Gregg 12-19-07 Viral Causes Of Gi Infections

Front 1

Name the Herpes viruses

Back 1

-

Front 2

HHV-1 or HSV-1 causes what problem in children

Back 2

Gingivostomatitis and Oral lesions

Front 3

HHV-1 or HSV-1 causes what problem in adults

Back 3

Pharyngotonsillitis, Esophagitis
and Oral lesions

Front 4

What type of virus is HHV-1 or HSV-1?

Back 4

ds DNA virus; enveloped

Front 5

What cells do HHV-1 or HSV-1 affect?

Back 5

Lytic infections of fibroblasts and epithelial cells

Front 6

for HSV-1 what are Primary Reactivation Events?

Back 6

Febrile illness (common cold)
- Direct sunlight (UV-B)
- Stress
- Trauma
- Menstruation
- Spicy or acidic foods
- Immunocompromise

Front 7

What are some complication of HSV-1 in Immunocompetent pts

Back 7

Perinatal Infection (mostly HSV-2)
Necrotizing Encephalitis
Keratoconjunctivitis
Meningitis (mostly HSV-2)

Front 8

Leading cause of infectious blindness in US

Back 8

Keratoconjunctivitis

Front 9

What are some complication of HSV-1 in Immunodeficient pts

Back 9

Pneumonia
Severe Mucocutaneous Infections

Front 10

By age 30, _____% individuals HSV-1 seropositive

Back 10

50-80

Front 11

Diagnostic for HSV-1:
Multinucleated cells AKA

Back 11

syncytia

Front 12

Diagnositic for HSV-1:

____ bodies

Back 12

inclusion

Front 13

DDx of HSV-1 lesions

Back 13

Candidiasis
Hand-Foot-and-Mouth Disease
Aphthous ulcers (canker sores)
Small, round (ovoid), recurrent ulcers with erythematous halo and yellow-gray floor

Front 14

Diet high in L_____ shown to reduce HSV recurrent infections

Back 14

Diet high in Lysine shown to reduce HSV recurrent infections

Front 15

Drug used for treatment of HSV-1

Back 15

Acyclovir (Zovirax)

Front 16

HHV5 or CMV is what type of virus?

Back 16

ds DNA virus; enveloped

Front 17

HHV-5 or CMV Replicates in ___________ and ___________ (salivary glands and kidneys)

Back 17

HHV-5 or CMV Replicates in macrophages and fibroblasts (salivary glands and kidneys)

Front 18

HHV-5 or CMV Establishes latency in _ cells and __ stromal cells

Back 18

HHV-5 or CMV Establishes latency in T cells and BM stromal cells

Front 19

Mononucleosis Syndrome (HHV-5 or CMV):
Fever, malaise, pharyngitis, blood atypical lymphocytes
Monospot-________ test result (test for heterophile Ab)
Duration: ~60d

Back 19

Mononucleosis Syndrome (HHV-5 or CMV):
Fever, malaise, pharyngitis, blood atypical lymphocytes
Monospot-negative test result (test for heterophile Ab)
Duration: ~60d

Front 20

What conditions are necessary for HHV5 or CMV to cause GI tract symptoms?

Back 20

Immunocompromised Diseases
Disseminated disease in lungs, GI tract (esophagitis), liver, retina and CNS

Front 21

Only host for CMV

Back 21

humans

50-100% seropositive in areas within the US
Worldwide distribution

Front 22

Blood test for CMV

Back 22

Peak viral titers 4-7wks after infection; measure anti-CMV IgM

Front 23

DDX for CMV

Back 23

Enteroviruses
HIV opportunistic infection
Hepatitis A, B, D, E
HHV6
EBV (mononucleosis)

Front 24

Prevention & Treatment
of CMV

Back 24

Prevention & Treatment
Gancicyclovir (Cytovene) or Foscarnet (Foscavir) – treat complications
Gancicyclovir useful as a prophylactic prior to BM transplant

Front 25

type of virus of enterovirus

Back 25

ss RNA virus; nonenveloped

Picornaviridae:Polioviruses, Coxsackie viruses A & B, Echoviruses, Hepatitis A

Front 26

Clinical Syndromes
Coxsackie virus A:

Back 26

Herpangina (3mo-16yrs)


Hand-Foot-and-Mouth Disease (<10yrs)

Front 27

Clinical Syndromes
Coxsackie virus B:

Back 27

Pleurodynia

Front 28

Clinical Syndromes
Coxsackie viruses A & B (Echoviruses also):

Back 28

Aseptic Meningitis

Myocarditis (neonates, young children)

Front 29

Where does Enterovirus replicate?

Back 29

peyer's patches

Front 30

Echo virus affects what body parts?

Back 30

skin, muscle, meninges

Front 31

Cox a and B affects what body parts

Back 31

muscle

Front 32

Cox A affects what body parts

Back 32

skin and muscle

Front 33

Complications of Enterovirus

Back 33

Complications
Acute Hemorrhagic Conjunctivitis
Secondary bacterial infections
Coma (Aseptic Meningitis)

Front 34

Enterovirus is nonenveloped and is resistant to pH and _____.

Back 34

detergents

Front 35

DDX of Hand-Foot-and-Mouth Disease

Back 35

DDX of Hand-Foot-and-Mouth Disease
HSV-1 infection
Varicella

Front 36

DDX of Aseptic Meningitis

Back 36

DDX of Aseptic Meningitis
Arbovirus infection
Lyme disease
Rocky Mountain Spotted Fever
Erhlichiosis

Front 37

DDx of Pleurodynia

Back 37

DDx of Pleurodynia
Pneumonia
Acute abdomen

Front 38

DDx of Herpangia

Back 38

DDx of Herpangia
Bacterial or other viral tonsillitus

Front 39

Treatment and Prevention of enterovirus

Back 39

Prevention through adequate sanitation practices
Treat symptomatically

Front 40

_______ esophagitis is by far the most common esophageal infection

Back 40

Candida esophagitis is by far the most common esophageal infection

Front 41

Conditions predisposing to Candida esophagitis in the normal host include:
A_________ use
Inhaled or ingested c_________________,
Antisecretory therapy or hypochlorhydric
states
D_______ ________.
_______ism, malnutrition, and advanced
age

Back 41

Conditions predisposing to Candida esophagitis in the normal host include:
Antibiotic use
Inhaled or ingested corticosteroids,
Antisecretory therapy or hypochlorhydric
states
Diabetes mellitus.
Alcoholism, malnutrition, and advanced
age

Front 42

Symptoms of Infectious Gastroenteritis

Back 42

Diarrhea
Nausea
Vomiting
Important complications:
Dehydration
Malnutrition
Electrolyte imbalances
Death

Front 43

Main cause of childhood viral gastroenteritis

Back 43

Rotavirus

Front 44

Rotavirus is what Type of virus

Back 44

ds RNA virus; nonenveloped
Reoviridae family

Front 45

Rotavirus lyses the cell:

Loss of villus epithelial cells results in
Decreased __ absorption
Decreased level of intestinal ___________ases
Decreased absorption of ____ose and other macromolecules
Increased water enters lumen

Back 45

Rotavirus lyses the cell:

Loss of villus epithelial cells results in
Decreased Na absorption
Decreased level of intestinal disaccharidases
Decreased absorption of lactose and other macromolecules
Increased water enters lumen

Front 46

nonenveloped viruses: what is the worry?

Back 46

they are resistant to acid, detergents, and disinfectants

can use 95% EtOH and chlorine to kill them

Front 47

Diarrhea from rotavirus also results from viral protein (____) which acts as enterotoxin- causes excess ________ secretion

Back 47

Diarrhea from rotavirus also results from viral protein (NSP4) which acts as enterotoxin- causes excess chloride secretion

Front 48

How does rotavirus bind to villus epithelial cells

Back 48

Viral capsid protein (vp4) binds to glycolipids on the membrane of villus epithelial cells in the small intestine

Front 49

Describe ORT for rotavirus dastroenteritis

Back 49

-

Front 50

Again, describe ORT for gastroenteritis:

Back 50

By providing a 1:1 proportion of Na to glucose, classic oral rehydration solution (ORS) takes advantage of a specific Na-glucose transporter (SGLT-1) to increase the reabsorption of Na, which leads to the passive reabsorption of water.
Alternatively, rice- and cereal-based ORS take advantage of Na-amino acid transporters to increase reabsorption of fluid and electrolytes

Front 51

Enteric _____viral infections are clinically and pathologically similar to rotavirus

Back 51

Enteric adenoviral infections are clinically and pathologically similar to rotavirus

Front 52

Ship sickness?

Back 52

Norovirus

Front 53

Norovirus is what type of virus?

Back 53

ss RNA virus; nonenveloped
Caliciviridae family: Calicivirus, Astrovirus, Norwalk virus


Resistant to freezing and temps up to 140ºF and chlorine reagents

Front 54

Rotavirus:
Greatest risk – 6-24mo

Norovirus:
Greatest risk – Adults and children >____

Back 54

Rotavirus:
Greatest risk – 6-24mo

Norovirus:
Greatest risk – Adults and children >4yrs

Front 55

Rotavirus is most commonly infectious in what places?

Back 55

Most common infections seen in day care centers, cruise ships, camps, institutions, military bases