Viruses - DNA - Herpes Family Flashcards

Question

**_Cytomegalovirus_ (aka HHV5)** **_Congenital_ presentations** of **_CMV_** * **Most common** **_fetal**_ _**viral_** infection! * **Most** of the time (80%) ****_a_**symptomatic!** * **#1 cause** of **Sensory-neural deafness** from viral inf. * **#1 cause** of mental **retardation** from viral inf.

Answer 1

**_Cyto "Mega-Lo" Virus_** **\*** **TO**_R_**CHeS** infection! * **Congenital** **_cataracts_**, **Sensory-neural** **_Deafness_** * **_Blueberry muffin_ rash;** (thrombocytopenia) (similar rash also seen in Rubella) * ****_Ventriculo_**megaly** from **peri**_ventricular_** _calcifications_** (also seen in Toxoplasmosis) * mental **retardation** and **seizures** from the ****_Intra_**cranial _calcifications_** * ****_Hepato_**megaly**, jaundice. * **_Hydrops fetalis_**; **Heart failure** leading to **severe _edema_**

Answer 2

**_Cyto "Mega-Lo" Virus_** * **_Transplant_** **pts** at **↑ risk** for **CMV _pneumonia_!** * **CMV _retinitis_**; Full thickness **retinal necrosis** (**"_Pizza pie_ retinopathy"**) → Blind spots, flashing lights, vision loss (Typically unilateral but can be bilateral) * **CMV _esophagitis_ and _colitis_**; **Ulcerations** are **_singular_, _deep_, and _linear_** (**ddx _HSV_** ulcers which are _multiple_ and _shallow_) * **CMV _mononucleosis_** (similar to reg mono w/ **sore throat, lymphadenopathy, and fatigue**) but **monospot test** would be **(-)**

Answer 3

**_Cyto "Mega-Lo" Virus_** ****_G_**an**_cicl_**ovir** **or** ****_F_**os**_car_**net** (when **_UL97_ gene mutation** makes it **resistant to **_G_**an**_cicl_**ovir**)

Answer 4

**_Varicella "Zeus" ster virus_** * ****_D_**S **_D_**NA** * **_Enveloped_** virus * Replicates in **nucleus** (like most DNA viruses) * **_Tzanc smear_** (older test, scrape) to look for **multinucleated giant cells**

Answer 5

**_Varicella "Zeus" ster virus_** * **Congenital Varicella Syndrome** (a **T**_O_**RCHeS** infection!) If infected in 1^st and 2^ndtrimesters * **Chickenpox (Varicella)** Spread by respiratory droplets or ruptured vesicles * **Shingles (Herpes Zoster)** Reactivation of previous VZV infection

Answer 6

**_Varicella "Zeus" ster virus_** * **Headache** and **fever** * **Xanthem** ("**widespread** **rash**"); **itchy** * **Vesicular rash** → Vesicular lesions w/ surrounding erythema (like HSV dew drops on rose petal) * All **rashes** are **at _different_ _stages_** of **healing** (**vs. smallpox** w/ similar looking rash but all _at same stage_!) * **_Adults_** can get **pneumonia** (major cause of morbidity & mortality in adults w/ chicken pox) * **_Encephalitis_**

Answer 7

**_Varicella "Zeus" ster virus_** * **Vesicular rash** on **erythema base** travels down **_dorsal root_** (**sensory nerves! _painful_!**) in a **_dermatone_ _pattern_\***, **rarely crossing** the **midline**. * ****_Post_**herpetic _neuralgia_**: pain after shingles! * **Herpes Zoster _opthalmicus_** if VZV infects the **V₁ branch** of **trigeminal** nerve → **_vision loss_** \* **If rash crosses** the **midline** it is **_Disseminated_ VCV** and is a **_red flag_** of immunocompromisation! **test for HIV** if no Hx!!!

Answer 8

**_Varicella "Zeus" ster virus_** * **Limb **_hypo_**plasia** * **Cutaneous _scarring**_ in a _**dermatomal_ pattern** * **_Blindness_**

Answer 9

**_Varicella "Zeus" ster virus_** * **_Live_** attenuated **Chickenpox (_Varicella_)** vaccine * **Shingles (_Zoster_) vaccine\***, is simply a larger-than-normal dose of the vaccine used against chickenpox. **\* Shingles (_Zoster_) vaccine** recommended for **adults _over 60_**; **HIV pts** can get **if CD4 \> _200_**

Answer 10

**_Varicella "Zeus" ster virus_** **For _chickenpox_ (Varicella)**: A**_cycl_**ovir **For _shingles_ (Herpes Zoster):** A**_cycl_**ovir or **_Fam_**c_ycl_ovir or **_V_**al**_cycl_**ovir

Answer 11

**_A roseola by any other name would smell as sweet_** * ****_D_**S **_D_**NA** * **_Enveloped_** virus

Answer 12

**_A roseola by any other name would smell as sweet_** * Occurs **between 6 months** and **2 years** of **age**. * Starts with **high _fever_** (over **104º**) often **lasting _3-4 days_** → can cause **febrile _seizures_** * **After 3-4 days\*** pt develops **_diffuse_ maculopapular _lacy_ rash** that **_spares the face_\*.** **\* (ddx measles** which has a _fever and rash together_, and _does not spare_ the _face_!)

Answer 13

**_A roseola by any other name would smell as sweet_** * Roseola **infects CD**_4_**+ cells** (**_helper_** t cells) * the infection **kills** the **CD4+ cells** * Causing **immuno**_suppression_****

Answer 14

**_A roseola by any other name would smell as sweet_** * NO tx * **keep pt. cool** and **give fluids**

Answer 15

**_Ring around the kaposi_** * ****_D_**S **_D_**NA** * **_Enveloped_** virus * **_Lymphocytic_ infiltrates** (**ddx Bartonella hensleae** and _bacillary angiomatosis_ w/ a _neutrophil infiltrate_!)

Answer 16

**_Ring around the kaposi_** * Causes the ****_dys_**regulation** of **vascular endothelial growth factor** (**_VEGF_**) → **_aberrant_ angiogenesis**

Answer 17

**_Ring around the kaposi_** **1)** **_AIDs pts_** _(and immunocompromised_): * **AIDS defining** illness **2)** **_Elderly russian men_** * often have **lower extremity** **lesions** **3) _Endemic_** _areas of_ **_Africa_:** * **Adults** will have classic presentation with p**alatal lesions**. In **children** it can be **fatal**.

Answer 18

**_Ring around the kaposi_** * **Sexual** contact * **Kissing** **\*\*\*** especially **M to M** **\*\*\***

Answer 19

**_Ring around the kaposi_** * **Erythematous _violaceous_ lesions** on **_nose_**, **_extremities_**, and **_mucous_ membranes**. * The **_hard palate_** is **frequently affected** by **lesions**, followed by the **gums**. * May be present as a **plaque**, **patch**, **macule**, or **nodule**! (rise **from primitive mesenchymal cells** involving **_angiogenesis_** causing the **violaceus color**) * ****_Intra_**intestinal lesions** (mucous membranes!)

Answer 20

**_Ring around the kaposi_** * HHV8 can cause a B cell lymphoma called **_primary enfusion lymphoma_** **(PEL)** * Primary enfusion lymphoma is a **rare HIV-associated** non-Hodgkin's lymphoma (**NHL**)

Answer 21

**_Ring around the kaposi_** * If HIV (+) and not yet on tx, **give AIDs therapy** (should help shrink lesions)