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Exam IV Viruses Flashcards

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1
Q

influenza: hemagglutinin

A
  • protein for cell attachment, sialic acid binding
  • target of vaccines
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2
Q

influenza: transmission

A
  • respiratory droplets
  • very contagious in winter
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3
Q

influenza: natural reservoir

A
  • infected humans
  • pigs, birds can carry certain strains
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4
Q

influenza: pathogenesis

A
  • incubates for 1-4 days
  • viral shedding 1 day before onset of symptoms
  • loss of ciliated and mucus producing cells
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5
Q

influenza: treatment

A

oseltamivir, zanamivir (tamiflu)

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6
Q

influenza symptoms

A
  • acute onset w/ fever, cough, malaise, sore throat
  • can get secondary bacterial pneumonia
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7
Q

influenza: prevention

A
  • intramuscular vaccine: inactivated virus
  • live attenuated nasal spray vaccine
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8
Q

influenza complications

A
  • otitis media in children
  • primary influenzal pneumonia (s. aureus)
  • secondary bacterial or viral pneumonia (s. aureus, h. influenzae, s. pneumoniae)
  • acute encephalopathy in children taking aspirin
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9
Q

parainfluenza: transmission

A
  • respiratory droplets
  • fomites
  • aerosols
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9
Q

parainfluenza: natural reservoir

A
  • infected humans
  • ubiquitous: can exist on surfaces
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10
Q

parainfluenza: disease

A

acute laryngotracheobronchitis
- cold-like, bark-like cough, stridor and hoarseness

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11
Q

parainfluenza: ID

A

bark-like cough is confirmatory
- PCR can be done to rule out other causes

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12
Q

common cold: viruses

A
  • rhinovirus: 30-50% of cases. 100s of serotypes of A, B, C
  • coronavirus: 10-30% of cases. 2 serogroups, 4 strains
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13
Q

common cold: symptoms

A

nasal congestion, discharge, sore throat, fever, erythema of nasopharynx, oropharynx

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14
Q

common cold: risk factors/pathogenesis

A
  • immunity is not useful due to 100s of serotypes
  • many strains
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15
Q

common cold: natural reservoir, transmission

A
  • humans
  • respiratory secretions, close contact, aerosols
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16
Q

RSV: natural reservoir

A

humans

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17
Q

RSV: transmission

A

aerosols, fomites, nosocomial

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18
Q

RSV: ID

A

ELISA

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19
Q

RSV: diseases

A
  • infant RSV: lower resp infections (bronchiolitis, pneumonia, tracheobronchitis,) (poor feeding, resp distress, fever, cough, hypoxemia)
  • cold-like in adults
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20
Q

RSV: prevention

A
  • isolation in hospital
  • anti-sera for those exposed nosocomially
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21
Q

adenovirus: natural reservoir and transmission

A
  • infected humans
  • aerosols, fomites, fecal-oral
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22
Q

adenovirus: risk factors

A
  • close quarters (military base, hospital)
  • swimming pools
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23
Q

adenovirus: prevention

A
  • good hygiene
  • vaccine for military personnel only
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24
adenovirus: pathogenesis
resistant to disinfectants, stable in GI tract
25
adenovirus: conjunctivitis
- epidemic keratoconjunctivitis - adults and children get eye pain, inflammation, fever, preauricular lymphadenopathy - pharyngoconjunctival fever - conjunctivitis w/ pharyngitis - epidemics in summer
26
herpesvirus: lytic infection
- lytic replication produces more viral particles, most viral genes are expressed - produces progeny - induces apoptosis of infected cell
27
herpesvirus drug target and drug
lytic cycle - early stage: DNA synthesis acyclovir
28
herpesvirus: latent infection
- latent infection maintains genome - exists in equilibrium w/ host immune system - type 1 establishes latency in trigeminal ganglia, type 2 establishes latency in sacral ganglia
29
herpesvirus: encoded proteins
- DNA polymerase and terminase: successful drug targets - thymidine kinase: successful drug targeth
30
HSV 1, 2: pathogenesis
- primary infection is of mucosal surfaces: limited by IFN, innate response - cell-cell spread to immune, neuronal cells - establishes latency in nucleus of nerves
31
HSV 1, 2: symptoms
vesicular lesion that is wet, then crusts over and can ulcerate
32
HSV 1, 2: natural reservoir, transmission
- infected humans - type 1 is oral contact: sharing contaminated items - type 2 is sexual contact
33
HSV 1, 2: ID
- cytology of lesions - PCR - culture, IF - serology for prior exposure
34
HSV 1, 2: prevention
-safe sex - C-section for pregnant mother for active lesions
35
herpes labialis
HSV 1, 2 cold sores: pain, itching, tingling before lesion appears
36
herpes gingivostomatitis
HSV 1 for toddlers and children, either 1 or 2 for adults - pharyngeal erythema, edema, clear pharyngeal and buccal vesicles that ulcerate rapidly
37
herpes gladiatorum
HSV 1 or 2 - infection from cuts, abrasions on face/chest - common in wrestlers, rugby players
38
herpes whitlow
HSV 1 - inoculation of finger, can be mistaken for paronychia
39
herpes meningitis
- common in primary infection, especially in women - fever, headache, photophobia, nuchal rigitidy - aseptic: usually HSV2
40
herpes encephalitis
- rare but serious - CSF w/ elevated protein, pleocytosis, erythrocytosis - alteration in mental status
41
varicella-zoster: pathogenesis, latency
1. infection of upper resp tract 2. replication in lymph nodes 3. replication in secondary lymphoid organs 4. replication in skin latency in neurons
42
varicella-zoster: natural reservoir, transmission
- infected humans - from aerosols, skin
43
varicella-zoster: risks, prevention
- risk to those unvaccinated - shigrix vaccine: subunit - varicella vaccine: live-attenuated
44
chicken pox + complications
- varicella causes - mostly in children - complications: varicella pneumonia, encephalitis, neonatal varicella
45
shingles
- zoster causes - reactivation in adults - neuralgia, pain, burning, itching
46
epstein-barr virus: pathogenesis, latency
- B-cells are latently infected, inducing immune response - EBV nuclear antigens and latent membrane proteins are expressed in human cancers
47
epstein-barr virus: ID
- monospot test: heterophile antibodies - uses latex bead agglutination - older technique: blood smear w/ atypical lymphocytes
48
epstein-barr virus: reservoir, transmission, prevention
- infected humans - spread through saliva - standard hygiene for prevention
49
EBV and cancer
- nasopharyngeal carcinoma and Burkitt's lymphoma are endemic - Hodgkin's lymphoma
50
mononucleosis: cause, symptoms
- EBV - high fever, malaise, pharyngitis, fatigue, lymphadenopathy, hepatosplenomegaly
51
human herpesvirus 6A, 6B, 7: reservoir, transmission
- infected humans - direct contact
52
human herpesvirus 6A, 6B, 7: disease
roseola
53
cytomegalovirus: reservoir, transmission, risks
- infected humans - spread through direct contact - transplant complication
54
cytomegalovirus: treatment
gancyclovir
55
cytomegalovirus: latency
- in epithelial cells - can be reactivated by T-cell immunity breakdown
56
cytomegalovirus: ID
- CMV-specific serology - 4-fold increase in CMV-specific IgG titers
57
cytomegalovirus: diseases
- heterophile - mono - cytomegalic inclusion disease in infants: hearing loss, microcephaly, intracerebral calcification - multi-site symptomatic disease in HIV patients
58
kaposi's sarcoma-associated herpesvirus : reservoir, transmission, risks
- infected humans - spreads through saliva, blood, sexually - immunosuppressed at risk, higher seropositivity in Africa
59
kaposi's sarcoma
- infects endothelial cells - polyclonal, multifocal lesions
60
acute hepatitis
- lasts less than 6 months - rarely causes hepatic failure - increased serum aminotransferases x1000
61
chronic hepatitis
- more than 6 months - starts mild, but liver can fail - increased serum aminotransferase x100 - decreased albumin, increased clotting time
62
hepatitis A: natural reservoir, transmission, risks
- infected humans, contaminated water, shellfish - fecal-oral transmission - risk is raw seafood ingestion
63
hepatitis A: prevention
vaccine w/ neutralizing antibodies
64
hepatitis A, E: diagnosis
serology: IgM appearance IgG indicates prior infection or vaccination
65
hepatitis A, E: disease
acute hepatitis
66
hepatitis E: reservoir, transmission, risks
- infected humans, contaminated water, can be in pigs - fecal-oral - more likely in underdeveloped nations
67
hepatitis B, D: reservoir, transmission, risks
- infected humans' blood, fluids - spread through contact w/ blood or fluid: IV drug use, sex, mother to baby
68
hepatitis B, D: treatment, prevention
-entecavir - recombinant subunit vaccine for prevention
69
hepatitis B: diagnosis (antigens, antibodies)
Ag-Ab tests - HBsAg+ and DNA + = active infection - Anti-HbS+ and DNA- = cured - HBeAg shows higher infectivity
70
hepatitis B: diseases
neonatal hepatitis: almost always chronic. asymptomatic early in life, complications arise later
71
hepatitis D: pathogenesis
- new host has to be HBV+ - requires HBV's HBsAg
72
HBV + HDV coinfection vs superinfection
coinfection: severe acute superinfection: chronic
73
hepatitis C: natural reservoir, transmission, risks
- infected humans' blood, fluid - bloodborne - IV drug use, contaminated tattoo, piercing
74
hepatitis C treatments
- sofosbuvir + velpatasvir for polymerase - glecaprevir + pibrentasvir for protease
75
hepatitis C ID
antibody blood test if positive: RNA test
76
measles: reservoir, transmission, risks
- infected humans - spread through direct contact, resp. droplets, fomites - risk to those unvaccinated
76
hepatitis C diseases
usually asymptomatic - chronic HCV similar to HBV
77
measles: prevention
live attenuated vaccine
78
measles: diagnosis
- cough, coryza, conjunctivitis - koplik's spots - IgM, RNA
79
measles, mumps, rubella, smallpox: pathogenesis
1. replication in upper resp tract 2. infection of local lymphatic tissues 3. viremia 4. spread to other systems
80
measles: complications
- major cause of childhood blindness in developing countries - pneumonia is usually the fatal complication in children - otitis media - encephalitis
81
mumps, rubella: reservoir, transmission, risks
- infected humans - resp droplets - risk to those unvaccinated
82
mumps: symptoms
swollen, puffy cheeks (from swollen salivary glands)
83
HPV pathogenesis
1. virus travels to basal layer - viral DNA replicated in basal layer 2. differentiating keratinocytes re-enter S phase: epidermis thickens 3. late genes expressed in granular, cornified layers: package viral DNA
84
HPV: cancer association
cervical cancer - second most common cause of death in women - abnormal squamous cells found in pap smear - from high risk genotypes: usually 16 or 18 - virus must be integrated into chromosome
85
HPV: treatments and target
imiquimod: targets TLR7, activating macrophage secretion of pro-inflammatory cytokines podophyllotoxin: binds microtubules, inhibiting polymerization --> mitotic arrest
86
HPV: prevention
- 9 valent vaccine for high-risk types - cervical cancer vaccine induces high titers of neutralizing ABs - subunit vaccine w/ major capsid protein
87
HPV: transmission
- direct contact - sexual contact
87
poliovirus: prevention
- no recent cases in the US - inactivated intramuscular vaccine: prevents paralytic poliomyelitis - oral vaccine: prevents local, CNS infection
88
polio: major illnesses
- serious aseptic meningitis, poliomyelitis - paralysis
89
non-polio enteroviruses: transmission, common diseases
- second most infectious virus - resp. secretions, direct contact, exists on surfaces - summer cold
90
enteroviruses neurological diseases
paralytic: polio meningitis: all enteroviruses can cause encephalitis: not common
91
herpangina
- group A coxsackie - sore throat w/ grayish-white ulcers
92
hand-foot-mouth disease
- group A coxsackie - sore throat w/ vesicles, bullae - rash
93
HIV acute infection: clinical and lab findings, course
- non-specific signs, symptoms: headache, muscle aches, sore throat, lymphadenopathy - decreasing CD4/CD8 ratio, lymphopenia - course: lasts for weeks, lymphadenopathy and malaise for months
94
HIV asymptomatic period
clinical latency: viral replication in lymph nodes, gradual CD4 depletion
95
HIV immunodeficiency
- susceptibility to opportunistic infections - impaired ability to mount immune response to new antigen, maintain memory response
96
HIV common opportunistic infections
- Tb, salmonella, legionella, candida, histoplasmosis, toxoplasmosis, leishmania - EBV lymphomas, KSHV sarcoma
97
HIV macrophage infection
CCR5 - binds CD4, then looks for and binds co-receptors - typically transmitted version
98
HIV T cell infection
- CXCR4 T cell infection - shift to T cell infection is associated w/ disease progression
99
HIV treatment
- anti-retroviral therapy (HAART) - polymerase inhibitor, protease inhibitor, fusion or integrase inhibitor
100
HIV prevention
emtricitabine-tenofovir used prophylactically - nucleoside reverse transcriptase inhibitor
101
HIV diagnosis
- antigen-antibody test - 1/2 differentiation assay - if diagnosed: HIV viral load, CD4 count
102
rabies: reservoir, transmission, risks
- foxes, skunks, dogs, raccoons, bats - bite transmission - worldwide: most deaths from canine transmission
103
rabies: pathogenesis
1. viral replication in inoculation site 2. virus enters PNS via neuromuscular junction 3. spreads to CNS 4. spreads along nerves to glands, tissues
104
rabies: phases
1. incubation: 2 weeks - 18 months 2. prodromal phase: 1 week, nonspecific symptoms 3. rabid phase: neurological symptoms
105
rabies: ID
- rapid virus antigen: skin biopsy - PCR saliva - post mortem histopathology for negri bodies
106
rabies: treatment, prevention
- post-exposure prophylaxis, antibody therapy w/ rabies immune globulin - pre-exposure prophylaxis
107
arboviruses: urban cycle + diseases
- man to arthropod to man - dengue, yellow fever
108
arboviruses: sylvatic cycle + diseases
- animal to arthropod to animal - humans infected incidentally - yellow fever, west nile
109
arbovirus: pathogenesis
1. virus introduced through bite 2. local replication 3. virus disseminates, replicates in specific tissues 4. crosses blood brain barrier 5. neuron infection
110
arboviruses: ID
- serology: IgM in CSF is diagnostic - PCR for viral nucleic acids
111
arboviruses: symptoms, diseases
- often subclinical - viremia - arbovirus encephalitis
112
west nile virus: transmission, reservoir, risks
- in birds - transmitted through mosquito bite - increasing prevalence in US
113
dengue: diseases
- dengue hemorrhagic fever: hemorrhagic fever and shock - if exposed to one type, antibodies can help another type infect - break bone fever
114
ebola: reservoir, transmission
- bats - nosocomial, blood and sexual contact

Immuno (6 decks)

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