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56 Cards in this Set
- Front
- Back
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Herpes Virus GC:
- Replicates where? - Endogenous enzymes? x2 - Envelope? |
Nucleus
DNA Polymerase Enzymes for nucleotide biosynthesis Yes |
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HSV I and HSV II:
- family - subfamily - genus - natural host - prevalence - body fluid person to person |
Herpesviridae
Alphaherpesvirinae Simplexvirus Humans Worldwide Person to person via body fluid |
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Define recurrent infection
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Reactivation of latent genome
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HSV Primary Infection:
- Route of entry x2 - Avg. incubation rate - Avg. length of lesion formation |
Abraded skin
Mucous membrane 6 days 7-10 days |
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T/F - During convalescence, scarring does not occur in HSV.
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True
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On the cellular level, primary infection lesions usually occur where?
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Local nerve endings
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In the head region, primary infection would manifest as what?
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Herpes gingivostomatitis
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For latent infection, what is the neuronal ganglia associated with:
- HSV - 1 - HSV - 2 |
Trigeminal
Sacral |
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What is the name of the genomic sequence associated with the latency of HSV pathogenesis?
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LAT
Latency associated transcripts |
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T/F - HSV latency infection is subject to immune surveillane.
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False
It is NOT subjected |
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List the primary infection stages
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Early stage
Mid stage Full stage Late stage |
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Define recurrent infection
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Reactivation of the latent genome
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Viral DNA persists in the target cell of the host for how long?
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The LIFE of the host
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In comparison to the primary lesion, describe the duration and severity of the recurrent infections.
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Milder
Shorter duration |
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In the head region, recurrent infection would manifest as what?
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Herpes labialis
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What are the primary orofacial symptoms associated with HSV-1? x3
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1. Herpes stomatitis
2. Herpetic gingivostomatitis 3. Fever blisters/cold sores |
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In HSV-1, _______ is the rule.
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Asymptomatic infection
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What are the symptoms that are associated with HSV-I? x7
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Fever
Anorexia Malaise Gingivostomatitis Lymphadenopathy (localized) Ulcerative/vesicular lesions Edema |
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For children with HSV-I, some may come in with inability to swallow liquids. Why?
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B/c significant edema of the mucosal membrane and the associated pain.
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For young adults with HSV-I, primary infection may be associated with what?
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HSV pharyngitis
associated with mononucleosis-like syndrome |
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What percent of HSV-1 seropositive individuals have recurrent infections?
From here, what percent has it once a month? What percent has it once between 2-11 months? What percent has it once of 1 year or less? |
33%
Most are asymptomatic 5% 34% 61% |
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Herpetic keratitis is the second leading cause of what?
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Corneal blindness
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Primary Herpetic Keratitis:
- limitation - pathognomonic finding - associated symptoms x3 |
Usually limited to one eye
Branching dendritic lesions Photophobia Eyelid edema Tearing |
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What is herpes gladiatorum?
How does the virus transmit? What population group is most prone to this disease? |
Herpes infection of the body.
Through cuts and abrasions of the skin Wrestlers and rugby players |
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Most severe clinical symptoms are encountered when for HSV-2 patients?
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Most severe are encountered following primary infection.
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HSV-2 Acquisition probability for heterosexual men:
- 1 partner - 2-10 partners - 11-50 partners - >59 partners |
0%
20% 35% 70% |
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HSV-2 Acquisition probability for heterosexual women:
- 1 partner - 2-10 partners - 11-50 partners - >59 partners |
<10%
40% 62% >80% |
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What are the associated symptoms of HSV-2? x7
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Fever
Malaise Dysuria Inguinal adenopathy Photophobia Stiff neck Headache |
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Primary infection of women with HSV-2, usually results in what?
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A more severe form of associated symptoms.
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What is the main clinical symptoms associated with primary infections of HSV-2 in men?
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Vesicular lesions on the penis glans/shaft.
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T/F - For HSV-2 in men, extragenital lesions can occur in thighs, buttocks, perineum, and anus.
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True
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For men with primary infections of HSV-2, are there any complications?
If so, name and describe prevalence. |
Aseptic meningitis
(Systemic complication) Rare |
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For primary infections of HSV-2 in women, what is the most common clinical symptom?
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BILATERAL lesions of the vulva
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For women, primary infections in women can lead to lesions where else besides the most obvious location?
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Perineum
Buttocks Cervix Vagina Anus |
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What are the severe complications that can occur with women who have a primary infection of HSV-2?
List the probability also. |
Urinary Retention syndrome
(10-15%) Aseptic Meningitis (25%) |
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List the frequency of recurrent infections for HSV-2.
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Less than 4 per year (33%)
Between 4 to 7 per year (33%) Greater than 7 per year (33%) |
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Which is usually worse?
Primary infection or recurrent infection? |
Primary is worse
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Does HSV-1 cause genital infections?
If so, how severe is it and what is the frequency? |
Yes.
Less severe with less recurrent infections than HSV-2 |
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Herpetic Whitlow:
- what is it? - virus responsible? - seen in what population? |
HSV infection of the digits
HSV-1 or HSV-2 Medical and dental personnel |
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List two neurological complications that can arise from Herpes.
List which virus type causes it. |
Herpes encephalitis
(HSV-1 and HSV-2) Herpes meningitis (HSV-2) |
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T/F - Herpes encephalitis with HSV-1 is not so serious.
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False.
Severe morbidity and mortality |
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Herpes encephalitis with HSV-2 is associated with what type of infection?
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Associated with
Neonatal infection |
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List the types of neonatal infections
What viruses are associated wiht them. State the most common form. Which one results in congenital infection. |
In utero: HSV-2
(results in congenital infection) Intrapartum: HSV-2 (75-80% of neonatal infections) Postnatal: HSV-1 |
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Neonatal infection is almost always ________ and can often be ________.
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Symptomatic
Lethal |
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Which types of herpetic neonatal infections most severely afflict babies?
What are the symptoms of such? Mortality rate? |
Congenital infections
(In utero) Microcephaly, multiorgan system involvement, skin scarring/vesicles, eye disease 50% |
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Infection of babies intrapartum or postnatally can be divided into three categories. List the three categories.
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1. SEM (Skin Eye Mouth) disease
2. Localized CNS disease 3. Disseminated disease |
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List the laboratory tests used to diagnose HSV.
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Cell culture (definitive)
Cytology/histology |
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What would you see on a positive cell culture for HSV?
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CPE of syncytial (cell fusion)
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What types of smears would you use for cytology/histological labs? x3
What would a positive lab look like? |
Tzanck smear
Papanicolaou smear Biopsy Cowdry type A intranuclear inclusions |
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Can you use serology for HSV diagnosis?
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Yes but only useful for diagnosing a primary infection or epidemiology
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What would you use to treat HSV keratitis? x3
Describe the mechanism of these drugs. |
Vidarabine (adenosine analog)
Idoxuridine (thymidine analog) Trifluridine (thymidine analog) Nucleoside analog will inhibit HSV DNA polymerase. |
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What would you use to treat Acyclovir resistant infections?
Describe mechanism of this drug. |
Foscarnet (pyrophosphate analog)
Binds and inhibits HSV DNA polymerase |
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List four drugs used to treat HSV.
Describe the mechanism. Which one is topical? |
Acyclovir (guanosine analog)
Valacyclovir (Acyclovir prodrug) Famciclovir (prodrug of penciclovir) Penciclovir (topical cream) HSV TK phosphorylates these compounds, which will prevent DNA replication |
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Are antivirals used for primary infection or recurrent infection?
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Both
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HSV resistance can be localized to where?
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HSV TK
polymerase gene |
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List the vaccines associated with HSV.
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None presently available
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