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

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Flashcards in Ch4: Skin, Musculoskeletal, Blood, and Lymph Part II Deck (289):
1

Infections of joint and bone include? 4

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

2

5 classic childhood viral rashes?

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

3

5 herpes virus of skin?

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

4

4 families of viruses of skin?

1. Herpes
2. HPV
3. Coxsackie
4. Poxviruses

5

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

Alpha: Short
Beta: Long
Gamma

6

Members of alpha herpes family? 3

HSV-1
HSV-2
Varcicella Zoster

7

Members of gamma herpes family? 2

EBV: HSV-4
Kaposi' sarcoma: HHV-8

8

Members of beta herpes family? 3

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

9

In terms of herpes
Size?
Envelope presence?
Genome shape?
Genome type?
Shape of capsule?

Large
Enveloped
Linear
DsDNA
Icosadeltahedral

10

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

Enzymes for replication

11

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

Receptors

12

What are the viral adhesins of herpesvirus?

Envelope glycoproteins

13

What is the primary manifestation of herpesvirus in humans?

Common infections but benign in children

14

What is the immune response of herpesvirus?

CMI

15

What is the primary treatment of herpesvirus?

Targeting viral DNA polymerase

16

What main feature do all herpesviruses have?

Latency

17

How do viruses do latency? (2)

1. Make non-encoding transcripts that prevent apoptosis
2. Express proteins during latency

18

What is state of herpesvirus genomes during latency?

Circular, episomal form separate from host genome

19

How are herpesviruses spread? 3

Respiratory droplets
Oral mucosa
DIrect contact

20

What herpesviruses can be be spread without symptoms?

HSV 1-2
EBV 4
CMV 5
HHV-6
HHV-7

21

When is VZV transmitted?

Only when patient has varicella or zoster

22

What is required for HSV spreading?

Direct contact

23

Most herpesviruses are diagnosed how?

Clinical symptoms

24

What is used in confirming acute or previous herpesvirus infection?

Serology

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