Infectious Disease (Block 6): Prions & Parvo, Adeno, Pox, Polyoma, And Papillomaviruses

Front 1

Diseases associated with Prions are typically HIGH/LOW inflammatory response. Explain.

Back 1

low; dz is due to altered form of nL host protein, so immune system less likely to go all out attack on it
- the conformational change causes it to become protease resistant

Front 2

prions are ALPHA/BETA pleated sheets that are difficult to eradicate because they are_______?

Back 2

beta; resistant to heat and most chemicals

Front 3

Prions cause a characteristic ________ encephalopathy

Back 3

spongiform (make brain look like sponge microscopically)

Front 4

incubation period of prions

Back 4

decades

Front 5

name the dz's caused by prions

Back 5

- Kuru: transmitted by cannabalism
- Sporadic Creutzfeldt-Jakob dz (CJD): can get from corneal transplants (or other tissue)
- Bovine spongiform encephalopathy - only present in animals : only present in animals
- variant CJD: consumption of cows with "mad cow dz"

Front 6

prion dz that causes cerebellar ataxia, shivering tremor, athetosis, chorea

Back 6

kuru dz

Front 7

prion dz that causes presenile dementia, EEG changes, astrogliosis, neuronal loss

Back 7

sporadic creutzfeldt jakob dz (CJD)

Front 8

responsible for mad cow dz

Back 8

variant CJD

Front 9

infections of parvovirus B19 is most common in what age group?

Back 9

b/w 4-10 yrs old (with cyclical epidemics in spring)

Front 10

structure of parvovirus B19

Back 10

naked, ssDNA (single stranded DNA)

"simple as a Par-ONE golf course"

ALL DNA VIRUSES ARE DS DNA -- EXCEPT PARVOVIRUS!!

Front 11

this virus replicates in rapidly dividing cells (especially RBC precursors)

Back 11

parvovirus B19

Front 12

how is parvovirus transmitted?

Back 12

respiratory secretions & blood transfusions

Front 13

incubation period of parvovirus

Back 13

1 week

Front 14

what's the more common clinical manifestation for children with parvovirus?

Back 14

Erythema infectiosum "fifth dz"
- prodromal flu-like illness
- rash "slapped cheek appearance", arthralgia, arthritis 17-18 days after infection
- due to immune complex formation

Front 15

what is more common to see in adult pts with parvovirus infection

Back 15

arthritis, arthralgia

Front 16

what occurs in pts with underlying hemolytic anemia that get parvovirus?

what about in immunocompromised pts?

what about in pregant women?

Back 16

aplastic crisis (rapid fall in hematocrit)

chronic anemia

1st trimester-spontaneous abortion
2nd trimester- hydrops fetalis (heart failure of infant)
3rd trimester- still birth

Front 17

Dx and Tx for Parvovirus

Back 17

Dx:
-B19 DNA in serum/throat secretions
-serology: IgM or rising IgG
-ultrasound monitoring of fetus in infected mother

Tx:
-transfusions for aplastic crisis or hydrops fetalis
-IgG for immunocompromised pts

Front 18

Pox virus structure is NAKED/ENVELOPED, __ DNA

Back 18

enveloped; dsDNA

it's a LARGE virus and the exception to rule that viruses are labile in the environment ==> smallpox can remain in environment for years (resistant to heat/drying)

Front 19

how does pox virus transmit (2 patterns)?

Back 19

- localized: invade broken skin, spread through lymphatic drainage
- generalized: respiratory tranmsision, viremia spreads virus to organs, skin

Front 20

What are the clinical manifestations of pox virus?

Back 20

- smallpox (maculopapular rash beigins in oral mucosa, face, forearms -> spread to trunk/legs)
- vaccinia
- monkeypox
- molluscipox (umbilicated papules)

Front 21

characteristic lesion of smallpox

Back 21

vesiculopustular lesion with residual scarring

Front 22

Dx and Tx of pox virus

Back 22

Dx:
-clinical Dx, EM, culture (except molluscipox)
-histopathology for Guarnieri bodies (eosinophilic cytoplasmic inclusions)

Tx:
- local Tx on lesins
- vaccinia immune globulin

Front 23

structure of adenovirus

Back 23

naked, dsDNA

Front 24

T or F. adenovirus can be associated with tumors.

Back 24

F.

Front 25

adenovirus is most common in children during which season?

what does it clinical manifest itself as?

Back 25

winter

clinic:
- pharyngitis: infants/children
- gastroenteritis: serotype 40/41
- pneumonia
- keratoconjunctivitis (pink eye that actually impairs your vision)
- pharyngoconjunctival fever

Front 26

pneuonia caused by adenovirus is common in which 2 populations? which serotypes is responsible?

Back 26

military recruits/young adults

serotypes 3/4/7 (vaccine available)

Front 27

Tx of adenovirus

Back 27

cidofovir and donor leukocyte infusion for bone marrow transplant pts

Front 28

structure of polyomavirus

Back 28

naked dsDNA (like adenovirus!)

Front 29

polyomavirus is ubiquitous and infects worldwide most commonly in CHILDHOOD/ADULTHOOD

Back 29

CHILDHOOD (respiratory transmission)

Front 30

what are the 2 polyomaviruses and what do they cause?

Back 30

BK (for burger king) and JC (for JC Penney)

- both persist in kidneys

BK:
- ureteral stenosis (nephropathy and hemorrhagic cystitis)

JC:
- likes to grow in oligodendrocytes
- causes progressive multifocal leukoencephalopathy (PML) in immunocompromised pts (CNS damage)

"Visualize shoppers at JC Penney with PML, walking around the store with memory loss, poor speech and incoordination."

Front 31

papillomavirus is NAKED/ENVELOPED with __DNA

Back 31

naked; dsDNA

"you have to get naked for pap smears"

Front 32

most commonly sexually transmitted virus

Back 32

papillomavirus (infection persists about 8 months- most resolve)

Front 33

clinical manifestations of papillomavirus

Back 33

- warts
- condyloma acuminata (serotypes 6 and 11)
- assoc with cervical cancer (serotypes 16 and 18)

Front 34

Dx and Tx for papillomavirus

Back 34

Dx:
- cytology (pap smear), EM, colposcopy, serology NOT useful

Tx (for warts):
- surgery
- caustic agents
- interferon
- imiquimod??

Front 35

prevention for HPV

Back 35

-pap smear
- vaccine (containing 6, 11, 16 and 18)