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33 Cards in this Set

  • Front
  • Back
which type of Herpes virus cause...
oral and genital?
oral and genital = HSV-1
genital = HSV-2 and some HSV-1
prevalence of HSV-1?

How do you get it?

Where does HSV stay latent?

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

latent in ganglia
Clinical manifestation of HSV-1:
1) primary (adult and kid)
2) secondary
1) gingivostomatitis, fever, malaise in child, last 3 weeks;severe pharyngitis in adult, last 1 week

2) cold sore
HSV-1 clinical manifestation in:
1) immune competent
2) immune suppressed
1) genital herpes, encephalitis, keratitis

2) pneumonia, severe mucocutaneous lesions
How to prevent HSV-1?
You can't! many people shed asymptomatiaclly.
prevalance of HSV-2?
pathogenesis of HSV: from transmission to manifestation
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
Define non-primary first episode.
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.
Can a patient be shedding viruses if HSV remains latent within the ganglia?
differences between a vesicle and a pustule
vesicle = clear-fluid containing, elevated
pustule = pus-containing, not clear
List some symptoms from a primary genital infection with HSV
1) Constitutional signs including pain, urethral discharge, vaginal discharge, fever, meningitis

2) genital lesions
What immune cells prevent recurrence?
CD4, CD8 cells

NOTE: high antibody titer does NOT prevent recurrences
How to clinically differentiate between HSV-1 and HSV-2?
1) clinical appearance
2) viral isolation with typing
3) viral antigen detection
4) serology with typing
Treatment of HSV-1 and HSV-2?
acyclovir and related compounds
How can you prevent yourself from getting genital herpes?
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
Varicella-Zoster virus has two forms. What are they commonly known as?
1) young form
2) adult form
1) chicken pox
2) shingles
prevalence of VZ?
pathogenesis of VZ from transmission to manifestation
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)
describe the pain in zoster
pain before, during and after the rash

post herpetic neuralgia can be very severe
List the 3 types of lesions used for clincal diagnosis for HSV
1) maculpapular
2) vesicular
3) scabes

all 3 are present simultaneously
Treatment for
1) chicken pox
2) zoster rash
3) pain
1) acyclovir only in severe cases, clean the skin
2) acyclovir, famciclovir, valacyclovir
3) lose dose tricyclic antidepressants, several treament modalities
What microbes may cause exudative pharyngitis?
1) group A streptococci
2) Epstein-Barr virus
3) primary infection of HIV
symptoms of infectious mononucleosis
1) exudative pharyngitis
2) cervical lymphadenopathy
3) fever
4) profound fatigue
5) +/- splenomegaly
prevalence of EBV?

How do you get it?

transmitted by saliva

lower income groups infected as young children (asymptomatic), higher income groups infected as adolescents or young adults (symptomatic of infectious mononucleosis)
pathogenesis of EBV from transmission to manifestation
1) enters oropharynx
2) replicate in epithelial cells
3) infect B cells (like VZV)
4) symptomatic/asymptomatic infection
5) latency in WBC
Clinical manifestation from reactivation of EBV
1) inapparent shedding
2) lymphoproliferative disorders and cancer
3) oral hairy leukoplakia
4) autoimmunity
Unique features for diagnosis:
1) laboratory test
2) serology
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
Will the following be tested positive for heterophil antibody test?
1) IM syndrome
2) silent EBV
1) no
2) not necessarily, only the one with active infectious mononucleosis
Cancers associated with EBV
Burkitt's lymphoma
Nasopharyngeal carcinoma
hodgkin's lymphoma
lymphoproliferative diseases in immune supressed
T cell malignancies
seroprevalence of cytomegalovirus (CMV)

latent in what cells?

latent in WBC and possibly other cells
when can you acquire CMV (which two periods)?

routes of transmission?

what income level is at risk for Primary infections while pregnant?
neonatal period and puberty onward

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

higher income
Clinical manifestation of CMV
1) primary infection
2) secondary infection/ reactivation (for immune competent and suppressed)
1) most likely asymptomatic or mono-like illness

2) immune supressed: pneumonia, retinitis, GI disease, encephalitis; immune competent: asymptomatic shedding, trasnplacental transmission
what is the difference between the neonatal manifestation of 10% symptomatic and 90% asymptomatic?
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)