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61 Cards in this Set
- Front
- Back
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What viruses are included in the Alpha virus family of HV?
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1. HSV
2. VZV |
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What virus is included in the Beta virus family of HV?
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Cytomegalovirus
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What virus is included in the Gamma virus family of HV?
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Epstein-Barr Virus
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Which family of HV viruses has a variable host range?
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Alpha virus
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Where do Alpha viruses lay latent?
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DRG
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Where do Beta viruses lay latent?
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Lymphocytes (hematologic cells)
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Where do Gamma viruses lay latent?
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Lymphoid tissue
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Most of the HV cause what is clinically described as...
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Mononucleosis syndrome
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What characterizes mononucleosis syndrome?
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1. Hepatosplenomegaly
2. Fever 3. Malaise 4. Lymphadenopathy 5. Pharyngitis |
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What are three lab findings in mononucleosis syndrome?
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1. Increased number of lymphocytes
2. Atypical lymphocytes 3. Incresed LFTs |
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When someone comes in with mononucleosis syndrome symptomes, what should always be considered on the DDx?
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HIV
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The atypical lymphocytes seen in mononucleosis syndrome are typically what type?
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T-Regulatory cells
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How many serotypes of human CMV are there?
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One
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What are the possible routes of transmission of CMV in children?
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1. Congenital
2. Peri-partum 3. Horizontal |
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What are two routes of transmission of CMV in adults?
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1. Sexually
2. Child to parent |
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What are the potential routes of transmission in nosocomial infection of CMV?
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1. Breast milk bank
2. Organ transplantation 3. Blood products |
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Where are the two population peaks in the incidence of CMV?
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1. Children
2. Adults |
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What is the seroprevalence of CMV in the US?
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40% to 50%
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Is CMV infection considered to be endemic, epidemic or pandemic?
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Endemic
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What seems to be the rule with CMV?
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Infection is common, disease is rare.
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What two areas of the body does CMV seem to replicate at the most?
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1. Kidney
2. Salivary glands |
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What two cells types does CMV typically replicate in?
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1. Lymphocytes
2. Epithelial cells |
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What histopathological sign is seen in CMV infected patients?
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Owl's eye - intranuclear inclusion bodies that represent sites of CMV replication
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In immunocompetant patients, reactivation of CMV results in what?
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No disease, just shedding of virus in the urine.
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What patient group seems to be the most problematic with CMV?
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Immunocompromised patients such as HIV patients and transplant patients.
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When performing molecular analysis of someone who potentially has CMV, what would you be looking for?
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Presence of pp65 - the surface antigen of CMV
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What the problem with PCR detection of CMV?
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It is an issue of quantification. People who are seropostive with test positive via PCR but people who are currently infected with an active infection will have higher PCR levels. The cut-off to distinguish the two needs to be established.
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The most effective diagnosis of CMV uses what?
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A constellation of laboratory findings
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What are the three main clinical syndromes of CMV?
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1. Congenital infection
2. Mononucleosis syndrome 3. Visceral organ infection in immunocompromised patients |
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What is the most common virus transmitted in utero?
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CMV
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What is the situation of most concern involving congenital transmission of CMV? What does this situation result in?
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1. Primary infection of a seronegative pregnant mother.
2. Cytomegalic inclusion disease (CID) |
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What are some preventive measures that are being thought about for congenital CMV?
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1. Active immunization of prospective mothers
2. Passive immunotherapy of infected pregnant women |
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What is the term to describe a baby with CID?
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Blueberry muffin baby
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What is the marker for increased risk of passing CMV to a baby in a seropositive mother?
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Shedding of virus in the cervix
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What percentage of babies with congenital CMV (from seropositive mothers) are asymptomatic? What does this lead to?
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1. 90%
2. If not checked on, they can develop sensorineural hearing loss |
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What percentage of babies born with perinatal CMV are asymptomatic? How is this different than congenital CMV babies?
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1. 99%
2. They usually don't ever develop any sequelae |
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How do babies acquire CMV perinatally?
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1. During labor and delivery
2. Breast milk 3. Nosocomial |
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What is the only situation where infection from breast milk is not benign?
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In immunocompromised babies
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CMV mononulceosis infection in a young adult is usually a....
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Primary infection
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CMV mononucleosis is more like...
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Typhoid fever
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What is the most likely source of CMV infection in an organ transplantation?
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The organ itself
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What CMV caused infection used to be a huge problem in AIDS patients?
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Retinitis
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What are three ways to prevent infection in CMV?
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1. Create a vaccine
2. Screen blood products and tissues 3. Prevent sexual transmission of CMV |
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What drug is used in immunocompromised patients as a preventive measure?
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Ganciclovir
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How many serotypes of human EBV are there?
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One
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What is the most common cause of malignancies in HV?
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EBV
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Name three EBV caused malignancies.
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1. Burkitt lymphoma
2. Nasopharyngeal carcinoma 3. PTLD |
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What is an EBV caused disease only really seen in HIV patients?
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Oral hairy leukoplakia
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What percentage of adults are latently infected with EBV?
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90%
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If you get a primary infection of EBV as a adolecent or adult, what is the usual result?
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Mononucleosis syndrome
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Where are EBV virions shed from?
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Oropharyngeal epithelial cells hence the "kissing disease"
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When establishing latency, what happens to some B cells?
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They are lysed.
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How is EBV diagnosed?
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Serology
1. monospot non-specific 2. Specific against EBNA and VCA |
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What are common laboratory findings in EBV?
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1. Atypical lymphocytes
2. Elevated LFTs |
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In primary EBV, the specific serology test would look like?
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VCA IgG(+), VCA IgM(+), EBNA IgG(-)
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Which antibody in a specific serotype means that the current infection is NOT due to EBV?
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EBNA IgG(+)
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Human herpes virus type 6 has how many subgroups? What cell does it lay latent in?
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1. Two
2. T Cells |
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What diseases are associted with HHV-6?
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1. Exanthem subitum
2. Mono 3. Encephalitis 4. Pneumonia |
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What is a word that describes the infection rate in HHV-6?
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Ubiquitous
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How is HHV-6 diagnosed?
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PCR and serologic titers
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What diseases are associated with HHV-8?
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1. Kaposi sarcoma
2. Primary effusion lymphoma 3. Multicentric castleman disease |
