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MICRO > Ch4: Skin, Musculoskeletal, Blood, and Lymph Part II > Flashcards

Ch4: Skin, Musculoskeletal, Blood, and Lymph Part II Flashcards

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1
Q

Infections of joint and bone include? 4

A
  1. Parovirus B19: Developed countries (Slapped cheek)
  2. Rubella: Nonvaccinated adults
  3. Hep B: HIV-1 and HTLV-1
  4. Alphavirus
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2
Q

5 classic childhood viral rashes?

A
  1. Measles: Rubeola
  2. German measles: Rubella
  3. Roseola
  4. Fifth disease
  5. Chickenpox: Varicella zoster
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3
Q

5 herpes virus of skin?

A
  1. Herpes simplexes 1 and 2
  2. Varicella zoster
  3. Human herpes virus 6, 7, 8
  4. EBV
  5. CMV
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4
Q

4 families of viruses of skin?

A
  1. Herpes
  2. HPV
  3. Coxsackie
  4. Poxviruses
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5
Q

3 subfamilies of herpesvirus?
Which has short growth cycle?
Which has long?

A

Alpha: Short
Beta: Long
Gamma

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6
Q

Members of alpha herpes family? 3

A

HSV-1
HSV-2
Varcicella Zoster

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7
Q

Members of gamma herpes family? 2

A

EBV: HSV-4

Kaposi’ sarcoma: HHV-8

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8
Q

Members of beta herpes family? 3

A

CMV (HHV-5)
HHV-6
HHV-7

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9
Q 
In terms of herpes
Size?
Envelope presence?
Genome shape? 
Genome type? 
Shape of capsule?
A 
Large
Enveloped
Linear
DsDNA
Icosadeltahedral
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10
Q

Since herpes have a capsule, they have a tegument which contains what?

A

Enzymes for replication

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11
Q

What determines what cell/tissue, the herpes virus attacks?

A

Receptors

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12
Q

What are the viral adhesins of herpesvirus?

A

Envelope glycoproteins

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13
Q

What is the primary manifestation of herpesvirus in humans?

A

Common infections but benign in children

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14
Q

What is the immune response of herpesvirus?

A

CMI

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15
Q

What is the primary treatment of herpesvirus?

A

Targeting viral DNA polymerase

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16
Q

What main feature do all herpesviruses have?

A

Latency

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17
Q

How do viruses do latency? (2)

A
  1. Make non-encoding transcripts that prevent apoptosis

2. Express proteins during latency

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18
Q

What is state of herpesvirus genomes during latency?

A

Circular, episomal form separate from host genome

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19
Q

How are herpesviruses spread? 3

A

Respiratory droplets
Oral mucosa
DIrect contact

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20
Q

What herpesviruses can be be spread without symptoms?

A 
HSV 1-2
EBV 4
CMV 5
HHV-6
HHV-7
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21
Q

When is VZV transmitted?

A

Only when patient has varicella or zoster

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22
Q

What is required for HSV spreading?

A

Direct contact

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23
Q

Most herpesviruses are diagnosed how?

A

Clinical symptoms

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24
Q

What is used in confirming acute or previous herpesvirus infection?

A

Serology

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25
PCR is used to test what herpesvirus? 1-6
``` HSV 1-2 VZV 3 EBV 4 CMV 5 HHV-6 ```
26
How to detect VZV in ski nlesions?
Ab testing
27
What herpesviruses cause both intranuclear and cytoplasmic inclusions?
CMV 5 | HHV-6
28
What herpesviruses result in only intranuclear inclusions?
HSV 1-2 | VZV 3
29
HSV 1-2 infection Can infect what cell types? Where is it lytic? (2) Where is it latent?
Most cell types Mucoepithelial and fibroblasts Neurons
30
``` Where does HSV-1,2 initially attach? What gives it a tight binding? (2) What does gC do? What does gE and GI do? ```
Heparin sulfate proteoglycans Nectin-1alpha and HVEM Binds to and depletes C3 from seru Complex with Fc on IgG
31
Which is worse for HSV, 1-2 | Primary eruption or recurrence?
Primary eruption
32
What happens in primary eruption of HSV?
Vesicle that erupts into a wet ulcer with pain and itching an dmalaise and fever.
33
What happens in recurrence of HSV?
Lesions with some local symptoms
34
Where does the HSV remain latent?
Trigeminal or sacral nerve
35
First episode of HSV-1 has what two features?
Gingivostomatitis | Pharyngitis
36
How do primary lesions look in HSV?
Dewdrop on rose petal
37
First episode primary genital herpes lasts how long?
Longer: 10-12 days
38
First episodes of genital herpes caused by HSV-2 in patients who already had HSV-1 are different how? 2
1. Less frequent systemic symptoms | 2. Faster healing
39
Herpetic Whitlow signs include what? (3)
Edema Erythema Localized tenderness at finger
40
Herpes gladiatorum is seen in who? Why? Where do they have herpes lesions?
Wrestlers Trauma to skin transmission Thorax, ears, face, hands
41
In patients with eczema, how does HSV present?
Eczema herpeticum
42
Reactivation triggers of HSV? (5)
1. Fever 2. Nerve injury 3. UV 4. Stress 5. Hormone changes
43
HSV Reactivation sees what changes in immune response?
Shift from HSV-specific T cells to Th2 cells
44
What is different about location of lesions in recurrence of HSV?
Only one one side of body
45
Innate response to HSV? CMI response to HSV? How does HSV counteract? 2
IFN and NK cells limit progression CMI kills infected cells 1. Blocks IFN 2. Blocks TAP proteins --> No MHC Class I
46
Incubation period of HSV 1-2?
1-26 but usually 6-8
47
How to stain for HSV? (3)
1. Wright 2. Giemsa (Tzanck preparation) 3. Pap
48
Things seen upon HSV staining? 3
1. Cowdry type A acidophilic intranuclear inclusions 2. Syncytia 3. Giant cells
49
What can you not separate HSV from upon staining?
VZV
50
Treatment of HSV?
Acyclovir
51
VZV is broken into what two parts?
``` Varicella = Primary Zoster = Recurrence ```
52
What keeps VZV in latency?
T cell response
53
What allows zoster to reoccur?
T cells aging leading to shingles
54
How does VZV infect and remain latent in body?
Droplets inhaled --> Gets in lymphatics (Primary viremeia) --> Goes to secondary lymph organs --> Gets in blood (Secondary viremia) --> Goes to skin --> Goes into latency in neurons
55
Rash is described how in VZV?
Cropping rash that are at one location for one stage in disease
56
How is VZV described? How long does the dermal rash last? Where does the rash occur most? 2
Self-limiting infection 3-5 days of cropping Trunk and SCALP
57
How is VZV infection different in adults for first time?
More serious: Pneumonia and encephalitis
58
How long does VSV incubation last?
10-21 days
59
Reactivation of VZV results in what?
Zoster or Shingles
60
Where does Zoster/Shingles occur?
Entire dermotome due to virus at that nerve root spreading down it.
61
What dermatomes are most involved in zoster/shingles?
Thoracic and lumbar
62
Herpes zoster goes where if 1st or 2nd branch of 5th cranial nerve is affected?
Eyelids
63
How does someone know a shingles attack is coming? | What happens after?
Pain in dermotome 2-3 days before Chronic debilitating pain
64
Zoster/shingles last how long?
10-15 days
65
Zoster/shingles is seen in what % of population?
Over 45 years old
66
Immune response to VSV? 2 | Evasion? 3
1. CMI 2. TLR-2 of innate 1. FcRgammaII receptor 2. Inhibition of MHC-I 3. Decreased IFN-gamma
67
Route of transmission of VZV?
Respiratory
68
Latency of VZV?
Sensory neuronal cells (trigeminal, dorsal root, cranial ganglia)
69
How is VZV different during latency from other herpes?
Expresses different RNA transcripts during latency
70
How do you diagnose VZV?
Same as you would HSV 1-2 Stains PCR
71
How do you treat adult zoster infections? (3)
1. Acyclovir (DNA Poly inhibitors) 2. Pain killers 3. Plasma
72
How do you treat someone with chickenpox? 2
1. Good hygiene | 2. Acetaminophen
73
The vaccine for VSV is in what form?
Live attenuated Oka strain
74
The VSV vaccine has what immune reaction?
T cell immunity
75
Zoster vaccine is different from VSV vaccine how?
High titer version of Oka
76
What is common side effect of VSV vaccine? | What is the risk factor for it?
Rash | Immunosuppressed
77
HHV-6 and HHV-7 infect what type of cells? What do they cause? What patients do they reactivate in?
T cells | Exanthema subitum/roseola infantum
78
Two types of HHV-6?
HHV-6A and HHV-6B
79
HHV-6 lives where? Infects what type of T Cells? HHV-6A likes what type of cells? HHV-6B likes what type of cells
CNS CD4 Neural cells Peripheral Blood Mononuclear cells
80
HHV-6 is in what type of form in WBC's? | Infection in these cells appears how?
Latent ballooning cells with intranuclear inclusions
81
What percentage of adults are seropositive for HHV-6? | Why do moms pass on HHV-6 to their kids so easily?
95% Mom's antibodies decline and allow kids to get infected
82
HHV-7 infects what cells?
CD4 T cells Salivary gland cells Lung and skin cells
83
Where is HHV-7 shed the most?
In saliva
84
How does HHV-7 combat immune response?
Induces degradation of MHC I
85
What is the main cause of roseola? | Subset of roseola cause?
HHV-6B HHV-7
86
Primary manifestation of HHV6 and HHV7?
High fever (several days) followed by a rash (1-3) days
87
How to diagnose HHV6 and 7?
Culture, PCR, serology
88
How to detect acute HHV6 in children?
Compare acute and latent serum
89
HHV-6 is sensitive to what in vitro?
Ganciclovir, foscarnet, cidofovir
90
HHV6, HHV7 and CMV are not sensitive to what famous anti-viral?
Acyclovir
91
Kaposi's sarcoma is a tumor arising where?
Multiple locations in blood an dlymph
92
What virus is Kaposi's sarcoma? What cells are infected? Two main changes that will cause tumor?
HHV-8 Endothelial cells 1. Spindle shaped proliferating cells 2. Angiogenesis
93
Nuclecapsid contains what two things in measles/Rubeola?
Helical symmetry | -ssRNA
94
Envelope contains what two things in measles/Rubeola?
Fusion Protein F | Attachment Protein Hemagglutinin H
95
What enzyme is NOT found in measles virus?
Neuraminidase
96
What is the diagnostic progression of measles? 3
Cough, Coryza, Conjunctivitis --> Koplik's spots --> Rash
97
What is the path of measles pathogenesis?
Inhaled --> Replicates in RT --> Spreads by lymph --> Viremia --> Conjunctiva + RT + UT + BV's + lymph + CNS --> Endothelial cells infected --> Rash --> Usually recover
98
What is a fatal manifestation of measles/rubeola? | What causes it? 2
Subacute sclerosing panencephalitis 1. Host: Defective immunity and Ab's 2. Virus: Defective virus that can't replicate
99
Immune response to measles?
CMI
100
Route of measles transmission?
Respiratory droplets
101
When is measles most contagious?
Late prodromal phase: Peak of CCCP peak
102
Incubation period of measles?
9-11 days
103
What is historically best test for diagnosing measles?
Hemagglutination inhibition test
104
What's diagnostic in serum for measles?
Serum titer 4X increase in measles Ab
105
Vaccine type for measles?
Live attenuated
106
Treatment for measles? 3
1. Treat secondary bacterial infections 2. Antipyretics 3. Fluids
107
``` German measles/rubella has what main clinical manifestation? What demographic is it significant in? Type of virus? Envelope presence? Genome type? ```
Lacey rash Pregnant women Togavirus Enveloped +ssRNA
108
Pathogenesis of Rubella?
URT infection --> Lymph --> Viremia --> Rash
109
What is the important protein in Rubella for attachment, fusion, hemagglutination and neutralization
E1
110
How many viremias occur in Measles and german measles?
Two
111
Rubella/German measles virus is seen in which cells first
Leukocytes
112
What determines severity of Rubella/German measles?
Age
113
How does Rubella/German measles rash change over 3 days?
Day 1: Starts on forehead then spreads down and back | Day 3: Becomes faint but disappears how it appeared
114
What is the problem if a fetus gets Rubella/German measles?
High risk for serious sequelae
115
Immune response to Rubella? 3
1. Ab's limit viremia 2. Type III HS results in rash 3. CMI clean up
116
Rubella pathogenesis transmission?
Droplets
117
When are patients most contagious with Rubella/German measles?
While rash erupts
118
Incubation of rubella?
14-21 days
119
Best lab diagnosis for Rubella/German measles?
Serology
120
Vaccine for Rubella/German measles?
Live attenuated MMR
121
Rubella vaccine may have what side effects
Viremia --> Type III HS --> fever, arthritis
122
Complications in Rubella/German measles vaccine is seen in who?
Women older than 25
123
What is the smallest DNA virus?
Parovirus
124
Does Parovirus have a envelope? Shape? Genome shape? Genome type?
No Icosahedral Linear ssDNA
125
Parovirus B19 replicates where? | Which causes what? (2)
URT | Viremia and spread to bone marrow
126
What does parovirus B19 depend on for replication? Specifically? What seems to be spared? Is the infection cytotoxic?
Active replicating cells Bone marrow blood cells Pluripotent stem cells Yes
127
What are required for Parovirus B19 to replicate?
Replicating factors of S phase | Cellular DNA polymerase
128
What acts as primer for parovirus B19? Where is assembly? How is the virus released?
Inverted repeats Nucleus Cell lysis
129
Target cell receptor for parovirus B19?
Blood Group P antigen (globoside)
130
2 phases of Parovirus B 19?
Lytic infection phase | Noninfectious immunologic phase
131
Things happening during Parovirus B10 lytic phase? 3
1. Hb and RB count drops 2. Virus in throat and blood 3. Flu like symptoms
132
Things happening during noninfectious immunologic phase of parovirus b19? 3
1. Hb and RB count drops 2. Virus-specific IgG Ab present 3. Rash/arthralgia (Type III HS)
133
Primary manifestation of Parovirus B19?
Slapped cheek rash
134
Parovirus B19 can cause what in patients with anemia?
Aplastic crisis
135
Intrauterine infection with parovirus b19 results in what?
Abortion (anemia + CHF)
136
Immunodeficient patients develop what with parovirus b19?
Bone marrow suppression
137
Immune response to parovirus b19?
Ab's stop viremia
138
Route of transmission for parovirus b19?
Respiratory
139
Diagnosis for parovirus b19?
Clinical | ELISA or PCR
140
In most people how do you treat parovirus b19?
You don't. it's self-limiting
141
Coxsackie A and B are members of what family? Envelope presence? Type of genome? Shape of genome? (2)
Picornaviridae No + ssRNA Linear and nonsegmented
142
Coxsackie A produces what?
Vesicular lesions
143
Enterovirus pathogenesis?
Enters through mouth --> Replicates in oropharynx --> Primary viremiain blood --> Goes to target tissue --> Secondary viremia
144
What is herpangina? Who is it seen in? How many lesions?
Vesicular ulcerated lesions around soft palate and uvula Children under 10 1-12 lesions
145
Hand/foot and mouth disease is caused by what?
Coxackie A16
146
What is seen in Hand/foot and mouth disease? 2
1. Tender, papules and vesicles on hands, feet, mouth, and tongue surrounded by erythema 2. Fever
147
HSV gangiostomatitis occurs where?
Anterior oral cavity: Inner lips, buccal mucosa, tongue
148
What is seen in HSV and not herpangina?
1. Gingivitis 2. Systemic toxicity 3. Cervical lymphadenitis
149
Aphthous stomatitis is what?
Recurrent ulcers on lips, tongue, buccal mucosa of older children and adults
150
3 manifestations of Coxsackie B?
Pleurodynia Myocarditis Pericarditis
151
What is Pleurodynia also known as? What are the symptoms? (2) How long does it last? Where is it tender?
Bornhom disease or Devil's grip 1. Fever 2. One sided low thoracic pleuritic chest pain 2 weeks Involved side muscles
152
Myocarditis coxsackie B is life threatening when?
In children
153
HPV has what genome shape? What genome type? Envelope? Shape?
Circular DsDNA Naked Icosahedral
154
Does HPV genome integrate into host? | How many regions does HPV genome have?
No | 3 regions
155
What are most important proteins in HPV?
E5, E6, E7
156
E5 in HPV does what? (2)
1. Prevents acidification of endosomes | 2. Stimulates EGF-R
157
E6 in HPV does what?
Binds and destroys P53:
158
E7 in HPV does what?
Binds and inhibits Rb
159
How does HPV replication rates differ by location?
In basal epidermis --> Little to no replication | As you move to surface --> More replication
160
Most of the time what do you get from EPV on skin?
Wart
161
Upregulated E6 and E7 can cause what?
Benign mass or invasive cancer
162
Does HPV spread?
No, remains local
163
Plantar warts are found where? Why is their growth different? Are they painful? Are most warts plainful?
Sole of feet Weight compression forces them to grow inward Yes No
164
How do patients with HPV caused Benign head and neck tumors present?
1. Hoarseness of strange cry 2. Respiratory distress 3. Airway obstruction
165
What forms of HPV cause laryngeal tumors that can kill children?
6 and 11
166
HPV manifestations on the cervix?
Warts after sexual contact
167
Main types that cause cervical growth in HPV?
16, 18, 31, 45
168
What is special about HPV 16 and 18?
Can get in our genome
169
Immune response to HPV?
Attack the L1 protein of the virus
170
Route of transmission of HPV? 4
Direct contact: abrasions, fomites, sex, birth
171
Incubation of HPV?
Weeks to years
172
Diagnosis of HPV?
Koilocytes (Enlarged keratinocytes with clear haloes around shrunken nuclei)
173
Vaccine for HPV?
Inactivated quadrivalent 6, 11, 16, 1
174
HPV's status in permissive cells? | Non-permissive cells?
Lytic | Chronic latent and transforming
175
Besides cervical cancer what can HPV 16 and 18 also cause?
Oropharyngeal cancer
176
HPV treatment?
Remove clinical manifestations (freeze, burn, chemicals, duct tape)
177
``` Smallpox/Variola replicates where? Family of viruses? Genome shape? Genome type? Envelope? ```
``` Cytoplasm Orthopoxvirus Linear DsDNA Enveloped ```
178
How does poxvirus leave the cell?
Disruption of exocytosis
179
How does smallpox spread?
Virus is inhaled --> Multiplies in URT --> Gets in lymph --> Nodes --> Goes systemic + hemorrhages in BV's --> Rash
180
4 main clinical types of variola/smallpox?
Ordinary small pox Vaccine-modified small pox Flat smallpox Hemorrhagic smallpox
181
Ordinary smallpox is what % of cases? Symptoms? What does mortality depend on?
90% Fever and rash Extent of rash
182
Vaccine-modified smallpox produces what?
Mild prodrome with a few skin lesions
183
Flat smallpox sees what?
Slow focal lesions with overall infection and 50% death rate
184
Hemorrhagic smallpox sees what?
Bleeding into skin and mucous membranes --> Death in a week
185
Where are smallpox lesions seen most? | Where are chickenpox lesions seen most?
Palms, soles, and Face (EXTREMITIES) Torso
186
Route of transmission of smallpox? (2)
1. Skin | 2. RT mucosa
187
Incubation period of smallpox?
5 to 17 days
188
Diagnosis of smallpox by histo?
Rounded and fused cells | Pock morphology
189
Vaccine for smallpox is important why?
1st live vaccine
190
What are two of 11 pox viruses that are not zoonoses? Which zoonose can be transferred by humans
Variola Molluscum contagiosum Monkeypox
191
Reservoir host of monkeypox? | Most important symptom?
Rodents Lymphadenopathy of submandib, cervical and sublingual
192
``` Cowpox is acquired how? Where are lesions? (2) Skin lesions eventually form what? Is lesion painful? Initial symptoms? ```
``` Contact with cows and other animals Hands and face Black crust Yes Flu like ```
193
Molluscum contagiosum causes what type of lesion? How is it transmitted? What do the lesions become? Where are they seen?
Wart-like Direct contact Umbilicated nodules with central caseous plug Trunk and genitalia
194
Molluscum contagiosum incubation period? Treatment? (2) Diagnosed how?
2-8 weeks Curettage or liquid nitrogen Clinical appearance
195
Epstein-Barr virus? target tissue? (2) Target cell? (2) Target cell receptor? (2)
Oropharynx + salivary gland B cells + Epithelial cells C3d receptor + MHC II
196
At peak of infection, how many B cells have EBV?
20%
197
Why is good immune response needed for EBV? | What is the consequence?
Have to shutdown proliferation of B cells Cause infectious mononucleosis
198
Why is there an increase in EBV infection with age of seroconversion?
Differences in immune response of different age groups (Young better than old)
199
EBV pathogenesis?
EBV in saliva --> B cells --> B cells proliferate --> T cells activated -
200
How is EBV mono spread?
Intimate contact
201
How does the imune system respond to EBV?
CD8 and CD4 T cells and NK cells attack B cells
202
The killing of lymphocytes by the immune system is done by who?
CD8 T cells
203
CD8 t cells also are responsible for the symptoms of mono why?
Release cytokines
204
What is the humoral response to EBV?
Ab's against EBV antigens VCA and EA
205
When does the Ab response to latency EBV antigens occur? | What are these?
In convalescence EBNA1-3, EBNALP
206
Diagnosis of EBV? (7)
1. Clinical symptoms 2. Palatal petechiae 3. Atypical lymphocytes 4. Heterophile Ab 5. Anti-EBV Ab's 6. IgM to VCA 7. IgG to VCA and EBNA
207
Primary treatment of EBV?
Treat symptoms
208
What cells are seen in EBV in histo?
Downey cells
209
When do you see all but the Anti-EBNA Ab together?
Acute primary
210
When do you see Anti-EBNA?
In latency
211
``` CMV is of what family of viruses? Envelope? Shape of genome? Genome type? Size? ```
Herpesviridae Enveloped Linear dsDNA Largest herpes virus
212
Target tissue of CMV? (5)
1. Salivary gland 2. Kidney tubules 3. Cervix 4. Testes 5. Epididymis
213
How does CMV mess with immune response?
1. Interfere with MHC-1 | 2. Induce FC receptors
214
Target cell type of CMV?
Epithelial
215
Target cell receptor of CMV?
Heparan sulfate proteoglycans
216
CMV appears how clinically in most people?
Silent
217
Primary infection with CMV In young adult can produce what?
Mono with fever, lymphadenopathy
218
What % of mono is EBV? | What % is CMV?
79% | 21%
219
How do you determine EBV vs. CMV?
EBV = Heterophile ab
220
CMV result in normal person? Seronegative mother's baby? Immunosuppressed?
1. Silent or mono Cytomegalic inclusion disease Multisite symptomatic disease
221
When is CMV DNA monitored in whole blood?
Transplant patients
222
Infected specimens with CMV show what on histo?
Large cells with basophilic intranuclear inclusions called Owl's Eye
223
Immune response to CMV?
Since CMV goes latent in blood cells, CMI takes forever to get rid of it
224
Route of transmission for CMV?
Saliva, sex, blood, transplant
225
Latency of CMV is in what cells? (3)
monocytes macrophages CD34 cells
226
Primary treatment of CMV?
Anti-virals
227
HIV has what adherence infusion proteins? 2
1. TM gp41 | 2. SU gp120
228
HIV-1 has what 4 groups?
M, N, O, P
229
M group of HIV-1 contains what subtypes? Which are in North America? Which are in Africa?
A-K B A and C
230
HIV-2 has what subtypes? | How does it compare to HIV-1?
A-F Less aggressive
231
How does HIV attach?
Gp120 and Gp41 binds to Primary CD4 receptor but also needs either CCR5 co-receptor on monocytes or CXCR4 on T cells
232
Penetration of HIV is done how?
Bind to chemokine receptor --> gp41 has change
233
Early phase of genome replication for HIV involves what?
Reverse transcriptase synthesizes complementary -cDNA copye of genome
234
What else does RT do for HIV?
Serves as ribonuclease H --> Degrades RNA + Finishes dsDNA
235
What happens after HIV's dsDNA is made?
Put into genome of cell
236
Late phase of HIV expression sees what? | What does this require?
Transcription by host RNA Polymerase II | Activation of cell and ability of host TF's
237
Products of gag, gag-pol and env are what?
Polyproteins
238
How is HIV assembled?
Gag and gag-pol proteins are acetylated and bind to PM glycoproteins --> 2 RNA molecules with tRNA then complex --> Budding
239
After envelopment, what happens to HIV?
Protease cleaves gag and gag-pol --> Release RT
240
Major determinant of where HIV goes in tissues is what?
CD4
241
HIV-1 will stick to what in epithelium? Using what? What will these cells then do?
Dendritic cells Lectin DC-SIGN Deliver HIV to T cells in lymph nodes
242
HIV replicates where in the body?
Lymph nodes
243
Acute phase of HIV lasts how long? | How much virus made daily?
First 2-4 weeks | 10^10 virions
244
What is acute retroviral syndrome during HIV acute phase?
Flu-like symptoms with a rash of the trunk
245
What does HIV do during latency? | What cells is it latent in?
Replicate in lymph nodes --> Destroys lymph nodes Macrophages and resting T cells
246
What is AIDS related complex? (4)
Chronic lymphadenopathy and fever, weight loss, malaise
247
What is seen in late phase? At what level do you see symptoms? At what level do you see opportunistic infections?
Viral levels increase with decrease in CD4 CD4 450/ml CD4 350/ml
248
Immune response has what effect on HIV/AIDS?
Restricts replication
249
What cell is in dire need for good immune response against HIV? What does it need?
CD8 CD4 activation
250
Describe the change in virus levels in HIV and AIDS
Initial burst during HIV --.> Drops to almost nothing during latency --> Slowly increases during AIDS phase due to loss of T cells
251
Describe the change in CD4 and T cell count in HIV and AIDS?
Slow steady decline in both from start to finish
252
Describe change in Anti-HIV-1 antibody?
Initial big increase due to immune response --> But immune cells start dying --> Don't produce enough Ab
253
Below what blood level do you see really bad AIDS problems?
Below 200
254
Transmission of HIV?
Bodily fluids
255
What are sources of infected lymphocytes and monocytes in HIV?
Ulcers and discharge
256
Why is RT-PCR good in HIV?
Determine viral load (higher it is, poorer the prognosis)
257
What is the Rule Out test for HIV?
ELISA: Looks for anti-HIV antibodies
258
What is the Rule IN test for HIV?
Western blotting
259
How does CD4/8 ratio give prognosis in HIV?
Higher CD8 numbers = better
260
Treatment for HIV/AIDS?
1. Nucleoside analogues 2. Non-nucleoside analogues 3. Protease and integrase inhibitors
261
What is HAART? | What does it involve?
High active anti-retroviral therapy | 2 NRTI, 1 NNRTI/Protease inhibitor
262
Side effects of HAART?
Kills mitochondria and alters fat distribution
263
Arboviruses multiply where?
Arthropod vector
264
Arborviruses have what symptoms? 2 | What can it lead to?
Silent or Flu-like Encephalitis
265
Togaviruses and Flaviviruses have an envelope? Shape? Genome type?
Yes Icosahedral +ssRNA
266
Vector-borne togaviruses belong to what genera?
Alphavirus
267
Humoral response to alpha and togaviruses? | CMI response?
AB block prevents secondary viremia | Interferon release
268
Dengue fever is also known as? What is the virus? Where does it replicate? (2)
Break-bone fever Flavivirus Monocytes and vascular endothelium
269
When is dengue fever really serious?
Second time you get it with different antigen
270
Treatment for dengue fever?
none
271
Incubation of dengue fever? | Symptoms?
4-8 days | Flu + rash
272
Serious complication of Dengue Fever? | When does it occur?
Dengue Hemorrhagic fever/Dengue shock syndrome When someone gets a second version of the dengue fever (different antigens)
273
Arenaviruses have an envelope? Genome type? Appears how on EM?
Yes 2 -ssRNA circles Sandy appearance in ribosomes
274
Lassa Fever replicates how? Where is it seen? transmission?
Binds to alpha-dystroglycan on mammalian cells West Africa Rodents, some humans
275
Incubation in lassa fever? Symptom? What can it cause?
5-10 days Fever Hemorrhaging due to capillary damage --> 50% fatality
276
Pathogenesis of arenaviruses?
Infect macrophages --> Release of mediators --> Vascular damage
277
Treatment of arenaviruses?
Ribavirin
278
Filoviruses shape? Envelope? Genome type?
Filamentous Enveloped -ssRNA
279
Pathogenesis of filoviruses?
Tissue necrosis of parenchymal cells --> Vascular injury
280
Manifestation of filoviruses?
Flu like --> Rash --> Fatal hemorrhaging fevers
281
Diagnosis of filoviruses? (2)
Large eosinophilic cytoplasmic inclusion bodies | Detect viral Ag by immuno or ELISA
282
Treatment for filoviruses?
Quarantine
283
Ebola has what 4 subtypes?
Zaire, Sudan, Ivory Coast, Reston
284
How does Ebola and Marburg enter body?
Mucus membranes of abraded skin
285
Incubation for Ebola? | Incubation for Marburg?
2-21 | 5-10
286
4 symptoms of Ebola and Marburg?
Fever, hemorrhaging, rash, Disseminated intravascular coagulation
287
Reservoir for Marburg?
Tropical rainforest fruit bat
288
Transmission of marburg and ebola? 2
Syringes and semen
289
Diagnosis of marburg and ebola?
Detect Ag

MICRO (22 decks)

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