5/31/06
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| Naked nucleic acids from what kind of strands are infectious? | dsDNA (except poxvirus & HBV) and (+)strand ssRNA (~mRNA)
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| Naked nucleic acids of which strands are not infectious? | (-)RNA viruses and dsRNA viruses
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| Name the Naked (nonenveloped) RNA viruses...naked CPR | Calcicivirus, Picornavirus, Reovirus
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| All enveloped viruses gain their envelopes from the plasma membrane when they exit the cell except... | herpesvirus, which acquires it from the nuclear membrane
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| All viruses are haploid (1 copy of RNA or DNA) except... | retroviruses, which have 2 identical ssRNA molecules (diploid)
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| All DNA viruses replicate in the nucleus except | poxvirus
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| All RNA viruses replicate in the cytoplasm except | retroviruses and influenza
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| What kind of immunity does a live attenuated vaccine induce? | humoral and cell-mediated; can be virulent (avoid in immunocompromised/their family)
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| Killed vaccines activate what type of immunity? | humoral; these are stable
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| What are the live attenuated vaccines? | MMR, Sabin polio, VZV, yellow fever, smallpox
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| What are the killed vaccines? | rabies, influenza, HAV, Salk polio
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| Which vaccine is recombinant? | HBV; HbsAg
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| Define recombination | exchange of genes btw 2 chromosomes by crossing over w/in regions of significant base sequence homology
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| Define reassortment | when viruses with segmented genomes (ex: influenza) exchange segments; high-frequency recombination; causes worldwide pandemics
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| Define complementation | when 1 of 2 viruses that infect a cell has a mutation that results in a nonfunctional protein. The nonmutated virus "complements" the mutated one by making a functional protein to serve both viruses
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| Define phenotypic mixing | genome of virus A can be coated w/surface ptns from virus B; Type B ptn coat determines the infectivity of the phenotypically mixed virus but the Progeny of type A infxn is encoded by A genome
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| DNA enveloped viruses | Herpesviruses (HSV type 1 & 2, VZV, CMV, EBV), HBV, smallpox
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| DNA nucleocapsid viruses | Papillomavirus, Adenovirus, Parvovirus
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| RNA enveloped viruses | Influenza, parainfluenza, RSV, MMR, rabies, HTLV, HIV
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| RNA nucleocapsid viruses | Enteroviruses (polio, coxsackie, echo, HAV), rhino, reo
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| Slow viral infections (exist in pt for years before manifesting as clinical dz) | Subacute Sclerosing Panencephalitis (measles sequelae), Progressive Multifocal Leukoencephalopathy (reactivated JC virus in AIDS pts)
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| Segmented viruses: BOAR | Bunyaviruses, Orthomyxoviruses (influenza; 8 segments of (-)stranded RNA...reassortment), Arenaviruses, Reoviruses;
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| PicoRNAviruses = small RNA viruses | polio, rhino, coxsackie, echo, HAV; RNA is translaged into 1 large polypeptide that is cleaved by proteases into fxnl viral ptns; can cause aseptic (viral) meningitis except rhino and HAV
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| Rhinovirus...has a runny nose | cause of common cold; cannot cause meningitis; nonenveloped; 100 serologic types
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| ROTAvirus (right out of anus) | most important global cause of infantile gastroenteritis!!; segmented dsRNA reovirus; acute diarrhea in US in winter
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| Paramyxoviruses | parainfluenza (croup), mumps, measles, RSV (bronchiolitis, pneumonia) in infants; all have 1 serotype except parainfluenza (has 4) and RSV (has 2)
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| Mumps is a paramyxovirus with | 1 serotype; it gives you bumps (parotitis), meningitis, & orchitis (testes); can cause sterility esp after puberty
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| Measles virus is a paramyxovirus that | causes measeles; Koplik (blue/gray) spots on buccal mucosa; SSPE, encephalitis, giant cell pneumonia; cough, coryza, conjunctivitis
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| Influenza viruses are | segmented enveloped ssRNA; Hemagglutinin +, Neuraminidase +; Pandemic; risk for bacterial superinfxn; rapid genetic changes (shift or drift)
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| Define Genetic Shift | reassortment of viral genome; ex: when human flu A recombines with swine flu A
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| Define Genetic Drift | minor changes based on random mutation
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| How do you protect against influenza? | killed vaccine which is reformulated each fall; offered to elderly, newborns, healthcare workers
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| Which drugs are used as prophylaxis for influenza A exposure? | Amantadine and Rimantadine
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| Which drugs are used as prophylaxis for influenza A and B exposure? | Zanamivir and Oseltamivier (neuraminidase inhibitors)
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| Rabies infection is characterized by | Negri bodies (inclusions in neurons); Retrograde migration in CNS thru axons; virus has a bullet-shaped capsid; Long (wks-3mo) Incubation; Fatal encephalitis w/seizures & hydrophobia; Bat/racoon/skunk bites in US; Tx = antiserum and vaccine
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| ARBOvirus are ARthopod-BOrne viruses including: | flavi, toga, bunyaviruses; mosquitos, ticks; Dengue fever (bone-break) and Yellow fever; variant in SE Asia is hemorrhagic shock syndrome
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| Yellow Fever is caused by | flavivirus; Aedes mosquito; Monkey and human reservoir; High fever, BLACK VOMITUS, jaundice; "Councilman bodies" in liver (acidophilic inclusions)
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| HSV-1 is acquired via .... and causes... | respiratory secretions or saliva; gingivostomatitis, keratoconjunctivitis, temporal loba encephalitis, herpes labialis
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| HSV-2 is acquired by... and causes ... | sexual, perinatal; herpes genitalis, neonatal herpes meningoencephalitis
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| VZV is acquired by ... and causes... | respiratory secretions; shingles, encephalitis, pneumonia
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| EBV is acquired by.... and causes... | respiratory secretions, saliva; infectious mononucleosis, Burkitt's lymphoma
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| CMV is acquired by... and causes... | congenital, transfusion, sex, saliva, urine, transplant; Congenital infxn (cutaneous bleed, deaf, CNS periventricular calcification, microsephaly), mononucleosis, pneumonia
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| What is the most common cause of intrauterine fetal viral infection? | CMV
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| HHV-8 is acquired by.... and causes ... | sex; Kaposi's sarcoma (HIV pts)
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| Facts about mononucleosis...cause...symptoms...incidence... | EBV (herpesvirus); fever, hepatosplenomegaly, pharyngitis, lymphadenopathy (esp Post Auricular Nodes); 15-20yo "kissing dz"
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| Tests for EBV mononucleosis | Positive Monospot/heterophil Ab test (agglutinates sheep RBCs); atypical CD8 lymphocytes
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| Tzanck Test is performed by... | smearing an open skin vesicle to detect Multinucleated Giant Cells; used to assay for HSV-1, -2, or VZV
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| HIV genome | diploid; 2 RNA molecules; uses Reverse Transcriptase to make dsDNA which integrates with the host DNA
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| p24 | HIV rectangular nucleocapsid protein
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| gp41 and gp120 | HIV envelope proteins
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| Presumptive HIV diagnosis | ELISA (sensitive, high false + rate...this test rules out negatives)
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| Positive HIV ELISAs are confirmed with... | western blot (specific, high false-negative rate; rule in test)
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| HIV PCR/viral load tests | measures viral RNA in blood; allows Dr to monitor drug therapy by observing decrease in levels
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| ELISA and Western blot tests for HIV are often Falsely Negative during this time period: | 1-2 months following infection; they screen for antibodies to viral proteins
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| CCR5 mutation is a/w | 1% and 20% of caucasians who either have immunity (homozygous) or a slower course (heterozygous) when exposed to HIV
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| CXCR1 mutation is a/w | rapid progression to AIDS
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| Acute phase of HIV infection | 0-3 months; viral load is up in the middle causing flu-like symptoms
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| Latent phase of HIV infection | CD4 lymphos are stable, viral load is low, Abs produced against p24 and gp120; 2-3months - years
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| Immunodeficiency; AIDS phase of HIV infection | plummeting CD4 levels; decline in antibodies, rise in viral/p24Ag load
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| Bacterial opportunistic infections in AIDS | TB, Mycobacterium avium-intracellulare complex
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| Viral opportunistic infections in AIDS | HSV, VZV, CMV, PML (JC virus)
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| Fungal opportunistic infections in AIDS | Thrush (candida), cryptococcosis (meningitis), histoplasmosis, pneumocystis pneumonia
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| Protozoan opportunistic infections in AIDS | Toxoplasmosis, cryptosporidiosis
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| Prions | infectious proteins that do not have RNA or DNA ; encoded by cellular genes; Creutzfeld-Jakob (rapid progressive dementia), kuru; a/w Spongiform encephalopathy; beta-pleated sheets
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| Congenital HSV | acquired during delivery; vesicles, encephalitis, retinitis, or disseminated disease
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| Congenital Rubella | MR, heart abnormalities, blindness, encephalitis, motor abnormalities
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| Congenital Syphilis | death in utero; teeth, bone, CNS abnormality
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| Congenital Toxoplasmosis | severe if acquired during pregnancy; still birth, chorioretinitis, intracerebral calcifications, microcephaly
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