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50 Cards in this Set
- Front
- Back
whats the micro on retroviruses |
1. enveloped, diploid + sence ssRNA
glycoproteins in envelope 2. ssRNA, RNA --> DNA by reverse transcriptase adn then integrated into host genome 3. virions released by budding from cytoplasm membrane |
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what are hte 2 genra of retroviruses that infect humans
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1. Lentivirus (HIV): 2 strains, leads to neurological/immunosuppressive disease. HIV 2 is less virulent and is seen in W africa
2. ONCOVIRUS (DELTARETROVITUS) HTLV: 3 strains. infection w/1 or 2 results in immortalization/transformation of target cells |
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tell me about the 2 strains of lentivirus
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1. HIV 1: world wide, prevalent, serious neuro/immunosuppression
2. HIV 2: West Africa, less severe |
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we know retroviruses have envelopes, what are the glycoproteins on the HIV 1 envelope
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gp120
gp41 **these are encoded in teh env gene and bind to chemokine receptors on out host cells (CXCR4, CCR5)- allows fusion **has a diploid ssRNA genome. has reverse transcriptase to make RNA --> DNA, this DNA enters our cells (T, macro) |
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what are 3 super important HIV 1 genes
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1. gag- encodes precursor to p53/55
2. pol- encodes precursoe that is cleaved into RT, integrase, and protease 3. env: cleaved into gp120 and gp41 (the glycoproteins in the envelope of HIV1) |
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gag
pol env |
the genes in HIV 1
GAG- encodes p53/55 precursor, cleaved into p7/9/17/24/25 POL: makes reverse transcriptase, integrase nad protease env- makes gp120 adn gp41 |
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whats the cellular interaction to let HIV enter our T cells/macro
how then does it replicate |
1. gp120/gp41 on HIV binds chemokine receptors to let plama membranes bins (binds CXCR4, CCR5)
2. FUSION 3. HIV RNA enters cytoplasm and is converted by reverse transcriptase (RT, pol) to DNA 4. DNA enters our nucleus adn is integrated 5. actication of T cell to make replication, HIV genome being replicated 6 make new virions 7. budding, maturation into new infectious virions |
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HIV 1 develops into...
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AIDS
first: acute HIV infection, viral load increases and CD4 decreases clinical latency/chronic phase: CD4 increase a bit and viral load decreases early sx HIV infection AIDS CD4<400? or 200? |
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tell me about hte acute HIV 1 infection
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asx or flu like
mononuclear cells are infected with HIV, sx are result of cytokine release there is partial control of virus BUT there is still some HIV replication going on in LN |
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tell me about the clinical latency stage of HIV 1
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asx,
VARIABLE time **persistent infection and replication of HIV in infected cells GRADUAL decline in CD4 cells |
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whats the micro on retroviruses
1. envelope? 2. genome? 3. release |
1. enveloped, diploid + sence ssRNA
glycoproteins in envelope 2. ssRNA, RNA --> DNA by reverse transcriptase adn then integrated into host genome 3. virions released by budding from cytoplasm membrane |
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what are hte 2 genra of retroviruses that infect humans
|
1. Lentivirus (HIV): 2 strains, leads to neurological/immunosuppressive disease. HIV 2 is less virulent and is seen in W africa
2. ONCOVIRUS (DELTARETROVITUS) HTLV: 3 strains. infection w/1 or 2 results in immortalization/transformation of target cells |
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tell me about the 2 strains of lentivirus
|
1. HIV 1: world wide, prevalent, serious neuro/immunosuppression
2. HIV 2: West Africa, less severe |
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we know retroviruses have envelopes, what are the glycoproteins on the HIV 1 envelope
|
gp120
gp41 **these are encoded in teh env gene and bind to chemokine receptors on out host cells (CXCR4, CCR5)- allows fusion **has a diploid ssRNA genome. has reverse transcriptase to make RNA --> DNA, this DNA enters our cells (T, macro) |
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what are 3 super important HIV 1 genes
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1. gag- encodes precursor to p53/55
2. pol- encodes precursoe that is cleaved into RT, integrase, and protease 3. env: cleaved into gp120 and gp41 (the glycoproteins in the envelope of HIV1) |
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what stage of HIV infection is there a persistent HIV replication and decline in CD4 cells
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clinical latency
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tell me about the early sx stage of HIV 1 infection
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chronic sx bc of T cell decline
diarrhea, night sweats, opprotunistic infections HIV induces several CPE that may kill the infected cell infectinos are NOT AIDS defining |
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alright, waht is the AIDS stage of HIV 1 infection
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MUST be HIV +, duh
CD4 T <200 or <14%CD4, AIDS defining lesions |
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why is AIDS related demintia common
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the macro deliver HIV to neurons
**in AIDS the immine response is super low there is <200 CD4 |
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tell me about AB to gp120
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they target hte gp120 on HIV BUT AB coated ciral particles are infectious and are phago by macro. it just kind helps the aids spread. bad news
|
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what are some AIDS defining lesions
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1. kaposis sarcoma
2. cryptococcal meningitis 3. CMV 4. MAI 5. toxoplasmosis **these are AIDS defining lesion, along with HIV + status they DEFINE AIDS, also defining aids is CD4 <200 or CD4 <14% |
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who gets HIV 1 infections
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1. 14-24 yo
2. most common infectinos through unprotected sex 3. transfisions are rare, we screen for HIV 4. spread by needles ~10%, 5. virus is spreas sex, parental, transplacental |
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A 27-year-old male presents with complaints of fever, headache, sore throat, and malaise over a week and a rash for the past two days. He admitted to having unprotected sex with other men. His last encounter was three weeks earlier. He denied prior transfusions or IVDU.
Physical exam: T: 39.2oC, P 94, R 14, BP 136/82 mmHg Pharynx was erythematous; cervical and axillary lymphadenopathy was present. A diffuse maculopapular rash was observed on his abdomen. Labs: mostly normal; slight elevation in serum transaminases What’s likely? |
CMV
EBV HIV, HIGH index of suspicion secondary syphalis |
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how is HIV dx made
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your pt has risk factors, unprotected sex, needles, etc
rare infections in pt- kaposis sarrcoma, pneumocystis pneumonia, other opprotunistic infections |
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in HIV what is ...
1. category A 2. cetagory B 3. category C |
A: acute HIV presentation, clinical latency
B: infections seen in early stages of sx HIV infection C: AIDS defining illness, pt dx with AIDS even in CD4 >200 **if at anytime the pt is CD4 <200 or 14% its AIDS regardless of wht category of sx are present |
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dx of HIV
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elisa
confirmed with WB: band at p31 or p24, band at 160/120 or gp41 |
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what is a normal CD4:CD8 ratio, what is it in AIDS
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CD4: Cd8 1:6
**in AIDS its lower **T cell analysis as well as PCR viral load are done once pt is confirmed HIV w.ElISA and WB |
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what are hte 7 classes of antiretrovirals used for HIV 1 tx
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1. Nucleoside RT inhibitors
2. Non nucleoside RT inhibitors 3. Protease inhibitors 4. Fusion inhibitors 5. Integrase inhibitors 6. Maturation inhibitors 7. antisence drugs: **often used in combination, called HAART- highly active antiretroviral treatment |
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what are the following used for
nucleoside RT inhibitors non nucloside RT inhibitors protease inhibitors fusion inhibitors integrase inhibitors |
HAART- HIV tx
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how is HIV controlled./prevented
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EDUCATIONL use condom, clean needles, know your sex partners
vaccines not ready yet, they dont elicit a strong enough IR |
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tell me a little about oncoviruses
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second category of retrovirus (HIV1/2 is in the lentivirus genra)
HTLV- 3 strains, 1-2 lead to transformation of target cells |
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tell me about the micro of the HTLV
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retrovirus (like HIV lentivirus)
NOT CYTOLYTIC like HIV, persist in host for years |
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is HIV or HTLV cytolytic
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HIV, recall it binds, fuses integrates, replicated and BUDS
HTLV doesnt do this, it persists inside the host for YEARS |
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tell me about the clinical of HTLV1
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asx for YEARS! can progress to Acute T cell lymphocytic leukemia after 30 year latency
**Maligannt proliforation of CD4 T cells --> lymphadenopathy, hepatosplenomegaly, popular cutaneous lesion |
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what retrovirus is associated with malignant proliforation of CD4 T cells
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HTLV-1
**can --> ATLL (acute t cell lymphocytic leukemia) after like 30 year latency **when we get the malignant transformation the asx disease progresses to hepatosplenomegaly, lymphadenopathy and papulo-nodular lesions of the skin |
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what is the additional gene seen in HTLV that is NOT seen in HIV
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TAX- transactivates genes for IL2 and IL2R (needed for cell proliforation)
**HTLV virus is in blood stream like HIV and infects CD4 cells |
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what does TAX do
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its seen in HTLV
1. transcriptional activation of cytokine, GF, and survival factors 2. abnormal cell cycle, repressed DNA repair 3. abnormal cell cycle inhibition of appoptosis, genomic instability **it should make sence. HTLV 1 is associated with acite t cell lymphocytic leukemia **the tax gene makes IL2 and IL2R that is needed for cell proliforation |
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what sim uncontrolled clonal proliforation that is seen in HTLV
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production of IL2 an IL2R from TAX gene in the ABSENCE of AG
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how is HTLV transmitted
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breast milk, sex, blood
HTLV infect T cells clonol proliforation of CD4 T cells by TAX alterations of host genome malignant expansion (ATL) |
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where might we see more causes of HTLV
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japan
caribbean central aftica AA |
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whats the most common way HTLV is spread in US, overall is this disease increasing or decreasing
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IVDA, blood transfusion
also canbe sexial transmission adn brest milk overall increase!!! bad news, latent for LONG time then makes cancer |
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what is the dx of HTLV
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1. HTLV AG or AB w/ELISA
2. atypical lymphs on peripheral smear 3. increases WBC 4. hx: japan, caribbean, skin lesion, neurological manifestation |
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what is the tx for HTLA retrovirus
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IGNa and AZT
lymphoma chemo EDUCATION to prevent spread |
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what disease
1. infects helper T cell, mono, macro 2. infects only helper T |
HIV 1
HTLV |
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what disease
is WORLD WIDE is limited to japan, caribbean, Africa, SE US |
HIV 1
HTLV |
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what is the transmission of HIV and HLTV
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BOTH are blood
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what causes and acute, latency, early and full on disease?
what about what causes acute t cell lymphocytic leukemia |
HIV
HTLV |
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what is the pathogensis of
HIV HTLV |
1. HIV- destruction of T cell, cytokine stimulation enhances HIV replication
2. incontrolled proliforation of T helper cells, transactivation of IL2 adn IL2R |
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whats the dx
1. decreased T, decreased CD4:CD8. what AB is detected 2. icnreased WBC, atypical lumphs, detection of what AB |
1. HIV; detect HIV AB
2. HTLVL detect HTLV AB |
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what is the tx for HIV, HTLV
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HIV: nucloside RT inhibitor, non nucleoside RT inhibitos, protease inhibitor, fusion inhibitor, integrase inhibitor, maturation inhibitor, antisense drugs
HTLV: IFNa, AZT |