Common Viral Pathogens

Question 1

What type of virus is herpes simplex type 1?

Answer 1

a

Question 2

Which cells are targeted for primary infection and latency in herpes simplex type 1?

Answer 2

PI: Mucosal epithelium

L: Neuron (ganglia)

Question 3

How is herpes simplex type 1 transmitted? What is it’s incubation period?

Answer 3

T: close contact

IP: 2-12 days (average 4)

Question 4

Describe the disease entities of herpes simplex type 1. What are its clinical presentation?

Answer 4

Orofacial lesions and (some) genital lesions
Encephalitis
Herpes whitlow
Herpes keratitis
Neonatal herpes

Question 5

How is herpes simplex type 1 diagnosed? What are the key diagnostic tests used?

Answer 5

• Viral culture of lesions
• Direct fluorescent Ab stain of lesions
• PCR of lesions

None of tests can distinguish between primary or recurrent infection

Question 6

What are the treatments for herpes simplex type 1?

Answer 6

• Acycloguanosine (a nucleoside analog)

Question 7

What types of prophylaxis exist for herpes simplex type 1?

Answer 7

• Oral antiviral suppressive therapy given to pts w/ frequent painful oral/genital herpes
• Used in pts who are sexually active w/ a partner who doesn’t have herpes

Taken once/twin daily and cannot miss days!!

Question 8

What type of virus is herpes simplex type 2?

Answer 8

a

Question 9

Which cells are targeted for primary infection and latency in herpes simplex type 2?

Answer 9

PI: Mucosal epithelium

L: Neuron (ganglia)

Question 10

How is herpes simplex type 2 transmitted? What is it’s incubation period?

Answer 10

T: Close contact, usually sexual

IP: 2-12 days (average 4)

Question 11

Describe the disease entities of herpes simplex type 2. What are its clinical presentation?

Answer 11

Genital lesions
Encephalitis
Herpes whitlow
Herpes keratitis
Neonatal herpes

Question 12

How is herpes simplex type 2 diagnosed? What are the key diagnostic tests used?

Answer 12

• Viral culture of lesions
• Direct fluorescent Ab stain of lesions
• PCR of lesions

None of tests can distinguish between primary or recurrent infection

Question 13

What are the treatments for herpes simplex type 2?

Answer 13

• Acycloguanosine (a nucleoside analog)

Question 14

What types of prophylaxis exist for herpes simplex type 2?

Answer 14

• Oral antiviral suppressive therapy given to pts w/ frequent painful oral/genital herpes
• Used in pts who are sexually active w/ a partner who doesn’t have herpes

Taken once/twice daily and cannot miss days!!

Question 15

What type of virus is varicella zoster virus?

Answer 15

a

Question 16

Which cells are targeted for primary infection and latency in varicella zoster virus?

Answer 16

PI: Mucosal epithelium

L: Neuron (ganglia)

Question 17

How is varicella zoster virus transmitted? What is it’s incubation period?

Answer 17

T: Contact or respiratory route

IP: 10-21 days

Question 18

Describe the disease entities of varicella zoster virus. What is the clinical presentation?

Answer 18

Chickenpox (varicella)

Shingles (zoster)

Question 19

How is varicella zoster virus diagnosed? What are the key diagnostic tests used?

Answer 19

V and Z both diagnosed clinically

In Z, direct fluorescent Ab, PCR, or viral culture used to diagnose

Question 20

What are the treatments for varicella zoster virus?

Answer 20

V: often no therapy needed in kids — anti-virals needed in pts who are immunocompromised or pregnant, or have severe disease (teens/adults)

Z: Acyclovir, forms of pain control for neuropathic pain

Question 21

What types of prophylaxis exist for varicella zoster virus?

Answer 21

V: Varicella vx - 2-dose series

Z: Zoster vx - 1 dose

Question 22

What type of virus is cytomegalovirus?

Answer 22

a dsDNA virus

Question 23

Which cells are targeted for primary infection and latency in cytomegalovirus?

Answer 23

PI: Epithelia, monocytes, lymphos

L: Monos, lymphos

Question 24

How is cytomegalovirus transmitted? What is it’s incubation period?

Answer 24

T: Contact, blood transfusions, transplants, congenital, breast milk

IP: 2 weeks to 2 months

Question 25

Describe the disease entities of cytomegalovirus. What are its clinical presentation?

Answer 25

Infectious mono Burkitt lymphoma CNS lymphoma (in immunocompromised pts)

Question 26

How is cytomegalovirus diagnosed? What are the key diagnostic tests used?

Answer 26

a

Question 27

What are the treatments for cytomegalovirus?

Answer 27

a

Question 28

What types of prophylaxis exist for cytomegalovirus?

Answer 28

a

Question 29

Describe the virion structure of herpesviruses

Answer 29

a

Question 30

Describe the replication cycle of herpesvirus.

Answer 30

a

Question 31

What are primary infections?

Answer 31

a

Question 32

Describe the concepts of latency and reactivation

Answer 32

a

Question 33

Explain the clinical manifestations of primary infection for herpes simplex type 1

Answer 33

a

Question 34

Explain the clinical manifestations of primary infection for herpes simplex type 2

Answer 34

a

Question 35

Explain the clinical manifestations of reactivation of herpes simplex type 1

Answer 35

a

Question 36

Explain the clinical manifestations of reactivation of herpes simplex type 2

Answer 36

a

Question 37

Which of the herpesviruses have asymptomatic shedding associated with reactivation?

Answer 37

a

Question 38

What are the complications of chickenpox?

Answer 38

a

Question 39

To whom do we give the varicella vaccine? Discuss

Answer 39

a

Question 40

To whom do we give the shingles vaccine? Discuss

Answer 40

a

Question 41

Explain the importance of T-cell mediated immunity to varicella zoster virus infection

Answer 41

a

Question 42

Explain the consequences of maternal herpesvirus infection during pregnancy. What is the risk of the infant developing neonatal HSV, or congenital VZV and CMV syndromes?

Answer 42

aa

Question 43

Describe how CMV can be diagnosed histologically in infected tissues

Answer 43

a

Question 44

How do you interpret serology (IgM and IgG tests) in the diagnosis of CMV disease?

Answer 44

a