Hdm Test 3: Viral Stis - Hpv

Front 1

Structure of HPV

Back 1

Circular dsDNA, icosahedral, non-structural proteins with viral DNA replication, cause condylomas, 15 high risk serotypes

Front 2

Family name for HPV

Back 2

Papillomaviruses (close to polyomaviruses)

Front 3

Classification of HPV

Back 3

>100 serotypes, 16 and 18 are high risk for cervical carcinoma

Front 4

HPV gene expression

Back 4

early promoter drives expression of genes for viral DNA replication

Front 5

Replication cycle

Back 5

Linked to differentiation state of epithelial layer
-virus has to gain entry so basal daughter cells will contain episomal DNA

Front 6

What regulates vegetative DNA replication?

Back 6

E2/E1 heterodimer (helps unwind origin of replication)

E2/E2 homodimer (binds and negatively regulates early E6 and E7 promoters, build up E6 and E7 potential)

Front 7

Where do structural proteins collect with HPV?

Back 7

Upper layers of epidermis

Front 8

Clinical manifestations of HPV

Back 8

incubation of 2-6 mo (have to establish genomes in basal layer)
epithelial dysplasia (common warts on hands/feet)
condylomas (on mucosal epithelium, usually flat, non-fluid filled, usually regress, prolonged acute infection)

Front 9

ID of condylomas

Back 9

on mucosal epithelium, usually flat, non-fluid filled, usually regress, prolonged acute infection

Front 10

Persistence of keratinocyte nucleus as cells rise in stratum corneum, keeps in state for DNA replication

Back 10

Parakeratosis

Front 11

Hypertrophy of stratum corneum

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hyperkeratosis

Front 12

Squamous cells with enlarged nuclei and perinuclear clearing in upper and middle layers of epithelium

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koilocytes

Front 13

Single or clusters of slightly raised papules, 50-90% resolve within 1-5 yrs

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cutaneous warts

Front 14

Autosomal recessive disease with heightened susceptibility to HPV, can lead to invasive SCC

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Epidermodysplasia verruciformis

Front 15

Hyperkeratotic papules present in genital area

Back 15

anogenital warts

Front 16

Most common laryngeal neoplasm in children; papillomas common on vocal cords

Back 16

recurrent respiratory papillomatosis

Front 17

Transmission of HPV

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direct contact with lesions or surfaces harboring virus (have to have break in the skin)
incredibly common (75% have had >1 infection)

Front 18

Clinical features of cervical cancer

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discharge and abnormal vaginal bleeding, detect with Pap smear and follow up biopsy

Front 19

2 cancer types causing cervical cancer by HPV

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SCC (about 80-85%) + adenocarcinoma (15%, originating in glandular tissue)

Front 20

CIN1,2,3

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cervical intraepithelial neoplasia
1: lower 1/3
2: basal 2/3
3: full thickness

Front 21

At what stage is viral DNA integrated into the host?

Back 21

CIN 3

Front 22

Initiating step of HPV oncogenesis

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Rare integration of viral DNA into host chromosome

Front 23

Role of E7

Back 23

Increases leads to loss of cell cycle regulation

Front 24

Role of E6

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Blocks apoptosis

Front 25

Two main proteins driving uncontrolled growth of HPV lesions/oncogenic transformation

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E6 and E7

Front 26

Synergy between E6 and E7 for SCC

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E7 drives differentiation, E6 blocks apoptosis through p53, both combine to unchecked growth, no p53 to check tumor cells

Front 27

HPV16 is frequently associated with what non-cervical cancer?

Back 27

Oral SCCC, 20% are HPV associatedl 21% contained both EBV and HPV DNA

Front 28

Dx of HPV

Back 28

genital warts by visual inspection, cervical changes ID'd by routine Pap tests

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Prevention of HPV

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limited # of partners, use of condoms, regular Pap smears

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VLP vaccines contain...

Back 30

no viral DNA, only proteins expressed by viruses

Front 31

Tx of HPV

Back 31

-surgery or cryotherapy for warts, but common recurence
-podophyllin, an anti-mitotic