Step 1 Sketchy Micro Viruses

Front 1

Is Adenovirus a DNA, RNA positive, or RNA negative virus?

Back 1

DNA

Front 2

Is Adenovirus enveloped or naked?

Back 2

naked

Front 3

What is the most common cause of adenoids and tonsillitis?

Back 3

Adenovirus

Front 4

How is Adenovirus transmitted?

Back 4

1. Respiratory droplets
2. Fecal-oral route

Front 5

What is the most common demographic for Adenovirus?

Back 5

1. Little children
2. Military baracks
3. Swimming at public pools

Front 6

Clinical presentations of Adenovirus? (3)

Back 6

1. Hemorrhagic cystitis
2. Viral conjunctivitis (pink eye)
3. Adenoid/tonsillitis

Front 7

How are military recruits protected from Adenovirus?

Back 7

Live attenuated virus vaccine

Front 8

What type of virus is Togavirus?

Back 8

Positive RNA virus

Front 9

Is Togavirus enveloped or naked?

Back 9

Enveloped

Front 10

Protein processing of Togavirus?

Back 10

Long polypeptide cleaved by proteases

Front 11

What two diseases are caused by Togavirus?

Back 11

1. Arbovirus
2. Rubella

Front 12

What are the three subdiseases of Togavirus' Arbovirus?

Back 12

1. Western equine encephalitis
2. Easter equine encephalitis
3. Venezuelan equine encephalitis

Front 13

How do you treat Togavirus' Arbovirus?

Back 13

No treatment

Front 14

What type of disease is Rubella?

Back 14

Childhood exanthema

Front 15

Another name for Rubella

Back 15

German measles

Front 16

How is Rubella spread?

Back 16

Respiratory droplets

Front 17

Symptoms of childhood Rubella (4)

Back 17

1. Postauricular and occipital lymphadenopathy
2. Maculopapular rash starts at head and descends - only present for 3 days, moves fast, dosen't darken or coalesce
3. Fever
4. Fatigue

Front 18

Is Rubella a torches infection?

Back 18

Yes

Front 19

Symptoms of Congenital Rubella (9)

Back 19

1. Congenital cataracts

2. Patent ductus arteriosus

3. Sensory-neural deafness

4. Blueberry muffin rash
5. Jaundice
6. Blindness
7. Mental retardation
8. Microcephaly
9. Bone lesions

Front 20

Adult Rubella symptoms (3)

Back 20

1. Lymphadenopathy
2. Arthritis
3. Fever

Front 21

What is the treatment for Rubella?

Back 21

No treatment available

Front 22

MMR vaccine

1. Vaccine?
2. Who's at risk

Back 22

1. Live attenuated vaccine, humoral and cell mediated immunity

2. Avoid while pregnant and immunocompromised C4 count < 200

Front 23

What is one particular group at risk for Rubella?

Back 23

Immigrants because often not vaccinated

Front 24

What type of virus is Picornavirus?

Back 24

Positive RNA virus

Front 25

Are Picornaviruses naked or enveloped?

Back 25

Naked

Front 26

How are Picornaviruses transmitted?

Back 26

Fecal-oral, except Rhinovirus which is respiratory droplets

Front 27

Do Picornaviruses have a large polyprotein product that viral proteases cleave?

Back 27

Yes

Front 28

Hepatits A's family

Back 28

Picornavirus

Front 29

Enterovirus's family

Back 29

Picornavirus

Front 30

Rhinovirus's family

Back 30

Picornavirus

Front 31

Poliovirus's genus

Back 31

Enterovirus

Front 32

Coxsackie virus's genus

Back 32

Enterovirus

Front 33

Echovirus genus

Back 33

Enterovirus

Front 34

What are the number one cause of aseptic meningitis?

Back 34

Enteroviruses

Front 35

What patient population is most commonly affected with aseptic meningitis?

Back 35

Children

Front 36

Is Poliovirus acid stabile or labile?

Back 36

Acid stable

Front 37

Where does Poliovirus replicate? (2)

Back 37

1. Lymphoid tissue of tonsils

2. Peyer's patches of sumucosa of ileum

Front 38

How long does Poliovirus take to replicate in the lymphoid tissue?

Back 38

2-3 weeks

Front 39

Symptoms of Poliovirus (3)

Back 39

1. Asymmetric flaccid paralysis concentrated in lower legs
2. Can ascend to diaphragm => respiratory insufficiency
3. Aspetic meningitis

Front 40

SALK vaccine

Back 40

Killed Polio parenteral vaccine that only forms IgG antibodies not IgA

Front 41

SABIN vaccine

Back 41

live attenuated Polio oral vaccine forms both IgA and IgG with potential to revert back to active form in feces

Front 42

When is Coxsackie infection most common?

Back 42

Summer

Front 43

Coxsackie A symptoms (3)

Back 43

1. Hand, foot, mouth disease
2. Red vesicular rash
3. Aseptic meningits

Front 44

Coxsackie B virus symptoms (2)

Back 44

1.

Dilated cardiomyopathy

2.

Devil's grip - Bornholm's disease/pleurodynia - extreme sharp unilateral pain in chest, difficult to breath

Front 45

How is Rhinovirus spread (2)?

Back 45

1. Transmitted through respiratory droplets

2. Transmitted through fomites (grubby hands)

Front 46

Are Picornaviruses acid stable or labile?

Back 46

Acid stabile, except Rhinovirus

Front 47

What is the only Picornavirus that is acid labile?

Back 47

Rhinovirus

Front 48

How does Rhinovirus attach/enter host cells?

Back 48

ICAM-1

Front 49

What temperature does Rhinovirus grow best at?

Back 49

Slightly cooler than body temperature (33 degrees) which is why it prefers cooler URT

Front 50

How is Hepatitis A transmitted in developing countries?

Back 50

Contaminated water

Front 51

How is Hepatitis A transmitted in developed countries?

Back 51

Uncooked shellfish

Front 52

How do young children present with Hepatitis A?

Back 52

Often anicteric hepatitis (no jaundice)

Front 53

Smokers with an aversion tobacco may have...

Back 53

Hepatitis A

Front 54

How do symptoms of hepatitis A last?

Back 54

1 month

Front 55

What type of vaccine is used for hepatitis A?

Back 55

Inactivated vaccine

Front 56

Calicivirus is what type of virus?

Back 56

Positive RNA virus

Front 57

Is Calicivirus naked or enveloped?

Back 57

Naked

Front 58

Does Calicivirus create one long polyprotein that is cleaved by viral proteases?

Back 58

Yes

Front 59

What is the most common Calicivirus?

Back 59

Norovirus (Norwalk)

Front 60

Norovirus (Norwalk)'s family

Back 60

Calicivirus

Front 61

Who gets Norovirus (Norwalk)?

Back 61

1. Lots of people in closed quarters

2. Cruises

3. Young children and day cares/schools

Front 62

What type of food do you get Norovirus (Norwalk) from? (2)

Back 62

1. Shellfish

2. Buffets

Front 63

Symptom of Norovirus (Norwalk)

Back 63

Diarrheal illness- viral gastroenteritis with Explosive watery diarrhea

Front 64

What type of virus is Flavivirus?

Back 64

Positive RNA virus

Front 65

Is Flavivirus enveloped or naked?

Back 65

Enveloped

Front 66

Is Flavivirus segmented?

Back 66

No

Front 67

What virus causes Dengue fever?

Back 67

Flavivirus

Front 68

What virus causes Yellow fever?

Back 68

Flavivirus

Front 69

What virus causes West Nile?

Back 69

Flavivirus

Front 70

What virus family causes Hepatitis C

Back 70

Flavivirus

Front 71

What is the vector of Dengue fever

Back 71

Aedes Egyptei mosquitos

Front 72

Another name for Dengue fever

Back 72

Break-bone fever

Front 73

Dengue fever type II Features (5)

Back 73

1. Bone marrow problems
2. Thrombocytopenia
3. Renal failure
4. Hemorrhagic fever
5. Septic shock/death

Front 74

What is the vector for Yellow fever?

Back 74

Aedes Egyptei mosquito

Front 75

Symptoms of yellow fever (4)

Back 75

1. Jaundice
2. Backache
3. Bloody diarrhea
4. Bloody vomiting

Front 76

What type of vaccine is there for yellow fever?

Back 76

Live attenuated vaccine

Front 77

What is the vector for West Nile virus?

Back 77

Mosquito

Front 78

What is the reservoir for West Nile virus?

Back 78

Birds

Front 79

Symptoms of West Nile virus (5)

Back 79

1. Encephalitis
2. Meningitis
3. Flaccid paralysis
4. Seizures
5. Coma

Front 80

What is unique about the envelope of Hepatitis C?

Back 80

Envelope proteins have antigenic variability making it difficult to make a vaccine

Front 81

What leads to the antigenic variation in Hepatitis C?

Back 81

Noproofreading 3'-5' exonuclease activity in virion encoded RNA polymerase

Front 82

What is associated with Cryoglobulins and what are they?

Back 82

1. Serum proteins containing IgM that precipitate in cooler temperatures

2. Hepatitis C

Front 83

Liver enzymes in acute Hepatitis C?

Back 83

ALT will rise and fall by 6 months in acute infection

Front 84

Does anti-HCV antibodies indicate acute, chronic, both or neither infection?

Back 84

Acute or chronic, since HCV mutates a lot

Front 85

What indicates chronic Hepatitis C infection?

Back 85

Hepatitis C RNA persisting longer than 6 months

Front 86

How do you treat Hepatitis C?

Back 86

1. Ribavirin with IFN-α

2. Protease inhibitors

Front 87

Rubella is caused by what virus?

Back 87

Togavirus

Front 88

What type of virus is Coronavirus?

Back 88

Positive RNA virus

Front 89

Describe the coronavirus capsule?

Back 89

Encapsulated with a helical shape

Front 90

Coronavirus diseases (4)

Back 90

1. Common cold

2. SARS

3. MERS (Middle east respiratory syndrome)

4. Acute bronchitis => ARDS

Front 91

Is HIV enveloped?

Back 91

Yes

Front 92

What type of virus is HIV?

Back 92

Diploid Positive RNA virus

Front 93

What positive RNA virus is diploid?

Back 93

HIV

Front 94

Gag function

Back 94

makes p24 for the HIV capsule

Front 95

Env function (2)

Back 95

makes glycoprotein 41 (transmembrane protein) and glycoprotein 120 (outer glycoprotein) for the HIV envelope

These are made initially from one polypeptide product

Front 96

Glycoprotein 41

Back 96

Transmembrane protein made from Env gene of HIV for envelope

Front 97

Glycoprotein 120

Back 97

Outer glycoprotein made from Env gene of HIV for envelope

Front 98

Pol in HIV

Back 98

Reverse transcriptase

Front 99

What cells does HIV initially infect?

Back 99

1. Macrophages

2. Helper T cells

Front 100

Where does HIV replicate in the latent period?

Back 100

Lymph nodes

Front 101

How is AIDS defined (2)?

Back 101

1.

CD4 count < 200 OR

2.

AIDS defining illness with any CD4 count

Front 102

What type of cancer can HIV cause?

Back 102

Diffuse large B cell lymphoma

Front 103

How does HIV enter host cells in the early stages?

Back 103

CCR5 receptor

Front 104

How does HIV enter host cells in the later stages?

Back 104

CXCR4 receptor

Front 105

How do you screen for HIV?

Back 105

ELISA screening test but could be negative in first 6 months of infection

Front 106

How do you confirm HIV?

Back 106

Western Blot

Front 107

How do you test a neonate for HIV from vertical transmission? Why?

Back 107

1. Test for HIV RNA and HIV DNA

2. Mother will have passed down antibodies to HIV down to neonate making a false positive since ELISA and Western Blot test for antibodies

Front 108

What drug do you use for HIV during pregnancy, labor, and post-partum? What class is this?

Back 108

Zidovudine - NRTI

Front 109

Maraviroc is what class of drug and used for what disease?

Back 109

CCR5 inhibitor for HIV

Front 110

What is the only RNA virus to replicate in the nucleus?

Back 110

Orthomyxovirus

Front 111

What kind of virus is Orthomyxovirus?

Back 111

Negative RNA virus

Front 112

Do Negative RNA viruses bring their own RNA polymerase or use host machinary?

Back 112

Bring their own RNA polymerase

Front 113

Do Positive RNA viruses bring their own RNA polymerase or use host machinary?

Back 113

Host machinary

Front 114

Is Orthomyxovirus enveloped or naked?

Back 114

Enveloped

Front 115

Influenza A, B, C's family

Back 115

Orthomyxovirus

Front 116

How many segments does Orthomyxovirus have?

Back 116

8 virus segments

Front 117

Which RNA viruses are segmented? (4)

Back 117

BOAR:

Bunyavirus

Orthomyxovirus

Arenavirus

Reovirus

Front 118

Antigenic shift vs antigenic drift

Back 118

Antigenic shift - segments switch => pandemic

Antigenic drift - point mutations => epidemic (seasonal flu)

Front 119

Does influenza A cause pandemics, epidemics, or both?

Back 119

BOTH ie antigenic shift/drift

Front 120

Does Influenza B cause pandemics, epidemics, or both?

Back 120

Epidemics only ie antigenic drift only

Front 121

Hemaglutitinin (HA)

Back 121

glycoprotein that binds sialic acid on cells of Upper respiratory tract or causes agglutination of RBC

Front 122

what type of antibodies are protective in orthomyxovirus?

Back 122

Anti-HA antibodies

Front 123

For orthomyxovirus what determines tropism (what cells the virus can bind to)?

Back 123

Hemagluttinin (HA)

Front 124

M2 protein

Back 124

In influenza A, M2 protein creates proper pH for viral uncoating

Front 125

Amantadine

1. Mechanism

2. Use

Back 125

1. inhibits M2 => no uncoating

2. Treatment for Influenza A only

Front 126

Rimantadine

1. Mechanism

2. Use

Back 126

1. inhibits M2 => no uncoating

2. Treatment for Influenza A only

Front 127

Does Influenza A have M2 protein?

Back 127

Yes

Front 128

Does influenza B have M2 protein?

Back 128

No

Front 129

Neuraminidase (NA)

Back 129

cleaves sialic acid to allow virus to escape from cell

Front 130

Oseltamivir

1. Mechanism

2. Use

Back 130

1. NA inhibitor => inhibit virion release

2. Treats Influenza

Front 131

Anamivir

1. Mechanism

2. Use

Back 131

1. NA inhibitor => inhibit virion release

2. Treats Influenza

Front 132

What is a major complication of Influenza? What causes this complication?

Back 132

Secondary pneumonia caused by Staph aureus, or possibly Strep pneumoniae

Front 133

What happens if a parent gives their children aspirin if they have the flu or other viral illness?

Back 133

Reyes syndrome - aspirin contraindicated

Front 134

Reyes syndrome symptoms (5)

Back 134

1. Uncoupling of electron transport chain in hepatocytes
2. Liver failure
3. Fatty liver
4. Encephalitis
5. Fever

Front 135

What syndrome is associated with orthomyxovirus?

Back 135

Guillan-Barre Syndrome - ascending paralysis

Front 136

What type of virus is Paramyxovirus?

Back 136

Negative RNA virus

Front 137

Is Paramyxovirus enveloped or naked?

Back 137

Enveloped

Front 138

How is paramyxovirus spread?

Back 138

Respiratory droplet transmission

Front 139

Another name for measles

Back 139

Rubeola

Front 140

Measles's family

Back 140

Paramyxovirus

Front 141

Mumps's family

Back 141

Paramyxovirus

Front 142

RSV's family

Back 142

Paramyxovirus

Front 143

Croup's family

Back 143

Paramyxovirus

Front 144

Measles symptoms

Back 144

1. Cough
2. Coryza (rhinorrhea)
3. Conjunctivitis
4. Koplik spots (small bluish white spots with surrounding erythema on buccal mucosa)
5. Fever
6. Descending rash starting on the face that is likely to form confluent rash (multiple spots melting together)

Front 145

Descending rash starting on the face that is likely to form confluent rash

Back 145

Measles

Front 146

Koplik spots (define and what disease)

Back 146

1. small bluish white spots with surrounding erythema on buccal mucosa

2. Measles

Front 147

Complications of Measles (2)

Back 147

1. Pneumonia
2. Subacute Sclerosing Pan encephalitis (SSPE)

Front 148

Subacute Sclerosing Pan encephalitis (SSPE)

1. Define

2. Symptoms (4)

3. Diagnosis

Back 148

1. Post measles infection complication occurring many years later

2. Personality changes

3. Myoclonus

4. Seizures

5. Death

6. Diagnosis: Anti-measles antibodies in CSF

Front 149

What virulence factors does measles have?

Back 149

1. HA
2. Fusion protein - forms multinucleated giant cells called Warthin-Finkeldey cells in lymphoid tissue with eosinophilic inclusion bodies

Front 150

Warthin-Kinkeldey cells

Back 150

Multinucleated giant cells in Measles formed by fusion protein in lymphoid tissue with eosinophilic inclusion bodies

Front 151

Is Neuraminidase in Measles?

Back 151

No

Front 152

How do you reduce measles morbidity and mortality

Back 152

Vitamin A

Front 153

Where does mumps replicate?

Back 153

Parotid gland

Front 154

Mumps symptoms (5)

Back 154

1. Parotitis

2. Unilateral orchitis (inflammation of the epididymis)

3. Testicular atrophy

4. Impaired fertility

5. Meningitis

Front 155

What are the virulence factors of Mumps?

Back 155

1. HA

2. Fusion protein

3. NA

Front 156

Respiratory Syncytial Virus (RSV) demographic

Back 156

Infants < 6 months

Front 157

How does RSV attach to the respiratory epithelium?

Back 157

G protein

Front 158

What is the most common cause of pneumonia and bronchiolitis in infants?

Back 158

RSV

Front 159

Virulence factor of RSV

Back 159

Fusion protein

Front 160

How do you treat RSV?

Back 160

Ribavirin treatment for adults only, but not in pregnant women

Front 161

Palivizumab use

Back 161

Prophylaxis for high risk children for RSV such as premature

Front 162

Laryngotracheobronchitis other name

Back 162

Croup

Front 163

Parainfluenza virus symptoms (2)

Back 163

1. Seal bark cough

2. Inspiratory stridor

Front 164

Virulence factors of parainfluenza virus

Back 164

1. HA

2. Fusion protein

3. NA

Front 165

X-ray sign of parainfluenza virus

Back 165

Steeple sign - narrowing of the subglottic region

Front 166

Demographic of parainfluenza virus

Back 166

Usually children, but adults may present as a bad cold

Front 167

What type of virus is Rhadovirus?

Back 167

Negative RNA virus

Front 168

Is Rhabdovirus enveloped or naked?

Back 168

Enveloped

Front 169

What is the shape of the capsule of Rhadovirus?

Back 169

Bullet shaped

Front 170

What is the shape of the capsid of Rhadovirus?

Back 170

Helical

Front 171

How is Rhabdovirus transmitted?

Back 171

Zoonotic virus - most commonly bats

Front 172

Pathogenesis of Rhabdovirus (2)

Back 172

1. Glycoprotein binds to nicotinic acetylcholine receptors –initially infects neurons at the post-synaptic motor endplate-replicates here

2. Retrograde from peripheral nerves to dorsal root ganglia-1-3 mm per day

Front 173

Where does Rhadovirus replicate?

Back 173

Motor neurons

Front 174

Symptoms of Rhadovirus (5)

Back 174

1. Tingling/muscle spasms

2. Increased salivary production

3. Excruciating spasm of throat/larynx muscles - dysphagia

4. High fever

5. Encephalitis

Front 175

Eosinophilic Negri bodies

Back 175

Rhabdovirus

Front 176

What cells do you seen eosinophilic negri bodies in Rhabdovirus? (2)

Back 176

1. The cytoplasm of Hippocamus pyramidal cells

2. Purkinje cells

Front 177

How do you treat Rhabdovirus? (2)

Back 177

1. Passive immunization with human rabies immunoglobulin for post exposure prophylaxis
2. Killed vaccine for active immunization

Front 178

When should you give the Rhabdovirus vaccine?

Back 178

Before symptoms appear or else deadly

Front 179

What type of virus is Filovirus?

Back 179

Negative RNA virus

Front 180

What is the shape of the Filovirus capsid?

Back 180

Helical

Front 181

Is Filovirus enveloped or naked?

Back 181

Enveloped

Front 182

When do symptoms appear in Filovirus?

Back 182

Days to weeks after contracting virus

Front 183

Symptoms of Filovirus (5)

Back 183

1. Fever

2. Petechial rash

3. Hemorrhagic fever

4. End-organ failure

5. Hemorrhagic (hypovolemic) shock

Front 184

How is Filovirus spread? (3)

Back 184

1. Direct contact with an animal infected such as primates /bats - Africa

2. Health care works taking care of infected

3. Bodily fluids

Front 185

Filoviruses include (2)

Back 185

1. Marburg virus

2. Ebola virus

Front 186

Marburg virus's family

Back 186

Filovirus

Front 187

Ebola virus's family

Back 187

Filovirus

Front 188

What type of virus is Bunyavirus?

Back 188

Negative RNA virus

Front 189

Is Bunyavirus enveloped or naked?

Back 189

Enveloped

Front 190

What is unique about the Bunyavirus envelope?

Back 190

Obtains envelope from golgi body of host cells

Front 191

Is Bunyavirus segmented?

Back 191

Yes

Front 192

How many segments is Bunyavirus

Back 192

3 circular segments

Front 193

Two major categories of Bunyavirus

Back 193

1.

Arbovirus

2.

Hantavirus

Front 194

Hantavirus's family

Back 194

Bunyavirus

Front 195

Hantavirus reservoir

Back 195

deer mouse

Front 196

How is Hantavirus transmitted?

Back 196

Urine/feces of deer mouse

Front 197

Symptoms of Hantavirus (3)

Back 197

1. Pulmonary edema via capillary leak

2. pre-renal azotemiavia capillary leak

3. Hemorrhagic fever

Front 198

Rift valley fever is similar to....

Back 198

California encephalitis

Front 199

Rift valley fever is caused by?

Back 199

An arbovirus of Bunyavirus

Front 200

California encephalitis is caused by?

Back 200

An arbovirus of Bunyavirus

Front 201

Rift valley fever and California encephalitis symptoms

Back 201

1. Seizures
2. Encephalitis

Front 202

How is Rift valley fever and California encephalitis transmitted

Back 202

Aedes mosquito

Front 203

Are Rift valley fever and California encephalitis fatal?

Back 203

Generally not fatal

Front 204

What type of virus is Arenavirus?

Back 204

Negative RNA virus, but acts ambisense (can be both negative and positive sense)

Front 205

Which RNA virus is ambisense?

Back 205

Arenavirus

Front 206

What type of capsid does Arenavirus have?

Back 206

Helical

Front 207

Is Arenavirus segmented?

Back 207

Yes

Front 208

How many segments is Arenavirus?

Back 208

2 segments

Front 209

How does Arenavirus look on EM?

Back 209

Sandy/grainy look

Front 210

Is Arenavirus enveloped or naked?

Back 210

Enveloped

Front 211

How is Arenavirus transmitted?

Back 211

Rodents

Front 212

Lymphocytic choriomeningitis virus (LCV)'s family

Back 212

Arenavirus

Front 213

Lymphocytic choriomeningitis virus (LCV) symptoms (2)

Back 213

1. Meningoencephalitis
2. Fever

Front 214

How is arenavirus inactivated (4)?

Back 214

1. Heating
2. Low pH
3. irradiation
4. Detergents

Front 215

What is the only double stranded RNA virus?

Back 215

Reovirus

Front 216

Is Reovirus enveloped or naked?

Back 216

Enveloped

Front 217

Where does Reovirus replicate?

Back 217

Cytoplasm

Front 218

Is Reovirus segmented?

Back 218

Yes

Front 219

How many segments is Reovirus?

Back 219

11ish

Front 220

Rotavirus's family

Back 220

Reovirus

Front 221

How is rotavirus spread?

Back 221

Fecal-oral

Front 222

Symptom of Rotavirus

Back 222

Watery diarrhea

Front 223

How does Rotavirus cause watery diarrhea?

Back 223

NSP4 toxin – secretory diarrhea (increase chloride permeability)

Front 224

What time of year is most common for Rotavirus?

Back 224

Winter

Front 225

Who is at risk of rotavirus?

Back 225

Children, daycare

Front 226

What is the leading cause of severe diarrhea in young children?

Back 226

Rotavirus

Front 227

Colorado tick virus's family

Back 227

Reovirus

Front 228

What separates Colorado tick virus from other diseases like Rocky Mountain Spotted Fever?

Back 228

No RASH

Front 229

Colorado tick virus symptoms (4)

Back 229

1. NO RASH

2. Myalgia

3. Fevers

4. Vomiting

Front 230

Where is Colorado tick virus located?

Back 230

Rocky Mountain states

Front 231

How do you treat rotavirus?

Back 231

oral rehydration

Front 232

Is there a vaccine for rotavirus and if so what kind of vaccine?

Back 232

Yes, live attenuated virus vaccine (oral)

Front 233

When should you give the rotavirus vaccine?

Back 233

First dose should be given before 3 months of age due todecreased efficacy and increased side effects later

Front 234

What is the side effect of the rotavirus vaccine?

Back 234

intussusception = telescoping of the bowel from enlarge ofPeyer’s patches

Front 235

What type of virus is HSV1 and HSV2?

Back 235

Linear DNA virus

Front 236

Is HSV1/HSV2 enveloped or naked?

Back 236

Enveloped?

Front 237

Are herpes viruses enveloped or naked?

Back 237

Enveloped

Front 238

Cowdry bodies

Back 238

Intranuclear inclusion bodies contained in big red eosinophilic cells seen in HSV1 and HSV2

Front 239

Initially presents as gingivostomatitis (infection of lipsand gums) – more often in infants

Back 239

HSV1

Front 240

Herpes labialis

Back 240

cold sore (HSV1)

Front 241

Keratoconjunctivitis

Back 241

Serpiginous(snake like) corneal ulcers on fluorescent slit lamp exam - HSV1

Front 242

What is a significant complication of HSV1?

Back 242

Temperal lobe encephalitis – hemorrhage and necrosis oftemporal lobes, including fever, seizures, personality changes and olfactoryhallucinations

Front 243

What is the #1 cause of sporadic encephalitis in USA?

Back 243

HSV1

Front 244

Where is latent HSV1?

Back 244

Trigeminal ganglia

Front 245

Describe the HSV1 rash

Back 245

rashhas “dew drops on rose petal” appearance – clear vesicles sitting on anerythematous base

Front 246

Herpetic whitlow

Back 246

morecommon in dentists, vesicles on a finger (can be HSV1 or HSV2)

Front 247

What hypersensitivity reaction is associated with HSV1?

Back 247

Erythema multiform – hypersensitivity reaction => smalltarget lesions that move in centrally from the backs of hands and feets, 1-2 weeksafter initial infection

Front 248

Herpes genitalis

Back 248

HSV2 – painful vesicular, inguinal lymphadenopathywith red base

Front 249

Where does HSV2 lie dormant?

Back 249

Sacral ganglia

Front 250

What is a significant complication of HSV2?

Back 250

Aseptic meningitis in adolescents and adults

Front 251

How do you diagnose HSV? (2)

Back 251

1. Tzank smear showing multinucleated giant cells,characteristic of herpes infections

2. PCR diagnostic test

Front 252

How do you prevent HSV breakouts? (2)

Back 252

1. Acyclovir

2. Valcyclovir

Front 253

What type of virus is Epstein-Barr virus?

Back 253

DNA virus

Front 254

Symptoms of EBV (5)

Back 254

1. Fever

2. Tender lymphadenopathy (posterior cervical) / can also begeneralized lymphadenopathy

3. Splenomegaly due to T-cell proliferation

4. Pharyngitis

5. tonsillar exudates

Front 255

What causes the Splenomegaly in EBV?

Back 255

T-cell proliferation

Front 256

What do you see on blood smear in EBV?

Back 256

Reactive cytotoxic CD8+ T cells (Downey, or atypical cells)

Front 257

What cells are the target of initial infection in EBV?

Back 257

B lymphocytes

Front 258

Where does EBV remain latent?

Back 258

B cells

Front 259

How does EBV infect B cells?

Back 259

Envelope glycoprotein binds CD21 on B cells

Front 260

How does EBV typically present in children?

Back 260

Asymptomatic

Front 261

What happens if someone who you think has Strep pharyngitis is given amoxicillin or ampicillin develops a maculopapular rash?

Back 261

Actually EBV infection

Front 262

What cancers does EBV predispose you to?

Back 262

B cell lymphomas:

1. Hodgkin lymphoma-Reed-Sternberg cells that look like owl’seyes, usually the mixed cellular type

2. Non-Hodgkin’s lymphoma: Endemic or African Burkitt lymphoma–large jaw lesion and swelling

3. Nasopharyngeal carcinoma associated with Asian EBV patients

Front 263

EBV Nasopharyngeal carinoma is associated with what race?

Back 263

Asian

Front 264

HIV patients with EBV can develop....

Back 264

Oral hairy leukoplakia in HIV patients but is non-cancerouslesion (can’t scrape off tongue)

Front 265

Monospot test mechanism

Back 265

EBV activates B cells to secrete heterophile antisheep RBCantibodies that will agglutinate sheep or horse RBCs => basis of Monospottest – rapid diagnosis

Front 266

Treatment for EBV

Back 266

supportivetherapy but most avoid contact sports due to risk of splenic rupture

Front 267

What type of virus is Cytomegalovirus?

Back 267

DNA virus

Front 268

Cytomygalovirus's family

Back 268

Herpes virus

Front 269

Where does CMV remain latent?

Back 269

mononuclearcells (WBC with one nucleus) – B, T, and macrophages

Front 270

Can CMV be transmitted cross-placenta?

Back 270

Yes

Front 271

Symptoms of congenital CMV (6+)

Back 271

1. Blueberry muffin rash (thrombocytopenia withpurpura)
2. Jaundice and hepatosplenomegaly
3. Sensorineural deafness
4. Intracranial/Periventricular calcifications
5. Ventriculomegaly (large ventricles in brain)
6. Mental retardation or Seizures fromcalcifications/ventriculomegaly

Front 272

What percent of congenital CMV is asymptomatic?

Back 272

80-90%

Front 273

What is a possible complication of asymptomatic congenital CMV later in childhood?

Back 273

Sensorineural deafness later in life

Front 274

When is a pregnant woman most likely to transmit CMV across the placenta? Consequences?

Back 274

1. second trimester

2. Risk of Hydrops fetalis - severe edema => spontaneous abotion

Front 275

What is the #1 cause of sensorineural hearing loss in children?

Back 275

CMV

Front 276

What is the #1 cause of congenital viral mental retardation?

Back 276

CMV

Front 277

Who is at risk of CMV pneumonia? How do you detect?

Back 277

1. Organ transplant patients

2. candetect with Buffy Coat Culture(part of blood with WBC and platelets) andincubate with anti-CMV antibodies to detect virus presence

Front 278

What CD4 count puts AIDS patients at risk of CMV?

Back 278

CD4 count < 50

Front 279

Most common manifestation of CMV in AIDS patients

Back 279

1. CMV retinitis with retinal necrosis described as “pizza pie retinopathy” –blind spots, flashing light, vision loss unilaterally

2. Linear ulcerations in esophagus (singular deep linearcompared to Herpes which is multiple and shallow) – esophagitis

3. CMV colitis with ulcerated walls

Front 280

Pizza pie retinopathy

Back 280

CMV retinitis with retinal necrosis - blind spots, flashing light, vision loss unilaterally

Front 281

Compare linear ulcerations in esophagus in CMV vs Herpes?

Back 281

Linear ulcerations in esophagus (singular deep linear compared to Herpes which is multiple and shallow) – esophagitis

Front 282

CMV histology appearance

Back 282

Owl’s eye inclusion bodies

Front 283

How do you treat CMV? (2)

Back 283

Ganciclovir, second line treatment Foscarnet when resistantto Ganciclovir due to mutations in UL97 gene

Front 284

UL97 gene mutation

Back 284

In CMV, requires use of Foscarnet instead of Ganciclovir

Front 285

CMV mononucleosis in immunocompetent patients

Back 285

fatigue,sore throat, lymphadenopathy with negative Monospot test

Front 286

What type of virus is varicella zoster virus?

Back 286

DNA virus

Front 287

Varicella zoster virus's family

Back 287

Herpes

Front 288

Is Varicella zoster virus enveloped or naked?

Back 288

Enveloped

Front 289

Descibe the chicken pox rash (2)

Back 289

1. Vesicular “dew drop on a rose”rash – surrounding erythema

2. Lesions in different stages ofhealing (unlike small pox which is all the same stage)

Front 290

Difference between small pox rash and chicken pox rash

Back 290

Chicken pox- lesions are in different healing stages

Small pox - lesions all same stage

Front 291

How do you diagnose Chicken pox?

Back 291

-Tzank smear shows multinucleatedgiant cells (similar to HSV)

Front 292

What are adults likely to present with as a major cause of morbidity in chicken pox?

Back 292

Pneumonia

Front 293

What complication in chicken pox can occur in immunocompromised?

Back 293

Encephalitis

Front 294

What kind of vacccine is available for Varicella zoster virus?

Back 294

Live attenuated vaccine for children

Front 295

How do you treat chicken pox?

Back 295

Acyclovir (children must be 12+)

Front 296

Where does chicken pox remain latent?

Back 296

Dorsal root ganglia

Front 297

How does shingles rash look?

Back 297

1. “dewdrop on a rose” appearance with dermatomal distribution

2. extremely painful

Front 298

Does Shingles cross the midline?

Back 298

Rarely crosses the midline unlessimmunocompromised and is a sign of dissemination

Front 299

What kind of vaccine is the Zoster vaccine?

Back 299

Live attenuated virus

Front 300

At what CD4 count can you give the Zoster vaccine?

Back 300

CD4 count > 200

Front 301

How do you treat shingles? (2)

Back 301

1. Famicilovir OR

2. Valacyclovir

Front 302

Is Herpes Zoster/Varicella Zoster a Torch infection?

Back 302

Yes

Front 303

Congenital Varicella syndrome

1. When infected?

2. Symptoms (3)

Back 303

1. Pregnant with varicella within first 2 trimesters

2. limb hypoplasia

3. cutaneous dermatomal scarring

4. blindness

Front 304

Human Herpes Virus 6 (HHV-6) causes what disease

Back 304

Roseola

Front 305

What type of virus is Roseola?

Back 305

DNA virus

Front 306

Roseola's family

Back 306

Herpes

Front 307

What cell does HHV-6 infect?

Back 307

CD4 helper T cells => immunosuppression

Front 308

What age group is at risk of Roseola?

Back 308

Children 6 months - 2 years

Front 309

Symptoms of Roseola (2)

Back 309

1. High fever lasting 4 days, canlead to febrile seizures (>104 degrees)

2. Diffuse macular rash with lacyappearance that spares the face after fever stops (compared to measles whichhas rash that covers face + rash during fever)

Front 310

Human Herpes Virus 8 (HHV-8) causes what disease?

Back 310

Kaposi Sarcoma

Front 311

Who gets Kaposi Sarcoma?

Back 311

Immunocompromised and specifically AIDS

Front 312

Symptoms/Location on body of Kaposi Sarcoma (3)

Back 312

1. Erythematous violaceous lesions onnose, extremities and mucous membranes (plaque, macule, nodule, patch) – newlycreated blood vessels within lesion

2. Lesions can be found within GItract

3. Hard palate lesions

Front 313

Pathogenesis of Kaposi Sarcoma (2)

Back 313

1. Causes proliferation ofvasculature
2. Causes dysregulation of VEG-F=> angiogenesis

Front 314

What cancer can Kaposi Sarcoma cause?

Back 314

Infection of B cells can causePrimary Effusion Lymphoma (B-cell lymphoma)

Front 315

How is Kaposi Sarcoma transmitted?

Back 315

Sexual contact including kissing,especially men who have sex with men

Front 316

Demographic/Location of Kaposi sarcoma (2)

Back 316

1. Higher incidence in elderlyRussian men with lower extremity lesions

2. Endemic to Africa

Front 317

What can Kaposi sarcoma be confused with?

Back 317

BartonellaHenseleae –(Kaposi has a lymphocytic infiltrate given viral illness)

Front 318

How do you treat Kaposi Sarcoma?

Back 318

Anti-retroviral treatment of HIV will improve infection

Front 319

What type of virus is Polyomavirus?

Back 319

Circular double stranded DNA

Front 320

Is Polyomavirus enveloped or naked?

Back 320

Naked

Front 321

JC virus's family

Back 321

Polyomavirus

Front 322

BK virus's family

Back 322

Polyomavirus

Front 323

The full name of JC virus

Back 323

John Cunningham virus

Front 324

What are the two circular DNA viruses?

Back 324

1. Polyomavirus

2. Heptatis B

Front 325

What does JC virus cause?

Back 325

Progressive multifocal Leukoencephalopathy (PML) in immunocompromised?

Front 326

What CD4 count puts a patient at risk of JC virus?

Back 326

CD < 200

Front 327

What does imaging show in a patient with PML?

Back 327

Non-enhancing multifocal bain lesions in white matter

Front 328

Pathogenesis of PML?

Back 328

Demyelination of CNS

Front 329

Who is at risk of BK virus?

Back 329

transplantpatients, especially kidney and bone transplants

Front 330

Symptoms of BK virus (2)

Back 330

1. Nepropathy

2. Hemorrhagic cystitis

Front 331

What type of virus is HPV?

Back 331

DNA virus

Front 332

Is HPV naked or enveloped?

Back 332

Naked

Front 333

Verruca vulgaris

1. Cause

2. Define

Back 333

1. HPV 1-4

2. cutaneouscommon wart (hands and feet)

Front 334

Laryngealpapillomatosis

1. Cause

2. Define

Back 334

1. HPV 6, 11

2. recurrentrespiratory papillomatosis – tumors develop in airway in children, acquiredduring vaginal birth

Front 335

Anogenitalwarts – condyloma acuminata cause

Back 335

HPV 6, 11

Front 336

What diseases do HPV 16, 18, 31, 33 cause?

Back 336

Anogenital cancers

Squamous cell carcinoma

Front 337

Post-coital bleeding

Back 337

Think Cervical cancer - HPV 16, 18, 31, 33

Front 338

How do HPV 16, 18, 31, 33 increase risk of cancer? (2)

Back 338

1. E6 protein responsible forproteolysis of p53 – cell cycle checkpoint at G1/S phase transition

2. E7 protein responsible forproteolysis of RB (retinoblastoma protein-tumor suppressor)

Front 339

What does Pap Smear show if infection with HPV?

Back 339

showsKoilocytes (cells infected with HPV) that look like dense bi-nuclei

Front 340

Guardasil

Back 340

HPV6, 11, 16, 18 in activatedsubunit vaccine (9-26 years old recommended)

Front 341

Immusuppresion in HPV.....

Back 341

Immunosuppression, particularlyHIV which increases E6/E7 activity, put patient at risk for invasive cervical,anal, penile cancer

Front 342

What is the smallest DNA virus?

Back 342

Parvovirus B19

Front 343

What is the only single stranded DNA virus?

Back 343

Parvovirus B19

Front 344

Is Parvovirus B19 naked or enveloped?

Back 344

Naked

Front 345

How is Parvovirus B19 transmitted? (2)

Back 345

1. Respiratory droplets

2. Vertical transmission (TORCH)

Front 346

Slapped cheek fever other names (2)

Back 346

Fifth disease

Erythema Infectiosum

Front 347

Disease caused by Parvovirus B19

Back 347

Slapped cheek fever = fifth disease = erythema infectiosum

Front 348

Slapped cheek fever symptoms (2)

Back 348

1. Low grade fever for a week =>post fever Rash starts on face and moves downward

2. May present with arthritis + edema in adults

Front 349

Complication of Parvovirus B19 in sickle cell patients?

Back 349

Aplastic anemia - cob web look of bone marrow (usually transient)

Front 350

If Parvovirus B19 is contracted in first 2 trimesters in pregnancy?

Back 350

Hydrops fetalis

Front 351

What is the largest DNA virus?

Back 351

Pox virus

Front 352

What is unique about the envelopes of Pox virus?

Back 352

Make their own envelopes instead of taking it from host

Front 353

Is Pox virus enveloped or naked?

Back 353

Enveloped

Front 354

Guarniernibodies (3)

Back 354

1. Intracytoplasmicinclusion bodies in host cells

2. Sites of viral replication in cytoplasm

3. Pox virus

Front 355

Dumbbell shaped core is seen with

Back 355

Pox virus

Front 356

What diseases are caused by Pox virus? (3)

Back 356

1. Variola (small pox)

2. Coxpox

3. Molluscum contagiosum virus

Front 357

Variola other name

Back 357

Small pox

Front 358

Variola - symptoms

Back 358

1. raised blisters on skin andmucosal surfaces

2. lesions are same age for smallpoxversus (all different age for varicella)

Front 359

Molluscumcontagiosum virus symptom

Back 359

Flesh colored, dome-shapedumbilicated skin lesions in children, usually on trunk and can occur inmultiple places except palms on soles

Front 360

How is molluscum contagiosum virus transmitted?

Back 360

Sexually transmitted

Front 361

How does molluscum contagiosum virus present in an immunocompetent adult?

Back 361

Single lesion

Front 362

Diffuse molluscum contagiosum infection in adults suggests...

Back 362

HIV infection

Front 363

What type of virus is Hepatitis B?

Back 363

Circular, partially double stranded DNA virus

Front 364

What is a partially double stranded DNA virus?

Back 364

Hepatitis B

Front 365

What is the virus family of Hepatitis B?

Back 365

Hepadnavirus family

Front 366

Is Hepatitis B enveloped or naked?

Back 366

Enveloped

Front 367

What where does replication occur for Hepatitis B?

Back 367

Intranuclear and cytoplasmicreplication

Front 368

Mechanism of replication for Hepatitis B

Back 368

Partially double-stranded DNA=> single stranded RNA => Reverse transcriptase => fully doublestranded DNA

Front 369

Does Hepatitis B cross the placenta?

Back 369

No, but still vertical transmission during delivery during mixing of blood

Front 370

What is the chance newborns infected with hepatitis B will develop chronic infection?

Back 370

90%

Front 371

What is the chance adults infected with hepatitis B will develop chronic infection

Back 371

<10%

Front 372

Hepatitis B features (5)

Back 372

1. Polyarteritis Nodosa (medium/smallarteries “bead on a string appearance”)

2. Purpuric rash – nonblanching darkmacules

3. Arthralgias

4. GlomerulonephritisMembranous glomerulonephritis –thickened glomerular BM

5. Membranoproliferativeglomerulonephritis – tram track appearance

Front 373

HbeAg

Back 373

antigen associated with level of infectivity

Front 374

What antibody is positive during the window period of Hepatitis B?

Back 374

Anti-HBc

Front 375

What type of virus is Hepatitis D?

Back 375

Circular Negative RNA virus

Front 376

Is Hepatitis D an enveloped or naked?

Back 376

enveloped

Front 377

What is worse Hepatitis D superinfection or coinfection?

Back 377

1. Superinfection = Hep D istransmitted on top of existing Hep B infection

2. Coinfection = Hep D is transmittedsimultaneously with Hep B infection
3. Superinfection is worse

Front 378

How do you treat Hepatitis B infection?

Back 378

1. Lamivudine and other nucleosidereverse transcriptase inhibitors and IFN-alpha used to treat chronic infectionand infection of pregnant women

2. Immunoglobulin given to at riskneonates