Viruses Flashcards
(138 cards)
1
Q
Herpes virus
A
Enveloped
DS + Linear DNA
2
Q
Poxvirus
A
Enveloped
DS + Linear (biggest) DNA
Molluscum contagiosum (papule with central umbilication)
3
Q
Hepadnavirus
A
Enveloped
Partially DS + Circular DNA
HBV (acute or chronic hepatitis, virus has a reverse transcriptase)
4
Q
Adenovirus
A
DS + Linear DNA
Febrile pharyngitis (sore throat)
Conjunctivitis
Acute hemorrhagic cystitis
Pneumonia
Gastroenteritis
Myocarditis
5
Q
Papillomavirus
A
DS + Circular DNA
HPV
- Warts (serotypes 1,2,6,11)
- Cancer (cervical, penile, anal etc serotypes 16, 18)
6
Q
Polyomavirus
“Junky Cerebrum, Bad Kidney”
A
DS + Circular DNA
JC virus (Progressive multifocal leukoencephalitis in HIV)
BK virus (Kidney failure in transplants)
7
Q
Parvovirus
A
SS + Linear (smallest) DNA
B19
- 5th disease/ Erythema Infectiosum, SCS
- Aplastic crisis in Sickle Cell Disease
- Hydrops fetalis (destroyed RBC precursors)
8
Q
HSV1
A
Trans via respiratory droplets & saliva
Latent in Trigeminal ganglion
Causes:
Gingivostomatitis
Keratoconjunctivitis
Cold sores
Herpetic whitlow
Temporal lobe encephalitis
Esophagitis
Erythema multiforme
9
Q
HSV2
A
Trans via sexual contact
Latent in Sacral ganglion
Genital herpes
Neonatal herpes
10
Q
VZV (varicella zooster virus) HHV3
A
Trans via respiratory droplets & vesicle fluid
Latent in trigeminal or dorsal root ganglion
Chicken pox (all over)
Shingles (one dermatome)
Encephalitis
Pneumonia
11
Q
EBV (Epstein Barr virus) HHV4
“must be 21 to drink Beer at a Barr”
A
Trans via respiratory droplets & saliva (Kissing disease)
Mononucleosis (monospot +, heterophile +, & Ab agglutination in sheeps blood)
Infects B cells via CD21
Fever hepatosplenomegaly
Pharyngitis
Lymphadenopathy
Nasopharyngeal carcinoma (asians)
Treating with amoxicillin = maculopapular rash
12
Q
CMV (Cytomegalovirus) HHV 5
A
Trans via sex, urine, transfusions, or congenitally
Mononucleosis-like syndrome (monospot & heterophile -)
in AIDS & transplant patients
OWL eye inclusions & lies latent in mononuclear cells
Esophagitis
Cotton-wool exudates
Vison loss
Congenital CMV
13
Q
HHV6-7
&
HHV8
A
6-7: picture I
Trans via saliva
Roseola infantum
First fever several days then macular rash (starting at trunk & spreading to arms/legs)
8: picture J
Trans via sex
Kaposi sarcoma in HIV/AIDS & transplant patients (dark/violaceous plaques/nodules)
14
Q
ID HSV (4)
A
PCR skin lesion
CSF PCR (Herpes encephalitis)
Tzank smear (Multinucleated giant cells)
Intranuclear Cowdry A inclusions
15
Q
Receptors for:
CMV
A
Integrins (heparan sulfate)
16
Q
Receptors for:
EBV
A
CD21
17
Q
Receptors for:
HIV
A
CD4, CXCR4, CCR5
18
Q
Receptors for:
Parvovirus B19
A
P antigen on RBC’s
19
Q
Receptors for:
Rabies
A
Nicotinic AChR
20
Q
Receptors for:
Rhinovirus
A
ICAM 1
21
Q
Reovirus
A
DS + Linear multisegmented RNA
Icosahedral
Coltivirus (Colorado tick fever)
Rotavirus (Fatal diarrhea in kids)
22
Q
Picornavirus
“PERCH”
A
SS + Linear RNA
Icosahedral
Poliovirus
Echovirus
Rhinovirus
Coxsackie virus
HAV
23
Q
Hepevirus
A
SS + Linear RNA
Icosahedral
HEV
24
Q
Calicivirus
A
SS + Linear
Icosahedral
Norovirus (Viral gastroenteritis)
25
Flavivirus
Enveloped
SS + Linear RNA
Icosahedral
HCV
Yellow fever
Dengue
St. Louis encephalitis
West Nile virus (meningoencephalitis + flaccid paralysis)
Zika
26
Togavirus
"CREW"
Enveloped
SS + Linear RNA
Icosahedral
Chikungunya virus
Rubella
Easter/Western equine encephalitis
27
Retrovirus
Enveloped
SS + Linear (with 2 copies) RNA
Have a reverse transcriptase
Icosahedral (HTLV= T cell leukemia)
Conical (HIV = AIDS)
28
Coronavirus
Enveloped
SS + Linear RNA
Helical
SARS
MERS
Covid 19
29
Orthomyxovirus
Enveloped
SS + Linear RNA in 8 segments
Helical
Influenza
30
Paramyxoviruses
(childhood viruses)
Enveloped
SS + Linear RNA Non-segmented
Helical
Parainfluenza
RSV (Croup)
Measles
Mumps
31
Rhabdovirus
Enveloped
SS - Linear RNA
Helical
Rabies
32
Filovirus
Enveloped
SS - Linear RNA
Helical
EBOLA
Marburg hemorrhagic fever
33
Arenaviruses
Enveloped
SS +/- Circular RNA in 2 segments
Helical
LCMV (Lymphocytic Choriomeningitis virus)
Lassa fever encephalitis (Rodents)
34
Bunyaviruses
Enveloped
SS - Circular RNA in 3 segments
Helical
California encephalitis
Sandfly/Rift valley fever
Crimean-Congo hemorrhagic fever
Hantavirus (hemorrhagic fever & pneumonia)
35
Deltavirus
Enveloped
SS - Circular RNA
HDV (needs HBV to replicate)
36
Negative stranded viruses
Need to transcribe their negative RNA to positive
they bring their own RDRP
Arenavirus
37
Segmented RNA viruses
"BOARding flight 382 in 10-12 minutes"
Bunyavirus (3 segments)
Orthomyxovirus (8 segments)
Arenavirus (2 segments)
Reovirus (10-12 segments)
38
PircoRNAvirus
"Small RNA viruses PERCH "
Poliovirus
Echovirus
Rhinovirus
Coxsackie virus
HAV
All are main causes of Aseptic meningitis
39
Rhinovirus
A picornavirus
NON-Enveloped
100+ Serotypes causing the common cold
Acid labile (can't infect the GI)
40
Rotavirus
A reovirus
Segmented DS RNA
Infantile gastroenteritis (destroys villi causing less Na absorption and loss of K+) aka diarrhea.
41
Influenza
An orthomyxovirus
Enveloped
SS - RNA with segments
Hemagglutinin (binds sialic acid and lets virus in)
Neuraminidase (prompts progeny release)
42
Influenza can be superinfected with which 3 viruses
S.aureus S. pneumoniae, & H.influenza
43
Influenza treatment
Oseltamivir & Zanamivir
(+/- Neuraminidase inhibitor)
44
Influenza vaccine
Killed and live attenuated (nasal only)
45
Influenza
Genetic Shift vs Drift
Shift:
2 different strains (swine + human) infect the same cell and recombine their RNA to make major changes causing a new variant (can cause PANDEMICS)
Drift:
Random hemagglutinin or neuraminidase protein/gene mutations that cause minor changes to a strain (can cause EPIDEMICS)
46
Rubella
A togavirus
Rubella/German Measles:
Fever, postauricular/lymphadenopathy, arthralgias, fine maculopapular rash (that starts at the face & spreads to the trunk then extremities)
mild in kids
severe congenital
47
Congenital Rubella
A severe TORCH syndrome
Deafness, Cataracts, Patent ductus arteriosus, Blueberry muffin rash appearance
48
Paramyxoviruses
Parainfluenza (croup)
Mumps
Measles
RSV
Human metapneumovirus z
All have F (fusion) surface proteins that cause respiratory epithelium to fuse forming multinucleated cells causing bronchiolitis & pneumonia
49
Treating Paramyxoviruses
Palivizumab (monoclonal antibody against F proteins)
50
Croup
aka acute laryngotracheobronchitis
presents with a seal bark cough & steeple sign on X-RAY
51
Measles
Prodromal fever + cough
Coryza, Conjunctivitis, Koplik spots (bright red spots with blue-white center in mouth)
Lymphadenitis with Warthin-Finkeldey Gian cells
52
Measles sequelae
Subacute sclerosing panencephalitis
Encephalitis
Giant cell pneumonia
53
Reduces Measles morbidity
Vitamin A supplements
54
Mumps
"mumps make your testes the size of POM PomS"
Parotitis
Orchitis
aseptic Meningitis
Pancreatitis
Sterility
55
Chikungunya virus
Togavirus (alphavirus)
Trans via aedes mosquito
Systemic infection (inflammatory polyarthritis, high fever, maculopapular rash, headache, & lymphadenopathy)
56
Diagnosis test for Chikungunya
RT-PCR & Serology
57
Dengue fever
Flavivirus
Trans via aedes mosquito
Dengue fever (fever, myalgia, rash, headache, arthralgias, & neutropenia)
Dengue Hemorrhagic fever (Dengue fever & thrombocytopenia)
Dengue Shock ( Circulatory collapse)
58
Dengue fever test & treatment
test:
PCR/Serology
Rx. Live recombinant vaccine
59
Rabies
Bullet shaped virus
Negri bodies usually in Purkinje cells of cerebellum & hippocampal neurons
Weeks to months IP
It travels to the CNS via retrograde (dynein) after binding ACh receptors causing fever, malaise --> agitation, photo/hydrophobia, & hypersalivation --> Paralysis, coma, & death
60
Treating Rabies
Post exposure prophylaxis with killed vaccine & rabies immunoglobin
61
Yellow Fever
A flavivirus
Trans via aedes mosquitos
High fever, black vomitus, jaundice, hemorrhages, backaches, & Councilman bodies in the liver
62
Ebola
A filovirus
21-day IP period
Abrupt onset of flu symptoms, diarrhea/vomiting, high fever, myalgia, & progressive diffuse hemorrhagic shock
63
Ebola test
RT-PCR within 48hrs
64
Zika virus
A flavivirus
Trans via aedes mosquito
Conjunctivitis, low-grade pyrexia, & itchy rash
65
Congenital Zika
Can end up in miscarriage or congenital Zika.
Ventriculomegaly, Subcortical calcifications, microencephaly, ocular abnormalities, spasticity, & seizures
66
Common symptoms of all Hepatitis infections
Naked viruses that cause
Fever, Jaundice, High ALT/AST
67
HAV (Hepatitis A)
A picornavirus (RNA)
Trans via fecal-orally (shellfish)
Acute & self limiting (adults)
Asymptomatic (kids)
No hepatocellular carcinoma risk
No carrier state
68
HBV (Hepatitis B)
A hepadnavirus (DNA)
Trans via Parentally (Blood/Sex) & Perinatally (Birthing)
Initially like serum sickness (fever, arthralgia, rash, which may progress to carcinoma)
Adults (usually resolves)
Neonates (worse)
High risk of Hepatocellular carcinoma
Common carrier state
69
HBV (Hepatitis B) Liver biopsy shows
Granular eosinophilic "ground-glass opacities" that are the accumulation of surface antigens in infected hepatocytes
(CD8 mediated damage)
70
HCV (Hepatitis C)
A flavivirus (RNA)
Trans via (Blood, IV drugs, or post transfusions)
May progress to cirrhosis or carcinoma
Majority develop stable chronic hep C
High risk for hepatocellular carcinomas
Carrier state is common
71
HCV (Hepatitis C) Liver Biopsy
Lymphoid aggregates with focal areas of macrovesicular steatosis
72
HDV (Hepatitis Delta)
A deltavirus (RNA)
Trans via Blood/Sex/Perinatally
Superinfection (HDV after HBV) = short infection
Coinfection (HDV with HBV) = long infection
May progress to cirrhosis or carcinoma
High hepatocellular carcinoma risk
HDV needs HBV's HBsAg coat to enter hepatocytes
73
HDV (Hepatitis Delta) Liver biopsy
Lymphoid aggregates with focal areas of macrovesicular steatosis
74
HEV (Hepatitis E)
A hepevirus (RNA)
Trans via Fecal-oral (waterborne)
Fulminant hepatitis in pregnant patients (higher mortality)
No hepatocellular carcinoma risk
No carrier states
75
HEV (Hepatitis E) Liver biopsy
Patchy necrosis
76
Extrahepatic manifestations of HBV
Aplastic anemia
Membranous Glomerular nephritis
Polyarthritis
77
Extrahepatic manifestations of HCV
Essential mixed cryoglobulinemia
High risk of B cell non-Hodkin lymphoma
Autoimmune hemolytic anemia
Membranoproliferative Glomerular nephritis
Leukocytoclastic vasculitis
Sporadic porphyria cutanea tarda
Lichen planus
High risk of diabetes mellitus
Auto immune hypothyroidism
78
Hepatitis serology markers:
Anti-HAV (IgM)
Anti-HAV (IgG)
Acute HAV
A prior HAV infection or vaccination (protects against reinfection)
79
Hepatitis serology markers:
HBsAg
Anti-HBs
HBV infection
Vaccination or recovery from infection indicates immunity
80
Hepatitis serology markers:
HBc-Ag
Anti-HBc (IgM or IgG)
Core HBV
IgM = acute/recent infection
IgG = Chronic/prior infection
81
Hepatitis serology markers:
HbeAg
Anti-HBe
Active viral replication + high transmissibility
Low transmissibility
82
Acute HBV infection Serology markers
HBsAg
HBeAg
Anti-HBc IgM
83
Window HBV infection Serology markers
Anti-HBe
Anti-HBc IgM
84
Chronic with high transmissibility HBV infection Serology markers
Anti-HBc IgG
HBeAg
HBsAg
85
Chronic with low transmissibility HBV infection Serology markers
Anti-HBc IgG
Anti-HBe
HBsAg
86
Recovery HBV infection Serology markers
Anti-HBc IgG
Anti-HBs
Anti-HBe
87
Immunized HBV infection Serology markers
Anti-HBs
88
HIV 3 structural genes
env:
gb120 (attaches to host CD4 + Tcell)
gb41 (fusion + entry)
gag:
p24 (capsid protein)
p17 (matrix protein)
pol:
Reverse transcriptase (makes DS DNA from RNA)
Integrase (DS DNA is integrated into host's genome)
Protease (Virus binds CD4 & a coreceptor either CCR5 (Macrophages in early inf) or CXCR4 (T cells in late inf)
Homozygous CCR5 = Immune
Heterozygous CCR5 = Slower disease course
89
Diagnosing HIV
HIV 1/2 Ag/Ab immunoassay
Detecting P24 Ag capsid protein & IgG Abs to HIV 1/2
90
AIDs Defining conditions:
CD4 <500
Candida albicans (oral thrush, a scrapable white plaque with pseudohypae on microscopy)
EBV (Oral hairy leukoplakia, an Un scrapable white plaque on tongue)
HHV8 (Kaposi sarcoma, perivascular spindle cells invading & forming vascular tumors)
HPV (Squamous cell carcinoma)
91
AIDs Defining conditions:
CD4 <200
Histoplasma (fever, weight loss, fatigue, cough, dyspnea, nausea, vomiting, & diarrhea, oval yeast cells in macrophages)
HIV (Dementia, cerebral atrophy)
JC virus (Progressive multifocal leukoencephalopathy, non-enhancing areas of focal demyelination on MRI)
Pneumocystis jirovecii (Pneumocystis pneumonia with ground-glass opacities on chest imaging)
92
AIDs Defining conditions:
CD4 <100
Aspergillus fumigatus (Hemoptysis, pleuritic pain, with cavitation on infiltrates on chest imaging)
Bartonella spp (Bacillary angiomatosis, Mutiple red-purple papules/nodules, biopsy with neutrophilic inflammation)
Candida albicans (esophagitis, white plaques on endoscopy with yeast + pseudohyphae on biopsy)
CMV (Colitis, Retinitis, Esophagitis, Encephalitis, Pneumonitis with Linear ulcers on endoscopy, cotton-wool spots on fundoscopy, & owl eye inclusions in biopsy)
Cryptococcus neoformans (Meningitis, with encapsulated yeast on Indian ink stain or capsular Ag +)
Cryptpsporidium spp (Chronic watery diarrhea with acid fast oocysts in stool)
EBV (B cell lymphoma showing ring enhancing lesions)
Mycobaterium avium intracellulare & complex (fever, night-sweats, weight loss or focal lymphadenitis, & risk of toxoplasma gondii infection)
93
Prion diseases are due to
A mutation causing a helix PrPc to convert to B-pleated PrPsc, which accumulate in CNS causing spongiform encephalitis, dementia, & ataxia
93
CJD (Creutzfeldt-Jakob disease)
Spongiform encephalopathy causing rapidly progressive dementia
94
BSE
Bovine Spongiform encephalopathy aka Mad cow disease
95
Kuru
Acquired prion disease noted in tribes that practice cannibalism
96
Normal dominant flora:
Skin
Nose
Oropharynx
Dental plaque
Colon
Vagina
Skin = S. epidermidis
Nose = S. epidermidis, colonized s. aureus
Oropharynx = Viridians group streptococci
Dental plaque = S. mutans
Colon = B. fragilis + E.coli
Vagina = Lactobacillus, colonized E.coli + group B streptococci
97
Bacillus cereus infection is from
Re-heated rice
98
C. botulinum infection is from
Improperly canned food (toxins) or raw honey (spores)
99
C. perfringes infection is from
Re-heated meat
100
E.coli 0157:H7
Undercooked meat
101
L. monocytogenes
Deli meats + soft cheese
102
Salmonella
Poultry + eggs
103
S. aureus
Meat, mayo, custard, preformed toxin
104
V. parahaemolyticus & V. vulnificus
Raw/undercooked seafood
105
Major causes of bloody diarrhea (infections)
Campylobacter
E. histolytica
Enterohemorrhagic E.coli
Enteroinvasive E.coli
Salmonella (non-typhi)
Shigella
Y enterocolitica
106
Major causes of watery diarrhea (infections)
C. difficile
C. perfringes
Enterotoxigenic E.coli
Giardia
Cryptosporidium
V. cholerae
Norovirus
Rotavirus
Enteric adenovirus
107
Major causes of pneumonia (infections):
Neonates
Children
N:
Group B streptococci
E.coli
C:
RSV
Mycoplasma
C. trachomatis
C. pneumoniae
S. pneumoniae
108
Major causes of pneumonia (infections):
Adults
Elderly
A:
Mycoplasma
C. pneumoniae
H. influenza
Anaerobes
E:
S. pneumoniae
Influenza
Anaerobes
Gram neg rods
109
Common infections with Alcohol use
Klebsiella
Anaerobes
110
Common infections with IV drugs
S. pneumoniae
S. aureus
111
Common infections causing meningitis
S. agalatiae
E.coli
Listeria monocytogenes
112
Bacterial CSF
High opening pressure
Elevated PMN cells
Elevated proteins
Low glucose
113
Fungal/TB CSF
High opening pressure
Elevated lymphocytes
Elevated proteins
Low glucose
114
Viral CSF
Normal or high opening pressure
Elevated lymphocytes
Normal or high proteins
Normal glucose
115
Bacterial vaginosis
Gardnerella vaginalis
No inflammation & thin white discharge with a fishy smell
Clue cells
Positive KOH Whiff test
Lower pH (below 4.5)
116
Treat Gardnerella vaginalis
Metronidazole or clindamycin
117
Trichomonas vaginitis
Inflammation (Strawberry cervix)
Frothy, yellow-green, & foul-smelling discharge
Motile pear-shaped trichomonads
Low pH (below 4.5)
118
Treat Trichomonas vaginitis
Metronidazole
119
Candida albicans
Inflammation
Thick-white "cottage-cheese" discharge
Pseudohyphae
Normal pH (4-4.5)
120
Treating Candida albicans
Azoles
121
TORCH
Toxoplasma gondii
Trans via cat poop or undercooked pork
Neonates:
chorioretinitis
hydrocephalus
intracranial calcifications
Blueberry muffin rash
122
TORCH
Rubella
Trans via respiratory droplets
Mom:
Rash, lymphadenopathy, pharyngitis, polyarthritis
Neonate:
Cataracts, deafness, congenital heart disease, Blueberry muffin rash
123
TORCH
CMV (Cytomegalovirus)
Trans via sex/transplants
Mom: Asymptomatic or mononucleosis-like illness
Neonate: Hearing loss, seizures, Blueberry muffin rash, chorioretinitis, periventricular calcifications
124
TORCH
HIV
Trans Sex/needle stick
Mom= variable
Neonate= Recurrent infections & chronic diarrhea
125
TORCH
Herpes Simplex Virus 2
Trans Skin/mucous membranes
Mom: Genital herpes
Neonate: Meningoencephalitis, herpetic vesicular lesions
126
TORCH
Syphilis
Trans Sex
Mom: Chancre & disseminated rash
Neonate:
Death via still birth or hydrops fetalis
Survived causes facial defects, saber shins, & VIII deafness
127
VZV (Varicella Zooster virus)
Chicken pox (Vesicular rash starts on the trunk & spreads to face/extremities with lesions at different stages)
128
Coxsackie A
Hand-foot-mouth disease (Oval-shaped vesicles on palms/soles; with vesicles + ulcers in the oral mucosal (herpangina))
129
HHV6
Roseola (exanthem subitum)
Asymptomatic rose colored macules on the body after a several day long fever with febrile seizures (usually infants)
130
Measles virus (Rubeola)
Confluent rash (starts at the head & moves down) then cough, coryza, conjunctivitis, & Koplik spots (blue-white spots on the mouth mucosa)
131
Parvovirus B19
Erythema infectious (5th disease) slapped cheek syndrome on the face.
&
Hydrops fetalis in pregnant patients
132
Rubella virus
Rubella (pink macules & papules (that start at the head and move down as a fine desquamating truncal rash, & post auricular lymphadenopathy)
133
Streptococcus pyogenes "SCARLET"
Scarlet fever"
Sore throat
Circumoral pallor
group A streptococci
Rash
Lymphadenopathy
Erythrogenic toxin
strawberry Tongue
134
Sexually transmitted infections:
HIV
AIDS (Opportunistic infections, Kaposi's sarcoma, & lymphoma)
135
Sexually transmitted infections:
Haemophilus ducreyi
(do cry)
Chancroid (a painful genital ulcer with exudate & inguinal adenopathy)
136
Chlamydia trachomatis (D-K)
Chlamydia (urethritis, cervicitis, epididymitis, conjunctivitis, reactive arthritis, & PID)
137
