC45 on macrophages (early) or CXCR4 on T cells (late)

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18
Q

How is diagnosis of HIV made?

A

Screening test - ELISA

Confirmatory test - Western blot

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19
Q

How is diagnosis of HIV made in babies? Why?

A

PCR; ELISA/Western blots are often falsely positive initially in babies born to infected mothers because gp120 can cross the placenta

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20
Q

a. What bug causes Rocky Mountain Spotted Fever?
b. What is the vector?
c. What other bug can be transmitted by the same vector?

A

a. Rickettsia rikettsii
b. Tick (Dermacenter - dogtick)
c. Francisella tularensis (lymphadenopathy, site specific ulcer, granuloma formation)

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21
Q

What vector transmits the following diseases and what do they cause?

a. Trypanosoma cruzi
b. Yersinia pestis
c. Plasmodium vivax
d. Leishmania donovani

A

a. Reduviid bug; Chagas disease
b. Flea; Plague
c. Mosquito; malaria
d. Sandfly; Visceral leishmaniasis

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22
Q

What species/diseases does the Ixodes tick transmit?

A
  1. Anaplasma phagocytophilum - human granulocytic anaplasmosis
  2. Borrelia burgdorferi - Lyme disease
  3. Babesia microti -
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23
Q

Which stain do you use for each of the following?

a. Cryptococcus neoformans
b. Pneumocystis jirovecii
c. Chalmydia

A

a. India ink
b. Silver stain
c. Giemsa stain

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24
Q

What kind of virus is Orthomyxovirus?

A

Negative sense ss RNA (has 8 segments); enveloped

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25
Q

What are the four segmented viruses?

A 
Orthomyxovirus
Bunyavirus
Arenavirus
Reovirus
(BOAR)
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26
Q

Why is it important if virus is segmented?

A

A segmented virus can undergo reassortment and genetic shift to cause pandemics

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27
Q

What is Hemagglutinin? What is it’s role? (HA)

A

It is a protein that binds sialic acid in the upper respiratory tract or on RBCs that promote viral entry
It causes RBCs to clump together
Seen in influenza virus; the subtype (H1, H2, H3) determines the type of cells it can bind to (determines cell tropism)

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28
Q

What is role of M2 protein of influenza?

A

It is a protein channel that creates the proper pH for viral uncoating; only found on Influenza A

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29
Q

What is the mechanism of Amantadine/Rimantadine?

A

Inhibit M2 so that viral uncoating cannot happen; not used for influenza anymore

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30
Q

What is the function of Neuraminidase? (NA)

A

It cleaves the sialic acid to release the newly formed virus particles from the host cell

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31
Q

What is mechanism of Oseltamivir?

A

NA inhibitor; prevents release of viral progeny

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32
Q

enveloped ss - RNA virus, non-segmented

A

Paramyxovirus

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33
Q

Parmyxovirus viruses

A

Parainfluenza
RSV
MEasles
Mumps

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34
Q

4 C’s of Rubeola (Measles)

A

Cough
Coryza
Conjunctivitis
Koplik spots - white spots on buccal mucosa

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35
Q

What kind of vitamin can reduce measles mortality in malnourished children?

A

Vitamin A

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36
Q

What is Subacute Sclerosing Pancencephalitis?
Presentation?
Treatment?

A

Late complication of measles infection
Inflammation and sclerosing of brain caused by persistent measles infection
6 year interval between symptom development; presents as behavioral changes, clumsiness, involuntary jerky movements, seizures, coma, death
No treatment

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37
Q

Symptoms of Mumps

A 
Parotitis
Orchitis (inflammation of testis) --> can cause sterility
aseptic Meningitis 
Meningitis
POM
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38
Q

Where does mumps replicate?

What kind of virus is it?

A

In the parotid glands - or in the CNS

Paramyxovirus (enveloped ss - RNA)

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39
Q

Virus that causes Croup

Symptoms of Croup

A

Paramyxovirus (enveloped ss - RNA)

Seal-like barking cough, inspiratory stridor

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40
Q

X-ray finding for Croup

A

Steeple sign (from narrowing of trachea and subglottis)

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41
Q

Virulence factor of all Paramyxoviruses

A

Fusion protein –> causes respiratory epithelial cells to fuse and form multinucleate cells

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42
Q

Pallivizumab

A

monoclonal antibody against F protein that prevents pneumonia caused by RSV infection in premature infant

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43
Q

Most common cause of pneumonia and bronchiolitis in infants

A

RSV (Paramyxovirus; enveloped ss - RNA)

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44
Q

Rhabdovirus

A

enveloped ss - RNA that causes Rabies virus

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45
Q

Cytoplasmic inclusions in neurons infected by Rabies virus

A

Negri bodies

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46
Q

Shape of Rhabdovirus envelope

A

Bullet shaped

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47
Q

Progression of Rhabdovirus

A

Fever, malaise –> agitation, photophobia, hydrophobia, hypersalivation –> paralysis, coma –> death

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48
Q

Pathogenesis of Rhabdovirus

A

Binds to Nicotinic Ach receptors and travels to CNS by migrating in retrograde fashion up nerve axons; initial infection happens in post synaptic motor endplate

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49
Q

Replication and Infection of Rhabdovirus

A

Incubation period of weeks to months; depends on distance of original infection from CNS

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50
Q

Where are Negri bodies found?

A

Purkinje cells of cerebellum and hippocampal neurons in Rhabdovirus (Rabies) infection

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51
Q

Filovirus

A

Enveloped ss - RNA virus (helical capsule)

Causes Ebola/Marburg hemorrhagic fever

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52
Q

Filovirus targets which types of cells?
Presentation?
What can it progress to?

A

Targets endothelial cells, phagocytes and hepatocytes
Presents with abrupt onset of flu-like symptoms, diarrhea/vomiting, high fever, myalgia
Can progress to DIC, diffuse hemorrhage, shock

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53
Q

What kind of virus is Bunyavirus?

A

Enveloped ss - RNA virus (3 segments)

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54
Q

Where does Bunyavirus get it’s envelope from

A

Golgi body complex of host cells

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55
Q

What kind of virus is Hanta virus?

A

Bunyavirus

Enveloped, ss - RNA (3 segments)

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56
Q

What is the vector of Hanta virus?

A

Deer mouse

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57
Q

What are symptoms of Hanta virus?

A

Pulmonary edema via capillary leak
Pre-renal azotemia
Hemorrhagic fever

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58
Q

What are other Bunyaviruses? What are they transmitted by?

A

California encephalitis and Rift Valley fever - transmitted by Aedes mosquito
Hantavirus - transmitted by deer mouse

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59
Q

What kind of virus is Arenavirus?

A

Enveloped, SS - circular RNA (2 segments)

BOAR = Segmented viruses = Bunyavirus, Orthomyxovirus, Arenavirus, Reovirus

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60
Q

How are Arenaviruses spread?

A

By rodents

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61
Q

What diseases does Arenavirus cause?

A

Lymphocytic choriomeningitis virus -> febrile, meningoencephalitis

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62
Q

How can you inactivate Arenavirus?

A

Heating, low pH, detergent, irradiation

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63
Q

What kind of virus is Reovirus?

A

NAKED DS RNA (10-12 segments)

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64
Q

1 cause of fatal diarrhea in children

A

Rotavirus (a Reovirus = DS RNA virus)

65
Q

How is Rotavirus transmitted? What does it cause?

A

Transmitted fecal-oral route

Exposive, watery diarrhea caused by toxin

66
Q

What does the Rotavirus toxin do?

A

Toxin = NSP4 enterotoxin

Increases Chloride permeability –> secretory diarrhea

67
Q

What is classic time of year for Rotavirus outbreak? In which population

A

Winter; especially in day care centers, kindergartens

68
Q

What is a S/E of the Reovirus vaccine?

When is vaccine given?

A

Intussusception - telescoping of bowel

Before 3 months of age

69
Q

What is a S/E of the Reovirus vaccine?

When is vaccine given?

A

Intussusception - telescoping of bowel

Before 3 months of age

70
Q

What kind of virus is EBV?

A

Herpesviruses ds DNA, enveloped

HHV-4

71
Q

What kind of virus is EBV?

A

Herpesviruses ds DNA, enveloped

HHV-4

72
Q

What are symptoms of EBV Mononucleosis?

A

Fevere
HepatoSPLENOMEGALY (from T cell proliferation)
Lymphadenopathy (especially POSTERIOR CERVICAL)

73
Q

How is EBV transmitted?

A

Respiratory secretion and saliva

74
Q

What cells does EBV infect?

A

Infects B cells through CD21 but then causes proliferation of reactive cytotoxic T cells (Downey cells) trying to control infection

75
Q

How is EBV detected?

A

+ Monospot Test (heterophile Abs detected by agglutination of sheep or horse RBCs)

76
Q

What are associations of EBV?

A

Nasopharyngeal carcinoma (tumor of Asians)
B cell lymphoma (endemic Burkitt lymphoma in jaw, sporadic Burkitt lymphoma in ileocecum, with t(8;14))
Oral Hairy Leukoplakia seen in patients with HIV, not precancerous

77
Q

What are associations of EBV?

A

Nasopharyngeal carcinoma (tumor of Asians)
B cell lymphoma (endemic Burkitt lymphoma in jaw, sporadic Burkitt lymphoma in ileocecum, with t(8;14))
Oral Hairy Leukoplakia seen in patients with HIV, not precancerous

78
Q

What are the TORCHeS infections?

A 
Toxoplasma
Other (VZV, Parvo)
Rubella
CMV
HIV, Herpes
Syphilis
79
Q

What are the TORCHeS infections?

A 
Toxoplasma
Other (VZV, Parvo)
Rubella
CMV - most common fetal viral infection 
HIV, Herpes
Syphilis
80
Q

What are the TORCHeS infections?

A 
Toxoplasma
Other (VZV, Parvo)
Rubella
CMV - most common fetal viral infection 
HIV, Herpes
Syphilis
81
Q

Congenital CMV Infection

A

Blueberry muffin rash from thrombocytopenia
Jaundice
Hepatosplenomegaly
Sensorineural hearing loss
Intracranial calcifications –> seizures, mental retardation

82
Q

Congenital CMV Infection

A

Blueberry muffin rash from thrombocytopenia
Jaundice
Hepatosplenomegaly
Sensorineural hearing loss
Intracranial calcifications –> seizures, mental retardation
(Congenital CMV is more likely to be asymptomatic)

83
Q

Congenital CMV Infection

A

Blueberry muffin rash from thrombocytopenia
Jaundice
Hepatosplenomegaly
Sensorineural hearing loss - develop hearing loss later in life
Intracranial calcifications –> seizures, mental retardation
(Congenital CMV is more likely to be asymptomatic - 80-90%)

84
Q

Which trimester is associated with highest risk of Congenital CMV?

A

Second trimester

Hydrops fetalis = heart failure –> severe edema —> leads to spontaneous abortion

85
Q

Which trimester is associated with highest risk of Congenital CMV?

A

Second trimester

Hydrops fetalis = heart failure –> severe edema —> leads to spontaneous abortion

86
Q

1 cause of mental retardation from congenital viral infection

A

CMV

87
Q

1 cause of sensorineural hearing loss in infants

A

CMV

88
Q

Organ transplant patients at risk of developing which CMV infection?

A

Pneumonia

89
Q

Organ transplant patients at risk of developing which CMV infection?

A

Pneumonia

90
Q

When are HIV patients at risk of CMV infections?

A

With CD4 counts

91
Q

What is common CMV disease in HIV patients?

A

AIDS retinitis (vision loss, flashing lights, etc - usually unilateral)

92
Q

What is common CMV disease in HIV patients?

A

AIDS retinitis (vision loss, flashing lights, etc - usually unilateral)

93
Q

CMV vs. Herpes esophagitis

A

CMV - singular, deep and linear

Herpes - multiple and shallow

94
Q

CMV vs. Herpes esophagitis

A

CMV - singular, deep and linear

Herpes - multiple and shallow

95
Q

Treatment for CMV

A

Ganciclovir

96
Q

Treatment for CMV

A

Ganciclovir - first line

Fascarnet - second line (when virus has UL97 gene mutation that makes it resistant to Ganciclovir)

97
Q

Treatment for CMV

A

Ganciclovir - first line

Fascarnet - second line (when virus has UL97 gene mutation that makes it resistant to Ganciclovir)

98
Q

How do you distinguish CMV and EBV?

A

CMV has (-) monospot test

99
Q

What is the characteristic looking cell in CMV?

A

Owl eye inclusions

100
Q

How do you transmit CMV?

A 
Congenitally
Transfusion
Sexual Contact
Saliva
Urine 
Transplant
101
Q

Where is CMV latent?

A

In mononuclear cells (T, B, macrophages)

102
Q

What kind of virus is CMV?

A

Herpesvirus - Enveloped, ds DNA (HHV-5)

103
Q

What kind of virus is CMV?

A

Herpesvirus - Enveloped, ds DNA (HHV-5)

104
Q

What is Congenital Varicella syndrome?

A

Limb hypoplasia
Cutaneous scarring in dermatomal pattern
Blindness

105
Q

What virus is responsible for Roseola?

A

HHV6 (also called Exanthema subitum)

106
Q

What characterizes Roseola illness?

A

High fevers for several days that can cause seizures, followed by a diffuse macular rash
Affects children ages 6 months - 2 years

107
Q

What does the rash of Roseola look like?

A

Diffuse macular rash that has lacy appearance and spares the face

108
Q

What virus is responsible for Kaposi sarcoma?

A

HHV-8 (enveloped, DS DNA)

109
Q

Which patients does Kaposi sarcoma commonly affect?

A

HIV/AIDS, transplant patients

Seen in old Russian men and African patients

110
Q

What does Kaposi sarcoma look like?

A

Dark/violaceous plaques/nodules on nose, extremities or mucous membranes (most commonly HARD PALATE)
Also affects GI tract and lungs

111
Q

What is the pathophysiology of Kaposi sarcoma plaques?

A

They represent vascular proliferations from the virus causing dysregulation of VEGF

112
Q

How is HHV8 (Kaposi sarcoma) transmitted?

A

By sexual contact (includes kissing)

113
Q

What diseases does Polyomavirus cause?

A

JC virus - progressive multifocal leukoencephalopathy in HIV

BK virus - transplant patients, commonly targets kidney

114
Q

What is JC virus?

A

A polyomavirus (naked ds DNA) that causes PML in HIV patients; they are non-enhancing ring lesions caused by demyelination

115
Q

What is BK virus?

A

A polyomavirus (naked ds DNA) that causes hemorrhagic cystitis in transplant patients

116
Q

What is the only ss DNA virus?

A

Parvovirus

117
Q

What kind of virus is Papillomavirus?

A

Naked ds DNA

118
Q

Diseases caused by HPV 1-4

A

Verruca vulgaris (cutaneous wart)

119
Q

Diseases caused by HPV 6, 11

A

1) Laryngeal papillomatosis (recurrent respiratory papillomatosis) - tumors in airway, seen in kids from transmission during birth
2) Anogenital warts - sexually transmitted

120
Q

Diseases caused by HPV 16, 18, 31, 33

A

Anogenital cancers (squamous cell carcinoma)

121
Q

HPV Vaccine

A

Gardasil

Inactivated subunit vaccine against HPV 6, 11, 16, 18

122
Q

Pathogenesis of HPV

A

Disrupts cell cycle –>

  • E6 degrades p53 and removes break from transition from G1 –> S phase
  • E7 degrades Rb (tumor suppressor)
123
Q

Most common STD

A

HPV

124
Q

Post coital bleeding

A

Think cervical cancer

125
Q

ss DNA virus

A

Parvovirus

126
Q

How is Parvovirus spread?

A

By respiratory droplets

127
Q

Parvovirus disease in children and adults

A

Children - Slapped cheeks rash
Adults - arthritis and edema
Sickle cell patients - Aplastic crises

128
Q

Causes RBC destruction in fetus that leads to hydrops fetalis and death

A

Parvovirus B19 (smallest DNA virus, single stranded)

129
Q

NAKED ss DNA virus

A

Parvovirus

130
Q

Causes RBC destruction in fetus that leads to hydrops fetalis and death

A

Parvovirus B19 (smallest DNA virus, single stranded)

131
Q

What diseases does Adenovirus cause?

A

Conjunctivitis
Hemorrhagic cystitis
Pharyngitis, sore throat
Pneumonia

132
Q

What diseases does Adenovirus cause?

A

Conjunctivitis
Hemorrhagic cystitis
Pharyngitis, sore throat
Pneumonia

133
Q

What kind of virus is Adenovirus?

A

Naked, double stranded DNA virus

134
Q

What kind of virus is Adenovirus?

A

Naked, double stranded DNA virus

135
Q

How is Adenovirus transmitted?

A

Fecal oral transmission

136
Q

Who is commonly infected with Adenovirus?

A

Military recruits
Kids in daycare
People swimming in public pools

137
Q

How is Adenovirus transmitted?

A

Fecal oral transmission or by respiratory droplets

138
Q

Who is commonly infected with Adenovirus?

A

Military recruits
Kids in daycare
People swimming in public pools

139
Q

Who can be given an Adenovirus vaccine? What kind of vaccine is it?

A

Military recruits are given a live attenuated vaccine

140
Q

Who can be given an Adenovirus vaccine? What kind of vaccine is it?

A

Military recruits are given a live attenuated vaccine

141
Q

Enveloped Double Stranded DNA virus (LARGEST)

A

Poxvirus

142
Q

Enveloped Double Stranded DNA virus (LARGEST)

A

Poxvirus

143
Q

B cytoplasmic inclusions (Guarnierni)

A

Sites of viral replication of Poxvirus

144
Q

B cytoplasmic inclusions (Guarnierni)

A

Sites of viral replication of Poxvirus

145
Q

Where does Poxvirus replicate?

A

In the cytoplasm because it contains everything it needs - it makes it’s own envelope and it has a DNA dependent RNA polymerase

146
Q

Where does Poxvirus replicate?

A

In the cytoplasm because it contains everything it needs - it makes it’s own envelope and it has a DNA dependent RNA polymerase

147
Q

Flesh colored papule with central umbilication

A

Molluscum contagiosum (caused by Poxvirus)

148
Q

Flesh colored papule with central umbilication

A

Molluscum contagiosum (caused by Poxvirus)

  • Spread by sexual contact in adults (single papule)
  • In kids, multiple papules on trunk
149
Q

What kind of virus is Hepatitis B?

A

Enveloped, partially DS DNA virus

150
Q

Enveloped DNA viruses

A

Herpesviruses
Hepadnavirus (Hepatitis B)
Poxvirus

151
Q

Non-enveloped DNA viruses

A

Adenovirus
Parvovirus (single stranded)
Papillomavirus
Polyomavirus (JC and BK)

152
Q

Transcription of HBV genome

A

Starts as partially DS DNA virus –> ss RNA –> ds DNA

Carries reverse transcriptase and does NOT integrate into host chromosome like HIV

153
Q

Transcription of HBV genome

A

Starts as partially DS DNA virus –> ss RNA –> ds DNA

Carries reverse transcriptase and does NOT integrate into host chromosome like HIV

154
Q

How is HBV transmitted?

A

Sex and blood

155
Q

Associations of HBV (3)

A
  1. Polyarteritis nodosa - purpuric rash with non-blanching dark merciless, arthralgia and kidney damage (vasculitis)
  2. Membranous glomerulonephritis (thickened BM)
  3. Membranoproliferative glomerulonephritis (tram track)
156
Q

Which liver enzyme is higher in viral hepatitis?

A

ALT

157
Q

How is HBV transmitted?

A

Sex and blood, perinatally

158
Q

Which liver enzyme is higher in viral hepatitis?

A

ALT

159
Q

What is given to babies of moms infected with HBV?

A

Immunoglobulin AND the HBV vaccine

Step 1 AB (29 decks)

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