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Flashcards in Micro Viruses Deck (123):
1

Reassortment
What is it?
What does it lead to?
Danger?
Example

Viruses with segmented genomes exchange segments
High frequency re-combination
Worldwide pandemics
Influenza virus

2

Complementation

1 of 2 viruses that infects a cell has a mutation that results in a nonfunctional protein. The non-mutated virus complements the mutated one by making a functional protein that serves both viruses

3

Phenotypic mixing

Simultaneous infection --> Genome of virus A partially or completely coated in surface protein from virus B

4

Live attenuated vaccines
What does it induce?
Risk
Names

Humoral and cell-mediated immunty
Reversion to virulence (rare)
"Live! one night only! see Small Yellow Chickens get vaccinated with Sabin's and MMR! It's INcredible"
Smallpox, Yellow fever, Chickenpox (VZV), Sabin's Polio, MMR, Influenza (intranasal)

5

Can MMR be given to HIV pts?

Even though its a live attenuated vaccine, it can be given to HIV pts if they don't show signs of immunodeficiency

6

Killed Vaccines
What does it induce?
Names

Only humoral response
"SalK = Killed. RIP Always"
Rabies, Influenza (injected), Salk Polio, HAV

7

Recombinant vaccines

HBV (Ag = recombinant HBsAg)
HPV (6, 11, 16, 18)

8

dsDNA viruses

All DNA viruses except Parvoviridae

9

ssDNA viruses

Parvoviridae (Parvovirus)
"Part-of-a-virus" has less DNA"

10

Circular DNA viruses

Papilloma and Polyoma (circular supercoiled), and Hepadnaviruses (circular, incomplete)

11

Linear DNA viruses

All DNA viruses except for Papilloma, Polyoma, and Hepadnaviruses

12

ssRNA viruses

All RNA viruses except for Reoviridae

13

dsRNA viruses

Reoviridae
"REpeatO virus is redundant with 2 strands"

14

+ssRNA viruses

"I went to a Retro Toga party where i drank Flavored Coronas and ate Hippy California Pickles"
Retrovirus, Togavirus, Flavivirus Corona virus, Hepevirus, Calicivirus, Picornavirus

15

Naked viral genome infectivity

Infectious: dsDNA viruses (except Poxvirus and HBV), and +ssRNA (like mRNA) viruses
Non-infectious: -ssRNA and dsRNA. Require polymerase contained in complete virion

16

Virus ploidy

All viruses are haploid except retrovirus which has 2 identical ssRNA molecules

17

Where do viruses replicate?

All DNA viruses replicate in the nucleus except poxvirus
All RNA viruses replicate in the cytoplasm except influenza and retroviruses

18

Non-enveloped viruses
Names
Where is envelope from?

"give PAP smears and CPR to Naked HEPpy"
DNA = PAPP, RNA = CRP and HEP
Papillomavirus, Adenovirus, Parvovirus, Polyomavirus, Calcivirus, Picornavirus, Reovirus, Hepevirus
Usually from cell membrane except for Herpes, which gets it from nuclear membrane

19

DNA viruses names

"HHAPPPPy"
Hepadna, Herpes, Adeno, Pox, Parvo, Papilloma, Polyoma

20

Icosahedral DNA viruses?

All except Pox (complex)

21

DNA viruses that replicate in the nucleus?

All except Pox (carries its own DNA dependent RNA pol)

22

Herpesviruses
Nucleic acid? Envelope?
Names

dsDNA, Linear. Enveloped
HSV1, HSV2, VZV (HHV3), EBV (4), CMV (5), HHV6, HHV7, HHV8

23

Hepadnavirus
Nucleic acid? Envelope?
Names w/ disease
Vaccine
Transcription

dsDNA, partially circular. Enveloped
HBV: acute or chronic hepatitis
Vaccine available. Contains HBV surface Ag
Not a retrovirus but has a reverse transcriptase

24

Adenovirus
Nucleic acid? Envelope?
Diseases

dsDNA, Linear. Not enveloped
Febrile pharyngitis (sore throat, acute hemorrhagic cystitis), Pneumonia, Conjunctivitis (pink eye)

25

Parvovirus
Nucleic acid? Envelope?
Names with diseases

-ssDNA, Linear. Not enveloped
B19: aplastic crisis in sickle cell disease, Erythema infectionsum (5th disease, slapped cheek), RBC destruction in fetus --> hydrops fetalis and death, Pure RBC aplasia and RA-like symptoms in adults

26

Papillomavirus
Nucleic acid? Envelope?
Names with diseases
Vaccine

dsDNA, Circular. Not enveloped
HPV 1,2,6,11: warts
Cervical intraepithelial neoplasia (CIN)
Cervical cancer (16, 18)
Vaccine for 16 and 18

27

Polyomavirus
Nucleic acid? Envelope?
Names with diseases and Findings

dsDNA, Circular. Not enveloped
JC: progressive multifocal leukoencephalopathy (PML) in HIV pt
MBP present in CSF
BK: Transplant pt, commonly targets kidneys
"JC = Junky Cerebrum. BK = Bad Kidney"

28

Poxvirus
Nucleic acid? Envelope?
Diseases

dsDNA, Linear. Enveloped
Smallpox, Vaccina (cowpox - milkmaid's blisters)
Molluscum contagiosum: flesh colored dome lesions with central dimple

29

HSV1
Nucleic acid? Envelope?
Diseases caused by it?
Latency?
Transmission?

dsDNA, Linear. Enveloped
Oral (and some genital lesions), Gingivostomatitis, Keratoconjunctivitis, Temporal lobe encephalitis (most common cause of sporadic encephalitis in the US), Herpes Labialis
Latent in V ganglia
Respiratory secretions, Saliva

30

HSV2
Nucleic acid? Envelope?
Diseases caused by it?
Latency?
Transmission?

dsDNA, Linear. Enveloped
Genital (and some oral lesions), Herpes genitalis, Neonatal herpes
Latent in Sacral ganglia
Sexual contact, Perinatal

31

VZV
Name
Nucleic acid? Envelope?
Diseases caused by it?
Latency?
Vaccine?
Transmission?

HHV3
dsDNA, Linear. Enveloped
Varicella-Zoster (chickenpox and shingles), Encephalitis, Pneumonia
Latent in DRG or Trigeminal Ganglia
Vaccine available
Respiratory secretions

32

EBV
Name
Nucleic acid? Envelope?
What does it infect?
Diseases caused by it?
Latency?
Transmission?

HHV4
dsDNA, Linear. Enveloped
Infectious mononucleosis, Burkitt's Lymphoma, Hodgkin's Lymphoma, Nasopharyngeal carcinoma
Infects B cells
Latent in B cells
Respiratory secretions, Saliva

33

CMV
Name
Nucleic acid? Envelope?
Diseases caused by it?
Who gets infected?
Histo
Latency?
Transmission?

HHV5
dsDNA, Linear. Enveloped
Congenital infection, Mononucleosis (negative Monospot), Pneumonia, Retinitis
Immunosuppressed and Transplant pts
Owl's eye inclusions
Latent in mononuclear cells
Congenital, Transfusion, Sexual contact, Saliva, Urine, Transplant

34

HHV6
Nucleic acid? Envelope?
Diseases caused by it with presentation?
Transmission
Related virus?

dsDNA, Linear. Enveloped
Roseola (exanthem subitum): high fevers for several days that can cause seizures, followed by diffuse macular rash
Undetermined transmission
HHV7 a less common cause of Roseola

35

HHV8
Nucleic acid? Envelope?
Diseases caused by it?
Who gets it?
Transmission

dsDNA, Linear. Enveloped
Kaposi sarcoma in HIV pt
Sexual contact

36

HSV identification

PCR is test of choice
Tzaneck test: smear of an open skin vesicle to detect multinucleated giant cells commonly seen in HSV1, HSV2, VZV
Infected cells also have intra-nuclear Cowdry A inclusions

37

Mononucleosis
Caused by...
Presentation
Peak incidence?
Histo
Diagnosis

EBV infecting B cells
Fever, HSM, Pharyngitis, and Lymphadenopathy (esp posterior cervical nodes)
15-20 years of age
Atypical lymphocytes seen on peripheral blood smear are not infected B cells, they are reactive Tc cells
+Monospot test

38

Monospot Test
What is it?
Positive test equals...

Heterophile Abs detected by agglutination of sheep or horse RBCs
Mononucleosis, Hodgkin's lymphoma, Endemic Burkitt's lymphoma, Nasopharyngeal carcinoma

39

Reovirus
Nucleic acid? Envelope? Segments
Caspid
Diseases

dsRNA, Linear, Not enveloped, 10-12 segments
Icosahedral (double)
Coltivirus: Colorado tick fever. Arbovirus transmitted by arthropods (mosquitoes and ticks)
Rotavirus: #1 cause of fatal diarrhea in children

40

Picornaviruses
Nucleic acid? Envelope? Segments
Caspid
Diseases
Replication process
Transmission

+ssRNA, Linear, Not enveloped, Non-segmented
Icosahedral
"PERCH"
Polio, Echovirus (aseptic meningitis), Rhinovirus (common cold), Coxsackievirus [aseptic meningitis, herpangina (mouth blisters, fever), hand-foot-and-mouth disease, myocarditis], HAV
All cause aseptic (viral) meningitis except rhinovirus and HAV
RNA is translated into 1 large polypeptide that is cleaved by proteases into functional viral proteins
All are enteroviruses (fecal-oral spread) except Rhinoviruses

41

Hepevirus
Nucleic acid? Envelope? Segments
Caspid
Diseases

+ssRNA, Linear, Not enveloped, Non-segmented
Icosahedral
HEV

42

Caliciviruses
Nucleic acid? Envelope? Segments
Caspid
Diseases

+ssRNA, Linear, Not enveloped, Non-segmented
Icosahedral
Norovirus: viral gastroenteritis

43

Flaviviruses
Nucleic acid? Envelope? Segments
Caspid
Diseases

+ssRNA, Linear, Enveloped, Non-segmented
Icosahedral
"CYD went from STL to the Nile"
HCV, Yellow fever, Dengue, St Louis encephalitis, West Nile Virus.
All except HCV are Arbovirus: transmitted by arthropods (mosquitoes and ticks)

44

Togaviruses
Nucleic acid? Envelope? Segments
Caspid
Diseases

+ssRNA, Linear, Enveloped, Non-segmented
Icosahedral
Rubella
Eastern/Western Equine Encephalitis (Arbovirus: transmitted by arthropods (mosquitoes and ticks))

45

Retrovirus
Nucleic acid? Envelope?
Caspid
Special capability
Diseases

+ssRNA, Linear, Enveloped
Icosahedral (HTLV), Complex and Conical (HIV)
Reverse transcriptase
HTLV: T cell leukemia, HIV: AIDS

46

Coronaviruses
Nucleic acid? Envelope? Segments
Caspid
Diseases

+ssRNA, Linear, Enveloped, Non-segmented
Helical
Common cold and SARS

47

Orthomyxoviruses
Nucleic acid? Envelope? Segments
Caspid
Diseases

-ssRNA, Linear, Enveloped, 8 segments
Helical
Influenza virus

48

Paramyxoviruses
Nucleic acid? Envelope? Segments
Caspid
Diseases
Markers
Treatment

-ssRNA, Linear, Enveloped, Non-segments
Helical
Causes disease in children "PaRaMysovirus"
Parainfluenza (croup: seal-like barking cough), RSV (bronchiolitis in babies, treat with Ribavirin), Measles, Mumps
Surface F (fusion) protein causes respiratory epithelial cells to fuse and form multi-nucleated cells
Palivizumab (monoclonal Ab against F protein) prevents pneumonia caused by RSV infection in premature infants

49

Rhabdoviruses
Nucleic acid? Envelope? Segments
Caspid
Diseases

-ssRNA, Linear, Enveloped, Non-segments
Helical
Rabies

50

Filoviruses
Nucleic acid? Envelope? Segments
Caspid
Diseases

-ssRNA, Linear, Enveloped, Non-segments
Helical
Ebola/Marburg hemorrhagic fever
Often fatal

51

Arenaviruses
Nucleic acid? Envelope? Segments
Caspid
Diseases
Transmission

-ssRNA, Circular, Enveloped, 2 segments
Helical
LCMV: Lymphocytic Choriomeningitis Virus
Lassa fever encephalitis
Spread by mice

52

Bunyaviruses
Nucleic acid? Envelope? Segments
Caspid
Diseases
Transmission

-ssRNA, Circular, Enveloped, 3 segments
Helical
California encephalitis, Sandfly/Rift Valley fevers, Crimean-Congo hemorrhagic fever
Hantavirus (hemorrhagic fever, pneumonia)
All but Hantavirus are Arbovirus: transmitted by arthropods (mosquitoes and ticks)

53

Delta Virus
Nucleic acid? Envelope? Segments
Caspid
Diseases

-ssRNA, Circular, Enveloped, Non-segmented
Uncertain symmetry
HDV is a defective virus that requires HBV co-infection

54

Negative-Stranded Viruses
Replication process
What special proteins does it have?
Names

Transcribe neg strand to +
Brings its own RNA-dependent RNApol
"Always Bring Polymerase Or Die Failing Replication"
Arenavirus, Bunyavirus, Paramyxovirus, Orthomyxovirus, Delta virus, Filoviruses, Rhabdoviruses

55

Segmented Viruses

All are RNA viruses
"BOAR"
Bunyaviruses, Orthomyxoviruses (influenza), Arenaviruses, Reoviruses

56

Rhinovirus
Kind of virus
Diseases it causes?
Types
Route of infection

Picornavirus
Causes common cold
Over 100 serologic types
Acid labile - destroyed by stomach acid

57

Yellow Fever Virus
Kind of Virus
Transmission
Reservoir
Presentation

Flavivirus (also an arbovirus)
Aedes Mosquitoes
Monkey and human reservoir
High fever, black vomit, jaundice

58

Rotavirus
Kind of virus?
Diseases it causes
Context
PathoPhys
Prophylaxis

Reovirus
"ROTAvirus = Right Out The Anus"
Infantile gastroenteritis: acute diarrhea
Winter, day-care centers, kindergartens
Villous destruction with atrophy leads to ↓ absorption of Na and loss of K
CDC recommends vaccination of all infants

59

Influenza Viruses
Kind of virus
Ags
What are pts at risk for?
Evolves?
Vaccines

Orthomyxoviruses
Hemagglutinin (promotes viral entry) and Neuraminidase (promotes progeny virion release)
Pts at risk for fatal bacterial superinfection
Rapid genetic changes
Killed vaccine is a major mode of protection. Vaccine containing live, temp sensitive mutant that replicates in the nose but not in lung also available for children

60

Influenza virus
Genetic Shifts/Antigenic Shifts
Genetic Drifts

"Sudden Shifts more deadly than graDual Drift"
Shifts cause pandemics. Reassortment of viral genome; segments undergo high frequency recombination such as when human flu A virus recombines with swine flue A virus
Drift causes epidemics. Minor (antigenic drift) changes based on random mutation

61

Rubella Virus
What kind of virus
Presentation
Children vs Congenital disease?

Togovirus
Rubella (German 3 day measles): Fever, Postauricular adenopathy, Lymphadenopathy, Arthralgias, Fine Truncal rash that starts at head and moves down
Mild disease in children, Serious congenital disease (ToRCHS infection)

62

Measles
What causes it?
Presentation
Possible sequelae
Do not confuse with?

Paramyxovirus
"3Cs: Cough, Coryza, Conjunctivitis"
Koplik spots (red spots with blue-white center on buccal mucosa) and descending maculopapular rash. Presents last and spreads from head to toe including hands and feet (vs truncal rash in rubella)
SSPE (Subacute Sclerosing Panencephalitis) occuring years later, Encephalitis, Giant cell pneumonia (rarely in immunosuppressed)
Do not confuse with Roseola (HHV6)

63

Mumps
What causes it?
Presentation
Danger

Paramyxovirus
"Mumps makes your parotid glands and testes as big as POM-poms"
Parotitis, Orchitis (inflammation of testes), and aseptic Meningitis
Sterility (esp after puberty)

64

Rabies Virus
What kind of virus? Shape?
Histo? What does it infect?
Incubation
Post-exposure treatment
How does it travel?
Presentation
Transmission

Rhabdoviruses. Bullet-shaped virus
Negri bodies in cytoplasm of neurons
Purkinje cells of cerebellum
Weeks to months incubation
Wound cleansing and vaccination +/- rabies immune globulin
Travels to CNS by migrating in a retrograde fashion up nerve axons
Fever, Malaise --> Agitation, Photophobia, Hydrophobia --> Paralysis, Coma --> Death
Bat, Raccoon, Skunk, Dog bites

65

HAV
Kind of virus?
Mode of transmission?
Carrier
Incubation time
HCC risk
Symptoms
Time course of infection

Picornavirus (Non-enveloped +strand RNA)
Fecal-Oral
No carrier
Short incubation (weeks)
No risk of HCC
Asymptomatic
Acute

66

HBV
Kind of virus?
Mode of transmission?
Carrier
Incubation time
HCC risk

Hepadnavirus (Enveloped dsDNA)
Parenteral, Sexual, Vertical
Has Carriers
Long incubation (months)
Integrates into host genome and acts as oncogene

67

HCV
Kind of virus?
Mode of transmission?
Carrier
Incubation time
HCC risk
Course of infection
What can it cause?

Flavivirus (Enveloped +sRNA)
Primarily blood, IVDU, Post-transfusion
Has Carriers
Long incubation
HCC risk from chronic inflammation
Chronic course
Cirrhosis, Carcinoma

68

HDV
Kind of virus?
Mode of transmission?
Carrier
Incubation time
HCC risk
Can it infect alone?
Prognosis

RNA delta virus (enveloped, -ssRNA)
Parenteral, Sexual, Vertical
Has carriers
Superinfection - short. D infects after B
Co-infection - long. B and D infect together
HCC risk
Defective virus and dependent on HBV
Superinfection has worsened prognosis

69

HEV
Kind of virus?
Mode of transmission?
Carrier
Incubation time
HCC risk
High mortality rate in
Mnemonic

Hepevirus (Non-enveloped +ssRNA)
Fecal-Oral especially with water-born epidemics
No carriers
Short intubation
No risk for HCC
High mortality rates in pregnant women
Enteric, Expectant, Epidemics

70

Signs and Symptoms of all Hepatitis viruses

Fever, jaundice, elevated ALT/AST

71

Viral reproduction of HBV

B uses its own DNA dependent DNA pol to make full dsDNA
Uses host RNA pol to make mRNA

72

Anti HAV (IgM)
Best to detect?

IgM Ab to HAV
Best test to detect HAV

73

Anti HAV (IgG)
What does it indicate?
What does it do?

IgG Ab indicates prior HAV infection and/or vaccination
Protects against re-infection

74

HBsAg

Surface antigen indicates Hep B infection

75

Anti HBs
What does it indicate

Ab to HBsAg
Indicates immunity to HepB

76

HBcAg

Antigen associated with core HBV

77

Anti HBc
IgM
IgG
Positive during...

Ab to ABcAg
IgM = acute or recent infection
IgG = prior exposure or chronic infection
Positive during window period

78

HBeAg
What is it?
What does it indicate?

A second, different antigenic determinant in the HBV core
Indicates viral replication and therefore high transmissibility

79

Anti HBe
What is it?
What does it indicate

Antibody to HBeAg
Indicates low transmissibility

80

Labs in Acute HBV
HBsAg
Anti HBs
HBeAg
Anti HBe
Anti HBc

HBsAg +
Anti HBs -
HBeAg +
Anti HBe -
Anti HBc IgM

81

Labs in Window HBV
HBsAg
Anti HBs
HBeAg
Anti HBe
Anti HBc

HBsAg -
Anti HBs -
HBeAg -
Anti HBe +
Anti HBc IgM

82

Labs in Chronic HBV (high infectivity)
HBsAg
Anti HBs
HBeAg
Anti HBe
Anti HBc

HBsAg +
Anti HBs -
HBeAg +
Anti HBe -
Anti HBc IgG

83

Labs in Chronic HBV (low infectivity)
HBsAg
Anti HBs
HBeAg
Anti HBe
Anti HBc

HBsAg +
Anti HBs -
HBeAg -
Anti HBe +
Anti HBc IgG

84

Labs in Recovery HBV
HBsAg
Anti HBs
HBeAg
Anti HBe
Anti HBc

HBsAg -
Anti HBs +
HBeAg -
Anti HBe +
Anti HBc IgG

85

Labs in Immunized HBV
HBsAg
Anti HBs
HBeAg
Anti HBe
Anti HBc

HBsAg -
Anti HBs +
HBeAg -
Anti HBe -
Anti HBc -

86

Sequence of events in HBV infection

SECES
HBsAg, HBeAg, AntiHBc, AntiHBe, AntiHBs

87

Which Hepatitis viruses can cause acute infection?

A,B,C,D,E

88

Which hepatitis viruses can cause chronic infection?

B, C, D

89

HBV Treatment

Interferons (alpha and pagylated)
Lamivudine, Adefovir, Entecavir, telbivudine (Nucleoside Analogs --/ HBV DNApol)

90

HIV
Nucleic acid? Enveloped? Segments?
Structural genes

+ssRNA, Linear, Enveloped. Diploid (2 molecules of RNA)
env: gp120 and gp41 formed from cleavage of gp160 to form envelope proteins
gp120 stuck on top of gp41 and attaches to host CD4 T cell. gp41 is transmembrane and mediates fusion and entry
gag (p24): caspid protein
pol: Reverse transcriptase, aspartate protease, integrase

91

HIV Pathogenesis
Immunity

ssRNA --> dsDNA --> integrates into host genome
Virus binds CCR5 (early) or CXCR4 (late) co-receptor and CD4 on T cell
Binds CCR5 and CD4 on macrophages
CCR5 homozygous mutation = immunity

92

How are envelope proteins acquired by the HIV virus?

Acquired through budding from host cell plasma membrane

93

HIV virus inside to outside

RNA + reverse transcriptase --> caspid protein p24 --> Matrix protein p17 --> Lipid membrane --> gp41 goes through membrane and gp120 on top of it

94

HIV diagnosis
When are they falsely negative
When are they falsely +

Presumptive Dx made with ELISA for antiHIV Abs (sensitive with high false positive rule out with low threshold)
+ results are confirmed with Western blot assay for AntiHIV Abs (specific, high false negative rate, rule in with high threshold)
Falsely negative in first 1-2 months after infection
Falsely + in babies born to infected mothers (anti gp120 crosses placenta)

95

HIV monitoring

PCR/viral load determines amount of viral RNA in the plasma
High viral load associated with poor prognosis
Used to monitor effects of drug therapy

96

AIDS Dx

CD4+ less than 200 (normally 500-1500)
HIV+ with AIDS-defining condition (PCP) or CD4/CD8 ratio less than 1.5

97

Couse of HIV infection

CD4 count drops then rebounds briefly (after HIV RNA copies peak) then steady decreases
HIV RNA copies peaks then drops (when CD4 count rebounds) then gradually rises

98

Stages of HIV infection

"4Fs"
1. Flu-like acute
2. Feeling fine (latent)
3. Falling count
4. Final crisis

99

What happens during latency

Virus replicates in lymph nodes

100

Common diseases of HIV+ adults

Reactivation of past infections (TB, HSV, Shingles)
Disseminated bacterial and fungal infections
Non-Hodgkin's Lymphoma

101

HIV pt w/ low-grade fever, cough, HSM, Tongue ulcer
Pathogen
Findings
CD4

Histoplasma capsulatum (causes only pulmonary symptoms in immunocompetent hosts)
Oval yeast cells w/in Macrophages
CD4 less than 100

102

HIV pt w/ Fluffy white cottage-cheese lesions
Pathogen
Findings
CD4

C albicans (thrush)
Pseudohyphae
Oral if CD4 less than 400, Esophageal if CD4 less than 100

103

HIV pt w/ Superficial vascular proliferation
Pathogen
Findings

Bartonella henselae (bacillary angiomatosis
Biopsy reveals neutrophilic inflammation

104

HIV pt w/ Chronic watery diarrhea
Pathogen
Findings
CD4

Cryptosporidium
Acid-fast cyst in stool when CD4 less than 200

105

HIV pt w/ Encephalopathy
Pathogen
Findings
CD4

JC virus reactivation (cause of PML)
Reactivation of latent virus
Results in demyelination
CD4 less than 200

106

HIV pt w/ Abscesses
Pathogen
Findings
CD4?

Toxoplasma gondii
Many ring-enhancing lesions on imaging
CD4 below 100

107

HIV pt w/ Meningitis
Pathogen
Findings
CD4?

Cryptococcus neoformans
India ink stain reveals yeast with narrow-based budding and large capsule
CD4 less than 50

108

HIV pt w/ Retinitis
Pathogen
Findings
May also occur w/...
CD4?

CMV
Cotton wool spots on funduscopic exam
May also occur with esophagitis
CD4 less than 50

109

HIV pt. w/ Dementia

Directly associated with HIV. Must differentiate from other causes

110

HIV pt w/ Superficial neoplastic proliferative vasculature
Pathogen
Do not confuse w/
Findings

HHV8 (causes Kaposi Sarcoma)
Do not confuse with bacillary angiomatosis caused by B henselae
Biopsy reveals lymphocytic inflammation

111

HIV pt w/ Hairy Leukoplakia
Pathogen
Location

EBV
Often found on lateral tongue

112

HIV pt w/ Non-Hodgkin's Lymphoma
Pathogen
Location

EBV
Often on oropharynx (Waldeyer's ring)

113

HIV pt w/ Squamous Cell Carcinoma
Pathogen
Location

HPV
Anus (men who have sex with men) or Cervix (women)

114

HIV pt w/ Primary CNS lymphoma
Pathogen
Distribution
Differentiate from

EBV
Focal or multiple
Differentiate from toxoplasmosis

115

HIV pt w/ Interstitial pneumonia
Pathogen
Findings

CMV
Biopsy reveals cells with intra-nuclear (Owl's Eye) inclusion bodies

116

HIV pt w/ Invasive aspergillosis
Pathogen
Findings

Aspergillus fumigatus
Pleuritic chest pain, Hemoptysis, Infiltrates on imaging

117

HIV pt w/ Pneumonia
Pathogen
CD4

Pneumocystis jirovecii
CD4 less than 200

118

HIV pt w/ TB-like disease
Pathogen
CD

Mycobacterium avium-intracellulare
CD4 less than 50

119

Prions
Pathology
Qualities of the protein
Presentation

Conversion of a normal cellular protein (termed prion protein PrPc) to a β-pleated form (PrPsc) which is transmissible
PrPsc resists degradation and facilitates the conversion of still more PrPc to PrPsc
Spongiform encephalopathy and dementia, ataxia, and death

120

Forms of Prion disease

Sporadic: Creutzfeldt-Jakob disease --> rapidly progressive dementia
Inherited: Gerstmann-Straussler-Scheinker Syndrome
Acquired: Kuru

121

Icosahedral RNA viruses

Reovirus and All +ssRNA viruses except Coronavirus

122

Helical RNA viruses

All -ssRNA viruses + Coronavirus

123

RNA viruses with circular genomes

"BAD"
All are -ssRNA viruses
Arenavirus, Bunyavirus, Delta virus