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IHO week 1 > Viruses of the hematopoietic system > Flashcards

Viruses of the hematopoietic system Flashcards

1
Q

parvovirus B19 stats:

A

linear ssDNA(-)

non-enveloped

icosahedral capsid symetry

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2
Q

Tropism of parvovirus B19:

A

human erythroid progenitor cells

blood group P antigen (people deficient in P antigen are immune)

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3
Q

Transmission of parvovirus B19?

A

respiratory droplets

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4
Q

Role of viral protein NS1?

A

induction of erythroid apoptosis

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5
Q

typical clinical presentation of parvovirus B19?

A

fifth disease

“slapped cheek”–>lacy macular rash on extremeties

arthralgias

Tx: supportive of sx, no vac or antiviral available
-give immunocompromised pts IV-Ig

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6
Q

Colorado tick fever virus stats:

A

Linear dsRNA

non-enveloped

icosahedral symetry

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7
Q

Tropism of Colorado tick fever virus:

A

Erythrocytes

Animal vectors:

  • Rocky mountain wood tick
  • small mammals

spring/summer

Rockies/west coast

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8
Q

CTFV method of replication:

A

uses negative strand of its genome for transcription and as a template for replication of the positive strand

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9
Q

Typical clinical presentation of CTFV…

A

fever/chills, body aches, lethargy malaise

dx: PCR of blood or CSF–detection of viral RNA/IgM

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10
Q

Tx of CTFV?

A

supportive care

**may be more complicated in form of meningitis or encephalitis

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11
Q

Epstein Barr Virus stats:

A

dsDNA (gamma-1 herpes virus)

enveloped

icosahedral capsid symmetry

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12
Q

tropism of EBV?

A

Lytic cycle in epithelial tissue

Latent infx in B-cells

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13
Q

Malignancies associated with EBV:

A
  • Burkitt’s lymphoma
  • anaplastic nasopharyngeal carcinoma
  • Hodgkin’s disease
  • Lymphomatoid granulomatosis
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14
Q

How does EBV establish infx?

A
  • contact with CD21 on surface of B-cells
    • directly in tonsillar region
    • indirectly through contact with epithelial cells
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15
Q

What is LMP1?

A

EBV oncogene homolog of CD40-TNF subtype

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16
Q

What is LMP2?

A

EBV oncogene homolog of BCL2–>antiapoptotic–>B-cell proliferation

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17
Q

What is EBNA-3C?

A

EBV oncogene:

essential for EBV’s ability to cause B-cell transformation

induces epigenetic silencing of pro-apoptotic protein BIM

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18
Q

Presentation of infectious mononucleosis:

Dx?

A

Fever 10-14 days

sore throat

3-5 days severe swollen glands (usually posterior cervical lymph nodes)

Dx: monospot test detects IgM produces by B cells

-Downey cells in blood smear

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19
Q

EBV x-linked lymphoproliferative disease presents as?

A

Recessive disorder in young boys, can present as severe infectious mononucleosis and be fatal

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20
Q

Important molecule in mediating X-linked proliferative disease?

A

SAP proteins

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21
Q

Cytomegalovirus stats:

A

dsDNA

enveloped

icosahedral nucleocapsid

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22
Q

Tropism of cytomegalovirus:

A

Systemic infx: epithelial cells, smooth muscle cells, macrophages, neurons

Latent infx: CD34 myeloid progenitor cells

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23
Q

How does cytomegalovirus establish infx?

A

attaches to host cell via glycoprotein B [gB] and a gH-gL dimer

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24
Q

How does cytomegalovirus evade host immune system?

A

MHC-1 is destabilized in infected host cells so viral antigens are not presented to cytotoxic T-cells

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25
Q

A typical clinical presentation of CMV infectious mononucleosis is . . .

A

Infants:

microcephaly, seizures, deafness, jaundice, and purpura.

The purpuric lesions resemble a “blueberry muffin” and are due to thrombocytopenia.

Hepatosplenomegaly is very common.

Adults: heterophil-negative mononucleosis:
-fever, lethargy, and the presence of abnormal lymphocytes

-Systemic CMV infections, especially pneumonitis, esophagitis, and hepatitis, occur in a high proportion of immunosuppressed individuals.

26
Q

CMV Dx?

A

enzyme linked immunoassay for pp65 within leukocytes

and…

“OWL’S EYE” in blood smear

27
Q

Tx for CMV:

Complicated and uncomplicated

A

uncomplicated: supportive care

severe systemic can be treated with Ganciclovir

28
Q

Why is acyclovir ineffective in CMV?

A

CMV has no thymidine kinase

29
Q

HHV 6&7 stats:

A

dsDNA

enveloped

icosahedral

30
Q

HHV 6&7 tropism:

A

CFU-GEMM (hematopoietic stem cells), monocytes, peripheral blood mononuclear (neutrophil, macrophage, eosinophil, basophil, T & B cells), epithelial cells

31
Q

Difference between HHV 6 & 7?

A

HHV-7 has narrower tissue tropism

32
Q

Clinical presentation of HHV 6/7?

A

exanthem subitum (also called sixth disease or Roseola infantum)–occurs mostly in infancy or early childhood

-faint pink or rose colored, non-puritic rash following approx 72 hrs after a high fever

33
Q

Tx for HHV 6/7:

A

Ganciclovir, foscarnet, cidofovir

34
Q

Kaposi sarcoma virus stats:

A

(HHV-8)

dsDNA

enveloped

icosahedral

related malignancies: Kaposi sarcoma

People affected: immuncompromised pts

35
Q

Kaposi sarcoma virus (HHV-8) tropisms:

A

B-cells

36
Q

Kaposi sarcoma virus (KSV) (HHV-8) protein that messes with apoptosis?

A

vFLIP–> replaces FLIP which is pro-apoptotic meaning vFLIP is anti-apoptotic and therefore oncogenic

37
Q

Treatment for KSV target_______.

A

lytic pase

38
Q

Tx options for KSV? how do they work?

A

Ganciclovir–chain terminator

Cidofir–inhibits viral DNA polymerase

Foscarnet–inhibits binding site on viral DNA polymerase (dose not affect human DNA polymerase)

39
Q

Human T-cell Lyphotrophic Virus (HTLV-1 and HTLV-2) stats:

A

ssRNA w/reverse transcriptase

enveloped

icosahedral

40
Q

HTLV tropism:

A

T-cells

41
Q

How are HTLV-1 and HTLV-2 different?

A

1-causes T-cell leukemia and myelopathy/troapical spastic paraperris
2-is non pathogenic, more common in caribbean, eastern SA, west africe, and south japan

42
Q

How does HTLV enter host cells?

A

binds host cell gp46 –> fusion with cell’s plasma membrane

**must integrate into host cell’s DNA to become pro virus

gene expression:

  • Tax-transcription
  • Rex-translation of viral mRNA
43
Q

HTLV causes leukemia by …

A

Tax upregulates NFkB, IFN-I, IFN-B, TBK1 and IKKE

downregulates p53

44
Q

Typical clinical presentation of Acute T-cell Lymphoma:

A
  • malaise
  • night sweats
  • fever
  • cachexia
  • adenopathy
45
Q

What is HAM/TSP? How does it present?

A

HTLV-1 Associated Myelopathy aka Tropical Spastic Paraparesis
-infected T cells trafficked into spinal cord and cause astrocytosis and inflammation of gray and whit matter leading to progressive demyelination

Presenting sx:

  • gait disturbance
  • stiffness/weakness in legs
  • back aches
  • “weak” bladder
  • constipation
46
Q

Human Immunodeficiency Virus (HIV-1, HIV-2) stats?

A

Lentivirus (subgroup of retrovirus group VI)
ssRNA (+) w/reverse transcriptase

enveloped

capsid symmetry: icosahedral

47
Q

HIV tropism:

A

CD4+ T-cells primarily (also Macs and Dendrites)

  • CD4
  • CCR5
  • CXCR4
48
Q

What is the difference between HIV 1 and 2?

A

2 has lower transmissibility and less potential to progress to AIDS.

1 is world wide, 2 is more confined to West Africa

49
Q

Number of CD4+ T-cells to be considered AIDS?

A
50
Q

Do patients die of HIV or AIDS?

A

No, the die of inability to respond to another disease

51
Q

thymidine analog (nucleoside reverse transcriptase inhibitor), blocks RT at active site.

A

zidovudine (Retrovir)

52
Q

non-nucleoside reverse transcriptase inhibitor (NNRTI), binds RT far from active site

A

efavirenz

53
Q

Entry inhibitor, inhibits catalytic activity of HIV integrase

A

raltegrovir

54
Q

HIV protease inhibitor

A

ritonavir

55
Q

Chemokine receptor 5 antagonist. HIV entry inhibitor.

A

maroviroc

56
Q

Ebola virus stats:

A

non-segmented negative strand RNA
-group V

enveloped

**Helical capsid

57
Q

Ebola virus tropism:

A

Can infect many cells.

Blood cells: monocytes, macrophages, dendrites

58
Q

Clinical presentation of Ebola:

A

very general

  • fever, myalgia, and general malaise and sometimes accompanied by chills
  • often confused with malaria or dengue in tropical climates. -initial period is followed by flu-like symptoms, gastro-intestinal symptoms and in severe cases maculo-papulary rash, petichae, conjunctival hemorrhage, epistaxis, melena, hematemesis, shock and encephalopathy
59
Q

Supportive care for Ebola patients:

A

aggressive replacement of fluids and electrolytes

  • oral rehydration solution when possible, intravenous infusion when necessary
  • Oxygen and vasopressors should be used if available and necessary to maintain adequate bodily function
60
Q

Cause of death from Ebola?

A

End stage disease w/ severe organ dysfunction, encephalitis, anuria, seizures

IHO week 1 (13 decks)

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