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Virology
USMLE basic virology
| Question | Answer |
|---|---|
| Explain the difference between cell susceptibility and permissiveness. ` | Susceptibility means the surface receptors for viral attachment are available. Permissiveness means that all the machinery for viral replication are available, including the surface receptors. |
| Can viral RNA be circular | No, viral RNA comes as ssRNA (+), ssRNA (-), dsRNA, and single stranded with DNA intermediate. All types are linear. only DNA virus carry circular DNA. |
| List the required to know dsDNA naked viruses. | adenoviridae, papillomoviridae |
| List the required to know dsDNA enveloped viruses. | herpesviridae and poxviridae |
| List the circular partially dsDNA enveloped virus. | Hepadnaviridae |
| List the ssDNA naked virus | Parvoviridae |
| List the naked dsRNA virus. | Reoviridae |
| List the naked ssRNA (+) viruses. | picornaviridae*, caliciviridae*, hepeviridae*, astroviridae |
| list the enveloped ssRNA (+) viruses. | coronaviridae*, flaviviridae*, togaviridae*, arteriviridae |
| list the enveloped ssRNA (+) diploid with iDNA virus. | Retroviridae |
| List the enveloped ssRNA (-) viruses. | orthomyxoviridae (helical H1N1 and influenza B and C)*, paramyxoviridae (helical measles, mumps, RSV, croup, and metapneumonia)*, rhabdoviridae (helical; rabies)*, filoviridae (filamentous; ebola, marburg)*, arenaviridae (pleiomorphic; lasa, etc) |
| List the filamentous, pleomorphic, baccillum, and spherical virus families. | Filoviridae, arenaviridae, coronaviridae, flaviviridae. |
| acquired primarily orally, syncitia inclusion bodies, and may cause hepetic whitlow and/or herpes gladiatorum | HSV-1 |
| Associated with a common sarcoma in Africa, but primary infection is rarely observed. This virus is an important cause of cancer in immunocompromised and transplant patients. | HHV-8 Koposi's sarcoma-associated herpesvirus |
| Russell bodies, downey-cell type, and monospot test are things to look out for with this virus. May cause Burkits lymphoma, Hodgkins disease, and nasopharyngeal lymphoma with a possible recurrence in pregnancy. | Epstein-barr virus HHV-4 |
| The most common viral cause of congenital defects along with being an opportunistic pathogen in immunocompromised patients. Can be passed by sexual, oral, congenital, blood transfusion or tissue transfusion routes. Look for "owl's eye" in slides. | cytomegalovirus HHV-5 |
| Causes xanthoma subitum (roseola) with signs of high fever, erythmatous macular rash on neck and trunk lasting a few days without sequelae. May cause encephalitis in immunocompromised patients. | HHV 6 & 7 |
| This virus causes inflammation and activation of NF-kB to block apoptosis while also activating transcription factors with its own genes. It may cause hepatocellular carcinoma. | HBV (HBX gene) |
| This virus enters B-cells through CD21 and promotes proliferation, increasing the risk of a (8,14) translocation. Burkitts lymphoma, hodgkins lymphoma, CNS B-cell lymphoma in AIDs, and nasopharyngeal carcinoma. starry-sky appearance in microscopy. | EBV |
| This virus has a protein that inhibits P53 and another that inhibits Rb, P21, and P53 to cause squamous cell carcinom in the larynx, oropharynx, cervix, vulva, penis, anogenital regions. | HPV (HPV E6 and E7) 16,18,31 are high risk while 6 and 11 are low risk. |
| Associated with kaposis sarcoma in AIDs by causing spindle cell proliferation. | HHV-8 |
| Associated with T-cell leukemia and lymphoma by activating TAX genes promoting T-cell proliferation and later monoclonal T-cell proliferation. Japan and caribbean basin are high incidence areas. | HTLV-1 |
| This virus produces proteins that activate growth promoting signal transduction pathways which causes chronic liver injury and regeneration eventually leading to hepatocellular carcinoma. | HCV |
| List antiretroviral NRT1 drugs. | Abacavir, Didanosine, emtricitabine, lamivudine, stavudine, tenofovir, zidovudine |
| List antiretroviral NNRTI drugs. | Dalaviridine, Efavirenz, Nevirapine. |
| List antiretroviral PI drugs. | Atazanavir, indinavir, lopinavir, ritonavir, saquinavir |
| List Antiretroviral entry inhibitor drugs. | Enfuvirtide, maraviroc. |
| List antiretroviral integrase inhibitor drugs. | Raltegravir |
| HIV-1 and HIV-2 treatment that requires intracytoplasmic activation via phosphorylation to a triphosphate form to competitively inhibits HIV reverse transcriptase. Has mitochondrial toxicity and lactic acidosis adverse effects. | Abacavir, Didanosine, emtricitabine, lamivudine, stavudine, tenofovir, zidovudine |
| HIV-1 specific treatment with no phosphorylation steps and highly metabolized and eliminated by CYP450. Binds HIV-1 reverse transcriptase resulting in allosteric, noncompetitive inhibition of the enzyme. | Dalaviridine, Efavirenz, Nevirapine. |
| No intracellular activation is required but is extensively metabolized by CYP3A4. Treatment of HIV-1 and HIV-2 by competitively inhibiting HIV aspartyl protease. Inhibits CYP3A4 and redistributes body fat, increases LDL/triglyceride, hyperglycemia. | Atazanavir, indinavir, lopinavir, ritonavir, saquinavir |
| Given SC 2X/day to treat HIV-1 specifically by binding gp41 to prevent fusion and inhibit CD4 and cell-to-cell HIV transmission.Treats therapy-experienced adults and children >6y/o. causes injection site reaction. | Enfuvirtide |
| Taken orally to bind specifically to CCR5 to block CCR5-tropic R5 HIV-1 gp120 binding.URis, arthritis/musculoskeletal symptoms, and hepatotoxicity are potential SAs. | Maraviroc |
| Oral pyrimidinone treating HIV-1 and HIV-2 by inhibiting integrase. Total cholesterol is increased and suicidality are potential side affects. | Raltegravir. |
| Given to prevent the transmission of HIV to newborns from mothers or post-occupational exposure prophylaxis. | Zidovudine, nevirapine |
| Peptidomimetic that is used as an inhibitor of CYP34A in combination with PIs to decrease frequency of dosing, increase tolerability, and increase potency. May have life-threatening drug inteactions. | Ritonavir. |
| Taken on an empty stomach due to gastric acid inactivating the drug and has highest risk to cause pancreatitis and optic neuritis | Didanosine |
| HIV medications that can also be used in the treatment of HBV. | Tenofovir, Lamivudine, Emtricitabine, |
| List the best combination of NNRTI + 2 NRTIs for treatment of HIV. | Efavirenz + tenofovir/emtricitabine |
| List the best combination of booster PI + 2 NRTIs for treatment of HIV. | Atazanavir/ritonavir + tenofovir/emtricitabine |
| List the best combination of integrase inhibitor + 2 NRTI's | Raltegravir + tenofovir/emtricitabine |
| Deltavirus associated with Hairy T-cell Leukemia. | HTLV-2 |
| ATLL and presentation of myelopathy/tropical spastic paraparesis due to preferential damage to thoracic spinal cord. Which deltavirus is indicated? | HTLV-1 |
| V-Src oncogenic mechanism | Focal adhesion kinase (Fak) increases tyrosine phosphorylation; Fac and Src cascades influence cell shape and adhesion. Map kinase pathway is induced for cell proliferation. |
| HTLV-1 oncogenesis | Tax-IL2 and IL2R promotion=Tcell growth, viral mRNA synthesis, and induction of NF-kB; REX and HBZ limit Tax activity promoting cell survival= long latency, but poor prognosis. |
| Epstein-Barr Virus oncogenesis | AfBL/hodgkins- EBNA1 consistently on; LMP1 activates NF-kB/Erk/p38/JNK/Akt and is growth factor mimicer; EBNA-2 activates cyclin D/src; malaria, t(8:14)-cmyc are cofactors AfBL; salted/dried fish w/ NPC;PTLD and HCLP from overactive jak/STAT |
| human herpesvirus 8 oncogenesis | Kaposi's sarcoma from sexual transmission that precedes sarcoma by 3 years with several viral factors stimulating cell proliferation and defense modification |
| Papillomaviridae oncogenesis | HPV-16 and HPV-18 are most common high risk while HPV-6 and HPV-11 are the most common cause of angogenital and laryngeal warts. E6 and E7 inactivate Rb, p53 and other proteins. |
| Hepadnaviridae oncogenesis | partially double stranded DNA enveloped with DNA polymerase and RNA intermediate HBV may cause cirrhosis with cell-mediated immunity, phagocytic ROS responses, and protein X (P53 binding) playing role in hepatocellular carcinoma. |
| Flaviviridae oncogenesis | ssRNA enveloped HCV can cause persistent infection leading to cirrhiosis and potentially hepatocellular carcinoma. |
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