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Viruses Flashcards

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1
Q

Viral infection clinical features

A
  • lymphocytosis
  • lymphadenopathy
  • recurrent viral infections: T-cell deficiency
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2
Q

DNA Viruses

A

HHAPPPPy:
H - herpes
H - hepadna
A - adeno
P - pox
P - parvo
P - papilloma
P - polyoma

all DNA viruses are icosahedral

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3
Q

enveloped DNA viruses

A

3 are enveloped: High Profile Hat

H - herpes
P - pox
H - hepadna

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4
Q

non-enveloped DNA viruses

A

4 are naked: PAPP (pap smear)
P - parvo
A - adeno
P - papilloma
P - polyoma

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5
Q

circular DNA viruses

A

papilloma
polyoma
hepadna

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6
Q

ssDNA virus

A

Parvo (smallest DNA virus)
- strand folds over to allow for replication

“Pervo = naked and single”

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7
Q

DNA virus replication

A

cytoplasm:
- pox (largest DNA virus, already contains all machinery needed for replication)

“Pox, progeny are outside of the box!”

nucleus:
- all other DNA viruses

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8
Q

Herpes classifications

A
  • enveloped, double-stranded, linear
  • alpha, beta, gamma
  • all herpesviruses induce lifelong latent infection
  • oncogenesis
  • spread by direct contact
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9
Q

Herpes alpha viruses

A

alpha:
- herpes simplex virus 1 (HSV-1)
- herpes simplex virus 2 (HSV-2)
- varicella-zoster virus (VZV)

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10
Q

Herpes beta viruses

A

beta:
- cytomegalovirus (CMV)
- human herpes virus 6 (HHV-6)
- human herpes virus 7 (HHV-7)

HHV-6 and 7 are cause of Roseola Infantum

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11
Q

Herpes gamma viruses

A

gamma:
- Epstein-Barr virus (EBV)
- human herpes virus 8 (KSHV)

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12
Q

Herpes simplex virus (HSV) clinical manifestations

alpha herpesvirus

A

HSV-1: gingivostomatitis, cutaneous herpes
HSV-2: genital herpes, cutaneous herpes

Infection & latency:
- mucosa infection ==> moves through neurites ==> latency in sensory ganglia ==> recurrent reactivation
- transmitted through direct contact
- intermittent viral shedding w/o lesions
- lesions can be seen in primary infection and reactivation

Clinical presentation:
- painful papules ==> vesicles ==> pustules ==> ulcers ==> crusted lesions ==> healing
- multinucleated giant cells <- Tzank smear

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13
Q

Herpes simplex virus (HSV) treatment

alpha herpesvirus

A

genital herpes treatment:
acyclovir or valacyclovir

for recurrent/suppressive genital herpes, same medications but different doses

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14
Q

Varicella zoster virus (VZV) clinical manisfestations

alpha herpesvirus

A

primary infection: varicella (chickenpox)
- generally benign in children
- diffuse vesicular rash (blisters)

latent infection: zoster (shingles)
- VZV becomes latent in dorsal root or cranial nerve ganglia
- grouped erythematous papules evolve into vesicles or bullae (large fluid-filled blisters)
- painful

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15
Q

Varicella zoster virus (VZV) vaccines

alpha herpesvirus

A

varicella vaccine: live, attenuated virus vaccine

Shingrix: adult prevention of shingles

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16
Q

cytomegalovirus (CMV) pathogenesis

beta herpesvirus

A

CMV causes mononucleosis (heterophile-negative type), hepatitis, retinitis, esophagitis

Infection:
- undergoes lytic infection in human fibroblasts, epithelial cells, macrophages <- many organ systems affected
- latency in leukocytes (mononuclear cells) ==> lifelong infection
- high risk of infection in organ & bone marrow transplant recipients, also immunocompromised
- ventricular calcifications in brain
- megalocytes: giant cells with owl’s eye nuclei

Treatment: Ganciclovir

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17
Q

Epstein-Barr virus (EBV) pathogenesis

gamma herpesvirus

A

Infection:
- initial site of infection: epithelial cells
- latency in B-lymphocytes, using CD21 receptors to infect B-cells ==> oncogenic potential

Clinical presentations:
- primary agent of infectious mononucleosis (atypical CD8+ T cells in blood)
- immunocompromised: oral hairy leukoplakia (cannot be scraped off)
- associated with development of malignancies: nasopharyngeal carcinoma, Burkitt lymphoma
- CT: single ring-enhancing lesion

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18
Q

Infectious mononucleosis

A
  • classical triad: fever, tonsilar pharyngitis, lymphadenopathy (LAD) (swollen lymph nodes)
  • peripheral blood lymphocytosis (high WBC count) with atypical lymphocytes

if given antibiotics incorrectly, pts usually develop a morbilliform (measles-like) rash

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19
Q

Epstein-Barr virus (EBV) diagnosis and treatment

A
  • primary infection induces human hterophile antibodies (act against viral antigens & unrelated antigens that can be found on sheep/horse RBCs)
  • Monospot test: heterophile antibodies agglutinate horse RBCs

Treatment: typically supportive, no antivirals (acyclovir can reduce duration of viral shedding)

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20
Q

Human herpes virus (HHV) types

beta and gamma herpesviruses

A

beta:
- HHV-6: Roseola infantum
- HHV-7: Roseola infantum

gamma:
- HHV-8: Kaposi sarcoma, febrile exanthem

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21
Q

Human herpesvirus-6 (HHV-6)

beta herpesvirus

A
  • most HHV-6 primary infections occur in first 3 years of life: roseola infantum, exanthem subitum
  • reactivation in immunocompromised hosts
  • roseola infantum: rash starts after high fever breaks
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22
Q

Human herpesvirus-7 (HHV-7)

beta herpesvirus

A
  • less common cause of roseola infantum
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23
Q

Human herpesvirus-8 (HHV-8 aka KSHV)

gamma herpesvirus

A

causes Kaposi sarcoma (cancer on skin/mucous membranes)
- AIDS-associated KS most common in MSM
- cutaneous lesions: hyperpigmented, painless, non-pruritic

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24
Q

Hepadna

Study These Flashcards
A
  • enveloped, double-stranded, circular
25
Adeno
- nonenveloped, double-stranded, linear - cause pharyngitis, conjunctivitis, hemorrhagic cystitis (inflamed urinary bladder lining)
26
Pox
- enveloped, double-stranded, linear - largest, most complex DNA viruses - replicates in cytoplasm, brings its own DNA-dependent RNA polymerase - smallpox - **Molluscum contagiosum virus**: skin infection common in children, flesh-colored domed lesions with central umbilication
27
Parvovirus B19
- nonenveloped, single-stranded, linear Infection: - directly cytotoxic to erythroid precursors in bone marrow ==> inhibition of erythropoiesis Clinical manifestations: - erythema infectiosum ("Fifth disease"): slapped cheek rash - reticulocytopenic anemia in immunocompromised patients (leukemia, HIV/AIDS, organ transplants) ## Footnote Pervo = naked and single
28
Papilloma | Human papillomavirus (HPV)
- nonenveloped, double-stranded, circular - HPV causes almost all cases of cervical cancer and most anal cancer - types 6 & 11: warts - types 16& 18: cervical neoplasia (abnormal cell growth on cervix) - oncogenic types: 16, 18, 31, 33 diagnosis: visual inspection
29
Polyoma
- nonenveloped, double-stranded, circular - John Cunningham (JC) virus <- **AIDS-defining disease** - immunocompromised patients may develop progressive multifocal leukoencephalopathy (PML) or hemorrhagic cystitis - MRI: non-enhancing demyelination of white matter
30
RNA Viruses
mnemonic: CHRP CRFT BADPROF (chirpy crafty bad prof) **(+) sense, icosahedral:** naked: CHRP ("location" viruses) C - Calici ("Cali") H - Hepe ("CA people are hippies") R - Reo ("Rio de Janiero") P - Picorna ("people in Rio are spicy, like pico de gallo") enveloped: CRFT ("party" viruses) C - Corona (beer) <- helical R - Retro (themed) F - Flavi ("flavored" Corona) T - Toga (costume) **(-) sense, helical:** enveloped: BADPROF B - Bunya A - Arena D - Delta P - Paramyxo R - Rhabdo O - Orthomyxo F - Filo
31
positive sense (+ssRNA) vs. negative sense (-ssRNA) RNA
**+ssRNA** - a type of viral RNA that can be readily translated into proteins (looks like mRNA) - does not require RNA-dependent RNA polymerase **-ssRNA** - a type of viral RNA that must be transcribed by RNA-dependent RNA polymerase into +ssRNA before it can be translated into proteins
32
dsRNA virus
Reo virus "repeato-virus" has double stranded RNA
33
circular RNA viruses
mnemonic: BAD B - Bunya A - Arena D - Delta
34
segmented RNA viruses
mnemonic: BOAR B - Bunya O - Orthomyxo A - Arena R - Reo *important for hypermutation (influenza)
35
RNA virus replication
replicates in cytoplasm - all except OR replicates in nucleus: OR O - Orthomyxo R - Retro <- uses reverse transcriptase (DNA)
36
Calici
- single-stranded - (+) sense - icosahedral - naked - linear - non-segmented - replicates in cytoplasm Norovirus
37
Hepe
- single-stranded - (+) sense - icosahedral - naked - linear - non-segmented - replicates in cytoplasm Hepatitis E (HEV)
38
Reo
- double-stranded - (+) sense - icosahedral - naked - linear - segmented - replicates in cytoplasm Rotavirus
39
Picorna
- single-stranded - (+) sense - icosahedral - naked - linear - non-segmented - replicates in cytoplasm PERCH: P - Polio E - Echo R - Rhino C - Coxsacki H - Hepatitis A (HAV) Enteroviruses (GI tract): - Polio - Echo - Coxsacki
40
Rhinovirus
- #1 cause of common cold - infects the nose because it cannot survive in stomach acid (acid-labile) - runny nose, sniffles for 3-4 days, maybe posterior throat discomfort and redness, NO FEVER - transmission: aerosols and fomites (inanimate objects)
41
Corona
- single-stranded - (+) sense - helical - enveloped - linear - non-segmented - replicates in cytoplasm Corona, SARS-CoV, MERS-CoV, SARS-CoV2 - 2nd most frequent cause of common cold
42
Coronavirus pathogenesis
- spike (S) glycoprotein on envelope recognizes target cell ==> binds Angiotensin Converting Enzyme 2 (ACE2) ==> endocytosis
43
Retro
- single-stranded - (+) sense - icosahedral - enveloped - linear - non-segmented - replicates in nucleus **HIV**, HTLV (human T-cell lymphotropic viruses)
44
Flavi
- single-stranded - (+) sense - icosahedral - enveloped - linear - non-segmented - replicates in cytoplasm WSHDY ("flavor town is washed up") W - West Nile Virus (WNV) S - St. Louis encephalitis H - Hepatitis C (HCV) D - Dengue Y - Yellow fever
45
Toga
- single-stranded - (+) sense - icosahedral - enveloped - linear - non-segmented - replicates in cytoplasm beautiful girl (bella) in a toga riding a horse: **Rubella** (aka German measles or three-day measles), Eastern Equine Encephalitis virus (EEEV), Western EEV
46
Bunya
- single-stranded - (-) sense - helical - enveloped - circular - segmented - replicates in cytoplasm CCHRS ("bun catcher"): C - California encephalitis C - Crimean-Congo H - Hanta R - Rift Valley
47
Arena
- single-stranded - (-) sense - helical - enveloped - circular - segmented - replicates in cytoplasm Lassa, Lymphocytic choriomeningitis virus (LCMV)
48
Delta
- single-stranded - (-) sense - helical - enveloped - circular - non-segmented - replicates in cytoplasm Hepatitis D (HDV)
49
Paramyxo
- single-stranded - (-) sense - helical - enveloped - linear - non-segmented - replicates in cytoplasm PRM: P - Parainfluenza R - Respiratory syncytial virus (RSV) M - Measles (aka Rubeola) and mumps
50
Mumps ## Footnote Paramyxovirus
"Mumps has bumps" - fever, headache, malaise - parotitis (inflammation of parotid salivary glands accompanied with lateral cheek/jaw swelling) - orchitis (swelling of testicles) Vaccine: - live viral vaccine (MMR)
51
Paramyxovirus pathogenesis
- Fusion protein (F protein) on surface of capsid - F protein fuses with respiratory epithelial cells ==> formation of multinucleated cells
52
Measles ## Footnote Paramyxovirus
- maculopapular (flat & raised) rash on face -> neck -> trunk - 3 C's: cough, conjunctivitis, coryza (sniffling) - Koplik spots: blue-white spots with red halo on inner cheek
53
Rhabdo
- single-stranded - (-) sense - helical - enveloped (bullet-shaped) - linear - segmented - replicates in cytoplasm Rabies
54
Orthomyxo
- single-stranded - (-) sense - helical - enveloped - linear - segmented - replicates in nucleus - Types A, B, C (determined by cell surface antigen) **Influenza**
55
Influenza virus pathogenesis ## Footnote Orthomyxovirus
2 spike protein subtypes: 1. **Hemagglutinin (H)**: facilitates viral entry by binding sialic acid residues; first step in viral infection 2. **Neuraminidase (N)**: cleaves sialic acid residues on infected host cells and virions, preventing aggregation of virions <- aids in release from host cells ex: H1N1, H3N3
56
influenza antigenic drift vs. shift
Antigenic drift: - epidemics (contained) - minor antigenic changes due to point mutations - changes to "H" and/or "N" Antigenic shift: - pandemics (uncontrolled) - major antigenic changes due to genetic reassortment - 2 different viral strains infect the same host (e.g., pig infected with human and avian influenzas) *segmented virus allows for more reassortment
57
Filo
- single-stranded - (-) sense - helical - enveloped - linear - non-segmented - replicates in cytoplasm Ebola, Marburg
58
Prions
- irreversibly misfolded protein particle derived from normal body protein - do NOT contain DNA or RNA - prions force normal proteins to misfold ==> accumulation in cells ==> cell death

Block 2 (11 decks)

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