Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Term 5: Infectious Disease > 5/27- Human Herpes Virus (HHV) 2 > Flashcards

5/27- Human Herpes Virus (HHV) 2 Flashcards

1
Q

Three subfamilies of herpesvirus?

A

Alpha

Beta

Gamma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Viruses within alpha subfamily of herpesvirus?

A

H. simplex type 1 (HHV1), 2, and 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Viruses within beta subfamily of herpesvirus?

A

Cytomegalovirus (HHV5)

HHV 6

HHV 7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Viruses within gamma subfamily of herpesvirus?

A

Epstein-Barr (HHV4)

KSHV (HHV8)- Kaposi’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Characteristics of alpha subfamily?

A
  • Rapid growth
  • Variable host range
  • Latent in ganglia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Characteristics of beta subfamily?

A
  • Slow growth
  • Persist in CD4+ cells, monocytes/macrophages, mesenchymal cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Characteristics of gamma subfamily?

A
  • Poor growth/abortive
  • Latent in lymphocytes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Question:

Acute infxn followed by complete elimination from the host is characteristic of which one of the following viruses?

A. Influenza virus

B. Herpes varicella-zoster virus

C. BK virus

D. Adenovirus

A

Answer:

Acute infxn followed by complete elimination from the host is characteristic of which one of the following viruses?

A. Influenza virus

B. Herpes varicella-zoster virus

C. BK virus

D. Adenovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Common targets of antiviral therapy of herpesvirus?

A

Genomes encode numerous enzymes involved in NA metabolism and DNA synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Is herpes lytic or lysogenic?

A

Production of infectious progeny results in lysis of infected cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Clearance or latency for herpes?

A

All persist and may reactivate; reactivation may/may not be associated with disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What molecules are required for infectivity?

A

gB and gD (gG is type specific)

(gB is most important ‘neutralizing epitope’)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Epidemiology of HSV?

A
  • Worldwide
  • Seroprevalance varies by age and SES
  • more HSV1 in lower SE groups; earlier 1’ infxn
  • more HSV2 after puberty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Transmission of herpes virus?

A

Direct contact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pathogenesis of 1’ herpes infxn?

A
  • Penetrates into skin
  • Local replication and entry of virus into cutaneous neurons
  • Centripetal migration in axon of uncoated nucleocapsids
  • Synthesis of infectious virions
  • Centrifugal migration fo infectious virions to epidermis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When is viremia most common with HSV?

A
  • Among pts with 1st episode of genital HSV
  • Especially women with HSV 2 infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What cells are involved in the immune response for HSV? Other lines of immune defense?

A
  • NK cells
  • Cell-mediated immunity with CD8+ T cells

Other:

  • TLRs
  • Serum antibodies (neut, CF, IF, ELISA)
  • peripheral mucosal immune system
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Most reactivations of herpes in healthy people are long/symptomatic or short/asymptomatic?

A

Short/asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Where does the herpes virus remain latent?

A

Trigeminal ganglion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What percentage of 1’ herpes infxns are asymptomatic?

A

> 90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Common disease syndromes for HSV?

A
  • Gingivostomatitis -> fever blister (HSV 1 > 2)
  • Keratitis
  • Whitlow
  • Encephalitis
  • Cutaneous herpes (‘herpes gladiatorum’)
  • Genital herpes (now HSV1 > 2 in US)
  • Neonatal herpes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What layer are the vesicles with HSV infxn?

A

Intra-epithelial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What do HSV lesions look like?

A

Grouped vesicles on erythematous base

24
Q

Symptoms of herpetic gingivostomatitis?

A
  • Fever
  • Malaise
  • Myalgias
  • Irritability
  • Pain
  • Tender lymph nodes

Signs:

  • Typical lesions on: tongue, palate, lip, gingiva, face, pharynx
  • Adenopathy
25
Q

Symptoms of herpetic keratitis

A
  • Pain
  • Blurred vision
  • Conjunctivitis
  • Dendritic lesions of cornea

- HSV keratitis is MCC of corneal blindness in the US!

26
Q

Symptoms of herpetic whitlow?

A

Lesions of fingers may result from autoinoculation or from occupational/other exposure. (may be confused w/ pyogenic bacterial infxn)

27
Q

What is the MCC of acute, sporadic viral encephalitis in the US?

A

Herpes simplex virus

28
Q

Symptoms of herpes simplex encephalitis?

A
  • Fever
  • Headache
  • Focal neurologic Sx/signs
29
Q

Symptoms of genital HSV2 infxn (1’ and recurrent)

A

1’: fever, headache, malaise, and myalgia; pain, itching, inguinal adenopathy, vaginal & urethral discharge, possible acute urinary retention and aseptic meningitis

reactivation: often mild or asymptomatic

30
Q

% breakdown of different types of vertical transmission?

A

90% perinatal

5-8% congenital

few postnatal

31
Q

Symptoms of neonatal herpes?

A

Involves skin, viscera, and/or CNS

32
Q

What is eczema herpeticum?

A

Widespread lesions that may develop in people who have underlying skin disorders such as eczema

33
Q

Question:

Direct contact with characteristic lesions in which one of the following clinical settings does NOT transmit infection to susceptible individuals?

A. Genital herpes

B. Erythema infectiosum (“Fifth Disease”)

C. Condyloma accumulata (genital warts)

D. Orf (parapox)

A

Answer:

Direct contact with characteristic lesions in which one of the following clinical settings does NOT transmit infection to susceptible individuals?

A. Genital herpes

B. Erythema infectiosum (“Fifth Disease”)

C. Condyloma accumulata (genital warts)

D. Orf (parapox)

34
Q

Mechanisms of latent HSV?

A
  • Viral DNA persists as an episome
  • Latency-associated transcript encodes microRNA that is anti-apoptotic (no symptoms/lesion/virus)
35
Q

Reactivation from trigeminal ganglia results in what?

A
  • No symptoms, or
  • Intraoral mucosal lesions of lip/face (cold sore)
36
Q

What is herpetic stomatitis

A

Extensive lesions that may develop in pts who are immunocompromised (gross tongue pic)

37
Q

Detection/Diagnosis of HSV?

A
  • Tzanck prep to look for multinucleated giant cells
  • Fluorescent antibody staining
  • Isolation in tissue culture (needle aspirate to see cytopathic effect of HSV in tissue culture)
  • Serodiagnosis (higher in 1’ infxn, no rise w/ recurrent infxn, significant rise in CSF/serum with encephalitis)
38
Q

Question:

A 25 yo sexually-active woman presents with a 2 day Hx of headache and burning on urination. PE reveals genital ulceration; several vesicular lesions are noted. Which of the following is LEAST likely to provide useful diagnostic info?

A. Tzanck smear of lesion scrapings

B. Rapid antigen test of lesion swabs

C. Viral culture

D. Routine urine for culture and sensitivities

A

Answer:

A 25 yo sexually-active woman presents with a 2 day Hx of headache and burning on urination. PE reveals genital ulceration; several vesicular lesions are noted. Which of the following is LEAST likely to provide useful diagnostic info?

A. Tzanck smear of lesion scrapings

B. Rapid antigen test of lesion swabs

C. Viral culture

D. Routine urine for culture and sensitivities (routine is bacteria)

39
Q

Peak epidemic season(s) fro VZV?

A

Winter

40
Q

Main transmission of VZV?

A

Respiratory

41
Q

What factors could contribute to reactivation of varicella?

A
  • Aging
  • Radiation
  • Surgery/trauma
  • Immunosuppression
42
Q

Pathogenesis of Varicella?

A
  • Incubation period
  • Mucosal inoculation: aerosol or contact
  • Replication in regional nodes
  • VZV-infected T cells enter capillaries
  • Primary T-cell viremia
  • Replication in liver and spleen
  • Secondary T-cell viremia
  • Development of rash after 24-72 hours
43
Q

Symptoms of Varicella/Chickenpox?

A
  • Usually mild
  • Fever and malaise
  • Followed by development of rash (24-72 after infxn) (itchy rash)
44
Q

What can complicate varicella infxn?

A

2’ infxn with Group A strep

45
Q

Varicella pneumonia occurs in what pts?

A
  • More often in adolescents and adults
  • Immunocompromised
46
Q

When is varicella fatal?

A
  • immunocompromised children (e.g. SCID)
47
Q

Greatest risk of maternal infxn for vertical transmission of varicella?

A

Maternal dz occurring 5 days before or up to 48 hrs postpartum

48
Q

What is herpes zoster (HZ)?

A

Reactivation dz associated with VZV infxn (aka Shingles)

49
Q

What increases risk of HZ?

A
  • Aging
  • Immunosuppression
50
Q

How many (%) people develop HZ in lifetime?

A

20% (1/2 of these by age 85)

51
Q

What debilitating symptom may accompany HZ? %?

A

Postherpetic neuralgia (PHN) in 20-50%

52
Q

Characteristics of HZ rash?

A
  • Unilateral
  • Dermatomal
  • Often thoracic
53
Q

Common organ involved with HZ?

A

Eye (ophthalmoplegia)

54
Q

Antivirals and other methods used to treat and prophylax for HHV3?

A

Antivirals:

  • Acyclovir
  • Famciclovir
  • Valacyclovir (other topical and parenteral drugs)

Live attenuated vaccine

Varicella-zoster immunoglobulin (VZIG) to prevent/modify dz after exposure

Strict infxn control msrs to prevent nosocomial spread

55
Q

Who should receive the VZV vaccine?

A
  • Healthy susceptible children and adults
  • High dosage vaccine for prevention of shingles in people > 60 yo
56
Q

Question:

Which of the following diagnostic tests is LEAST likely to establish the diagnosis of recurrent VZV infection (or shingles)?

A. Viral culture of vesicular fluid

B. Detection of nucleic acid via PCR of lesion scrapings

C. Acute IgG titer vs. VZV

D. Tzanck smear of lesion scrapings

A

Answer:

Which of the following diagnostic tests is LEAST likely to establish the diagnosis of recurrent VZV infection (or shingles)?

A. Viral culture of vesicular fluid

B. Detection of nucleic acid via PCR of lesion scrapings

C. Acute IgG titer vs. VZV

D. Tzanck smear of lesion scrapings

57
Q

Question:

A 52 yo female presents w/ 2 day Hx of pain on R side of chest. New rash this morning- unilateral, vesicular in T8 distribution. Which statement about condition is CORRECT?

A. No treatment is available

B. No vaccine is available which could have prevented this condition

C.. The lesions are potentially infectious

D. These lesions are probably the result of direct contact with a persons who had varicella within the last 3 wks

A

Answer:

A 52 yo female presents w/ 2 day Hx of pain on R side of chest. New rash this morning- unilateral, vesicular in T8 distribution. Which statement about condition is CORRECT?

A. No treatment is available

B. No vaccine is available which could have prevented this condition

C.. The lesions are potentially infectious

D. These lesions are probably the result of direct contact with a persons who had varicella within the last 3 wks

Term 5: Infectious Disease (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions