Viral Infections of Oral Cavity and GI

Question 1

What type of virus is CMV?

Answer 1

Herpesvirus, dsDNA, enveloped

Question 2

What is the leading cause of congenital infections in the world?

Answer 2

CMV

Question 3

What long term consequences can CMV cause when it is a congenital infection?

Answer 3

Hearing loss, visual deficits and cognitive delays

Question 4

When is CMV frequently acquired?

Answer 4

Late childhood and early adulthood and rarely causes symptoms

Question 5

What type of cells can CMV infect?

Answer 5

Epithelial, endothelial, fibroblasts, myeloid

Question 6

After infection, CMV may remain ______ within lymphoid cells

Answer 6

latent

Question 7

How is CMV transmitted?

Answer 7

Via saliva, urine, blood, sexual contact, breast milk, organ transplants

Question 8

Why are organ transplant patients susceptible to HCMV?

Answer 8

They are given drugs that suppress the immune system to prevent organ rejection

Question 9

Is CMV infection usually asymptomatic or symptomatic?

Answer 9

Asymptomatic

Question 10

Life long CMV latency is established in __________ following infection

Answer 10

lymphocytes

Question 11

CMV is shed in _______ for months or years after an active infection ends

Answer 11

saliva

Question 12

CMV is a ubiquitous virus spread by

Answer 12

contact with infected body fluids especially saliva and urine

Question 13

If a women becomes infected with CMV while pregnant, what can happen?

Answer 13

Virus can damage the placenta trophoblast or fetus resulting in birth defects and or reduced birth weight

Question 14

Only about 1 our of 10 infants congenitally infected with CMV have the following symptoms:

Answer 14

• Inflammation of the retina
• Jaundice
• Large spleen and lvier
• Low birth weight
• Mineral deposits in the brain
• Rash at birth
• Seizures
• Small head size

Question 15

How does congenital cytomegalovirus occur?

Answer 15

When infected mother passes CMV to fetus through the placenta

Question 16

What is a common microscopic appearance of CMV?

Answer 16

Owls eye

Question 17

What is an oral manifestation of CMV?

Answer 17

Ulcers

Question 18

There is no cure for CMV, but what medications are commonly given?

Answer 18

Antivirals such as Ganciclovir and Valganciclovir

Question 19

Where do hepatitis viruses replicate?

Answer 19

In hepatocytes and Kupffer cells in liver

Question 20

What is the clinical presentation of all forms of acute hepatitis?

Answer 20

• Jaundice
• Fever, weight loss and fatigue
• Dark urine
• Hepatosplenomegaly
• Nausea, vomiting, abdominal pain

Question 21

HBV or HCV associated cirrhosis and ascites can result in

Answer 21

hepatocellular carcinoma

Question 22

What is the most common vaccine preventable disease?

Answer 22

Hep A

Question 23

What type of virus is Hep A?

Answer 23

Naked RNA virus, related to enteroviruses

Question 24

Describe growing Hep A in cell culture

Answer 24

Its dificult to grow

Question 25

How is Hep A transmitted?

Answer 25

- Close contact - Contaminated food and water - Blood exposure (rare)

Question 26

Acute infection of Hep A is diagnosed by the detection of what?

Answer 26

HAV_IgM in serum

Question 27

Past infection of Hep A is determined by the detection of what?

Answer 27

HAV-IgG

Question 28

Describe direct detection of Hep A

Answer 28

EM, RT-PCR of feces. Can detect illness earlier than serology but rarely performed

Question 29

ATL is a liver enzyme indicative of what if detected in the blood?

Answer 29

Liver damage

Question 30

Describe levels of ALT in Hep A infection

Answer 30

Dramatically increase in infected individuals, then after weeks, goes back down to normal

Question 31

Transaminases are enzymes that catalyze the transfer of

Answer 31

alpha-amino groups from amino acids to alpha-keto acids

Question 32

The HAV vaccine or hyper immune globulin is for who?

Answer 32

- Travelers - Parents adopting children from abroad - Countries with high endemic HAV - High risk communities

Question 33

Hep B is caused by what type of virus?

Answer 33

Hepatnavirus, DNA

Question 34

Incubation of Hep B is how long?

Answer 34

1-6 months

Question 35

What are most common causes of Hep B?

Answer 35

- Transmission through use of used needles - Sexual transmission - Vertical transmission

Question 36

90% of cases in children of Hep B become

Answer 36

chronic

Question 37

Hep B causes increased risk of what?

Answer 37

Liver cancer

Question 38

What is HBcAg

Answer 38

nucleocapsidcore protein that resides within hepatocytes and resembles virion

Question 39

What is HBeAg?

Answer 39

Nucleocapsidcore and pre core protein, is a marker of high (active) infectivity

Question 40

What is HBsAg?

Answer 40

Non-infective envelope glycoprotein, a marker of current infection

Question 41

Describe the Hep B vaccine

Answer 41

purified, inactivated and aluminum adsorbed prep derived from Human plasma of HBsAg asymptomatic carriers

Question 42

When do infants get Hep B vaccine?

Answer 42

1st at birth, complete series at 6-18 months

Question 43

Birth dose of hep B vaccine is an important part of

Answer 43

preventing long term illness in infants and the spread of hep B in the US

Question 44

What type of virus is Hep C caused by?

Answer 44

Flavivirus- RNA

Question 45

What is the incubation period for Hep C?

Answer 45

2-6 months

Question 46

How is Hep C transmitted?

Answer 46

- Injection drug users - Sexual

Question 47

Hep C significantly increases the risk of what?

Answer 47

Cirrhosis and cancer

Question 48

Is there a vaccine for Hep C?

Answer 48

No

Question 49

There are 6 HCV genotypes, what are the most prevelant and problematic in the USA?

Answer 49

Type 1a and 1b

Question 50

What are symptoms associated with HCV infection?

Answer 50

Vomiting, nausea, loss of appetite, diarrhea, fatigue, pale stools, dark colored urine, jaundice or yellowing of skin, pain on right side of abdomen, rash

Question 51

What is the most common extrahepatic manifestation of HCV infection?

Answer 51

Cryoglobulinemia vasculitis

Question 52

Cryoglobulinemic vasculitis is a form of inflammation affecting the blood vessels caused by the deposition of abnormal

Answer 52

proteins called cryoglobulins in the blood vessels. It affects skin and may cause rash with detectable circulating cryoglobulin proteins

Question 53

Hep D is caused by what type of virus?

Answer 53

Deltavirus RNA

Question 54

Hep D needs the _________

Answer 54

HBV envelope

Question 55

Hep D is transmitted how?

Answer 55

Percutaneously thru skin, scaring, piercing, and tattooing

Question 56

Hep D is an incomplete virus that requires the

Answer 56

helper function of HBV to replicate

Question 57

HBV vaccine can also protect against

Answer 57

HDV

Question 58

What type of virus is Hep E caused by?

Answer 58

Calicivirus-RNA

Question 59

Hep E course is similar to what?

Answer 59

HAV

Question 60

Hep E is most dangerous in

Answer 60

pregnant women

Question 61

What is the most common cause of Hep E?

Answer 61

Contaminated water

Question 62

What are main sy,ptoms of enteric viral infections?

Answer 62

Diarrhea, nausea, vomiting, fever, malaise and abdominal pain

Question 63

What is the most common cause of gastroenteritis in children?

Answer 63

Rotavirus

Question 64

Why is rotavirus less common in adults?

Answer 64

Due to acquired immunity

Question 65

Is there a vaccine for rotavirus?

Answer 65

Yes (RotaTeq and Rotarix)

Question 66

What is the most common cause of gastroenteritis among adults in America?

Answer 66

Norovirus

Question 67

What are risk factors for norovirus?

Answer 67

Close contact/gatherings such as cruises, hospitals or resturaunts