Herpes I and II

Question 1

Reactivation of CMV –> what clinical problem?

Answer 1

Pneumonia

Question 2

WHere does HSV-1 reside in a latent infection?

Answer 2

Trigeminal ganglion

Question 3

Where does HSV-2 reside in a latent infection?

Answer 3

Sensory cells of sacral ganglion

Question 4

Acyclovir must first be phosphorylated by what enzyme?

Answer 4

Viral thymidine kinase

Question 5

What subset of patients tends to develop resistance to acyclovir?

Answer 5

Immunocompromised

Question 6

What is the MOA of Pritelivir?

Answer 6

Anti-herpes drug: inhibits the herpes helicase-primase complex and inhibits synthesis of viral DNA

Question 7

What type of vaccine is the chicken pox vaccine?

Answer 7

Live attenuated virus- may be administered with the MMR vaccine

Question 8

Where does viral DNA from varicella reside in the latent period?

Answer 8

Dorsal root ganglion

Question 9

Name two cancers associated with Epstein Barr

Answer 9

Burkitt Lymphoma (malaria is a cofactor)
Nasopharyngeal carcinoma

Question 10

How long does an EBV infection last?

Answer 10

Life-long with asymptomatic shedding

Question 11

What cells are infected by EBV?

Answer 11

Virus in the saliva infects epithelia and spreads to B cells in the lymphatics

Question 12

What is the effect of T-cell deficiency in EBV infections?

Answer 12

Severe disease

T-cells kill/control B-cell outgrowth and and promote latency of B cells. Defective T cells –> worse disease

Question 13

What disease is caused by a chronic EBV infection in the presence of AIDS?

Answer 13

Hairy oral leukoplakia

Question 14

What is the consequence of a congenital infection with CMV?

Answer 14

Cytomegalic inclusion disease

Question 15

What is the consequence of CMV in an AIDS patient?

Answer 15

Multisite symptomatic disease- often retinitis and pneumonitis

Question 16

How long are infections with CMV?

Answer 16

Lifelong, but they are asymptomatic in normal healthy people

Question 17

What is the mode of transmission of CMV?

Answer 17

blood/secretion

Question 18

WHere does latent CMV reside?

Answer 18

Macrophages and T cells

Question 19

What is the anti viral used to treat CMV infections? How does it work?

Answer 19

Ganciclovir- it is activated in CMV infected cells

Question 20

What is the major adverse effect associated with ganciclovir?

Answer 20

Bone marrow toxicity

Question 21

What drug is used for prophylaxis of CMV in bone marrow transplants

Answer 21

Letermovir

Question 22

What is the MOA of letermovir?

Answer 22

Inhibits the CMV terminase complex

Question 23

How can we differentiate roseola from other infections?

Answer 23

High fever for 4 days followed by a rash with NO fever

Question 24

What cells are infected by HVS-6/7?

Answer 24

T-cells

Question 25

How common is roseola?

Answer 25

Very common- 95% seropositive by 5

Generally it is symptomatic in infancy

Question 26

Which is the most common neoplasm in AIDS patients?

Answer 26

Kaposi’s - HSV-8