Neoplasia/Hematology - Sketchy - Coronaviruses, HIV, Filoviruses, Arenaviruses, EBV Flashcards

1
Q

Coronaviridae are a family of ______-sense ______ viruses.

A

Coronaviridae are a family of positive-sense RNA viruses.

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2
Q

Coronaviruses _________ (are/are not) enveloped and are ________ (helical/icosahedral/complex).

A

Coronaviruses are enveloped and are helical.

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3
Q

Name a few viruses that can cause the common cold:

_______viruses

_______viruses

RSV

Parainfluenza viruses

Adenoviruses

A

Name a few viruses that can cause the common cold:

Rhinoviruses

Coronaviruses

RSV

Parainfluenza viruses

Adenoviruses

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4
Q

__________ can cause upper respiratory infections that can lead to SARS or MERS (and even acute respiratory failure).

A

Coronaviruses can cause upper respiratory infections that can lead to SARS or MERS (and even acute respiratory failure).

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5
Q

Human immunodeficiency virus (HIV) is a ________-sense ______ virus in the ______viridae family.

A

Human immunodeficiency virus (HIV) is a positive-sense RNA virus in the _Retro_viridae family.

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6
Q

Is HIV enveloped?

A

Yes.

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7
Q

HIV is a ___ploid virus; each HIV virion is composed of ____ copy(ies) of positive-sense RNA.

A

HIV is a diploid virus; each HIV virion is composed of 2 copies of positive-sense RNA.

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8
Q

The ____ gene of HIV encodes the p24 protein (thousands of p24 protein products comprise the conical ______ of HIV).

A

The gag gene of HIV encodes the p24protein (thousands ofp24protein products comprise the conical capsid of HIV).

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9
Q

The gag gene of HIV encodes the ____ protein (thousands of ____ protein products comprise the conical ______ of HIV).

A

The gag gene of HIV encodes the p24** protein (thousands of **p24 protein products comprise the conical capsid of HIV).

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10
Q

The ____ gene of HIV encodes the gp41 and gp120 ________ proteins.

A

The env gene of HIV encodes the gp41 and gp120 envelope proteins.

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11
Q

The env gene of HIV encodes the ______ and ______ envelope proteins.

A

The env gene of HIV encodes the gp41 and gp120 envelope proteins.

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12
Q

The ____ gene of HIV encodes a reverse transcriptase (an ____-dependent ____ polymerase), which converts RNA to DNA.

A

The pol gene of HIV encodes a reverse transcriptase (an RNA-dependent DNA polymerase), which converts RNA to DNA.

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13
Q

The pol gene of HIV encodes a _______ _______, which converts _____ to _____.

A

The pol gene of HIV encodes a reverse transcriptase (an RNA-dependent DNA polymerase), which converts RNA to DNA.

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14
Q

HIV initially infects what cell type in particular?

It later infects what cell type in particular?

A

Macrophages;

CD4+ T cells

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15
Q

In general HIV infects what category of cells?

A

Reticuloepithelial cells

(e.g. macrophages, CD4+ T cells, dendritic cells, microglia, etc.)

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16
Q

Acute HIV infection (or HIV prodrome) frequently presents with _____- or _____-like symptoms such as cervical lymphadenopathy and pharyngitis.

A

Acute HIV infection (or HIV prodrome) frequently presents with flu- or mono-like symptoms such as fever, cervical lymphadenopathy, and pharyngitis.

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17
Q

What are some of the generic S/Sy associated with acute HIV infection (or HIV prodrome)?

A

Fever, cervical lymphadenopathy, and pharyngitis

(flu- or mono-like symptoms)

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18
Q

HIV undergoes a clinical latent period (or incubation period or chronic period) that can last up to how long?

A

10 years

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19
Q

A CD4+ count 3) is the diagnostic marker of AIDS.

A

A CD4+ count <200 (per mm3​) is the diagnostic marker of AIDS.

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20
Q

Patients with HIV are at a higher risk of some lymphoid malignancies, such as what?

A

Diffuse large B cell lymphoma

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21
Q

In early stages of infection, HIV gains entry into host cells via the _____ receptor.

A

In early stages of infection, HIV gains entry into host cells via the CCR5 receptor.

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22
Q

In later stages of infection, HIV gains entry into host cells via the _____ receptor.

A

In later stages of infection, HIV gains entry into host cells via the CXCR4 receptor.

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23
Q

In ______ stages of infection, HIV gains entry into host cells via the CXCR4 receptor.

A

In later stages of infection, HIV gains entry into host cells via the CXCR4 receptor.

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24
Q

In _____ stages of infection, HIV gains entry into host cells via the CCR5 receptor.

A

In early stages of infection, HIV gains entry into host cells via the CCR5 receptor.

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25
Q

What test detects the presence of anti-HIV antibodies?

(used to screen for HIV)

A

Enzyme-linked immunosorbent assay (ELISA)

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26
Q

A _______ _______ (which detects the ____ antigen) is done to confirm HIV infection in patients who tested positive on an ELISA screening test.

A

A western blot (which detects the p24 antigen) is done to confirm HIV infection in patients who tested positive on an ELISA screening test.

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27
Q

What test is used to screen for HIV by detecting antibodies?

What test is used as a confirmatory test by detecting p24 antigen?

A

ELISA

western blot

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28
Q

Western blotting is used as a confirmatory test for HIV by detecting what?

ELISA is used to screen for HIV by detecting what?

A

p24 antigen

anti-HIV antibodies

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29
Q

_________ reverse transcriptase inhibitors (NRTIs) are non-functional _________ analogs that prevent the elongation of DNA molecules synthesized by HIV’s reverse transcriptase (NRTIs are incorporated into the DNA chain).

A

Nucleotide reverse transcriptase inhibitors (NRTIs) are non-functional nucleotide analogs that prevent the elongation of DNA molecules synthesized by HIV’s reverse transcriptase (NRTIs are incorporated into the DNA chain).

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30
Q

What medication should be administered to pregnant HIV patients to reduce the risk of transmitting HIV to the fetus?

A

Zidovudine

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31
Q

What is the general mechanism of action of NRTIs and NNRTIs in treating HIV infection?

A

Blocking reverse transcriptase

(nucleoside and non-nucleoside analogs that get incorporated into the DNA chain, thus disrupting elongation)

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32
Q

True/False.

NRTIs and NNRTIs are integrase inhibitors.

A

False.

NRTIs and NNRTIs are reverse transcriptase inhibitors

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33
Q

Protease inhibitors block _________ of HIV by binding proteases and preventing cleavage of proteins that are vital for what?

A

Protease inhibitors block replication of HIV by binding proteases and preventing cleavage of proteins that are vital for producing infectious forms of the virus.

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34
Q

What medication type blocks the CCR5 host cell membrane protein, preventing HIV from fusing with the host cell?

A

Maraviroc

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35
Q

Maraviroc blocks the _______ host cell membrane protein, preventing HIV from ______ the host cell.

A

Maraviroc blocks the CCR5 host cell membrane protein, preventing HIV from fusing with the host cell.

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36
Q

Ebolavirus and Marburgvirus belong to what family of RNA viruses?

A

Filoviridae

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37
Q

Filoviruses (i.e. Ebolavirus, Marburgvirus) are __________-sense _____ viruses.

A

Filoviruses (i.e. Ebolavirus, Marburgvirus) are negative-sense RNA viruses.

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38
Q

The capsids of filoviruses (i.e. Ebolavirus, Marburgvirus) are __________.

A

The capsids of filoviruses (i.e. Ebolavirus, Marburgvirus) are helical.

39
Q

Are filoviruses enveloped?

A

Yes.

40
Q

Marburg virus and Ebola virus infections may present with ________ ________ and ________.

A

Marburg virus and Ebola virus infections may present with petechial rash and fever.

41
Q

Severe cases of Marburg virus and Ebola virus can cause ___________ _______.

A

Severe cases of Marburg virus and Ebola virus can cause hemorrhagic fever.

42
Q

Hemorrhagic fever caused by Marburg virus or Ebola virus can result in widespread ___________, _________, and end-______ failure.

A

Hemorrhagic fever caused by Marburg virus or Ebola virus can result in widespread bleeding, shock, and end-organ failure.

43
Q

Marburg virus and Ebola virus are likely transmitted via _________, with _________ as a reservoir.

A

Marburg virus and Ebola virus are likely transmitted via primates, with bats as a reservoir.

44
Q

Among U.S. citizens, what population is most at-risk for infection with Marburg virus or Ebola virus?

A

Healthcare workers who care for infected patients

45
Q

Arenaviridae (e.g. lymphocytic choriomeningitis virus) are ______ viruses.

A

Arenaviridae (e.g. lymphocytic choriomeningitis virus) are RNA viruses.

46
Q

Are arenaviruses (i.e. lymphocytic choriomeningitis virus) negative-sense RNA viruses?

A

Sort of, they are ambi-sense.

They are classified as negative-sense, but they also harbor sections of positive-sense RNA.

47
Q

True/False.

Arenaviruses (i.e. lymphocytic choriomeningitis virus) are naked.

A

False.

Arenaviruses (i.e. lymphocytic choriomeningitis virus) are enveloped.

48
Q

True/False.

Arenaviruses (i.e. lymphocytic choriomeningitis virus) possess both positive and negative-sense RNA sections, making them ambisense.

A

True.

49
Q

What shape is the capsid making up arenaviruses?

A

Helical

50
Q

The arenavirus genome is __________ and contains _____ RNA segments.

A

The arenavirus genome is segmented and contains two RNA segments.

51
Q

How do arenaviruses (i.e. lymphocytic choriomeningitis virus) appear when visualized by electron microscopy?

A

‘Grainy’

52
Q

What is the reservoir for arenaviruses (i.e. lymphocytic choriomeningitis virus)?

A

Rodents

53
Q

What is the most relevant virus of Arenaviridae to know?

A

Lymphocytic choriomeningitis virus

54
Q

Lymphocytic choriomeningitis virus infection may lead to aseptic _______________itis, manifesting with fever.

A

Lymphocytic choriomeningitis virus infection may lead to aseptic meningoencephalitis, manifesting with fever.

55
Q

Arenaviruses can be inactivated by ______ and ______.

A

Arenaviruses can be inactivated by heat and irradiation (e.g. light).

56
Q

The Epstein-Barr virus is a ____ virus in the _______viridae family.

A

The Epstein-Barr virus is a DNA virus in the _herpes_viridae family.

57
Q

Epstein-Barr virus is primarily transmitted through what?

A

Saliva

58
Q

________ + painful lymphadenopathy in the ________ ________ region + splenomegaly + pharyngitis are some of the classic features of Epstein-Barr virus-induced mononucleosis.

A

Fever + painful lymphadenopathy in the posterior cervical region + splenomegaly + pharyngitis are some of the classic features of Epstein-Barr virus-induced mononucleosis.

59
Q

Fever + __________ __________ in the posterior cervical region + __________ + pharyngitis are some of the classic features of Epstein-Barr virus-induced mononucleosis.

A

Fever + painful lymphadenopathy in the posterior cervical region + splenomegaly + pharyngitis are some of the classic features of Epstein-Barr virus-induced mononucleosis.

60
Q

Epstein-Barr virus infection causes peripheral lymphocytosis and the presence of atypical lymphocytes (abnormally large reactive CD___+ T-cells with abundant cytoplasm) and _________ cells (atypical lymphocytes with strongly basophilic cytoplasm pathognomonic of EBV infection).

A

Epstein-Barr virus infection causes peripheral lymphocytosis and the presence of atypical lymphocytes (abnormally large reactive CD8+ T-cells with abundant cytoplasm) and Downey cells (atypical lymphocytes with strongly basophilic cytoplasm pathognomonic of EBV infection).

61
Q

Epstein-Barr virus remains latent in what cell type?

A

B cells

62
Q

To initiate infection, the Epstein-Barr virus envelope glycoprotein binds to the _____ membrane protein of _____ cells.

A

To initiate infection, the Epstein-Barr virus envelope glycoprotein binds to the CD21 membrane protein of B cells.

63
Q

The four basic S/Sy of EBV mononucleosis are:

A

The four basic S/Sy of EBV mononucleosis are:

Fever

Pharyngitis

Painful lymphadenopathy (posterior cervical)

Splenomegaly

64
Q

Pharyngitis with production of _________ _________ is a common feature of Epstein-Barr virus-induced mononucleosis.

A

pharyngitis with production of tonsillar exudate is a common feature of Epstein-Barr virus-induced mononucleosis.

65
Q

Patients with Epstein-Barr virus infections who are mistakenly treated with ________ or ________ (due to suspicion of streptococcal pharyngitis) can develop a maculopapular rash.

A

patients with Epstein-Barr virus infections who are mistakenly treated with penicillin or amoxicillin (due to suspicion of streptococcal pharyngitis) can develop a maculopapular rash.

66
Q

Patients with Epstein-Barr virus infections who are mistakenly treated with penicillin or amoxicillin (due to suspicion of streptococcal pharyngitis) can develop what?

A

A maculopapular rash

67
Q

EBV is associated with what malignancies?

A

B cell malignancies

(Hodgkin’s + non-Hodgkin’s + Burkitt lymphomas)

68
Q

EBV is associated with what B cell malignancies?

A

Hodgkin’s,

non-Hodgkin’s,

and Burkitt lymphomas

69
Q

EBV infection may be associated with the development of Hodgkin’s lymphoma, which is characterized by what characteristic cells?

A

Reed-Sternberg cells

(classically described as having an “owl eye” appearance)

70
Q

EBV is associated with which form of Burkitt lymphoma?

A

African (or endemic) Burkitt lymphoma

(often presents with a large jaw lesion and/or jaw swelling)

71
Q

EBV is associated with a higher risk for development of __________ carcinoma, which is more commonly seen in patients with Asian ancestry.

A

EBV is associated with a higher risk for development of nasopharyngeal carcinoma, which is more commonly seen in patients with Asian ancestry.

72
Q

Epstein-Barr virus is associated with a higher risk for development of what oral lesion that occurs most commonly in HIV patients?

A

Hairy leukoplakia

73
Q

What can be used to rapidly diagnose acute Epstein-Barr virus infection?

A

The monospot test

(utilizes horse or sheep RBCs, which will agglutinate when mixed with patient serum due to production of anti-horse/sheep blood IgM antibodies induced by the presence of Epstein-Barr virus)

74
Q

How does the monospot test identify acute cases of EBV?

A

It utilizes horse or sheep RBCs, which will agglutinate when mixed with patient serum due to production of anti-horse/sheep blood IgM antibodies induced by the presence of Epstein-Barr virus.

75
Q

Patients with what viral infection should avoid contact sports due to risk of splenic rupture?

A

Infectious mononucleosis

76
Q

Patients with what viral infection should avoid contact sports due to risk of what?

A

Splenic rupture

77
Q

What test is more expensive than ELISA or Western blot for HIV, but is more accurate?

A

NAAT

78
Q

True/False

Individuals infected with HIV should be started on ART as soon as possible.

A

True.

79
Q

All of the following are risk factors for poor ART adherence except:

Low SES

Active EtOH abuse

Depression

Poor patient education by MD

Low literacy

Pill burden

A

Low SES

80
Q

What is the best method of determining a patient’s adherence to HIV ART?

A

Monitoring viral load

81
Q

HIV is at an untransmissable level when the viral load is at what level?

A

< 200 copies / mL

82
Q

What medication is the most commonly used pre-exposure prophylaxis for HIV infection?

PrEP

A

Tenofovir/emtricitabine

(Truvada)

83
Q

What is the difference between the medication give for HIV pre-exposure prophylaxis (PrEP) and HIV post-exposure prophylaxis (PEP)?

A

No difference

84
Q

What percentage of HIV cases are made up of homo- or bisexual men?

A

50%

85
Q

Which of the following has the highest rate of HIV transmission?

(I.e. infected fluids/tissues from which of the following is most likely to lead to seroconversion?)

1. Anal intercourse

2. Blood product transfusion

3. Kidney transplant

4. Transplacental transmission

A

2. Blood product transfusion

(higher direct viral load transmission as viral load is highest in the blood)

86
Q

Which HIV protein binds CCR5 on macrophage surfaces?

A

gp 120

87
Q

Which HIV protein is responsible for HIV penetration through the host lipid bilayer?

A

gp 41

88
Q

What part(s) of the HIV virion actually make it into the cell?

A

The RNA

(+ enzymes?)

89
Q

What are the phases of HIV infection?

A
  1. Acute (initial infection)
  2. Chronic (latent period)
  3. Crisis
90
Q

Homozygous mutation of what protein can lead to immunity to HIV infection?

A

CCR5

91
Q

How can HIV lead to increased likelihood of lymphoproliferative diseases?

A

Decreased T cell immunosurveillance

92
Q

Non-hodgkin’s B cell lymphomas resulting from HIV infection are most often associated with translocations involving what chromosome?

A

8

93
Q

What two neoplasias are most associated with HHV-8 infection?

A

Kaposi sarcoma;

primary effusion lymphoma