M2-C3-L78 --> Ebv

Front 1

What subfamily does EBV belong to?

Back 1

Gammaherpesvirinae

Front 2

Gamma herpes viruses are characterized by:

- infection
- cell target

Back 2

Latent

B-cells (proliferation)

Front 3

HHV-4 is also known as?

Back 3

Epstein Barr Virus

Front 4

HHV-8 is also known as?

Back 4

Kaposi's Sarcoma Herpes Virus

Front 5

T/F - EBV is the most prevalent of human virues.

Back 5

True

Front 6

EBV transmission. Describe

Back 6

Typical direct, close personal contact
- saliva
- blood
- tissue transplant
- sexual

Front 7

EBV:

- genome type
- linear or circular
- capsule
- envelope
- unique structure

Back 7

dsDNA

Linear (becomes circular in cell)

Icosohedral

envelope

tegument

Front 8

EBV will INITIALLY infects what cells?

EBV eventually ENDS UP infecting what cells?

Expansion of viral genome done through what?

How long does it stay in host?

Back 8

Oropharyngeal epithelium

B-cells

Forced proliferation of B-lymphocytes

Lifetime

Front 9

List two benign diseases of EBV and describe their association with patients.

Back 9

Infectious Mononucleosis (IM)
- targets immunocompetent

Oral Hairy Leukoplakia (OHL)
- targets immunosuppressed

Front 10

What is the classic triad for EBV induced IM?

Back 10

Fever

Sore throat (pharyngitis)

Cervical lymphadenopathy

Front 11

What is the hematological finding associated with EBV induced IM?

Back 11

Greater than 10% ATYPICAL lymphocytes

Front 12

What is the serotological finding associated with EBV induced IM?

Back 12

Transient HETEROPHILE antibodies

Permanent EBV-sprecific antibodies

Front 13

When EBV infects a resting B-cell, describe the receptor interactions for:

- binding
- fusion/entry

Back 13

B-cells CD21 receptor binds to viral gp350

B-cell HLA class II (HLA-DR) coreceptor binds to viral gp42-gL-gH

Front 14

When progeny viruses leave the resting B-cell, why do they lack a gp42?

What is the consequence of this?

Back 14

The gp42 will bind with the internally synthesized cellular HLA-DR. This causes them to become degraded along the proteolytic pathway.

Thus only gL-gH is found on the progeny virus.

This is beneficial b/c epithelial cells will not allow entry to viruses with gp42, but will allow gL-gH entry.

EBV can then make new progeny with gL-gH AND gp42 b/c epithelial cells do not have HLA molecules for it to bind to.

Front 15

EBV replication:

- rate
- requires what? why?
- depends on what enzymes

Back 15

Once per cell cycle

EBNA-1 b/c it binds to EBV origin of replication

Cellular enzymes

Front 16

Why would acyclovir not work on EBV induced IM?

Can acyclovir be used at all when dealing with EBV diseases?

Back 16

Because this is a disease of latency and is dependent on cellular enzymes.

ACV is used to target viral polymerase and to inhibit lytic viral diseases

Yes, can use with Oral Hairy Leukoplakia.

Front 17

EBV-Specific Cytotoxic T-cells:

- infected with EBV?
- targets what
- eliminates what

Back 17

Non-infected

EBV latency proteins (EBNAs & LMPs)

proliferatint B cells

Front 18

T/F - Heterophile antibodies react with EBV antigens.

Back 18

False.

These Ab target the massive random antibodies created by the proliferating B-cells.

Front 19

What test will detect heterophile antibodies?

How does this test work?

Back 19

Monospot test

These antibodies are IgM class that agglutinate sheep RBC's.

Front 20

EBV-specific antibodies:

- persist for how long?
- useful for what kind of infection?
- essential for diagnosis?

Back 20

For LIFE

Acute

Rarely, but can be used to distinguish for leukemia

Front 21

Question

Back 21

Answers

Front 22

What is the average incubation period for IM?

Back 22

50-60 days

Front 23

What organ complication can occur with the overload of B-cells in IM?

Back 23

Splenic rupture.

Front 24

What are the hematological complications of IM?

Back 24

Hemolytic anemia
Thrombocytopenia
Neutropenia

Front 25

What is the most frequent cause of death in IM complications?

What is the recovery prognosis for such a complication?

Back 25

Encephalitis/Meningitis

85% complete recovery

Front 26

IM usually manifests how for children:

- usually what symptoms during seroconversion?
- any atypical presentations?

Back 26

Usually asymptomatic seroconversion

Neutropenia
Periorbital swelling
Rash
Respiratory infection

Front 27

What is so unique about the serology of IM children?

Back 27

50% - HETROPHILE NEGATIVE !!!!

(80% when less than 4 y.o.)

Front 28

IM manifestion for young adults:

- symptomatic association
- serology

Back 28

50% symptomatic at primary infection

90% heterophile positive

Front 29

IM manifestation for elderly:

- common symptoms x3

Back 29

Fever
Abdominal pain
Hepatic abnormalities

Front 30

T/F - For IM, is acyclovir used?

why or why not?

Back 30

Not indicated

It inhibits EBV replication, yet IM is a disease associated EBV LATENCY!

Front 31

What is the best treatment for IM?

Back 31

Supportive

Front 32

When would you use corticosteroids for IM? x3

Back 32

Impending airway obstruction

Severe thrombocytopenia

Hemolytic anemia

Front 33

List all the EBV associated disease that involve B-cells.

Back 33

Burkitt's Lymphoma

Hodgkin's Lymphoma
IM
PLTD (post transplant lymphoproliferative disorder)

Front 34

Describe the genetic association with Burkitt's Lymphoma.

Back 34

Associated with a translocation involving chromosome 8 (c-myc gene)

AND

chr 2, 22, 14

Front 35

EBV Latency proteins

- how many LMPs (latent membrane proteins)

- how many EBNAs (Epstein Barr Nuclear Antigens)

Back 35

3

6

Front 36

EBV latency proteins are:

- critical for what in vivo
- required for what in vitro

Back 36

B-cell proliferation

Cell transformation

Front 37

What is unique about the total CD8+ T-cell pool in association with EBV?

Back 37

EBV-specific CD8+ T-cells constitute 5%

Front 38

Specify the EBV latency proteins in the tumor tissues associated with the following:

- Post transplant lymphomas
- Nasopharyngeal Carcinoma (NPC)
- Gastric Carcinoma
- Hodgkin's Lymphoma
- Burkitt's Lymphoma

Back 38

All 9

EBNA-1, LMP-1, LMP-2
EBNA-1, LMP-1, LMP-2
EBNA-1, LMP-1, LMP-2

Only EBNA-1

Front 39

In order to survive T-cell detection, EBV will do what?

Back 39

Downregulate latency proteins to just EBNA-1, LMP-1, and LMP-2

Front 40

Describe the latency proteins associated with exploiting the physiological B-cell pathway.

Back 40

EBNA-1 : maintains episome in cell

LMP-1 : Mimicry of CD40 receptor

LMP-2 : Mimicry of B-cell receptor/surface immunoglobulin

Front 41

List the EBV associated disease that involves epithelial cells. x3

Back 41

Nasopharyngeal carcinoma (NPC)

Oral Hariy Leukopenia (OHL)

Gastric Carcinoma

Front 42

Nasopharyngeal Carcinoma (NPC)

- prevalent population
- characterized by what type of infection
- symptom

Back 42

Southern Asia + Alaskan eskimos

Latency

Highly metastatic beginning in the OROPHARYNX, and may travel to cervical.

Front 43

Oral Hairy Leukoplakia (OHL)

- prevalent population
- characterized by what type of infection
- Symptom
- Can look like what other syndrome?

Back 43

Immunosuppressed patients (AIDS)

Active Viral Replication

Benign hyperplastic lesion of epithelial cells in tongue

Candida