M2-C3-L77 --> Cmv

Front 1

HCMV Classification:

- family
- subfamily
- genus

Back 1

herpesviridae

betaherpesvirinae

cytomegalovirus

Front 2

HCMV Epidemiology:

- natural host
- prevalence
- transmission

Back 2

humans

worldwide

person-to-person (body fluid)

Front 3

Associate HCMV's involvement as an agent of the following:

- congenital
- opportunistic
- complications

Back 3

#1 viral infectious cause of congenital CNS damage (TORCH agent)

Leading opportunistic pathogen in AIDS patients

Leading cause of complications in transplant patients

Front 4

HCMV can cause what disease?

Back 4

Mononucleosis
(Heterophile-negative)

Front 5

List the populations at risk with CMV infections. x7

Back 5

Fetus
Neonates / Young children
Sexually active
Pregnant
Immunocompromised
Blood product recipient
Health care workers

Front 6

Describe the transmission of HCMV in fetuses.

Back 6

Intrauterine transmission

Front 7

What poses the greatest risk of CMV to fetuses?

Back 7

Primary infection of seronegative mothers

Front 8

What is associated with the MOST severe CMV disease?

Back 8

Intrauterine infection

Front 9

If an immune pregnant mothers had a CMV infection, what symptoms would the new-born baby manifest?

Back 9

Asymptomatic

Front 10

Describe how neonates/young children become CMV infected:

- perinatally
- postnatally

Back 10

Birth

Breast-feeding

Front 11

Prior to conception, 45% - 91% of pregnant women are what?

Back 11

CMV seropositive

Front 12

What puts pregnant others at risk? x2

Back 12

Contact with young children <24 months of age.

Going to day care centers

Front 13

Sexually active populations are at risk b/c HCMV can be found and shed from where? x2

Back 13

Cervix

Semen

Front 14

List the involvement of HCMV in two types of immunocompromised patients.

Back 14

In transplant patients, all major transplantations are associated with an increased risk of this infection or this disease.

It is one of the most common opportunistic infections in AIDS patients.

Front 15

What percent of transplant patients show signs of HCMV infection?

Back 15

50%

Front 16

100% of homosexual men with HCMV are also co-infected with what?

Back 16

HIV-1

Front 17

CMV infections associated with recipients of blood products are also associated with these two diseases.

Back 17

Postperfusion syndrome

Transfusion Associated disease

Front 18

What are three possible outcomes of someone who becomes seropositive with HCMV following a blood transfusion.

Back 18

Asymptomatic

Posttransfusion CMV Mononucleosis

CMV hepatitis

Front 19

For immunocompetent individuals, describe the pathogenicity of CMV.

Back 19

Low pathogenicity.

Front 20

What 2 things about the patient affects the pathogenesis profoundly?

Back 20

Age

Immune status

Front 21

Primary infection during what time for the pregnant mother would most likely cause in utero infection?

Back 21

First six months of pregnancy

Front 22

Majority of congenital infections are symptomatic of what?

Back 22

Asymptomatic

Front 23

For babies with congenital infection, 80% of symptomatic infants exhibit what?

Back 23

lasting neurological abnormalities

Front 24

Neonates with full CID (Cytomegalic Inclusion Disease) exhibit what 3 most common symptoms?

Back 24

Jaundice

Petechiae

Hepatosplenomegaly

Front 25

What is the worst case scenario for neonates with full CID in terms of symptoms?

Back 25

End stage organ disease

Front 26

What is the radiographical evidence supporting the diagnosis of a CMV congenital infection?

Back 26

Paraventrical calcification

Front 27

What are the symptoms associated with perinatal CMV infection?

Back 27

Usually asymptomatic

Front 28

What are some ways that perinatal CMV infection can occur? x4

Back 28

Delivery
Breast milk consumption
Blood transfusion
Nursery spread

Front 29

50% of infants born to mothers with this condition will acquire HCMV.

Back 29

Cervical infection

Front 30

Childhood CMV infection:

- prevalence
- symptoms

Back 30

Common

Asymptomatic

Front 31

CMV mononucleosis:

- severity
- limitation

Back 31

Mild

Self-limiting

Front 32

CMV mononucleosis symptoms. x7

Back 32

Fever
Malaise
Rash

Tonsilitis
Abnormal liver functions
Lymphadenopathy
Leukocytosis

Front 33

What antibody difference exists with CMV and EBV mononucleosis?

Back 33

CMV is heterophil-negative

Front 34

In terms of Cardiovascular Diseases, HCMV seropositivity correlates with what medical conditions? x3

Back 34

RESTONOSIS following balloon angioplasty

more severe ATHEROSCLEROTIC symptoms

TRANSPLANT VASCULAR SCLEROSIS

Front 35

In CVDs, HCMV antigens and nucleic acid sequences have been demonstrated in what tissues?

Back 35

Smooth muscle cells
Endothelial cells
Monocytes/macrophages

Front 36

What percentage of individuals with AIDS are seropositive for CMV?

Back 36

>90%

Front 37

What are the 2 arguments supporting the fact that HCMV may contribute to AIDS progression?

Back 37

1. CMV is able to infect the same cell type as HIV.

2. CMV has genes that are capa ble of increasing the expression of long terminal repeat regions of HIV.

Front 38

With HIV-infected patients living longer, what is the consequence to HCMV's?

Back 38

HCMV induced diseases in these patients may rise as the virus acquires various drug resistance.

Front 39

What would a fundoscopic exam reveal for a person with HCMV retinitis?

Back 39

Retinal necrosis

Hemorrhage

Front 40

What is the MOST important infectious agent affecting organ transplantation?

Back 40

CMV

Front 41

T/F - HCMV diseases varies with each type of transplantation.

Back 41

True

Front 42

The severity of end-organ disease is related to severity of what?

Back 42

immunosuppression

Front 43

What status can affects the outcome of transplantations?

Back 43

CMV Seropositivity

Front 44

What is the most common life-threatening complication of allogeneic bone marrow transplant? x4

What are the symptoms?

Back 44

Interstitial pneumonia

Fever
NON-productive cough
Dyspnea
Hypoxia

Front 45

CMV is the most common pathogen isolated from what?

Back 45

Solid organ transplantation

Front 46

What is the leading cause of morbidity during the first 14 weeks after liver transplantation?

What are the symptoms? x3

Back 46

Hepatitis

Elevated liver enzymes
Liver failure
Fever

Front 47

CMV morbidity lowest in what type of transplant?

What are the symptoms? x4

Are antivirals helful to CMV kidney transplant infections?

Back 47

Kidney

Fever
Malaise
Leukopenia
Hepatosplenomegaly

Yes, well responding

Front 48

CMV should be suspected in? x3

Back 48

Newborns with microencephaly, jaundice, hepatosplenomegaly

Mononucleosis syndrome with heterophil antibody negative

Immunocompromised

Front 49

T/F - CMV infections can be diagnosed on clinical manifestations alone.

Back 49

False

Front 50

What is the most DEFINITIVE lab diagnosis for HCMV?

Back 50

Tissue CULTURE
(isolate virus from body secretions or tissue homogenates)

Front 51

Besides the definitive lab technique in diagnosing HCMV, what other alternative lab methods are there for diagnosis?

Back 51

1. Viral marker by Immunofluorescence, ELISA, or EM (viral particles)

2. Vrius genome by DNA hybridization

3. PCR

4. Serology to detect seroconversion or rise in CMV Ab antitier (paired sera)

Front 52

What is the positive sign seen in cultured cells for HCMV?

Back 52

HCMV inclusions known as "Owl Eye"

Front 53

What is the treatments for HCMV retinitis in AIDS patients?

Back 53

Cidofovir
Foscarnet
Formivirsen

Front 54

What is the vaccine name for HCMV?

Back 54

There is none.

Front 55

What is the treatment for Tranplant patients with AIDS? x2

Back 55

Valciclovir
Ganciclovir

Front 56

What drug is controversial for use in treating HCMV?

When would you use this drug?

Back 56

Immune globulins (IgG)

(controversial, but warrented as immunoprophylaxis in bone marrow transplant)