Common Viral Pathogens I

Question 1

Herpes Simplex Type I (HSV1)

Type

Answer 1

dsDNA

Question 2

Herpes Simplex Type II (HSV2)

Type

Answer 2

dsDNA

Question 3

Varicella Zoster Virus (VZV)

Type

Answer 3

dsDNA

Question 4

Cytomegalovirus (CMV)

Type

Answer 4

dsDNA

Question 5

HSV1

Cells targeted for primary infection and latency

Answer 5

Primary- mucosal epithelium

Latency- Neuron

Question 6

HSV2

Cells targeted

Answer 6

Primary- mucosal epithelium

Latency- Neuron

Question 7

VZV

Cells Targeted

Answer 7

Primary- mucosal epithelium

Latency- Neuron

Question 8

CMV

Cells targetted

Answer 8

Primary- Epithelia, monocytes and lymphocytes

Latency- Monocytes and lymphocytes

Question 9

HSV1

Transmission and incubation period

Answer 9

Close contact, 2-12 days

Question 10

HSV2

Transmission and incubation

Answer 10

Close contact usually sexually, 2-12 days

Question 11

CMV

Transmission and incubation

Answer 11

Contact, blood transfusion, transplantation, congenital, 2 weeks to 2 months

Question 12

VZV

Transmission and incubation

Answer 12

Contact or respiratory (droplet), 10-21 days

Question 13

HSV1

Disease entity and clinical presentation

Answer 13

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

Question 14

HSV2

Disease Entitity and clinical presentation

Answer 14

Same as HSV1, but predominately genital lesions with some orofacial lesions

Question 15

CMV

Disease Entity and clinical presentation

Answer 15

Infectious mononucleosis-like,
In immunocompromised- retinitis, penumonia, colitis
Congential CMV in newborns

Question 16

VZV

Disease entity and clinical presentation

Answer 16

Chickenpox for varicella and shingles for zoster

Shingles is super painful and confined to infected dermatomes

Question 17

HSV1

DIagnosis

Answer 17

Clinically, viral culture, direct fluorescent Ab staining og lesions, PCR of lesions

Question 18

HSV2

Diagnosis

Answer 18

Clinically, viral culture, direct fluorescent Ab staining og lesions, PCR of lesions

Question 19

VZV

Diagnosis

Answer 19

Both clinically

but also
Fluorescent antibody, PCR and Culutre

Question 20

CMV

Diagnosis

Answer 20

Culture, PCR, antibody stain, serology, histology

Question 21

HSV1

Treatment

Answer 21

Nucleoside analog (acyclovir)

Question 22

HSV2

Treatment

Answer 22

Nucleoside analog (acyclovir)

Question 23

VZV

Treatment

Answer 23

Acyclovir to shorten course of chickenpox

Question 24

CMV

Treatment

Answer 24

No indicated treatment, but ganciclovir for immunocompormised patients

Question 25

HSV1 | Prophylaxis including vaccines

Answer 25

Oral antiviral suppressive therapy

Question 26

HSV2 | Prophylaxis including vaccines

Answer 26

Oral antiviral suppressive therapy

Question 27

VZV | Prophylaxis including vaccines

Answer 27

Live attenuated VZV vaccine for chicken pox | Shingles vaccine for 50 years and older

Question 28

CMV | Prophylaxis including vaccines

Answer 28

No vaccine, but CMV-IG can be given to immunocompromised patients for high risk patients

Question 29

Describe the virion structure and replication cycle of herpesvirus

Answer 29

Icosahedral capsid, surroudnmed by a glycoprotein rich envelope Entry- envelope fusion mediated by targeted receptors Replication- Immediate-early (IE) genes encode for transcription activators, E proteins code for proteins involved in DNA replication, L genes are viral structures Assembly- In the nucleus, self assembly, budding through the nucleus and getting their glycoprotein from the golgi Exit/Egress- lysis or exocytosis

Question 30

Complicaytions of chickenpox

Answer 30

Secondary infection/cellulitis, pneumonia, necrotizing faciitis, encephalitis, hepatitis and congenital VZV

Question 31

Who we do and do not give the varicella and shingles vaccine to

Answer 31

Contraindicated in immunocompromised patients

Question 32

What is the importance of T cell mediated immunity to the VZV infection

Answer 32

Its what essentially prevents shingles in people, as is why we see singles happen often in older people

Question 33

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

Answer 33

Neonatal HSV- mostly caused by HSV2, high morbidity and mortality. 3 forms, SEM, CNS, or disseminated Congenital VZV- first 8-20 weeks of pregnancy, with fetus exhibiting multiple tissue/organ abnormalities Congenital CMV- more often in primary infection, 3-5% chance baby will be born with CMV (leads to complications such as low BW, microcephaly, hearing loss, mental impairment)

Question 34

Know and be able to recognize how CMV can be diagnosed histologically in infected tissues

Answer 34

Owl's eye appearance , a dense dark nuclear body surrounded by a halo, representing intranuclear unclusions

Question 35

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

Answer 35

+igm - igg, acute CMV -igm -igg, no infection -igm +igg, previous infection in life +igm +igg, reactivation of CMV recently

Question 36

Herpes Whitlow

Answer 36

Infection of the fingers through oral or GU contact, can lead to painful pustules

Question 37

Herpes Keratitis

Answer 37

HSV infects cornea of the eye, from primary infection or reactivation, leading to dendritic scarring that can result in blinding