1A: Dt 7-2

Front 1

Live attenuated vaccine:
MOA
Indications
Examples

Back 1

Humoral and cell-mediated immunity (but have reverted to virulence on rare occasions)

No booster required

Dangerous to immunocomp'd pts or their close contacts

Ex:
Live! See small yellow chickens get vaccinated with Sabin's and MMR!

Smallpox
Yellow fever
Chickenpox (VZV)
Sabin's Polio virus
MMR (Measles, Mumps, Rubella)

Front 2

Killed vaccines:
MOA
Examples

Back 2

Humoral immunity only, but stable

RIP Always
SalK = Killed

Rabies
INfluenza
Salk Polio
HAV

Front 3

Which live attenuated vaccine can be given to HIV-positive patients?

Back 3

MMR

Front 4

Which vaccines are recombinant?

Back 4

HBV
HPV--6,11,16,18

Front 5

Which vaccines are egg-based?

Back 5

Flu
Yellow fever

Front 6

HSV-1:
Presentation

Back 6

Cold sores
Gingivostomatitis
Temporal lobe encephalitis
Esp. during times of stress

Front 7

HSV-2:
Presentation

Back 7

Multiple genital PAINFUL lesions

Front 8

VZV:
Presentation

Back 8

Primary: Chickenpox

Secondary reaction: Shingles--grouped vesicles in dermatomal pattern (DOES NOT CROSS MIDLINE)

Front 9

EBV:
Presentation
Diagnosis

Back 9

Infectious Mono***--fever, pharyngitis, ~strep throat

Burkitt's lymphoma
(Infects B cells)

Monospot: agglutinates with sheep RBCs

Front 10

Mononucleosis
Negative Monospot

Back 10

CMV
(listeria possible but less commonly)

Front 11

Owl's eye cellular inclusions

Back 11

EBV

Front 12

HHV-6:
Presentation

Back 12

aka sixth disease

High grade fever, young kids
Can be followed by full body rash

Front 13

HHV-8:
Presentation

Back 13

Kaposi Sarcoma in HIV patients
(not a true malignancy)--purple looking rash

Front 14

Acyclovir
MOA
Use

Back 14

Mono-phosphorylated by THYMIDINE KINASE to activate it-->inhibits DNA polymerase

HSV
VZV
EBV

NO CMV

Front 15

Ganciclovir:
MOA
Use

Back 15

THymidine kinase activates it to Inhibits viral DNA polymerase

Used for CMV, esp in IC'd

Front 16

Foscarnet:
MOA
Use

Back 16

Viral DNA polymerase inhibitor that doesn't require kinase activation

Used in CMV when ganciclovir fails

Front 17

Hepadnavirus:
Describe
Example

Back 17

Hepatic DNA virus; Hep B virus

Front 18

HBV:
Virus Type
Transmission
MOA
Effects

Back 18

DNA virus--cellular RNA polymerase transcribed RNA from viral DNA template

Sexual transmission

Hepatocellular carcinoma; alpha-fetoprotein is a marker of it!

Front 19

HCV:
Virus Type
Transmission
MOA
Effects
Treatment

Back 19

Flavivirus

Transmitted through blood, carriers.

Prominent amont IVDU's.

Cirrhosis, Carcinoma

Tx: Ribavrin, IFN-alpha

Front 20

HDV:
Transmission

Back 20

Defective virus; requires HBsAg to infect

Front 21

HAV:
Virus type
Transmission
Presentation

Back 21

Picornavirus (RNA)

Fecal-oral transmission

Asyx usually; acute, no chronic carriers

Front 22

HEV:
Virus Type
Transmission
Presentation

Back 22

RNA virus

Enteric transmission; water-borne epidemics

~HAV in course; high MORTALITY RATE in PREGNANT WOMEN

Front 23

HBsAg:
Indication of

Back 23

Indication of active dz

Front 24

Anti-HBsAg Ab:
Indication of

Back 24

-Recovered from active dz
-Have been immunized

Front 25

Anti-HBcAg Ab:
Indication of
IgG vs IgM

Back 25

Active disease

If IgG--chronic
If IgM--acute

Front 26

HBeAg:
Indication of

Back 26

Transmissibility; can spread (DNA replication)

Front 27

Anti-HBeAg:
Indication of

Back 27

Low transmissibility

Front 28

Adenovirus:
Presentation

Back 28

Conjunctivitis***
Pharyngitis
Pneumonia

Front 29

Parvovirus:
Presentation

Back 29

B19, classic crisis of sickle cell dz

Fifth Dz, cranial nerve 5, slapped cheek

Front 30

This DNA virus is double-stranded and linear.

Back 30

Adenovirus

Front 31

HPV:
Presentation

Back 31

1,6,11: warts
16,18: CIN-->cervical cancer, penile cancer too!

Front 32

Poxvirus:
Presentation

Back 32

Smallpox
Cowpox (milkmaid's blisters)
Molluscum contagiosum--flesh-colored dome lesions with central pimple

Front 33

Which DNA virus:
Erythema infectiosum

Back 33

Parvovirus B19

Front 34

Which DNA virus:
Heterophil-positive mononucleosis

Back 34

EBV

Front 35

Which DNA virus:
Can cause conjunctivitis or diarrhea

Back 35

Adenavirus

Front 36

Which DNA virus:
Enlarged cell with owl's eye inclusions

Back 36

CMV

Front 37

Which DNA virus:
Identified with Pap smear

Back 37

HPV-16,18

Front 38

Which DNA virus:
Milkmaid's blisters

Back 38

Cowpox

Front 39

Which DNA virus:
Burkitt's lymphoma and nasopharyngeal carcinoma

Back 39

EBV

Front 40

Which DNA virus:
Gingivostomatitis

Back 40

HSV-1,2

Front 41

Which DNA virus:
Hides in sensory ganglia of S2 and S2

Back 41

HSV-2

Front 42

Which DNA virus:
Hides in trigeminal ganglia

Back 42

HSV-1

Front 43

Which DNA virus:
Hides in dorsal root ganglia

Back 43

VZV

Front 44

Which DNA virus:
Viral family of JC virus

Back 44

Polyomavirus (progressive multifocal leukoencephalopathy in HIV)

Front 45

Which DNA virus:
Downey cells

Back 45

EBV

Front 46

Which DNA virus:
Human progressive multifocal leukoencephalopathy

Back 46

JC Virus

Front 47

Which DNA virus:
Oral hairy leukoplakia

Back 47

EBV

Front 48

Which DNA virus:
Multinuclear giant cells on Tzank test

Back 48

HSV-1,2
VZV

Front 49

Which DNA virus:
Only DNA virus that's not double-stranded

Back 49

Parvovirus

Front 50

Which DNA virus:
Roseola

Back 50

HSV-6

Front 51

Which DNA virus:
Heterophil-negative mononucelosis

Back 51

CMV

Front 52

Reoviruses:
Presentation

Back 52

Colorado tick fever--flu-like illness

Front 53

Rotavirus:
Presentation

Back 53

Fatal watery diarrhea in children
Winter months, Infantile gastroenteritis

Front 54

Picornaviruses

Back 54

Enteroviruses:
Polio
Echovirus
Rhinovirus
Coxsackie
Hep A

Front 55

Polio

Back 55

Affects motor neurons of anterior horns (paralysis)

Front 56

Echovirus

Back 56

Asceptic meningitis and myocarditis--commonly transmitted in swimming pools

Front 57

Coxsackievirus

Back 57

Asceptic meningitis
Myocarditis
Hand, food, and mouth dz

Front 58

Back 58

Coxsackie enxanthem (hand-foot-mouth dz)

Front 59

Rhinovirus

Back 59

Cold

Front 60

Flaviruses

Back 60

Flavi = yellow; so anything causing jaundice

HCV
Yellow fever
Dengue
West Nile

Front 61

Yellow fever virus

Back 61

Mosquitoes in Africa/South America

High fever, hemorrhagic dz (bloody diarrhea, hematuria, ecchymoses), jaundice (liver dz)

Front 62

Dengue virus

Back 62

Most prevalent mosquito dz

"Break bone fever":
Retro-orbital pain
Muscle/joint pain
HA
Hemorrhagic fever

Front 63

West Nile Virus

Back 63

Bird reservoir
Mosquito vectors
Humans are incidental hosts

Sx: HA, malaise, back pain, myalgia, anorexia (flu-like)

Meningitis
+/- encephalitis including muscle weakness and flaccid paralysis (anterior horn involvement)

Front 64

Togaviruses

Back 64

Rubella

Front 65

Coronavirus

Back 65

Common cold

Front 66

Influenza virus:
Virus type
Antigens, role of Ag's

Back 66

ss-RNA virus with segmented genome

Ag's: Hemagglutinin (promotes viral entry), neuraminidase (promotes progeny virion release)

Often superinfected with strep pneumo

Front 67

Genetic drift vs Genetic shift
Which virus exhibits this?

Back 67

Sudden Shift is more deadly than GraDual Drift ("Oh shift!"--dangerous)

Drift (epidemic): minor (antigenic drift) changes based on random mutation

Shift (pandemic): reassortment of viral genoma (such as when human flu A virus recombines with swine flu A virus)

Exhibited by influenza

Front 68

Croup:
Virus family
Symptoms

Back 68

Parainfluenza = Croup
Barking seal cough, resp distress ~asthma, inspiratory stridor

Tx: cool mist humidifier, recemic epinephrine, dose of dexamethasone, supportive, O2 as needed

Front 69

RSV bronchiolitis:
Symptoms
Treatment

Back 69

Bronchiolitis ±pneumonia

Characteristic brassy cough, wheezing, resp distress ~asthma

Tx: Ribavirin not used in children, adults only
Albuterol or racemic epinephrine

Front 70

Rubeola:
Symptoms
Risks

Back 70

MEASLES

Kopplik spots due to immune reactions
Rash due to immune reactions --not seen in immunocompromised pts

Cough
Choriza (rhinitis, nasal congestion)
Conjunctivitis

Subacute sclerosing panencephalitis

Front 71

Back 71

Measles

Front 72

Back 72

Koplik spots
Measles

Front 73

Which RNA virus:
Asthma-sounding infection in infants

Back 73

RSV

Front 74

Which RNA virus:
Meningitis in summer months

Back 74

Echo
Coxsackie
Enterovirus

Front 75

Which RNA virus:
Tourniquet test helps diagnose hemorrhagic disease

Back 75

Dengue

Front 76

Which RNA virus:
Infects motor neurons of the anterior horn

Back 76

Polio
West Nile Virus

Front 77

45-year old male with squamous cell carcinoma of penis.

Virus?

Back 77

HPV 16, 18

Front 78

20 year-old college student presents with LAD, fever, HSM.

Serum agglutinates sheep RBCs.

What cell type is infected?

Back 78

EBV-->B Cells (Downy Cells)

Front 79

how does rabies virus travel through the CNS so that it can cause fatal encephalitis with seizures?

Back 79

Retrograde fashion up axons

Front 80

What is the characteristic shape of rabies virus?

Back 80

Bullet-shaped

Front 81

Amantadine:
MOA
Use

Back 81

MOA: Block viral penetration/UNCOATING

Use: Flu, PD

"A man to dine" takes off his coat.

Because used in PD, must cross BBB, so expect CNS side effects.

Front 82

Mumps:
Symptoms

Back 82

Parotitis
Orchitis (inflammn of testes)
Viral meningitis (Coxsackie, echo too, just a side note)

Front 83

Rabies virus:
Presentation

Back 83

Bullett-shaped (Old Yeller shot with a bullet)

Fever, malaise-->agitaiton, photophobia, hydrophobia-->paralysis, coma

Front 84

Bullett-shaped capsid

Back 84

Rabies (Old Yeller)

Front 85

Which RNA virus:
Hand, foot, mouth disease

Back 85

Coxsackie

Front 86

Which RNA virus:
Break bone fever

Back 86

Dengue

Front 87

Which RNA virus:
Barking seal cough

Back 87

Croup/parainflu

Front 88

Which RNA virus:
African hemorrhagic fever

Back 88

Ebola

Front 89

Which RNA virus:
Common cold

Back 89

Rhino
Corona

Front 90

Which RNA virus:
Fever
Jaundice
Black vomit

Back 90

Yellow fever

Front 91

Which RNA virus:
Childhood diarrhea in winter months

Back 91

Rotovirus

Front 92

Zanamivir:
MOA
Use

Back 92

Inhibit influenza neuraminidase, decreasing release of progeny virus

Flu

Front 93

Oseltamivir:
MOA
Use

Back 93

Inhibit influenza neuraminidase, decreasing release of progeny virus

Flu

Front 94

Ribavirin:
MOA
Use

Back 94

Inhibits synthesis of gunaine nucleotides by competitively inhibiting IMP dehydrogenase

Use: RSV, HCV (along with IFN-alpha)

Front 95

Which antiviral:
Prophylaxis for influenza A

Back 95

Zanamivir
Oseltamivir

Front 96

Which antiviral:
Inhibits CMV DNA polymerase

Back 96

Foscarnet

Front 97

Which antiviral:
Used in treatment for chronic HCV

Back 97

Ribavirin + IFN-alpha

Front 98

Which antiviral:
First-line for HSV or EBV

Back 98

Acyclovirs (ganciclovir, etc)

Front 99

Which antiviral:
Blocks viral penetration and uncoating

Back 99

Amantadine

Front 100

Which antiviral:
Treats both influenza A and B

Back 100

Zanamivir
Oseltamivir

Front 101

Which antiviral:
Second-line for CMV retinitis

Back 101

Foscarnet

Front 102

Which antiviral:
Derivative of amantadine with fewer side effects

Back 102

Ramantidine

Front 103

Which antiviral:
Inhibits viral DNA polymerase when phosphorylated by viral thymidine kinase

Back 103

Acyclovir (all cyclovirs)

Front 104

Tzanck Test:
Utility

Back 104

Tests for multinucleated giant cells

Can dx: HSV-1/2, VZV