Herpes Viruses Flashcards Preview

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Flashcards in Herpes Viruses Deck (27):
1

What is the structure of the herpes virus?

enveloped
dsDNA
linear

2

What are the herpes viruses?

HHV1/HSV1-Oral herpes
HHV2/HSV2-Genital Herpes
VZV
EBV
CMV
HHV6/7
HHV8-Kaposi's Sarcoma
HHVECHKO

3

What are some things that can be caused by HSV1? treatment?

cold sores
temporal lobe encephalitis
keratoconjunctivitis
gingivostomatitis

acyclovir or valacyclovir

4

Where does HSV1 lie dormant?

sensory neurons, trigeminal ganglion

5

What does HSV2 cause? treatment?

genital and some oral lesions
get multiple painful vesicles
acyclovir or valacyclovir

6

What is the transmission of HSV2?

sexual contact
birth vaginal
or in utero if primary infection

**lies dormant in sacral nerve root ganglion

7

What does HHV3 cause?

VZV
primary: chickenpox-transmitted via resp secretions
secondary shingles. single dermatome, does not cross midline, transmitted via direct contact

8

What is the treatment for VZV? Where does it lie dormant?

lies dormant in sacral nerve root ganglion

treatment: famicyclovir

9

What's the deal with EBV?

mono
increased risk for lymphomas, nasopharyngeal carcinoma, oral hairy leukoplakia
**infects B cells via CD21

10

What is the usual presentation of EBV?

fever, HSM, pharyngitis (looks like strep, exudative), LAD, esp posterior cervical nodes

11

What is the important histo feature of EBV?

atypical lymphocytes (T cells)-->Downy cells: foamy w/ basophilic cytoplasm

12

How do you test for Mono?

monospot test, checks for heterophils antibodies to RBCs of sheep, horse, beef

13

If mono is misdiagnosed as strep throat, what could happen?

given amoxicillin for strep throat
get maculopapular rash
think allergic to pencillins when NOT

14

With heterophile - mono, what could it be?

CMV
HIV
Acute toxoplasmosis
viral hepatitis
strep throat

15

How is CMV passed on?

congenitally (TORCH)
sexual contact
saliva, breast milk, urine
transplant

16

What does CMV do in patients who have received bone marrow transplants?
IN patients with AIDS?

bone marrow transplants: life-threatening pneumonia
AIDS: retinitis, GI ulcers, Candida esophagitis (won't respond to antifungals)

17

What is the histo feature w/ CMV?

Owl eye inclusion

18

Where does CMV remain latent?

in mononuclear and polymorphonuclear cells

19

What's the deal with HHV6/7 infections?

Produce Roseola (6th disease)
high fevers
then diffuse macular rash
febrile seizures possible

20

What's the deal with HHV8 infection?

Kaposi's sarcoma
neoplasm of endothelial cells, spindle cells lining lymphatic and vascular vessels
classic: slow growing
HIV type
immunocompromised, transplant patients
dark/violaceous plaques or nodules

**treat w/ HAART, alitretinoin, vinblastine, daunorubicin, doxorubicin

21

Kaposi's can also affect which things?

lungs-hemoptysis
GI tract

22

What is the tzanck smear?

multinucleated giant cells: HSV1, HSV2, VZV

23

What are the intranuclear inclusions you see w/ HSV?

Intranuclear Eosinophilic Inclusions
Type A Cowdry Bodies
Type 1 Cowdry Inclusions

24

Describe acyclovir and valacyclovir?

guanosine analog
it is activated inside HSV/VZV thymidine kinase
inhibits viral DNA pol

25

What does famiciclovir?

used for VZV preferentially, also guanosine analog and is activated by thymidine kinase

26

Ganciclovir?

guanosine analog
activated by CMV viral kinase
inhibits viral DNA pol

SE: bone marrow suppression and renal toxicity

**Treats CMV infections

27

Foscarnet?

doesn't need to be activated
DNApol inhibitor AND HIV reverse transcriptase inhibitor

**good for resistant bugs

**can cause nephrototoxicity, anemia