Herpes

Question 1

Double-stranded DNA genome
enveloped
Genome = 125,000 -236,000 base pairs
1. Encode a large array of enzymes involved ina. nucleic acid metabolism (thymidine kinase, thymidylate synthetase, dUTPase, ribnucleotide reductase)b. DNA synthesis (DNA polymerase, helicase, primase)c. protein processing (protein kinases)
2. Synthesis of viral DNAs and capsid assembly occur in the nucleus, while final processing of virions occurs in the cytoplasm
3. Production of virus results in destruction of the infected cell
4. Able to exist in a latent state in their natural hosts while retaining the capacity to replicate and cause disease upon reactivation

Answer 1

Human Herpesviruses (Chapters 41 and 42)

Question 2

What are the 4 significant biological properties shared by the herpes viruses?

Answer 2

1. Encode a large array of enzymes involved ina. nucleic acid metabolism (thymidine kinase, )
   b. DNA synthesis (DNA polymerase)
   c. protein processing (protein kinases)
2. Synthesis of viral DNAs and capsid assembly occur in the nucleus, while final processing of virions occurs in the cytoplasm
3. Production of virus results in destruction of the infected cell
4. Able to exist in a latent state in their natural hosts while retaining the capacity to replicate and cause disease upon reactivation

Question 3

_____ herpesvirus:
HSV-1 (HHV-1) fever blisters
HSV-2 (HHV-2) sexually transmitted genital lesions
VZV(HHV-3) chicken pox and shingles

Answer 3

Alpha herpesviruses

Question 4

_____ herpesvirus:
CMV
HHV-6 roseola
HHV-7 Roseola

Answer 4

Beta herpesviruses

Question 5

_____ herpesvirus:
EBV (HHV-4) infectious mononucleosis
Kaposi’s sarcoma-associated herpesvirus

Answer 5

Gamma herpesviruses

Question 6

______ viruses are fragile (enveloped)susceptible to heat, detergent, drying

Answer 6

Herpes

Question 7

Generally require direct inoculation
mucous membranes more susceptible than skinCMV and EBV can be transmitted through infected leukocytesVZV is mostly transmitted by aerosols

Answer 7

Herpes

Question 8

____:
Cascade of gene expression
Attach to and infect adjacent cells upon release
Budding directly onto and into adjacent cells
Therefore get a local spread of virus (predominantly)
Syncytia can form

Answer 8

Herpesvirus lytic cycle

Question 9

Get changes in nuclear structure -chromatin shifted to margins of nucleus
-Cowdry type A acidophilic intranuclear inclusion bodies

Answer 9

herpes virus

Question 10

Stained cells infected with a herpes virus show _____ formation (multinucleated cells)(= Tzanck cells from Tzanck smear (scraping from the base of the lesion) and _______ bodies (darkly staining nuclear region).

Answer 10

syncytia formation; intranuclear inclusion

Question 11

Anti-herpesvirus antibodies play _____ role in recovery from primary disease and on recurrent disease

Answer 11

minor

Question 12

anti-herpes virus antibodies can help prevent ______

VZV vaccine is effective

Answer 12

primary disease

Question 13

Cell-mediated immune mechanisms play the _____ role in recovery

Answer 13

major

Question 14

MHC class I and II proteins displaying viral antigens on surface of infected cell activate T lymphocytes directly kill the infected cell or secrete cytokines and chemokines to attract macrophages, etc.
Cell-mediated immune response varies with age neonates: problems with HSVs; elderly: problems with VZV

Answer 14

CMI herpes virus immune response

Question 15

HSV-1, HSV-2, and VZV envelope glycoproteins bind ____domain of antibodies and complement components, blocking their ability to promote an antiviral response.

Answer 15

Fc domain

Question 16

____ proteins reduce type I interferon production and its downstream signaling pathway

Answer 16

HSV proteins

Question 17

_____ proteins can prevent MHC class I and II proteins from being expressed on the surface of infected cells

Answer 17

HSV proteins

Question 18

____ results in no expression of viral proteins and therefore no peptides for MHC proteins to display

Answer 18

Latency

Question 19

_____: disease facial or genital herpes, stomatitis, or keratitisl ocalizied

Answer 19

Acute herpes

Question 20

Exposure of skin, mucosa, or cornea to secretions containing virus
Replication of virus in epithelial cells, causing vesicular mucocutaneous lesions, stomatitis, or keratitis
Spread to peripheral sensory or autonomic nerve endings and ganglia

Answer 20

Acute herpes

Question 21

____: acquired very early in life (e.g. kissing)2/3 of adults are Ab+

Answer 21

HSV-1

Question 22

____: mostly transmitted by genital contact uncommon before adolescence1/5 of adults are Ab+

Answer 22

HSV-2

Question 23

Are HSV-1 or 2 infections symptomatic or asymptomatic?

Answer 23

Asymptomatic

Question 24

Healing of lesions and establishment of latent infections in neurons

Answer 24

2. Recovery

Question 25

Maintenance of latent infections in neurons

Answer 25

3. Latency

Question 26

______: cold sores, fever blisters, keratitis, or genital lesions localized -Reactivation of latent virus and distal spreadRecurrent lesions caused by virus replication in epithelial cells

Answer 26

4. Recurrent disease

Question 27

``` ______ of various herpesviruses can be induced by: Local trauma (surgery or nerve pressure) Mental tension Fatigue Menstruation Exposure to bright light Aging effects ```

Answer 27

reactivation

Question 28

Ocular herpes is which HSV?

Answer 28

1

Question 29

Oral herpes is mainly which HSV?

Answer 29

1

Question 30

Genital herpes is mainly HSV?

Answer 30

2

Question 31

____ is an infection of the eye related to herpes and can lead to scarring/blindness

Answer 31

Herpes keratitis

Question 32

______; vesicles on oral mucosa, the tongue, and gingivae confused with acute necrotizing ulcerative gingivitis (ANUG) when gingivae inflamed

Answer 32

Primary infection by HSV-1 or HSV-2

Question 33

_____: -reactivation of latent HSV-1 or HSV-2

Answer 33

Herpes labialis (cold sore)

Question 34

_____ causes chicken pox and shingles

Answer 34

VZV

Question 35

Aerosol transmission Local viral replication in respiratory tract Virus progresses to phagocytic cells via the bloodstream and lymphatic system Secondary viremia spreads the virus throughout the body, including the skin occurs 11-13 days post infection skin lesions appear over the entire body systemic spread is different from herpes simplex viruses Virus spreads cell-to-cell like HSVs except epithelial cells of lung keratinocytes and skins lesions, which can release virus

Answer 35

VZV

Question 36

_____ replication is similar to HSVs but slower [smallest genome of HHVs (~125,000 bp)] also establishes latent infection of neurons dorsal root ganglia or cranial nerve ganglia

Answer 36

VZV

Question 37

_____ reactivated in older adults with impaired cell-mediated immunity virus is released along the entire neural pathway to infect the skin causes a vesicular rash along the entire dermatome = herpes zoster or shingles postherpetic neuralgia in 30% of older patients pain for months to years after zoster

Answer 37

VZV

Question 38

______ is area of skin innervated by fibers from a single dorsal root spinal nerve

Answer 38

Dermatome

Question 39

Anti-VZV antibodies play ____ role in recovery from primary disease and on recurrent disease

Answer 39

minor

Question 40

Cell-mediated immune mechanisms play the _____ role in recovery as for HSVs

Answer 40

major

Question 41

)infects B lymphocytes and epithelial cells

Answer 41

Epstein-Barr virus (EBV; HHV-4

Question 42

infects a wide variety of cells

Answer 42

Cytomegalovirus (CMV; HHV-5)

Question 43

____ and _____ replication within host cells is very similar to general description of herpesvirus replication given previously

Answer 43

EBV and CMV

Question 44

Establishment of _____ persistent/chronic infection

Answer 44

CMV

Question 45

Establishment of _____ latent infection latent infection in memory B cells virus proteins produced during latency promote B cell proliferation

Answer 45

EBV

Question 46

``` ____and _____ infections are very common 95% of adults in developing world 50-60% of adults in United States usually asymptomatic when acquired early ```

Answer 46

CMV and EBV

Question 47

breast milk not a important route of virus spread | Symptomatic infections when acquired after childhood: infectious mononucleosis

Answer 47

EBV

Question 48

most common viral infection of the fetus in humans leads to severe disease and permanent neurological damage, including hearing loss and learning disabilities

Answer 48

Congenital CMV

Question 49

_______ is seen in: Hodgkin disease, African Burkitt lymphoma, and nasopharyngeal carcinoma

Answer 49

EBV:

Question 50

large inclusions in tissue specimens (“owl eye”inclusions)

Answer 50

CMV

Question 51

- PCR - heterophile antibody or “monospot” test - infection induces production of large number of antibodies that recognize RBC antigens of other species (“heterophile antibodies”) - Monospot test: agglutination of horse RBCs by heterophile antibody in patient’s serum

Answer 51

EBV

Question 52

_____ virus: congenital infection and mononucleosis

Answer 52

CMV

Question 53

____ virus:mononucleosis

Answer 53

EBV

Question 54

______: roseola

Answer 54

HV-6 and 7

Question 55

trigeminal nerve affected in 15% of cases Ophthalmic > maxillary > mandibular divisions involved (lesions) oral pain often precedes rash and mimics toothache pain most common intraoral sites affected: anterior half of tongue soft palate cheek

Answer 55

Shingles (VZV)

Question 56

-infectious mononucleosis painful sore throat at onset of infection rash may be present at junction of hard and soft palates (fine petechial hemorrhages) White pseudomembrane may develop on tonsils and other parts of oral mucosa

Answer 56

Epstein-Barr virus (EBV)

Question 57

_______ and _____ are present in majority of advanced periodontal lesions

Answer 57

Epstein-Barr virus(EBV) and cytomegalovirus (CMV)

Question 58

Possible roles for herpesviruses in ________: 1. Viruses may cause direct cytopathic effects 2. Gingival viruses may promote bacterial attachment/colonization 3. CMV and EBV can infect monocytes, macrophages, and lymphocytes in lesions and impair cell function. 4. Viruses induce a proinflammatory response that can result in tissue destruction. 5. Viruses can suppress host defenses locally and systemically

Answer 58

periodontal disease