Buxton Herpes Viruses 4/21 (Nt)

Front 1

which type of Herpes virus cause...
oral and genital?
genital?

Back 1

oral and genital = HSV-1
genital = HSV-2 and some HSV-1

Front 2

prevalence of HSV-1?

How do you get it?

Where does HSV stay latent?

Back 2

70%

contact with saliva or genital contact (oral-genital contact)

latent in ganglia

Front 3

Clinical manifestation of HSV-1:
1) primary (adult and kid)
2) secondary

Back 3

1) gingivostomatitis, fever, malaise in child, last 3 weeks;severe pharyngitis in adult, last 1 week

2) cold sore

Front 4

HSV-1 clinical manifestation in:
1) immune competent
2) immune suppressed

Back 4

1) genital herpes, encephalitis, keratitis

2) pneumonia, severe mucocutaneous lesions

Front 5

How to prevent HSV-1?

Back 5

You can't! many people shed asymptomatiaclly.

Front 6

prevalance of HSV-2?

Back 6

25%

Front 7

pathogenesis of HSV: from transmission to manifestation

Back 7

1) virus transmitted through contact with body fluid
2) replicated in epithelial cells
3) ascend to ganglia
4) remain latent in ganglia
5) descend to skin and mucous membrane once opportunity presents itself

Front 8

Define non-primary first episode.

Back 8

the person is infected for the first time but remains asymptomatic. When the virus is re-activated and shows symptoms, that is defined as non-primary first episode.

Front 9

Can a patient be shedding viruses if HSV remains latent within the ganglia?

Back 9

yes

Front 10

differences between a vesicle and a pustule

Back 10

vesicle = clear-fluid containing, elevated
pustule = pus-containing, not clear

Front 11

List some symptoms from a primary genital infection with HSV

Back 11

1) Constitutional signs including pain, urethral discharge, vaginal discharge, fever, meningitis

2) genital lesions

Front 12

What immune cells prevent recurrence?

Back 12

CD4, CD8 cells

NOTE: high antibody titer does NOT prevent recurrences

Front 13

How to clinically differentiate between HSV-1 and HSV-2?

Back 13

1) clinical appearance
2) viral isolation with typing
3) viral antigen detection
4) serology with typing

Front 14

Treatment of HSV-1 and HSV-2?

Back 14

acyclovir and related compounds

Front 15

How can you prevent yourself from getting genital herpes?

Back 15

1) abstinence
2) mutally monogamous relations with seronegative partners
3) condoms, but not complete prevention

NOTE: virus can be transmitted in the absence of lesions

Front 16

Varicella-Zoster virus has two forms. What are they commonly known as?
1) young form
2) adult form

Back 16

1) chicken pox
2) shingles

Front 17

prevalence of VZ?

Back 17

97%

Front 18

pathogenesis of VZ from transmission to manifestation

Back 18

1) virus enters and replicates in respiratory tract
2) replication in regional lymph node
3) infection of T cells
4) viremia
5) virus infects skin (chicken pox)
6) latency in ganglia
7) decline in anti-VZV T cell immunity
8) recurrence along dermatomes (shingles)

Front 19

describe the pain in zoster

Back 19

pain before, during and after the rash

post herpetic neuralgia can be very severe

Front 20

List the 3 types of lesions used for clincal diagnosis for HSV

Back 20

1) maculpapular
2) vesicular
3) scabes

all 3 are present simultaneously

Front 21

Treatment for
1) chicken pox
2) zoster rash
3) pain

Back 21

1) acyclovir only in severe cases, clean the skin
2) acyclovir, famciclovir, valacyclovir
3) lose dose tricyclic antidepressants, several treament modalities

Front 22

What microbes may cause exudative pharyngitis?

Back 22

1) group A streptococci
2) Epstein-Barr virus
3) primary infection of HIV

Front 23

symptoms of infectious mononucleosis

Back 23

1) exudative pharyngitis
2) cervical lymphadenopathy
3) fever
4) profound fatigue
5) +/- splenomegaly

Front 24

prevalence of EBV?

How do you get it?

Back 24

85%

transmitted by saliva

lower income groups infected as young children (asymptomatic), higher income groups infected as adolescents or young adults (symptomatic of infectious mononucleosis)

Front 25

pathogenesis of EBV from transmission to manifestation

Back 25

1) enters oropharynx
2) replicate in epithelial cells
3) infect B cells (like VZV)
4) symptomatic/asymptomatic infection
5) latency in WBC

Front 26

Clinical manifestation from reactivation of EBV

Back 26

1) inapparent shedding
2) lymphoproliferative disorders and cancer
3) oral hairy leukoplakia
4) autoimmunity

Front 27

Unique features for diagnosis:
1) laboratory test
2) serology

Back 27

1) CBC and differential: lymphocytosis (larger and strange, more cytoplasm than usually, irregular nucleus)

2) Heterophil antibody test, which is produced only in response to EBV

Front 28

Will the following be tested positive for heterophil antibody test?
1) IM syndrome
2) silent EBV

Back 28

1) no
2) not necessarily, only the one with active infectious mononucleosis

Front 29

Cancers associated with EBV

Back 29

Burkitt's lymphoma
Nasopharyngeal carcinoma
hodgkin's lymphoma
lymphoproliferative diseases in immune supressed
T cell malignancies

Front 30

seroprevalence of cytomegalovirus (CMV)

latent in what cells?

Back 30

70%

latent in WBC and possibly other cells

Front 31

when can you acquire CMV (which two periods)?

routes of transmission?

what income level is at risk for Primary infections while pregnant?

Back 31

neonatal period and puberty onward

in utero, breast milk, blood/organs, saliva, urine, sexual intercourse

higher income

Front 32

Clinical manifestation of CMV
1) primary infection
2) secondary infection/ reactivation (for immune competent and suppressed)

Back 32

1) most likely asymptomatic or mono-like illness

2) immune supressed: pneumonia, retinitis, GI disease, encephalitis; immune competent: asymptomatic shedding, trasnplacental transmission

Front 33

what is the difference between the neonatal manifestation of 10% symptomatic and 90% asymptomatic?

Back 33

10% symptomatic neonates get is from primary maternal infection during pregnancy.

90% asymptomatic neonates get it from recurrence in mother during pregnancy. (Most common infections cause of deafness)