Chap8- Viral Infections Flashcards Preview

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Flashcards in Chap8- Viral Infections Deck (88):
1

What viruses attack upper respiratory tract

adenovirus
rhinovirus
influenza viruses A B
Respiratory syncytial virus

2

What viruses affect the digestive tract

mumps
rotavirus- childhood
norovirus
Hep A
Hep B
Hep D
Hep C
Hep E

3

What viruses cause systemic with skin eruptions

measles
rubella
varicella zoster
Herpes simplex virus 1
Herpes simplex virus 2

4

What viruses cause systemic with hematopoietic disorders

CMV
EBV
HIV 1 and 2

5

What are the arboviral and hemorhhagic fever viruses

dengue virus1-4
yellow fever

6

what virus causes skin warts

papillomavirus

7

What viruses affect CNS

polio and JC

8

How do you confirm a measles Dx

detection of viral antigen in nasal exudate or urinary sediment

9

What type of virus is measles

ss RNA of the paramyxovirus family

10

What virus causes croup

parainfluenza virus

11

What cell R are associated with measles

CD46- C' regulatroy protein that inactivates C3 converses
SLAM- involved in T cell activation

12

How does measles spread

respiratory droplets and from there can multuply in epithelial cells, endothelial, monocytes, macrophages, dendritic cells and lymphocytes

13

What does measles cause clinically

croup, pneumonia, diarrhea with protein-losing enteropathy, keratitis with scarring and blindness, encephalitis and hemorrhagic rashes in malnourished children

14

Most people develope what type immunity to measles

T cell, with hypersensitivity rash

15

What is the cause of measles morbiditiy and mortality rates

its immunosuppression resulting in secondary bacterial and viral infection

16

What are some of the late complications of measeles

subacute sclerosing panencephalitis and inclusion body encephalitis

17

What does the rash to measles look like and what causes it

blotchy reddish, brown rash on face, trunk and proximal extremities
from dilated skin vessels, edema and mononuclear perivascular infiltrate

18

What are the pathonomonic findings in measles

Koplik spots, ulcerated mucosal lesions in oral cavity near opening
Warthin-Finkeldey cells- multinucleate giant cells in lymphoid tissue

19

What are the 2 types of glycoproteins on the mumps virus

one with hemagglutinin and one with neuraminidase activities

20

Where does mump replicate

preferentially in activate T cells
travel in drained lymph

21

What are common signs of mumps

salivary gland pain and aseptic meningitis

22

Describe morphology of the parotitis in mumps

moist, glistening and reddish brown
diffusely infiltrated by macrophages, lymph and plasma cells which compress acini and ducts
some neutrophils and necrotic debris

23

Describe morphology mumps orchitis

swelling from edema and mononuclear cell infiltration with focal hemorrhages
can have ares of infarction leading to sterility

24

What does mumps look like in pancreas

fat necrosis and neutrophil rich inflammation

25

describe mumps encephalitis

causes perivenous demylination and perivascular mononuclear cuffing

26

What type of virus is polio

unencapsulated RNA from the enterovirus genus

27

What are the enteroviruses

coxsackievirus A and B, enterovirus 70, echovirus

28

How many strains are there of polio and what vaccines are available

3 strains
the salk formalin(killed) and sabin oral (attenuated live) have all 3

29

how is polio transmitted

oral fecal route
multipling in intestinal mucosa and lymph nodes

30

Why does polio only affect humans

uses human CD155 to gain entry

31

What group of viruses does west nile belong to

arbovirus of flavivirus group

32

Where does west nile replicate

in dendritic cells then migrating to lymph nodes where it can enter blood stream and potentially cross bbb

33

What is the double edge about CCR5

without it more prone to west nile
with it- can be affect by HIV

34

What are the symptoms of west nile if any

short lived febrile illness with HA and myalgia
maculopapular rash in some

35

What is found in brains of those who died of West nile

perivascular and leptomeningeal chronic inflammation with microglial nodes and neronophagia in temporal lobes and brain stem

36

what is the best way to confirm Dx of west nile

usually serology but viral culture and PCR used too

37

what type of viruses cause viral hemorrhagic fevers and what are the 4 families

enveloped RNA viruses
arenaviruses, filoviruses, bunyaviruses and falviviruses

38

what are the mild acute diseases cause by viral hemorrhagic fevers VHF

fever, HA, myalgia, rash, neutropenia and thrombocytopenia

39

what are the severe diseases cause by VHF

hemodynamic deterioration and schock

40

What immune response contributes to VHF

innate because activation of macrophages leads to release of mediators that modify vascular function

41

What type of DNA is herpes

ds DNA

42

what are the categories of herpes and types of cells they each infect

alpha group: HSV 1 and 2, VZV infecting epithelial cells and latency in neurons
lymphotropic beta group: CMV, herpes-6 and herpes-7 infect a variety of cells
-group: EBV KSHV-8 latent infections in lymphoid cells

43

Where do HIV 1 and 2 replicate

in the skin and mucous membranes at site of entrance where they cause vesicular lesions

44

What occurs during latency in HSV

viral DNA remains in nucleus and viral RNA trancripts are synthesized
no viral proteins are produced

45

how do HSV evade CTLs

inhibit class I MHC and elude humoral immune defenses by producing R for the Fc domain of Ig and inhibitors of C'

46

Where in the brain does HSV attack first

temporal lobes, orbital gyri of frontal lobes

47

what do HSV cells looks like

large with inclusions that have intact disrupted virions with stained host cell chromatin pushed to edges of nucleus

48

what is gingivostomatitis

children with HSV-1 that have a vesicular eruption extending from tongue to retropharynx casing cervical lymphadenopathy

49

What does HSV-2 look like in neonate

mild, more commonly with generalized lymphadenopathy, splenomegaly and necrotic foci throughout lungs, liver, adrenals and CNS

50

What type of corneal lesions does Herpes cause

herpes epithelial keratitis- cytolysis of superficial epithelium
herpes stromal keratitis- infiltrates of mononuclear cells around keratinocytes and endothelial cells-->neovascularization, scarring, opacificaiton of cornea and eventual blindness

51

What is kaposi varicelliform eruption

generalized vesiculating involvement of skin

52

what is eczema herpeticum

confluent pustular or hermorrhagic blisters with bacterial superinfection and viral dissemination to internal viscera

53

how does herpes affect resp tract

herpes esophagitis and bronchopneumonia

54

what conditions are caused by varicella zoster virus

chicken pox and shingles

55

how is VZV transferred

aerosols, and causes widespread vesicular skin lesions

56

Describe the recurrence of VZV

painful in dermatomes innervated by trigem ganglia

57

How is VZV Dx confirmed

viral culture or detection of viral Ag in cells from superficial lesions

58

what do chicken pox vesicles have in them

intranuclear inclusions in epithelial cells like that of HSV-1

59

What is shingles

when VZV has been latent a long time, after having chicken pox
will infect keratinocytes that have vesicular lesions assoc with itching, burning or sharp pain

60

What can VZV cause in immunocompromised patients

interstitial pneumonia, encephalitis, transverse myelitis, necrotizing visceral lesions

61

What type of cells does CMV attack latently

monocytes and their bone marrow progenitors

62

What does CMV cause in healthy patients? neonateS? immunocompromised?

asymptomatic or mononucleosis like infection with fever and lymphadenopathy, hepatomegaly
intrauterine: cytomegalic inclusion disease- growth retardation, jaundice, HSM, anemia, encephalitis, microcephaly, deafness
perinatal: interstitial pneumonitis, skin rash, hepatitis, failure to thrive
immunocompromised pneumonitis, colitis, ARDS, intestinal necrosis with formation of pseudomembranes and diarrhea

63

What cells does CMV acutely affect

dendritic cells and impair their maturation and ability to stimulate T cells

64

how does CMV elude immune system

downmodulates Class I and II MHC and produces homologues to TNF R, IL 10 and MHC I

65

how does CMV affect NK cells

activate and evade NK cells by inducing ligands for activating R

66

What do CMV cells look like morpho

enlarged
intranuclear basophillic inclusions spanning half the nuclear diameter

67

what tissues and components are affected by CMV

glands- parenchymal epithelium
brain- neurons
lungs- alveolar macrophages
kidneys- tubular epithelium and glomerular endothelial

68

What is the most common opportunistic viral pathogen in AIDS

cytomegalovirus

69

What does HBV (HepB) cause

acute and chronic liver disease

70

how is HBV transmitted

drug IV, blood, perinatally, sexually

71

The cellular injury of liver from HBV occurs how

from immune response to infected liver cells
when the rate of infection overcomes rate that CTL can clear virus

72

Patients with HBV are at increased for developing what

hepatocellular carcinoma

73

What does EBV cause

infectious mononucleosis, self limited lymphoproliferative disorder
assoc with developing neoplasms like lymphomas and nasopharyngeal carcinoma

74

What are the symptoms of EBV

fever, generalized lymphadenopaty, splenomegaly, sore throat and blood of atypical T lymphocytes

75

How is EBV transmitted

saliva, kissing

76

What type of proteins are on EBV

CD21 (CR2) whicis the R for C'3d on B cells

77

what are the ways that B cells are infected

lysis of infected cells releasing virions that can infect other cells
majority just establish latent infection

78

What type of disease is protective for EBV

X- agamaglobulinemia because don't have B cells

79

What are the gene products of EBV latency

EBNA1 which mediates maintenance
EBNA2 and latent membrane protein1 LMP1 that dirve proliferation

80

What type of R does the LMP1 from EBV bind

TNFR activating pathways that mimic B cell activation by CD40

81

What is used Dx for EBV

detection of heterophile anti-sheep red blood cell Ab

82

What cells are most important against EBV

CD8 CTLs and NK cells

83

What type of lymphomas does EBV contribute to in immunocompromised patients

B cell lymphomas
Burkitt lymphoma with the 8:14 translocation amplifying c-myc

84

what is characteristic of EBV in peripheral smear

lymphocytosis with >60% WBC and many of them being atypical huge with many clear vacillations and oval indented nucleus with scattered granules

85

where are lymph nodes enlarged first in EBV

groin, axillary and posterior cervical

86

What areas of lymph nodes are expanded in EBV

paracortical by activated T cells

87

The Dx of EBV depends on what

lymphocytosis with characteristic atypical lymphocytes in peripheral blood
+ heterophile Ab rxn
specific Ab for EBV Ag

88

what disease if concurrent with EBV infection is fatal in 1/3 patients

X linked lymphoproliferation syndrome "Duncan disease"