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):
1

What is viral myocarditis?

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

2

What is the typical presentation of viral myocarditis?

Dyspnea
Exercise intolerance
Fatigue

3

What are most US myocarditis cases associated with?

Viral infection

4

What viruses most commonly cause myocarditis?

Historically:
- Adenovirus (Type 2&5)
- Enterovirus (Coxsackievirus B)

Currently:
- B19 Parvovirus
- HHV-6

5

How is viral myocarditis diagnosed?

- A high index of suspicion in patient's with "CHF of unknown origin"
- CXR, ECG, & endomyocardial biopsy
- Nucleic acid test of biopsied material

6

How is viral myocarditis treated?

1) Manage CHF & arrhythmia
2) Bed rest & observation if only mild disease

7

What is the prognosis of viral myocarditis?

50% have full cardiac function restored

8

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

5-14 year old with:
- Swollen, tender parotid glands
- Sometimes accompanied by submandibular gland swelling

*Prodrome of malaise & anorexia for 1-2 days

9

List the characteristics of the mumps virus.

- Paramyoxviridiae family
- ssRNA
- One serotype

10

What are the complications of Mumps?

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

11

How is mumps diagnosed?

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

12

How is Mumps treated?

Uncomplicated cases resolve without intervention within ~10 days

13

How is Mumps transmitted?

Direct contact with:
- Respiratory droplets
- Saliva
- Contaminated fomites

14

How is Mumps prevented?

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

Who is at increased risk for Mumps?

- Healthcare workers
- International travelers
- Students at post high-school educational institutions

16

What is Kaposi's Sarcoma (KS)?

Multicentric tumor associated with hyperproliferation of endothelial cells

17

Describe the presentation of KS.

- 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

How are KS cells histologically identified?

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

19

What is KS associated with?

Immunosuppression

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

20

What are the different types of KS?

- Classic
- Endemic
- Transplant-related
- AIDS-related

21

Describe Classic KS.

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

22

Describe Endemic KS.

- 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

Describe Transplant-related KS.

KS seen in post-transplant immunosuppression

24

Describe AIDS-related KS.

KS seen in AIDS patients
- More lesions that involve multiple organ systems
- Lung involvement is fatal

25

What virus causes KS?

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

26

List the characteristics of KSHV.

Herpesvirus
Enveloped
dsDNA

27

How is HHV-8 transmitted?

Sexual
Needle sharing

28

What diseases besides KS are associated with KS?

Castleman's Disease
Primary effusion lymphomas

29

How is HHV-8 prevented?

- No vaccine
- Prevent transmission by practicing safe-sex & avoiding needle sharing

30

How is HHV-8 or KS treated?

- Often, controlling immunosuppresion is more important than "treating" KS--allowing the immune system to combat KS will clear lesions
- Typical cancer

31

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

Latent state

32

What is ATL?

Adult T-cell Lymphoma

33

Describe the clinical presentation of ATL.

Lymphadenopathy
Hepatosplenomegaly
Hypercalemia
Skin infiltration of tumor cells

34

How does skin infiltration of tumor cells present?

Papules
Plaques
Tumors
Ulcers

35

What is the key cytological marker for ATL?

"Flower cells"--multi-lobulated nuclei in T-cells

36

Where is ATL endemic?

Japan
Caribbean
Central Africa

37

How is ATL diagnosed?

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

38

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

HAM (HTLV-1 Associated Myelopathy)

39

What is HAM? What are the symptoms?

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

List the characteristics of HTLV-1.

Retorvirus
Enveloped
+ssRNA
Reverse transcriptase

41

What cells does HTLV-1 infect?

CD4 & CD8 positive T-cells

42

What receptor does HTLV-1 use?

GLUT-1

43

How is HTLV-1 transmitted?

Nursing
Blood transfusion
Sexual

*note that this is cell-assocaited

44

How is HTLV-1 prevented?

Nursing is discouraged
Screen blood supply
Safe-sex

45

How is HTLV-1 treated?

Chemotherapy

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