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84 Cards in this Set
- Front
- Back
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Diagnosis of HPV infections
(Papovavirus - naked DNA) |
Wart can be confirmed 1)microscopically = hyperplasia of the prickle cells & excess productions of keratin (hyperkaratosis)
2) Pap Smear - appearance of koilocytotic squamous epithelial cells 3) DNA molecular probes 4) PCR |
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Treatment and prevention of HPV (Papovavirus- naked DNA)
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Warts are removed by surgical methods
Injection of interferon is beneficial Avoid direct contact with infected tissue Vaccine:Recombinant vaccine has HPV L1 capsid protein |
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What are the characteristic features of JC (Polymovirus - naked DNA)?
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1) gait disturbances usually leading to hemiparesis
2) muscle weakness 3) cognitive abnormalities |
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How to diagnosis BK or JC (polymoviruses - naked DNA)?
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1) Urine cytologic tests can reveal BK and JC
*basophilic intranuclear inclusions 2) in situ immunofluorescence 3) immunoperoxidase 4) DNA molecule probes 5) PCR analysis of (CSF, urine, or biopsy material) |
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Treatment for BK or JC?
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No specific treatment for polyomavirus
* can decrease the amount of immunosuppression |
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Tissues the adenovirus (naked DNA) can infect?
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1) eye
2) respiratory 3) GI 4) urinary |
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Once you contract adenovirus are you susceptible to re-infection?
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No and Yes
You are protected against that serotype BUT not other serotypes |
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What is the diagnostic hallmark (histologically) for adenovirus?
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presences of intranuclear inclusions
*consist of viral DNA and proteins other diagnostic tools utilized are: 1) Immunoassay (ELISA) 2) PCR 3) DNA probe |
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Treatment for Adenovirus?
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No specific therapy
Live oral vaccines for Ad4 and Ad7 are available for military |
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Diagnosis of B19 (parvovirus- ssDNA)?
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Diagnosis of Ertythema Infectisoum (fifth's disease or slapped cheeks) is based on clinical presentation
Hydrops fetalis detected by ultrasound IgM and IgG ELISAs or can detect viral DNA by PCR |
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Treatment of B19 (parvovirus -ssDNA)?
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immunoglobulin preparations are effective against PRCA
prospect of a vaccine is good |
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What are all the herpesviruses?And what do they all have in common?
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Herpes Virus 1 &2, VZV, CMV, EBV, Kaposi sarcoma
* they all can produce a productive and latent infection *produce a life long infection |
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What can primary infections and reactivations of herpes be treated with?
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acyclovir
- which works by being phosphorylated by a viral thymadine kinase then cellular kinases get it to a triphophate which is its active state - integrate in to DNA - cause chain termination |
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What is the treatment for VZV (enveloped DNA)?
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protective vaccine is recommended for infants
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What two viruses produce intranuclear inclusions?
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1)adenovirus
2) CMV |
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What cells do CMV replicate within?
Where is the latent virus harbored? |
The initial infection replicates within WBC
The latent infection is harbored by monocytes |
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Therapy for CMV (enveloped DNA)?
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gancyclovir
* phosphorlyated by the viral kinase and inhibit viral DNA polymerase |
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What cell type does EBV like to live in?
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B cells - immortalizes them
this is what leads to Burkitt's lymphoma |
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Detection of EBV?
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EBV IM - detected with anti-VCA titer (viral core antigen) and hertophile Ab test
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Treatment for Herpesvirus-8 (Kaposi Sarcoma)?
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gancyclovir only somewhat effective
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What is the characteristic that makes poxvirus different?
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They are a enveloped dsDNA virus that can replicate in they cytoplasm
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What are some of the complications with the vaccine for Poxvirus?
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1) CNS
2) dermal 3) encephalitis |
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Diagnosis for smallpox (Variola poxvirus)?
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1) EM
2) gel diffusion of vesicular scrapings 3) Guarnieri's bodies 4) PCR |
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Diagnosis of Molluscum Contagiosum?
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*correlation between the extent and severity of molluscum contagiosum and a low count of CD4+ T lymphocytes
1) histologic examination 2) Henderson Paterson inclusion cells by EM 3) Cidofovir |
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Therapy for Molluscum Contagiousum?
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Local therapy with carbon dioxide laser, cryotherapy with liquid nitrogen
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What viruses are included in the picornaviruses?
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(Enterovirus) Poliovirus, Cocksackie A & B, Echo & Entero-viruses, (Rhinovirus), and Hepatitis A
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What viruses are included in Arbovirus?
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Yellow Fever virus
West Nile virus Dengue Virus |
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What is the transmission, spread, and destination of poliovirus?
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Transmission: fecal- oral
Spread: Viremia Reaches: CNS * incubaction for a few days * Can cause everything from a subclinical disease to minor illness to aseptic meningitis or frank poliomyelitis |
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What is Frank Poliomyelitis?
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an acute gray matter inflammatory spinal cord disease
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What are the two different polio vaccines?
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Salk = killed poliovirus vaccine by chemical inactivation of WT
Sabin = live attenuated vaccine by repeated passage of each of the three strains through tissue culture. |
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Advantage and Disadvantage to the Salk Poliovirus vaccine?
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Advantage: cannot revert to virulent strain = more stable
Disadvantage: possible inadequate inactivation & no spread in the community |
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Advantage and Disadvantage to the Sabin Poliovirus vaccine?
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Advantage: easily administed by the oral route & spreads through the community. Also it grows poorly in the CNS and does not cause paralysis
Disadvantage: possible reversion & can not be cleared by agammaglobulinemic individuals (not used in immunocompormised) |
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Diagnosis of an Enterovirus (Cocsackie A &B and Echo)
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Virus can be identified via the use of a specific antibody or RT-PCR
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Treatment for Enterovirus (Cocsackie and Echo)?
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Pleconaril
* administered only early in infection **major control is improvement of hygiene and living conditions |
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Why can rhinovirus only grow in the Upper Respiratory Tract?
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Because it needs to grow at 33C
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What causes the runny nose symptoms with the rhinovirus?
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The cells release bradykinin and histamine
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Treatment options for Rhinovirus?
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1)Nasal vasoconstrictors - temporary relief (can worsen symptoms)
2) arildone and rhodanine- block uncoating of the virus *too many serotypes for a successful vaccine *good hygiene and living conditions |
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What are the two genera under togaviridae (+ssRNA - in cytoplasm)?
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1) alpha virus (arbociruses)
2) rubivirus (rubella - not an abrovirus) |
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What are the three genera undeer flaviviridae (+ssRNA - in cytoplasm)?
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1) flavivirus (arbovirus)
2) pestivirus 3) hepacivirus (hep C - not arbo) |
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What are the three areas of the body the alpha virus likes to target?
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skin - rash
joints- arthritis nervous system - encephalitis |
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What are the three components found in the synovial fluid of people infected with alpha virus?
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1) increased protein
2) CD4 Lymphocytes 3) activated macrophages * this is not due to immune complex deposition * the rash isn't due to immune complex deposition either - CTLs and monocytes |
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What are the main cellular targets for the flaviviruses?
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monocytes and macrophages
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Where is yellow fever maintained (flavi - +ssRNA)?
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South America through jungle transmission cycle
Africa through Aedes aegypti mosquito |
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What flaviviruses can lead to Fever with Rash?
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West Nile and Dengue
* low grade fever 1-3 days * "breakbone fever" * febrile and pain in bones and muscles *rash on day 2-5 - becomes petechial ** don't develop hemorrhagic fever then usually survive |
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What flaviviruses can lead to hemorrhagic fevers?
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Yellow fever, dengue fever, and less common Kyasanur Forest disease and Omsk hemorrhagic fever
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How to diagnosis alpha and flavivirus?
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PCR based methods and serologic detection methods also exist fort these viruses
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Treatment for Flavi and Alpha viruses?
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*Elimination of the vector and the breeding ground
*Live vaccine for Yellow fever * Killed vaccine for EEE, WEE, Japanese and Russian encephalitis = only given to high risk people |
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How is Rubella (+RNA) diagnosed?
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Confirmed by anti-rubella IgM
Isolation of the virus is difficult |
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Treatment for Rubella (+RNA)?
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No treatment for rubella
* prevented by vaccination with a live, cold adapted strain - administered in MMR |
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What are the target tissues for bunyavirus?
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CNS
liver kidney endothelium |
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What are the important clinical syndromes of bunyavirus?
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1) encephalitis - incubation 1 week then abrupt onset
2)Hemorrhagic fever- fever and bleeding (death in 1/2) 3) Hantavirus pulmonary syndrome - fever, muscle aches, pulmonary edema followed by respiratory failure |
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Diagnosis of Bunyavirus (+RNA)?
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Seroconversion detected by ELISA
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Treatment, prevention, and control of Bunyavirus(triple segmented, +ssRNA)?
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no treatment for bunyavirus
prevention is control of the arthropod vector *Rift Valley fever vaccine available |
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Diagnosis of orthomyovirus (-ssRNA)?
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1)Virus isolation
2) Viral antigen detection 3) PCR 4) 4x antibody rise in acute/convalescent sera |
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Treatment and Prevention of Orthomyovirus (-ssRNA, segment genome)?
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Vaccines
1) Formalin reactivated * grown in egg * need yearly vaccines 2) Live attenuated vaccine * intranasal route *mutations that have disabled the ability of the virus to multiply at normal temperatures of the lower respiratory tract 3)Amantadine Rimantidine - inhibits the uncoarting or late in cycle by preventing type A virus maturation *drug resistant variants have mutation in M2 * M2 drugs have been removed by the CDC |
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What are the two neuraminidase inhibitors used against orthomyxovirus?
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1) Zanamavir
2) Oseltamavir |
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What is the hallmark feature of the paramyxoviridae (measles, mumps, RSV, and parainfluenza = nonsegemented -RNA)?
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Induce cell-cell fusion within the cytoplasm at a neutral pH, creating mutlinucleated giant cells.
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Does infection of the measles virus produce life long immunity?
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Yes!
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What leads to atypical measles?
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occured in some people who received the older inactivated measles vaccine
*more intense presentation of measles (prolonged fever & skin lesions) |
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Treatment for Measles?
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1)Ribavirin may reduce symptoms
2)High does of Vitamin A 3)Immune globulin for immunocompromised *Live attenuated vaccine in MMR |
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When is the MMR vaccine administered?
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15-24 months and at 4-6 years
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Treatment and Prevention of Mumps?
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No specific drugs
* treat orchitis with IFN-alpha-2B **live attenuated mumps vaccine is used |
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What is the major cause of pneumonia and bronchiolitis in children?
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RSV
* natural immunity doesn't prevent re-infection |
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Treatment, Prevention and Control of RSV (non segmented - RNA)?
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1) supportive care - oxygen and removal of plugs
2)Drugs: cortiocsteriods = anti-inflammatory, ribavirin for severe cases 3) Passive immunoprophylaxis *IV - RSV-IVIG * Palivuzimab - monoclonal antibody against viral F protein - administered with high risk infants **No prophylactic vaccine |
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Treatment, Prevention and Control of Human Parainfluezna Vaccine(nonsegmented -RNA)?
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1) supportive care: nebulized cold or hot steam
2) Drugs: large doses of corticosteriods may shorten croup **passie immunoprophylaxis and vaccines: not available |
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What is the major cause of croup (laryngotracheobronchitis) in children?
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Human Parainfluenza Virus
*infection doesn't lead to natural immunity *second to RSV for respiratory diseases |
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Treatment for Rhabdovirus (enveloped, nonsegmented, -RNA)?
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No successful treatment once clinical symptoms have set in = fatal
*immediate prophylaxis *multiple doses of rabies vaccine *anti-rabies immunoglobulin *wound care |
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What are the three dsRNA viruses of the Reoviridae family?
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1) Reovirus
2) Orbivirus 3) Rotavirus *non-enveloped double shelled capsid *viral replication in cytoplasm |
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What does Rotavirus lead to? What is the treatment?
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Leads to infantile diarrhea
*RotaTeq vaccine released soon |
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Why does syncytia formation occur in HIV?
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Syncytia form as a consequence of the fusion of the infected cells with CD4+ T cells mediated by env proteins on cell surface
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How is AIDS defined?
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AIDS is defined by HIV infection + CD4 T cell count <200 OR Acquiring an AIDS defying illness
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Treatment for AIDS?
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HAART (Highly Aggressive Anti-Retroviral Therapy)
* Reverse Transcriptase inhibitors: AZT-zidovudine, ddI,ddC,d4T *nucleoside inhibitors: chain termination and competative inhibition *non-nucleosides - bind away from the active site and inhibit enzymatic activity Protease inhibitors: target active site and prevent cleavage |
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What are the 4 clinical phases to viral hepatitis?
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1) incubation period
2) prodrome - fever, fatigue, malaise, nausea, vomiting 3) icteric stage - jaundice and liver enzymes 4) convalescent period - histopathological lesions observed in the liver * HV not cytolytic |
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Hepatitis Viruses leading to chronic infection?
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HBV, HCV. HDV
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Hepatitis viruses leading to cancer?
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HBV & HCV
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Treatment for HAV?
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Treatment: no specific treatment usually just supportive care
prevention: avoid contaminated food and water passive immunization: Immune serum globin *active immunization: formalin killed vaccine |
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What is different about HBV?
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dsDNA instead of ssRNA like all the other hepatitis viruses
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How to diagnosis HBV?
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can be distinguished by the pattern of antibodies to the individual HBV antigens in the serum of the patient
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Treatment and Prevention of HBV?
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Prevention screen donated blood for HBsAg and anti-HBc
1) Immunomodulatory agents: * Nonspecific: interferons *Viral specific: Therapeutic vaccine *Cell based: adoptive immune transfer 2) Antivirals *nucleoside analogs: lamivudine, famciclovir *glycosylation inhibitors: inhibit viral assembly *Gene therapy: antisense, ribozyme, targeted drug delivery |
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Treatment for HDV?
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no specific treatment- just need to prevent, treat, and control the HBV infection
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Diagnostics for HCV?
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Screening blood donors for the prescnece of antibody to HCV antigens
ongoing infections are validated by HCV RNA assay analysis = genotyping of the virus |
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Treatment for HCV?
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HCV genotypes 2 &3 = respond to current antiviral therapy
*Ribavirin + IFN-alpha (1000 mg daily for 6 months for 2&3 and 12 months for genotype 1) |
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Diagnosis for HEV infection?
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an enzyme immunoassay (EIA) that measures antibodies for HEV
*presence of anti-HEV IgM indicates recent infection |
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Treatment for HEV infection?
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There is no current treatment for HEV infection
*vaccine is in clinical trials |
