viruses Flashcards

1
Q

non- enveloped vs enveloped?

A

NAKED (non-enveloped):

  • survive well
  • may be bile resistant
  • tougher capsid - harder to disinfect
  • faecal oral route transmission

ENVELOPED:

  • survive transiently outside
  • spread by close contact/intimacy/blood/sneezes and coughs etc…
  • capsid can dry out
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2
Q

what are the envelopes made of?

A

lipid bilayer of host origin
PLUS viral-encoded glycoprotein spikes that:
- have receptors to target next cell to attack
- help attach to new cell and facilitate entry
- are the targets for antibodies of host

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3
Q

Pox virus - capsid symmetry? and is it enveloped?

A

COMPLEX enveloped

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4
Q

describe the 3 capside symmetries

A

Complex, helical and icosahedral. They can all be DNA strands and can all be enveloped.

COMPLEX can only be DNA strand and can ONLY be enveloped

HELICAL can be DNA or RNA but ONLY enveloped also

ISOHEDRAL can be anything.

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5
Q

HIV virus? enveloped? capsid? RNA/DNA?

A

retrovirus so - enveloped + ICOSAHEDRAL + RNA strand

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6
Q

how do retroviruses work?

A

use reverse transcriptase to turn their RNA strand into cDNA and then integrate that into host DNA using integrase before transcribing itself again and reproducing and releasing itself out to infect more cells - a process requiring protease to cleave GAG into matrix, capsid and nucleocapsid (enabling it to be infectious)

(3 enzymes to rmb: reverse transcriptase, integrase, protease)

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7
Q

what does HIV require to get into the cell?

A

CD4 and chemokine receptors either CCR5 or CXCR4

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8
Q

What are the important viral load figures to remember?

A

less than 50 means it’s very controlled and AIDS free. Over 200 = AIDS.

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9
Q

TAT?

A

activator of viral transcription

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10
Q

REV?

A

mediates RNA nuclear export

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11
Q

VIF?

A

works against APOBEC to ensure virus not too mutated and still functional

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12
Q

what is APOBEC?

A

protein that mutates virus by changing C to U on DNA strand - can be both good and bad (APOBEC3 is host protein that also inhibits RT), but mutations can also cause virus to evade immune system

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13
Q

NEF?

A

removes CD4 from surface of cell - stops T-cells from working

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14
Q

VPU

A

destroys tetherin

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15
Q

What’s tetherin?

A

protein that inhibits release of virus from cell surface

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16
Q

SERIN C?

A

interferes with viral entry

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17
Q

SAMHD1

A

suppresses RT in myeloid cells by hydrolyzing dNTPs

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18
Q

what cells are affected by HIV?

A

Mainly CD4 depletion, loss of memory t-cells,
DC, macrophages also affected and can enhance t-cell infectivity
GALT also affected and can never recover even with therapy

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19
Q

which cell controls the acute infection phase of HIV?

A

CD8 cells

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20
Q

How is HIV diagnosed?

A

ELISA to look for anti-p24 (capsid) antibodies IF already seroconverted (usually after 3 months)
pre conversion must use RT-PCR - blood test to confirm (pinprick needed)

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21
Q

List some opportunistic infections that are associated w HIV

A
Kaposi's sarcoma
CMV
pneumococi jirovecii
candida
pneumocystis carinii
toxoplasmosis
reactivation of herpes simplex
MCB TB
MCB avium complex
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22
Q

Describe HAART

A

combination of 3 HIV drugs used to fight mutation

Usually 2 NRTI (nucleoside reverse transcriptase inhibitors) + 1 NNRT (non-NRTI) OR 1 protease inhibitor

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23
Q

positive RNA strands means? negative strand means?

A

positive RNA strands are equivalent to mRNA strand so can immediately be translated, unlike negative strands that must first be converted to positive strands. cells with negative RNA strands need replicative polymerase enzyme to make new negative strands from positive strands because cells don’t contain that enzyme

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24
Q

In any lymphoma/ see lymph nodes what virus should you suspect?

A

EBV

also in nasopharyngeal carcinoma

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25
what cancers can HPV cause?
cervical carcinoma | anogenital & vulvo-perineal tumours
26
What is the body's first line of defence against viruses?
interferon
27
DNA viruses are HHAPPPPy
Herpes, Hepad, Adeno, Papilo, Parvo, Polyoma, Pox Hs and Pox have envelope
28
What is the name of the stage for the time between exposure and onset of a specific clinical sign?
Incubation period
29
What is the name of the stage where non-specific symptoms like fever and loss of appetite occur?
Prodrome
30
What do superantigens increase the process of?
SEPSIS
31
How to diagnose hepatitis
LFTs ALT:AST ratio should be both raised and abount 1:1 ALT is the more important marker for inflammation Should look for Hx viral load, HbeAg, Hx core IgM (if seen had infection within last 6 months) Alpha-fetoprotein - if raised is indication of possible cirrhosis, hepatitis and is risk factor for hepatocellular carcinoma Antibodies: look for ANA + ASMA = HEPC ANA + SMA = autoimmune hepatitis Fibroscan and ultrasound to truly diagnose - assess liver fibrosis level, fatty deposits and general composition Might biopsy depending on other results.
32
How are Hep A and Hep E alike?
Both ss-RNA naked Both don't cause chronic illnesses usually. (Hep E can be chronic in immunosuppressed individuals.) Have similar incubation periods (A: 3-5/E:6), lab diagnosis and transmission (faeco-oral/person to person transmission: hep A - raw fruit, shellfish; hep E - uncooked raw meat, sewage contaminated water and blood transmission) Both diagnosed by looking for HA/EV IgM in blood samples
33
Which Hep viruses can cause chronic infection? What symptoms are associated with this?
B, C, D, (E only in immunocompromised) You can only get D if also B positive surface antigens present. Associated with chronic liver disease, chronic active/persistent hepatitis, cirrhosis which can lead to hepatocellular carcinoma
34
What are some non-specific symptoms of hepatits?
``` Jaundice Right hypochondriac quadrant pain Dark urine (bilirubin) Clay coloured faeces (bilirubin) Nausea and vomiting Malaise Fever Headache ```
35
HEP E mortality in pregnancy?
20-40%
36
How to treat Hep A?
No real treatment, mainly symptomatic control There is a Hep A vaccine to prevent spread - offered to high risk individuals e.g. travelling to a poor country that might be less hygienic
37
How to treat Hep E?
Persistent infection in immunocompromised patients can be treated with ribavirin (antiviral agent) or interferon (immunomodulator)
38
How do you interpret serology for Hep B
HbsAg - only seen when infection actively happening (can be acute or chronic) Hb c Ab - seen in anyone who's ever been infected or is currently infected Hb core IgM - seen in anyone who's been acutely infected within last 6 months Hb e antigen/antibody - if present, and Hb core IgM is high, could be chronic infection as it raises IgM. Hb surface antibody - if above 10 mIU/ml = no infection - either had it way in past or is vaccinated for it.
39
Describe how Hep B works
it is a dsDNA with reverse transcriptase incubation period of a few months (2.5 ish) transmitted by blood, injecting, piercings, tattoos If get ACUTE - icteric and then resolves If CARRIER - HbaAg is in circulation for more than 6 months; usually anicteric, but can lead to cirrhosis and hepatocellular carcinoma. Pathogenesis: viral replication and immune mediated cytotoxicity + host chromosomal infections
40
How to treat/prevent/control Hep B
Vaccine available Give antiviral prophylaxis for transplants if they've had hep b in the past Hep B carriers not allowed to be doctors (?) Treat with antiviral therapy: adefovir, lamivudibem tenofovir, entecavir - won't kill but will stop replication Also give interferon
41
How does Hep D work
ssRNA virus enveloped by HbsAg, needs it to survive. | Hep B vaccination is protective against it
42
How does Hep C work
ssRNA enveloped flavivirus transmitted with injecting, blood, tattoos, piercings, vertical route (mother to child) and sexual intercourse (lower risk) 40% route unknown incubation period 6-12 weeks Majority of people don't know they have the disease -75% present with a bit of abdominal pain and LFTs that are only slightly off. 20% are icteric but resolves on tis own. 40-50% of carriers can get chronic liver damage and of these 20% can get cirrhosis and potentially develop hepatocellular carcinoma
43
How to treat Hep C
With antivirals - can eradicate infection as long as virus doesn't integrate itself into the chromosome.
44
What is an eclipse phase?
period from viral entry to release of infected virions
45
Describe the herpesviridae family
Large dsDNA Isohedral Enveloped All members morphologically similar under EM
46
What are three classes of herpesviridae and what are they each known for? +give 2 examples of each
Alpha, beta and gammeherpesviridae Alpha e.g. VZV and herpes simplex 1,2 known for causing blisters and having neuronal latency Beta e.g. CMV and HP 6,7, known for only affecting immunocompromised Gamma e.g. EBV and HP8, known for causing malignancies
47
Lytic vs latent infection?
Lytic is when viruses are replicating, host cells are productively infective Latent is when no more virions are made but cells still infected - can be reactivated
48
Does a seropositive status indicate infection or immunity?
infection
49
What antivirals are used to treat herpes virus?
Acyclovir, ganciclovir (ends w CLOVIR) doesn't eradicate only controls latent infection
50
Describe the structure of a varicella zoster virus (VZV)
Large dsDNA enveloped, isocahedral | an alphaherpesvirinae
51
Where is latency of VZV?
In dorsal or cranial nerve ganglia | Reactivation causes shingles
52
What are potential complications of VZV/HZV?
Severe haemorrhagic varicella - problems clotting Secondary bacterial infection causing pneumonia or rash Encephalitis Acute cerebellar ataxia (especially in kids - start walking funny and off balance) Visceral inflammation (especially seen in immunocompromised): pneumonitis, hepatitis, meningoencephalitis With shingles can also affect trigeminal nerve sensory area - can cause eye- 50% and cause loss of eye sight (in opthalmic zoster - mandatory opthalmological assessment) In elderly post-herpetic neuralgia can occur - pain that goes on and on
53
When is the infectivity and incubation period for VZV
Incubation is 10-21 days after exposure | Infectivity is from 48hrs before rash developed to until all lesions are crusted over
54
What memory cells remain after primary infection of VZV
VZV specific IgG and IgA | VZV specific CD4 and CD8 t-cells
55
How is VZV transmitted?
Respiratory route before rash Skin lesions also infective Shingles spread by contact e.g. door handles Maternal varicella in first 20 weeks gestation can result (2%) in fetal abnormalities Maternal shingle is harmless to fetus Perinatal infection can cause neonatal varicella (associated with high mortality of infant)
56
What prophylaxis measures are there for VZV?
Varivax vaccine - administer within 72 hours (but live vaccine so not for immunicompromised) Varicella zoster immunoglobulin - administer within 7 days of significant contact e.g. pregnant, immunosuppressed, or neonate of a seronegative mother
57
How to treat VZV
None given in uncomplicated childhood chicken pox Give anti-virals in adults and immunocompromised - Aciclovir (can be IV), valacivlovir, famciclovir - if given orally give with amino acid valine to increase its absorption in GI tract Need more to treat VZV than HZV
58
What vaccines are there for VZV/HZV?
Oka varicella vaccine - live vaccine - may still develop chicken pox but will be less severe - can cause rash Zoster vaccine - recommended when over 70 - reduces risk of shingles and post-herpetic neuralgia
59
What is bronchiolitis?
Inflammation of the bronchioles - smallest airways of the lungs - become inflamed and infected
60
What causes bronchiolitis?
Most commonly RSV - respiratory synctium virus
61
Who gets bronchiolitis?
90% of children 0-2. Peaks at 2-5 months Rare in first month of life and after 2 years Very low mortality 0.002% Can also get infected by RSV post hematopoeictic stem cell transplantation - from URTI to LRTI (50% nosocomially acquired)
62
What lines respiratory airways?
Cilliated psudostratified columnar epithelial cells
63
What lines the back of mouth and throat?
Mucosa - stratified squamous epithelium
64
What is croup?
Laryngo-tracheo-Bronchitis | Presents with hoarseness, barking cough and stridor
65
What is croup caused by?
Mainly parainfluenza viruses
66
What are common viral causes of pneumonia?
Influenza virus RSV Adenoviruses
67
What two viruses transmit with large droplets
RSV and the common cold
68
Descrive the influenza virus structure
RNA capsid, enveloped with two main glycoprotein: H - haemaglutinin - binds to cell it wants to enter at sialic acid receptor N - neuroaminidase - helps virus cleave off and be released Ion channel is M2: releases virus
69
What diseases do coronaviruses lead to?
Mostly common cold or other benign respiratory infection. But can be more severe: SARS & MERS
70
ebola is what kind of virus?
filovirus | ssRNA enveloped
71
where in body does ebola effect?
liver, kidney, GI tract, respiratory system, | most die within few weeks from renal failure due to hypotensive shock
72
lab findings of ebola
minimal abnormalities in early stages low thrombocytopaenia AST>ALT hypo all salts ca, k, na, mg
73
what is vaccine for ebola called?
rVSV-EBOV
74
what type of virus is Zika?
flavivirus