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61 Cards in this Set

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