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20 Cards in this Set

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Picorna Overview ssRNA+, naked, transmission: fecal-oral (except rhino=resp), uses host own RNA polymerase (coin stamp machine), viral RNA translated into long polyprotein that needs to be cleaved, all RNA replicated in CYTOPLASMMembers:HepA-hepatosplenomegalyEnteroviridae-- Polio, Coxsackie, Echo#1 cause of aseptic meningitis (100% aseptic inside)-- CSF findings= normal glucose, no organisms, elevated protein-- child with meningitis helmetRhinovirus- common cold, resp transmission- URI mud on face

PoliovirusssRNA+, naked, picornavirus, fecal oral route, acid stabile, replicated in tonsils/Peyer's Patches, takes 2-3 weeks to breed, spreads to anterior horn of spinal cord. Sx: asymmetric paralysis, respiratory insufficiency most common cause of death. Aseptic meningitis (enterovirus #1 viral cause). No tx, only vaccine- Salk=killed injected only IgG- US uses; Sabin= oral, live, get IgA too, can revert back

RhinovirusssRNA+, naked, picorna, transmission respiratory because acid LABILE (lemon), attached to host cell via ICAM-1, grows best at 33 dg C- UPT cooler--mud on face, many different serotypes-no vaccine

CalciviridaessRNA+, naked, produces long polyprotein that needs to be cleavedNorwalk Virus--diarrheal outbreaks in close quarters- cruise ships, day care, kindergarten, shellfish, buffets. Explosive diarrhea

Flaviviridaess+RNA, ENVELOPED, nonsegmented (straw does not bed)Hep CDengue Fever- mosquito vector, infects BM (break bone fever), cannot produce as many platelets, risk of bleeding= Hemorrhagic fever, renal failure is serious complication. Tx: supportiveYellow Fever- mosquito vector, bloody stool, jaundice, hepatomegaly, backache (hump), Vx- live attenuated for travelersWest Nile Virus= bird is reservoir(crows)--mosquito vector, encephalitis, meningitis, flaccid paralysis (flopping neck) seizures, coma death, Tx: supportive

TogaviridaessRNA+, envelopedArbovirus- arthropod born (mosquito), equine encephalitis. Tx: netting, bug sprayRubella- German Measles- tender postauricular and occipital LAD (child grabbing neck), maculopapular rash that starts are face and rubies fall DOWNWARD, rubella rash moves faster than measles and lasts 3 days. Spread via respiratory droplets. Makes long polyprotein needs cleavage. No tx. Vx: MMR- no pregnant or immunocompCongenital Rubella-(ToRCHeS)- triad: ductus arteriosus, sensory-neural deficit, congenital cataracts--plus bluberry muffin rash, jaundice.Adults= LAD, fever, arthritis, arthralgiaBUZZWORD: immigrant, descending rash with LAD

HSV1/HSV2dsDNA, herpes family, enveloped. *All DNA virus replicate in nucleus.* transmission: sex, saliva, ToRCHeS*Cowdry Bodies- intranuclear inclusion bodies*HSV1- upper half of body, gingivostomatosis (inflammation gum and lips), turns into herpes labialis, keratoconjunctivitis (snake ulcers), Temporal lobe encephalitis (winged red hat)- hemorrhage and necrosis of temporal lobe= bizzare behavior, weird smell hallicuinations, [#1 cause of sporadic encephalitis]. Latent in Trigeminal nerve, reactivated by stress. Herpes rash= dew drops on petal; whitlow on finger. erythema multiform may form 1-2 wks after infectionHSV2- lower half, sexual/preg transmission, *painful* inguinal LAD, clusters of lesions with red base, latent in sacral ganglia, aseptic meningitis in adolescents and adultsDx: PCR (old = Tzank- scrape, look for giant mutlinuc)Tx: prevent breakouts with acyclovir or valcyclovir

EBVdsDNA, herpes fam, enveloped, infectious mononucleosis, fever, tender LAD, CD8+ reactive cells seen on smear- atypical with lots of cytoplasm (seen in EBV/CMV mono), T cell proliferate in response to infection, splenomegalynew host= target B cells- envelope protein attaches to CD21, latent in B cellsPharyngitis and tonsillar exudate-- different from strep- mono is college and if give penicillin will get adverse rxn maculopapular rashRisk factors for: Hodgkin, NH-Burkitts (jaw 8;14), Nasopharyngeal carcinoma (asians). Hairy cell leukoplakia in AIDS patientsDx: acute- makes B cells make heterophile sheep blood ab- agglutinate- Monospot.Tx: supportive, no contact sports

CMVdsDNA, herpes fam, remain latent in mononuclear leukocytes (lymphocytes, monocytes, macrophage), reactivation by immunosup (transplant- CMV pneumo; HIV-esophagitis, colitis) , transmission by everything (ToRCHes)Congenital : blueberry muffin rash, jaundice/hepatosplenomegaly, sensoneural loss, intracranial calcifications--ventriculomegaly--seizures.2nd trimester= spontaneous abortions, hydrops fetalis80-90% asymptomatic#1 cause of mental retardation from viral congenital infection, #1 cause of sensineural hearing losstx: gancyclovir and foscarnet (if mutation UL97)patients NOT immunosup= Mono (LAD, fatigue sore throat) -- monospot NEGATIVE

VZVdsDNA, herpes fam, envelopedChickenpox-fever, headache, spread via resp/rash themselves, vesicular dew drops on rose- lesions are in different stages [versus smallpox all same stage], Tzank smear. Adults=severe, pneumonia, encephalitis, esp in immunocomp. Vx: live attenuated. Tx: acyclovir (child 12+ and immunocomp)latent in dorsal root ganglion-- reactivation= HERPES ZOSTER/ Shingles= dew drops in dermatome, immunocomp can affect trigeminal and get blindness, rash extremely painful and does not subside after rash. Vx: live attenuated for 60+ and HIV if over 200. Tx: acyclovir, famcyclovir, valcyclovirToRCHeS-- limbs short, blindness, dermatome scarring

HHV6dsDNA, herpes, ROSEOLA, rosixola, CD4+ infection (4belt/feather), children 6 mo-2 years of age.High fever 2-4 days (4 suns) can cause febrile seizures. After fever, diffuse maculopapular rash, SPARES FACE, lacey (blue angel, cool after fever has red dress covers everything but face and carrying child 6mo-2yr)tx: supportive

HHV 8dsDNA, herpes, AIDS defining illness, Kaposi.Violacious lesions-can cause angiogenesis with VEGFcan have mucosal lesions on GI and Hard palatecan also infect B cells- lymphomatransmission:kissing- AIDS, Russia, AfricaTx: AIDS therapy, lesions go away

HPVdsDNA, NAKED, most common STDHPV1-4= verucca vulgaris, cutaneous common wartHPV6,11= laryngeal papillomatosis (respiratory), anogenital warts= condyloma accuminata-- STCHPV16,18= anogenital squamous cell carcinoma (also HPV 31, 33- add 15), E6 affects p53 G/S checkpoint, E7 affects Rb. Buzzword: post-coital bleeding. Dx: pap smear. Risk increased if HIV+, immunosupVx includes 6,11, 16, 18

AdenovirusdsDNA, nakedmost common cause of tonsilitis- adenoids (back of cave red, lions yawm)transmitted: resp drop, fecal-oral= PUBLIC POOLS, military camp, kidscauses: tonsilitis, hemoraghic cystitis, conjunctivitis (pink eyes)Vx: live attenuated only for military

Pox VirusdsDNA, dumbell shaped core, largest DNA virus, has EVERYTHING in its box- never needs to enter nucleus0 replicated in CYTOPLASM-- makes its own envelope, has its own DNA dependent RNA polforms intra-cytoplasmic inclusion bodies in cells affected-- type B inclusions= Guarnieris-- sites of viral replication in cytoplasm-- DIAGNOSTICSmall Pox- Variolla- raised lesions on mucosal surface, all of SAME stage. Cow Pox- used to eradicate small pox from world. Bioterrorism Molluscum Contagiosum- from snails(snail mail), flesh colored dome shape with umbilication skin lesion- everywhere BUT THE FACE. Transmission: sexually, and local infection- if diffuse test for HIV!

OrthomyxoviridaessRNA-, enveloped, segmented, must bring own RNA pol, replicated in NUCLEUS not cytoplasm! (babies in head), 8 segments= antigenic shift segments (pandemic from H and N - influ A only) and antigenic drift (different flue each year- point mutation). HA= binds to sialic acid in UPT, HA ag determine tropism, causes RBC to clump in test tube. HA binds, endocytosed M2 protein (inhibit via aMANTAdine) acidifes environment to uncoat. After replication NA breaks sialic acid bond to release newly formed virions (inhibit tamaflu- oseltamivir only if 72 hours of infection)Transmission: resp droplets. Flue season Dec-Feb. Vx starting Oct. Live attenuated = nasal spray. Killed= injectMajor complication: PNEUMONIA (staph aureus)- UPI ruins cellsDo NOT give ASPIRIN to KIDS = Reyes-- liver failure, encephalitis, fever

ParamyxossRNA-, enveloped, transmission resp drop, Vx: MMR (no pregnant/immunocomp)Measles- Rubeola= First sx: cough, coryza (nasal drip), conjunctivitis, Koplik spot in buccal mucosa DIAGNOSTIC, fever. After Koplik spot- maculopapular rash starts at back of ears, neck, face then DOWNWARD rest of body. Starts as spots then blends together (dress all red together). Complications: Pneumo, SSP-subacute sclerosing panencepahlitis: hx of measles as child or immigrant with no vx-- 5-10 yrs later develop personality changes, seizures, anti-measles Ab in CSF. Virulence factors: HA, fusion protein, cytoplasmic AND intranuclear red inclusion bodies. Mumps- parotitis, orchitis testes, meningitis, Virulence factor: HA, NA, fusionRSV- Resp Syncytial Virus- infants LESS than 6 mo, attaches to resp endothelium via G protein, #1 cause of pneumonia and bronchiolitis in infants, virulence: fusion only- makes synctia- multinuc giant fusion cells. Tx: ribafarin for adults, palivizumab- stops fusion protein (rib and IgG rattle)Parainfluenza Virus- Croup (laryngotracheobronchitis)- barking seal cough and inspiratory stridor, virulence: NA, HA, fusion; steeple sign on Xray subglottic,

RhabdovirusssRNA-, enveloped, helical nucleocapsid, capsule looks bullet shaped. common carrier: bats. binds to nicotinic Ach receptors, infection occurs in post synaptic motor endplate, incubation period weeks-months, travels retrograde to peripheral nerve until at DSG---salivary gland, dysphagia, foaming, encephalitis,dx: clinical, Negri bodies (in purkinje or pyramidal cells)need to get antidote prior to sx--human rabies Ig-preformed ab and then actively immunized with killed vaccine to develop immunity. If ever near bat--prophylax

Coxsackie A and BssRNA+, naked, picorna, A: Hand foot and mouth disease [others= ricketsia and syphyllis]. Aseptic meningitis, in summer monthsB: cardiomyopathy, Devil's grip-pleurodynia- sharp pain in chest, hard to breathsupportive tx

Hep AssRNA+, naked, picorna, acid stable transmitted fecal oral- [water must be purified: boiled, chlorinated, irradiated], Hx: travel or shellfish. Sx: usually asymptomatic but can cause acute hepatitis- have jaundice (adults), vomiting, smokers won't want cigs, Sign at shellfish bar-- one month duration, no carriers, self-limiting. Inactivated Vx for high risk (travel/MSM)