Micro Winter Final Sti- Hsv, Hpv

Front 1

what are the 2 types of HSV infection

Back 1

Type I: oral. get EARLY in life, fever blister

Type II: genital. more viscous, onset of sexual activity

Front 2

HAV I and II are part of what viral family

whats the DNA

Back 2

alpha-herpes virus

single linear dsDNA

Front 3

what 2 thigns are important in HSV patogenicity

Back 3

1. ability to penetrate CNS and replicate
(gets in and replicates locally but then gets into sensory ganglia and replicates there as well)

2. Ability to establish LATENCY

Front 4

where does HSV replicate

Back 4

in the host NUCLEUS

*at site of entry adn CNS

**causes DESTRUCTION

Front 5

what happens to the host cell as HSV replicates

Back 5

it replicates in the nucleas and this DESTROYS host- ballooning, intranuclear inclusions, giant cells form

**so this destructino can happen but it can also be latent and NOT cause damage

Front 6

does HSV always get into host and just start replicating like crazy and destroy host cells

Back 6

nope, hangs out quiet and latent

Front 7

what type of HSV is...

1. oral
2. genital
3. more likely to recurr

Back 7

oral I

genital II

reoccur: II

**these are guidlines, sexual practices can move these around, also there is some cross imminuty but NOT enough for resistance

Front 8

what stain is used for HSV

Back 8

Tzank

Front 9

HSV...


1. Primary Infection
2. Recurrent Infection
3. Initial Infection

Back 9

1. Primary infection: occurs after FIRST exposure, if type I primary infection occurs early in life NO HSV AB,

2. Recurrent infection: recrudescence of an established HSV infection

3. INITIAL: pts that have AB to one type but then are first exposed to a second type

Front 10

what is the worst for preggo mom

primary
recurrent
initial

Back 10

primary infection is a HUGE risk for the baby

Front 11

ok so your pt has HSV I IgG but then recently is exposed to HSV II though sexual contact. what is the type of HSV II infection

Back 11

INITIAL

**this is when you ahve one and then get the other

**primary is the first time you are exposed
**recrurrent is recrudescence of an establised infecion

Front 12

what is does the primary HSV II infection look like

Back 12

painful macules/papules --> vesicles (great spreading!!!) --> pustule/ulcer

**fever, maliase, lymphadenopathy

**more severe in females
**lasts about 3 weeks

**recall primary is the FIRST time you are exposed

Front 13

what type of tissue does HSV LovE

Back 13

transitional epithelium

Front 14

what does an initial HSV 2 infection look like

Back 14

this happens when you have been exposed previously to HSV 1 but are then exposed to HSV for the FIRST TIME

**less severe and heals faster (<3weeks) than a PRIMARY infection

Front 15

why is an initial HSV 2 infection less severe than a primary HSV 2 infectino

Back 15

in an initial infection you ahve been exposed to HSV 1 and so will have limited immunity

**can suppress initial infection w/acyclovir but can still be xmitted

Front 16

in what cell type does HSV establish latency

will it remain in latency

Back 16

ganglion cells

nope, recrudesence can occur even WITH good immune system- the more severe the intial outbreak the more liekly you will have lots of recurrence

Front 17

do HSV lesions scar

Back 17

not really, even if you have multiple outbreaks in the same ares

Front 18

what is a discordant couple

Back 18

if one has HSV and the other does not.

Front 19

can you autoinoculate HSV

Back 19

you bet

if you ahve a sore dont be touching thigns!

Front 20

how often do HSV reinfections occutr

Back 20

1/3 get 1-2
1/3 get 4-7
1/3 get >8
**if initial infection was SEVERE its more liekly to have recurrence

Front 21

when is HSV infection spread

Back 21

ANYTIME!!

if you have clinical sx its easier but can still xmit w/o sx

Front 22

does humoral immunity (AB) prevent HSV reinfection

Back 22

nope

**we often see recurrence when we are stressed and immunity is decreased

**transplacental AB from mom are NOT totally protective for baby

Front 23

what other animals get HSV

Back 23

NONE, humans are hte only reservoire

there is an increase in rate of xmission

Front 24

how is HSV spread?

when is most spreading

Back 24

from vesicular fluid, saliva and other secretions of infected ppl

**MOST ARE SPREAD WHEN ASX!!!!!!

**in order to infection the virus must enter mucosa through an abraision

Front 25

HSV I is acquired when
what about II

Back 25

I- young, early in life, from parnets

II- later, onset of sexual activity

MOST PPL q/HSV II dont know they have it. scary

Front 26

if you have an acitve HSV I infection does this make it less likely to get HIV bc you have maximal AB

Back 26

NO!!!! its EASIER to get HIV bc you have an open sore from the HSV I

Front 27

who gets HAV more M or F

married or divorced
city or rural

what is stongest rpedictor of getting HSV infection

Back 27

Female

more common in divorced/single
more common in cities

MULTIPLE sex partners

Front 28

is neonatal HSV infection something to worry about

Back 28

OH YA!

**can be acquired in utero bc moms AB are NOT protective or as babe passes through birth canal (a primary infection is esp worrysome)

**fetal scalp monitors can be a site of viral inoculation, CI in mom w/Hx HSV 2

Front 29

whats the most common form of HSV infection during preggo

Back 29

recurrent infection, good bc its less severe and worrysome (primay infectino is BAD, initial is also not good)

Front 30

what are 3 pays HSV can be given to neonate

Back 30

1. in utero (rare)

2. during birth

3. post natal- from mom kissing the babe or whatever

**mom having HSV AB are good bc they can help protect but BAD bc they put baby at risk for exposure

Front 31

we know some HSV infectinos are asx (most ppl doent know they have it) is this true for neonatal infection

Back 31

nope, almost always sx, sometimes lethal

Front 32

what are some manifestations of neonatal HSV infection

Back 32

1. Encephalitis (micro/hydroencephalopathy)
2. skin disease
3. eye disease

**disseminated disease has WORST prognosis

Front 33

how is HSV dx

Back 33

tissue sample: ballooning pathology (from viral replication), Tzank smear, COWDRY A inclusions

PCR to detect HSV DNA- wont ID active/latent infection

Culture > PCR

test for AB is asx pts

Front 34

does PCR ID active vs latent HSV infections, what is a better method

Back 34

nope

culture > PCR

**if you sample the tissue you can have Tzank cells, coqqdry A inclusions etc

Front 35

whats the tx for HSV

Back 35

acyclovir will suppress but...

NO Tx will elimiate latency/recurrent infection

**also can still spread

Front 36

long term tx of acyclovir for HSV is good for what

Back 36

decrease recurrence, will STILL shed virus

Front 37

how is HSV prevented in babes

Back 37

c section, major infection risk is initial or primary infection. so its in moms who are HSV - but become + at some point in preggo

vaccine in works

Front 38

what is the deal with HPV

Back 38

initial infection is manageable but can progress to...

1. warts (6,11)
2. Cervical cancer (16,18)

Front 39

what viral family is HPV in

Back 39

papova virus

HPV is the largest and most complex virus in this family

circular dsDNA

Front 40

we know HSV causes latent infection, what about HPV

Back 40

yep

Front 41

are HPV virus resistant

Back 41

ya! they are TOUGH!!!

resist ether, acid, heat. this means that its hard to kill it with laser surgery or coagulation procedure

Front 42

what cells are infected with HPV

how is HPV replicated

Back 42

basal epithelium (so as the infected cell divides the daughter cell moves away from the BM and differentiates into epithelium)

**replication of HPV is not well understood. linked to host cell division. virions are made only in the differentiated cells

Front 43

hoe does HPV get into the basal cells

Back 43

through breaks in skin

**the HPV then stim the basal cells to divide and differnetiate into epithelium. the virion is only released through differentiated epithelium NOT hte basal cells.

**evades immune system

Front 44

what causes the wart in HPV

Back 44

its viral induced division which increases numper of cells and causes thickening whoch is the wart (6/11)

Front 45

common warts

what are they called, what are they caused by

Back 45

common (cutaneous warts) are called verruca vulgaris and are caused by HPV 1-4. flat!!

Front 46

whats a plantar wart

Back 46

flat hyperkeratotic region on the feet, can be painful!!!

the common warts on teh skin are caused by HPV 1-4 and are called common (cutaneous) warts (verruca vulgaris)

Front 47

whats condylomata acuminta

Back 47

genital warts

caused by HPV 6 or 11

**grey, fleshy color

Front 48

cervical dysplasia is caused by what

Back 48

HPV 16,18

Precancerous lesion of cervical epithelium

Front 49

what are respiratory papillomatosis

Back 49

juveline form of HPV <5 yp

caused by 6/11

**kid aspirated warts from the mom during birth (condylomata acuminata)

Front 50

how does HPV 16 18 cause cervical cancer

Back 50

E6: degrades p53
E7: binds to and inactivated Rb
p53
Rb

**net= trigger cell cycle progression

**this alone does NOT explain development into cancer, there are way more NON malignant infections

Front 51

when we have HPV that does indeed cause cancer what can be said about the genetics

Back 51

Viral DNA is integrated into host and E6/7 are expressed. E2 is inactivated

*in NON malignant cells E2 is still expressed and so E6 and E7 are not overexpressed

Front 52

how is HPV spread

Back 52

direct skin contact, genital contact, fomite transmission

ENDEMIC

Front 53

what increases the transmission of plantar warts

Back 53

seen more in winter
associated with heated swimming pools and communal baths

**common warts are in kids and are HPV 1-4

**ppl who handle meat, pultry, fish are lieky to get wart infections

Front 54

HIV infection affectes HPV infection how

Back 54

more likely to get HPV if you have HIV

**the immune suppression in HIV makes it more likely to get anogenital HPV infection

Front 55

whats the most common VD in US

Back 55

HPV

Front 56

what HPV is in the vaccine

Back 56

6 11- warts

16 18- cancer

Front 57

how is HPV dx

Back 57

clinical findings- pap, warts

Hiso is NO good for latent infection. but for active infection will see koilocyte- large vacules

Front 58

is recurrence of HPV common

Back 58

ya

Front 59

how is HPV prevented

Back 59

pap smear

HPV DNA test <30yo

Front 60

molluscum contagiosum is part of what viral family

Back 60

pox virus

DNA, replication in our cytoplasm

typically we fight this off so easily, bigger problem for our HIV pts

Front 61

what is clinical manifectation of MCV infection

Back 61

Molluscum contagiosum

skin infection- multiple, small white lesions. seen in genital/anal area.

not a big problem when healthy but big problem in HIV

Front 62

whats the spread of MCV

Back 62

direct contact, usually sexual contact

**lesion goes away on own. its NOT inflammatory

This disease was regarded as trivial and treated for largely cosmetic reasons until the advent of large numbers of AIDS patients