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Viruses Flashcards

1
Q

Basic morphology of a virus

A

Nucleic acid (DNA or RNA)
Capsid
Envelope

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2
Q

What are the two types of RNA viruses?

A

+ stranded
- stranded

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3
Q

Describe positive stranded RNA viruses

A

RNA just like mRNA and can be translated immediately

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4
Q

Describe negative stranded RNA viruses

A

RNA needs to be transcribed into positive strand of RNA and the positive strand can then be translated

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5
Q

What special enzyme do negative RNA viruses carry?

A

RNA dependent RNA polymerase

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6
Q

Describe DNA viruses

A

Have positive and negative strand (double stranded) and negative strand must be transcribed into mRNA

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7
Q

What are the two types of capsids?

A

Icosahedral symmetry capsids
Helical symmetry capsids

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8
Q

Only this type of virus (nucleic acid) makes helical symmetry capsids

A

RNA

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9
Q

Viruses with membranes formed from the host cell’s glycoproteins

A

Enveloped

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10
Q

Viruses without glycoprotein membranes

A

Naked

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11
Q

What is the acronym used to remember DNA viruses? And the viruses?

A

HHHAPPPy
Herpes
Hepadna
Adeno
Papova
Parvo
Pox

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12
Q

Describe most DNA viruses

A

Double stranded icosahedral

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13
Q

DNA viruses with envelopes

A

Herpes
Hepadna
Px

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14
Q

Three naked DNA viruses

A

Papova
Adeno
Parvo

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15
Q

Description for most RNA viruses

A

Single stranded
Enveloped
Helical capsid symmetry

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16
Q

DNA or RNA virus- toga

A

RNA

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17
Q

DNA or RNA virus- corona

A

RNA

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18
Q

DNA or RNA virus- retro

A

RNA

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19
Q

DNA or RNA virus- picorna

A

RNA

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20
Q

DNA or RNA virus- herpes

A

DNA

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21
Q

DNA or RNA virus- calci

A

RNA

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22
Q

DNA or RNA virus- reo

A

RNA

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23
Q

DNA or RNA virus- hepadna

A

DNA

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24
Q

DNA or RNA virus- adeno

A

DNA

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25
Q

DNA or RNA virus- flavi

A

RNA

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26
Q

DNA or RNA virus- papova

A

DNA

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27
Q

DNA or RNA virus- orthomyxo

A

RNA

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28
Q

DNA or RNA virus- paramyxo

A

RNA

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29
Q

DNA or RNA virus- rhabdo

A

RNA

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30
Q

DNA or RNA virus- parvo

A

DNA

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31
Q

DNA or RNA virus- pox

A

DNA

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32
Q

DNA or RNA virus- bunya

A

RNA

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33
Q

DNA or RNA virus- arena

A

RNA

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34
Q

DNA or RNA virus- filo

A

RNA

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35
Q

What 3 RNA viruses are nonenveloped?

A

Picorna
Calici
Reoviridae

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36
Q

What 3 RNA viruses are nonenveloped?

A

Picorna
Calici
Reoviridae

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37
Q

Only double stranded RNA virus

A

Reovirus

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38
Q

Acronym for positive rna

A

The calcified Pico spilled flavorful Corona on his retro toga

Calici
Pico
Flavi
Corona
Retro
Toga

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39
Q

Acronym for negative RNA viruses

A

Old Pete’s Rabid dog Filo fights Paul Bunyon in the Arena

Orthomyxo
Paramyxo
Rhabdo
Filo
Bunya
Arenaviridae

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40
Q

Viral replication steps

A

1) adsorption and penetration
2) uncoating of virus
3) synthesis and assembly of viral products
4) release of visions from host cell

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41
Q

What are the 4 host cell outcomes of viral infection?

A

1) death
2) transformation
3) latent infection
4) chronic slow infection

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42
Q

What important virus is in the orthomyxoviridae family?

A

Influenza virus

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43
Q

What important viruses are in the paramyxoviridae family?

A
  1. Parainfluenza virus
  2. respiratory syncytial virus
  3. Metapneumovirus
  4. Mumps virus
    5? Measles (rubeola) virus
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44
Q

Main disease manifestations of parainfluenza and rsv in children

A

Bronchitis
Viral pneumonia
Croul

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45
Q

Main disease manifestations of parainfluenza and rsv in adults

A

Cold / flu

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46
Q

Diseases caused by metapneumovirus.
Who is at highest risk?

A
  • uri / pro
    Young children and older adults
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47
Q

Classic clinical symptoms of mumps

A

Parotitis
Testicular inflammation

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48
Q

Classic clinical manifestation measles

A

Prodrome
Koplik’s spots
Rash
Encephalitis

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49
Q

Symptoms flu

A

High fever
Chills
Headache
Malaise
Myalgias (muscle pain)
Dry cough
Sore throat
Rhinorrhea

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50
Q

What type of flu causes pandemic influenza?

A

Influenza A virus

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51
Q

Clinical manifestation with pandemic influenza

A

-primary pneumonia
- weakens immune system for secondary bacterial pneumonia / otitis media
Staph aureus
Haemophilus influenzae
Strep pneumo

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52
Q

What are the two types of glycoproteins on influenza virus?

A

Hemagglutinin
Neuraminidase

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53
Q

Purpose of hemagglutinin

A

Adsorption by fusing to sialic acid

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54
Q

Purpose of neuraminidase

A

Cleaves cell mucin barrier

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55
Q

What are the three types of influenza?

A

A
B
C

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56
Q

What animals can be infected by influenza A

A

Humans, other mammals (swine), birds

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57
Q

What is the reservoir for influenza B and influenza C

A

Humans

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58
Q

Small changes due to mutations that occur during viral replication

A

Antigenic drift

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59
Q

How long does it usually take the flu symptoms to resolve?

A

3-7 days

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60
Q

What type of influenza can antigenic shift occur in

A

Influenza A

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61
Q

When there is a complete change in HA, NA, or both. Occurs when 2 influenza types (usually animal + human) coinfect the same cell and RNA segment mispackaged into another virus

A

Antigenic shift

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62
Q

What type of antigenic change is responsible for seasonal epidemics

A

Antigenic drift

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63
Q

What type of antigenic change is responsible for pandemics

A

Antigenic shift

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64
Q

Dx for influenza

A
  1. Viral culture
  2. Antigen detection
  3. RNA detection via PCR
  4. Serological- 4 fold increase over 2 weeks
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65
Q

How flu vaccines are made

A

Grown in chick embryos and inactivated and purified, choose 3-4 strains

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66
Q

Who should receive the vaccine

A

All persons six months or older
Immunocompromised
HCP

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67
Q

What is cold adapted influenza vaccine trivalent (CAIV-T)

A

Live, attenuated vax nasal spray for 2-49 years

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68
Q

Which influenza drugs are becoming less effective due to resistance?

A

Adamantanes (amantadine and rimantadine)

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69
Q

Antivirals effective against all strains of influenza, decrease duration of infection and likelihood of developing secondary bacterial infection if given within 48 hours of symptom onset

A

Neurominidase inhibitors (zanamivir and oseltamivir)

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70
Q

What is a prophylactic drug given after exposure to influenza?

A

Neurominidase inhibitors (ie zanamivir or oseltamivir)

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71
Q

Clinical signs H5N1

A

2-4 day incubation
Normal flu-like symptoms
Pneumonia with diffuse, patchy infiltrates progresses to acute respiratory distress syndrome (ARDS)

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72
Q

Mortality rate H5N1

A

50 percent

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73
Q

Basic description paramyxoviridae

A

Negative stranded RNA
HA and NA same protein spike
Fusion protein

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74
Q

Syncytial cells, where fusion protein causes host cell’s to fuse together

A

Multinucleated giant cells

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75
Q

Who do paramyxoviridae viruses impact?

A

Pediatric

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76
Q

Where do paramyxoviridae adsorb and replicate?;

A

Upper respiratory tract

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77
Q

All paramyxoviridae viruses can disseminate and cause ….

A

Veremia

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78
Q

What family is parainfluenza virus in?

A

Paramyoxviridae

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79
Q

Parainfluenza virus that infects larynx and upper resp tract in children. Causes airways to narrow

A

Croup

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80
Q

Typical symptoms croup (parainfluenza virus);

A

Stridor (wheezing)
Barking cough

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81
Q

Paramyxoviridae virus that has fusion protein that causes giant multinucleated cells and lacks HA and NA proteins. Causes resp infection

A

Respiratory syncytial virus

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82
Q

Number 1 cause of pneumonia in young children, esp infants less than 6 months

A

RSV

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83
Q

Season for RSV

A

Winter/ spring

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84
Q

Monoclonal antibody for RSV

A

Palivizumab

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85
Q

Paramyxoviridae isolated in 3001, and determined to be the second most common cause of lower resp infection in young kids

A

Metapneumovirus

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86
Q

Ages for RSV and metapneumovirus

A

RSV- under 6 months
Metapneumovirus- 1 year old

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87
Q

Season for metapneumovirus

A

Winter/ early spring

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88
Q

Symptoms of metapneumovirus

A

Bronchiolitis
Croup (20%)
Pneumonia (<10%)

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89
Q

Incubation period for mumps

A

About 3 weeks

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90
Q

Family of mumps

A

Paramyxoviridae

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91
Q

Pathogenesis of mumps

A

Replicates in upper respiratory tract and regional lymph nodes, spread via blood to other organs

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92
Q

Most common symptoms of mumps

A

Parotitis
Orchitis

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93
Q

Vaccine for mumps

A

Live attenuated, mmr

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94
Q

Another name for measles

A

Rubeola

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95
Q

Family of measles

A

Parmyxoviridae

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96
Q

Transmission of measles

A

Airborne or direct contact with nasopharyngeal secretions

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97
Q

First phase of measles

A

Prodrome

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98
Q

Incubation period for measles

A

Approx 10 days

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99
Q

How long does the prodrome last?

A

3-4 days

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100
Q

How long do koplik spots last?

A

1-2 days

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101
Q

How long does the measles rash last

A

6 days

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102
Q

Symptoms measles prodrome

A

Conjunctivitis, photophobia
Rhinitis, cough
High fever
Malaise

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103
Q

Describe koplik spots

A

Develop 1-2 days before rash of measles, small red lesions with blue white centers in the mouth

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104
Q

What does the rash of measles look like?

A

-Red, flat or slightly bumpy (maculopapular)
-Descending - forehead to face neck and torso, feet by day 3
- disappears in order it appears

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105
Q

Complications of measles

A

Pneumonia
Eye damage
Myocarditis
Encephalitis (10%)
Subacute sclerosing panencephalitis (SSPE)

Pregnant women - spontaneous abortion

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106
Q

Prevention measles

A

MMR vax

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107
Q

RNA hepatitis viruses

A

1) hepatitis A virus
2) hepatitis C virus
3) hepatitis D virus
4) hepatitis E virus
5) hepatitis G virus

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108
Q

What is the one DNA hepatitis virus called?

A

Hepatitis B virus

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109
Q

Hepatitis transmitted via the fecal oral route

A

Hepatitis A and hepatitis E

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110
Q

Which types of hepatitis are transmitted by blood?

A

Hepatitis B, hepatitis C, and hepatitis D

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111
Q

Sudden onset of viral hepatitis with a mild to severe coarse followed by complete resolution

A

Acute viral hepatitis

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112
Q

Hepatitis following a prolonged course of active disease or silent asymptomatic infection

A

Chronic viral hepatitis

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113
Q

What are the liver function enzymes?

A

Aspartate aminotransferase (AST)
Alanine aminotransferase (ALT)
Gamma-glutamyl transpeptidase (GGT)
Alkaline phosphatase

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114
Q

Symptoms acute viral hepatitis

A

2 weeks after symptoms onset:
Jaundice
Painful, enlarged liver
Elevated liver enzymes on blood

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115
Q

What two liver enzymes typically spike with acute viral hepatitis?

A

ALT and AST

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116
Q

Describe basics of Hepatitis A Virus

A

Naked
icosahedral capsid
+ Single strand RNA
Family picornaviridae
Fecal oral

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117
Q

Incubation period Hepatitis A

A

15-40 days

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118
Q

Test for acute HAV infection

A

Serology- IgM

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119
Q

Reservoir for HBV

A

All human body fluids (semen, urine, saliva, blood, breast milk)

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120
Q

Basic description HBV

A

Enveloped
Icosahedral capsule
Double stranded DNA

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121
Q

Name for intact HBV virus (DNA polymerase, DNA, proteins, envelope, isocahedral capsule)

A

Dane particle

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122
Q

Filamentous structures composed of the envelope and some capsid proteins that have disassociated from the intact HBV virion

A

Hepatitis B surface antigen

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123
Q

If you have this antibody, you are immune to HBV

A

Hepatitis B surface antigen (anti-HBsAg)

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124
Q

Viral core without HBSaG

A

Hepatitis B core antigen (HBcAg)

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125
Q

Are anti-HBcAg protective against HB

A

No

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126
Q

HBV marker for active disease and a highly infectious state

A

HBeAg

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127
Q

Describe HBV transmission

A

Parenteral

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128
Q

Most contagious hepatitis virus

A

HBV

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129
Q

Can Hepatitis A be chronic?

A

No, only acute

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130
Q

Disease states of HBV

A

1) acute hepatitis B
2) Fulminant hepatitis B (severe)
3) chronic hepatitis B
4) co-infection with Hepatitis delta virus

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131
Q

Forms of chronic HBV

A

1) asymptomatic carrier
2) chronic persistent hepatitis
3) chronic active hepatitis (acute state without normal recover last over 6 months)

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132
Q

What actually damages the liver in HBV?

A

Immune system, so immunocompromised tend to be asymptomatic

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133
Q

Complications of HBV

A

Primary hepatocellular carcinoma
Cirrhosis

134
Q

Presence of this antigen always means there is live HBV virus and infection, either acute, chronic, or carrier

135
Q

This antibody means the person is immune or cured and has no active HBV disease

A

Anti-HBsAg

136
Q

Core HBV IgM antibody indicative of new infection

A

IgM anti-HBcAg

137
Q

Core antibody indicative of old HBV infection

A

IgG anti-HBcAg

138
Q

Antigen that indicates HBV infection present with hight infectivity

139
Q

Presence of this antibody means HBV present with low infectivity

A

Anti-HBeAg

140
Q

HBV prevention

A

HBv vax- recombinant vax
Birth, 1-2 months, 6-18 months

141
Q

Is there a treatment for HBV?

A

Yes- interferon and oral antivirals, but cannot cure HBV

142
Q

Basic description HDV

A

Can only replicate with HBV
RNA
Parenteral transmission
Used HBV envelop

143
Q

Types of infection with HDVx

A

1) co-infection
2) superinfection

144
Q

How does HBV and HDV co-infection work?

A

Infected with both viruses at the same time and cause acute hepatitis.
Both can be cleared of anti-HbsAg antibodies form

145
Q

How does HDV and HBV superinfection work?

A

HDV infects person with chronic HBV
Acute hepatitis
Severe, Fulminant disease
Chronic infection with both

146
Q

Prevention of HDV

A

HBV vaccine

147
Q

Leading cause of chronic hepatitis in the US

A

Hepatitis C

148
Q

If infected as adult, what percent of acute hep b will continue to chronic HBV?

149
Q

What percentage of HCV cases become chronic?

150
Q

Basic description HCV

A

Enveloped
Icosahedral
RNA
Flavovirus

151
Q

What are the HCV genotypes? Which is most common in the US?

A

1, 2, 3

Genotype 1 most common in US

152
Q

Transmission HCV

A

Parenteral, most often IV drug use

153
Q

Incubation for Hep c

A

6-12 weeks

154
Q

Usual symptoms of acute HCV infection

A

Asymptomatic
Few fever, right upper quadrant pain, jaundice
85% develop chronic
20% corrhosis

155
Q

How long after HCV exposure are anti-HCV detectable?

156
Q

Confirmatory test for positive anti-hcv

157
Q

Treatment for HCV

A

Combo antivirals (interferon-free)
8-12 weeks
Cure rates greater than 90%
High cost

158
Q

Where is HEV endemic?

A

Asia, India, Africa, central America

159
Q

Transmission HEV?

A

Fecal oral

160
Q

What makes retroviridae viruses unique

A

Retroviruses
Can cause cancer

161
Q

How do retroviruses work

A

Carry reverse transcriptase. rNA coded into DNA and incorporated into host genome

162
Q

How can retroviruses cause cancer?

A

Carry oncogenes

163
Q

Major HIV capsid protein that can be measured in serum to detect early HIV infection

164
Q

What subgroup of HIv Is responsible for most of the world’s infections

165
Q

What is the predominate HIV subtype in North America and Europe

A

HIV-1 type B

166
Q

Barrier to universal HIV vaccine

A

Genetic variation in gp 120 glycoprotein
Variation between subtypes

167
Q

Number living with HIV worldwide and estimated new infections each year

A

34 million
2.7 million

168
Q

Estimate for HIV in US

169
Q

HIV trandmission

A

Sex
Blood products
iV drug use
Transplant
Other parenteral

170
Q

What is the only blood product that has not been associated with HIV transmission

A

Gamma globulin

171
Q

How do they screen blood products for HIV?

A

ElLISA for antibodies to HIV-1 and HIV-2 and p24 antigen
PCR

172
Q

How can HIV spread from mother to baby

A

Transplacental
During delivery
Perinatally

173
Q

Risk for contracting HIV from needle stick contaminated with HIV infected blood

174
Q

What increases the risk for contracting HIV from a needle stick?

A
  • deep puncture
  • needle in patient’s artery or vein
  • needle had visible blood on it
  • patient has high viral load
175
Q

Risk of transmission of the following after HCP needle stick:
HIV
HCV
HBV

A
  1. HIV: 0.3%
  2. HCV: 3%
  3. HBV: 30%
176
Q

Can casual contact or salaiva, urine, tears, or sweat transmit HIV?

A

No evidence for that, no

177
Q

What cells does the HIV virion bind to?

A

CD4 T-helper cells

178
Q

What receptors must be present for HIV virions fo bind to the host cell?

179
Q

HIV is integrated into the host DNA. What are some things that may activate it to start the replication process?

A

Infections: TB, PCP, cytomegalovirus, herpes, mycoplasma
Immunizatiobs

180
Q

What are the 3 stages of HIV

A

1) acute viral illness
2) clinical latency
3) AIDS

181
Q

Symptoms of acute viral stage of HIV

A

Like mono-
Fever
Malaise
Lymphadenopathy
Pharyngitis

182
Q

When does acute phase of HIV happen?

A

1 month after exposure

183
Q

Pathogenesis of acute viral HIV

A
  • High levels of viremia (HIV in blood)
  • Virus infects lymph nodes
  • Immune response occurs and decreased veremia
  • Replication continues in lymph nodes
184
Q

What happens during HIV latency period?

A
  • No clinical symptoms for about 8 years
  • Steady gradual destruction of CD4 T lymphocytes
185
Q

What is the CD4 count for AIDS

A

Less than 200

186
Q

What are typical opportunistic infections in AIDS patients?

A

Candida esophagitis
Pneumocystis jeroveci pneumo
Kaposi’s sarcoma
cryptococcus neoformans
Toxoplasma gondii

187
Q

What are normal CD4 count

A

1000 cells/ ul blood

188
Q

How many CD4 cells per year on average decline in HIV infected person?

A

60 cells per year

189
Q

What are the clinical symptoms and common infections when CD4 counts drop to 200-400

A

Weight loss
Fever
Night sweats
Adenopathy

Skin infections (candida, herpes zoster)
Bacterial infections (TB)

190
Q

Infection common in AIDS patients with CD4 counts of 0-50

A

Disseminated disease from Mycobacterium avium intracellulare
Cytomeglovirus

191
Q

What does viral load tell you about HIV?

A

Speed it’s progressing

192
Q

What do CD4 counts tell about the HIV patient?

A

How likely they will develop opportunistic infection

193
Q

Are there neurological effects of HIV?

A

Yes, also grows in macrophages and monocytes which can cross blood brain barrier

194
Q

What are the potential neurological symptoms of AIDS?

A
  • encephalopathy
  • AIDS dementia complex (reduced cognitive function)
  • aseptic meningitis
  • myelopathy (infected spinal cord)
  • neuropathy
195
Q

What malignancies are people with AIDs at increased risk for?

A
  • b cell lymphoma (EBV)
  • Kaposi’s sarcoma (HHV-8)
  • non-hodgkin’s lymphoma
  • cervical cancer (HPV)
    -anal neoplasia
196
Q

What is an opportunistic infection?

A

Bugs that do not normally infect someone with an intact immune system but will infect someone with a compromised immune system

197
Q

What type of immunity does HIV impact?

198
Q

Common opportunisitc bacterial infections in AIDS patients

A
  • encapsulated bacteria - esp strep pneumo
  • mycobacterium tuberculosis
    -mycobacterium avium intracellulare
199
Q

Common opportunistic fungal infections in AIDS patients

A

1) candida albicans
2) cryptococcus neoformans
3) histoplasma capsulatum
4) coccidioides immitis
5) pneumocystis jirovechii pneumonia

200
Q

Difference between meningitis in AIDS patients and immunocompetent patient

A
  • Don’t present with normal sign and symptoms (headache, stiff neck)
  • May just present with fever
201
Q

Most common opportunistic infection of AIDS patients in the US

A

Pneumocystis jirovechii pneumonia

202
Q

What can be done to prevent PCP in AIDS patients?

203
Q

What are the most common opportunistic viral infections in AIDS patients

A
  • herpes zoster
  • EBV
  • herpes simplex virus
  • cytomegalovirus
204
Q

What impacts can cytomeglovirus have on the AIDS patient?

A

Retinitis
Esophagitis

205
Q

What are the opportunistic protozoa infections that are common in AIDS patients?

A
  • toxoplasma Gondii (masses in brain)
  • cryptosporidium (diarrhea)
  • microsporodia (diarrhea)
  • isospora belli (diarrhea)
206
Q

When do antibodies form for HIV?

207
Q

What serological tests are used to DX HIV

A
  1. ELISA (sensitive- false positives)
  2. Confirm with western blot
208
Q

Describe the window period for HIV

A

3-6 weeks
HIV virus circulating in blood but no antibodies formed

209
Q

What test can be used during the window period to diagnose HIV?

A

PCR for HIV RNA

210
Q

What are prevention strategies for HIV?

A

Education
Antiviral prophylaxis (PEP and PrEP)
Screening blood products

211
Q

Describe PEP for pneumocystis jirovechi pneumonia in AIDS patients

A

tmp-smp when CD4+ counts drop below 200

212
Q

Treatment toxoplasmosis in AIDS patients

A

Tmp-smp (also a prophy to prevent PCP)

213
Q

Prophy for MAC in AIDS patients

A

Azithromycin/ clarithromycin

214
Q

What are the 3 general things that all herpesviridae have in common?

A

1) latent state
2) cause cells to become multinucleated giant cells with intranuclear inclusion bodies
3) held at bay by cell mediated immune response

215
Q

Acronym to remember organisms that can cross the placental barrier

A

TORCHES
TOxoplasmosis
Rubella
Cytomeglovirus
Herpes, HIV
Syphilis

216
Q

Different manifestations of HSV 1 and HSV 2

A

1) gingivistomatis
2) genital herpes
3) herpatic keratitis
4) neonatal herpes
5) herpatic Whitlow (hands)
6) disseminated herpes (immunocompromised)
7) encephalitis

217
Q

Most common infectious cause of corneal blindness in the US

A

Herpetic kertosis

218
Q

Most common cause of viral encephalitis in the US

219
Q

Infection rate for VZV?

220
Q

Season for varicella zoster virus

A

Winter and spring

221
Q

Incubation period varicella

A

About 2 weeks

222
Q

First signs of chickenpox

A

Fever, malaise, headache

223
Q

What does the chickenpox rash look like

A

Starts on face and trunk and spreads everywhere on body including mucous membranes

Lesions have red base with fluid filled top, and scab over. Arise in crops and crops form at different stages

224
Q

Chickenpox or smallpox: superficial lesions

A

Chickenpox

225
Q

Chickenpox or smallpox: lesions usually not umbilicated

A

Chickenpox

226
Q

Chickenpox or smallpox: lesions at different stages of development

A

Chicken pox

227
Q

Chickenpox or smallpox: lesions more common on the trunk

A

Chickenpox

228
Q

Chickenpox or smallpox: deep hard lesions

229
Q

Chickenpox or smallpox: lesions often umbilicated (central depression)

230
Q

Chickenpox or smallpox: lesions at the same stage of development

231
Q

Chickenpox or smallpox: lesions more common on the extremities

232
Q

When varicella reactivates and migrates to peripheral nerves, causing burning, painful skin in area supplied by sensory nerves

233
Q

What drug can decrease the severity of varicella infection?

234
Q

In immune compromised patients such as with leukemia or AIDS varicella can be more serious leading to..

A

Pneumonia and encephalitis

235
Q

What is recommended for immuno compromised patients who were exposed to varicella?

A

Varicella immune globulin

236
Q

Term for when infected cells become swollen

A

Cytomegaly

237
Q

What are the four infectious states of cytomegalovirus?

A

1) asymptomatic infection
2) congenital disease
3) cytomegalovirus mononucleosis
4) reactivated cytomeglovirus and amino compromised patients

238
Q

What percentage of cytomegalovirus is asymptomatic an adults?

239
Q

Most common viral cause of mental retardation

A

Cytomeglovirus

240
Q

What congenital diseases can CMV cause?

A
  • mental retardation
  • microcephaly
  • deafness
  • seizures
  • other birth defects
241
Q

What does CMV look like when it’s reactivated and immunocompromised patients?

A

Retinitis (blindness)
Pneumonia
Disseminated infection
Death

242
Q

What does CMV look like in AIDS patients with CD4 counts below 50 to 100 cells?

A

CMV veremia
Retinitis (leads to blindness unless treated)
CMV colitis

243
Q

How does CMV prevent in reactivation or new infection in bone marrow transplant recipients?

A

CMV pneumonia which is rare in AIDS patients

244
Q

What are the three CMV tests?

A

1) Buffy coat
2) antigen
3) PCR

245
Q

What cancers is Epstein-Barr virus responsible for?

A

Burkitt’s lymphoma
Nasopharyngeal cancers

246
Q

What herpes virus causes Kaposi’s sarcoma?

247
Q

What makes poxviridae different from other DNA viruses?

A
  • most complex virus, large with DNA to code for hundreds of proteins
  • carries most of its own enzymes
  • replicates in cytoplasm of cell
248
Q

Describe the transmission of small pox

A

Person to person via large droplets, sometimes aerosol

249
Q

Describe droplet transmission

A

Particles over 5 microns propelled 3-6 ft and deposited onto mucous membrane of another person or env surface

250
Q

Describe aerosol transmission

A

Particles less than 5 microns remain suspended for long periods of time and may travel long distances, inhaled

251
Q

Describe molluscum contagiosum and who it effects

A

Pox virus
Small white bumps, similar to warts
AIDS patients

252
Q

What are the 2 members of the papaviridae family that infect humans

A

Papillomavirus
Polyomavirus

253
Q

General description papoviridae

A

DNA virus
Circular double stranded DNA, naked icosahedral

254
Q

What conditions does papilloma virus cause?

A

Warts and cervical cancer

255
Q

What are the two HPV strains that cause cervical cancer?

A

HPV 16 and 18

256
Q

Who is primarily impacted by the DNA virus polyomavirus?

257
Q

Polyomavirus that causes nephritis and uterus sepsis in renal transplant patients

A

Bk polyomavirus

258
Q

Polyomavirus that causes hemorrhagic cystitis in bone marrow transplant recipients

A

BK polymoavirus

259
Q

How does BK polymoavirus usually present?

A

Ubiquitous, mild or asymptomatic infection in children

260
Q

What opportunistic disease does JC polyomavirus cause?

A

Progressive multifocal leukoencephalopthy

261
Q

More than 10% of childhood respiratory disease is cause by this DNA virus and virtually all adults have serological evidence of prior exposure to it

A

Adenovirus

262
Q

What are the most common respiratory illnesses in children?

A

1) RSV
2) metapneumovirus
3) parainfluenza
4) rhinovirus
5) adenovirus

263
Q

What does parvovirus cause?

A

Fifths disease in children

264
Q

Another name for fifths disease

A

Erythema infectiosum

265
Q

Are arboviruses DNA or RNA?

266
Q

What are the arbovirus families?

A

Togavirodae
Flaviviridae
Bunyaviridae

267
Q

What are the two members of togaviridae that infect humans

A

1) alpha virus
2) rubivirus

268
Q

What symptoms do the alpha viruses cause?

A

Encephalitis
Fever

269
Q

What is the vector for alphaviruses?

A

Mosquitoes

270
Q

What disease does rubivirus cause?

271
Q

What diseases do the alphaviruses cause?

A

Western equine encephalitis
Eastern equine encephalitis
Venezuelan equine encephalitis
Chickungunya

272
Q

True or false- rubivirus are spread by mosquitoes

A

False- only humans are infected

273
Q

Symptoms of rubella

A

Mild febrile rash

274
Q

Concern for rubella

A

Congenital rubella

275
Q

Mode of transmission for rubella

A

Resp secretions

276
Q

Clinical presentation of rubella

A

-Prodrome- fever, lymphadenopathy and flu like symptoms
-Rash- red maculopapular from face to torso to extremities
- arthritis- women

277
Q

How long does the rubella rash last?

278
Q

When is there the greatest risk of congenital rubella?

A

Early in pregnancy

279
Q

What body areas are affected by rubella?

A

1) heart
2) eye
3) CNS

280
Q

Should rubella vaccine be given to pregnant women

A

No, theoretical risk to fetus because love vax

281
Q

What ailment do flaviviridae cause? Vector?

A
  • encephalitis
  • mosquito
282
Q

Naming convention for encephalitis caused by flaviviridae

A

By place
St. Louis encephalitis
Japanese encephalitis
Russian encephalitis….

283
Q

Second leading cause of epidemic viral encephalitis in the US

A

St. Louis encephalitis

284
Q

What febrile diseases are part of the flaviviridae family?

A

1) yellow fever
2) dengue fever
3) zika

285
Q

What is another name for dengue fever?

A

Break-bone fever

286
Q

Transmission of zika

A

1) mosquito
2) mother to fetus
3) sex

287
Q

Complications of zika

A

In adults, zika typically mild and self limited BUT

1) microcephaly (babies)
2) GBS (adults)

288
Q

Flavovirus that is spread mainly by mosquitoes and causes epidemics across the US, infects humans, birds, horses

A

West Nile Virus

289
Q

Type of virus (DNA or RNA): West Nile and other flaviviruses

290
Q

Transmission of WNV

A

Mainly mosquitoes
Blood transfusion
Organ transplant
Transplacentally
Breast milk
Blood innoculation (lab accident)

291
Q

Who is at highest risk for complicated WNV infection?

292
Q

Clinical manifestation WNV

A

1) asymptomatic (most people)
2) mild- rash and headache for a week
3) neuroinvasive (meningitis, encephalitis, paralysis)

293
Q

Dx of WNV

A

1) PCR
2) CSF IgM
3) four fold rise IgG
4) neutralization

PCR not best test, should always do with antibody titers

294
Q

Treatment WNV

A

Supportive
Prevention is best

295
Q

Diseases cause by RNA viral family bunyaviridae

A

California encephalitis
Rift valley fever
Hantavirus

296
Q

Picornaviridae genera

A

Enterovirus
Rhinovirus
Hepatovirus
Parechovirus

297
Q

What are the 5 subgroups of enterovirus?

A

1) poliovirus
2) Coxsackie A virus
3) Coxsackie B virus
4) echovirus
5) new enteroviruses (including rhinovirus)

298
Q

Where can polio infect?

A

Peters patches of intestine
Motor neurons

299
Q

Clinical presentations of polio

A

Mild illness or asymptomatic infection
Aseptic meningitis that clears in a week
Or
Paralytic poliomyelitis

300
Q

Who typically has the most serious effects from polio infection?

301
Q

Acronym for live vaccines

A

Mr Rota and Ms Yellow are Small but VIP

MMR (Mr)
Roatavirus (Rota)
Adenovirus (and)
Yellow fever (yellow)
Smallpox (small)
Varicella, influenza, and oral polio virus (VIP)

302
Q

Most common cause of aseptic (no bacterial) meningitis in U.S.

A

Enteroviruses

303
Q

What enterovirus causes hand foot and mouth and herpangina?

A

Coxsackie A

304
Q

Type of Coxsackie A illness that is a mild self limiting illness characterized by fever, sore throat, and small red based vesicles over the back of the throat

A

Herpangina

305
Q

Common acute illness, primarily in children, characterized by fever, oral vesicles, and small tender lesions on the hands, feet, and buttocks

A

Hand, foot, and mouth syndrome

306
Q

This type of enterovirus causes pleurodynia and myocarditis/ pericardotis

A

Coxsackie B

307
Q

This Coxsackie B virus causes fever, headache, and severe lower thoracic pain on breathing (pleuritic pain)

A

Pleurodynia

308
Q

Enterovirus associated with 50% of myocarditis/ pericardotis cases

A

Coxsackie B

309
Q

Viruses that cause the common cold

A

Rhinoviruses (85%) and coronaviruses (15%)

310
Q

Viruses implicated in diarrhea

A

Calicivirus
Roatavirus
Adenovirus
Astrovirus

311
Q

What is the most important virus in caliciviridae?

312
Q

Population at highest risk for caliciviridaw

A

Young children and infants

313
Q

Virus responsible for 90% of nonbacterial outbreaks of gastroenteritis

314
Q

Symptoms of caliciviridae

A

Fever, vomiting, diarrhea

315
Q

General about coronasviruses

A

Respiratory
High mortality rates
Spread bats to humans- pandemic
SARS, MERS, COVID

316
Q

One of leading causes of acute infectious diarrhea and major cause of infant mortality worldwide

317
Q

True or false- there are vaccines for rotavirus

A

True, part of standard vax. Rotateq and rotatrix

318
Q

Describe astrovoruses

A

RNA virus that cause periodic outbreaks of diarrhea in infants, children, and the elderly

319
Q

What care is offered, especially in underdeveloped nations for viral diarrheal illnesses?

A

Dehydration can kill so supportive
Use oral rehydration therapy when IV not accessible

320
Q

Collection of rabies virions in the cytoplasm

A

Negri bodies

321
Q

Family of rabies

A

Rhabdoviridae

322
Q

Disease with the highest case fatality ratio of any infectious disease

323
Q

Important viruses in filoviridae

A

Marburg and ebola

324
Q

Transmission of filoviridae viral hemorrhagic fevers

A

Direct contact with body fluid
Possible airborne in HCP

325
Q

What body fluids carry ebola

A

Blood
Vomit
Urine
Stool
Semen
(Living or dead)

326
Q

Precautions for filoviridae

A

Contact precautions
Face shield
Droplet precautions
Consider airborne

327
Q

How to dispose of Ebola waste (laundry/ equip)

A

Incinerate, autoclave, or wash with bleach

328
Q

Group of viruses with slower but similar manifestations to filoviridae

A

Arenaviridae

329
Q

Examples of arenaviridae

A

Lassa fever
Lymphocytic choriomeningitis virus
South American hemorrhagic fevers

330
Q

Transmission of arenoviruses

A

Direct contact with rodent droppings/ urine through broken skin, inhalation, or ingestion

331
Q

Treatment for arenaviruses

A

High dose ribavirin

Clinical Micro (12 decks)

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