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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

Where does VZV lie dormant?

DRG
CN ganglia