Coronaviridae are a family of ______-sense ______ viruses.
Coronaviridae are a family of positive-sense RNA viruses.
Coronaviruses _________ (are/are not) enveloped and are ________ (helical/icosahedral/complex).
Coronaviruses are enveloped and are helical.
Name a few viruses that can cause the common cold:
_______viruses
_______viruses
RSV
Parainfluenza viruses
Adenoviruses
Name a few viruses that can cause the common cold:
Rhinoviruses
Coronaviruses
RSV
Parainfluenza viruses
Adenoviruses
__________ can cause upper respiratory infections that can lead to SARS or MERS (and even acute respiratory failure).
Coronaviruses can cause upper respiratory infections that can lead to SARS or MERS (and even acute respiratory failure).
Human immunodeficiency virus (HIV) is a ________-sense ______ virus in the ______viridae family.
Human immunodeficiency virus (HIV) is a positive-sense RNA virus in the _Retro_viridae family.
Is HIV enveloped?
Yes.
HIV is a ___ploid virus; each HIV virion is composed of ____ copy(ies) of positive-sense RNA.
HIV is a diploid virus; each HIV virion is composed of 2 copies of positive-sense RNA.
The ____ gene of HIV encodes the p24 protein (thousands of p24 protein products comprise the conical ______ of HIV).
The gag gene of HIV encodes the p24protein (thousands ofp24protein products comprise the conical capsid of HIV).
The gag gene of HIV encodes the ____ protein (thousands of ____ protein products comprise the conical ______ of HIV).
The gag gene of HIV encodes the p24** protein (thousands of **p24 protein products comprise the conical capsid of HIV).
The ____ gene of HIV encodes the gp41 and gp120 ________ proteins.
The env gene of HIV encodes the gp41 and gp120 envelope proteins.
The env gene of HIV encodes the ______ and ______ envelope proteins.
The env gene of HIV encodes the gp41 and gp120 envelope proteins.
The ____ gene of HIV encodes a reverse transcriptase (an ____-dependent ____ polymerase), which converts RNA to DNA.
The pol gene of HIV encodes a reverse transcriptase (an RNA-dependent DNA polymerase), which converts RNA to DNA.
The pol gene of HIV encodes a _______ _______, which converts _____ to _____.
The pol gene of HIV encodes a reverse transcriptase (an RNA-dependent DNA polymerase), which converts RNA to DNA.
HIV initially infects what cell type in particular?
It later infects what cell type in particular?
Macrophages;
CD4+ T cells
In general HIV infects what category of cells?
Reticuloepithelial cells
(e.g. macrophages, CD4+ T cells, dendritic cells, microglia, etc.)
Acute HIV infection (or HIV prodrome) frequently presents with _____- or _____-like symptoms such as cervical lymphadenopathy and pharyngitis.
Acute HIV infection (or HIV prodrome) frequently presents with flu- or mono-like symptoms such as fever, cervical lymphadenopathy, and pharyngitis.
What are some of the generic S/Sy associated with acute HIV infection (or HIV prodrome)?
Fever, cervical lymphadenopathy, and pharyngitis
(flu- or mono-like symptoms)
HIV undergoes a clinical latent period (or incubation period or chronic period) that can last up to how long?
10 years
A CD4+ count 3) is the diagnostic marker of AIDS.
A CD4+ count <200 (per mm3) is the diagnostic marker of AIDS.
Patients with HIV are at a higher risk of some lymphoid malignancies, such as what?
Diffuse large B cell lymphoma
In early stages of infection, HIV gains entry into host cells via the _____ receptor.
In early stages of infection, HIV gains entry into host cells via the CCR5 receptor.
In later stages of infection, HIV gains entry into host cells via the _____ receptor.
In later stages of infection, HIV gains entry into host cells via the CXCR4 receptor.
In ______ stages of infection, HIV gains entry into host cells via the CXCR4 receptor.
In later stages of infection, HIV gains entry into host cells via the CXCR4 receptor.
In _____ stages of infection, HIV gains entry into host cells via the CCR5 receptor.
In early stages of infection, HIV gains entry into host cells via the CCR5 receptor.
What test detects the presence of anti-HIV antibodies?
(used to screen for HIV)
Enzyme-linked immunosorbent assay (ELISA)
A _______ _______ (which detects the ____ antigen) is done to confirm HIV infection in patients who tested positive on an ELISA screening test.
A western blot (which detects the p24 antigen) is done to confirm HIV infection in patients who tested positive on an ELISA screening test.
What test is used to screen for HIV by detecting antibodies?
What test is used as a confirmatory test by detecting p24 antigen?
ELISA
western blot
Western blotting is used as a confirmatory test for HIV by detecting what?
ELISA is used to screen for HIV by detecting what?
p24 antigen
anti-HIV antibodies
_________ 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).
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).
What medication should be administered to pregnant HIV patients to reduce the risk of transmitting HIV to the fetus?
Zidovudine
What is the general mechanism of action of NRTIs and NNRTIs in treating HIV infection?
Blocking reverse transcriptase
(nucleoside and non-nucleoside analogs that get incorporated into the DNA chain, thus disrupting elongation)
True/False.
NRTIs and NNRTIs are integrase inhibitors.
False.
NRTIs and NNRTIs are reverse transcriptase inhibitors
Protease inhibitors block _________ of HIV by binding proteases and preventing cleavage of proteins that are vital for what?
Protease inhibitors block replication of HIV by binding proteases and preventing cleavage of proteins that are vital for producing infectious forms of the virus.
What medication type blocks the CCR5 host cell membrane protein, preventing HIV from fusing with the host cell?
Maraviroc
Maraviroc blocks the _______ host cell membrane protein, preventing HIV from ______ the host cell.
Maraviroc blocks the CCR5 host cell membrane protein, preventing HIV from fusing with the host cell.
Ebolavirus and Marburgvirus belong to what family of RNA viruses?
Filoviridae
Filoviruses (i.e. Ebolavirus, Marburgvirus) are __________-sense _____ viruses.
Filoviruses (i.e. Ebolavirus, Marburgvirus) are negative-sense RNA viruses.
The capsids of filoviruses (i.e. Ebolavirus, Marburgvirus) are __________.
The capsids of filoviruses (i.e. Ebolavirus, Marburgvirus) are helical.
Are filoviruses enveloped?
Yes.
Marburg virus and Ebola virus infections may present with ________ ________ and ________.
Marburg virus and Ebola virus infections may present with petechial rash and fever.
Severe cases of Marburg virus and Ebola virus can cause ___________ _______.
Severe cases of Marburg virus and Ebola virus can cause hemorrhagic fever.
Hemorrhagic fever caused by Marburg virus or Ebola virus can result in widespread ___________, _________, and end-______ failure.
Hemorrhagic fever caused by Marburg virus or Ebola virus can result in widespread bleeding, shock, and end-organ failure.
Marburg virus and Ebola virus are likely transmitted via _________, with _________ as a reservoir.
Marburg virus and Ebola virus are likely transmitted via primates, with bats as a reservoir.
Among U.S. citizens, what population is most at-risk for infection with Marburg virus or Ebola virus?
Healthcare workers who care for infected patients
Arenaviridae (e.g. lymphocytic choriomeningitis virus) are ______ viruses.
Arenaviridae (e.g. lymphocytic choriomeningitis virus) are RNA viruses.
Are arenaviruses (i.e. lymphocytic choriomeningitis virus) negative-sense RNA viruses?
Sort of, they are ambi-sense.
They are classified as negative-sense, but they also harbor sections of positive-sense RNA.
True/False.
Arenaviruses (i.e. lymphocytic choriomeningitis virus) are naked.
False.
Arenaviruses (i.e. lymphocytic choriomeningitis virus) are enveloped.
True/False.
Arenaviruses (i.e. lymphocytic choriomeningitis virus) possess both positive and negative-sense RNA sections, making them ambisense.
True.
What shape is the capsid making up arenaviruses?
Helical
The arenavirus genome is __________ and contains _____ RNA segments.
The arenavirus genome is segmented and contains two RNA segments.
How do arenaviruses (i.e. lymphocytic choriomeningitis virus) appear when visualized by electron microscopy?
‘Grainy’
What is the reservoir for arenaviruses (i.e. lymphocytic choriomeningitis virus)?
Rodents
What is the most relevant virus of Arenaviridae to know?
Lymphocytic choriomeningitis virus
Lymphocytic choriomeningitis virus infection may lead to aseptic _______________itis, manifesting with fever.
Lymphocytic choriomeningitis virus infection may lead to aseptic meningoencephalitis, manifesting with fever.
Arenaviruses can be inactivated by ______ and ______.
Arenaviruses can be inactivated by heat and irradiation (e.g. light).
The Epstein-Barr virus is a ____ virus in the _______viridae family.
The Epstein-Barr virus is a DNA virus in the _herpes_viridae family.
Epstein-Barr virus is primarily transmitted through what?
Saliva
________ + painful lymphadenopathy in the ________ ________ region + splenomegaly + pharyngitis are some of the classic features of Epstein-Barr virus-induced mononucleosis.
Fever + painful lymphadenopathy in the posterior cervical region + splenomegaly + pharyngitis are some of the classic features of Epstein-Barr virus-induced mononucleosis.
Fever + __________ __________ in the posterior cervical region + __________ + pharyngitis are some of the classic features of Epstein-Barr virus-induced mononucleosis.
Fever + painful lymphadenopathy in the posterior cervical region + splenomegaly + pharyngitis are some of the classic features of Epstein-Barr virus-induced mononucleosis.
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).
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).
Epstein-Barr virus remains latent in what cell type?
B cells
To initiate infection, the Epstein-Barr virus envelope glycoprotein binds to the _____ membrane protein of _____ cells.
To initiate infection, the Epstein-Barr virus envelope glycoprotein binds to the CD21 membrane protein of B cells.
The four basic S/Sy of EBV mononucleosis are:
The four basic S/Sy of EBV mononucleosis are:
Fever
Pharyngitis
Painful lymphadenopathy (posterior cervical)
Splenomegaly
Pharyngitis with production of _________ _________ is a common feature of Epstein-Barr virus-induced mononucleosis.
pharyngitis with production of tonsillar exudate is a common feature of Epstein-Barr virus-induced mononucleosis.
Patients with Epstein-Barr virus infections who are mistakenly treated with ________ or ________ (due to suspicion of streptococcal pharyngitis) can develop a maculopapular rash.
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.
Patients with Epstein-Barr virus infections who are mistakenly treated with penicillin or amoxicillin (due to suspicion of streptococcal pharyngitis) can develop what?
A maculopapular rash
EBV is associated with what malignancies?
B cell malignancies
(Hodgkin’s + non-Hodgkin’s + Burkitt lymphomas)
EBV is associated with what B cell malignancies?
Hodgkin’s,
non-Hodgkin’s,
and Burkitt lymphomas
EBV infection may be associated with the development of Hodgkin’s lymphoma, which is characterized by what characteristic cells?
Reed-Sternberg cells
(classically described as having an “owl eye” appearance)
EBV is associated with which form of Burkitt lymphoma?
African (or endemic) Burkitt lymphoma
(often presents with a large jaw lesion and/or jaw swelling)
EBV is associated with a higher risk for development of __________ carcinoma, which is more commonly seen in patients with Asian ancestry.
EBV is associated with a higher risk for development of nasopharyngeal carcinoma, which is more commonly seen in patients with Asian ancestry.
Epstein-Barr virus is associated with a higher risk for development of what oral lesion that occurs most commonly in HIV patients?
Hairy leukoplakia
What can be used to rapidly diagnose acute Epstein-Barr virus infection?
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)
How does the monospot test identify acute cases of EBV?
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.
Patients with what viral infection should avoid contact sports due to risk of splenic rupture?
Infectious mononucleosis
Patients with what viral infection should avoid contact sports due to risk of what?
Splenic rupture
What test is more expensive than ELISA or Western blot for HIV, but is more accurate?
NAAT
True/False
Individuals infected with HIV should be started on ART as soon as possible.
True.
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
Low SES
What is the best method of determining a patient’s adherence to HIV ART?
Monitoring viral load
HIV is at an untransmissable level when the viral load is at what level?
< 200 copies / mL
What medication is the most commonly used pre-exposure prophylaxis for HIV infection?
PrEP
Tenofovir/emtricitabine
(Truvada)
What is the difference between the medication give for HIV pre-exposure prophylaxis (PrEP) and HIV post-exposure prophylaxis (PEP)?
No difference
What percentage of HIV cases are made up of homo- or bisexual men?
50%
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
2. Blood product transfusion
(higher direct viral load transmission as viral load is highest in the blood)
Which HIV protein binds CCR5 on macrophage surfaces?
gp 120
Which HIV protein is responsible for HIV penetration through the host lipid bilayer?
gp 41
What part(s) of the HIV virion actually make it into the cell?
The RNA
(+ enzymes?)
What are the phases of HIV infection?
- Acute (initial infection)
- Chronic (latent period)
- Crisis
Homozygous mutation of what protein can lead to immunity to HIV infection?
CCR5
How can HIV lead to increased likelihood of lymphoproliferative diseases?
Decreased T cell immunosurveillance
Non-hodgkin’s B cell lymphomas resulting from HIV infection are most often associated with translocations involving what chromosome?
8
What two neoplasias are most associated with HHV-8 infection?
Kaposi sarcoma;
primary effusion lymphoma