Flashcards in EXAM #2: MAJOR VIRAL PATHOGENS Deck (37):
1
Where do all Herpes viruses replicate?
Nucleus
2
Where do Herpes viruses remain latent?
Ganglion
3
How is Herpes transmitted?
- Direct contact with active lesions
- Asymptomatic shedding/secretion
*Can contract Herpes from asymptomatic partner
4
What is the tropism for HSV-1 and HSV-2?
HSV-1= oral mucosa
HSV-2= genitals
5
In classic HSV-1 infection, which is usually more severe, primary infection or reactivation?
Primary infection
6
What are the complicated HSV-1 oral infections?
1) Gingivostomatitis
2) Eczema herpeticum
3) Erythema multiforme
7
What type of genital lesion is associated with HSV-2?
Painful vesicular lesions
8
What is HSV proctitis? What patient population is this most common in?
HSV leading to inflammation of the prostate; more common in HIV patients
9
What is wrestler's herpes called?
Herpes Gladiatorum
10
What do you need to remember about HSV eye infections?
Can damage the retina i.e. it is an emergency
11
What radiologic sign is associated with HSV encephalitis?
Temporal lobe enhancement
12
What do you need to do if you have a patient with suspected HSV encephalitis b/c of temporal lobe enhancement?
Antvirals
13
What is Mollaret Syndrome?
Recurrent meningitis associated with HSV
14
How are HSV infections diagnosed?
1) Clinical
2) Tzanck smear (multi-nucleated giant cells)
3) Culture/PCR
15
What causes resistance to acyclovir?
Lack of thymidine kinase
16
What is the major adverse effect associated with acyclovir?
Crystal-induced renal failure
17
What does VZV cause in primary infection? What about reactivation?
Primary= chicken pox
Reactivation= herpes zoster i.e. shingles
18
What is the characteristic rash seen with Chickenpox?
Different stages of vesicles
19
How is VZV transmitted?
1) Aerosolized droplets
2) Direct contact with vesicle fluid
20
How do you know when VZV is no longer contagious?
All vesicles are crusted
21
What is the most common visceral complication of VZV?
Varicella pneumonia
*Associated with smoking, pregnancy, and immunosupression
22
What antiviral is used for treatment of VZV?
Acyclovir
*Vaccine prior
23
What is treatment of Herpes Zoster aimed at treating/ preventing?
Acute neuritis and post-herpetic neuralgia
24
What is the treatment for Herpes Zoster? When should treatment be started?
- Ideally, start within 72 hours
- Acyclovir
25
How does EBV differ from the other Herpes viruses?
Does not have a cytopathic effect; rather, transforms in cells
26
Where is EBV latent in the body?
B and T-cells
27
How does EBV infection in kids and adolescents differ?
Adolescents= infectious mono
Kids= typically subclinical
28
What can cause a rash in EBV infection?
Ampicillin
29
What is the normal treatment for EBV infection?
Supportive care/ no contact sports
30
What lymphporliferative disorder highly associated with EBV?
HLH
31
How is EBV diagnosed?
1) Heterophile antibody (monospot)
2) Antibodies VCA IgG/IgM
32
Where does CMV remain latency?
Multiple cell types/organ tissues
33
What is the histologic appearance of CMV?
Large cells with internucelar "owl eye" inculsions
34
What does CMV cause?
CMV mononucleosis (esp. in sexually active young adults)
35
How is CMV treated?
Ganciclovir
36
What are the consequences of congenital CMV?
1) Developmental delay
2) Hearing impairment
3) Ocular abnormalities
37