Virus II - HSV

Question 1

Name all HHV 1 - 8

Answer 1

HSV1
HSV2

HHV3 - Chicken Pox // Varicella
HHV4 - Epstein-Barr virus

HHV5 - CMV

HHV6 - Sixth disease - Exanthema Subitum - Roseola
HHV7 - also can cause exanthema subitum;
HHV8 - Kaposi’s Sarcoma

Question 2

HHV Structure

• special property
• Histology?

Answer 2

Structure
- dsDNA, YES envelop

Histology

• Cowdry inclusion bodies, except EBV;
• Herpes simplex and herpes zoster viruses cause abnormal cell division in epidermal cells, and this creates MGC
• Hallmark of latency, reactivation and recurrent infection; at Dorsal Ganglion; Trigeminal ganglion

Question 3

HSV 1 and HSV2

• location
• shared pathology
• transmission

Answer 3

Primary sites - Lips // Genitalia;
kissing vs sexually transmitted

Pathology

• vesicles, blister w clear serous fluid;
• inclusion bodies - Cowdry bodies

Question 4

HSV 1
Pathology - above umbilicus

Give patho characteristic of encephalitis and test;

Answer 4

Eyes, Fingers, Lips
- labialis, gums; cold sores; whitlow for fingers;

Brain

• aseptic meningitis
• encephalitis
• • Temporal lobe necrosis; multinucleated GC; cowdry bodies
• • CSF - lymphocytes, PCR

Question 5

HSV 2
Pathology

note HSV2 encephalitis is 2%

Answer 5

STI; lumbar sacral ganglia reactivation
Genitalia warts;
Neonatal herpes

Question 6

Note reactivation of HSV is not prevented by IgG
Recall we give acyclovir (guanosine analog)
- viral thymidine kinase to phosphorylate it

Answer 6

okie

Question 7

HSV3

Spread
Pathology
Immunology
Vaccine

Answer 7

Chickenpox // Varicella-Zoster

Saliva, Skin; Vertical can also

Centripetal distribution of vesicles
- skin superinfection, itch, scratch
Got other stuff, meningitis, pneumonia;

Lifelong immunity; just not to Zoster
MMR vaccine

Question 8

Whats Zoster
Pathology; 1 presentation

Note IgM can be found in Zoster due to reactivation

Answer 8

reactivation of Varicella
- dermatome from dorsal nerve ganglion/ cranial nerve ganglion

• painful vesicular eruption

Question 9

HHV5

Pathology [7] 4 infants, 3 adults
Histology

Answer 9

CMV

1: Cyclomegalic inclusion disease - severe generalized infection of infants;
- jaundice, low platelet, anaemia
- hepatosplenomegaly
CNS:
- microcephaly
- periventricular ICC

2: Chorioretinitis + Sensorineural Hearing loss
3: Mental retardation
4: post natal hepatitis
5: infectious mononucleosis - atypical mononuclear cells
- like EBV but without heterophile AB
6: reactivation
7: GBS

Organs w enlarged cells - large intranuclear owl eye inclusion;

Question 10

CMV

• spread
• treatment

Answer 10

Bodily fluids; close contact, transplant;

Gancyclovir

• uses viral phosphotransferase
• prevent hearing loss

Question 11

HHV 4

pathologies
Cx [3] - very important
explain fully

test

Answer 11

EBV - bodily fluids

• targets B cells
• lead to immortalization

Glandular fever

• infectious mononucleosis
• • exudative tonsilitis

Cx
- CNS infection

• Burkitt’s Lymphoma
• • myc gene, t (8;14);
• • proto-oncogene
• • aggressive; good cure rate
• NPC
• • EBV associated w NK SCC NP;

test for heterophil AB
These AB from human agglutinates stuff from other species – heterophile

• note Peripheral blood flim for atypical mononuclear cells;

Question 12

HHV6
HHV7
HHV8
- spread; what isit

Answer 12

Roseolovirus

• roseola infantum // 6th disease
• b-lymphocytic

also lead to roseola infantum
- CD4 T cell

HHV8

• Kaposi’s sarcoma - associated Herpevirus
• tumor of VASCULAR endothelial cell of AID’s px
• sexual route

Question 13

CMV
- intrauterine damages
[7 CNS]
- think anterior posterior sides [3]
[3 elsewhere]

Answer 13

Cytomegalic inclusion disease

Periventricular ICC
Microcephaly, Cerebral, cerebellum volume loss // ventriculomegaly for compensation
Hearing loss
Abnormal neuronal migration leads to
- shallow sulci and broad gyri 
White matter disease
- fluid accumulation // brighter than normal anterior white matter on CT scan
- parietal lobes
Anterior temporal cysts

• 2nd trimester - cleft, fluid - Schizencephaly

Thrombocytopenic purpura
Choreoretinitis
Hepatosplenomegaly

Question 14

3 trimesters of CMV intrauterine damages

• whats common to all [3]
• diff between 1st and 2nd trimester

Answer 14

Worse early

Commons:

• ICC
• Ventriculomegaly;
• White Matter disease - leukoencephalopathy

1st: microcephaly; lissencephaly, no folding, neuronal migration problem
2nd: polymicrogyria - neuronal migration problem; schizencephaly - cysts in brain

Question 15

Zika features [7]

Answer 15

Microcephaly; Cerebral atropy, ventriculomegaly

• Redundant scalp skin @ occipital + prominent occipital protuberance
• Craniofacial disproportion
• ICC at grey white matter junction instead