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Ebola Flashcards

1
Q
  1. What order does Ebola belong to?
A

a. Mononegavirales

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2
Q
  1. What family is the Ebola virus in?
A

a. Filoviridae

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3
Q
  1. Ebola is enveloped/unenveloped?
A

a. Enveloped

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4
Q
  1. What genetic material does Ebola contain?
A

a. negative-stranded RNA virus

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5
Q
  1. How many structural and regulatory genes does it contain?
A

a. 7

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6
Q
  1. What latin word do ebola get their name from?
A

a. Thread

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7
Q
  1. What other virus are in the same family as ebola?
A

a. Marburg virus (1967)
b. Ebola virus (1976)
c. Cueva virus (2002)

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8
Q
  1. When was Ebola first discovered? In what countries?
A

a. 1967

b. Ziare and sudan

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9
Q
  1. Ebola is ______nm in diameter around _____nm in length
A

a. 80nm

b. 970nm

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10
Q
  1. The surface of the Ebola virus is covered in _________ and ____nm spikes which project from the lipid bilayer
A

a. Viraly encoded glycoproteins

b. 7-10nm

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11
Q
  1. The 7-10nm spikes are important for?
A

a. Attacing to the host cell and enteringthe host cell

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12
Q
  1. What size is the Ebola genome? Which incoded for ho many proteins? And what are the proteins?
A

a. 18-19kb
b. 7 proteins
i. Glycoprotein
ii. Nucleoprotein
iii. Transcription factor VP 30
iv. Polymerase
v. Polymerase co-facter VP 35
vi. VP 24
vii. Matrix VP-40

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13
Q
  1. How many species of Ebola are there? And what are they called? How many can infect man?
A

a. • Cote d’Ivorie ebola virus (Tai Forest): Man
b. • Sudan ebola virus: Man
c. • Zaire ebola virus: MAn
d. • Bundibugyo ebola virus: MAn
e. • Reston ebola virus: non-human primates: crab eating macaques
f. • Bombali ebola virus: 2018: bats Anotolian free tailed bat and little free tailed bat
g. Four

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14
Q
  1. What Ebola only affects non-human primates? Which specific primate?
A

a. Reston ebola virus: non-human primates: crab eating macaques

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15
Q
  1. Which Ebola was isolated in 20 18? And what animals does it effect?
A

a. Bombali ebola virus: 2018: bats Anotolian free tailed bat and little free tailed bat

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16
Q
  1. Which form of Ebola vius is the most virulent?
A

a. • Zaire ebola virus: Man

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17
Q
  1. What is the second most virulent Ebola in man?
A

a. Sudan ebola virus: Man

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18
Q
  1. What is the third most virulent ebola in man?
A

a. Bundibugyo ebola virus: Man

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19
Q
  1. What form of Ebola which can infect humans, has no humans died from?
A

a. Cote d’Ivorie ebola virus (Tai Forest): Man

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20
Q
  1. What cells do Ebola typically replicate in when they have entered the bod?
A

a. monocytes/macrophages & dendritic cells

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21
Q
  1. What is micropinocytosis.
A

a. macropinocytosis is (cytology) a form of endocytosis in which a large fluid-filled vesicle, or macropinosome, is pinched off from the cell membrane and brought into the interior of the cell.

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22
Q
  1. What part of the cell membrane is pinched off when Ebola enters?
A

a. The ruffled section

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23
Q
  1. Once the Ebola virus is in the cell within the vesicle the glycoproteins are clipped off by what protein?
A

a. CTSB Cathepsin B

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24
Q
  1. When the CTSB cleaves the glycoproteins, exposes the ________ binding domain of the glucoprotein
A

a. putative receptors

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25
Q
  1. The vesicle containing the viruses then fused with the ______ which is carrying the structure ______
A

a. Endosome

b. NPC1

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26
Q
  1. What is the NPC1 stand for? And what is it?
A

a. Niemann-Pick Disease, Type C1

b. Cholesterol transporter

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27
Q
  1. What complex mediates the binding of the NPC1 and the viral containing vacuole?
A

a. HOPS complex

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28
Q
  1. What is the HOPS complex?
A

a. Homotypic vacuole fusion sorting complex

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29
Q
  1. What has to take place inorder for the Ebola virus to be released into the cytoplasm?
A

a. The HOPS needs to bind the Endosome containing the NPCI and the vacuole holding the virus

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30
Q
  1. Once the virus is released into the cytoplasm what takes place?
A

a. Secondary infection of neighbouring cells

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31
Q
  1. Once the cells begin to get infected what does the immune response do?
A

a. Cytokine storm

b. Release of inflammatory mediators

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32
Q
  1. What mechanisms does the body use to try and fight the Ebola virus?
A

a. Tetherin: BS-2 or CD317

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33
Q
  1. What is tetherin? What causes it to be released? were does it localise the virus?
A

a. A human cellular protein which inhibits retroviruses infection by preventing the diffusion of virus particles after budding from infected cells
b. High levels of interferon
c. Membrane of the infected cell

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34
Q
  1. What protein can Ebola disable? And which what protein signals the disabling?
A

a. Tetherin

b. Glucoprotein

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35
Q
  1. _______: Marburg virus: European laboratory workers ______ number of cases and _____ deaths. _______ were imported from Uganda. Lab workers were working with the blood.
A

a. 1967
b. 31
c. 7
d. Green

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36
Q
  1. ______: Ebola virus; Ebola Zaire; Ebola Sudan/ This was why there are two subtypes
A

a. 1976

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37
Q
  1. ____ and ______: Ebola Reston USA and Italy Imported _____from Philippines, from a breeding centre
A

a. 1989
b. 1992
c. Macaques

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38
Q
  1. ______: Ebola Côte d’Ivoire: Chimpanzee
A

a. 1995

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39
Q
  1. ______: Ebola Reston – ________ in Philippines
A

a. 2008

b. Pigs

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40
Q
  1. OutBreaks:
    a. 1976 CRC: ______ case ______ Death ______ Strain ______& Case Fatality
    b. 1976 Sudan: ______ case ______ Death ______ Strain______& Case Fatality
    c. 1995: DRC: ______ case ______ Death ______ Strain______& Case Fatality
    d. 2000: Uganda: ______ case ______ Death______ Strain______& Case Fatality
    e. 2003: Congo: ______ case ______ Death______ Strain______& Case Fatality
    f. 2007 DRC: ______ case ______ Death______ Strain______& Case Fatality
    g. 2007 Uganda: ______ case ______ Death______ Strain______& Case Fatality
    h. 2012 DRC: ______ case ______ Death______ Strain______& Case Fatality
    i. 1976 CRC: ______ case ______ Death ______ Strain ______& Case Fatality
    ii. 1976 Sudan: ______ case ______ Death ______ Strain______& Case Fatality
    iii. 1995: DRC: ______ case ______ Death ______ Strain______& Case Fatality
    iv. 2000: Uganda: ______ case ______ Death______ Strain______& Case Fatality
    v. 2003: Congo: ______ case ______ Death______ Strain______& Case Fatality
    vi. 2007 DRC: ______ case ______ Death______ Strain______& Case Fatality
    vii. 2007 Uganda: ______ case ______ Death______ Strain______& Case Fatality
    viii. 2012 DRC: ______ case ______ Death______ Strain______& Case Fatality
A
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41
Q
  1. Where do you find the Zaire ebolavirus?
A

a. West , central Africa

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42
Q
  1. Where do you find the sudan ebola virus?
A

a. South Sudan
b. Uganda
c. East parts of the DRC

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43
Q
  1. Where do you find tai forest ebola?
A

a. Coat de ivorie

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44
Q
  1. Where do you find the Bundibugyo virus
A

a. East DRC

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45
Q
  1. Where do you find the Bombali ebolavirus?
A

a. Kenya

b. Sirre Leonne

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46
Q
  1. Can Bombali ebolavirus spill over to humans? And from what animal?
A

a. Unknown

b. Bats

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47
Q
  1. Where do you find Ebola reston?
A

a. Phillipines

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48
Q
  1. What is the Reseviour for the tentitvely?
A

a. Bats

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49
Q
  1. What is the issue with identify the reseviour of bats?
A

a. They only found 1/5th the virus and that’s why it says bats

50
Q
  1. What range do the bats that carry Ebola cover?
A

a. Africa, southeast assia and Australia

51
Q
  1. What other animals has EBOLA bee isolated n?
A

a. Antelope
b. Bush pigs
c. Non-human primates

52
Q
  1. How do people become infected with EBOLA?
A

a. Sexual transmitted
b. Breast Milk
c. Saliva
d. Semen
e. Bloods

53
Q
  1. How long can Ebola live in the SPERMS?
A

a. 512 days

54
Q
  1. What is an issue with getting people to listen to western scientist? What incident happened? What other issues have arisen?
A

a. They don’t trust the advice and isgnore
b. Ebola team were murdered
c. Looting of hospitals

55
Q
  1. What is the only Ebola virus known to be spread by aerosol?
A

a. Ebola Reston

56
Q
  1. How much Bush meat is confiscated at airports? What species does this meat come from?
A

a. 1 ton each year in the UK ports and airports

b. Giraffe, rats, chimpanzees, antelope

57
Q
  1. How long does it take for initial acute onset symptoms to begin? What is the possible range?
A

a. 8-10days

b. 2-20 days

58
Q
  1. What are initial symptoms?
A

a. Initial: Fever, chills, myalgias, malaise, anorexia
b.  5 days p.i.: GI symptoms - nausea, vomiting, watery diarrhoea, abdominal pain
c.  Other - headache, conjunctivitis, hiccups, rash, chest pain, shortness of breath, confusion, seizures
d.  Haemorrhagic symptoms in 18% of cases

59
Q
  1. What other diseases present as the same initially?
A

a.  Malaria, typhoid fever, meningococcemia, Lassa fever & other bacterial infections

60
Q
  1. How many people infected complain of having a headache?
A

a. >50%

61
Q
  1. What eye issues can happen as a result of infection?
A

a. Conjunctivitis

62
Q
  1. What is an unusualk symptom of Ebola? Why did this happen?
A

a. Hiccups

b. Reduction in oxygen

63
Q
  1. How many people actually show the heamoraghic symptoms of ebola?
A

a. 18%

64
Q
  1. What do the early non-specific smptoms progress to ?
A

a. Hypovolemic shock and multi-organ failure
b. • Haemorrhagic disease
c. • Death

65
Q
  1. How long to non-fatal cases take to begin improvements?
A

a. 6–11 days after symptoms onset

66
Q
  1. Where are 70% of tha fatality rates reported?
A

a. Rural Africa

67
Q
  1. What can increase survival rates?
A

a. intensive care, especially early intravenous and electrolyte management, may increase survival rate

68
Q
  1. The outbreak between ____-_____ predicted that those who presented with more severe initial symptoms lead to higher rates of fatalities
A

a. 2014 – 2017

69
Q
  1. Where do people typically bleed from when they have the heamorpgheic version?
A

a. Ears, eys, and mouth

70
Q
  1. What were the general clinical manifestations?
A

a. Fever (87%), fatigue (76%), arthralgia (39%), myalgia (39%)

71
Q
  1. What were the neurological manifestations?
A

a. Headache (53%), confusion (13%), eye pain (8%), coma (6%)

72
Q
  1. What are the cardiovascular manifestations?
A

a. Chest pain (37%),

73
Q
  1. What are the pulmonary manifestation?
A

a. Cough (30%), dyspnea (23%), sore throat (22%), hiccups (11%)

74
Q
  1. What are the gastrointestinal manifestations?
A

a. Vomiting (68%), diarrhea (66%), anorexia (65%), abdominal pain (44%), dysphagia (33%), jaundice (10%)

75
Q
  1. What are the Hematological manifestations?
A

a. Any unexplained bleeding (18%), melena/haematochezia (production of black stool)(6%),
b. haematemesis (vomit blood)(4%), vaginal bleeding (3%), gingival bleeding (2%),
c. haemoptysis (Coughing up blood)(2%), epistaxis (nose) (2%), bleeding at injection site (2%),
d. haematuria (1%), petechiae/ecchymoses (1%)

76
Q
  1. What are the integumentary manifestations?
A

a. Conjunctivitis (21%), rash (6%)

77
Q
  1. What is the 2014 hospitalised fatality rate?
A

a. 55-62% fatality rate in hospitalised patients in 2014

78
Q
  1. Patients who survive often have signs of clinical improvement by ________ week of illness
A

a. 2 weeks

79
Q
  1. Antibody with neutralising activity against Ebola persists >______ yr p.i.
A

a. 12

80
Q
  1. Prolonged convalescence issues?
A

a. Includes arthralgia, myalgia, abdominal pain, extreme fatigue & anorexia; many symptoms resolve by 21 months
b. • Significant arthralgia and myalgia may persist for >21 months
c. • Skin sloughing and hair loss has also been reported

81
Q
  1. The inflmation response results in an endokine strom resulting in?
A

a. Endothelial damage: become permeable and leaky
b. Multiorgan dysfunction from drop in pressure
c. The body then releases: Diffuse Intravascular coagulopathy (DIC)
i. Small clots in narrow vesciles

82
Q
  1. When is the peak of interferon production? What does this stimulate?
A

a. 2-3 days

b. Inflammatory response

83
Q
  1. What increase after the peak interferon?
A

a. Viral RNA
b. IgM
c. IgG

84
Q
  1. What do the people who survive maintain high levels of?
A

a. IgG

85
Q
  1. What animals can get Ebola Zaire? And how does it affect them?
A

Same clinical course as humans

b. − Domestic animals don’t develop disease
c. − Pigs can develop and transmit infection

86
Q
  1. What is the primate mortality rate with ebola Reston?
A

a. ~82%

87
Q
  1. Philippines
    a. • 1989-1990 – Reston_______: Traced back to macaques in Philippines in breeding facilities
    b. • 1992-1993 – Sienna, Italy: Philippines Traced back to macaques in _____in breeding facilities
    c. • 1996-_______, America: when it was discovered to be aerosol as it was spread between huts with no crossover of staff
    d. • 2008/9 –_____, Philippines: abattoir: pigs with Reston and workers were ill, showed antibodies
    e. • 2015 –_____, Manilla
A

i. Virginia
ii. Philippines
iii. Texas
iv. Pigs
v. macaques

88
Q
  1. What percentage of workers were found to be serologically positive in the macaque breeding centers in the phillipense? What test was used for testing? How did is present?
A

a. 20%
b. Fleurescent antibody tests: IFAT
c. Asymptomatic

89
Q
  1. ____ outbreak, Meliandou, _____, _____ year old was patient zero, and spread to healthcar workers in Jan-March _______.
A

a. 2013
b. Guinea
c. 2 year old
d. 2014

90
Q
  1. 2013: First diagnosed ________, dies within ____ days. Symptoms. Then passed to? How did it initially spread to a new village? What countries did it spread to
A

a. Emile
b. 4days
c. Fever, black stools, vomiting
d. Family
e. Granny and nurse  health care system
f. Guinea, Liberia, and Sierra Leone

91
Q
  1. What is a cultural issue with ebola?
A

a. Its common for family members to clean the bodies of dead people
b. People kiss the dead body

92
Q
  1. How many people are allocated to one doctor in Liberia?
A

a. 70,000

93
Q
  1. What country closed its borders with Guinness in the 2014 outbreak? Did it work
A

a. Senegal

b. nope

94
Q
  1. Where have cases been reported outside of Africa?
A

a. USA
b. UK
c. Most of Europe

95
Q
  1. What type of lab do you need for diagnosis? And what type of lab do you need to isolate it?
A

a. BSL-3

b. BSL-4

96
Q
  1. What diagnostics test can be used at the early stages?
A

a. Antigen-capture enzyme-linked
b. immunosorbent assay (ELISA) testing
c.  IgM ELISA
d.  Polymerase chain reaction (PCR)
e.  Virus isolation

97
Q
  1. What can be used for diagnosis later?
A

a.  Serology: IgM and IgG

98
Q
  1. What diagnosis can be used in diseased patients?
A

a. Immunohistochemistry testing
b.  PCR
c.  Virus isolation

99
Q
  1. What is the longest IgM has been shown to last in people?
A

a. IgM

100
Q
  1. What are the treatments for Ebola?
A

a. • No approved treatments available for EVD
b. • Clinical management focus - supportive care of complications:
c. – hypovolemia, electrolyte abnormalities, hematologic abnormalities, refractory shock,
d. hypoxia, haemorrhage, septic shock, multi-organ failure, and DIC

101
Q
  1. What recommended care is encouraged?
A

a. Recommended care includes:
b. – volume repletion
c. – maintenance of blood pressure (with vasopressors if needed)
d. – maintenance of oxygenation
e. – pain control
f. – nutritional support
g. – treating secondary bacterial infections and pre-existing comorbidities

102
Q
  1. Are there any vaccines for Ebola?
A

a. • rVSV ZEBOV (Ervebo) - 2019- Guinea, Liberia, Sierra Leone
b. 2nd vaccine - 2 doses called Zabdeno (Ad26.ZEBOV) & Mvabea (MVA-BN-Filo) for individuals 1 year & older
c. Zmapp: secret serum, hyper immune from survirers
d. BCx-4430: adenosine anolog inhibits RNA function
e. Tekmira: siRNA

103
Q
  1. What preventions and controls are there?
A

a. • Protective clothing
i. – Disposable gowns, gloves, masks & shoe covers, protective eyewear when splashing might occur, or if patient is disoriented or uncooperative
b. • WHO and CDC developed manual
i. – “Infection Control for Viral Haemorrhagic Fevers In the African Health Care Setting”
c. • Chemical toilet for suspected VHF patients
d. • Disinfect & dispose of instruments

104
Q
  1. What happens with traditional cures?
A

a. Chewing bitter cola (Gracinia cola or G. Afzelii)
b. – Eating ewedu; Cochorus olitorius
c. – Salt bath & drink
d. – Kerosene bath
e. – Bleach bath (sodium hypochlorite)

105
Q
  1. What did more people die from during the Ebola outbreak then in theEbola in Nigeria?
A

a. Salt drinks and baths

106
Q
  1. Ebola biological weapon
A

a. • Outbreak of undifferentiated febrile illness 2-
i. 21 days following attack
ii. −Could include
1. Rash, haemorrhagic diathesis and shock
b. • Diagnosis could be delayed
i. −Unfamiliarity
ii. −Lack of diagnostic tests
c. −Ebola causes high mortality rates: possible 90%

107
Q
  1. What does protein V40 do? What is it
A

a. Membrane associated protein
b. Matric protein
c. Blocks immune response
d. Virus budding
e. Viral assembly

108
Q
  1. What is the nucleocapsid? What is it made from? What does it do?
A

a. Nuceloproteins

b. Encapsulates the viral genome

109
Q
  1. What is VP30? What does it do?
A

a. Involved in RNA transcription

b. Phosphoproteins

110
Q
  1. What is VP35? What does it do?
A

a. A nucleocapsid protein that

b. inhibits the antiviral immune response

111
Q
  1. What is VP 24?
A

a. Membrane associated protein
b. Matric protein
c. Blocks immune response
d. Virus budding
e. Viral assembly

112
Q
  1. What is a glycoprotein and what does it do?
A

a. Located on the cell envelop

b. Aid attachment to host cell

113
Q
  1. What part of the human cell plays a role in the attachment of the Ebola virus?
A

a. DC-SIGN and DC-SIGNR

114
Q
  1. When Ebola enters the cell what is this process called and what mediatest eh process?
A

a. Macropinocytosis or clathrin-mediated endocytosis.

b. Clathrin

115
Q
  1. How Does Macropinocytosis take place?
A

a. In this process, ruffled segments of the host’s plasma membrane protrude outward from the cell and form invaginations where the virus utilizes glycoproteins in order to attach to the surface of the plasma membrane. Macropinocytosis is a process in which the Eukaryotic host cells form macropinosomes, segments of plasma membranes that extend out from the cell approximately 0.2-10 µm, in order to incorporate the virus into the cell. The formation of macropinosomes occurs spontaneously, as a result of the activation of various growth factors, or simultaneously with the intake of cellular molecules or extracellular fluid.

116
Q
  1. If ________ is missing Ebolavirus cannot leave the vesicle in order to replicate and cause infection in other cells.
A

a. NPC1 cholesterol transporter

117
Q
  1. What does the viral RNA transcribe? And what determines their length?
A

a. seven monocistronic mRNAs whose length is determined by highly conserved start and stop signals.

118
Q
  1. What is the RNA transcription process?
A

a. The transcription process begins with the binding of the polymerase complex to a single binding site located within the leader region of the genome. The complex then slides along the RNA template and sequentially transcribes the individual genes in their 3’ to 5’ order. Encapsidated, negative-sense genomic ssRNA is used as a template for the synthesis (3′-5′) of polyadenylated, monocistronic mRNAs and, using the host cell’s ribosomes, tRNA molecules, etc., the mRNA is translated into individual viral proteins.

119
Q
  1. What happens once replication of viral proteins reach a high density level?
A

a. Using the negative-sense genomic RNA as a template, a complementary +ssRNA is synthesized; this is then used as a template for the synthesis of new genomic (-)ssRNA, which is rapidly encapsidated

120
Q
  1. What type proteins are recruited from the cell for the virus to exit? What are the specific proteins? What do they do?
A

a. ESCRT endosomal sorting complex required for transport
b. ESCRT-0, ESCRT-I, ESCRT-II, and ESCRT-III
c. ESCRT-0, ESCRT-I, ESCRT-II: cleaves the bud neck from its cytosolic face
d. ESCRT-III: cleaves the bud neck from its cytosolic face

121
Q
  1. What cells does the Ebola Virus infect?
A

a. EBOV productively infects a broad range of cell types such as monocytes, macrophages, dendritic cells, endothelial cells, fibroblasts, hepatocytes, and adrenal cortical cells. Following host cell attachment (Figure 1), the virus is internalized by macropinocytosis, a non-selective process of engulfment

Zoonoses (23 decks)

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