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Virology > Viruses > Flashcards

Viruses Flashcards

1
Q

What is the taxonomy of HPV? Family, Genus, and Species

A

Family: Papovaviridae
Genus: Papillomavirus
Species: Human papilloma virus

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2
Q

Viruses within genus Papillomavirus cause what symptoms?

A

Warts and cancer (cervical, vaginal, anal, penile, and oral). Frequently STDs.

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3
Q

What is the structure of HPV? Capsid, Genome, Envelope

A

Capsid: Icosahedral
Genome: dsDNA, circular
Enveloped: No

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4
Q

How is HPV grouped? What are two examples?

A

Predilection for type of tissue they infect: 1. Cutaneous HPV (growths on epithelium of skin) 2. Mucosal HPV (growths on mucous membranes)

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5
Q

What is the mechanism by which the virus enters and develops symptoms?

A

Enters basal layer thru skin breaks and replicates, stimulating hyperplasia–> thickening of skin (acanthuses)–> warts (3-4 mos)
*Regress w/in 2 yrs but can recur

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6
Q

***What is the most common STD in the US?

A

***Papillomavirus

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7
Q

What is the epidemiology of HPV?

A

Direct contact and infection of live skin thru broken skin.

Fomites, surfaces, bathroom floors, pools

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8
Q

Which HPV types cause laryngeal papilloma and conjuctival papilloma?

A

HPV type 6 and 11

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9
Q

Which HPV types cause oral papilloma

A

HPV type 6, 11, 2, and 16

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10
Q

Which HPV types cause focal epithelial hyperplasia

A

13, 32

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11
Q

Which HPV types cause cervical cancer?

A

16, 18, 31, and 45

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12
Q

What is the clinical syndromes for conjunctival papillomas?

A

Non-malignant, mushroom-shaped growths on eyelid. Most benign and asymptomatic wo associated conjunctivitis or folliculitis. (6,11)

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13
Q

What areas of the mouth are frequently involved in oral warts caused by papillomavirus?

A

Can occur anywhere but frequently hard/soft palates or uvula.

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14
Q

What are the 2 forms of lesions that form as oral warts?

A
  1. Exophytic warts: Dome-shaped papules or have hyperkeratosed fronds. Appear individually or in groups.
  2. Focal epithelial hyperplasia: (Heck’s disease) multiple nodular lesions in the mouth (13,32)
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15
Q

Which HPV types cause genital warts? How is it generally contracted?

A

6 and 11. Sexual contact

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16
Q

How is the mechanism by which HPV causes cervical cancer?

A

HPV DNA integrates into host cell DNA and cell cycle control disrupted (16, 18, 31, 45)

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17
Q

What are the two methods in which HPV is diagnosed in the lab?

A
  1. Pap smears: to observe koilocytotic (vacuolated cytoplasm) squamous epithelial cells
  2. In situ DNA probe analysis, PCR and Southern blotting to determine genotypes
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18
Q

How are HPV warts typically removed?

A

Surgical cryotherapy, electrocautery or chemical (Podofilox) but still recurrent

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19
Q

What two class of drugs are used against papillomaviral infection?

A

Interferon and Imiquimod (stimulate host immune system)

Cidofovir (nucleotide inhibitor)

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20
Q

What are two specific vaccines used against HPV?

A
  1. Gardasil: Protect against 6 & 11 (genital warts); 16 &18 (cervical cancer)
  2. Cervarix: 16 &18
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21
Q

What is the taxonomy of Adenovirus? Family, genus, species

A

Family: Adenoviridae
Genus: Mastadenovirus
Species: Human adenovirus

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22
Q

What is the structure of adenovirus? Capsid, genome, and envelope

A

Capsid: icosahedral
Genome: dsDNA, linear
Enevelope: No

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23
Q

What is the most common disorders associated with adenovirus?

A

Upper respiratory tract (URT) infections, conjunctivitis, hemorrhagiv cystitis, and gastroenteritis.

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24
Q

***What is the most common cause of viral conjunctivitis?

A

Adenovirus (children & military)

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25
Q

Where does adenovirus infect?

A

Epithelial cells lining respiratory tract and enteric organs

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26
Q

How is adenovirus spread?

A

Aerosol, close contact, fecal-oral routes to infect oropharanyx. Finger to eye, contaminated water. Can be latent in lymphoid tissue.

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27
Q

What is the histology of adenovirus-infected cells?

A

Dark basophilic nuclear inclusions: accumulation of DNA, proteins, and capsids.

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28
Q

What is the epidemiology of adenoviruses?

A

Stable in environment and easy to spread by fomites. Resistant to drying, detergents, GI secretions (acid & bile) and mild chlorine.
Serotypes 1-7: most common; 4-7: military

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29
Q

What are the clinical syndromes of Acute Febrile Pharyngitis and Pharyngoconjunctival Fever?

A

Pharyngitis that mimics strep throat: nasal congestion, cough, coryza (URT inflammation, head cold), malaise, fever, chillds, and headache 3-5 days.
CONJUNCTIVITIS often accompanies pharyngitis

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30
Q

What are the clinical syndromes of Conjunctivitis and Epidemic Keratoconjunctivitis (EKC)?

A

Adenovirus infection causes mucosa of palpebral conjunctiva to become nodular and both conjunctivae (palpebral and bulbar) are inflamed.

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31
Q

Where is a common source of Adenovirus-related conjunctivitis outbreak?

A

Swimming pools

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32
Q

What are the clinical syndromes for Acute Respiratory Distress Syndrome (ARDS)?

A

An acute, severe injury to most or all of both lungs. Often require mechanical ventilation due to respiratory failure.

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33
Q

Is ARDS a specific disease?

A

Not a specific disease, it is severe, acute lung dysfunction associated with variety of diseases (pneumonia, shock, sepsis, or trauma).

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34
Q

What are clinical syndromes for Atypical Pneumonia?

A

Community acquired pneumonia characterized by extreme fatigue and nonproductive gough with pulmonary infiltrates.

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35
Q

What are clinical syndromes for Gastroenteritis and Diarrhea?

A

Serotypes 40-42: enteric adenoviruses responsible for infant diarrhea. Rarely cause fever or respiratory tract infections.

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36
Q

What are methods by which to diagnose adenovirus in the lab?

A

Culture from throat infections (not diarrhea)

Immunoassays, PCR, and DNA probe analysis

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37
Q

What are treatment and prevention plans for adenovirus?

A

None. Must run course.

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38
Q

What is the taxonomy Herpesvirus? 1 Family and 3 Subfamilies

A

Family: Herpesviridae
Subfamilies: Alphaherpesvirinae, Betaherpesvirinae, and Gammaherpesvirinae

39
Q

Which species are part of the Alphaherpesvirinae?

A

HHV1 (Herpes Simplex Virus 1)
HHV2 (Herpes Simplex Virus 2)
HHV3 (Varicella-Zoster Virus)

40
Q

Which species are part of the Betaherpesvirinae?

A

HHV5 (Cytomegalovirus)
HHV6
HHV7

41
Q

Which species are part of the Gammaherpesvirinae?

A 
HHV 4 (Epstein-Barr Virus)
HHV 8
42
Q

What is the structure of Herpesvirus? Capsid, genome, and enveloped

A

Capsid: Icosahedral
Genome: dsDNA, linear
Enveloped: Yes

43
Q

How many herpes viruses cause disease in humans? And of them, how many are relevant to dentistry?

A

8 cause clinical disease, 6 relevant to dentistry (HHV1-HHV5; HHV8)

44
Q

***True or False:

All herpes viruses have capacity to persist in host indefinitely in the form of episome.

A

***True (for LIFE)

45
Q

What are the 3 disease phases of human herpes viruses?

A
  1. Primary infection- (virus replicating, asymptomatic, but infectious)
  2. Latency- (control of virus, but not cleared)
  3. Reactivation- (reactivation, replication, infectious)
46
Q

What 3 factor influence severity of primary infection?

A
  1. Age
  2. Site of infection (brain and system dangerous)
  3. Immunocompetence (T-cells)
47
Q

Is the clinical disease during reactivation same as what occurred during primary infection? Why?

A

No, virus may have establish latency in cell type different from cell initially infected.

48
Q

***What is an example of a type of herpes virus that is different in clinical disease when reactivated from primary infection?

A

***Varicella-Zoster Virus (VZV)
Primary infection: Chicken pox
Reactivated: Shingles

49
Q

What elements of the herpes virus help initiate replication?

A

Proteinaceous tegument layer btwn capsid and envelope: contains viral proteins and enzymes.

50
Q

What factors of the herpes virus helps inhibit clearance by immune system?

A

Some of its surface glycoproteins bind the Fc portion of IgG or C3 of complement system.

51
Q

How is the herpes simplex virus (HSV-1,2) contracted?

A

Direct contact (oral or genital). Initially infect mucoepithelial cells then establish latent infection of innervating neurons.

52
Q

Where is the most common sites of inoculation with HSV-1? HSV-2?

A

HSV-1: oral mucosa

HSV-2: genital mucosa

53
Q

How does HSV affect immunocompetent individuals differently from immunocompromised ones?

A

Immunocompetent: rarely cause viermia

Neonates and immunocompromised: herpetic encelphalitis (teratogenic organism)

54
Q

True or False:

HSV-1 and HSV-2 are specified and localized and highly distinguishable.

A

False

Both can cause oral herpes and are clinically indistinguishable.

55
Q

What are the clinical syndromes of Herpetic gingivostomatitis?

A

HSV-1: Occurs mostly in young children. Sores on lips, gums, tongue, and cheeks. Red, swollen gums. Self-limiting. Reactivation results in cold sores.

56
Q

What are clinical syndromes for Herpes labialis?

A

aka Cold sores. Reactivation of HSV-1 from trigeminal ganglia. Occur in ~1/3 of primary herpetic gingivostomatitis.

57
Q

***What are clinical syndromes for Herpes keratitis?

A

Reactivation of HSV-1, but virus travels down opthalmic branch rather than mandibular branch of trigeminal nerve ganglion ***limited to one eye

58
Q

What is the leading cause of blindness due to disease in the US?

A

Herpes keratitis

59
Q

What is a clinical syndrome of Herpetic whitlow?

A

Painful HSV-1 and HSV-2 infection usually of the finger

60
Q

Genital herpes usually occurs on what specific part of the body?

A

(90% HSV-2, 10% HSV-1)
Male: Shaft of penis
Female: vulva, vagina, cervix, perianal area or inner thigh

61
Q

What are clinical syndromes of Herpes encephalitis?

A

(HSV-1) Significant morbidity and mortality. Leading cause of sporadic encephalitis in US adults, w early onset of seizures. Temporal lobe involvement.

62
Q

By which methods can herpes encephalitis be diagnosed in the lab?

A

Viral culture & isolation: from vesicles not crusted lesions (long wait)
PCR: for HSV DNA (accurate and fast)
Tzanck Smear: for epidermal multi-nucleated cells and eosinophilic intranuclear inclusions

63
Q

What are two drugs used to treat and prevent Herpes virus?

A

Acyclovir: Topical cream or tablets for non-ocular herpes infections
Trifluidine: ophthalmic solution for HSV ocular infections.

64
Q

What type of foods has been suggested in keeping herpesvirus outbreaks at a minimum?

A

High arginine, low lysine content food by suppressing HSV viral replication.

65
Q

Where is the initial site of Varicella Zoster Virus?

A

Respiratory tract: viral aerosols inhaled and infects epithelial cells and fibroblasts.

66
Q

How does VZV spread?

A

Forms synctia and spreads cell to cell. Viremia spreads virus from respiratory tract to lymphatics to liver and spleen.

67
Q

What causes chicken pox?

A

Secondary viremia spreads virus to skin and mucous membranes, to cause rash. ***Reactivation causes vesicular rash, herpes zoster/shingles

68
Q

What is the epidemiology of VZV?

A

ONLY HHV that spreads via airborne transmission: respiratory droplets and direct contact.

69
Q

What are the clinical syndromes of vericella?

A

Chickenpox: vesiculopustular rash, “dewdrop on rose petal” starts on trunk and spreads to head and limbs. Painless but itchy. Can appear on mucous membranes.

70
Q

What are clinical syndromes of Herpes zoster?

A

Shingles: reactivated VZV. More common with immunocompromised and older ppl. Severe neuronal pain prior to herpetic dermatome. Lesions. Orally, devitalization of teeth or root resorption.

71
Q

What are the clinical syndromes of Postherpetic neuralgia?

A

Complication of shingles, affects nerve fibers and skin. Limited to area of skin of 1st shingle outbreak. Symptoms: pain sensitivity to touch & temp, itching, and numbness. Occurs in 1/2 of Zoster patients after 60 yo

72
Q

What are clinical syndromes of Herpes zoster ophthalmicus?

A

Ranges from primary infection in lids to persistent conjunctivitis, keratouveitis, glaucoma, papillitis, ocular nerve palsy and deep ocular pain.

73
Q

What are ways in VZV can be diagnosed in the lab? (Lab seldom required, clear-cut clinical signs)

A

Observation: “dewdrops on a rose petal” rash in stages of vesicles–>pustules–>scabs
Vesicle scraping histologically show Giant cells
VZV-specific antigens id’ed with immunofluorescent techniques and ELISA to detect anti-VZV antibodies from patient serum

74
Q

What are 2 vaccines for varicella (chicken pox)?

A

Varivax and MMRV (ProQuad) vaccines

75
Q

What is a vaccine for Herpes zoster?

A

Zostavax

76
Q

What is given to pregnant women when exposed to VZV and newborns?

A

Varicella-zoster immunoglobulin (VZIg)

77
Q

What are 3 vaccines against VZV for adults and immunocompromised pts?

A

Acyclovir, valcyclovir, famcyclovir

78
Q

What are two other names for Epstein-Barr Virus (EBV)?

A

Lymphocryptovirus and herpesvirus 4 (HHV4)

79
Q

What is the pathogenesis of EBV?

A

Spread through saliva (kissing disease) and infects epithelial cells of the oropharynx causing pharyngitis.

80
Q

What happens when EBV infects B cells?

A

Lytic infection can spread to B cells in lymphatic tissue or blood and stimulates growth, altering normal immune B cell functions. Can lead to lymphoma.

81
Q

What is mononucleosis?

A

Occurs partly due to T cell proliferation in response to EBV’s B cell outgrowth. The T cells are activated to destroy infected B cells–> swollen lymph glands, spleen, and liver.

82
Q

True or False

Infection with EBV may be asymptomatic and vary in severity. Infection is common.

A

True

83
Q

Who is EBV different, symptomatically, for normal adults and immunocompromised individuals?

A

Normal: infectious mononucleosis
Immunocompromised: Develop neoplastic disease

84
Q

What are 7 clinical syndromes of EBV?

A
  1. Infectious mononucleosis
  2. Hairy Oral Leukoplakia
  3. African Burkitt’s Lymphoma
  4. Hodgkin’s Lymphoma
  5. Nasopharyngeal carcinoma
  6. Epithelial keratitis
  7. Stromal keratitis
85
Q

What is infectious mononucleosis?

A

(Glandular fever)
Children: mild or asymptomatic
Adolescent/Adults: Fatigue, high fever, malaise, pharyngitis, lymphadenopathy, and hepatosplenomegaly

86
Q

What are meningoencelphalitis and Guillain-Barre syndrome?

A

Complications associated with infectious mononucleosis.

87
Q

What is Hairy Oral Leukoplakia?

A

Corrugated white lesions in mouth on lateral border of tongue. Mostly in immunocompromised patients.

88
Q

What is African Burkitt’s Lymphoma (endemic lymphoma)?

A

B cell cancer of the jaw and face. Endemic to children in malarial regions of Africa. Connection in EVB with AfBL with malaria is unclear.

89
Q

What is Hodgkin’s lymphoma?

A

Malignancy of lymph tissue found in the lymph nodes, spleen, liver and bone marrow.

90
Q

What is Nasopharyngeal carcinoma?

A

Cancer in nasopharynx. Endemic to adults in Orient but rare in US.

91
Q

What is stromal keratitis?

A

Ring opacities due to multifocal anterior stromal infiltrates

92
Q

Infectious mononucleosis a presenting sign for which disease?

A

Follicular conjunctivitis

93
Q

How is EBV diagnosed in lab?

A
  1. Large, lobed B lymphocytes with atypical nuclei and neutropenia: early indications of EBV infection
  2. Immunofluorescent microscopy using fluorescein-tagged antibodies against anti_EBV antibodies or ELISA with anti-EBV antibodies
94
Q

What is the treatment for EBV?

A

None

Virology (3 decks)

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