Virology7

Question 1

Herpesviridae 
genome:
Spectrum of infections:
Host range:
Type of infection:
Reactivation:
High risk patients:
Shape of capsid:
Envelope
Presence on site of lesion

Answer 1

DNA (linear ds)
Wide
From narrow(EBV) to wide
Persistent latent infection (viral latency)
Periodic
Elderly and immunosuppressed
Icosahedral
Present
Not present lama ykun saheh

Question 2

T or F

Herpes viruses don’t have tegument

Answer 2

False

Question 3

T or F

HSV 1 and 2 have 70% homology

Answer 3

False

50%

Question 4

Terminal and internal repeats are involved in ——-

Answer 4

Gene rearrangement

Question 5

T or F

In general herpes viruses resemble each other

Answer 5

False

Question 6

We know which virus it is from —— which is adding endonucleases and then ——-

Answer 6

Finger printing

Migrating fragments on southern

Question 7

In the latent phase the DNA takes a —— shape

Answer 7

Circular

Question 8

Replication of herpes viruses:

Answer 8

Adsorption (the virus sticks to GAGs like heparan sulfate)
The capsid enters the cell
The DNA is thrown thru the nuclear pore (uncoating)
The DNA becomes circular
Bser mtl l episome
Tegument protein initiates the replication:
Immediate early : alpha proteins
Early: beta
Late: gamma (structural)
Cellular RNA pol II
MicRNA regulates the expression (latency)

Question 9

HSV1 and 2 can cause :

1-
2-
3-
4-

Answer 9

Skin infections (burning,tingling—) macules then small bumps then vesicles then ulcer (vesiculo ulcerative lesions)
Mucosal
Encephalitis
Conjunctivitis

Question 10

Herpes viruses hide in ——— in HSv1 and in —— in HSV2
They are homologous by —–

Answer 10

Dorsal ganglia of trigeminal nerve
Dorsal ganglie of sacral plexus
50% (fhemna)

Question 11

HSV I is mainly transmitted thru—-
HSV 2 transmitted thru——
The reverse is (possible/not)—

Answer 11

Saliva (orall) (1 tongue)
Genitally (2 genitals)
Possible

Question 12

T or F

We should screen for HSV 2/1

Answer 12

False

And antibody is useless laanu 3/4 l aalam already exposed

Question 13

T or F

Antibody test should be done for detection of HSV 1

Answer 13

False
80-90% has been exposed to HSV1
Common epitopes between 1 and 2

Question 14

T or F

Herpes viruses are cytolytic

Answer 14

True

Question 15

T or F

We can differentiate clinically between HSV and varicella

Answer 15

False both cause painfull vesiculo ulcerative lesions

Question 16

Site of primary infections should be either —– or —— , (can/can’t)—– transmitt the virus if he is asymptomatic.

Answer 16

Mucosal surfaces or breached skin

Can

Question 17

Primary infection is (more/less) ——- severe than reinfection amd that’s because of ——-

Answer 17

More

Immune system

Question 18

Cowdry type A are (intracutoplasmic/intranuclear)——- bodies present after infection with ——– while type B are present in——

Answer 18

Intranuclear
Varicella zoster
HSV

CMV

Question 19

Primary infection(rarely/often)-----can cause meningitis and encephalitis, by which it's (mild/severe)----- and can leave ------- resulting in -----
Primary infection in an intact skin (will/less likely happen)------ the most common case is transmission by----

Answer 19

Rarely
Mild
Sequela
Hear loss
Less likely
Mucosal
Breached skin

Question 20

Immunocompromised patients infected with HSV can suffer from ——- after——

Answer 20

Ulcers and vesicles on the esophagus

Viremia

Question 21

Reactivation can be caused by :

Answer 21

Uv rays
Stress
Menstruation

Question 22

The most seen for of herpes is —— presented by small vesicles on lips (with/without) —— crusting

Answer 22

Cold sore

With

Question 23

IP for HSV

Answer 23

Few days to 3 weeks

Question 24

Symptoms of HSV1 mainly

Answer 24

Fever sore throat (prodrome)
Vesicular ulcerative lesions 
Gingivitis mainly in children
Adults : pharyngitis and tonsilitis
Keratoconjuctivitis : will heal unless we have ulcers on the cornea(corneal ulcers) and lens that will lead to blindness

Question 25

Strep A can be accompanied with -------,------ and ------ viruses

Answer 25

EBV CMV HSV

Question 26

``` Genital herpes Mainly caused by ------ Painful for----- Site of infection: Spread to--- Could cause--- ```

Answer 26

``` HSV 2 3 weeks Genitals or perineum and thighs LNs enlargement Aseptic meningitis in primary infection ```

Question 27

T or F | Herpes can cause secondary bacterial infections because of ulcers

Answer 27

True

Question 28

T or F | Herpes can't cause pus

Answer 28

False

Question 29

Herpetic whitlow is most common in ------ upon small cuts or contamination on hands or toes

Answer 29

Hospital staff | Surgeries

Question 30

Herpes gladiatorum seen in ---------

Answer 30

Athletics

Question 31

Eczema herpeticum signs:

Answer 31

``` Malaise Skin lesions Itchy painful blisters and ulcers Enlaged lymph nodes Red purple and black blisters Dermatits is very common in children ( elbows and knees) and popliteal L jeled neshef (xerosis) And rhinitis then this kid has eczema We should always put hydrating creams ```

Question 32

Neonatal herpes -/---- delivers Mode of trans: Symptoms: In neonates most common cause of death is because of ----

Answer 32

1/5000 During delivery Localized/encephalitis or disseminated Viral pneumonitis

Question 33

Tx for HsV

Answer 33

Acyclovir (nucleoside analog) Important in neonates Eza baad 72 hrs ma baate she laanu mtl eltu (this applies to all anti-viral drugs)

Question 34

The only virus that causes all forms of rash at the same time is ----- also characterized by------

Answer 34

Varicella zoster virus (chicken pox) | When prodrome disappears rash appears even if vaccinated

Question 35

T or F | Macules appear in case of VZV infection (brown patches)

Answer 35

False | This case was for fungal infection

Question 36

------- is very -------- but not as measles | But varicella in children is ------ unlike -----

Answer 36

VZV Contagious Mild Measles

Question 37

Zoster is the ------ of ------

Answer 37

Reactivation | Varicella

Question 38

Zoster can be diagnosed clinically by appearance of ------- rash

Answer 38

Dermatomal | Pic of the trigeminal (ophthalmic)

Question 39

Postherpetic neuralgia is ------pain from ------ not from ----, it happens after------ Treated by ------ or ---- which are ---- The virus send messages of pain from ----

Answer 39

``` Neuropathic CNS not periphery Infection (not infected anymore) Pregabalin or gabapentin Antiepileptic drugs CNS ```

Question 40

T or F | Zoster can't be bilateral

Answer 40

False in immunosuppresed it could be bilateral

Question 41

Immunity against VZV is ------ however it's just against----- not to -----

Answer 41

Permanent lifelong Varicella (chicken pox) Zoster

Question 42

CMV duration of replication: | HSV duration of rep and clinical manifestation:

Answer 42

Slow | Quick

Question 43

T or F | 50% of herpes genes are not active in vitro

Answer 43

True | Because they need the host gene apparatus this allows us to make antiviral drugs (acyclovir)

Question 44

T or F | In HSV asymptomatic patients don't transmit the virus

Answer 44

False | Because most of primary infections are asymptomatic

Question 45

T or F | Secondary herpes infection is more severe

Answer 45

False | Milder

Question 46

In varicella the rash begins on ---- then ----- then ------

Answer 46

Face Trunk Extremities

Question 47

Macules: Papule: Vesicle:

Answer 47

Red spots or brown Bumps Fehn may

Question 48

In varicella we check ----- it will appear as ------- that resemble the ----

Answer 48

Oral mucosa 1 little vesicle on soft palate Koplik spot of measles

Question 49

``` VZV can cause 1- 2- 3---- except in ------ We usually are scared from varicella pneumonia in: 1- 2- ```

Answer 49

Encephalitis Sequela Varicella pneumonia except in healthy children Pregos People with malignancies (hodgkin,leukemias, lymphoproliferative diseases like EBV)

Question 50

Tzanck smear is caused by ------

Answer 50

VZV

Question 51

The most complication of zoster after the neurologic disorders is -------

Answer 51

Superinfections