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Microbiology > XIII - Virology > Flashcards

XIII - Virology Flashcards

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1
Q

Size of Viruses

A

20-300 nm

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2
Q

All viruses have a _____ coat.

A

protein coat (capsid), lipoprotein envelope in some

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3
Q

Virus capsids are composed of

A

repeating capsomeres

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4
Q

All helical viruses are

A

enveloped

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5
Q

Icosahedral (spherical) viruses can be enveloped or

A

naked

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6
Q

Viral Proteins

A

surface proteins, DNA or RNA polymerases, matrix protein, antigenic (serotypic) variants

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7
Q

Viral Proteins: Attachment to host cell receptors

A

surface protein

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8
Q

Viral Proteins: Interaction between nucleocapsid and envelope

A

matrix protein

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9
Q

Viral Proteins: Evasion of host defenses

A

antigenic (serotypic) variants

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10
Q

Lipid membrane derived from the host cell, acquired as the virus exits from the cell in a process called budding

A

viral envelope

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11
Q

All enveloped viruses acquire their envelope from plasma membrane except

A

herpesvirus - nuclear membrane

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12
Q

Enveloped viruses are _____ stable and _____ inactivated.

A

less stable, easily inactivated

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13
Q

Naked Viruses

A

RNA - Calici, Picorna, Reo, DNA - Parvo, Adeno, Papilloma, Polyoma

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14
Q

Purified nucleic acids of most dsDNA (except poxviruses and HBV) and (+) strand genome ssRNA viruses are

A

infectious

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15
Q

Naked nucleic acids of (-) strand ssRNA and dsDNA viruses are

A

not infectious

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16
Q

Naked nucleic acids of (-) strand ssRNA and dsDNA viruses require

A

enzymes contained in the complete virion

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17
Q

Infectious particles composed entirely of protein which case transmissible spongiform encephalopathies, highly resistant to inactivation, do not elicit an inflammatory response or an antibody response

A

Prions

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18
Q

Prion Proteins: Non-pathogenic

A

alpha-helix

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19
Q

Prions Proteins: Pathogenic

A

beta-pleated sheet

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20
Q

All viruses are haploid except

A

retroviruses

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21
Q

Genomes of RNA viruses can either have positive or negative

A

polarity

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22
Q

Some RNA viruses have a _____ genome.

A

segmented genome

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23
Q

Viruses with Segmented Genomes

A

Bunyavirus, Orthomyxovirus (influenza), Arenavirus, Reovirus

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24
Q

Must transcribe negative strand to positive, virion brings its own RNA-dependent polymerase

A

Negative-Strand RNA Viruses

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25
Q

Negative-Strand RNA Viruses

A

Arenavirus, Bunyavirus, Paramyxovirus, Orthomyxovirus, Filovirus, Rhabdovirus

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26
Q

Viral Genetics: Mutations can produce

A

antigenic, drug-resistant or attenuated variants

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27
Q

Viral Genetics: Causes epidemics

A

genomic reassortment

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28
Q

Viral Genetics: One virus produces a protein that can be used by another virus

A

complementation

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29
Q

Viral Genetics: Two different viruses infect the same cell

A

phenotypic mixing

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30
Q

Virus Life Cycle

A

attachment → penetration → uncoating → biosynthesis → maturation → release

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31
Q

Viral Growth Curve: A single virus particle infects a cell

A

Phase 0 - Entry

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32
Q

Viral Growth Curve: Virus decreases in number but continues to function

A

Phase 1 - Decline

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33
Q

Viral Growth Curve: No virus is detectable inside the cell

A

Phase 2 - Eclipse Period

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34
Q

Viral Growth Curve: Dramatic increase in amount of detectable viruses

A

Phase 3 - Rise Period

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35
Q

Viral Growth Curve: Amount of detectable viruses reach a plateau

A

Phase 4 - Latent Period

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36
Q

Viral Growth Curve: Marked derangement of cell function leading to lysis and cell death, remarkable amplification in number of viral particles

A

Phase 5 - Cytopathic Effect

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37
Q

Outcomes of Viral Infection: Visual or functional change in infected cells

A

Cytopathic Effect

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38
Q

Outcomes of Viral Infection: Oncogenic viruses induce transformation and unrestrained growth

A

Malignant Transformation

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39
Q

Outcomes of Viral Infection: Infected cells appear normal but are producing large numbers of progeny viruses

A

Commensal Symbiosis

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40
Q

Virulence Factors: Bind cytokines and block their ability to interact with receptors on their intended targets

A

Cytokine Decoys

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41
Q

Virulence Factors: Reduce the expression of antigen presenting cells and inactivate complement

A

Virokines

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42
Q

Viruses: Virulence Factors

A

antigenic variants of surface proteins, cytokine decoys, virokines

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43
Q

Persistent Viral Infections: Produce viruses for long periods of time, can serve as a source of infection for others

A

Carrier State

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44
Q

Persistent Viral Infections: Not producing virus at present but can be reactivated at a subsequent time

A

Latent Infections

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45
Q

Persistent Viral Infections: Long incubation period (years)

A

Slow Virus Infections

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46
Q

Viruses: Presumptive Identification

A

cytopathic effect, hemadsorption, interference, decrease in acid production (phenol red)

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47
Q

Presumptive Identification of Viruses: Attachment of RBCs to the surface of infected cells

A

hemadsorption

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48
Q

Presumptive Identification of Viruses: Disturbance with CPE by another virus

A

interference

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49
Q

Presumptive Identification of Viruses: Decrease in acid production by infected, dying cells

A

phenol red

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50
Q

Viruses: Definitive Diagnosis

A

complement fixation, hemagglutination inhibition, neutralization, fluorescent-antibody assay, radioimmunoassay, Enzyme-Linked Immunosorbent Assay (ELISA)

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51
Q

Virus Serologic Tests: Finding an antibody in one who previously had none

A

seroconversion

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52
Q

Virus Serologic Tests: Ig in current infection

A

IgM

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53
Q

Virus Serologic Tests: Ig that can be from previous infection

A

IgG

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54
Q

Gold Standard in Viral Dagnosis

A

viral DNA/RNA

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55
Q

Vaccines: Induce humoral and cell-mediated immunity but may revert to virulence on rare occasions, dangerous to give to immunocompromised patients or their close contacts

A

Live-Attenuated Vaccines

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56
Q

Only live-attenuated vaccine that may be given to HIV (+) patients

A

MMR

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57
Q

Live-Attenuated Vaccines

A

yellow fever, chicken pox (VZV), polio (Sabin’s), MMR

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58
Q

Vaccines: Induce only humoral immunity but are stable

A

Killed Vaccines

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59
Q

Killed Vaccines

A

rabies, influenza, polio (Salk’s), hepatitis A

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60
Q

Recombinant Vaccines

A

Hepatitis B (HBsAg), HPV (6, 11, 16, 18)

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61
Q

Hepatitis Virus: A

A

Picornaviridae

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62
Q

Hepatitis Virus: B

A

Hepadnaviridae

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63
Q

Hepatitis Virus: C

A

Flaviviridae

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64
Q

Hepatitis Virus: D

A

not classified

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65
Q

Hepatitis Virus: E

A

Caliciviridae

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66
Q

DNA Viruses

A

Hepadna, Herpes, Adeno, Pox, Parvo, Polyoma, Papilloma

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67
Q

All DNA viruses have dsDNA except

A

Parvovirus - ssDNA

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68
Q

All DNA viruses have linear DNA except

A

Papilloma, Polyoma, Hepadna

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69
Q

All DNA viruses are icosahedral except

A

Poxvirus - complex symmetry

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70
Q

All DNA viruses replicate in the nucleus except

A

Poxvirus - cytoplasm, Guarnieri bodies

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71
Q

Naked DNA Viruses

A

Parvovirus, Adenovirus, Human Papillomavirus

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72
Q

Naked DNA Viruses: Respiratory, transplacental, non-oncogenic, no vaccine

A

Parvovirus

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73
Q

Naked DNA Viruses: Respiratory, fecal-oral, non-oncogenic, vaccine available

A

Adenovirus

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74
Q

Naked DNA Viruses: Sexual, skin contact, oncogenic, vaccine available

A

Human Papillomavirus

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75
Q

Naked virus with icosahedral symmetry, ssDNA genome, one serotype

A

Parvovirus B19

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76
Q

Parvovirus: Transmission

A

respiratory droplets, transplacental

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77
Q

Parvovirus: Infections

A

Erythema Infectiosum (5th Disease), Aplastic Crisis, Fetal Infections, Arthritis, Chronic B19 Infection

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78
Q

Bright red cheeks (slapped cheeks), fever, coryza, sore throat

A

Erythema Infectiosum (5th Disease) - Parvovirus B19

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79
Q

Transient but severe aplastic anemia in children, sickle cell anemia, thalassemia, spherocytosis

A

Aplastic Crisis - Parvovirus B19

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80
Q

Parvovirus Fetal Infections: 1st Trimester

A

fetal death

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81
Q

Parvovirus Fetal Infections: 2nd Trimester

A

hydrops fetalis

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82
Q

Viral immune-complex arthritis of small joints

A

Parvovirus Arthritis

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83
Q

Chronic Parvovirus B19 infection causes _____ in immunodeficient patients.

A

pancytopenia

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84
Q

Naked virus, dsDNA, icosahedral nucleocapsid, only virus with fiber (penton), 41 antigenic types, Cowdry type B intranuclear inclusions

A

Adenovirus

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85
Q

Adenovirus: Transmission

A

aerosol droplet, fecal-oral, direct contact

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86
Q

Adenovirus: URT

A

pharyngitis, conjunctivitis, coryza

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87
Q

Adenovirus: LRT

A

bronchitis, atypical pneumonia

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88
Q

Adenovirus: GIT

A

acute gastroenteritis

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89
Q

Adenovirus: GUT

A

hemorrhagic cystitis

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90
Q

Adenovirus: Histopathology

A

Cowdry type B intranuclear inclusions

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91
Q

Naked virus with circular dsDNA, icosahedral nucleocapsid, at least 100 types

A

HPV

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92
Q

HPV: Transmission

A

sexually, direct contact

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93
Q

Infect squamous cells and induce formation of cytoplasmic vacuole (koilocytes), genes E6 & E7

A

HPV

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94
Q

HPV: Encode proteins that inactivate tumor suppressor genes

A

genes E6 & E7

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95
Q

HPV: Skin and plantar warts

A

HPV 1-4

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96
Q

HPV: Genital warts (condyloma acuminata), respiratory tract

A

HPV 6 & 11

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97
Q

Most common viral STD

A

HPV

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98
Q

HPV: Carcinoma of cervix, penis, anus

A

HPV 16, 18, 31, 33

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99
Q

HPV: Treatment for Genital Warts

A

Podophyllin

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100
Q

HPV: Treatment for Skin Warts

A

Liquid Nitrogen

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101
Q

HPV: Treatment for Plantar Warts

A

Salicylic Acid

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102
Q

HPV: Prevention

A

vaccine for HPV 6, 11, 16, 18, 9-26 y.o.

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103
Q

Only causes disease in immunocompromised hosts, causes progressive multifocal leukoencephalopathy (PML) in AIDS patients

A

JC Polyoma Virus

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104
Q

Demyelinating disease that affects oligodendrocytes characterized by deficits in speech, coordination and memory, AIDS patients

A

Progressive Multifocal Leukoencephalopathy (PML)

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105
Q

Only causes disease in immunocompromised hosts, causes hemorrhagic cystitis and nephropathy in patients with solid organ (kidney) and bone marrow transplants

A

BK Polyoma Virus

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106
Q

Enveloped DNA Virsues

A

HSV, VZV, EBV, CMV, HHV

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107
Q

Herpesviruses

A

CMV, HSV, EBV, VZV

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108
Q

Enveloped virus, icosahedral nucleocapsid, linear dsDNA, vesicle filled with virus particles and cell debris, multinucleated giant cells on Tzanck smear, large, pink-purple intranuclear inclusions (Cowdry type A)

A

Herpes Simplex Virus

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109
Q

Herpes Simplex Virus: Transmission

A

HSV 1 - saliva, direct (above umbilicus), HSV 2 - sexual, transvaginal (below umbilicus)

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110
Q

Herpes Simplex Virus: Site of Latency

A

HSV 1 - trigeminal ganglia, HSV 2 - lumbosacral ganglia

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111
Q

HSV: Gingivostomatitis, herpes labialis (lips), keratoconjunctivitis, temporal lobe encephalitis, herpetic whitlow (fingers), herpes gladiatorum (trunk)

A

HSV 1

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112
Q

HSV: Genital herpes (painful anogenital vesicles), neonatal herpes (contact within birth canal), aseptic meningitis

A

HSV 2

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113
Q

Herpes Simplex Virus: Treatment

A

Acyclovir

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114
Q

Needs virus kinase to be activated, analogue of guanine, shortens duration of lesions, reduces the extent of shedding of the virus, no effect on the latent sate

A

Acyclovir

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115
Q

Enveloped virus, icosahedral nucleocapsid, linear dsDNA, infects URT, hematogenous spread to the skin, becomes latent in the dorsal root ganglia, may reactivate as zoster, multinucleated giant cells with intranuclear inclusions

A

Varicella-Zoster Virus

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116
Q

Varicella-Zoster Virus: Transmission

A

respiratory droplets, direct contact with lesions

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117
Q

Varicella-Zoster Virus: Diseases

A

Varicella, Zoster, Ramsay Hunt Syndrome

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118
Q

VZV: Incubation period of 14-21 days, vesicular centrifugal rash in different stages (dewdrop on a rose petal), pneumonia, encephalitis, Reye’s Syndrome

A

Varicella

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119
Q

Aspirin in Pediatric Cases

A

Kawasaki, ARF, JRA

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120
Q

VZV: Painful vesicles along dermatomal distribution, debilitating pain (postherpetic neuralgia)

A

Zoster

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121
Q

VZV: Involvement of geniculate ganglion causes facial nerve paralysis

A

Ramsay Hunt Syndrome

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122
Q

Varicella-Zoster Virus: Site of Latency

A

dorsal root ganglia

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123
Q

Varicella-Zoster Virus: Treatment

A

Acyclovir - moderate to severe (shortens duration of lesions)

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124
Q

Enveloped virus, icosahedral nucleocapsid, linear dsDNA, cultured in shell tubes, (-) neutrophil test

A

Cytomegalovirus

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125
Q

Cytomegalovirus: Transmission

A

body fluids, transplacental, organ transplant

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126
Q

Immediate early proteins, giant cells with owl’s-eye nuclear inclusions

A

Cytomegalovirus

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127
Q

Cytomegalovirus: Translated from premade mRNAs, impair assembly of the MHC class I-viral peptide complexes

A

Immediate Early Proteins

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128
Q

Cytomegalovirus: Diseases

A

congenital CMV, heterophil (-) mononucleosis, systemic CMV

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129
Q

Most common cause of congenital abnormalities

A

Cytomegalovirus

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130
Q

Microcephaly, seizures, deafness, jaundice, purpura (blueberry muffin), most common when mother is infected in the 1st trimester

A

Congenital CMV

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131
Q

Fever, lethargy, abnormal lymphocytes in peripheral blood smears

A

Heterophil (-) Mononucleosis

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132
Q

Pneumonitis, hepatitis, colitis, retinitis in HIV

A

Systemic CMV

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133
Q

Cytomegalovirus: Treatment

A

Gancyclovir (resistant to Acyclovir), Foscarnet - retinitis

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134
Q

Enveloped virus, icosahedral nucleocapsid, linear dsDNA, infects mainly lymphoid cells (B-cells → Downey cells), elicits specific antibodies and nonspecific heterophil antibodies

A

Epstein-Barr Virus

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135
Q

Epstein-Barr Virus: Transmission

A

saliva

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136
Q

Kissing Disease

A

Epstein-Barr Virus

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137
Q

Epstein-Barr Virus: Diseases

A

Infectious Mononucleosis, malignancies

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138
Q

Fever, sore throat, lymphadenopathy, splenomegaly, splenic rupture

A

Infectious Mononucleosis

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139
Q

Epstein-Barr Virus: Malignancies

A

Burkitt’s Lymphoma (Africans), B-cell Lymphomas, Nasopharyngeal CA (Chinese), Hairy Leukoplakia (AIDS)

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140
Q

Malignancy of vascular endothelial cells, flat to nodular dark purple skin lesions at multiple sites

A

Kaposi’s Sarcoma (Human Herpesvirus 8)

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141
Q

Kaposi’s Sarcoma: Treatment

A

surgical excision, radiation

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142
Q

Only disease that has been eradicated from Earth

A

Smallpox (Variola Virus)

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143
Q

Largest virus, brick-shaped poxvirus, Guarnieri bodies (intracytoplasmic eosinophilic inclusions)

A

Smallpox (Variola Virus)

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144
Q

Smallpox: Transmission

A

aerosol, contact

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145
Q

Smallpox: Incubation Period

A

7-14 days

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146
Q

Smallpox: Findings

A

prodrome of fever and malaise followed by centrifugal rash

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147
Q

Pinkish, papular skin lesions with an umbilicated center, Henderson-Peterson bodies (intracytoplasmic eosinophilic inclusions)

A

Molluscum Contagiosum

148
Q

Molluscum Contagiosum: Transmission

A

direct contact

149
Q

Molluscum Contagiosum: Treatment

A

Cifodivir

150
Q

Enveloped virus, incomplete circular dsDNA

A

Hepadnaviridae (Hepatitis B)

151
Q

Hepatitis Types: Asymptomatic

A

Hepatitis A

152
Q

Hepatitis Types: Blood-borne

A

Hepatitis B

153
Q

Hepatitis Types: Chronic, cirrhosis, carcinoma, carriers

A

Hepatitis C

154
Q

Hepatitis Types: Enteric, expectant mothers, epidemics

A

Hepatitis E

155
Q

Hepatitis Types: Enteric infections

A

Hepatitis A & E

156
Q

Hepadnaviridae: Transmission

A

blood, birth, sexual

157
Q

Hepadnaviridae: Virulence Factors

A

HBsAg - surface antigen, HBcAg - core antigen, HBeAg - e antigen

158
Q

Only DNA virus that produces DNA by reverse transcription with mRNA as template

A

Hepadnaviridae (Hepatitis B)

159
Q

Hepadnaviridae causes hepatocellular injury due to

A

immune attack (HBV has no cytopathic effect)

160
Q

Hepadnaviridae: Incubation Period

A

10-12 weeks

161
Q

Fever, anorexia, jaundice, dark urine, pale feces, elevated transaminase levels, cirrhosis, hepatocellular CA, autoimmune vasculitides (polyarteritis nodosa)

A

Hepadnaviridae (Hepatitis B)

162
Q

Hepatitis B Complications: Functional renal failure from hepatic injury in the abscence of renal pathology

A

Hepatorenal Syndrome

163
Q

Hepatitis B Complications: Vascular dilatations cause overperfusion relative to ventilation leading to V/Q mismatch and hypoxemia

A

Hepatopulmonary Syndrome

164
Q

Hepatitis B Complications

A

hepatorenal syndrome, hepatopulmonary syndrome, portal HPN, hepatic encephalopathy

165
Q

Hepadnaviridae: Treatment

A

Interferon α, Lamivudine

166
Q

Hepadnaviridae: Prevention

A

vaccination - first vaccine to prevent human cancer

167
Q

All RNA viruses have ssRNA except

A

Reovirus, Rotavirus (dsRNA)

168
Q

All RNA viruses replicate in the cytoplasm except

A

Influenza, Retrovirus (nucleus)

169
Q

Picornaviridae

A

Polio, Echo, Rhino, Coxsackie, Hepatitis A

170
Q

Naked nucleocapsid, ssRNA with (+) polarity, oral-fecal transmission, replicates in motor neurons in the anterior horn of the spinal cord causing paralysis

A

Poliovirus

171
Q

Host range is limited to primates due to the binding of the viral capsid protein to a receptor found only on primate cell membranes

A

Poliovirus

172
Q

Has 3 serologic (antigenic) types based on different antigenic determinants on the outer capsid proteins

A

Poliovirus

173
Q

Poliovirus: Diseases

A

asymptomatic, abortive poliomyelitis, non-paralytic poliomyelitis, paralytic poliomyelitis

174
Q

Poliovirus: Most common clinical form, mild, febrile illness, headache, sore throat, nausea, vomiting

A

abortive poliomyelitis

175
Q

Poliovirus: Aseptic meningitis

A

non-paralytic poliomyelitis

176
Q

Poliovirus: Flaccid paralysis, permanent motor nerve damage

A

paralytic poliomyelitis

177
Q

Poliovirus: Histopathology

A

Cowdry type B intranuclear inclusions

178
Q

Poliovirus: Prevention

A

killed vaccine (Salk, IPV), live-attenuated vaccine (Sabin, OPV)

179
Q

Polio Vaccine: Interrupts transmission

A

live-attenuated vaccine (Sabin, OPV)

180
Q

Polio Vaccine: Induces humoral IgG

A

killed vaccine (Salk, IPV), live-attenuated vaccine (Sabin, OPV)

181
Q

Polio Vaccine: Induces intestinal IgA

A

live-attenuated vaccine (Sabin, OPV)

182
Q

Polio Vaccine: Affords secondary protection by spread to others

A

live-attenuated vaccine (Sabin, OPV)

183
Q

Polio Vaccine: Interferes with replication of virulent virus in gut

A

live-attenuated vaccine (Sabin, OPV)

184
Q

Polio Vaccine: Reverts to virulence

A

live-attenuated vaccine (Sabin, OPV)

185
Q

Polio Vaccine: Co-infection with enteroviruses may impair immunization

A

live-attenuated vaccine (Sabin, OPV)

186
Q

Polio Vaccine: Can cause disease in the immunocompromised

A

live-attenuated vaccine (Sabin, OPV)

187
Q

Polio Vaccine: Injection

A

killed vaccine (Salk, IPV)

188
Q

Polio Vaccine: Oral

A

live-attenuated vaccine (Sabin, OPV)

189
Q

Polio Vaccine: Requires refrigeration

A

live-attenuated vaccine (Sabin, OPV)

190
Q

Polio Vaccine: Short immunity

A

killed vaccine (Salk, IPV)

191
Q

Polio Vaccine: Long-lasting immunity

A

live-attenuated vaccine (Sabin, OPV)

192
Q

Naked nucleocapsid, ssRNA, (+) polarity, classified based on pathogenicity in mice

A

Coxsackievirus

193
Q

Coxsackievirus: Transmission

A

oral-fecal

194
Q

Coxsackievirus A: Diseases

A

herpangina, hand-foot-and-mouth disease, hemorrhagic conjunctivitis, aseptic meningitis

195
Q

Coxsackievirus B: Diseases

A

pleurodynia, myocarditis, pericarditis, aseptic meningitis

196
Q

Coxsackievirus: Fever, sore throat, tender vesicles in oropharynx

A

herpangina

197
Q

Coxsackievirus: Vesicular rash on hands and feet and ulcerations in the mouth

A

hand-foot-and-mouth disease

198
Q

Coxsackievirus: Fever, severe pleuritic chest pain

A

pleurodynia

199
Q

Coxsackievirus: Fever, chest pain, congestive failure

A

myocarditis, pericarditis

200
Q

Most common cause of myocarditis and pericarditis

A

Coxsackievirus

201
Q

Most common cause of aseptic meningitis

A

Coxsackievirus

202
Q

Coxsackievirus, Poliovirus and Echovirus are

A

enteroviruses

203
Q

Enteric Cytopathic Human Orphan

A

ECHOvirus

204
Q

Virus initially not associated with any disease

A

Echovirus

205
Q

Aseptic meningitis, URTI, febrile illness ± rash, infantile diarrhea, hemorrhagic conjunctivitis

A

Echovirus

206
Q

Echovirus: Transmission

A

fecal-oral

207
Q

Only respiratory picornavirus, causes common colds

A

Rhinovirus

208
Q

Naked nucleocapsid virus, ssRNA, (+) polarity, more than 100 serotypes, affect mainly the nose and conjunctiva, replicates better at 33°C, acid-labile, host range limited to humans and chimpanzees

A

Rhinovirus

209
Q

Rhinovirus: Transmission

A

aerosol droplets, hand-to-nose contact

210
Q

Naked nucleocapsid virus, ssRNA, (+) polarity, frequently infects children, self-limited hepatitis, anti-HAV IgM (most important test), Enterovirus 72, has 1 serotype

A

Hepatitis A Virus (Picornaviridae)

211
Q

Hepatitis A Virus: Transmission

A

fecal-oral

212
Q

Hepatitis A Virus: Diagnosis

A

anti-HAV IgM

213
Q

Fecal-oral transmission, no chronic carrier state, no cirrhosis, no hepatocellular CA, high mortality in pregnant women, causes hepatitis epidemics

A

Hepatitis E Virus (Caliciviridae)

214
Q

Non-enveloped virus, icosahedral nucleocapsid, one piece of ssRNA, (+) polarity, sudden onset of vomiting and diarrhea accompanied by fever and abdominal cramping

A

Norwalk Virus/Norovirus (Viral Gastroenteritis)

215
Q

Most common cause of non-bacterial diarrhea in adults

A

Norwalk Virus/Norovirus

216
Q

Naked double-layered capsid with 10-11 segments of dsRNA, most common cause of childhood diarrhea

A

Rotavirus (Viral Gastroenteritis)

217
Q

Enveloped virus, helical nucleocapsid, segmented ssRNA, (-) polarity, most common cause of respiratory tract infections

A

Influenza Virus

218
Q

Influenza Virus: Major Antigens

A

hemagglutinin (H), neuraminidase (N)

219
Q

Influenza Virus: Transmission

A

respiratory droplet

220
Q

Influenza Virus: Worldwide epidemics (pandemics)

A

Influenza A

221
Q

Influenza Virus: Major outbreaks

A

Influenza B

222
Q

Influenza Virus: Mild respiratory tract infections, does not cause outbreaks

A

Influenza C

223
Q

Influenza Virus: Pathogenesis

A

Envelope → 2 different types of spikes: hemagglutinin (H), neuraminidase (N)

224
Q

Influenza Virus: 16 types of hemagglutinin (H), 9 types of neuraminidase (N)

A

Influenza A

225
Q

Binds to the cell surface receptor (neuraminic acid/sialic acid) to initiate infection of the cell, target of neutralizing antibody

A

hemagglutinin

226
Q

Cleaves neuraminic acid (sialic acid) to release progeny virus from infected cell, degrades the protective layer of mucus in the respiratory tract → enhances access to the respiratory epithelial cells

A

neuraminidase

227
Q

Animal influenza viruses are the source of RNA segments that encode the antigenic _____ variants that cause epidemics among humas.

A

antigentic shift

228
Q

Creation of new influenza variants

A

Reassortment

229
Q

Common source of new influenza variants

A

aquatic birds (waterfowl)

230
Q

Influenza “Mixing Bowl”

A

Pigs

231
Q

Influenza Variants: Waterfowl

A

H1-H16, N1-N9

232
Q

Influenza Variants: Humans

A

H1-H3, N1 and N2

233
Q

Influenza: Only a human virus (no animal source), undergoes antigenic drift, new version every year

A

Influenza B

234
Q

Influenza Variants: Major changes based on the reassortment of segments of the genome RNA, causes pandemics

A

antigenic SHIFT

235
Q

Influenza Variants: Minor changes based on mutations in the genome RNA

A

antigenic DRIFT

236
Q

Influenza: Incubation Period

A

24-48 hours

237
Q

Fever, myalgias, headache, sore throat, cough

A

Influenza

238
Q

Influenza: Complications

A

Staphylococcal Pneumonia, Reye’s Syndrome

239
Q

Influenza: Treatment

A

Oseltamivir, Zanamivir, Influenza A - Amantadine, Rimantadine (Parkinson’s medicine, prevents viral uncoating)

240
Q

Influenza: Prevention

A

annual vaccination

241
Q

Paramyxoviridae

A

Parainfluenza, RSV, Measles, Mumps

242
Q

Paramyxoviridae: Hemagglutinin (+), Neuraminidase (-), Fusion Protein (+)

A

Measles

243
Q

Paramyxoviridae: Hemagglutinin (+), Neuraminidase (+), Fusion Protein (+)

A

Mumps, Parainfluenza

244
Q

Paramyxoviridae: Hemagglutinin (-), Neuraminidase (-), Fusion Protein (+)

A

RSV

245
Q

Enveloped virus, helical nucleocapsid, one piece of ssRNA, (-) polarity, infects URT, spreads to reticuloendothelial cells, hematologic spread to skin, transiently depress cell-mediated immunity

A

Measles

246
Q

Multinucleated giant cells (Warthin-Finkeldey bodies) form as a result of the fusion protein in the spikes - characteristic of the lesions, lifelong immunity after recovery

A

Measles

247
Q

Measles rash is caused by

A

cytotoxic T cells, attacking the infected vascular endothelial cells in the skin

248
Q

Measles: Shortly after the rash appears, the virus can no longer be recovered and the patient _____ spread the virus.

A

can no longer spread the virus

249
Q

Measles: Incubation Period

A

10-14 days

250
Q

Measles: Pathognomonic Sign

A

Koplik’s Spots

251
Q

Measles: Bright red lesions with white central dot on buccal mucosa

A

Koplik’s Spots

252
Q

Measles: Rash

A

face → trunk → extremities → palms/soles

253
Q

Rash: face → trunk → extremities → palms/soles

A

Measles

254
Q

Measles: Complications

A

encephalitis, pneumonia, subacute sclerosing panencephalitis (SSPE) or Dawson disease

255
Q

Measles: Triad

A

cough, coryza, conjunctivitis

256
Q

Measles: Prevention

A

live-attenuated vaccine, Vitamin A - reduces severity

257
Q

Enveloped virus, helical nucleocapsid, one piece of ssRNA, (-) polarity, initially infects URT, spreads to local lymph nodes, hematogenous spread to parotid glands, testes, ovaries, meninges, pancreas

A

Mumps

258
Q

Mumps: Transmission

A

respiratory droplets

259
Q

Mumps: Incubation Period

A

18-21 days

260
Q

Tender swelling of the parotid glands (parotitis) with increased pain when drinking citrus juices, orchitis, meningitis, resolves in 1 week

A

Mumps

261
Q

Mumps: Prevention

A

live-attenuated vaccine

262
Q

Surface spikes are fusion proteins (not hemagglutinin or neuraminidase) which causes cells to fuse, forming multinucleated giant cells (syncitia), humans are the natural hosts

A

Respiratory Syncitial Virus

263
Q

Most important cause of pneumonia and bronchiolitis in infants

A

Respiratory Syncitial Virus

264
Q

Severe disease in infants due to immunologic cross-reaction with maternal antibodies

A

Respiratory Syncitial Virus

265
Q

Respiratory Syncitial Virus: Treatment

A

Ribavirin

266
Q

Inspiratory stridor, cough, hoarseness, steeple sign (subglottic stenosis)

A

Laryngotracheobronchitis / Croup (Parainfluenza Virus 1 & 2)

267
Q

Laryngotracheobronchitis: Treatment

A

Racemic Epinephrine

268
Q

Bullet-shaped enveloped virus with helical nucleocapsid, one piece of ssRNA, (-) polarity

A

Rabies

269
Q

Rabies: Transmission

A

animal bite - dog, cats, skunks, racoons, bats

270
Q

Multiplies locally at the bite site, infects sensory neurons and moves by axonal transport to CNS

A

Rabies

271
Q

Rabies: Histopathology

A

Negri bodies

272
Q

Rabies: Incubation Period

A

2-16 weeks - depends on bite site

273
Q

Confusion, lethargy, hypersalivation, laryngospasm, hydrophobia, invariably fatal when encephalitis develops

A

Rabies

274
Q

Rabies: Treatment and Prevetion

A

pre- and post-exposure vaccine (only vaccine routinely used post-exposure), post-exposure Ig

275
Q

Rabies Post-Exposure Prophylaxis: Touching or feeding animals, licks on skin

A

Category I - no treatment

276
Q

Rabies Post-Exposure Prophylaxis: Nibbling of uncovered skin, minor scratches or abrasions without bleeding, licks on broken skin

A

Category II - vaccine

277
Q

Rabies Post-Exposure Prophylaxis: Single or multiple transdermal bites or scratches, contamination of mucous membranes with saliva from licks, exposure to bat bites or scratches

A

Category III - vaccine + Ig

278
Q

Enveloped virus, helical nucleocapsid, one piece of ssRNA, (+) polarity, prominent club-shaped spikes forming a corona, 2 serotypes

A

Coronavirus

279
Q

Coronavirus: Reservoir

A

horseshoe bat

280
Q

Coronavirus: Intermediate Host

A

civet cat

281
Q

Coronavirus: Transmission

A

respiratory droplets

282
Q

Coronavirus: Diseases

A

common cold, Severe Acute Respiratory Syndrome (SARS)

283
Q

SARS: Incubation Period

A

2-10 days

284
Q

Atypical pneumonia rapidly progressing to ARDS, virus binds to ACE-2 receptors, non-cavitary “ground glass” infiltrates

A

Severe Acute Respiratory Syndrome (SARS)

285
Q

Enveloped virus, icosahedral nucleocapsid, one piece of ssRNA, (+) polarity, flavivirus, 4 serotypes

A

Dengue

286
Q

Dengue: Vector

A

Aedes aegypti mosquito

287
Q

Dengue: Diagnosis

A

dengue IgM, tourniquet test

288
Q

Influenza-like syndrome with maculopapular rash and severe pains in muscles and joints (breakbone fever), leukopenia, thrombocytosis, hemorrhagic shock due to cross-reacting antibody during 2nd infection

A

Dengue

289
Q

Probable Dengue

A

endemic area, fever ± (nausea, vomiting, rash, aches/pains, tourniquet test (+), leukopenia, any warning sign)

290
Q

Dengue: Warning Signs

A

abdominal pain or tenderness, persistent vomiting, clinical fluid accumulation, mucosal bleed, lethargy, restlessness, liver enlargement > 2cm, increase in Hct concurrent with rapid decrease in PC

291
Q

Severe Dengue

A

severe plasma leakage (shock, fluid accumulation with respiratory distress), severe bleeding, severe organ involvement (AST or ALT ≥ 1000, impaired consciousness)

292
Q

Dengue: Prevention

A

insecticides, draining stagnant water, mosquito repellant

293
Q

Enveloped virus, one piece of ssRNA, (+) polarity, 6 serotypes, hypervariable region in envelope glycoprotein

A

Hepatitis C

294
Q

Hepatitis C: Diagnosis

A

anti-HCV or HCV RNA

295
Q

Most prevalent blood-borne pathogen

A

Hepatitis C

296
Q

IV drug abusers, needle-stick injury, vertical transmission, sexual transmission

A

Hepatitis C

297
Q

Most common needle-stick injury pathogen

A

Hepatitis B

298
Q

Replication in liver enhanced by liver-specific micro-RNA, hepatocellular injury due to immune attack, alcoholism greatly enhances rate of hepatocellular CA, chronic carriage is higher than HBV

A

Hepatitis C

299
Q

Hepatitis C: Incubation Period

A

8 weeks

300
Q

Hepatitis C: Autoimmune Reactions

A

thyroiditis, autoantibodies, MPGN, porphyria cutanea tarda, DM

301
Q

Main cause of essential mixed cryoglobulinemia

A

Hepatitis C

302
Q

Hepatitis C: Treatment for Acute Disease

A

Interferon

303
Q

Hepatitis C: Treatment for Chronic Disease

A

Peginterferon, Ribavarin

304
Q

Hepatitis C: Treatment for Severe Disease

A

liver transplant

305
Q

Most common indication for liver transplant

A

Hepatitis C

306
Q

Enveloped virus, icosahedral nucleocapsid, one piece of ssRNA, (+) polarity, togavirus

A

Rubella

307
Q

Rubella: Transmission

A

respiratory droplets, transplacental

308
Q

Rubella: Diseases

A

German Measles, Congenital Rubella Syndrome

309
Q

German Measles: Incubation period

A

14-21 days

310
Q

Prodrome followed by 3-day maculopapular rash and posterior CLAD, rash (face → trunk → arms/legs), immune-complex polyarthritis in adults

A

German Measles (Rubella)

311
Q

Infected during 1st trimester, PDA, congenital cataracts, sensorineural deafness, mental retardation

A

Congenital Rubella Syndrome

312
Q

Rubella: Prevention

A

live-attenuated vaccine (should not be given to immunocompromised or pregnant patients)

313
Q

RNA viruses with reverse transcriptase

A

Retroviridae

314
Q

Converts ssRNA viral genome into viral dsDNA

A

reverse transcriptase

315
Q

Enveloped virus with 2 copies (diploid) of a ssRNA, (+) polarity, most complex retrovirus, many serotypes

A

Human Immunodeficiency Virus (HIV)

316
Q

HIV: Transmembrane protein (TM) which is linked to a surface protein (SU)

A

fusion protein (gp41)

317
Q

HIV: Attachment protein

A

gp120

318
Q

HIV: Cone-shaped, icosahedral core containing the major capsid protein

A

CA (p24) - diagnosis

319
Q

HIV: Directs entry of dsDNA provirus into the nucleus and is later essential for the process of virus assembly

A

MA (p17)

320
Q

HIV: RNA is tightly packed with basic protein in a nucleocapsid structure that differs in morphology among diffent retrovirus genera

A

NC (p7)

321
Q

HIV Genes: p24, p7, p17

A

gag

322
Q

HIV Genes: Nucleocapsid, Matrix

A

gag

323
Q

HIV Genes: Reverse transcriptase, Protease, Integrase

A

pol

324
Q

HIV Genes: gp120, gp41

A

env

325
Q

HIV Proteins: gag

A

p24, p7, p17

326
Q

HIV Proteins: nucleocapsid

A

p24, p7

327
Q

HIV Proteins: matrix

A

p17

328
Q

HIV Proteins: pol

A

reverse transcriptase, protease, integrase

329
Q

HIV Proteins: Transcribes RNA genome into DNA

A

reverse transcriptase

330
Q

HIV Proteins: Cleaves precursor polyeptides

A

protease

331
Q

HIV Proteins: Integrates viral DNA into host cell DNA

A

integrase

332
Q

HIV Proteins: env

A

gp120, gp41

333
Q

HIV Proteins: Attachment to CD4 protein, antigenicity changes rapidly

A

gp120

334
Q

HIV Proteins: Fusion with host cell

A

gp41

335
Q

HIV: Group-specific antigen, core, not known to vary, antibodies against this do not neutralize infectivity but serve as important serologic markers of infection

A

p24

336
Q

HIV: Interacts with the CD4 receptor, mutates rapidly because of lack of editing, many antigenic variants, V3 - most immunogenic region, antibody neutralizes infectivity

A

gp120

337
Q

HIV: Mediates fusion of the viral envelope with the cell membrane

A

gp41

338
Q

HIV Genes: Activation of transcription of viral genes

A

tat

339
Q

HIV Genes: Transport of late mRNAs to cytoplasm

A

rev

340
Q

HIV Genes: Decreases CD4 and class I MHC proteins

A

nef

341
Q

HIV Genes: Enhances hypermutation

A

vif

342
Q

HIV Genes: Transport in non-dividing cells

A

vpr

343
Q

HIV Genes: Enhances virion release

A

vpu

344
Q

HIV: Transmission

A

originally from chimpanzees, transfer of body fluids, transplacental, perinatal, needlestick, sexual contact

345
Q

Preferentially infects and kills helper (CD4) T lymphocytes, loss of cell-mediated immunity, high probability of opportunistic infections, main immune response consists of cytotoxic (CD8) T-lymphocytes

A

HIV

346
Q

HIV Phases: Acquired through sexual contact, blood, perinatally

A

Phase 0 - Infection

347
Q

HIV Phases: Rapid viral replication but HIV test is (-)

A

Phase 1 - Window Period

348
Q

HIV Phases: Peak of viral load, (+) HIV test, mild flu-like illness lasting 1-2 weeks

A

Phase 2 - Seroconversion

349
Q

HIV Phases: Asymptomatic, CD4 goes down, lasts 1-15 years

A

Phase 3 - Latent Period

350
Q

HIV Phases: CD4 500-200, lasts 5 years, mild mucocutaneous, dermatologic and hematologic illness

A

Phase 4 - Early Symptomatic

351
Q

HIV Phases: CD4 < 200, lasts 2 years, AIDS-defining illnesses develop

A

Phase 5 - AIDS

352
Q

AIDS-Defining Illnesses: CD4 < 500

A

M. tuberculosis (disseminated TB), HSV (eophagitis), C. albicans (esophageal candidiasis), HHV-8 (Kaposi’s sarcoma)

353
Q

AIDS-Defining Illnesses: CD4 < 200

A

P. jiroveci (PCP pneumonia), T. gondii (cerebral toxoplasmosis), C. neoformans (meningoencephalitis), C. immitis (coccidioidomycosis), C. parvum (chronic diarrhea)

354
Q

AIDS-Defining Illnesses: CD4 < 50

A

M. avium (invasive pulmonary disease), H. capsulatum (histoplasmosis), CMV (retinitis)

355
Q

Most common AIDS-defining illnesses

A

P. carinii pneumonia (PCP), esophageal candidiasis, wasting, Kaposi’s sarcoma, disseminated MAC

356
Q

Most common among AIDS-defining illnesses

A

P. carinii pneumonia (PCP)

357
Q

HIV: Presumptive Diagnosis

A

ELISA

358
Q

HIV: Definitive Diagnosis

A

Western Blot (gp41, p24)

359
Q

HIV: Treatment

A

Highly Active Antiretroviral Therapy (HAART)

360
Q

2 nucleoside inhibitors (Zidovudine, Lamivudine) and protease inhibitor (Indinavir), immune reconstitution syndrome in patients co-infected with HBV, HCV, MAC/MAI

A

Highly Active Antiretroviral Therapy (HAART)

361
Q

HIV: General Prevention

A

condoms, not sharing needles, proper blood disposal, post-exposure prophylaxis

362
Q

HIV: Perinatal Prevention

A

perinatal prophylaxis, CS delivery, breastfeeding cessation

363
Q

Retrovirus causing adult T-cell leukemia and a HTLV-associated myelopathy, malignant T-calls with flower-shaped nucleus

A

Human T-cell Lymphotropic Virus (HTLV)

364
Q

Thread-like virus, longest virus, outbreak of hemorrhagic fever in Zaire (1976), 100% mortality rate

A

Ebola Hemorrhagic Fever

365
Q

Flavivirus, bird-mosquito-man cycle, initial self-limited febrile illness with progression to neuroinvasive disease

A

West Nile Fever

366
Q

Flavivirus, most common cause of epidemic encephalitis, most prevalent in SEA, transmitted by Culex mosquitoes, thalamic infarcts on CT scan

A

Japanese B Encephalitis

Microbiology (17 decks)

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