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76 Cards in this Set
- Front
- Back
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What are the stages of herpes?
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Acquisition of disease
Asymptomatic phase Prodromal phase Symptomatic phase Healing/Convalescence |
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What are the members of the HHV family?
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HSV-1 & HSV-2
VZV EBV-burkitt's lymphoma and mono CMV |
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When does viral shedding occur during a recurrent HHV infection?
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Viral shedding 3-5 days after the prodromal symptoms
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What are the stages of a recurrent HHV infection?
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Reactivated virus
Prodromal symptoms Minimal systemic symptoms Small group of vesicles Viral shedding Crusting of vesicles Healing |
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What are the 3 Phases of HSV Replication?
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1. Immediate Early Proteins (alpha) gene transcription
2. Early Proteins (beta) DNA polymerase 3. Late Proteins (gamma) structural proteins |
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What are the stages of Shingles?
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Incubation period
Prodrome Lesions Rash Crusting and shedding |
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What are the main HHV antiviral medications?
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Acyclovir
Famciclovir Valcyclovir |
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How soon can you begin to show prodromal signs after being exposed to chicken pox?
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14 days after exposure
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What is the difference between Primary VZV (chicken pox) and Herpes Zoster (shingles), regarding prodromal phases?
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Chicken pox: prodrom is 1-3 days, rare in children, adolescents and adults experience headache, back ache, sore throat
Shingles: prodromal lasts 4-5 days, pain, tenderness and parathesia in the dermatome. Fever, headache, malaise □ Prodrome: pre-eruptive pain, itching, burning localized in dermatome, precedes eruptions by 4-6 days, pain can mimic MI pain, migraine etc. difficult to dx. , malaise, fever, regional lymphadenopathy |
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T/F
HHV is responsible for shingles |
True
VZV is a member of the human herpes virus family |
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When does DNA uncoat when replicating?
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When it joins the nuclear membrane
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Where does RNA uncoating occur?
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In the Cytoplasm
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Where does assembly occur in DNA viruses?
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In the nucleus
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Where does RNA virus assembly occur?
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In the cytoplasm
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Where does DNA virus assembly occur?
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In the nucleus
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What diseases are associated with EBV?
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Mono, B cell lymphoma, Hodgkins, HOL (hairy oral leukoplakia), Lymphoproliferative disorders
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What areas do Herpes Zoster Affect?
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Follows dermatome and nerve distribution 2/3 of cases affect trunk, also can follow CN V
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Is HIV an RNA or DNA virus?
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HIV is a ssRNA virus
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How does HIV enter cells?
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HIV is a Retrovirus that enters Th cells
HIV envelope binds to M type CCR5 and T type CXCR4 Uses Reverse Transcriptase of RNA genome |
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T/F
Replication of HIV occurs by fusion with host T cell, unraveling, and are expressed? |
True
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What drugs are used to manage HIV?
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HAART
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How are mothers with HIV treated to prevent vertical transmission to infant?
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Mothers who are HIV+ are given a protease inhibitor before delivery to prevent the vertical transmission of HIV
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What is SLPI?
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Secreted Leukocyte Protease Inhibitor
Protein found in saliva that protects against HIV |
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What proteins are necessary for HIV to enter into the cell?
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Gp120
CCR5 CXCR4 |
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What is the disease course for HIV?
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1) Initial transmission stage
2) Acute retroviral syndrome (2-3 weeks) 3) Recovery and sero-conversion (within 6 weeks) 4) Asymptomatic chronic HIV stage 5) AIDS (1-2 years prior to death) 6) HAART prolongs length of stages |
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What is used in most treatment regimens for HIV?
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Most drugs are either protease inhibitors or nucleoside reverse transcriptase
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What are the cell walls of Candida albicans composed of?
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Cell wall comprised of glucans, mannans, chitins (basically complexes of carbohydrates)
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What factors affect growth of fungi?
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Environment dictates growth and morphology
Temperature pH Inoculum size Nutrient source Scaffolding or site of attachment |
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T/F
Fungal cell walls contain β1-3 and β1-6 glucans |
True
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How does candida emerge?
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Carriage - colonization - cadidiasis
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Why are some patients more susceptible to fungal infections than others?
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See above
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T/F
Hyphal wall proteins HWP are virulence factors |
True
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How many chromosomes do candida albicans have?
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8
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What is the 4th leading cause for all blood stream infections?
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Candida albicans
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What is Stachybotrys?
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Black mold that can cause anaphylaxis
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What is dimorphism?
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Multiple shapes, pseudohyphae for budding
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T/F
Mycelium is a bowl of spaghetti. It has finger like hyphae and reproduces via spores |
True
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What is an example of a dimorphic fungus?
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Candida albicans
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What causes dimorphic changes in candida albicans?
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pH
Temperature Metabolic substrates |
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Are candida species haploid or diploid?
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diploid
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What does aphthous mean?
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Apthous = Burning
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What are the effects of loss or disruption of mucosal barrier function?
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Salivary glands & saliva
Changes in epithelium Microbial insult (bacteria, fungal, and viral translocation) Alteration of Host Immune System (T&B cells) Iatrogenic Challenges (meds) |
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What are the mechanisms of mucositis?
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1. Initiation phase
2. Primary damage 3. Signal amplification 4. Ulceration 5. Healing phase |
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What kind of specimens should you obtain for culturing Adenovirus, Influenza virus, enterovirus, rhinovirus, paramyxovirus, rubella virus, & HSV?
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Nasal washing, throat swab, nasal swab, sputum
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What kind of cultures would you want to take for Reovirus, rotavirus, adenovirus, norwalk virus, and calicivirus?
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Stool, rectal swab
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What kind of tests would you want to perform for Reovirus, rotavirus, adenovirus, norwalk virus, and calicivirus?
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Electron microscopy and antigen detection (ELISA), VIRUSES ARE NOT CULTURED
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If you have a patient with a maculopapular rash, what specimens do you take?
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Throat swab or rectal swab
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If you have a maculopapular rash and you suspect Rubella virus or measles, what specimen would you take?
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Urine
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What types of viruses can cause vesicular rashes?
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Coxsackievirus
Echovirus HSV VZV |
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If you suspect a Coxsackievirus, echovirus, HSV, or VZV, what specimens should you take?
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Vesicle scraping
Enterovirus in stool |
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Which viruses can be obtained from a Tzanck Smear?
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HSV and VZV
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If you have aseptic meningitis or encephalitis, which viruses could be the culprit?
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Picornavirus
Togavirus, bunyavirus Rabies virus HSV CMV mumps, measles |
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What samples do you take for aseptic meningitis or encephalitis when picornavirus is suspect?
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Stool
Perform PCR |
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What samples do you take for aseptic meningitis or encephalitis when Rabies viruses are suspect?
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Tissue, Saliva, Brain biopsy
Immunofluorescence used to detect |
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What samples do you take for aseptic meningitis or encephalitis when HSV, CMV, mumps, or measles are suspect?
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Cerebrospinal fluid
PCR virus isolation and antigen are assayed |
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If you have a UTI, what viruses may be the culprit?
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Adenovirus or CMV
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If you suspect HIV or Hep B,C,D viruses, what should be used to test the blood sample?
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ELISA, PCR, and RT-PCR
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Which Influenza type is responsible for regular outbreaks?
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Influenza A
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What are the glycoproteins on an influenza envelope?
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Hemagglutinin (HA) and neuraminidase (NA)
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What is a virus that has eight helical nucleocapsis segments with negative sense RNA?
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Influenza Virus
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Which glycoprotein of influenza virus has a spike protein that promotes fusion of the envelope to the cell membran, hemagglutinates RBCs, and elicits the protective, neutralizing antibody response?
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HA Hemagglutinin
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Which glycoprotein of influenza virus is a tetramer, facilitates release of virus, and undergoes antigenic changes, which give the viruses different designations N1, N2, etc.?
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Neuraminidase NA
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Which antiviral drugs target Neuraminidase receptors on influenza envelopes?
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Zanamivir (Relenza) & Oseltamivir (Tamiflu)
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T/F
The M1, M2, & NP proteins are type specific and are therefore used to differentiate influenza A from B or C viruses |
True
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T/F
The HA and NA of influenza A virus can undergo major (reassortment: shift) and minor (mutation: drift) antigenic changes to ensure the presence of immunologically naïve, susceptible people |
True
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How are Strains of Influenza A virus classified?
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1) Type (A, B, C)
2) Place of original isolation 3) Date of original isolation 4) Antigen (HA & NA) A/Bangkok/1/79 (H3N2) |
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How are Strains of influenza B virus classified?
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Same as A only No antigen
i.e. B/Singapore/3/64 |
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What is the gradual accumulation of new epitopes on the H&N molecules of flu viruses called?
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Antigenic Drift
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What is a common mutation in the hemagglutinin gene?
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Missense Mutations
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What drugs inhibit one of the Matrix Proteins needed to get viral RNA into the cytosol of Influenza A viruses?
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Amantadine and Rimantadine
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Which drugs block the neuraminidase, which inhibits the release of fresh virions?
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Zanamivir (Relenza) & Oseltamivir (Tamiflu)
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What tests can detect whether it is influenza A or B?
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Rapid antigen assays
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Which tests can detect whether it is influenza A or B AND distinguish different strains i.e. H5N1?
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PT-PCR
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Which test can detect viral antigen in exfoliated cells, respiratory secretions, or cell culture and are more sensitive assays?
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Enzyme immunoassay or immunofluorescence
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Which test uses specific antibody to detect and distinguish different influenza strains?
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Immunofluorescence or hemagglutination inhibition
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What tests can detect whether it is influenza A or B?
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Rapid antigen assays
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