Viral Stds

Front 1

what complications can STDs lead to in females?

Back 1

PID, infertility

Front 2

20 yr old college kid comes to office with penis lesions. he had them few yrs ago but went away until recently following stressful test. What is it?

Back 2

Herpes w classic latent/active phases

Front 3

What family subfamily and genus is herpes in

Back 3

herpesviridae, alphaherepes viridae, simplex virus

Front 4

Characteristics of virus

Back 4

Linear ds DNA
Enveloped
lytic/productive infection
latent infection hides in neurons

Front 5

what kind of chromosome does herpes have?

Back 5

linear dsDNA inside enveloped virus

Front 6

where does the lytic infection occur

Back 6

epithelium of exposed area

Front 7

where does latent herpes hide

Back 7

neurons

Front 8

Can u always tell by looking who has herpes

Back 8

No, It can be asymptomatic or latent

Front 9

What are the two ways to spread

Back 9

Sex, birth
mom must have active HSV-2 at birth

Front 10

how long does it take for symptoms to show

Back 10

5 days post infection
and 5-15 days it ulcerates and starts leaking fluids

Front 11

how does herpes hide

Back 11

enters neuron via retrograde transport up the axon and produces Latency Associated Transcripts

Front 12

what does herpes virus do when it enters cell

Back 12

causes transcription of many proteins to help out the virus

Front 13

herpes life cycle

Back 13

herpes-->cytoplasm-->nuke-->transcribe IE genes(genome replication)-->rolling circle DNA replication-->transcribe late gamma structural genes-->viral mRNA moves to cytoplasm for translation-->structural proteins migrate back into nuke-->virus buds via exocytosis

Front 14

How does herpes integrate into host DNA

Back 14

it DOESN'T! it stays episomal in plasmid form

Front 15

how long after clearance of lesions is herpes completely gone from body

Back 15

NEVER

Front 16

how does herpes reactivation occur?

Back 16

stress-->prodrome(tingle or burn at original site) few days before lesions appear

Front 17

Is reactivated infection worse or weaker than initial herpes infection

Back 17

reactivated is weaker symptoms

Front 18

neonatal herpes

Back 18

from mom with active HSV-2 at birth
enters baby liver, lung, CNS-->sepsis, skin lesions, death, MR,

Front 19

how to prevent neonatal herpes?

Back 19

give mom Herpes drugs during birth.
C-section

Front 20

herpes evades immune response

Back 20

latent in neurons, move cell-to-cell, replicate in epithelia

Front 21

Herpes Tx:

Back 21

no vaccine
acyclovir, valacyclovir, penciclovir, famciclovir
acyclovir works best in rapid growth cells

Front 22

how does acyclovir work?

Back 22

inert by itself, must be activated by phosphorylation by thymidine kinase, incorporates into viral DNA and messes it up
doesnt help latent virus
resistant herpes evolving(mutants are less virulent)

Front 23

Px; of Herpes

Back 23

no sex until lesions clear
health care workers wear gloves
CONDOMS
C-section birth for herpes mom
future vaccine??

Front 24

HSV-1 vs HSV-2

Back 24

both similar but HSV-2 is genital and HSV-1 more commonyl cold sores

Front 25

sex active 18yo comes for pap smear. had gonorrhea 2 yrs ago. abnormal pap smear. cervical warts. what is it?

Back 25

HPV

Front 26

What kind of chromosome is HPV

Back 26

dsDNA circular 8 kb in non-enveloped virus
100 serotypes based on DNA sequence

Front 27

What two syndromes can HPV cause

Back 27

cutaneous-types 1-4 cause warts that self-resolve in 3-4 months

Mucosal-types 16 and 18 cause warts and cervical dysplasia, asymptomatic, soft flesh colored warts--cancer in 1 to 4 years

Front 28

How common is HPV

Back 28

Scary common-most prevalent STD in USA WRAP IT UP

cervical cancer is 8 leading cancer killer in US women

Front 29

HPV lifecycle

Back 29

infect squamous epithelium or mucus membranes-->induce epthelial proliferation-->warts in 3-4 months-->can regress spontaneously

Front 30

how hoes HPS cause cancer?

Back 30

drives cells falsely into S phase and grow rapidly

screws with E6 and E7. E6 prevents p53 from regulating growth of DNA damaged cells

Front 31

HPV-->cancer

Back 31

cells grow lots and eventually poke through basement membrane and keep growing
caused by type 16 and 18

Front 32

Dx: Type 16 and 18 HPV

Back 32

visual warts
histology: hyperkeratosis of epithelium and papanicolaou stain causes clear staining nuke
PCR/DNA probes
NOT ELISA or CULTURES

Front 33

what does abnormal pap smear look like?

Back 33

malformed cells, enlarged nuclei

Front 34

Tx: Px: and control of HPV

Back 34

self limiting
cryotherapy, chemicals, excision
condoms
HPV Vaccine:Gardasil(women)

Front 35

what is gardasil?

Back 35

quadrivalent recombinant protein vaccine
L1 coat proteins from 6, 11, 16, 18
must be given before infection

Front 36

Hep B virus

Back 36

hepadnavirus
hepatocyte specific
partially dsDNA circular
enveloped

Front 37

What is common between all types of Hepatitis viruses

Back 37

site of infection

Front 38

Weird Hep Life cycle

Back 38

virus binds liver via HBsAg-->DNA goes to nuke and becomes fully dsDNA-->integrates into liver genome but remains latent-->host regulates transcription-->RNA packed into virion-->(-) DNA made by RT in core-->RNA degraded-->(+) DNA made

Front 39

what does immune system do to Hep B

Back 39

clears it 90% of time
10% of time it becomes fulminant, primary and cirrhotic

Front 40

Spread of Hep B

Back 40

sex, blood, dirty needle
move from enrty poitn to liver and multiply in liver
patient symptom free for up to 45 days
can be acute, chronic, symptomatic, asymptomatic

Front 41

Hep B sydromes

Back 41

acute-long incubation, insidious onset, fever, malaise, jaundice, nausea, ab discomfort, dark pee, pale stools

hypersensitive rxns due to Ab-HBsAg complex

Front 42

Dx: Hep B

Back 42

symptoms
liver enzymes high
HBsAg and HBcAg in blood
BEST: anti HBc IgM

Front 43

Tx Px and control of Hep B

Back 43

IFN and anti herpes drugs??
screen transfused blood
vaccinate early with recombiannt HBsAg