Virals Flashcards by tcarlso 3

What is HSV I associated with?

Oral cold sores

How well did you know this?

Not at all

Perfectly

What does HSV 2 cause?

Genital herpes

How well did you know this?

Not at all

Perfectly

What is the herpes virus that causes Kaposi’s sarcoma?

HSV-8

How well did you know this?

Not at all

Perfectly

True or false: EBV is a herpes virus

True

How well did you know this?

Not at all

Perfectly

True or false: CMV is a herpes virus

True

How well did you know this?

Not at all

Perfectly

What is the genetic makeup of herpesviridae viruses?

dsDNA

How well did you know this?

Not at all

Perfectly

Where do herpes viruses become latent?

Ganglions of sensory or autonomic nerves

How well did you know this?

Not at all

Perfectly

What is the route of transmission for herpes viruses?

Exposure to virus at the skin or mucus membranes

How well did you know this?

Not at all

Perfectly

What is the mechanism of transport for herpes viruses into and out of the ganglion?

intra axonal transport

How well did you know this?

Not at all

Perfectly

Which more commonly reactivates: HSV-1 or HSV-2?

HSV1

How well did you know this?

Not at all

Perfectly

True or false: transmission of herpes can only occur when there is an outbreak of vesicular lesions

False-viral shedding periods as well

How well did you know this?

Not at all

Perfectly

What is the protein that does anterograde transport out of the neuron? Retrograde?

Anterograde = kinesin
Retrograde = dynein

How well did you know this?

Not at all

Perfectly

True or false: HSV-1 and HSV-2 can cause lesions at any site

True

How well did you know this?

Not at all

Perfectly

Are primary or secondary s/sx of HSV more symptomatic?

Primary

How well did you know this?

Not at all

Perfectly

How long do primary HSV lesions usually last for?

10-14 days (or longer)

How well did you know this?

Not at all

Perfectly

What are the prodromal ssx of HSV reactivation? How long do these recurrences last for?

pain, burning, tingling, and pruritus

3 days-ish

How well did you know this?

Not at all

Perfectly

What are the oro-facial ssx that can present with HSV-1 infections, besides herpes labialis?

Gingivostomatitis
Eczema herpeticum
erythema multiforme

How well did you know this?

Not at all

Perfectly

What are the s/sx that are associated with primary HSV-2 infections, besides the vesicular lesions of the genitalia?

Fever
HA
Malaise
myalgias

How well did you know this?

Not at all

Perfectly

What are the s/sx of HSV proctitis?

Anorectal pain, discharge and tenesmus

How well did you know this?

Not at all

Perfectly

Does HSV-1 or HSV-2 cause herpetic whitlow?

Both

How well did you know this?

Not at all

Perfectly

What is Herpetic gladiatorum?

Herpes infection of the forearm, usually 2/2 wrestling

How well did you know this?

Not at all

Perfectly

Why is herpetic eye infections an emergency?

Threaten sight

How well did you know this?

Not at all

Perfectly

What are the strains of HSV that can cause necrotizing retinitis?

HSV or VZV

How well did you know this?

Not at all

Perfectly

What is herpes simplex encephalitis?

Aseptic encephalitis caused by HSV–emergency

How well did you know this?

Not at all

Perfectly

What are the CT findings of herpes encephalitis?

Temporal lobe enhancement

What is Mollaret syndrome?

Occasionally recurrent meningitis associated with reactivation of HSV

What is the survival rate of a pt who presents with HSV encephalitis with a GCS of less than 6?

Nearly 0%

Which has a worse prognosis: HSV encephalitis or meningitis?

Encephalitis

What are the s/sx of transverse myelitis caused by herpes?

Sacral-autonomic dysfunction

What cranial nerve can often be affected with HSV?

CN V (bell's palsy)

What are the common visceral infections of HSV?

- Esophagitis | - Tracheitis

What immunocompromised patients are particularly susceptible to HSV recurrences?

Hematological malignancies, especially if on CD20 inhibitors (B cell lymphomas/leukemias)

How do you diagnose HSV infections?

Clinical picture + PCR or culture

What are the drugs that are used to treat herpes infections?

Acyclovir Foscarnet Ganciclovir

What is the MOA of acyclovir? HOw is this administered?

COnverted by thymidylate kinase, to then inhibit DNA polymerases PO administration

What is the MOA of foscarnet? HOw is this administered?

a structural mimic of the anion pyrophosphate that selectively inhibits the pyrophosphate binding site[citation needed on viral DNA polymerases at concentrations that do not affect human DNA polymerases. IV administration

What is the MOA of ganciclovir?

synthetic analogue of 2′-deoxy-guanosine. It is first phosphorylated to ganciclovir monophosphate by a viral kinase encoded by CMV. This goes on to inhibit dGTP incorporation into DNA via DNA polymerases

What is the main MOA of resistance of HSV to acyclovir?

Lack of thymidine kinase

What is the major side effect of foscarnet?

Marrow suppression

What are the topical agents used for HSV eye infections?

Idoxuridine Trifluridine Vidarabine

True or false: VZV infections in adults is usually more severe than in children

true

When is VZV no longer contagious?

When the vesicles have crusted over

What is the characteristic of VZV lesions that is pathognomonic?

Vesicles are in all different stages

What is the incubation period for VSV?

10-21 days

What is the main complication of VZV infection?

Coinfection with staph or strep

Can VZV cause encephalitis?

Yes

What is the most common visceral involvement of VZV?

Pneumonia

What is the mortality rate of VZV pneumonia that requires ventilation?

50%

What are the risk factors for VZV pneumonia?

Smoking Pregnant Immunosuppression

What is the treatment for VZV?

Acyclovir, but need higher doses than other HSV infections

What is the difference of using acyclovir for VZV than for other HSV infections?

Need a higher dose sooner, since VZV is less susceptible to the drug

Is it okay to give the varicella vaccine to immunocompromised patients?

Is the VZV vaccine good for post-exposure prophylaxis?

Yes

What are the spinal segments that are commonly associated with VZV reactivation?

T3-L3

What is the major ophthalmic concern with VZV reactivation?

Herpes zoster ophthalmicus or retinal necrosis

What is Ramsey-Hunt syndrome?

facial paralysis and hearing loss 2/2 VZV reactivation

How do you diagnose zoster?

PCR, but tzanck smear too

When should treatment for zoster be initiated? Why?

Within 72 hours--only affects the incidence of postherpetic neuralgia

Do steroids affect the outcome of zoster?

Nah

What is the most common presentation of EBV infection?

Subclinical viral infection--not usually mono

How is EBV unlike other VZV infections?

Transforms its host cells--does not have a cytopathic effect

True or false: asymptomatic shedding of EBV is common

True

What are the classic s/sx of EBV? (4)

Fever LAD Exudative pharyngitis Splenomegaly

What is the incidence of a rash in EBV infected patients if they are given Ampicillin?

90-100%

How long does EBV usually last?

3 weeks

What virus can cause or predispose to Guillain-Barre syndrome?

EBV

What is the cause of BUrkitt's lymphoma?

EBV

What are the malignancies that EBV can cause?

- Lymphoproliferative disorders - Nasopharyngeal CA - T-cell lymphoma

How do you diagnose EBV infections? (3)

- Heterophile abs - IgG or IgM - PCR

What is the treatment for EBV?

- Supportive - Avoid contact sports - Acyclovir iff active infection

How is CMV transmitted?

Sexual | Transplants

What are the classic histological characteristics of CMV infections?

Owl-eyed cells (large cells)

What are the s/sx of CMV mononucleosis?

Exudative pharyngitis and cervical LAD

What is the most common pathogen that complicates transplants?

CMV

Who is prophylaxis for CMV given to?

Immunocompromised hosts

How do you diagnose CMV infections?

PCR

What are the histological characteristics of CMV infections?

Intranuclear inclusions

What is the treatment for CMV?

Ganciclovir/valganciclovir Foscarnet

Virals Flashcards

(78 cards)