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56 Cards in this Set

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What is the largest HV?
Cytomegalovirus
What are the smallest HV?
VZV amd human herpes 7
Where does HSV go latent?
DRG
What are the three Alpha HV?
1. HSV-1
2. HSV-2
3. VZV
What things seem to reactivate HSV?
Stress, fever, UV light or menses
What seems to reactivate VZV?
Senescence of the immune system
What type of genome do all HV have?
Circular dsDNA
Which two glycoproteins on HSV are the most potent inducers of antibodies? Which is more dominant in producing an immune response?
1. Glycoprotein C
2. Glycoprotein D
3. Glycoprotein D is more dominant
Are most primary infections to HSV symptomatic or asymptomatic?
Asymptomatic
What is the only gene expressed in the DRG?
Latentcy Associated Trascript
What are two life-threatening diseases associated with HSV?
1. Herpes Simplex Encephalitis
2. Neonatal herpes simplex
What is the function of Glycoprotein C? What is the function of Glycoprotein D?
1. It identifies and binds to nectin receptors on the cell membrane
2. Entry of the virus into the cell
What are the three classes of viral replication genes in the nucleus?
1. Alpha genes
2. Beta genes
3. Gamma genes
What is the purpose of the Alpha genes in HSV? What is an example of an Alpha gene?
1. These genes "Rev-up" the virus so it is ready to replicate
2. Alpha-tif
What do Beta genes encode for?
1. DNA polymerase
2. Thymidine Kinase
What happens to the host cell when Beta genes are expressed?
Host cell machinery is shut down and the cell is committed to die.
What are Gamma genes responsible?
They are responsible for glycoproteins and structural aspects of the virus.
Where is the virus packaged?
Nuclear pore
When are multinucleated giant cells prominent?
During viral assembly in the cytoplasm.
What histopathologic finding is pathoneumonic for Herpes but not HSV?
Cowardy type A intranuclear inclusions
What is unique about the HV genome?
It is circular with a unique long segment and a unique short segment - both of which can invert to form a new circular DNA.
What segment of DNA is thymidine kinase and DNA polymerase located on?
The unique long segment
Where can HV infect immunocompromised patients?
1. Eye
2. Brain
3. Skin
How are HV infections spread?
On mucosal surfaces
Is HSV associated with any sort of cancer?
No because it is epigenic.
Adults who aquire HSV of the oropharynx are more likely to develop what?
Mono-like syndrome
Aquisition of HSV-1 is a product of what?
Socioeconomic status
The larger the amount of antiviral drug given during the prodrome of herpes labialis...
The greater impact you will have on the healing of the disease.
What is the percentage of transmitters of HSV according to PCR analysis?
6%
What is the mortality of desseminated neonatal disease?
25%
Primary infection in the absence of treatment lasts how long?
3 weeks
Recurrent infection with therapy usually lasts how long?
3 days
If a patient has recurrent vesicular lesions, regardless of the site, what should you be thinking?
Herpes Simplex
How do you distingiush between HSV-1 and HSV-2?
Compare their GGs
The sero prevalence of HSV-2 increases with....
Age
Transmission usually occurs when?
In the abscence of symptoms
Who are usually the transmitters, males or females?
Males
How do most cases of neonatal genital herpes come to light?
Exposure to maternal genital secretions
What does HSV in newborns cause?
Encephalomalacia
How would a newborn affected with neonatal herpes present?
1. SZ
2. Vesicular rash on its right big toe
What is a common finding in people with herpes encephalitis?
Focal encephalopathic processes with focal neurological findings. This is the most common cause for this in the US.
What is the diagnostic method of choice for HSV-1 and HSV-2 in herpes encephalitis and neonatal herpes?
PCR
What is the drug of choice for any life-threatening HSV for VZV infection?
Acyclovir
Famciclovir is the prodrug of what?
Penciclovir
What is the prodrug of acyclovir?
Valaciclovir
Ganciclovir is used in the treatment of what?
CMV
What is the only antisense molecule used for infectious diseases?
Fomivirsen
Aciclovir, Valaciclovir and Famciclovir all work by...
1. They are activated by thymidine kinase
2. They are then converted to triphosphate derivatives
3. They then all inhibit DNA polymerase
If someone is resistant to aciclovir treatment, what is the most probable reason for this?
They are thymide kinase negative
When does resistance usually occur?
In immunocompromised patients
How can you tell the difference between small pox and chicken pox?
Chick pox blisters are all in different stages while small pox blisters are all in the same stage.
Herpes Zoster is characterized by what?
Localized dermatomal rash
Herpes Zoster is caused by what?
Reactivation of VZV by immunosenescence.
VZV only recurs once in what type of patient?
Immunocompetent patients
The prevelance associated with shingles increases with what?
Age
What is the treatment of choice in a patient with shingles?
Valaciclovir or famciclovir