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213 Cards in this Set
- Front
- Back
What are 3 types of viral structure and what does each contain
|
1. naked icosahedral
-just icosahedral capsid and nucleic acid 2. enveloped icosahedral -surface protein, lipid bilayer, capsid, nucleic acid 3. enveloped helical -surface protein, lipid bilayer, matrix/core protein, nucleic acid+capsule attached |
|
Viral recombination
|
Exchange of 2 genes between 2 chromosomes by homologous crossing over
|
|
Viral reassortment
what do these cause |
Viruses with segmented genomes exchange segments
high frequency, cause of worldwide influenza pandemics |
|
viral complementation
|
when 2 viruses infect a cell
1 of the viruses has a mutation that makes a non-functional protein the other virus 'complements' the first by making the protein to serve both viruses |
|
phenotypic mixing
|
Infection with both type A and type B virus
Type A genome may be coated with surface proteins of coat B infectivity determined by type B protein coat, but all progeny will have type A coat/genetic material |
|
Viral vaccine
what do live attenuated vaccines induce 5 examples |
induce humoral and cell-mediated immunity
smallpox, yellow fever, chicken pox, Sabin's polio, MMR "Live! see SMALL, YELLOW, CHICKENS get vaccinated with SABIN'S and MMR!" |
|
live attenuated vaccines
a. do you need a booster b. who should you NOT give these to and why |
a. no booster needed
b. don't give to immunocompromised or their close contacts because they can revert back to virulence |
|
only live attenuated vaccine that can be given to HIV patients
|
MMR
measles, mumps, rubella |
|
Killed vaccines induce what?
4 examples |
induce only humoral immunity
Rabies, Influenza, salk Polio, hAv RIP Always |
|
2 examples of recombinant vaccines
|
1. HBV - antigen = recombinant HBsAg
2. HPV (types 6,11,16,18) |
|
DNA viral genomes
all are dsDNA except ...? all are linear except...? |
parvovirus (ssDNA)
Papilloma, polyoma, hepadnavirus (circular) |
|
All RNA viruses are ssRNA except...?
|
Reovirus (dsRNA)
- rota and coltivirus "double stranded because it needs to REpeatO" |
|
Positively stranded RNA viruses (7)
|
I went to a RETRO (RETROvirus) TOGA (TOGAvirus) party, where I drank FLAVored (FLAVivirus) CORONA (CORONAvirus) and ate HIPPY (HEPEvirus) CALIfornia (CALcIvirus) PICKLES (PICOrnavirus)
retrovirus, togavirus, flavivirus, coronavirus, hepevirus, calcivirus, picornavirus |
|
naked viral genome activity
purified nucleic acids a. are infectious b. are not infectious c. why aren't these infectious |
a. viruses with dsDNA (except pox and HBV) and (+) strand RNA
b. (-) strand ssRNA and dsRNA are not infectious c. need enzymes contained in complete virion |
|
which viruses are diploid?
which are haploid? |
diploid = retrovirus (2 ssRNA copies)
haploid = everything else (1 copy of DNA or RNA) |
|
Where do DNA viruses replicate
exception |
nucleus
poxvirus |
|
where do RNA viruses replicate
exceptions |
cytoplasm
influenza virus (orthymyxo) and retrovirus |
|
Naked viruses (7)
|
Naked CPR and PAPP smear
Calcivirus Picornavirus Reovirus Parvovirus Adenovirus Papilloma Polyoma |
|
Where do most viruses acquire their envelope
1 exception |
Most viruses acquire envelopes from the plasma membrane when they exit a cell
Herpesvirus acquires envelope from the nuclear membrane |
|
Herpesvirus (HSV 1 and 2, VZV, CMV, EBV), HBV, Smallpox virus
structure |
DNA enveloped viruses
|
|
Adenovirus, papillomavirus, parvovirus
Structure? |
DNA nucleocapsid virus
|
|
Influenza, parainfluenza, RSV, measles, mumps, rubella, rabies. HTLV, HIV
structure |
RNA enveloped viruses
|
|
Enteroviruses (poliovirus, coxsackievirus, echovirus, HAV), rhinovirus, reovirus (rotavirus)
structure? |
RNA nucleocapsid viruses
|
|
7 DNA viruses
|
DNA viruses are HHAPPPy
Hepadna Herpes Adeno Pox Parvo Papilloma Polyoma |
|
How are parvoviruses different from other DNA viruses?
|
single stranded (most other DNA viruses are double stranded)
"the hole is PAR ONE" |
|
Shape of most DNA viruses
exceptions |
linear
Papilloma and polyoma (circular, supercoiled) hepadna (circular, incomplete) |
|
In what two ways is poxvirus different from other DNA viruses
|
Not icosahedral (POX in a BOX - complex capsid)
Does not replicate in nucleus (because it carries its own DNA-dependent RNA polymerase) |
|
Herpesvirus
a. envelope? b. DNA structure |
a. yes
b. ds DNA, linear |
|
Which Herpesvirus?
causes... -Oral (some genital) lesions -spontaneous temporal lobe encephalitis -keratoconjunctivitis |
HSV-1
|
|
Which Herpesvirus?
causes... -mostly genital lesions, some oral |
HSV-2
|
|
Which Herpesvirus?
causes... Chickenpox, zoster (shingles) |
VZV (HHV-3)
|
|
Which Herpesvirus?
causes... Mononucleosis, Burkitt's lymphoma |
EBV (HHV-4)
|
|
Which Herpesvirus?
causes... -AIDS retinitis, infections in immunosuppressed, especially transplant -congenital defects |
CMV (HHV-5)
|
|
Which Herpesvirus?
causes... Chickenpox, zoster (shingles) |
VZV (HHV-3)
|
|
Which Herpesvirus?
causes... roseola (exanthem subitum) |
HHV-6
|
|
Which Herpesvirus?
causes... Mononucleosis, Burkitt's lymphoma |
EBV (HHV-4)
|
|
Which Herpesvirus?
causes... Kaposi's sarcoma-associated herpesvirus |
HHV-8
|
|
Which Herpesvirus?
causes... -AIDS retinitis, infections in immunosuppressed, especially transplant -congenital defects |
CMV (HHV-5)
|
|
Most common cause of spontaneous encephalitis in US
where can it remain latent |
HSV-1
trigeminal ganglia |
|
Virus that can cause
-gingivostomatitis (swollen gums, mucous membranes) -keratoconjunctivitis (corneal blindness) -temporal lobe encephalitis -herpes labialis route of transmission? |
HSV-1
respiratory secretions, saliva |
|
Which Herpesvirus?
causes... roseola (exanthem subitum) |
HHV-6
|
|
Which Herpesvirus?
causes... Kaposi's sarcoma-associated herpesvirus |
HHV-8
|
|
most common cause of corneal blindness in USA
|
keratoconjunctivitis from HSV-1
|
|
Which Herpesvirus?
causes... Chickenpox, zoster (shingles) |
VZV (HHV-3)
|
|
Patient had sexual contact, now has
-fever -headache -vaginal/urethral discharge -enlarged LNs -ulcerating vesicles on genitals on sample, you see multinucleated giant cells with intranuclear inclusion bodies dx? where is this latent? |
HSV-2
latent in sacral ganglia |
|
Most common cause of spontaneous encephalitis in US
where can it remain latent |
HSV-1
trigeminal ganglia |
|
Adult patient has a rash over a specific dermatome area
a. what is the virus b. where can this establish latency c. when is this especially dangerous |
a. VZV (member of herpesviruses)
b. trigeminal and dorsal root ganglia c. dangerous if reactivation over V1 segment of trigeminal (eye and corneal involvement) |
|
Virus that can cause
-gingivostomatitis (swollen gums, mucous membranes) -keratoconjunctivitis (corneal blindness) -temporal lobe encephalitis -herpes labialis route of transmission? |
HSV-1
respiratory secretions, saliva |
|
Which Herpesvirus?
causes... Mononucleosis, Burkitt's lymphoma |
EBV (HHV-4)
|
|
Which Herpesvirus?
causes... -AIDS retinitis, infections in immunosuppressed, especially transplant -congenital defects |
CMV (HHV-5)
|
|
most common cause of corneal blindness in USA
|
keratoconjunctivitis from HSV-1
|
|
Patient had sexual contact, now has
-fever -headache -vaginal/urethral discharge -enlarged LNs -ulcerating vesicles on genitals on sample, you see multinucleated giant cells with intranuclear inclusion bodies dx? where is this latent? |
HSV-2
latent in sacral ganglia |
|
Which Herpesvirus?
causes... roseola (exanthem subitum) |
HHV-6
|
|
Which Herpesvirus?
causes... Chickenpox, zoster (shingles) |
VZV (HHV-3)
|
|
Adult patient has a rash over a specific dermatome area
a. what is the virus b. where can this establish latency c. when is this especially dangerous |
a. VZV (member of herpesviruses)
b. trigeminal and dorsal root ganglia c. dangerous if reactivation over V1 segment of trigeminal (eye and corneal involvement) |
|
Which Herpesvirus?
causes... Mononucleosis, Burkitt's lymphoma |
EBV (HHV-4)
|
|
Which Herpesvirus?
causes... Kaposi's sarcoma-associated herpesvirus |
HHV-8
|
|
Most common cause of spontaneous encephalitis in US
where can it remain latent |
HSV-1
trigeminal ganglia |
|
Which Herpesvirus?
causes... -AIDS retinitis, infections in immunosuppressed, especially transplant -congenital defects |
CMV (HHV-5)
|
|
Virus that can cause
-gingivostomatitis (swollen gums, mucous membranes) -keratoconjunctivitis (corneal blindness) -temporal lobe encephalitis -herpes labialis route of transmission? |
HSV-1
respiratory secretions, saliva |
|
Which Herpesvirus?
causes... roseola (exanthem subitum) |
HHV-6
|
|
most common cause of corneal blindness in USA
|
keratoconjunctivitis from HSV-1
|
|
Patient had sexual contact, now has
-fever -headache -vaginal/urethral discharge -enlarged LNs -ulcerating vesicles on genitals on sample, you see multinucleated giant cells with intranuclear inclusion bodies dx? where is this latent? |
HSV-2
latent in sacral ganglia |
|
Which Herpesvirus?
causes... Kaposi's sarcoma-associated herpesvirus |
HHV-8
|
|
Most common cause of spontaneous encephalitis in US
where can it remain latent |
HSV-1
trigeminal ganglia |
|
Adult patient has a rash over a specific dermatome area
a. what is the virus b. where can this establish latency c. when is this especially dangerous |
a. VZV (member of herpesviruses)
b. trigeminal and dorsal root ganglia c. dangerous if reactivation over V1 segment of trigeminal (eye and corneal involvement) |
|
Virus that can cause
-gingivostomatitis (swollen gums, mucous membranes) -keratoconjunctivitis (corneal blindness) -temporal lobe encephalitis -herpes labialis route of transmission? |
HSV-1
respiratory secretions, saliva |
|
most common cause of corneal blindness in USA
|
keratoconjunctivitis from HSV-1
|
|
Patient had sexual contact, now has
-fever -headache -vaginal/urethral discharge -enlarged LNs -ulcerating vesicles on genitals on sample, you see multinucleated giant cells with intranuclear inclusion bodies dx? where is this latent? |
HSV-2
latent in sacral ganglia |
|
Adult patient has a rash over a specific dermatome area
a. what is the virus b. where can this establish latency c. when is this especially dangerous |
a. VZV (member of herpesviruses)
b. trigeminal and dorsal root ganglia c. dangerous if reactivation over V1 segment of trigeminal (eye and corneal involvement) |
|
Teenager comes in with
-fever, chills, headache -painful pharyngitis -atypical lymphocytes in blood -heterophile Abs agglutinate sheeps blood virus? |
EBV-infectious mononucleosis
AB-heterophile agglutination = monospot test |
|
Virus that causes
-Infectious mononucleosis -Burkitt's lymphoma -nasopharyngeal carcinoma how is it transmitted? latency? |
EBV
respiratory secretions or saliva latent in B cells |
|
Teenager comes in with
-fever, chills, headache -painful pharyngitis -atypical lymphocytes in blood -heterophile Abs agglutinate sheeps blood virus? |
EBV-infectious mononucleosis
AB-heterophile agglutination = monospot test |
|
Patient with AIDS with this infection can get
-retinitis -coltitis -veremia see cowdry type A owl's eye inclusions in cells infection? latency? transmission? |
CMV
mononuclear cells congenital, transfusion, sexual contact, saliva, urine, transplant |
|
Patient with transplant suffers from pneumonia
see multinuclear giant cell with owl eye inclusions virus? |
CMV
|
|
Virus that causes
-Infectious mononucleosis -Burkitt's lymphoma -nasopharyngeal carcinoma how is it transmitted? latency? |
EBV
respiratory secretions or saliva latent in B cells |
|
Virus that can cause
-congenital infection -mononuclosis (neg. monspot) -pneumonia especially in immunocompromised |
CMV
|
|
Patient with AIDS with this infection can get
-retinitis -coltitis -veremia see cowdry type A owl's eye inclusions in cells infection? latency? transmission? |
CMV
mononuclear cells congenital, transfusion, sexual contact, saliva, urine, transplant |
|
Patient is a child with high fever for 3-5 days, followed by diffuse macular rash
dx? |
HHV-6 roseola
|
|
Patient with transplant suffers from pneumonia
see multinuclear giant cell with owl eye inclusions virus? |
CMV
|
|
Patient with AIDS gets red papules all over
what virus can cause this? |
HHV-8 Kaposi's sarcoma
|
|
Virus that can cause
-congenital infection -mononuclosis (neg. monspot) -pneumonia especially in immunocompromised |
CMV
|
|
Latency
a. HSV-1 b. HSV-2 c. VZV d. EBV e. CMV |
a. trigeminal ganglia
b. sacral ganglia c. trigeminal and dorsal root ganglia d. B cells e. mononuclear cells |
|
Patient is a child with high fever for 3-5 days, followed by diffuse macular rash
dx? |
HHV-6 roseola
|
|
Patient with AIDS gets red papules all over
what virus can cause this? |
HHV-8 Kaposi's sarcoma
|
|
What is the Tzanck test
|
Test for HSV-1, HSV-2, VZV
Smear of open skin vesicle to detect multinucleated giant cells also see intranuclear cowdry A inclusions |
|
Virus that can cause acute or chronic hepatitis
virus is enveloped and has dsDNA that is partially circular a. virus? b. vaccine? c. what does this virus have that allows it to function |
a. HBV (Hepadnavirus family)
b. Vaccine has HBV surface antigen c. has reverse transcriptase |
|
Latency
a. HSV-1 b. HSV-2 c. VZV d. EBV e. CMV |
a. trigeminal ganglia
b. sacral ganglia c. trigeminal and dorsal root ganglia d. B cells e. mononuclear cells |
|
What is the Tzanck test
|
Test for HSV-1, HSV-2, VZV
Smear of open skin vesicle to detect multinucleated giant cells also see intranuclear cowdry A inclusions |
|
Teenager comes in with
-fever, chills, headache -painful pharyngitis -atypical lymphocytes in blood -heterophile Abs agglutinate sheeps blood virus? |
EBV-infectious mononucleosis
AB-heterophile agglutination = monospot test |
|
Virus that can cause acute or chronic hepatitis
virus is enveloped and has dsDNA that is partially circular a. virus? b. vaccine? c. what does this virus have that allows it to function |
a. HBV (Hepadnavirus family)
b. Vaccine has HBV surface antigen c. has reverse transcriptase |
|
Virus that causes
-Infectious mononucleosis -Burkitt's lymphoma -nasopharyngeal carcinoma how is it transmitted? latency? |
EBV
respiratory secretions or saliva latent in B cells |
|
Patient with AIDS with this infection can get
-retinitis -coltitis -veremia see cowdry type A owl's eye inclusions in cells infection? latency? transmission? |
CMV
mononuclear cells congenital, transfusion, sexual contact, saliva, urine, transplant |
|
Teenager comes in with
-fever, chills, headache -painful pharyngitis -atypical lymphocytes in blood -heterophile Abs agglutinate sheeps blood virus? |
EBV-infectious mononucleosis
AB-heterophile agglutination = monospot test |
|
Patient with transplant suffers from pneumonia
see multinuclear giant cell with owl eye inclusions virus? |
CMV
|
|
Virus that can cause
-congenital infection -mononuclosis (neg. monspot) -pneumonia especially in immunocompromised |
CMV
|
|
Virus that causes
-Infectious mononucleosis -Burkitt's lymphoma -nasopharyngeal carcinoma how is it transmitted? latency? |
EBV
respiratory secretions or saliva latent in B cells |
|
Patient is a child with high fever for 3-5 days, followed by diffuse macular rash
dx? |
HHV-6 roseola
|
|
Patient with AIDS with this infection can get
-retinitis -coltitis -veremia see cowdry type A owl's eye inclusions in cells infection? latency? transmission? |
CMV
mononuclear cells congenital, transfusion, sexual contact, saliva, urine, transplant |
|
Patient with AIDS gets red papules all over
what virus can cause this? |
HHV-8 Kaposi's sarcoma
|
|
Patient with transplant suffers from pneumonia
see multinuclear giant cell with owl eye inclusions virus? |
CMV
|
|
Latency
a. HSV-1 b. HSV-2 c. VZV d. EBV e. CMV |
a. trigeminal ganglia
b. sacral ganglia c. trigeminal and dorsal root ganglia d. B cells e. mononuclear cells |
|
What is the Tzanck test
|
Test for HSV-1, HSV-2, VZV
Smear of open skin vesicle to detect multinucleated giant cells also see intranuclear cowdry A inclusions |
|
Virus that can cause
-congenital infection -mononuclosis (neg. monspot) -pneumonia especially in immunocompromised |
CMV
|
|
Virus that can cause acute or chronic hepatitis
virus is enveloped and has dsDNA that is partially circular a. virus? b. vaccine? c. what does this virus have that allows it to function |
a. HBV (Hepadnavirus family)
b. Vaccine has HBV surface antigen c. has reverse transcriptase |
|
Patient is a child with high fever for 3-5 days, followed by diffuse macular rash
dx? |
HHV-6 roseola
|
|
Patient with AIDS gets red papules all over
what virus can cause this? |
HHV-8 Kaposi's sarcoma
|
|
Latency
a. HSV-1 b. HSV-2 c. VZV d. EBV e. CMV |
a. trigeminal ganglia
b. sacral ganglia c. trigeminal and dorsal root ganglia d. B cells e. mononuclear cells |
|
What is the Tzanck test
what would you be looking for? |
Test for HSV-1, HSV-2, VZV
Smear of open skin vesicle to detect multinucleated giant cells also see intranuclear cowdry A inclusions |
|
Virus that can cause acute or chronic hepatitis
virus is enveloped and has dsDNA that is partially circular a. virus? b. vaccine? c. what does this virus have that allows it to function |
a. HBV (Hepadnavirus family)
b. Vaccine has HBV surface antigen c. has reverse transcriptase |
|
Teenager comes in with
-fever, chills, headache -painful pharyngitis -atypical lymphocytes in blood -heterophile Abs agglutinate sheeps blood virus? |
EBV-infectious mononucleosis
AB-heterophile agglutination = monospot test |
|
Virus that causes
-Infectious mononucleosis -Burkitt's lymphoma -nasopharyngeal carcinoma how is it transmitted? latency? |
EBV
respiratory secretions or saliva latent in B cells |
|
Patient with AIDS with this infection can get
-retinitis -coltitis -veremia see cowdry type A owl's eye inclusions in cells infection? latency? transmission? |
CMV
mononuclear cells congenital, transfusion, sexual contact, saliva, urine, transplant |
|
Patient with transplant suffers from pneumonia
see multinuclear giant cell with owl eye inclusions virus? |
CMV
|
|
Virus that can cause
-congenital infection -mononuclosis (neg. monspot) -pneumonia especially in immunocompromised |
CMV
|
|
Patient is a child with high fever for 3-5 days, followed by diffuse macular rash
dx? |
HHV-6 roseola
|
|
Patient with AIDS gets red papules all over
what virus can cause this? |
HHV-8 Kaposi's sarcoma
|
|
Latency
a. HSV-1 b. HSV-2 c. VZV d. EBV e. CMV |
a. trigeminal ganglia
b. sacral ganglia c. trigeminal and dorsal root ganglia d. B cells e. mononuclear cells |
|
What is the Tzanck test
|
Test for HSV-1, HSV-2, VZV
Smear of open skin vesicle to detect multinucleated giant cells also see intranuclear cowdry A inclusions |
|
Virus that can cause acute or chronic hepatitis
virus is enveloped and has dsDNA that is partially circular a. virus? b. vaccine? c. what does this virus have that allows it to function |
a. HBV (Hepadnavirus family)
b. Vaccine has HBV surface antigen c. has reverse transcriptase |
|
Unenveloped virus that causes
-febrile pharyngitis, acute hemorrhagic cystitis -pneumonia -conjunctivitis - pink eye genome |
adenovirus
naked ds DNA linear |
|
virus that causes
-aplastic crises in sickle cell disease -fever + slapped cheek rash in kids -can cause RBC destruction in fetus --> hydrops fetalis -RBC destruction in adults --> RBC aplasia, RA genome |
Parvovirus
SS DNA virus (smallest DNA virus) |
|
Papillomavirus
a. envelope b. DNA structure c. which forms cause HPV warts d. which forms cause Cervical cancer |
a. no
b. ds-circular c. HPV warts = 1,2,6,11 d. HPV cancer = 16, 18 |
|
Virus that causes
-PML progressive multifocal leukoencephalopathy in HIV genome? envelope? |
polyomavirus - JC
no envelope ds circular |
|
virus that can cause
-small pox -cowpox (milkmaid's blisters) -mulluscum contagiosum (flesh colored dome lesion with central dimple) envelope? DNA structure? |
Poxvirus
Yes envelope DS linear DNA (largest DNA virus) |
|
6 negatively stranded RNA viruses
what must they bring to transcribe strand to positive |
Always Bring Polymerase Or Fail Replication
Arenavirus Bunyavirus Paramyxovirus Orthomyxovirus Filovirus Rhabdovirus Must bring RNA-dependent RNA polymerase |
|
4 segmented viruses (all RNA)
Implications of segmentation |
BOAR
Bunyavirus Orthomyxovirus Arenavirus Reovirus Segments can recombine --> antigenic shift --> pandemics (influenza) |
|
5 picornaviruses
genome? |
picoRNAvirus = small RNA virus
PERCH on a peak (pic) Poliovirus Echovirus Rhino Coxsackie HAV |
|
Picornaviruses
genome? how does it cause its effects? Common mode of transmission? Common disease association? |
ss RNA linear
RNA --> 1 large polypeptide --> cleaved by proteases to functional viral proteins fecal oral (except rhino) aseptic meningitis (except rhino and HAV) |
|
picornavirus that causes common cold, not spread by fecal oral
|
rhinovirus
|
|
picornavirus that causes acute viral hepatitis
|
HAV
|
|
Rhinovirus - what family
a. envelope? b. genome? c. disease? |
Picornavirus
a. no b. RNA c. common cold acid labile, so it cannot infect the GI tract like other picornavirus "rhinos have runny noses" |
|
Patient has high fever +
-black vomit -jaundice virus (family, genome)? reservoir? transmission? |
Yellow fever virus -->
flavivirus -enveloped, ssRNA, pos sense, linear b. monkey or human reservoir c. transmitted by Aedes mosquitos Flavi = yellow, jaundice |
|
Most important cause of infantile gastroenteritis worldwide
genome? |
Rotavirus
Reovirus - segmented dsRNA |
|
Virus that causes acute diarrhea in US in winter, especially in day care centers or kindergartens
MOA |
rotavirus
destroys villi + atrophy --> decreases Na and water resorption ROTA = right out the anus |
|
genome of orthomyxovirus
|
ss RNA, segmented
envelope |
|
Influenza
how is it different from common cold |
SEVERE high spking fever, painful headache, painful myalgias
more severe |
|
2 virulence factors in orthomyxovirus (influenzae)
what do they do |
Hemagglutinin - binds to sialic acid receptoors to promote viral entry into cells
Neuraminidase - ceaves neuramic acid in mucous to expose sialic acid receptors cleaves sialic acid - hemagglutinin bonds to allow budding, virion release |
|
what is responsible for influenza epidemics
what is responsible for influenza pandemics |
genetic drift = minor changes to HA or NA based on random mutation
genetic shift = reassortment of segmented genome (exchange) --> new influenza A virus |
|
protection for the population against influenza virus
|
killed viral vaccine
|
|
How should you NOT treat a child with the flu or chicken pox (VZV)
how should you treat them |
Don't give aspirin --> Reye's syndrome (liver and brain disease)
give acetaminophen |
|
Treatments for flu (2)
mechanisms and limitations |
1. Amantadine/rimantidine
-act by inhibiting M2 ion channel, preventing acidification --> no virion uncoating -only protects against influenza A 2. zanamavir/oseltamivir neuroaminidase inhibitor |
|
Patient comes in with
-fever -post auricular tenderness -lymphadenopathy -arthralgia -fine truncal rash lasts for 3 days dx? virus? when does it cause a serious disease? |
German measles from rubella virus (toga virus, ssRNA, pos, linear)
serious congenital disease (TORCH) |
|
Paramyxovirus
3 ways in which it is different than orthomyxovirus structurally |
1. (-) ss RNA genome (not segmented)
2. HA and NA in same spike (not on different spikes) 3. Fusion protein present --> causes respiratory epithelial cells to fuse and form multinucleated giant cells |
|
4 paramyxoviruses
where do they all infect? who do they all infect? |
parainfluenza
mumps measles RSV all infect lungs |
|
#1 cause of pneumonia in kids, especially < 6mo
|
RSV (paramyxovirus)
|
|
Child comes in with stridor and a seal-like barking cough
which virus? what should you see if you biopsy respiratory epithelial cells? |
parainfluenza virus (paramyxovirus) --> croup
see multinucleated giant cells due to fusion protein |
|
Infant gets bronchiolitis and pneumonia
virus? treat? |
RSV (paramyxovirus)
palivizumab = monoclonal Ab to neutralize F protein ribavirin |
|
RSV and parainfluenza virus
effect in kids? effect in adults? |
kids = pneumonia
adults = URI (bad cold) |
|
child comes in with
-cough -coryza (head cold - congestion) -Conjunctivitis in his mouth, you see tiny white spots surrounded by red -rash from head to toe what are these spots called? diagnosis? |
koplik spots
Measles from rubeola virus (paramyxovirus) |
|
Difference between rash in measles vs. rubella
|
measles = head to toe, includes hands and feet
rubella = truncal rash |
|
You see a rash
how do you differentiate measles from roseola (HHV-6) |
measles = associated with koplik spots, conjunctivitis
HHV-6 = associated with 3-5 day fever |
|
What is the #2 cause of viral encephalitis in the US
|
St. Louis virus - flavivirus (RNA pos, linear)
|
|
2 possible sequela of toagvirus infection
|
1. Rubella --> german measles (fever, truncal rash, dangerous if congenital)
2. E or W equine encephalitis |
|
Arthropod-borne viruses (caused by blood sucking ticks)
what conditions do these all cause |
toga
flavi bunya all cause fever, encephalitis |
|
2 viruses that cause common cold
|
coronavirus
rhinovirus |
|
1 virus that causes rabies
special shape of capsid |
rhabdovirus
bullet shaped |
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2 viruses that cause hemorrhagic fever, could be used as biological weapons
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filovirus --> ebola or marburg
arenavirus --> lassa fever or lymphocytic choriomeningitis |
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patient has koplik spots and head to toe rash that includes the hands and feet
what are three unlikely (but possible) sequelae of this disease a. comes on years later b. in immunocompromised c. rate of 1:2000 |
a. subacute sclerosing panencephalitis --> mental deterioration
b. giant cell pneumonia c. encephalitis |
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Vaccine to protect against measles
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MMR
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Patient had cough and fever a few days ago
-now has giant parotid gland -giant testicles -asceptic meningitis dx? major negative effect on patients who are post-pubescent? vaccine? |
Mumps (paramyxovirus)
can cause sterility MMR vaccine |
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Negri bodies in purkinje cells of cerebellum
dx? Pathology |
Rabies virus
Cytoplasmic inclusions in neurons after virus traveled retrograde up nerve axons |
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Patient was bitten by a bat
had fever/malaise --> agitation, photophobia, hydrophobia course? organism? what should patient have done as soon as he got bit? |
rabies (rhabdovirus - RNA, ss, neg, linear, bullet shaped capsule)
paralysis, coma, death should have come in for prophylactic vaccination right after bite |
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Lots of spots
truncal rash following 3-5 day fever |
rubella (togavirus) causing german measles
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Lots of spots
rash spreads from head to toe follows cough, coryza, conjunctivitis, with small white spots on buccal mucosa |
rubeola, measles
paramyxovirus |
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Lots of spots
patient has a diffuse maculopapular rash following a bout of high fevers in kids |
roseola caused by herpesvirus (HHV-6)
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patient has rash following dermatomal area
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varicella-zoster from herpesvirus
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Patient lives in crowded area
-gets flu-like symptoms -3 weeks later, gets elevated ALT, AST -mild jaundice seen later virus? diagnosis? how was it transmitted? |
Hep A (RNA picornavirus)
Active infection = HAV capsule IgM -if you see HAV capsule IgG, indicates previous exposure transmitted fecal-oral, no carrier |
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IgM anti-HAV and IgG anti-HAV
a. acute infection b. old infection c. no infection |
a. IgM +, IgG -
b. IgM - , IgG + c. both neg |
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Heptatitis viral transmission
a. fecal oral -why can they do this b. blood blood |
a. A, E
-naked, so not destroyed by gut because they have no envelope b. B, C, D |
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which hepatitis viruses can cause chronic hepatitis
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B, C, D
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Incubation time for
a. HAV b. HBV |
a. 3 weeks
b. 3 months |
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Patient has fever, malaise
3 months later, has highly elevated ALT, AST develops jaundice you diagnose HBV a. class of organism b. 3 enzymes involved in organisms replication/action c. how is it transmitted |
a. HBV is a DNA hepadnavirus
b. Cellular RNA pol transcribes DNA --> RNA Reverse transcriptase transcribes RNA --> DNA (for replication) virus contains DNA-dependent DNA pol c. parenteral, sexual, maternal-fetal transmission, has carriers |
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3 sequelae of HBV infection
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acute hepatitis
fulminant hepatitis chronic hepatitis |
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Seroogical markers
what do the following indicate if found in blood a. HBsAg b. anti HBsAg c. HBcAg d. Anti HBcAg (IgM) e. Anti HBcAg (IgG) f. HBeAg g. Anti HBeAg |
a. active hep B infection
b. immunity to hep B, no active infection c. antigen associated with core of HBV (?) d. Acute/recurent infection e. chronic infection f. highly transmissible infection g. lowly transmissible reaction |
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What is HDV and how does it act
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HDV = delta agent
carriers to body --> uses HBsAg as its envelope, coinfects (or superinfects) with HBV --> worse prognosis for hepatitis |
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HCV
a. class of virus b. transmitted how c. how do you detect |
a. RNA flavivirus
b. blood borne, carriers c. anti-HCV |
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patient is an IVDU (or post-transfusion)
has mild AST/ALT elevation, developing cirrhosis viral infection |
HCV is the leading cause of chronic hepatitis
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Hepatitis-inducing virus that is transmitted enterically, causes water born epidemics, and has high mortality rate in pregnant women
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HEV
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viruses that predispose patient to
-chronic active hepatitis -cirrhosis -hepatocellular carcinoma |
HBV, HCV
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As far as liver enzymes, how is viral hepatitis different from alcoholic hepatitis
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viral: ALT > AST
alcoholic: AST > ALT |
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On serology, you see
HBsAg HBeAg IgM for HBcAg stage |
acute HBV infection
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On serology, you see
-HBsAg -HBeAg -IgG to HBcAg stage |
chronic active HBV infection (high infectivity)
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On serology, you see
-HBsAg -anti-HBeAb -IgG to HBcAg stage |
chronic HBV infection (low infectivity)
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On serology, you see only
anti-HBs Ab stage |
recovery/immunity from HBV infection
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HIV
a. genome b. capsid protein c. envelope proteins and roles |
a. ss RNA, diploid (retrovirus)
b. p24 c. gp41 (fusion and entry), gp120 attach to host T cell |
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HIV
3 necessary enzymes |
reverse transcriptase
integrase protease - cleaves gag and pol from larger precursor molecules (post-translational modification) |
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HIV
matrix protein that holds gp41 and gp120 in place |
p17 matrix protein
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HIV
3 structural genes - what do these encode for a. env b. pol c. gag |
a. env for gp120 and gp41 (envelope proteins)
b. pol for reverse transcriptase c. gag for p24 (capsid) |
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HIV
how does it enter T cells? How does it enter macrophages? what mutation has been found to cause immunity to HIV infection |
T cells = binds CD4 and CXCR4
macrophages = binds CD4 and CCR5 homozygous CCR5 mutation--> immunity, heterozygous --> slower course of disease |
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HIV diagnosis
test you use to RULE OUT test you use to RULE IN |
rule out = ELISA (has a high false pos, so if this comes up negative, you can rule out HIV)
rule in = Western blot (high false neg, so if positive, you can pretty much rule in HIV) |
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Elisa/Western blots for HIV
a. what do these tests look for b. when are they especially falsely negative c. when are they especially falsely positive |
look for antibodies to viral proteins
b. false neg in first 1-2 months after infection c. false pos in babies born to infected mothers (because anti-gp120 crosses placenta) |
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HIV
test that allows physicians to monitor the effect of drug therapy on a viral load |
HIV PCR/viral load test
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AIDS diagnosis (3 ways)
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1. CD4 < 200
2. HIV pos + AIDS indicator condition (Pneumocystis jiroveci pneumonia) 3. CD4/CD8 ration < 1.5 |
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4 stages of AIDS infection (4 f's)
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1. flu-like (acute)
2. feeling fine (latent -- virus replicates in LN, avg 8 years) 3. falling count - more susceptible to infections, etc 4. final crisis - AIDS develops for 2 years, CD4<200 or AIDS defining infectoin |
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HIV infection
a. what would you find serologically in an acute attack CD4 anti-p24 antibodies anti-gp120 antibodies virus p24 antigen |
-small dip in CD4
-virus p24 antigen peaks anti-p24 and anti-gp120 slowly rising |
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HIV infection
a. what would you find serologically in a latent stage CD4 anti-p24 antibodies anti-gp120 antibodies virus p24 antigen |
everything steady except low p24 antigen
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HIV infection
a. what would you find serologically in a 3-10 years after initial attack CD4 anti-p24 antibodies anti-gp120 antibodies virus p24 antigen |
decline of CD4, antip24 Abs, anti-gp120 antibodies
increase in p24 viral antigen |
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patient has AIDS
5 possible infections in brain that patient is most susceptible to |
Cryptoccal meningitis
Toxoplasmosis CMV encephalopathy AIDS dementia PML (JC virus) |
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Patient with AIDS
1 complication in eyes |
CMV retinitis
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Patient with AIDS
4 complications in mouth/throat |
candida thrush
HSV CMV Oral hairy leukoplakia (EBV) |
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Patient with AIDS
which lung infections is she most susceptible to (3) |
pneumocystis jiroveci pneumonia
Tb histoplasmosis |
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Patient with AIDS is most susceptible to which GI infections
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Cryptosporidiosius
Mycobacterium avirum-intracellulare complex CMV colitis Non-Hodgkin's lymphoma (EBV) Isospora belli |
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Patient has AIDS
what are 2 cutaneous infections I worry about |
Shingles VZV
Kaposi sarcoma (HHV-8) |
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Patient has AIDS
susceptible to whcih genial infections |
Genital herpes, warts
Cervical cancr (HPV) |
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HIV associated infections - risk for these increases when CD4 count goes below what level
-oral thrush -tinea pedis -VZV reactivation -TB -bact infections |
CD4 < 400
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HIV associated infections - risk for these increases when CD4 count goes below what level
-reactivation HSV -cryptosporidiosis -Isospora -disseminated coccidiomycoisis -Pneumocystis pneumonia |
CD4 < 200
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HIV associated infections - risk for these increases when CD4 count goes below what level
-Candidal esphagitis -toxoplasmosis -histoplasmosis |
CD4 < 100
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HIV associated infections - risk for these increases when CD4 count goes below what level
-CMV retinitis and esphagitis -disseminated M. avium-intracellulare -cryptococcal meningoencephalitis |
CD4 < 50
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Kaposi sarcoma (HHV-8)
Invasive cervical carcinoma (HPV) Primary CNS lymphoma non-Hodgkin's lymphoma all associated with what condition |
HIV
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What causes prion disease
what are the symptoms |
conversion of normal cellular prion protein PrPc into b-pleated form PrPsc
spongiform encephalopathy --> dementia, ataxia, death |
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special features of converted prion to cause prion disease
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PrPsc is..
-transmissable -resists degradation -facilitates conversion of more PrPc to PrPsc |
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Prion diseases
a. sporadic b. inherited c. acquired |
a. creutzfeldt-Jakob (rapidly progressing dementia)
b. Gerstmann-Straussler-Scheinker syndrome c. Kuru |