Flashcards in L74 Deck (53)
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1
What receptor confines the tropism of EBV?
CR2 receptor
2
Which tissues and cells does EBV infect?
B lymphocytes
Mouth & nose epithelium
Also an STI b/c in vaginal secretions from the cervical epi, but weird b/c no CR2Rs here
3
Can EBV have a lytic stage of infection?
Yes
In B cells & epithelium
4
Can EBV have a latent stage of infection?
Yes
More common in B cells
5
What genetic element allows EBV to become latent?
Episome
6
What is the worst case scenario of an EBV infection?
CANCER
7
What cancers are EBV associated?
B cell lymphoma - Burkitt
Nasopharyngeal carcinoma
Post transplant lympho-proliferative disorder (PTLPD)
Maybe other T & B lymphomas (Hodgkin's)
8
Most common EBV disease in normal people.
Mono - aggultinin + !!
9
EBV transmission
Saliva
Blood product
Transplant
STI
10
How do you know staph vs EBV pharyngitis?
Present in clinic
Probably going to give penicillin (ampicillin)
EBV gets a RASH --> doesn't get better
11
Which arm of the immune system is most important in controlling EBV latent infection?
T cells
12
What is a cue that a pt is EBV infected during the acute phase?
See atypical lymphocytes on peripheral blood smear
13
Describe the Ab response to EBV in terms of symptom progression.
1. Before symptoms: IgM/IgG vs E antigens
2. Symptomatic: IgM Abs that agglutinate!!!
3. Resolving: Abs vs EBNA
14
What is EBNA?
Epstein Barr nuclear antigen
See Abs vs these - know infection is resolving
15
What is a neurologic disorder you might see with EBV in normal pts?
Guillain Barre - ascending paralysis
16
If an AIDs negative IC pt presents with falling CD4 ct + EBV infection, which clinical disease are you thinking of?
B cell (Burkitt) lymphoma
May present w/ malaria
17
Which EBV infection is most common in HIV pts?
Hairy oral leukoplakia
18
Which EBV infection is most common in transplant pts?
Post transplant lympho proliferative disorder
19
Describe the progression of PTLD.
Early = benign growth that respond to anti-virals
Late = malignant growths
20
How does PTLD present on histo?
HISTO: multi-nucleated giant cells
21
Diagnose EBV
1. PCR for EBV DNA
2. Immunocytochem for EBV proteins
22
EBV prophylaxis
Acyclovir
Gancyclovir (valgan)
23
Treat EBV mono
Supportive
Severe: steroids - prevent spleen damage
24
Can you treat EBV cancers with anti-virals?
No you dummy
That's why you don't what to progress this far - need chemo
25
Treat PTLD
Non-specific immunoglobulin
IFNa
Chemo
Rituximab (anti-CD20)
26
Name the 2 big diseases caused by VZV.
Chicken pox
Shingles
27
What does the chicken pox rash look like?
Infects EPI cells - duh, why its a rash!
Blistering rash
May also be pustular
At all different levels of progression
28
Why does it matter that VZV is neurotropic?
Reactivate (Shingles) = painful lesions
29
When in the disease does the chicken pox rash occur?
2nd!
Infection
1. Prodrome viremia = 9-13 days post-infection
2. Rash on face/scalp first, then trunk = 10-20 days post-infect
30
