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MID Exam 3 > Exam 3 - Herpesviruses > Flashcards

Exam 3 - Herpesviruses Flashcards

1
Q

Herpes

3 categories

A

alpha (HSV, VZ)
beta (CMV, HHV6)
gamma (EBV, HHV8)

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2
Q

Herpes
herpesviridae
morphology

A

-large, enveloped, dsDNA
-env. from host cell w/
viral glycoproteins
-nucleocapsid, tegument
-non-distinct in microscopy

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3
Q

Herpes
herpesviridae
latency

A
  • alpha: neurons
  • beta: mono/lymphocytes
  • gamma: B lymphocytes
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4
Q

Herpes
HSV
path

A
  • replication in epithelium
  • buds from host cell
  • syncytia possible
  • lysis, inflamm response
  • latency in sens root ganglia
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5
Q

Herpes
HSV
latency

A
  • retrograde axonal transport

- latent in sens root ganglion

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6
Q

Herpes
HSV
reactivation stimuli

A

UV light, stress, trauma,

immune suppression, menstruation

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7
Q

Herpes
HSV
epi/transmiss

A
  • Women>Men

- direct contact

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8
Q

Herpes
HSV
Primary Infxn Sx

A
  • 2-7 day incubation
  • fever, anorexia, malaise, headache
  • regional lymphadenopathy
  • severe vesicular rash
  • lesions heal after several wks
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9
Q

Herpes
HSV
Gingivostomatitis Sx

A
  • 2-12 day incubation
  • children <5 yrs
  • vesicles/ulceration soft palate, tongue, floor
  • oral pain, lymphadenopathy
  • 10-14 days
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10
Q

Herpes
HSV
Recurrent Infxn Sx

A
  • sterotyped lesions
  • fewer in # than primary
  • HSV2>HSV1
  • prodrome: itch, tingle, burn
  • heal 8-10 days
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11
Q

Herpes
HSV
Asymptomatic Shedding

A

-2% of days
-most common w/in 7 days
of recurrence
-HSV 2> HSV 1

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12
Q

Herpes
HSV
Neonatal Tranmiss

A
  • 30% transmiss w/ active lesions
  • C-section indicated
  • HSV 1 or 2
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13
Q

Herpes
HSV
Neonatal Sx

A

-seizures, blindness, DD,
psychomotor agitation, spasticity
…death

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14
Q

Herpes
HSV
Dx

A
  • clinical
  • Tzanck (giant multinuc cells)
  • viral culture
  • PCR
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15
Q

Herpes
HSV
Tx

A

-acyclovir (thymidine kinase

inhibitors)

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16
Q

Herpes
VZ
path

A
  • similar to HSV
  • varicella=primary
  • zoster=recurrence
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17
Q

Herpes
VZ
transmiss/epi

A
  • respiratory route
  • highly contagious
  • winter/spring
  • children
  • temperate zones
  • contagion starts 5 days before sx
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18
Q

Herpes
VZ
Sx

A
  • 14-15 day incubation
  • fever, rash (scalp/trunk->extremities)
  • vesicles, various stages
  • ulceration on membranes
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19
Q

Herpes
VZ
Dx

A

-clincial dx
-Tzanck prep from ulcer base
(giant multinuc cells)

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20
Q

Herpes
VZ
Tx

A
  • acyclovir

- higher dose than for HSV

21
Q

Herpes
VZ
Complications

A
  • hepatitis
  • pneumonitis
  • encephalitis
  • staph/strep co-infection
  • Reyes, Guillain-Barre
22
Q

Herpes
VZ
Latency

A
  • “zoster”

- dorsal root ganglia

23
Q

Herpes
VZ
Reactivation stimuli

A
  • stress
  • age
  • immunosuppression
24
Q

Herpes
VZ
Recurrence Sx

A
  • dermatomal distribution (1-3) (50% thoracic)
  • unilateral
  • prodromal pain
  • dissem to brain, liver, lung MAY occur
  • post-herpetic neuralgia (>1 mo), ^ w/ age
25
Q

Herpes
VZ
vaccine

A
  • live atten’d Oka strain
  • in US since 1995
  • given to children, >60yo
26
Q

Herpes
EBV
morphology

A
  • gamma herpesvirus

- dsDNA circular, capsid, envelope, glycoproteins

27
Q

Herpes
EBV
transmiss/epi

A
  • US infxns in adolescents, young adults
  • 90% US adults have serum Ab
  • transmit through “close personal contact”
28
Q

Herpes
EBV
path

A
  • replication in pharyngel lymph tissue
  • dissemination via lymphoretic. system
  • infected B cells can become malignant
29
Q

Herpes
EBV
clinical/sx

A

-infxous mononucleosis
-sore throat, fever, lymhpadenopathy
tonsilar englargement w/ exudate, palatal petechiae
-splenomegaly, hepatomegaly
-rash caused by ampicillin
-various secondary lymphomas

30
Q

Herpes
EBV
complications

A
  • hemolytic anemia, thrombocytopenia
  • splenic rupture
  • neurologic dz
31
Q

Herpes
EBV
latency/recurrence

A
  • B cell latency

- asymptomatic shedding

32
Q

Herpes
EBV
dx

A 
-"atypical" T-cell lymphocytes on 
peripheral blood film
-elevated transaminases
-heterophile antibody agglutination on 
horse RBCs (Weird) ("Monospot")
-antigen test
33
Q

Herpes
CMV
morphology

A
  • beta herpesvirus
  • largest human virus!
  • dsDNA linear, capsid, envelope
34
Q

Herpes
CMV
path

A
  • cytomegaly

- downregulation of CD8 response

35
Q

Herpes
CMV
transmiss/epi

A
  • kissytimes, peetimes, sexytimes, bloodtimes, milkytimes

- 60-100% adults seropositive

36
Q

Herpes
CMV
clinical/sx

A

-imm. competent: asx or mono-ey
-imm. compromised: retinitis, pneumonitis,
colitis, esophagitis, encephalitis, myelitis
-congenital infxn: 30% have sx (hepatosplenomeg,
petech rash, microceph, motor dysfxn, retinitis)

37
Q

Herpes
CMV
dx

A
  • IgM (primary) or IgG (latency)
  • assay, culture
  • “owl’s eye inclusions” (cytoplasmic nuclear incl)
38
Q

Herpes
CMV
tx

A

-antivirals

39
Q

Herpes
HHV6
morph

A
  • Beta (see CMV morph)
40
Q

Herpes
HHV 6
transmiss/epi

A
  • saliva
  • spring and fall
  • 90% of 2 y.o. are seropositive
41
Q

Herpes
HHV 6
path

A

-T, B, NK, Mac, glial, and epith cells

42
Q

Herpes
HHV 6
clin/sx

A

-10 day incubation
-asx OR:
-fever, roseloa infantum (benign rash), fever
-abrupt defeverensce, macular rash ,
suboccipital lymphadenopathy, red throat
-rare febrile seizures and encephalopathy
-adults: mono-ish

43
Q

Herpes
HHV 6
dx

A

-serologic testing

44
Q

Herpes
HHV 6
tx

A

-not indicated

45
Q

Herpes
HHV 8
morph

A
  • gamma herpesvirus (see EBV)

- aka Kaposi’s Sarcoma-Ass’d Herpesvirus (KHSV)

46
Q

Herpes
HHV 8
transmiss/epi

A
  • sexytimes

- 90% of Kaposi’s sarcoma are HHV8+

47
Q

Herpes
HHV 8
path

A
  • infects epithelial spindle fibers (Kaposi’s)

- lymph tissue (lymphoma/Castleman’s)

48
Q

Herpes
HHV 8
clin/sx

A
  • Kaposi’s: mult vascular tumors

- Castleman’s: lymphoma

49
Q

Herpes
HHV 8
latency

A

-(B) lymphocytes

MID Exam 3 (13 decks)

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