VIROLOGY Flashcards
site of latency of HSV-2
lumbosacral ganglia
all viruses are haploid except
retroviruses
o the antigen of the core of the virus (HBsAg removed)
o antibodies are not protective but yield information about the state of infection
o positive antibodies seen during the “window period” (a period of active infection)
HBcAg
interacts with the CD4 receptor in HIV
gp120
hepatocellular injury due to immune attack - NO cytopathic effect (host CD8+ T cells destroy infected hepatocytes)
HEPATITIS B VIRUS
MUMPS complications
Parotitis, Orchitis, Meningitis (aseptic)
most common cause of aseptic meningitis
ENTEROVIRUSES (Coxsackie virus, poliovirus and echovirus)
o painful vesicles along dermatomal distribution
o debilitating pain (postherpetic neuralgia)
Zoster
subacute sclerosing panencephalitis (SSPE) is a potential complication of ___
Measles
• “thread-like” viruses
• longest viruses
- outbreak of hemorrhagic fever in Zaire (1976)
- 100% mortality rate

EBOLA HEMORRHAGIC FEVER
aseptic meningitis POLIO
nonparalytic poliomyelitis
o fever and severe pleuritic-type chest pain
o pain due to an infection of the intercostal muscles (myositis), not of the pleura
Pleurodynia sec to coxackie
- only causes disease in immunocompromised hosts
- causes progressive multifocal leukoencephalopathy (PML) in patients with AIDS
- demyelinating disease that affects oligodendrocytes characterized by deficits in speech, coordination, and memory
JC POLYOMA VIRUS
ATTACHMENT PROTEIN of HIV
gp 120 / Surface Protein (SU)
only DNA virus that produces DNA by reverse transcription with mRNA as the template
HEPADNAVIRIDAE (HEPA B)
The most common sites of viral infection and disease is the
Oropharynx and respiratory tract
ANTIGENIC SHIFTS cause
PANDEMICS
o major changes based on the reassortment of segments of the genome RNA
SUDDEN CHANGE in molecular structure
o EXAMPLE: when human flu A virus recombines with swine flu A virus
o a soluble component of the viral core
o presence connotes high infectivity
HBeAg
- Called “orphans” because they were not initially associated with any disease
- Now known to cause aseptic meningitis, upper respiratory tract infection, febrile illness with and without rash, infantile diarrhea, and hemorrhagic conjunctivitis.
ECHOVIRUS
-
Herpangina
- fever, sore throat, and tender vesicles in oropharynx
-
Hand-foot-and-mouth disease
- vesicular rash on hands and feet and ulcerations in the mouth
- Hemorrhagic Conjunctivitis
COXSACKIE VIRUS
MASTER THIS TABLE!!!!

o presence of this antibody indicates that patient is immune and/or cured
o NO active disease present
Anti-HBsAg
PARAMYXOVIRUSES
PaRaMyxoviruses
Parainfluenza virus
RSV
Measles virus
Mumps virus
only virus with fibers
ADENOVIRUS
- pinkish, papular skin lesions with an umbilicated center
- HP: Henderson-Paterson bodies - intracytoplasmic eosinophilic inclusions
- transmission: direct contact
- treatment: Cidofovir
MOLLUSCUM CONTAGIOSUM VIRUS

presence connotes low infectivity
Anti-HBeAg
HHV 6
ROSEOLA / EXANTHEM SUBITUM / SIXTH DISEASE
directs entry of the double-stranded DNA provirus into the nucleus, and is later essential for the process of virus assembly; Outer matrix Protein
MA / p17
• member of flavivirus family
• most common cause of epidemic encephalitis
- most prevalent in SEA
- transmitted by Culex mosquitoes
• thalamic infarcts on CT scan
JAPANESE B ENCEPHALITIS

- preferentially infects and kills helper (CD4+) T lymphocytes
- loss of cell-mediated immunity
- high probability of opportunistic infections
- main immune response consists of cytotoxic (CD8+) lymphocytes
HIV
infected cells appear normal, but are producing large numbers of progeny viruses
Commensal Symbiosis
infect squamous cells and induce formation of cytoplasmic vacuole (koilocytes)

HPV
causes major outbreaks of influenza
*Does not lead to pandemic
Influenza B
o most common cause of MYOCARDITIS AND PERICARDITIS
o fever, chest pain, and signs of congestive failure.
COXSACKIE VIRUS
HP: Negri body

RABIES
Type-specific envelope glycoproteins in HIV
gp120 and gp41
all enveloped viruses acquire their envelope from plasma membrane EXCEPT
herpes virus (from nuclear membrane)
ALL RNA viruses have SINGLE-STRANDED RNA except
REO AND ROTAVIRUS (dsRNA)
describes a collection of inflammatory disorders associated with paradoxical worsening of preexisting infectious processes (HBV, HCV, MAC, MAI, etc.) following the initiation HAART in HIV-infected individuals
Immune reconstitution inflammatory syndrome (IRIS)
In Severe Acute Respiratory Syndrome (SARS), the virus binds to which receptor?
ACE-2 receptor
The only positive among vaccinated patients
Anti-HBs
old infection is present
IgG anti-HBcAg
most common clinical form of POLIO; mild, febrile illness with headache, sore throat, nausea, and vomiting.
abortive poliomyelitis
Coreceptors of HIV where gp 120 binds on the surface of the cells. Binding to these coreceptors are impt for HIV to infect normal cells.
CXCR 4 - located on T-cells
CCR 5 - T cells, macrophages, monocytes and dendritic cells
o Induce humoral and cell-mediated immunity but may revert to virulence on rare occasions
o Dangerous to give to immunocompromised patients or their close contacts
Live-Attenuated Vaccines
steeple sign on x-ray

LARYNGOTRACHEOBRONCHITIS (CROUP) secondary to PARAINFLUENZA VIRUS 1 AND 2
PICORNAVIRIDAE
PERCHed on a PIC (peak).
Poliovirus
Echovirus
Rhinovirus
Coxsackievirus
Hepatis A virus
PICornaviridae
Most DNA viruses have BOTH a negative strand and a positive strand except
PARVOVIRUSES, which have single-stranded DNA genome
FUSION PROTEIN of HIV
gp41 / Transmembrane Protein (TM)
o genital warts (condyloma acuminata)
o respiratory tract papilloma
o most common viral STD
• HPV-6 and 11
pathognomonic Koplik spots - bright red lesions with a white, central dot on buccal mucosa

MEASLES
most common cause of childhood diarrhea
ROTAVIRUS
DOC for Influenza
Oseltamivir or Zanamivir
• Amantadine or rimantadine for influenza A only
- no chronic carrier state
- no cirrhosis
- no hepatocellular carcinoma
- high mortality in pregnant women
HEPATITIS E
- retrovirus causing adult T-cell leukemia and HTLV associated myelopathy
- HP: malignant T cells with flower-shaped nucleus
HUMAN T-CELL LYMPHOTROPIC VIRUS (HTLV)

DOC for HSV
Acyclovir
o shortens the duration of the lesions
o reduces the extent of shedding of the virus
o no effect on the latent state
MCC of COMMON COLDS
RHINOVIRUS
- Replicate better at 33°C than at 37°C → they affect primarily the nose and conjunctiva rather than the lower respiratory tract.
- Acid-labile → killed by gastric acid when swallowed → they do not infect the gastrointestinal tract, unlike the enteroviruses.
- genital herpes
- painful anogenital vesicles
- neonatal herpes
- contact within birth canal
- aseptic meningitis
Herpes Simplex Virus Type 2
bind cytokines and block their ability to interact with their intended targets
cytokine decoys
Influenza that causes worldwide epidemics (pandemics)
Influenza A
*Each year, influenza is the most common cause of respiratory tract infections.
Examples of Live Attenuated Vaccines
§ MMR (the only live-attenuated vaccine that can be given to HIV-positive patients who do not show signs of immunodeficiency)
§ Influenza (intranasal)
§ Smallpox
§ Sabin’s polio vaccine
§ Chicken pox
§ Rotavirus
§ Yellow fever
Treatment for HBV
interferon-a and lamivudine
-
immediate early proteins
- translated from premade mRNAs
- impair assembly of the MHC class I–viral peptide complexes
- HP: giant cells with owl’s-eye nuclear inclusions

CMV
All double-stranded DNA have icosahedral symmetry except
POXVIRUS in which DNA has complex structural proteins looking much like a box.
one virus produces a protein that can be used by another virus
complementation
• Bullet-shaped enveloped virus with a helical nucleocapsid and one piece of single-stranded, negative-polarity RNA
• multiplies locally at bite site, infects sensory neurons, and moves by axonal transport to CNS
RABIES VIRUS
carcinoma of cervix, penis, and anus
HPV-16, 18, 31, 33
Kaposi sarcoma must be differentiated from _________ because of their similarities in terms of clinical presentation
bacillary angiomatosis (sec to Bartonella henselae and Bartonella quintana)

o oncogenicity associated with expression of latency-associated membrane protein 1 (LMP-1)
o Burkitt lymphoma: in African people
o B-cell lymphomas
o nasopharyngeal carcinoma: in Chinese people
o hairy leukoplakia in AIDS patients
EBV
True or False.
enveloped viruses are less stable and more easily inactivated.
TRUE
attachment of RBCs to surface of infected cells
Hemadsorption
Surface spikes are fusion proteins, not hemagglutinins or neuraminidases .
RESPIRATORY SYNCYTIAL VIRUS
MEMORIIIIZZZZEEEEE!!!!

German Measles
RUBELLA VIRUS (TOGAVIRIDAE)

o incubation period 14–21 days
o prodrome followed by 3-day posterior auricular LAD
o face - trunk - arms/legs
o immune-complex polyarthritis in adults
Cowdry type B intranuclear inclusions
POLIOVIRUS
Naked DNA Virus
Papillomavirus
Adenovirus
Parvovirus
Polyomavirus
Examples of Killed Vaccines
* Induce only humoral immunity but are stable
(RIP Always; SalK=Killed)
§ Rabies
§ Influenza (injected)
§ Salk’s polio vaccine
§ Hepatitis A
- Nonenveloped virus with icosahedral nucleocapsid and one piece of single-stranded, positive-polarity RNA
- Oral-fecal transmission
• most common cause of nonbacterial diarrhea in adults
• sudden onset of vomiting and diarrhea accompanied by fever and abdominal cramping
VIRAL GASTROENTERITIS secondary to NORWALK VIRUS (NOROVIRUS)
oncogenic viruses induce transformation and unrestrained growth
Malignant transformation
-
Erythema Infectiosum (Fifth Disease)
- bright red cheek rash (slapped cheeks) with fever, coryza, and sore throat
-
Aplastic crisis
- interferes with erythroid progenitor cells
- transient but severe aplastic anemia in children sickle cell anemia, thalassemia or spherocytosis
-
Fetal Infections
- 1 st trimester: fetal death
- 2 nd trimester: hydrops fetalis
-
Arthritis
- immune-complex arthritis of small joints
-
Chronic B19 Infection
- pancytopenia in immunodeficient patients
PARVOVIRUS B19

replicates in motor neurons in anterior horn of spinal cord, causing paralysis
POLIOMYELITIS
o new infection is present
o most specific marker for diagnosis of acute HBV infection because it persists during the window period
IgM anti-HBcAg
DNA VIRUSES
DNA Viruses are HHAPPPPy viruses.
Hepadna
Herpes
Adeno
Pox
Parvo
Polyoma
Papilloma
type of POLIO: flaccid paralysis; permanent motor nerve damage
paralytic poliomyelitis
principal marker of risk for developing chronic liver disease and liver cancer (hepatocellular carcinoma) later in life.
Persistence of HBsAg
ALL DNA viruses replicate in the NUCLEUS except
Poxvirus
E7 gene in HPV inhibits
Rb
have a bullet-shaped capsid
rhabdoviruses
Hepatitis that cause enteric infections
Hepatitis A and E
genomic reassortment causes
epidemics
o “kissing disease”
o fever, sore throat, lymphadenopathy, and splenomegaly
o splenic rupture is a rare complication
§ rapid increase in size produces a tense, fragile splenic
capsule
Infectious Mononucleosis secondary to EBV
HP: multinucleated giant cells (Warthin-Finkeldey bodies)

MEASLES
CONGENITAL RUBELLA SYNDROME
5 Bs of Congenital Rubella Syndrome
- Bulag (cataracts)
- Bingi (sensorineural deafness)
- Bobo (mental retardation)
- Butas ng puso (PDA)
- Blueberry muffin baby

Which is the first vaccine known to prevent a human cancer?
HBV
ANTIGENIC DRIFTS cause
EPIDEMICS
o minor changes based on mutations in the genome RNA
GENOME: Regulatory Genes in HIV

GENOME: Structural Genes


Nagayama spots: erythematous papules on soft palate and base of the uvula

ROSEOLA / EXANTHEM SUBITUM / SIXTH DISEASE
Major antigens of INFLUENZA
hemagglutinin (H) and neuraminidase (N)
HEMAGGLUTININ
- Binds to the cell surface receptor (neuraminic acid, sialic acid) to initiate infection of the cell
- The target of neutralizing antibody
NEURAMINIDASE
- Cleaves neuraminic acid (sialic acid) to release progeny virus from the infected cell
- Also degrades the protective layer of mucus in the respiratory tract → enhances access to the respiratory epithelial cells.
associated with autoimmune vasculitides (polyarteritis nodosa)
HBV
All DNA viruses are icosahedral except
Poxvirus (helical)
MEMORRRRIIIIZZZEEEE!!
RNA VIRUSES

Distinguished from all other RNA viruses by the presence of an unusual enzyme, reverse transcriptase → which converts a single-stranded RNA viral genome into double-stranded viral DNA.
RETROVIRIDAE
AIDS-DEFINING ILLNESSES and CD4 LEVELS
MEMORIIIIIZEEE!!!

o gingivostomatitis
o herpes labialis (lips)
o keratoconjunctivitis
o temporal lobe encephalitis
o herpetic whitlow (fingers)
o herpes gladiatorum (trunk)
Herpes Simplex Virus Type 1
- URT: pharyngitis, conjunctivitis, coryza
- LRT: bronchitis, atypical pneumonia
- GIT: acute gastroenteritis
- GUT: hemorrhagic cystitis
- histopathology
o Cowdry type B intranuclear inclusions
ADENOVIRUS
HHV-4
EBV
• visual or functional change in infected cells
Cytopathic effect
NEGATIVE-STRAND RNA VIRUSES
o When negative-stranded RNA viruses enter the cell, they are not able to begin translation immediately
o Must transcribe negative strand to positive (–) → (+)
o Virion brings its own RNA-dependent polymerase, which will carry out the transcription of the negative-strand into positive.
“Always Bring Polymerase Or Fail Replication.”
Arenaviruses
Bunyaviruses
Paramyxoviruses
Orthomyxoviruses
Filoviruses
Rhabdoviruses
The only DNA virus that replicates in the cytoplasm
Poxvirus
viruses with SEGMENTED GENOME
B–O–A–R
Bunyaviruses
Orthomyxoviruses (influenza)
Arenaviruses
Reoviruses
most immunogenic region of gp120
V3 loop
E6 gene in HPV inhibits
p53
Envelope Spikes of Paramyxoviruses

finding antibody in one who previously had none
Seroconversion
can be used to diagnose current infection
Presence of IgM
- infects mainly lymphoid cells, primarily B lymphocytes
- elicits EBV-specific antibodies and nonspecific heterophil antibodies
EBV
main cause of essential mixed cryoglobulinemia
HEPATITIS C VIRUS
- Enveloped virus with icosahedral nucleocapsid and linear dsDNA
- cultured in shell tubes
• negative heterophil test
CYTOMEGALOVIRUS
ALL DNA viruses have LINEAR DNA except
CIRCULAR
- Papilloma
- Polyoma
- Hepadna
- only disease that has been eradicated from the face of the Earth
- largest viruses
- brick-shaped poxvirus containing linear dsDNA
- HP: Guarnieri bodies - intracytoplasmic eosinophilic inclusions
- transmission: aerosol or contact
- incubation period of 7–14 days
- prodrome of fever and malaise followed by centrifugal rash
SMALLPOX (VARIOLA VIRUS)

Receptors used by viruses

NAKED VIRUSES
NAKED CPR and PAPP smear
- Calicivirus
- Picornavirus
- Reovirus
- Parvovirus
- Adenovirus
- Papillomavirus
- Polyomavirus
HIV protein that mediates the fusion of the viral envelope with the cell membrane at the time of infection.
gp41
VIRAL LIFE CYCLE AND PHARMACOTHERAPY

o having this antigen means the patient has the disease (chronic, acute, or asymptomatic carrier)
o precedes onset of symptoms and elevation of liver enzymes
HBsAg
most prevalent blood-borne pathogen
HEPATITIS C VIRUS
reduce the expression of antigen presenting cells and inactivate complement
virokines
Naked RNA Virus
Calicivirus
Picornavirus
Reovirus
Hepevirus
cannot be used to diagnose current infection; antibody may be due to an infection in the past
Presence of IgG
Most RNA viruses have helical symmetry except:
icosahedral symmetry
§ Flaviviruses
§ Caliciviruses
§ Reoviruses
§ Picornavirus
§ Togaviruses
§ Hepevirus
What can differentiate chronic active infection from chronic carrier in HBV
HBeAg
The interstitial space between the nucleocapsid and the envelope is called the
Tegument/Matrix
most common cause of congenital abnormalities
Congenital CMV infection
- microcephaly, seizures, deafness, jaundice, and purpura
- most common when mother infected in 1 st trimester
large, pink to purple intranuclear inclusions (Cowdry type A)
HSV
Influenza B virus is only a human virus. True or false.
TRUE
HUMAN HERPESVIRUS – 8
- Kaposi sarcoma (KS) is a rare type of cancer that can affect both the skin and internal organs
- M.ost common symptoms: red or purple patches on the skin.

complications of VZV
§ pneumonia
§ encephalitis
§ Reye syndrome
Cone-shaped, icosahedral core containing the major capsid protein
p24 / CA
- only causes disease in immunocompromised hosts
- causes hemorrhagic cystitis and nephropathy in patients with solid organ (kidney) and bone marrow transplants
BK POLYOMA VIRUS
ROSEOLA / EXANTHEM SUBITUM / SIXTH DISEASE
HHV-6

*rose-colored macules appear on body after several days of high fever; can present with febrile seizures; usually affects infants
two different viruses infect the same cell
phenotypic mixing
POLIO VACCINES
o killed (Salk IPV)
o live, attenuated (Sabin OPV)

site of latency of HSV-1:
trigeminal ganglia
ALL RNA viruses replicate in the CYTOPLASM except
INFLUENZA AND RETROVIRUS
DOC for CMV
Ganciclovir
the most important test in Hepa A virus
anti-HAV IgM
FIFTH DISEASE
PARVOVIRUS B19
highly active antiretroviral therapy (HAART) regimen
3 drugs to prevent resistance: 2 NRTIs (zidovudine and lamivudine) and protease inhibitor (indinavir)
involvement of geniculate ganglion causes facial nerve paralysis
Ramsay Hunt Syndrome secondary to VZV

CARDINAL MANIFESTATIONS OF MEASLES
3 Cs: Cough, Coryza, Conjunctivitis, Koplik spots
vesicular centrifugal rash : “dewdrop on a rose petal” appearance
VZV