Jt Microbiology - Virology

Front 1

Cell culture of what virus?

Back 1

RSV
(note the syncytia)
(Lack of inclusions)

Front 2

Cell culture of what virus?

Back 2

Adenovirus

(grape-like clusters of rounded cells)
(dark basophilic nuclear inclusions)

Front 3

Cell culture of what virus?

Back 3

Measles

(Syncytia)
(Large intranuclear eosinophilic inclusions)

Front 4

Cell culture of what virus?

Back 4

Mumps

(Syncytia. Indistinguishable from RSV based on CPE - cytopathic effect - but has a hemagglutin protein = RBCs adhere to cell surfae. aka hemadsorption & allows differentiation between mumps & RSV)

Front 5

Which viruses form syncytia?

Back 5

RSV
Measles
Mumps
HSV

Front 6

Cell culture of which virus?

Back 6

HSV

-Grows fast in culture (3d)
-Plaques of rounded cells
-Nuclear inclusions
-Formation of giant cells and multi-nucleate syncytia
-COWDRY BODIES

Front 7

Virus?

Back 7

CMV

Grows only in fibroblasts
Slow
OWLS EYE NUCLEI
Nuclear & cytoplasmic inclusions

Front 8

DNA viruses that are nonenveloped?

enveloped?

Back 8

Non: Parvo, Adeno, Papova, Polyoma

Env: Herpes, Pox, Hepadna

Front 9

RNA viruses that are nonenveloped?

enveloped?

Back 9

Non: Calici (HEV), Picorna (enterov, HAV, rhino), Reo (Rota)

Env: all the rest

Front 10

Nuclear & cytoplasmic inclusions are seen in what viruses?

Back 10

CMV
Measles

Front 11

Nuclear inclusions only?

Back 11

HSV

VZV
Adeno

Front 12

Cytoplasmic inclusions only?

Back 12

Rabies

RSV

Parainfluenza (rarely observed)

Front 13

EM of what virus?

Back 13

Adenovirus

Front 14

Virus?

Back 14

Rabies

NEGRI BODY (cytoplasmic inclusion)

Front 15

Name the 7 DNA viruses

Back 15

Parvo-viridae
Hepadna-
Polyoma-
Papilloma-
Adeno-
Herpes-
Pox-

Front 16

Which DNA viruses are enveloped?

Back 16

Hepadna
Herpes
Pox

Front 17

there are 14+ RNA viruses.. which are NOT enveloped?

Back 17

Rio / Rota
Bonya / Hanta
Picorna (HAV, entero, rhino)
Calici (Novo, HEV)
Astro

Front 18

Which virus is ssDNA?

Back 18

Parvo

Front 19

Which virus is dsRNA?

Back 19

Rota

Front 20

What families are the hepatitis viruses in?

Back 20

HAV: Picorna (RNA)
HBV: Hepadna (dsDNA, enveloped)
HCV: Flavi (RNA, enveloped)
HDV: not included - a funny type
HEV: Calici (RNA)

Front 21

Which hepatitis virus is a DNA virus?

Back 21

HBV

Front 22

– Pneumonia in immunocompromised patients & military recruits
– Acute gastroenteritis children (40,41)
– Pharyngitis, pharyngoconjunctival fever
– Keratoconjunctivitis
– HEMORRHAGIC CYSTITIS
– Cervicitis, urethritis
– Disseminated disease

Back 22

Adenovirus

Front 23

Back 23

Adenovirus
NUCLEAR inclusion only, large basophilic
Smudgy and coarse
No cytomegaly or multinucleation

Front 24

Back 24

Shingles (zoster)
Affects one dermatome

Front 25

CMV establishes latency in?

Back 25

Macrophages

Front 26

CPE of which virus?

Back 26

CMV

Foci of rounded cells in a clean background

Front 27

Back 27

CPE of VZV
Foci of sandpaper with rounded cells

Front 28

Back 28

HSV
Rounded cells at the edge

Front 29

What virus causes roseola and what cell does it live in?

Back 29

HHV6 (sixth disease)

T CELLS!

Front 30

What virus is the hardiest to transport and is the quickest to grow in cell culture?

Which takes the longest to grow in cell culture?

Back 30

HSV (24hrs!)


CMV (14-21d)
RSV (10-14d)

Front 31

Adenovirus is latent in?

Back 31

Lymphoid tissue

Front 32

What strains of adenovirus cause gastroenteritis in kids?

Back 32

40 & 41

Front 33

HEMORRHAGIC CYSTITIS

Back 33

adenovirus
BK virus

Front 34

Fifth disease

Back 34

Parvovirus B19

Front 35

Bone marrow aspirate. Dx?

Back 35

Parvovirus

Mature erythroid precursors are absent, and giant pronormoblasts are typical of B19 infection.

Front 36

Polyomaviruses & associations

Back 36

JC - PML

BK - hemorrhagic cystitis

Front 37

Dane particle

Back 37

HBV virion

Front 38

HBV belongs to what family?

Back 38

Hepadnavirus (dsDNA enveloped)

Front 39

HBeAg?

Back 39

Chronic infection

Front 40

HCV belongs to what family?

Which type of HCV is worst?

HCV treatment?

Back 40

Flaviviridae

Type 1 is worst.

IFN & ribavirin

Front 41

What % of HBV becomes chronic?

HCV?

Back 41

9% HBV becomes chronic

80% HCV; 25% get cirrhosis

Front 42

Back 42

Enterovirus

Teardrop & Kite-like cells!

Front 43

Coxsackie A

Coxsackie B

Back 43

A: Hand-foot-and-mouth disease

B: Pericarditis, myocarditis

Front 44

Picornaviridae

Back 44

Enteroviruses (Polio, coxsackie, enterovirus)
HAV
Rhinovirus

non-enveloped RNA

Front 45

Orthomyxoviridae

Back 45

Influenza

enveloped RNA
Helical capsid

Front 46

Antigenic drift

Back 46

Minor change in amino acid of H or N. cross-antibody protection

Front 47

Antigenic shift

Back 47

Major change. Genome rearrangement. "New" virus! No protection

Front 48

Subtyping of influenza is based on what?

Back 48

H (hemagglutinin) and N (neuraminidase)

Front 49

Which influenza type is worse and why?

Back 49

Influenza A. Can have antigenic drift or shift!

Influenza B only drifts.

Front 50

Amantidine treats?

Tamiflu treats?

Back 50

Amantidine treats Influenza A only

Tamiflu treats Influenza A & B

Front 51

Paramyxiviridae

Back 51

Measles
Mumps
RSV
Parainfluenza

enveloped RNA virus

Front 52

Back 52

Koplik spots of measles

Front 53

Atypical measles

Back 53

Hypersensitivity reaction that occurs in patients incompletely vaccinated for measles

high fever, headache, cough, and abdominal pain. The rash may appear 1 to 2 days later, often beginning on the limbs.

SUBACUTE SCLEROSING PANENCEPHALITIS

Front 54

Croup

Back 54

Parainfluenza

Member of paramyxoviridae, enveloped RNA virus

Front 55

Parotitis
testes/ovary
eye/ear
CNS

Back 55

Mumps (paramyxoviridae)

Front 56

Back 56

CPE of RSV

syncytium formation

Front 57

RSV is in what family?

Back 57

paramyxoviridae

Front 58

Gastroenteritis in a child
fecal specimen

Back 58

ROTAVIRUS! (wheels)

Front 59

Adult T cell lymphoma
Tropical spastic paraperesis

Back 59

HTLV (of the retroviruses)

Front 60

What type of vaccine is MMR?

Back 60

live attenuated

Front 61

What family are the arboviruses?

Back 61

Trick question!
term used to refer to a group of viruses that are transmitted by arthropod vectors. The word arbovirus is an acronym (ARthropod-BOrne viruses)

RNA viruses

Front 62

What mosquitoes transmit WNV, dengue and yellow fever?

Back 62

Aedes (A. aegypti)

Front 63

maculopapular and progresses to vessicular - all lesions
in same stage on a body area - central body outward

Back 63

Smallpox

ALL LESIONS SAME STAGE

Front 64

Back 64

smallpox

Front 65

Back 65

Rabies
bullet-shaped

Front 66

What family is rabies?

Back 66

rhabdoviridae

Front 67

Types of cell lines

Back 67

Primary -- monkey kidney

Diploid -- embryonically derived, fibroblast, lung

Permanent -- tumor derived, HeLa, A549, MRC5, HEp-2

Front 68

Inoculation of cells on cover slip in tube, centrifugation improves yield

Results in how long?

Back 68

Shell vial method

24-48 hours

Front 69

Cytopathic effect, early vs late

Back 69

Early: rounding of cells

Late: death, plaques

Front 70

Slow growing viruses

Back 70

CMV

VZV

Front 71

Non-growing viruses

Back 71

HBV

HPV

Front 72

Clusters of rounded cells

Hep-2 mostly

Back 72

Adenovirus

Front 73

Small foci of rounded cells

Fibroblast ONLY

Back 73

CMV

Front 74

Refractile, angular, tear-shaped

PMK mostly

Back 74

Enterovirus

Front 75

Rounded, swollen, refractile, syncytia

All lines

Back 75

HSV

Front 76

Degenerated cells

PMK only

Back 76

Influenza

Front 77

Usually no CPE

Back 77

Mumps

Parainfluenza

Front 78

Syncytia prominent

Hep-2 mostly

Back 78

RSV

Front 79

Foci of round, swollen, refractile cells

Fibroblasts

Back 79

VZV

Front 80

Rapid antigen tests

Back 80

Insensitive by available anywhere

Front 81

What is required to detect RNA viruses by a molecular method?

Back 81

Reverse transcriptase step

Front 82

Internal controls for molecular methods are for....

Back 82

detecting inhibition

Front 83

Uses of viral genotyping for HCV

Back 83

Duration and intensity of therapy

Front 84

Use of viral genotyping for HIV

Back 84

Drug susceptibility testing

Front 85

Early inclusions eosinophilic, finely granular, smaller andherpes-like (Cowdry A); late inclusions deeply basophilicand larger, with nucleocytoplasmic blurring (“smudgecells”)

Back 85

Adenovirus

Front 86

Cytomegaly; nucleolus often retained; single, amphophilicIN (Cowdry A) inclusion. IC inclusions multiple, smaller,basophilic, GMS- and PAS-positive; IN inclusion formedearly, IC inclusions later

Back 86

CMV

Front 87

Early inclusions amphophilic with “ground glass”appearance; late inclusions eosinophilic, homogeneous(Cowdy A) and surrounded by clear halo, with marginatedchromatin; multinucleated syncytia (giant cells) and“molding”

Back 87

HSV

VZV

Front 88

Multinucleated syncytia (giant cells); IN inclusionseosinophilic and herpes-like; IC inclusions pleomorphic,deeply eosinophilic, hyalinized, tallow-like

Back 88

Measles

Front 89

Multinucleated syncytia (giant cells); IC inclusions, whenpresent, pleomorphic, eosinophilic and indistinct

Back 89

Parainfluenza

Front 90

Multinucleated syncytia (giant cells); multiple, discrete,smoothly contoured and deeply eosinophilic IC inclusions

Back 90

RSV

Front 91

Smudge cells

Back 91

Adenovirus

Front 92

HSV - oral

Back 92

80% HSV1

Front 93

HSV - genital

Back 93

80% HSV2

Front 94

Multinucleation

Margination

Molding

Back 94

HSV

Front 95

Primary varicella

Back 95

Chickenpox

Disseminated

Front 96

Reactivation varicella

Back 96

Shingles

Dermatomal

Front 97

Disseminated zoster/herpetic rash in an immunocompromised patient

Back 97

Primary varicella

Disseminated zoster

Disseminated HSV

Front 98

Negri bodies

Back 98

Rabies

IC eosinophilic inclusions

Front 99

Associations with HCV

Back 99

Cryoglobulinemia

Kidney disease - MPGN

Autoimmune diseases

Lymphomas

HCC

Front 100

Perinatal transmission risk in HCV

Back 100

< 10%

Front 101

Acute Hep C

Back 101

< 25% of infected persons

Fulminant disease rare except in Japan

Front 102

Percent of patients with HCV who develop persistent infections

Back 102

50-85%

Front 103

When does HCV antibody become positive?

Back 103

6-8 weeks

Front 104

HCV genotype prognosis

Back 104

Strains 2 and 3 are more likely to respond to treatment than type 1

Front 105

Major drug targets in HIV

Back 105

Reverse transcriptase p66/p51

Protease p11

Front 106

Western blot for HIV: important bands

Back 106

p24

gp41

gp120

gp160

need 2 of 4

Front 107

HIV screening EIA

Back 107

1st gen: crude viral lysate

2nd gen: recombinant antigens (increased specificity)

3rd gen: improved IgM detection (closed window period partially)

4th gen: antibody and antigen detection

Front 108

HIV confirmatory tests

Back 108

WB

IFA

Front 109

HIV

Faint p24 band with otherwise negative WB

Back 109

Pregnancy

Front 110

HIV

Strongly positive EIA and negative WB

Back 110

HIV2

Front 111

gp41 band on EIA is blurry why?

Back 111

differential glycosylation

Front 112

Gold standard for influenza testing

Back 112

Shell vial

(may be surpassed by RT-PCR)

Front 113

Influenza results available in....

Back 113

Shell vial: 24-48 hours

DFA: 1-2 hrs

Molecular: 1hr

Front 114

Rapid tests for influenza, limitations

Back 114

50-70% sensitivity, lower in adults

Children shed more virus than adults; tests tend tobe more sensitive in kids

Front 115

Decision based on positive rapid flu test

Back 115

Do not start antibacterials

Start antivirals

Droplet precautions

Don’t do other tests

Consequences of error: potentially severe

Front 116

Specimen for flu testing

Back 116

Collection is critical

Nasopharyngeal washes are better than swabs

Must get ciliated cells

Front 117

Exanthems

Back 117

Exanthems: measles, rubella, enterovirus, parvovirusB19, HHV-6, dengue, West Nile, EBV, adenovirus,CMV

Front 118

Hepatitis viruses

Back 118

Hepatitis viruses

Hepatitis A, B, C, D, E

HSV, especially in newborns

EBV

CMV

Adenovirus

Front 119

Mononucleosis

Back 119

Mononucleosis: EBV, CMV, adenovirus, HIV, HHV-6

Front 120

Ocular

Back 120

Ocular: enterovirus, adenovirus, HSV, VZV, CMV,vaccinia, measles

Front 121

Marrow suppression

Back 121

Marrow suppression: EBV, MV, HHV-6, hepatitis A,B, C, parvovirus B19, influenza, adenovirus, HIV