Exam #7: Viral Infections of Circulatory, RES, & Lymphatic System II Flashcards Preview

Microbiology > Exam #7: Viral Infections of Circulatory, RES, & Lymphatic System II > Flashcards

Flashcards in Exam #7: Viral Infections of Circulatory, RES, & Lymphatic System II Deck (45)
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1
Q

What is viral myocarditis?

A

Inflammation of the middle musclar layer of the heart wall leading to ventricular dysfunction
- Most prevalent in adult men

2
Q

What is the typical presentation of viral myocarditis?

A

Dyspnea
Exercise intolerance
Fatigue

3
Q

What are most US myocarditis cases associated with?

A

Viral infection

4
Q

What viruses most commonly cause myocarditis?

A

Historically:

  • Adenovirus (Type 2&5)
  • Enterovirus (Coxsackievirus B)

Currently:

  • B19 Parvovirus
  • HHV-6
5
Q

How is viral myocarditis diagnosed?

A
  • A high index of suspicion in patient’s with “CHF of unknown origin”
  • CXR, ECG, & endomyocardial biopsy
  • Nucleic acid test of biopsied material
6
Q

How is viral myocarditis treated?

A

1) Manage CHF & arrhythmia

2) Bed rest & observation if only mild disease

7
Q

What is the prognosis of viral myocarditis?

A

50% have full cardiac function restored

8
Q

What are the symptoms of mumps? What is the typical age of onset?

A

5-14 year old with:

  • Swollen, tender parotid glands
  • Sometimes accompanied by submandibular gland swelling

*Prodrome of malaise & anorexia for 1-2 days

9
Q

List the characteristics of the mumps virus.

A
  • Paramyoxviridiae family
  • ssRNA
  • One serotype
10
Q

What are the complications of Mumps?

A

Meningitis
Orchitis (testicular inflammation)
Deafness
Myocarditis (rare, but often fatal)

11
Q

How is mumps diagnosed?

A
  • Clinically, acute onset of parotid gland swelling lasting more than 2 days without any other apparent cause
  • Lab assays to detect viral genomes
12
Q

How is Mumps treated?

A

Uncomplicated cases resolve without intervention within ~10 days

13
Q

How is Mumps transmitted?

A

Direct contact with:

  • Respiratory droplets
  • Saliva
  • Contaminated fomites
14
Q

How is Mumps prevented?

A

IM live attenuated vaccine that is part of the MMR & MMRV (Mumps, Measles, Rubella, & Varicella) vaccine combinations

  • 1 dose 12-15 months
  • Another before Kindergarden
  • One dose for adults
  • *Note that 1 dose is ~78% effective & 2x is ~88% effective
15
Q

Who is at increased risk for Mumps?

A
  • Healthcare workers
  • International travelers
  • Students at post high-school educational institutions
16
Q

What is Kaposi’s Sarcoma (KS)?

A

Multicentric tumor associated with hyperproliferation of endothelial cells

17
Q

Describe the presentation of KS.

A
  • Initially, flat or slight raised spots on the skin that can range from light pink to purple
  • Progressively become larger nontender nodules
  • Can become confluent or clump together
18
Q

How are KS cells histologically identified?

A

Spindle morphology (elongated) of cells vs. cuboid or round morphology

19
Q

What is KS associated with?

A

Immunosuppression

*There was a sharp increase in the number of cases during the AIDS epidemic

20
Q

What are the different types of KS?

A
  • Classic
  • Endemic
  • Transplant-related
  • AIDS-related
21
Q

Describe Classic KS.

A
  • Rare
  • Found in those with middle eastern or mediterranean descent
  • Few lesions
  • Rarely life-threatening
22
Q

Describe Endemic KS.

A
  • Most common in Africa
  • Two forms: 1 is identical to classic, other is more aggressive & seen in prepubescent children (fatal in 3 years of onset)
23
Q

Describe Transplant-related KS.

A

KS seen in post-transplant immunosuppression

24
Q

Describe AIDS-related KS.

A

KS seen in AIDS patients

  • More lesions that involve multiple organ systems
  • Lung involvement is fatal
25
Q

What virus causes KS?

A

Kaposi’s sarcoma-associated herpesvirus (KSHV)/ HHV-8

26
Q

List the characteristics of KSHV.

A

Herpesvirus
Enveloped
dsDNA

27
Q

How is HHV-8 transmitted?

A

Sexual

Needle sharing

28
Q

What diseases besides KS are associated with KS?

A

Castleman’s Disease

Primary effusion lymphomas

29
Q

How is HHV-8 prevented?

A
  • No vaccine

- Prevent transmission by practicing safe-sex & avoiding needle sharing

30
Q

How is HHV-8 or KS treated?

A
  • Often, controlling immunosuppresion is more important than “treating” KS–allowing the immune system to combat KS will clear lesions
  • Typical cancer
31
Q

Why can’t herpes antivirals be used to treat KS?

A

Latent state

32
Q

What is ATL?

A

Adult T-cell Lymphoma

33
Q

Describe the clinical presentation of ATL.

A

Lymphadenopathy
Hepatosplenomegaly
Hypercalemia
Skin infiltration of tumor cells

34
Q

How does skin infiltration of tumor cells present?

A

Papules
Plaques
Tumors
Ulcers

35
Q

What is the key cytological marker for ATL?

A

“Flower cells”–multi-lobulated nuclei in T-cells

36
Q

Where is ATL endemic?

A

Japan
Caribbean
Central Africa

37
Q

How is ATL diagnosed?

A

Detection of antibodies to Human T-cell leukemia virus-1 (HTLV-1)

38
Q

Aside from ATL, what other disease is HTLV-1 associated with?

A

HAM (HTLV-1 Associated Myelopathy)

39
Q

What is HAM? What are the symptoms?

A

HTLV-1 Associated Myelopathy, a disease that causes demyelination of neurons within the spinal

  • Stiff gait
  • Lower extremity weakness
  • Back pain
  • Incontinence

*Note that this is most common in women & endemic in the same regions as ATL (japan, central africa, & caribbean)

40
Q

List the characteristics of HTLV-1.

A

Retorvirus
Enveloped
+ssRNA
Reverse transcriptase

41
Q

What cells does HTLV-1 infect?

A

CD4 & CD8 positive T-cells

42
Q

What receptor does HTLV-1 use?

A

GLUT-1

43
Q

How is HTLV-1 transmitted?

A

Nursing
Blood transfusion
Sexual

*note that this is cell-assocaited

44
Q

How is HTLV-1 prevented?

A

Nursing is discouraged
Screen blood supply
Safe-sex

45
Q

How is HTLV-1 treated?

A

Chemotherapy

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