Week 5

Question 1

Regarding HSV, name:

1. Family
2. Subfamily
3. Type of genome
4. Envelope?

Answer 1

Herpesviridae family

Alpha subfamily

dsDNA virus

Yeah enveloped

Question 2

What two things would a biopsy of a HSV lesion show?

Answer 2

1. Mulcinucleated giant cells

2. Intranuclear inclusions (Cowdry nuclear inclusions w/ owl eye appearance)

Question 3

How is HSV diagnosed? (5)

Answer 3

1. Biopsy - multinucleate giant cells and intranuclear inclusions
2. DFA for herpes
3. PCR
4. Viral culture
5. Serology

Question 4

Whom must you treat for HSV infection?

Answer 4

Neonates and immunocompromised

Question 5

Name the common methods of diagnosing influenza (4).

Answer 5

1. Viral culture
2. DFA
3. PCR
4. Rapid antigen testing

Question 6

What is the gold standard for diagnosing influenza?

Answer 6

PCR

Question 7

What is the problem with rapid antigen testing for influenza?

Answer 7

Can’t trust a negative result when it is influenza season

Question 8

Name two reasons why pregnant women are at risk of influenza.

Answer 8

1. Increased Treg activity

2. Cardiopulmonary changes –> increased hypoxemia –> more severe disease

Question 9

What is at the top of your DDx when you see slowly declining mental status and basilar inflammation?

Answer 9

M. tuberculosis meningitis

Question 10

What is at the top of your DDx when you see meningitis w/ focal seizures?

Answer 10

HSV1 meningitis

Question 11

For which hepatitis is there no vaccine?

Answer 11

Hep C

Question 12

Which hepatitis types are spread via fecal-oral route?

Answer 12

A and E

Question 13

Name three arboviruses. What major family are these viruses part of?

Answer 13

1. Yellow fever
2. Dengue fever
3. West nile virus

Part of the Flavivirus family

Question 14

Name the early and late acute hepatitis lab findings associated with acute viral hepatitis.

Answer 14

Early:

1. Elevated AST and ALT
2. Normal GGT and AlkPhos

Late:

1. Jaundice
2. Elevated GGT and AlkPhos
3. Decreased liver proteins like albumin, clotting factors

Question 15

What lab findings are associated with chronic viral hepatitis?

Answer 15

LFTs normal of mildly abnormal

Question 16

Describe the Hep A serologic graph.

Answer 16

1st seen in stool Hep A virus (shows up at 2.5 weeks and peaks at 5 weeks)

Next is anti-Hep A IgM (starts at 5 weeks and peaks at 8 weeks)

Last is anti-Hep A IgG (starts at 8 weeks and goes up after that)

Question 17

How does Hep A end up in the poop?

Answer 17

Infection –> viremia –> goes to liver –> viral shedding into the bile

Question 18

For which hepatitis viruses is there no carrier state? What else is unique to these?

Answer 18

A and E have no chronic carrier state; these are both fecal-oral transmission

Question 19

What is the treatment for Hep A and E?

Answer 19

Supportive; most cases are self-limited and there is no chronic carrier state

Question 20

Is hepatitis D infectious on its own?

Answer 20

No, it needs the Hep B surface antigen (HBsAg) to be infectious

Question 21

Describe the serologic graph for acute Hep B.

Answer 21

1st to show up is HBsAg - marker of acute infection (either acute or chronic!)

2nd is HBeAg - marker of infectivity

3rd is anti-HBc IgM

4th is anti-HBsAb - marker of recovery and is the Ab made after immunization

Question 22

What is the most common bloodborne infection in the US?

Answer 22

Hep C

Question 23

Infection that causes an aversion to smoking.

Answer 23

Hep A

Question 24

How is Hep A transmitted in developed countries?

Answer 24

Often in contaminated shellfish

Question 25

How could you test for acute Hep C infection?

Answer 25

HCV RNA PCR test 2+ weeks after infection

Question 26

Name 3 inactivated/killed vaccines.

Answer 26

1. IPV 2. Hep A 3. Rabies

Question 27

Name 2 toxoid vaccines.

Answer 27

1. Tetanus | 2. Diphtheria

Question 28

Name 6 subunit vaccines.

Answer 28

1. Hep B 2. HPV 3. Pertussis 4. Influenza 5. Pneumococcal polysaccharide 6. Meningococcal polysaccharide My Pink Poodle Has a Head Infection

Question 29

Name 3 conjugate vaccines.

Answer 29

1. H. influenzae 2. Pneumococcal conjugate 3. Meningococcal conjugate

Question 30

Name 6 live, attenuated vaccines.

Answer 30

1. MMR 2. Varicella 3. Rotavirus 4. OPV 5. Yellow fever 6. BCG mr. bovy is alive

Question 31

Can you give OPV to an immunocompromised person?

Answer 31

Hellz nah

Question 32

What part of the body regulates body temp?

Answer 32

Thermoregulatory center of the hypothalamus.

Question 33

Name 3 viruses in the alpha herpesviridae family.

Answer 33

1. HSV 1 2. HSV 2 3. VZV

Question 34

Name 3 viruses in the beta herpesviridae family.

Answer 34

1. CMV 2. HHV 6 3. HHV 7

Question 35

Name 2 viruses in the gamma herpesviridae family.

Answer 35

1. EBV | 2. HHV 8

Question 36

Can EBV be latent?

Answer 36

Yeah

Question 37

Explain why zoster from VZV can happen along many different dermatomal areas?

Answer 37

Acute infection involves viremia, so the virus can go to any ganglia for latency

Question 38

How does EBV keep its genome on B cell DNA during B cell replication when EBV is in its latent phase?

Answer 38

EBNA-1 binds the viral episome to the B cell chromosome during B cell replication

Question 39

Describe what antibodies and antigens would be expected in a person with acute Hep B infection.

Answer 39

HBsAg positive total anti-HBc positive IgM anti-HBc positive anti-HBs Ab negative

Question 40

Describe what antibodies and antigens would be expected in a person with chronic Hep B infection.

Answer 40

HBsAg positive total anti-HBc positive IgM anti-HBc negative anti-HBs negative

Question 41

Describe what antibodies and antigens would be expected in a person acquired immunity to Hep B from natural infection.

Answer 41

HBsAg negative anti-HBc positive anti-HBs positive

Question 42

Describe what antibodies and antigens would be expected in a person acquired immunity to Hep B from immunization.

Answer 42

HBsAg negative anti-HBc negative anti-HBs positive