سليمة

Question 1

Properties of herpesviruses


Answer 1

Enveloped double stranded DNA viruses.4 isomers

Question 2

Three subfamilies of herpesviruses :

Answer 2

 Alphaherpesviruses –[ HSV-1, HSV-2, VZV]
 Betaherpesviruses –[ CMV, HHV-6, HHV-7]
 Gammaherpesviruses –[ EBV, HHV-8

Question 3

The genome of … share 50 - 70% homology.
 They also share several … with each other. There is
also antigenic cross-reaction with …

Answer 3

HSV-1 and HSV-2
cross-reactive epitopes
VZV

Question 4

HSV By far the most common form of infection results from a …
or adult from a person shedding the virus.

Answer 4

kiss given to a
child

Question 5

HSV
There are 2 peaks of incidence, the first at …
and the second in
the .., when sexual activity commences.

Answer 5

0 - 5 years
late teens

Question 6

Generally, … causes infection above the belt and …. below the
belt. In fact

Answer 6

HSV-1
HSV-2

Question 7

Latency, following …… the virus enters ….. at the site of inoculation, travels up the axon and establishes a…..
supplying that area of skin
 Genital area - … .
 Oro-facial …..
 The viral genome persists in the nucleus of the neuron.
Infection is life lo

Answer 7

primary infection,
sensory nerve
endings
latent infection in the ganglion
sacral ganglia
trigeminal ganglion

Question 8

Clinical conditions
HSV

Answer 8

Acute Gingivostomatitis
 Herpes Labialis (cold sore)recurrence
Ocular Herpes
Genital herpes
 Skin infections
 eczema herpeticum,Herpetic whitlow
Meningitis
8. Encephalitis
9. Neonatal herpes

Question 9

… is the commonest manifestation of
primary herpetic infection.

Answer 9

Acute gingivostomatitis

Question 10

Complications of Genital herpes

Answer 10

Transmission to newborn infant
 Aseptic meningitis
 Visceral herpes

Question 11

Encephalitis
.. is most common cause

Answer 11

 HSV-1

Question 12

Laboratory Diagnosis hsv
1. Cytopathology
• …… from skin scrapings

Answer 12

Multinucleated giant cells

Question 13

Immunofluorescence of skin scrappings - can
distinguish between ….

Answer 13

HSV and VZV

Question 14

….are among the easiest viruses to cultivate

Answer 14

HSV-1 and HSV-2

Question 15

Management hsv
… – this the drug of choice for most situations at present, it …..

Answer 15

Acyclovir
inhibits viral DNA synthesi

Question 16

Varicella- Zoster Virus[VZV]
 …. serotype only,

Answer 16

One antigenic

Question 17

Varicella is one of the classic diseases of …..

Answer 17

childhood

Question 18

Pathogenesis of Varicella- Zoster Virus[VZV]

Answer 18

The virus is thought to gain entry via the respiratory tract and
spreads shortly after to the lymphoid system.
 After an incubation period of 14 days, the virus arrives at its main
target organ, the skin.
 Following the primary infection, the virus remains latent in the
cerebral or posterior root ganglia. In 10 - 20% of individuals, a single
recurrent infection occurs after several decades.
 The virus reactivates in the ganglion and tracks down the sensory
nerve to the area of the skin innervated by the nerve, producing a
varicella form rash in the distribution of a dermatome

Question 19

The main target organ of VZV

Answer 19

Skin

Question 20

Primary infection of vzv results in …
Presents …..

Answer 20

varicella (chickenpox)
fever, lymphadadenopathy. a widespread vesicular rash

Question 21

Herpes Zoster (Shingles)
majority of patients are …
There is a characteristic…

Answer 21

more
than 50 years of ag
eruption of vesicles in the dermatome
which is often accompanied by intensive pain which may last for
months (postherpetic neuralgia

Question 22

 In the first 20 weeks of Pregnancy up to 3% chance of
transmission to the fetus, recognised …

Answer 22

congenital varicella
syndrome;
1. Scarring of skin
2. Hypoplasia of limbs
3. CNS and eye defects
4. Death in infancy normal

Question 23

week before, to a week after delivery – …….
 Neonatal varicella may vary from a mild disease to a fatal
disseminated infection

Answer 23

severe and even fatal
disease in the neonate

Question 24

VZIG can be given within …of
contact

Answer 24

ten days

Question 25

There are two vaccines against VZV: one designed to prevent varicella, called ..., and the other designed to prevent zoster, called .... Both contain ..

Answer 25

Varivax Zostavax live, attenuated VZV.

Question 26

The zoster vaccine is effective in preventing the symptoms of zoster, but does not ....

Answer 26

eradicate the latent state of VZV

Question 27

The varicella vaccine is recommended for , whereas the zoster vaccine is recommended for

Answer 27

children people older than 60 years and who have had varicell

Question 28

Most individuals are infected by human cytomegalovirus (HCMV) in the first few years of life and by adulthood 70-90% of people have...

Answer 28

IgG antibodies

Question 29

CMV rarely causes disease in healthy people, particularly when infection occurs...

Answer 29

in childhood.

Question 30

 When primary infection occurs in adulthood, patients may develop .. .. associated with,

Answer 30

an infectious mononucleosis-like illness fever, sore throat and lymphadenopathy.

Question 31

There are two clinical situations where infection with CMV may cause serious disease. (...

Answer 31

A) Congenital infection (B) Immunosuppressed individuals

Question 32

...is the commonest viral cause of congenital abnormalities Most infected babies appear normal at birth. However, affected infants may later develop ... Rarely a ...neonate may occur (Cytomegalic inclusion disease).

Answer 32

CMV deafness or mental retardation. severe generalized infection

Question 33

.. ..may develop life threatening disease following either primary infection with HCMV or reactivation.

Answer 33

Transplant patients and patients with AIDS,

Question 34

Epstein-Barr Virus[EBV] Following primary infection, the virus persists in a latent form in the ....

Answer 34

B lymphocytes of the host by binding to C3d[ CR2 , CD21

Question 35

Clinical Syndromes associated with EBV infection:

Answer 35

1) Infectious Mononucleosis 2) Burkitt's lymphoma 3) Nasopharyngeal carcinoma 4) Lymphoproliferative disease and lymphoma in the immunosuppressed patients 5) lymphoproliferative syndrome 6) Oral leukoplakia in AIDS patients 7) Chronic interstitial pneumonitis in AIDS patients 8) Hodgkin's disease

Question 36

Infectious Mononucleosis [I.M] Signs and symptoms

Answer 36

Illness results from primary infection with EBV. A clinically apparent illness usually only develops when primary infection occurs in adolescence or adulthood. Fever, generalized lymphadenopathy, sore throat, malaise, tiredness, splenomegaly, hepatomegaly, and atypical lymphocytosis in the peripheral blood. The disease is self-limiting

Question 37

Laboratory Diagnosis of Infectious Mononucleosis[I.M]

Answer 37

1. Abnormal liver function tests 2. Heterophile antibody - Paul-Bunnell test (Monospot): Screening test for acute IM; 70-80% of patients with acute IM develop IgM antibodies that agglutinate sheep red blood cells. 3. Leukocytosis 4. Lymphocytosis 5. Presence of Atypical lymphocytes are enlarged lymphocytes that have abundant cytoplasm, vacuoles, and indentations of the cell membrane. 6. Antibody to the viral capsid and nuclear antigens A. Viral capsid antigen IgM [VCA IgM]: only present during acute phase B. IgG to EBV nuclear antigens (EBNA): detectable late in convalescence (> 6 months’ post infection)

Question 38

Diseases which have been found to be associated with HHV6 infection include:

Answer 38

1)Roseola Infantum 2)Infectious mononucleosis-like illness 3)Interstitial pneumonitis 4) Encephalitis

Question 39

Human herpes virus 8 (HHV8, KSHV) Initially found in biopsy specimens of ...in AIDS patients Like EBV, ...are primary target, but also infects other cell types

Answer 39

Kaposi’s sarcoma B cells

Question 40

Human herpes virus 8 (HHV8, KSHV) Characteristic ... associated with AIDS It does not appear to be pathogenic in healthy individuals, but it is thought to play a role in the ....

Answer 40

opportunistic infection malignant process of all forms of Kaposi sarcoma in AIDS patients