Aetiology - viruses

Question 1

what are causes of oral cancer?

Answer 1

tobacco, alcohol, HPV, poor nutrition, UV light, immunocompromise, genetic, potentially malignant conditions

Question 2

describe the structure of HPV

Answer 2

double stranded DNA
circular
small
non-enveloped
capsid
72 capsomeres

Question 3

what does HPV target?

Answer 3

mucosa

Question 4

what are the types of HPV?

Answer 4

Alpha
beta
gamma
Mu
Nu

Question 5

what are high risk HPV types associated with carncinogens?

Answer 5

16 and 18

Question 6

what does HPV 16 target?

Answer 6

tumorous suppressor genes E6+7

Question 7

what types of cells does HPV16 infect?

Answer 7

undifferentiated proliferative basal cells capable of dividing

Question 8

what is an episome?

Answer 8

when DNA localises into the nucleus

Question 9

with HPV16 infection, what viral proteins are transcribed from the early promotor?

Answer 9

E1,2,6,7

Question 10

what do E6+7 do in HPV infection?

Answer 10

disturb the normal terminal differentiation by stimulating cellular proliferation and DNA synthesis

Question 11

where do capsid proteins L1 and 2 accumulate during HPV infection?

Answer 11

mature epithelial cells

Question 12

where does assembly of infectious virions take place?

Answer 12

terminally differentiated cells of upper epithelial layers

Question 13

what is an epidermodysplasia verruciformis?

Answer 13

exuberant growth by HPV
rare autosomal recessive genetic condition that effects skin and increases the risk of carcinoma of the skin

Question 14

what is a papilloma?

Answer 14

harmless/ benign
common on soft palate
small raised white lesion

Question 15

how would you treat a papilloma?

Answer 15

X vision

Question 16

what types of cancers may high risk HPV cause?

Answer 16

cervical, anal, oropharyngeal, vaginal, vulvar, penile

Question 17

how are most oropharyngeal cancers spread?

Answer 17

sexual contact

Question 18

who are most at risk of HPV cancers?

Answer 18

white, non-smoking males aged 35 to 55

Question 19

where is HPV associated oropharyngeal cancer commonly seen?

Answer 19

base of tongue and tonsillar bed

Question 20

how may HPV infection result in latency and malignant transformation?

Answer 20

interactions of E6 and E7 with p53 and PrB.

Question 21

where is DNA kept during the normal HPV cycle?

Answer 21

episomally in the nucleus of affected cell

Question 22

,what are low risk HPV types?

Answer 22

6 and 11

Question 23

where does the HPV lifecyle start?

Answer 23

basement membrane

Question 24

in the HPV lifecycle, where do mutagenic changes occur?

Answer 24

stratum spinosium

Question 25

what is angiogenesis?

Answer 25

formation of new blood vessels

Question 26

what are the differences between low risk and high risk HPV?

Answer 26

low risk doesn’t have: E6 products that knock out tumour suppressor genes no binding of PdX protein domains (doesn’t inhibit apoptosis) after infection of low risk you don’t get bypass of growth arrest, i.e., weaker inhibition of interferon response.

Question 27

what are the 2 types of benign oral HPV lesions?

Answer 27

papilloma condylomata

Question 28

describe an oral papilloma

Answer 28

layers of finger like projections

Question 29

where would you find oral papillomas?

Answer 29

soft palate

Question 30

are oral papillomas high or low risk?

Answer 30

low

Question 31

transmission of oral papilloma?

Answer 31

sexual contact

Question 32

what are the types of malignant oral HPV lesions?

Answer 32

keratinised lesion on ventral tongue SCC mucosa of gingivae surrounding teeth keratotic attached gingivae mixed red/white indurated alveolar surrounding teeth

Question 33

what makes the lingual gutter a high risk site?

Answer 33

saliva pools and if contained carcinogens from tobacco and alcohol it will be in direct contact with mucosa

Question 34

why may a SCC of gingivae be mistaken for perio disease?

Answer 34

mobile teeth

Question 35

what does indurated mean?

Answer 35

hard and rubbery

Question 36

what does exophytic mean?

Answer 36

growing out the way

Question 37

what does endophytic mean?

Answer 37

breaks down underlying structure

Question 38

what are HPV risk factors?

Answer 38

high number of sexual partners weakened immune system

Question 39

what are the 2 HPV detection methods?

Answer 39

p16 staining in-situ hybridisation

Question 40

how does p16 staining work?

Answer 40

looks for p16 protein down streaming of p53 and retinoblastoma gene (when these 2 genes are targeted by HPV, there is an increase in p16 expression)

Question 41

how does in-situ hybridisation work?

Answer 41

looks for HPV RNA/DNA in cells (dark brown staining within epithelial cells

Question 42

what are the 3 vaccines for HPV

Answer 42

Quadrivalent Gardasil Bivalent Cervarix Nonvalent Gardasil

Question 43

what types of HPV is quadrivalent gardasil for?

Answer 43

6 11 16 18

Question 44

what types of HPV is Bivalent cervarix for?

Answer 44

16 18

Question 45

what types of HPV is nonvalent gardasil for?

Answer 45

16 18 31 33 45 52 58

Question 46

what are low risk HPV types?

Answer 46

6 11 genital warts, papillomas

Question 47

what are high risk HPV types?

Answer 47

16 18 mouth cancer

Question 48

what is EPV?

Answer 48

a type of herpes

Question 49

what can EBV present as?

Answer 49

- Mononucleosis - Lymphoma - Nose and throat cancers

Question 50

how is EBV transmitted?

Answer 50

saliva sexual blood transfusions organ transplantation

Question 51

what are the 3 herpes subfamilies?

Answer 51

alpha beta gamma

Question 52

what is EBV categorised in to?

Answer 52

lymphocryptovirus Rhadinovirus

Question 53

what does EBV infect?

Answer 53

B-lymphocytes

Question 54

features of EBV?

Answer 54

- Toroid-shaped protein core, wrapped in DNA. - Nucleocapsid with 162 capsomeres. - Protein tegument between nucleocapsid and envelope. - Outer envelope with external glycoprotein spikes.

Question 55

What is the common impact of EBV in african countries?

Answer 55

direct impact on the nasopharynx causing a tumour called nasopharyngeal carcinoma

Question 56

what does EBV in mononucleic form cause?

Answer 56

glandular fever

Question 57

what are symptoms of glandular fever?

Answer 57

- Lymphadenopathy (enlargement of tonsillar bed) - Sore throat - Hepatomegaly and splenomegaly - Rash

Question 58

what is Burkitt's lymphoma?

Answer 58

cancer of nasopharynx associated with EBV

Question 59

what does HIV increase risk of?

Answer 59

- Kaposi sarcoma - Lymphomas - Cancers of cervix, anus, lungs, liver, and throat

Question 60

how is HIV transmitted?

Answer 60

blood sexual

Question 61

what are oral symptoms of HIV?

Answer 61

- Candidiasis - Hairy leucoplakia (unusual white patch) - Accelerated periodontal disease. - Kaposis’s sarcoma - Salivary gland disease - Oral ulcers

Question 62

Who is at risk of HIV?

Answer 62

- Men who have unprotected sex with other men. - People who share needles for drug injection - Heterosexual individuals who have unprotected sex with multiple partners

Question 63

how is HIV treated?

Answer 63

HAART

Question 64

what is human herpesvirus - 8?

Answer 64

kaposi sarcoma- associated herpesvirus

Question 65

what can KSHV cause?

Answer 65

Kaposi sarcoma, primary effusion lymphoma, multicentric Castleman disease

Question 66

how may people with HIV lower their risks of KSHV complications?

Answer 66

antiviral therapy

Question 67

what is kaposi sarcoma?

Answer 67

rare type of cancer that affects skin mouth and internal organs

Question 68

what causes kaposi sarcoma?

Answer 68

HHV-8 and HIV infection

Question 69

symptoms of kaposi sarcoma?

Answer 69

- Red, purple, or brown patches. - Plaques, or nodules on skin.

Question 70

what gives lesions purplish blue colour?

Answer 70

Abnormal growth of small blood vessels just below skin