Final Exam Review- Viruses Flashcards Preview

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Flashcards in Final Exam Review- Viruses Deck (51):
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DNA Viruses

HHAPPPy
Herpes
HepaDNAvirus (HBV)
Adenovirus
Parvovirus
Pox
Papova

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Naked DNA Viruses

Woman should be naked for PAP smear.

Papova
Adenovirus
Parvovirus

2

Positive sense RNA viruses

Call Pico and Flavaflav, theres a retro toga party with coronas.

Calicivirus
PicoRNAvirus
Flavivirus
Retrovirus
Togavirus
Coronavirus

3

Isocahedral RNA viruses and coating

Damn right flava flav in a toga, parties around the clock.

Deltaviridae, retroviridae, flaviviridae, togaviridae - ENVELOPED
PicoRNAvirus, Reoviridae, Caliciviridae -- NAKED

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Shape of most RNA viruses

Helical

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PicoRNAviruses- characteristics and members

PERCH on a peak(pico). Single stranded, positive sense, naked.

Polio
Echovirus
Rhinovirus
Coxsackie A/B
Hep A

6

Paramyxoviruses and their characteristics

Parainfluenza, RSV, Metapneumovirus, Rubeola (Measles), Mumps.

Single stranded negative RNA viruses.

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Parainfluenza key points

Croup in toddlers in spring/fall.

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RSV key points

Bronchiolitis in toddlers in winter.

More common in immunosuppressed and preterm birth. Give ribavirin.

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Ribavirin

Antiviral for RSV, nucleoside analog prevents transcription of viral RNA.

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Human metapneumovirus key points

Causes common colds and URIs. At risk groups are immunodeficient and preterm birth. Give palivizumab for immunocompromised patients.

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Palivizumab

Monoclonal antibody against fusion protein. Treats RSV.

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Coronavirus characteristics and key points

Positive sense ssRNA virus, enveloped. Causes SARS, MERS, common colds and gastroenteritis.

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Adenovirus characteristics and key points

dsDNA virus, causes wide variety of clinical symptoms based on tropism, can cause conjunctivitis and URIs. Infants and immunocompromised are at risk for encephalitis and meningitis. Use cidofovir.

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Cidofovir

Cytosine analog, prevents viral DNA synthesis. Use for adenovirus with immunocompromised and infant patients to prevent encephalitis/meningitis. NEPHROTOXIC, IV admin

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Influenza characteristics and key points

Negative sense RNA, helical, enveloped. HA, NA, M proteins, replicates in nucleus (like HIV). Genetic drift - escape from antibody recognition, causes reinfection. Genetic shift- from animals to humans. Lots of mutations because PB complex is error prone. Causes Fever cough and malaise. Treat with oseltamivir/zanamivir, not rimantadine/amantadine.

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Oseltamivir/zanamivir

Sialic acid analog, inhibits action of NA, prevents virus from leaving cell.

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PicoRNAvirus characteristics and key points

Positive sense ss RNA, naked, icosahedral. Occur in summer/fall, VP1 contains receptor binding sites hidden from antibodies. Transmission is fecal-oral or by contact. Initial infection prevented by SIgA, viremia prevented by IgG. Can cause paralysis or meningitis.

18

Polio

PicoRNAvirus: positive sense, ssRNA, naked, icosahedral. Causes paralytic injury but sensory intact. 90% asymptomatic. Vaccines exist.

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Characteristics of viral meningitis

Elevated WBC in CSF (not as high as bacterial), predominance of lymphocytes, normal glucose/protein (2/3?).

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Rubeola characteristics and key points

Paramyxovirus, morbillivirus. Single stranded negative sense, enveloped. Internalization into macrophages via CD46, SLAM, Nectin 4 and formation of syncytia in tissues after viremia. Causes maculopapular rash, Koplik's Spots, Very rare: SSPE (subacute sclerosing panencephalitis), and rare: ADEM (acute disseminating encephalomyelitis).

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Mumps characteristics and key points

Paramyxovirus: rubulavirus. -ssRNA, enveloped. Causes swelling of salivary glands, can cause meningitis.

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Rubella characteristics and key points

Togavirus: +ssRNA, icosahedral, enveloped. German measles, congenital rubella syndrome (deafness/cataracts).

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Rotavirus characteristics and key features

Non enveloped dsRNA, icosahedral (reovirus). Common cause of viral diarrhea in children. NSP4 is suspected toxin. Look for VP6 in ELISA. Other VPs are targets of sIgA.

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Norovirus characteristics and key features

Calicivirus (ss positive RNA, icosahedral, naked). Cruise ship gastroenteritis, worse in children. Secretor negative.

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HSV I and II

Large dsDNA viruses, cause oral and genital warts. Causes formation of syncytia (Tzanck test). Can also cause encephalitis and neonatal infections. treat with acyclovir and valacylovir. Foscarnet if resistant. Latency in sensory ganglia

27

VZV

Large dsDNA virus. Causes chicken pox, latency in DRG/sensory ganglia. Can cause shingles. Reactivation by immunosuppression/uv light.

28

Live attenuated vaccines

Smallpox
Yellow Fever
Chickenpox
Sabin
Influenza (nasal)
MMR

29

EBV

Causes mononucleosis syndrome (hepatosplenomegaly, rash). Latent in B cells, can immortalize them and cause lymphoma. Also causes atypical lymphocytes. Monospot test (weird IgMs from infected B cells). Supportive therapy but rituximab for EBV cancers

30

CMV

Causes mononucleosis-like syndrome but much milder. Leading cause of congenital deafness and other issues. Affects aids patients. Treat with gancicyclovir and valgancicyclovir.

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HHV 6 and 7

Roseola, high fever then rash.

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HHV 8

Causes KS in AIDS, tumors in vasculature.

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Therapy for EBV cancers?

Rituximab

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Treatment for CMV

Gancicyclovir and valgancicyclovir

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What to do if acyclovir resistant?

Foscarnet.

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Hepatitis B

HepaDNAvirus, needs RT to function. Vertical transmission, tattoos, blood transfusions. Can be acute (with anti HBs antibody) or chronic (anti HBsAB lost, HBsAg persists) causes jaundice, RUQ pain, vomiting, etc. Also can cause hepatocellular carcinoma. Treat with pegylated interferon alpha and NRTIs (tenofovir, lamivudine, entecavir). Most babies born with Hep B are chronic. Vaccine available.

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Hepatitis D

Satellite virus that infects with Hep B, needs envelope.

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Hepatitis C

Flavivirus, +ssRNA, icosahedral enveloped. Usually chronic, can be cured sometimes (20%). High mutation rate so exists as a quasispecies. Leading indication for liver transplant. Drug users, sexual transmission. Treat with pegylated interferon alpha, ribavirin, and protease inhibitors.

39

Hepatitis A

PicoRNAvirus, fecal-oral transmission (MSM, travel). Causes acute hepatitis, vaccination available. Usually affects kids.

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Hepatitis E

Countries with contaminated drinking water.

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HIV

Retrovirus, +ssRNA, reverse transcriptase (RNA dep DNA pol), GP120 (anchoring), GP41 (fusion), P24 capsid (ELISAs), first infection in CD4+ Tcells/macrophages, enters using CD4 and CCR5. Later infection uses CXCR4. Error prone RT so many quasispecies. Kills CD4 cells. Initial infection is a flu like illness, then long period of latency with very slow decline of T cells (billions dying, but billions produced, viral load at set point), then characteristic illness. Long lived cells provide a lasting reservoir. Constant cycle of inflammation/immune response. Better to PCR for viral load then do antibody tests.

42

NRTIs

Ten EMTs were taken aback by lame zidane.

Tenofovir (kidney toxicity), emtracitibine, abacavir (sensitivity with HLA-B5701), lamivudine, zidovudine.

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NNRTIs

Never effect extras

Nevirapine (Liver toxicity)
Efavirenz (teratogen, psychiatric symptoms)
Etravirine

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Protease inhibitors

End with navir
Atazanivir, lopinavir, darunavir, forsamprinavir, tipranavir

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Integrase Inhibitor

Raltegravir

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Fusion inhibitors

Maraviroc and enfuviritide

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HPV

dsDNA virus, naked, Types 16 and 18 have most E6 and E7 (cause cancers by screwing up p53 and Rb), types 6 and 11 cause genital warts, type 1 and 2 cause palmar/solar warts.

48

Dengue

Flavivirus, Serotype 2 is most virulent, spread by A. aegypti, causes biphasic illness, first phase is malaise, fever, RETROORBITAL PAIN, bone marrow suppression, myalgias. Second phase is dengue hemorrhagic fever and dengue shock syndrome. ANTIBODY DEPENDENT ENHANCEMENT

49

Yellow Fever

Flavivirus, infects hepatocytes, causes jaundice and hepatitis. Live attenuated vaccine available. Spread by A. aegypti

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West Nile Virus

Flavivirus, spread by Culex mosquito, transplant or blood. Causes encephalitis. NY/NJ

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Rabies

Rhabdovirus (negative strand ssRNA, enveloped). Binds to NACh receptors, causes negri bodies in brain. Early phase is flu like illness, then viral encephalitis (malaise, photophobia) that spreads to brainstem (foaming at mouth, inability to swallow). Give PEP vaccine.