Blood And Lymph - Blue - Cmv And Eb Viruses

Front 1

T/F: Both CMV (Cytomegalovirus) and EB (Epstein-Barr Virus) can cause mono, but EB is responsible for more mono cases

Back 1

TRUE

(CMV only develops into mono 10-15% of the time)

Front 2

Other names for monoculeosis?

Back 2

mono

Glandular fever

Front 3

What is the Classic triad for Epsteinn Barr virus infection?

Back 3

Lympahdenopathy (big lymph nodes)
Pharyngitis
Fever up to 104 deg. that may last 2 weeks

Front 4

What are the distinguishing characteristics of Epstein-barr virus on microscope?

Back 4

Atypical ie LARGE Lymphocytes and Heterophile Abs ie react with sheep, horse, bovine etc.

Front 5

How can you tell EB virus from CMV under microscope?

Back 5

EB = Atypical Lymphocytes = "Downey Cells", Heterophile Abs ie our Abs to EB react with other species for some reason
CMV = Owl's Eye cells

Front 6

Besides the triad of Lymphadenopathy, Pharyngitis and Fever up to 104, what other symptoms can be seen with EB Virus?

Back 6

Malaise, Rash,

Front 7

Pharyngitis of EB is often mis-diagnosed as what?

Back 7

Strep Throat

Front 8

Besides the lab, whats one of the only ways we can differentiate from EB and CMV?

Back 8

CMV will NOT have a rash EXCEPT if pt born with it ie at birth pt will have a "blueberry muffin" rash

Front 9

Whats the first cell infected with EB?

Back 9

Oral epi cells then B cells

Front 10

B cells block most of the EB Virus, so how is virus manifested?

Back 10

A small subset of virus is NOT blocked and can be made, thus resulting in proliferation of B cells. If left untreated we'd end up with B cell lymphoma

Front 11

Downey cells are seen with what? Owl's Eye cells are seen with what?

Back 11

Downey cells = EB

Owl's Eye = CMV

Front 12

What percent of the world is infected with EB?

Back 12

90-95%

Front 13

When does infection occur for EB vs when do the symptoms show up?

Back 13

Infection occurs at younger ages (1-5)

SYMPTOMS occur in adolescence or young adult (10-19)

Front 14

How is EB virus transmitted?

Back 14

Saliva ie kissing = why mono called kissing diease

Front 15

T/F: EB is infectious for many months after infection

Back 15

TRUE

Front 16

The monospot test works to help ID EB because of what characteristic of EB? (note - cal also ID CMV)

Back 16

The fact that EB is a heterophile and the Abs we make to it react with other Abs from dif. species ie horse, etc.

Front 17

How does monospot test work?

Back 17

Take pt. saliva, mix with solution that has heterophile antigens, EB has heterophile Ab = + is agglutination

NOTE- if you do test too early, pt won't have made Abs yet

Front 18

The monospot test is negative for EBV IgM. What is your Dx?

Back 18

If its pos. for CMV IgM pt has CMV mononucleosis

if Neg. for CMV IgM, pts has: Toxoplasmosis, Hep A, B, C, or Herpes virus 6

Front 19

RB virus can manifest itself as what?

Back 19

Burkitt's Lymphoma, Hodgkin's Lymphoma, nasopahryngeal carcinoma, AIDS-assoc. post-transplant lymphoma

Front 20

EB specific proteins can do what to p53/Rb, thus activating c-myc

Back 20

SUPRESS p53/Rb (a tumor suppressor) = Activate c-myc

Front 21

Pt comes in with all the signs and symptoms of EB-caused Mono. Treatment?

Back 21

NSAID, rest

Front 22

CMV is a common cause of what group of infections?

Back 22

TORCH

Toxoplasmosis
Other (cocksackie, Syphillis, Varicella-zoster, HIV, [arvo B19)
Rubella
Cytomegalovirus
Herpes

Front 23

T/F: Unless you are immunodeficient or a newborn, you won't show symptoms of being infected with CMV

Back 23

TRUE

Front 24

When infected with CMV via mother-baby transmission, the baby can present HOW?

Back 24

Liver dysfunction (jaundice)
Large spleen
Seizures
Purple Skin rash ie Blueberry muffin disease
Pneumonia
Small size at birth

Front 25

If a baby is infected with CMV, how can the disease affect the pt long term?

Back 25

ADHD
Vision Loss
Mental disability/retardation
Microcephaly
Lack of coordination
seizures
Death

Front 26

What symtpoms of CMV can we see in a pt where the disease is re-activated?

Back 26

Retinitis (=inflamm of retina)
esophagitis
pneumonia
disseminated (i assume he means DIC?)

Front 27

A 38 year old HIV+ pt comes into your office with retinits, esophagitis, pneumonia and DIC. Are her symptoms due solely to the HIV?

Back 27

The Retinits esp points to re-activation of underlying CMV disease

Front 28

T/F: 90-95% of world is infected with CMV but is asymtomatic

Back 28

TRUE

Front 29

EB is transmitted via saliva. How is CMV transmitted?

Back 29

Close personal contact ie droplet, fecal-oral, transplacental, breast milk and STD

Front 30

Pt Hilary Clinton shows signs and symptoms that are non-specific and could be either EB or CMV but they got the disease after kissing their skank of a husband, Bill Clinton. Whats your Dx?

Back 30

EB, NOT CMV, which can't be transmitted via saliva

Front 31

There is no treatment (besides NSAIDS and rest) for EB. BUT what can we do for pts with CMV?

Back 31

Gancyclovir
Valgancyclovie
Foscarnet

Front 32

Pt comes in with signs/symptoms of CMV. Whats your tx course?

Back 32

Gancyclovir

Front 33

Heterophile Abs for a pt with Cytomegalovirus will be????

Back 33

NEGATIVE