Week 1 - Day 5 Notes

Front 1

What is Reye's Syndrome?

Back 1

Children with the flu or chicken pox when given aspirin - may develop liver and brain disease.

Front 2

when was the last case of smallpox

Back 2

1977

Front 3

Name the 3 members of the Papovaviridae
PA
PO
VA

Back 3

1. Papillomavirus
2. Polyomavirus - 2 members BK and JC virus
3. Simian VAcuolating virus

Front 4

when was the last case of smallpox

Back 4

1977

Front 5

Guess your USMLE score? 240?

Back 5

Yeah right

Front 6

Name the two DNA virus with a circular dsDNA?

Back 6

Hepadnavirus(partial circular) and PapOvavirus

Front 7

Which is the largest DNA virus?

Back 7

Pox - (small pox, cow pox, molluscum contgiosum)

Front 8

what are the features of PICORNAvirus:
P
ICO
RNA

Back 8

Positive sense
ICOsahedral
RNA virus

Front 9

RNA viruses: negative stranded
"Always Bring Polymerase Or Fail Replication":

Back 9

Arena -LCV:Lymphocytic choriomeningitis (mice)
Bunya - Cali encephalitis,Hantavirus,Rift valley fevers, Congo hemorrhagic fever
Paramyxo
Orthomyxo
Filo - Ebola
Rhabdo - Rabies
· Note: Negative RNA viruses need there own polymerase

Front 10

Teratogens: placenta-crossing organisms
ToRCHeS:

Back 10

Toxoplasma
Rubella
CMV
Herpes/HIV
Syphilis
· Alternatively: TORCHES: with Others (parvo, listeria), Enteroviruses

Front 11

RNA enveloped viruses
FORT ABC, Puerto Rico:

Back 11

Flavivirus/ Filo
Orthomyxo
Retro
Toga
Arena
Bunya
Corona
Paramyxo
Rhabdo

Front 12

There are only 3 RNA viruses that dont have envelopes?
my convertible Small(pico) REO's trip to CALI?

Back 12

Picornavirus
Caliciviruses
Reoviruses

Front 13

Only ----- viruses have helical symmetry capsids

Back 13

RNA

Front 14

Name the six DNA viruses

Back 14

Herpes, Hepadna, Adeno, Papova, Parvo, Pox

Front 15

Most DNA viruses are double stranded except for ----. [it's a kid]

Back 15

parvoviridae

Front 16

Most DNA viruses have icosahedral symmetry except ---, which looks like a box.

Back 16

pox in a box

Front 17

Which three DNA viruses are naked?

Back 17

papova, adeno, parvo (a woman must be naked for a PAP smear)

Front 18

Which three DNA viruses have envelopes?

Back 18

Herpes, hepadna, pox

Front 19

Only RNA virus that is double stranded.

Back 19

Reovirus. "repeato virus"

Front 20

DNA viruses replicate in the ----, while RNA viruses replicate in the ----.

Back 20

nucleus. Cytoplasm

Front 21

Nonenveloped RNA viruses

Back 21

picorna, calici, reoviridae

Front 22

Five with icosahedral symmetry (the others are helical)s

Back 22

reo, picorna, toga, flavi, calici

Front 23

Two RNA viruses that undergo replication in the nucleus

Back 23

Retro and orthomyxo

Front 24

The late genes of DNA viruses are transcribed from the DNA of -----

Back 24

progeny

Front 25

Structural components are encoded by ----- genes.

Back 25

late

Front 26

Orthomyxoviridae are spherical virions that have segmented ---- stranded RNA.

Back 26

negative

Front 27

Hemagluttinin attaches to host sialic acid receptors on RBCs, causing agglutination, and on cell membranes of the cells of the ----- ------- ------. What bacterium has filamentous hemagluttinin which it uses to attach to the same area as orthomyxoviridae?

Back 27

upper respiratory tract. B. pertussis

Front 28

Neuraminidase cleaves neuraminic acid, which is an important component of -----.

Back 28

mucin

Front 29

Antigenic shift can only occur in influenza type ----. Why?

Back 29

type A is the only one that can also infect animals. The shift requires co-infection and mixed-up packaging

Front 30

A complication of the flu in elderly.

Back 30

viral pneumonia (spread to lower respiratory tract) --> bacterial pneumonia (staph, pneumococcus)

Front 31

New one hour test that helps to guide the choice of antiviral agents.

Back 31

detection of viral proteins

Front 32

Drugs that prevent uncoating of influenza A.

Back 32

amantadine, rimantadine

Front 33

Paramyxoviridae differ from orthomyxo in that the negative strand of RNA is not ------

Back 33

segmented

Front 34

Paramyxoviridae possess ----- ----- which allows infected cells to fuse together.

Back 34

F protein

Front 35

Paramyxoviridae infect the (upper/lower) respiratory tract of children, while the opposite is true in adults.

Back 35

lower Resp tract in children

Front 36

Parainfluenza infection of the larynx. Think Anne of Green Gables.

Back 36

Croup

Front 37

Number one cause of pneumonia in babies < 6mo

Back 37

Respiratory Syncytial virus

Front 38

IN the MMR, what is the constituent that protects against mumps? Measles?

Back 38

all three are live attenuated vaccines

Front 39

Four presentations of Mumps

Back 39

parotitis, orchitis, meningitis, encephalitis

Front 40

Four complications of measles.

Back 40

pneumonia, eye damage, myocarditis, encephalitis

Front 41

Measles is also called

Back 41

rubeola

Front 42

Other than RSV, what other groups of viruses can cause syncytial cells?

Back 42

herpesviridae and retroviridae

Front 43

Is bilirubin more likely to be elevated early in acute hepatitis or in biliary obstruction?

Back 43

biliary obstruction

Front 44

Liver enzymes are higher in (acute or chronic) hepatitis?

Back 44

acute

Front 45

Hepatitis A is milder in kids or adults?

Back 45

kids

Front 46

How are Hep A and E transmitted?

Back 46

fecal-oral (anal, enteric)

Front 47

what kind of vaccine is the Hep A vaccine?

Back 47

killed

Front 48

What kind of vaccine is the Hep B vaccine?

Back 48

recombinant HBsAg

Front 49

Which of the hepatitis viruses is a DNA virus?

Back 49

Hep B

Front 50

The Hep B particle is called

Back 50

dane particle

Front 51

Two complications of HBV.

Back 51

primary hepatocellular carcinoma, and cirrhosis

Front 52

The serological profile of an immunized person (Hep B) will show positive -----

Back 52

HBsAb only

Front 53

Can only replicated with the help of HepB because it needs the HBsAg for itself.

Back 53

Hep D

Front 54

Hep D can manifest itself in what two ways?

Back 54

co-infection, and super-infection (acute on chronic hepatitis)

Front 55

HepE rarely occurs here in the US. Where is it common? What family of virus is HepE part of?

Back 55

1.Asia, india, central america, and africa
2.Calicivirus

Front 56

What group of people are most seriously affected by Hep E

Back 56

pregnant women (high mortality)

Front 57

What percentage of those infected with Hep C go on to develop chronic disease?

Back 57

half

Front 58

What are the three essential retroviral enzymes?

Back 58

protease, reverse transcriptase, and integrase

Front 59

major capsid protein of HIV, can be measured in serum to detect early HIV infection

Back 59

p24

Front 60

What gene encodes p24?

Back 60

gag

Front 61

What is encoded by pol

Back 61

protease, reverse transcriptase, and integrase

Front 62

The env gene products bind to what receptors?

Back 62

CD4 receptors

Front 63

Name two other cell types that can become infected with HIV

Back 63

macrophages, monocytes, CNS dendritic cells

Front 64

What is the mechanism of autoantibody production in HIV?

Back 64

HIV infection results in polyclonal activation of B cells, resulting in the outpouring of immunoglobulins --> immune complex formation and autoimmunity

Front 65

How is HIV carried to the brain, if T cells don't cross the BBB?

Back 65

monocytes and macrophages cross the BBB and are reservoirs for HIV

Front 66

What malignancy has a high incidence in HIV? What malignancy is more common in homosexuals?

Back 66

B-cell lymphoma. Kaposi's sarcoma (HHV-8)

Front 67

Most common opportunistic infection

Back 67

PCP

Front 68

parasite causing mass lesions in the brain

Back 68

toxoplasma gondii

Front 69

within weeks of infection, what test can be done for HIV?

Back 69

test for p24 protein

Front 70

After 3-6 weeks of exposure, what test can be done?

Back 70

ELISA for HIV antibodies

Front 71

If ELISA is positive twice, what test can be done to confirm diagnosis?

Back 71

western blot

Front 72

Members of this family of viruses in the alpha subgroup (HSV1, HSV2, VZV) have a cytopathic effect on cells, producing multinucleated giant cells with intra----- inclusion bodies.

Back 72

nuclear

Front 73

What type of immune response fights herpesviridae?

Back 73

cell-mediated immune response

Front 74

During latency, herpesviridae live in ---- ganglia.

Back 74

sensory

Front 75

Intranuclear inclusions represent areas of ------ ------.

Back 75

viral assembly.

Front 76

Viral proteins are inserted into the host cell plasma membrane, causing ------ ------ ----- to form.

Back 76

multinucleated giant cells to form.

Front 77

Most common infectious cause of corneal blindness in US.

Back 77

HSV1 herpetic keratitis

Front 78

Most common cause of viral encephalitis in US. Patients present with FEVER and FOCAL NEUROLOGICAL ABNORMALITIES.

Back 78

HSV1.

Front 79

Is herpes encephalitis treatable?

Back 79

yes.

Front 80

Two of the TORCHES organisms that can cross the blood-placenta barrier that are also herpesviridae.

Back 80

CMV, HSV (mainly 2)

Front 81

cause of chickenpox.

Back 81

varicella-zoster virus

Front 82

The rash of varicella starts on the ----- and ------, then spreads to the entire body.

Back 82

face, trunk

Front 83

The skin vesicles in varicella are described as -------.

Back 83

dew on a rose petal.

Front 84

T/F. Skin lesions of varicella are all in the same stage at one time.

Back 84

False. The lesions can be at various stages.

Front 85

Dermatomal distribution of vesicles. Exquisitely painful. V1 involvement (see if the nose is involved) can lead to blindness.

Back 85

Zoster (shingles)

Front 86

Most common viral cause of mental retardation.

Back 86

CMV

Front 87

CMV causes two different patterns of infection in two different immunocompromised populations. For each of the following patterns, name the population.

Front 88

CMV retinitis, viremia, colitis

Back 88

AIDS = retinitis

Front 89

CMV pneumonitis, viremia, colitis

Back 89

Marrow transplant = pneumonitis

Front 90

CMV pneumonitis

Back 90

Marrow transplant = pneumonitis

Front 91

Which layer of centrifuged blood is most likely to yield CMV for culture, and why?

Back 91

CMV invades WBCs, so the buffy coat should be cultured.

Front 92

Major cause of mononucleosis.

Back 92

EBV

Front 93

EBV infects ----- cells.

Back 93

B-cells

Front 94

EBV-associated cancer found in central Africa

Back 94

Burkitt's lymphoma. Read p. 207

Front 95

High white blood cell count with ATYPICAL LYMPHOCYTES on blood smear. HETEROPHILE antibody positive. What disease is this? What are these atypical lymphocytes and what is the heterophile Ab?

Back 95

Mononucleosis. Atypical lymphocytes = large activated Tcells. Heterophile Ab = Ab to EBV that cross reacts with sheep rbcs (Monospot test)

Front 96

HHV-8

Back 96

Kaposi's sarcoma associated virus

Front 97

Periventricular calcifications in a neonate; mother with flu-like illness: what TORCHES condition is this?

Back 97

congenital CMV

Front 98

Cataracts, thrombocytopenia, purpura, PDA, bone lucency, meningoencephalitis in baby; mother with maculopapular rash some time during pregnancy

Back 98

congenital rubella (rubivirus, a togavirus)

Front 99

Baby with bone and teeth abnormalities and condyloma lata, saddle nose deformity

Back 99

congenital syphilis

Front 100

Murky brown amniotic fluid secondary to amnionitis (bacterial, not a TORCHES organism; causes meningitis in neonates.)

Back 100

neonatal listeriosis

Front 101

Structurally most complex of all known viruses

Back 101

poxviridae

Front 102

Pox, unlike other DNA viruses, carries many of the enzymes it needs and replicates in the -----

Back 102

cytoplasm

Front 103

Umbilicated papules caused by a pox virus. Often seen in AIDS pts

Back 103

molluscum contagiosum

Front 104

Papova viruses include papilloma and polyoma virus groups. What two viruses make up the polyoma group

Back 104

JC and BK

Front 105

Cervical carcinoma is associated with HPV types

Back 105

16 and 18

Front 106

Low risk HPV types

Back 106

6, 11

Front 107

JC virus is the agent of ----- ------ -----

Back 107

progressive multifocal leukoencephalopathy

Front 108

What do adenoviruses do?

Back 108

cause upper respiratory infection in kids

Front 109

List the top four viral respiratory illnesses in children in order.

Back 109

(1) RSV (2) Parainfluenza virus (croup) (3) Rhinovirus (4) Adenoviridae

Front 110

Only DNA virus with single strand of DNA.

Back 110

Parvovirus

Front 111

Parvovirus causes what condition in children that presents with fever and a slapped cheeks rash?

Back 111

erythema infectiosum (Fifth disease)

Front 112

arthropod borne viruses are called what?

Back 112

arboviruses

Front 113

What are the three groups of arboviruses?

Back 113

Flaviviridae, bunyaviridae, and togaviridae

Front 114

A large family of enteroviruses that includes Hep A, poliovirus, coxsackie A&B, and echoviruses.

Back 114

picornaviridae

Front 115

Name two viruses that cause the common cold

Back 115

Rhinovirus and coronavirus

Front 116

Name two viruses that cause diarrhea

Back 116

Rotavirus (a reovirus has DS RNA, unlike other RNA viruses) and calicivirus (includes Norwalk)

Front 117

Name the two manifestations of arbovirus infections

Back 117

fever and encephalitis

Front 118

The equine encephalitides are caused by what sub group of the arboviruses?

Back 118

togaviridae

Front 119

The agent that causes German measles is not a paramyxovirus like the measles virus. What is it?

Back 119

Rubivirus ( a toga virus that is not an arbovirus) the disease is mild with fever and rash that spreads like the measles rash from head to toe

Front 120

What are the TORCHES organisms?

Back 120

Toxo, Rubella, CMV, Herpes/HIV, Syphilis

Front 121

Congenital rubella causes problems in what three main organs?

Back 121

heart, eye, CNS

Front 122

What is the rubella vaccine?

Back 122

live attenuated (all three in MMR are live attenuated)

Front 123

Dengue causes death via what physiological effects?

Back 123

hemorrhage and shock

Front 124

Cause of of Rift Valley Fever is a ---virus

Back 124

bunya

Front 125

Bunnies hopping around in the Rift Valley

Front 126

This viral illness should be considered in a young person from Arizona with flu-like symptoms and pulmonary edema

Back 126

Hanta virus

Front 127

Bunnies in Arizona

Front 128

What neurons does the poliovirus destroy in a case of paralytic poliomyelitis?

Back 128

destroys presyaptic motor neurons in the anterior horn of the spinal cord as well as the postsynaptic neurons leaving the horn

Front 129

Causes painful contraction of pharyngeal muscles on swallowing and results in hydrophobia

Back 129

rabies

Front 130

What kind of paralysis results in poliomyelitis?

Back 130

flaccid

Front 131

The salk vaccine is what kind of vaccine?

Back 131

killed

Front 132

What kind of vaccine is the oral polio (Sabin vaccine)?

Back 132

live attenuated

Front 133

The most common cause of aseptic meningitis in the US

Back 133

enteroviruses (Coxsackie A and B, Echoviruses, etc.)

Front 134

What is the condition? Fever, vomitting, abdominal pain, diarrhea after a 1-2 day incubation. Symptoms resolve in 4-7 days.

Back 134

Viral gastroenteritis

Front 135

Viral gastroenteritis is caused by which two viruses?

Back 135

Rotavirus(Reo) and calicivirus (includes Norwalk)

Front 136

Rotavirus belongs to a family called -----, which is the only family of RNA viruses that is double stranded.

Back 136

Reovirus

Front 137

Collections of virions in the cytoplasm called Negri bodies in neurons are pathognomonic for ----

Back 137

rabies

Front 138

Death in rabies occurs secondary to ----- ----- -----

Back 138

respiratory center dysfunction

Front 139

Guanine analogs that act against the herpes family

Back 139

acyclovir, gancyclovir

Front 140

Why is it that acyclovir does not have a deleterious effect on human cells?

Back 140

it must first be phophorylated. Viruses have this thymidine kinase, we do not

Front 141

However there is some toxicity to rapidly dividing cells, so ----- and ----- are side effects.

Back 141

neutropenia, thrombocytopenia

Front 142

Which herpes virus lacks the thymidine kinase, making it less susceptible to acyclovir. Gancyclovir must be used instead because it is not dependent on the kinase.

Back 142

CMV

Front 143

IF given in high doses, acyclovir may crystallize in the -----

Back 143

kidney

Front 144

Has broader coverage of herpes viridae but is more toxic

Back 144

gancyclovir

Front 145

Because of its toxicity, gancyclovir is used only for ---- in immunocompromised hosts.

Back 145

CMV

Front 146

Foscarnet mechanism of action

Back 146

pyrophosphate analog inhibits DNA polymerase and reverse transcriptase

Front 147

Foscarnet covers both HIV and ----

Back 147

herpesviridae

Front 148

With Foscarnet, increased ----- potential is possible in patients with a Hx of this, head trauma, renal impairment.

Back 148

seizure

Front 149

First line standard of care for Hiv

Back 149

two nucleoside RT inhibitors + one protease inhibitor OR two nucleoside RT inhibitors+ one non-nucleoside RT inhibitor

Front 150

Drug that has reduced MTCT from 30% to 8%

Back 150

AZT

Front 151

In addition to HIV therapy, lamivudine also plays a role in the Tx of ----- ------ as monotherapy or with interferon alpha

Back 151

hepatitis B

Front 152

Nucleoside analogs need phosphorylation to become active, but non-nucleotide RT inhibitors do not. Name three NNRTis

Back 152

Nevirapine, delaviridine, efavirenz

Front 153

Frequently reported side effect of NNRTis

Back 153

rash

Front 154

all the drugs that end in -navir are ---- ---

Back 154

protease inhibitors

Front 155

Amantidine only inhibits uncoating of which virus?

Back 155

influenza A

Front 156

Oseltamivir and Zanamavir work by inhibiting -----, a virulence factor of Orthomyxoviruses (influenza type A and B)

Back 156

neuraminidase

Front 157

Ribavirin has a wide spectrum of activity against both DNA and RNA viruses. However, there are concerns about safety (severe teratogen, hemolytic anemia), so it is used only for severe ---- infections in infants and for ---- --- in Africa

Back 157

RSV; Lassa fever

Front 158

How does Ribavirin work?

Back 158

it inhibits synthesis of guanine nucleosides by competitivevly inhibiting IMP dehydrogenase.

Front 159

What is interferon used to treat?

Back 159

Chronic hepatitis B and C, Kaposi's sarcoma

Front 160

What is the main side effect of interferon?

Back 160

neutropenia

Front 161

How to remember the positive RNA viruses?

Back 161

Positively, Pico was having a Flaviful Corona at the retro Toga party in California.

Picovirus,Flavivirus,Coronavirus,
Retrovirus,Togavirus,Calicavirus

Front 162

There are only three RNA viruses with no envelope- how do you remember them?

Back 162

PICO and I went to California with my convertible Reo!

Picovirus, Calicivirus, Reovirus

Front 163

Which Vaccines are live strains(meaning they have been attenuated)?

Back 163

1. MMR (Measles, Mumps, Rubella)
2. Adenovirus
3. Polio (Sabin)- (Salk is killed)
4. VZV (Varicella)
5. Yellow fever virus (Flavi family)