Flashcards in Viremia Deck (100):
What are the four major diseases that viruses that cause circulatory infections cause?
2. Birth defects
4. Cardiac dysfunction
What is the state of viral infection for mono?
Productive, but disease due to immnopathology
What is the state of viral infection for oral hairy leukoplakia?
What is the state of viral infection for Burkitt's lymphoma?
What is the state of viral infection for Hodgkin's disease?
What is the state of viral infection for nasopharyngeal carcinoma?
What is the state of viral infection for PTLD?
What are the six diseases that the epstein Barr virus can present as?
2. Oral hairy leukoplakia
3. Burkitt's lymphoma
4. Hodgkins lymphoma
5. Nasopharyngeal carcinoma
What is the family of EPV? Enveloped? Genome?
What is the component of the complement that herpes viruses use to attach and enter into cells?
What two types of cells do EPVs replicate in?
What is the pathophysiology of EBV?
Infects B cells, causes them to reproduce and create heterophile antibodies
T cells come in to kill, but not perfect. leave memory B cells
What is the first test for EBV?
Look for heterophile antibodies
What cells contribute to EBV latency?
Memory B cells
What are the genes associated in EBV carcinogenesis?
1. Latent membrane protein 1
3. EBV nuclear antigen-1
What is LMP1? What does this protein lead to?
6 transmembrane domains protein with a CD40 homologue
Leads to high proliferation
What is LMP2?
Protein that increases growth of B cells
What is EBV nuclear antigen 1
Transactivation of EBV
What is the primary mode of transmission for EBV?
What are the four major symptoms of mono?
1. Fever, malaise etc
4. TTP lymphadenitis
What is the biochemical markers for mono?
What is the epidemiology of mono ( in the US)?
What is the major complication of mono?
What is the pathogenesis of mono?
Immune targeting of the infected B cells
What is the treatment for mono?
2. Avoid splenic rupture
Ampicillin treatment of EBV causes what?
A diffuse, petechial rash
How long are symptoms present with mono?
About a month
How long do atypical lymphocytes caused by EBV last?
About a month
How long does the heterophile titer remain elevated in EBV?
About a month
When does anti-EA production start in EBV infection?
about 10 days, and continues to end of the month of infx
When does anti-VCA production start in EBV mono infection?
day 10 to forever (IgM to IgG)
When do antibodies to the EBNA start?
How do you diagnose mono?
Mono spot test looking for heterophile antibodies agglutination to sheep or horse RBC
Antibodies to EBV
What are downey cells? What are the three characteristics of these cells?
Atypical T cells found in EBV infections
1. Have vacuoles
2. Altered nucleus
3. Indented cell margin
How can we prevent mono? Is there a vaccine?
antivirals to inhibit the viral pol
Are antivirals effective in EBV?
Yes, but symptoms remain unchanged b/c of immune response
Who usually gets oral hairy leukoplakia?
What causes oral hairy leukoplakia?
What is the treatment for oral hairy leukoplakia? (2)
1. Antiherpetic drugs
2. Podophyllin resin
What is Burkitt's lymphoma caused by?
Where in the body does Burkitt's lymphoma present? Symptoms?
B cells in the Jaw of children
CA of the jaw
Where is the world is Burkitt's lymphoma found?
What causes Burkitt's lymphoma?
Myc gene on ch14 translocated to ch8, changes E2F expression
What is the pathophysiology of Burkitt's lymphoma?
Increase in E2F d/t translocation of the Myc gene
What is the treatment for Burkitt's lymphoma?
What are the two cofactors of Burkitt's lymphoma?
What is Hodgkin's disease?
EBV caused B cell disruption
What are the symptoms of Hodgkin's disease?
Nontender, lymphadenopathy in the neck and/or axilla
Fever, weight loss, night sweats
What is a Reed-sternberg cell? What is this diagnostic of?
A large cell with two or more nuclei or nuclear lobes, each of which has eosinophils
This is associated with Hodgkins' disease
What is the treatment for Hodgkin's?
Radiotherapy or chemo
What is the cause of nasopharyngeal carcinoma?
What are the symptoms of nasopharyngeal carcinoma?
What cells are affected in nasopharyngeal carcinoma?
What is the treatment for nasopharyngeal carcinoma?
What is PTLD (post transplantation lymphoproliferation disorder)?
Abnormal proliferation of lymphoid cells in a transplant pt d/t EBV
What are the symptoms of PTLD?
Fever, weight loss, progressive encephalopathy
What is the major risk factor for PTLD?
EBV infection at the time of transplant
How do you diagnose PTLD?
What is the treatment for PTLD? (3)
1. reduce immunosuppression
2. Rituximab (binds CD20)
3. Conventional chemo
What is the family of CMV? Enveloped? Genome?
Most infections with CMV lead to what?
Asymptomatic to mono-like
CMV infections with AIDs pts result in what?
Mutlisite symptomatic disease
Primary CMV infections of new mothers lead to what?
Developmental problems (cytomegalic inclusion disease)
Where does the CCMV replicate? Where is it latent?
Latet in monocytes
Reactivation of CMV is (always/rarely) symptomatic in immunocompetent pts?
How is CMV transmitted?
How do you diagnose CMV?
1. Detection of viral DNA in diseases tissue
Why is it hard to diagnose CMV?
virus can shed for year after initial infection during other infections
What is the 1st line treatment for CMV?
What is the MOA of Ganciclovir?
Converted to viral pol inhibitor by CMV enzymes
What is the MOA of valganciclovir?
Converted to ganciclovir within the body
What is the toxicity associated with Ganciclovir?
Bone marrow toxicity
What is the 2nd line treatment for CMV? Why are they second line?
2nd b/c IV, and renal toxic
What is the MOA of cidofovir?
Converted to a viral pol inhibits by cellular enzymes
What is the MOA of Foscarnet?
Direct inhibitor of the CMV pol
What is the primary disease caused by CMV
CMV mono-like illness
What are the symptoms of CMV IM-like illness?
What is the etiology of CMV IM-like illness?
Primary infection with CMV
Is there heterophile antibody production with CMV IM-like illness?
How do you differentiate between CMV IM-like illness and IM caused by EBV? (2)
EBV has exudative pharyngitis and heterophile production
CMV IM-like illness does not
When is CMV inclusion body disease found in babies? Does it cross the placenta
Most common with primary infections of mother during prego
What are the symptoms of CMV inclusion body disease in newborns?
3. Petechial rash
What is the most common congenital viral infection in the US?
CMV inclusion body disease
How does congential CMV infection occur? How often is this passed on from mothers?
Mother exposure to primary CMV virus
33% of the time passed onto child
How do you prevent CMV inclusion disease?
Prevent seronegative pregnant women from coming into contact with babies or other infected with CMV
What is the treatment for maternal treatment with CMV?
What is the most common viral pathogen complicating organ transplant?
When do AIDS patient present with CMV diseases?
between 50-100 CD4 count
What are the symptoms of CMV in immunocompromised pts?
Spiking fever, followed by hypothermia
What are the two ways that transplantation result in a CMV infection?
Reactivation d/t immunosuppression
What are the usual diseases associated with CMV transplantation? For HIV pts?
CMV penumonitis = transplant
GI tract illness = HIV, CMV retinitis
What is the complication risk in CMV transplant infection?
Perforation and hemorrhage of GI epithelium
Graft vs host disease
What are the symptoms of CMV in AIDS pts?
CMV retinitis, GI tract illnesses
What are the symptoms of CMV retinitis?
1. Blurred vision
3. White, necrotic lesions on fundoscopic exam
How do you prevent CMV in organ transplants?
Seronegative matching donors
How do you diagnose CMV retinitis?
Fundoscopic exam seeing necrotic lesions
What is the treatment for CMV in immunocompromised pts?
Prophylaxis with antivirals
What are the general characteristics of viral diseases of the systemic circulation?
Hide and lay dormant
What abx is associated with a rash if given to pts with mono?