2: herpes viruses, papillomaviruses, epidemics Flashcards
(36 cards)
name viruses associated with chronic infection and neoplastic transformation
- HSV1
- HSV2
- EBV
- CMV
- HTLV
- HHV8
- papillomavirus
- Hep B, C
primary and recurrent forms of HSV1 and 2
primary: local reaction at site of contact (can get pharyngitis)
secondary: lyses cells to form vesicles! re-activation
- inside vesicles = fluid + herpes-infected cells
what does scrapings of herpes lesions reveal histologically?
inclusion-bearing multinucleared syncytia (giant cells)
-see on Tzanck smear
what is a good way to differentiate this from zoster?
herpes is independent of skin dermatomes
what are herpes blisters associated with?
edema
ballooning degeneration
cytopathic changes
necrosis
what happens if you get corneal lesions w/ herpes?
cell infiltrates
neovascularization
scarring
blindness
if herpes disseminates in immunocompromised people, what can happen
fatal sporadic encephalitis or corneal blindness
congenital infections
TORCH toxo other rubella CMV herpes
what are the classic signs/symptoms of congenital infections that occur in 3rd trimester?
deafness
ataxia
blindness
developmentally delayed
differentiate the honey-colored crusting of herpes and impetigo
herpes: due to ruptured vesicles w/ serous fluid that dries
impetigo: skin ruptures, drains inflammatory fluid
primary and secondary infections from EBV
primary: infectious mononucleosis
secondary: latent infection of B cells
- Burkitt’s lymphoma
- B cell lymphomas (immunosuppressed)
- nasopharyngeal carcinoma
- sarcoidosis
describe infectious mononucleosis
- benign, self limiting
- transmitted by saliva
- lymphoproliferative (hyperplasia, lymphadenopathy)
- fatigue, headache, low grade fever, pharyngitis
- TENDER cervical node enlargement
- splenomegaly
- if super widespread: hepatitis, meningoencephalitis, pneumonitis
pathology of infectious mononucleosis
- binds to complement receptor on epithelial cells and B cells
- spreads through oral epithelium to underlying B lymphoid tissues
- shed in saliva
- NONSPECIFIC POLYCLONAL AB STIMULATION
what will you see on peripheral blood smear?
ATYPICAL LYMPHOCYTES: anti-EBV T cells, not B cells
how does monospot test distinguish between EBV mono and CMV mono-like illness?
EBV- makes anti-carb Ab’s that cause polyclonal activation, so you get Ab’s of all kinds: mix pt serum with sheep RBCs and get agglutination
CMV - does not do this b/c doesn’t infect B cells like EBV does
what can the polyclonal activation of EBV give you a false positive for? what else gives false positive for this test?
false (+) VDRL
-lupus also does this
how to differentiate infectious mononucleosis from Hodgkin’s disease
difficult - but mono is tender, while Hodgkin’s is non-tender
what is diagnosis of infectious mono dependent on?
- finding atypical lymphocytes
- positive heterophile rxn
- specific Ab’s for EBV Ag’s
why is it really bad if a person with x-linked lymphoproliferative disease gets EBV?
they can die - have an absence of SAP gene: mutated protein involved in regulation of an intense CD8 cytotoxicity stimulated by EBV
-if they survive, they can develop B cell lymphomas
what histology is associated with CMV
large purple nuclear or cytoplasmic inclusions
CMV is usually a mild ish disease, unless what population gets it?
neonates - can mimic erythroblastosis fetalis
what is diagnostic of neonatal CMV
infects renal tubules, so you see CMV infected cells in urine sediment
most common opportunistic viral disease in AIDS patients
CMV (retinitis)
when CMV presents in AIDS patients, what does it almost always present with?
pneumocystis infection
