Skin: 10. Blue : Viral Rashes And Mucocutaneous Infections B19 Parvovirus; Papillomaviruses

Front 1

what are the 3 major fever/rash diseases seen in children

Back 1

roseola, B19 parvovirus, papillomavirus

Front 2

were is the target cell for parvovirus?

Back 2

the bone marrow

Front 3

what is the major disease/syndrome seen with B19 parvovirus

Back 3

Fifth's disease (aka slapped cheek disease)

Front 4

a patient comes in with a lacelike rash on their arms as well as a rash on the cheeks of the face. What is the likely cause of this?

Back 4

B19 parvovirus

Front 5

Transient aplastic crisis (TAC) is what? what causes it?

Back 5

affects precursor cells to red blood cells; see persistent anemia
in immunodeficiency

caused by B19 parvovirus

Front 6

how is B19 parvovirus spread?

Back 6

primarily by respiratory droplets

very common

Front 7

what age will you see the majority of parvovirus infected patients?

Back 7

6-15 account for 70%

Front 8

if a woman is not immune to B19 PV at the time of conception, is there concern that the child can get the virus?

Back 8

vertical transmission in approximately 1/4th of primary maternal infections.

90% of those are inconsequential again though

Front 9

how does B19 PV spread in the body?

Back 9

breathed in, cause fever, then move via lymph and blood to bone parrow

Front 10

what stage in erythropoesis do you have infection via B19

Back 10

at the proerythroblast stage it is expressing a large amount of P-antigen which the B19 virus can affect (may want more detail in this)

Front 11

what will you see in a blood smear of someone with B19 PV?

Back 11

you wont have reticulocytes (they aren't produced)

Front 12

where does B19 get replicated?

Back 12

in proerythroblasts

Front 13

why do RBCs get destroyed (hemophagocytic syndrome) when you have B19PV?

Back 13

the RBCs will be covered in B19 virus so macrophages come and destroy them, because they now appear to be foreign

Front 14

in addition to proerythroblasts, what expresses P-antigen? what effect can this have?

Back 14

Granulocytes and megakaryocytes have them

B19 can thus disrupt monocyte and platelet formation

this is small though

Front 15

What is the major receptor for the B19PV?

Back 15

p-antigen

Front 16

how do you get arthritis associated with B19PV?

Back 16

immune complexes will aggregate in the joint fluid

Front 17

how do you get rash associated with B19PV?

Back 17

immune complexes will aggregate on the wall of blood vessels

Front 18

before the rash occurs in erythema infectiosum what would you see in a blood smear?

Back 18

no reticulocytes

due to B19PV

Front 19

a patient comes in with a fever of unknown origin. You do a blood smear and find no reticulocytes. What do you know they have?

Back 19

B19 Parvovirus

Front 20

an adult male comes to your office with rash on the hands and feet, what do you think they have?

Back 20

gloves and socks syndrome

due to B19PV

Front 21

when does gloves and socks sydrome occur ?

what about Fifth's Disease?

Back 21

gloves and socks: at the time of the infection of B19pv

5ths: later than infection

Front 22

what causes the gloves and socks appearance?

Back 22

underlying capillaries have P-antigen that B19PV can bind to

the surface also has virus that can be easily transmitted

Front 23

What is non-immune hydrops fetalis?

Back 23

B19PV infection during pregnancy

greatest chance of adverse outcome is between 11 and 23 weeks of gestation.

affects the liver of child leading to anemia

fatality rate of 50%

Front 24

what is a preventative treatment of non-immune hydrops fetalis?

Back 24

fetal transfusion beneficial,
also postnatal IVIG

Front 25

what is Transient Aplastic Crisis (TAC):

Back 25

Follows B19 infection of patients with sickle cell disease, other hemolytic anemias, iron deficiency, ά and β thalassemias, other RBC deficiencies (rapid RBC turnover

Short RBC half-life (4-10 days) in SCA leads to hemoglobin deficiency

Front 26

a patient with known and managed sickle cell disease comes to your office and is seriously anemic. Upon blood smear you find no reticulocytes. you immediately order a transfusion because your patient has?

Back 26

Transient Aplastic Crisis (TAC)

B19PV

Front 27

MAKE CARDS OFF SLIDE 10

Back 27

it basically lays out how to diagnose

Front 28

papilloma virus causes what?

Back 28

benign tumors (warts)

Front 29

what is responsible for 95% of malignant cervical carcinoma?

Back 29

HPV

Front 30

what is the most common sexually transmitted disease in the world?

Back 30

HPV

Front 31

Where does BK virus effect?

Back 31

kidney

Front 32

JC virus causes infection of the?

Back 32

brain

Front 33

What 2 genes in HPV are important in causing problems in humans?

Back 33

E6 and E7 genes

affect cell cycle proteins

Front 34

what does the E7 gene of papilloma virus cause?

Back 34

retinoblastoma gene

no stop signal for growth

Front 35

what does the E6 gene of HPV do?

Back 35

inhibits p53

promotes telomerase

Front 36

what is a condyloma?

Back 36

mucocutaneous warts seen in HPV

high potential for malignancy

Front 37

what layer of skin does the papilloma virus infect?

Back 37

basal layer

Front 38

does the B19 parvovirus replicate in the basal layer?

Back 38

no just infects, doesn't have everything it needs to replicate

Front 39

what is acanthosis?

Back 39

hyperplasia of prickle cells in skin that leads to development of wart in HPV

Front 40

what are koilocytes?

Back 40

site of virus replication for HPV

Front 41

you see large vacuoles with inclusion bodies on a slide of a suspected HPV patient. What are you looking at?

Back 41

koliocytes