Viruses

Question 1

Virus example that do:

• Reassortment
• Complementation

Answer 1

Reassortment: flu, H1N1 pandemic
- BOAR viruses are segmented viruses that can do this: Bunya, Ortho (flu), Arena, Reo
Complementation: Hep D using Hep B

Question 2

Live attenuated vaccines: “Live! One night only! See small yellow rotating chickens get vaccinated with Sabin and MMR! It’s incredible!”

Answer 2

Ab + T cell immunity
Smallpox
Yellow fever
Rotavirus
VZV = chickenpox 
Sabin polio
MMR = measles, mumps, rubella
Flu - intranasal

Question 3

4 killed vaccines

Answer 3

Rabes
Flu shot
Salk polio
Hep A

Question 4

2 sub-unit vaccines

Answer 4

Hep B

HPV - types 6, 11, 16, 18

Question 5

HHAPPPy DNA viruses

Answer 5

Hepadna
Herpes
Adeno
Pox
Parvo
Papilloma
Polyoma

Question 6

+ssRNA viruses: “I went to a retro toga party where I drank flavored Corona and ate hippy California pickles.”

Answer 6

\+ sense = mRNA = infectious on own
Retro
Toga
Flavi
Corona
Hepe
Calici
Picorna

Question 7

-ssRNA viruses: Always Bring Polymerase Or Fail Rep

Answer 7

- sense = require polymerase in virion to become infectious
Arena
Bunya
Paramyxo
Orthomyxo
Filo
Rhabdo

Question 8

Which herpes virus has a + Monospot test? - ?

Answer 8

+ Monospot = EBV

• Heterophile Abs detected by agglutination of sheep or horse blood
• Monospot = CMV

Question 9

Characteristic cell of all Herpes viruses + how do you test for these

Answer 9

Culture lesion for mulitnucleated giant cells

Question 10

PERCH - picorna viruses and the diseases they cause

Answer 10

Polio
Echo - aseptic meningitis 
Rhino - cold
Coxsackie (many)
Hep A - acute viral hep

Question 11

What virus is yellow fever? What is unique about the presentation of this disease?

Answer 11

Flavivirus 
Aedes mosquito
Yellow like jaundice - infections liver
- Black vomit
- Abnormal coag -> excessive bleeding/shock

Question 12

Genetic shift vs drift

Answer 12

“Sudden shift is more deadly that gradual drift”
Shift = pandemic (flu reassortment)
Drift = epidemic, minor random mutations in hemagglutinin or neuraminidase genes (RNA pol making mistakes)

Question 13

Differentiate:

• Parvovirus
• HHV6
• VZV
• Measles
• Rubella

Answer 13

Parvo (ssDNA linear) = erythema infectiosum = 3 days “flu” -> slap cheek rash
HHV6 (dsDNA linear) = roseola = high FEVER -> diffuse macular rash
VZV = HHV3 (“ “) = purulent, dewdrop on rose petals
Measles (-ssRNA, paramyx) = rubeola = starts on face -> moves to full body rash + 3Cs + Koplik spots
Rubella (+ssRNA, toga) = purulent, face -> body, disappears as spreads

Question 14

Pathophys HIV

Answer 14

gp120 + CD40 + coreceptor -> bind as trimer 
- Early, infect macrophages = CCR5 [immunity aspect]
- Late, infect T cells CXCR4 
gp40 causes membrane fusion 
HIV genome into host cell
Viral RT: +ssRNA -> dsDNA
Viral integrase - into host genome
Hot RNA pol creates viral proteins
Viral protease cleaves products
New virion buds off

Question 15

6 HIV diseases CD4

Answer 15

1. Candida - scrapable
2. EBV = oral hairy leukoplakia - unscrapable on lateral tongue
3. Bartonella = bacillary angiomatosis (rash), 1ary neutrophils [bacteria]
4. HHV8 = Kaposi (rash), 1ary lymphocytes [virus]
5. Cryptosporidium = acid fast watery diarrhea
6. HPV = squamous cell carcinoma @ anus, cervix

Question 16

4 HIV diseases CD4

Answer 16

1. Toxo: ring-enhancing brain lesions
2. JC reactivation = PML: non-enhancing brain lesions (b/c demyelin)
3. Pneumocystis pna: “ground glass” CXR
   Dementia generally

Question 17

7 HIV diseases CD4

Answer 17

1. Aspergillus: cavitations on CXR, hemoptysis, pleuritic pain
2. Cryptococcus meningitis
3. Candida esophagitis
4. CMV: linear ulcers in esophagus, cotton wool spots in eye
5. EBV: B cell lymphoma, CNS lymphoma (single ring enhancing lesion)
6. Histoplasma: fever, weight loss, fatigue, etc
7. MAC: non-specific constitutional symptoms