VZ + HHV 6/7 Flashcards

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1
Q

Describe HHV 6/7 and VZV

A

They are all linear, enveloped, dsDNA large genome (150-250 kbp) with an icosahedral capsid and about dozen of glycoproteins inside; they are all herpesviruses

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2
Q

What do the glycoproteins of HHV6/7 and VZV do?

A

They are for attachment, penetration, and release

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3
Q

Where are the HHV6/7 and VZV viruses assembled inside the cell?

A

In the nucleus

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4
Q

What kind of infections to the herpesviruses produce?

A

Generally self limiting, but life threatening infections can occur in ICP’s

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5
Q

Describe the life cycle of a Herpesvirus? (3 phases)

A

Establishment, Maintenance, and Reactivation; First the initial infection, then goes into latent period in which no virus is produced and the genome is maintained extrachromasomally (undetectable), then it is reactivted usually due to a lapse in host immune status

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6
Q

Where does VZV go latent?

A

Neural cells (it is a alphaherpesvirus)

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7
Q

Where do HHV 6/7 go latent?

A

Lymphocytes (it is a betaherpesvirus)

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8
Q

What is the primary infection of VZV? secondary?

A

Chickenpox; shingles

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9
Q

How is VZV spread?

A

It is highly communicable and by aerosol, late winter and early spring

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10
Q

What are the symptoms of chickenpox?

A

Fever and then itchy rash starting on scalp and trunk, can radiate from there

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11
Q

Describe adult chickenpox

A

Usually more severe, less rash, chance of pneumonia

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12
Q

Describe the infection of chickenpox in a child

A

Initial respiratory infection leads to replication in mucosa of URT, virus then spreads and replicated in regional lymph nodes which results in primary viremia around day 4-6. Virus progresses to liver and spleen and leads to secondary viremia around day 12-14

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13
Q

When does the rash appear in chickenpox for a child?

A

Only after the secondary viremia (around 12-14 day post exposure)

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14
Q

When is a child good to go back to school after a bout of chickenpox?

A

Only after the rash has scabbed over, before they are still contagious

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15
Q

What is the reactivated form of chickenpox (Varicella) called?

A

Shingles (Zoster)

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16
Q

What is shingles characterized by?

A

Sudden onset of pain and rash along a single dermatome (unilateral) or forehead; rash can last 2-4 weeks with pain lasting longer (postherpetic neuralgia) and most people only have it ONCE

17
Q

How is VZV diagnosed?

A

Clinically

18
Q

Describe the VZV vaccine

A

Approved live attenuated vaccine recommended as part of MMR regimen, there is no evidence of reactivation to shingles

19
Q

What other drugs can treat chickenpox?

A

In immunocompromised kids use Acyclovir

20
Q

What may adult pneumonia require?

A

VZV Ig

21
Q

What do you exactly “treat” for chickenpox?

A

Symptoms

22
Q

How is Zoster treated?

A

Oral ACV and steroids (faster the better)

23
Q

What is the Zoster vaccine?

A

Booster to prevent or lessen zoster for patients 50 years or older

24
Q

What do HHV 6/7 cause?

A

Roseola (exanthem subitum)

25
Q

What is Roseola?

A

Mild respiratory illness followed by high fever

26
Q

How many kids will get the body rash associated with Roseola?

A

As few as 25% on face and body

27
Q

What group of people does HHV 6/7 infect?

A

3 months to 6 years old; 90% of US is seropositive