Virus Diarrhea

Question 1

Influenza virus is a _____ virus, causing _____

Answer 1

orthomyxo virus, ordinary flu

Question 2

Orthomyxoviridae is an epidemic influenza…why is it so infectious?

Answer 2

Spread by small-particle respiratoyr aerosols (stay in air and linger)

Question 3

List the two distinct glycoproteins on the outside membrane. of Orthomyxoviridiae. What are their functions? Which one does antiviral drugs target?

Answer 3

• HA (hemagglutinin activity) – fuses to the cell’s sialic acid residues
• NA (neuraminidase) – cleaves the cell mucin barrier/sialic acid receptor, critical for newly formed virus release

Neuraminidase inhibitors

Question 4

Antigenic drift vs. Antigenic Shift

Answer 4

DRIFT: Slight changes in the antigenic nature of orthomyxoviridiae glycoproteins due to viral replication mutations

-our immune system can’t attack as well, so we get mild disease

SHIFT: complete change of HA, NA, or both; cause pandemics of influenza

Question 5

Complications of Influenza seen in the elderly and immunocompromised

Answer 5

Spreads to lower respiratory tract –> pneumonia

Question 6

What is the classification of Orthommyxo and Paramyxo?

Answer 6

RNA virus, single negative stranded, enveloped

(orthomyxo is a segmented negative stand)

Question 7

Paramyxo causes a parade of diseases. What are the three main/importantdisease associations with paramyxo?

Answer 7

Big Picture:

1. lungs
2. kids
3. viremia

• mumps: local parotid and testis infection
• measles: severe systemic febrile illness
• mumps and measles: encaphalitis

Question 8

Mumps virus infection frequently involves _____

Answer 8

parotid gland - 3 weeks post exposure, you see painful parotid swelling

can also see orchitis (testes swelling)

Question 9

Cop licking a red-white-blue lollipop. What’s this image reference?

Answer 9

Kopliks spots – seens in measles; 2a day before the rash, you see small red lesions with blue white centers in the mouth

*(4 C’s of measles: Cough, Coryza, Conjunctivitis, Koplik’s) *

Question 10

Which two viruses cause the common cold?

Answer 10

Rhinovirus and Coronaviridae (rhino with the common cold drinking a corona beer)

Question 11

Class pinrciple behind HAART and reccommended agents

Answer 11

A 3 drug therapy:

• 2 nucleoside reverse transcriptase inhibitors
• 1 protease inhibitor or a non-nucleoside analog

Question 12

What is the function of reverse transcriptase in the HIV life cycle? Which type of drugs inhibit this step?

Answer 12

-Converts single standed RNA to double stranded DNA

nucleoside/nucleotide reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors block this process

Question 13

Important NRTIS (nucleoside/tide reverse transcriptase inhibitors)

Answer 13

1. Ziduvudine (ZDV or AZT)
2. Lamivudine
3. Tenofovir

Question 14

HHV I : Where does it hide (latency), what are the manifestations?

Answer 14

HHV1 = HSV-1; neurons; skin mucosa

Question 15

HHV II: Where does it hide (latency), what are the manifestations?

Answer 15

HHV II = HSV-2; neurons/senory ganglia; skin/mucosa

Question 16

HHV III: Where does it hide (latency), what are the manifestations?

Answer 16

HHV III = VZV; neurons/glial; skin, visceral, eye disease

Question 17

HHV IV: Where does it hide (latency), what are the manifestations?

Answer 17

HHV IV = EBV; B cells; mononucleosis, association with Burkitt’s lymphoma and nasopharyngeal cancers in SA Asia; oral hairyleukoplakia in AIDS

Question 18

HHV V: Where does it hide (latency), what are the manifestations?

Answer 18

HHV V = CMV; not sure where it stays latent; immunocompromised rhinitis

Question 19

HHV VIII: Where does it hide (latency), what are the manifestations?

Answer 19

HHV VIII= Kaposi’s sarcoma; endothelial cells, VEGF like substance, purple lesions

Question 20

What is mononucleosis syndrome, and what should be on your dDx?

Answer 20

Syndrome = fever, fatigue, rash, lymph nodes swollen with possible hepatosplenomegaly, pharyngitis

EVC (HHV 4) is most common, CMV is much less common (10%), also think about Toxoplasmosis

Question 21

Which herpes virus can lead to pancreatitis?

Answer 21

CMV - disseminated disease

when you see pancreatitis in immunocompromised, think of: Drugs, CMV, enteroviruses, and biliary disease

Question 22

What’s the treatment for CMV?

Answer 22

Ganciclovir

can’t use aciclovir because CMV doesn’t encode viral thymide kinase – instead it has geen for UL97

Question 23

Blueberry muffin baby –what’s the disease association?

Answer 23

CMV–you see thrombocytopenia in perinatal, blue hemorrhages

Question 24

Difference between rubella and rubeola

Answer 24

Rubella is the German one (bella girls from Germany)

• it is associated with joint symptoms so you see ARTHRITIS and a FAINTER rash
• congenital rubella is BAD

Question 25

Which is more infectious--Ebola or the Measles?

Answer 25

Measles-- measles, like chicken pox, are transmitted via aerosol, so they stay up in the air longer and can infect people faster. Meanwhile ebola is a droplet tranmission, and droplets drop/fall rapidly.

Question 26

How do you differentiate the cold from the flu?

Answer 26

In cold, you have coryza (runny nose). Don't see this in flu

Question 27

How do you diagnose the flu?

Answer 27

Can **culture flu** fairly easily; antigen detecting symptoms