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Microbiology
FA complete review part 4 Virology and Fungi
| Question | Answer |
|---|---|
| Viral recombination: | Exchange of genes between 2 chromosomes by crossing over within regions of significant base sequence homology |
| Which type of viral genomes undergo viral reassortment most readily? | Segmented genomes |
| What is a very common virus to undergo viral reassortment? | Influenza virus |
| Viruses with segmented genomes exchange genetic material. What is the name of this genetic viral process? | Viral reassortment |
| Viral reassortment can cause ____________________ shift. | Antigenic |
| What is viral complementation? | When 1 of 2 viruses that infect the cell has a mutation that results in a nonfunctional protein, the non mutated virus "complements" the mutated one by making a functional protein that serves both viruses |
| In case that one virus gets mutated and produces a nonfunctional protein, but another virus picks the problem and creates a protein for both viruses to work. This process is called_________________. | Complementation |
| What is a common association or example of viral complementation? | Hepatitis D virus requires Hepatitis B for survival |
| When does Phenotypic mixing occurs? | In simultaneous infection of a cell with 2 viruses |
| In phenotypic mixing of 2 viruses, which virus determines the tropism (infectivity)? | VIrus B (one with the surface proteins reacting to Virus A) |
| Which is the only DNA virus with single stranded DNA? | Parvoviridae |
| Which are the circular DNA viruses? | Papilloma-, polyoma-, and hepadna viruses |
| Which is the only RNA virus with a double stranded RNA? | Reoviridae |
| Reoviridae is the only RNA virus with: | Double stranded RNA |
| List of (+) stranded RNA viruses: | 1. Retrovirus 2. Togavirus 3. Flavivirus 4. Coronavirus 5. Hepevirus 6. Calicivirus 7. Picornavirus |
| How many (+) stranded RNA viruses exist (USMLE important)? | 7 |
| What conditions are known to always produce a non infectious virus? | Naked nucleic acids of (-) ssRNA and dsRNA viruses |
| All (+) strand ssRNA and most dsDNA virus have _____________nucleic acids, which makes them __________. | Purified; infectious |
| Naked DNA viruses are: | Papillomavirus, Adenovirus, Parvovirus, adn Polyomavirus |
| Naked RNA viruses are: | Calicivirus, Picornavirus, Reovirus, and Hepevirus |
| The PAPP mnemonic is used to remember: | Non Enveloped DNA viruses |
| CPR and hepevirus (mnemonic) | Used to remember non-enveloped RNA viruses |
| All DNA viruses are ___________________, except for: | ICOSAHEDRAL; Pox (complex) |
| What is the shape of most (except Pox) DNA viruses? | ICOSAHEDRAL |
| Which is the only DNA virus that does NOT replicate in the nucleus? | Poxvirus |
| Where do all DNA viruses, except Pox, replicate? | In the nucleus |
| What are the most common DNA viruses? | Hepadna, Herpes, Adeno, Pox, Parvo, Papilloma, and Polyoma. |
| Poxvirus structure: | Enveloped, dsDNA linear virus |
| Associated conditions with Poxvirus: | 1. Smallpox 2. Cowpox 3. Molluscum contagiosum |
| What virus causes Molluscum contagiosum? | Poxvirus infection |
| Which is the largest DNA virus? | Poxvirus |
| Poxvirus is the _________________ DNA virus. | Largest |
| Flesh-colored papule with central umbilication caused by Pox virus. | Molluscum contagiosum |
| Which is the only DNA hepatitis virus? | Hepatitis B |
| What is the structure of Hepadnavirus? | Enveloped, partially double stranded and circular DNA virus |
| Which DNA viral family has a partially ds DNA? | Hepadnavirus |
| Associated conditions with Adenovirus: | 1. Febrile pharyngitis - sore throat 2. Acute hemorrhagic cystitis 3. Pneumonia 4. Conjunctivitis - "pink eye" 5. Gastroenteritis 6. Myocarditis |
| What is the most common viral family responsible for viral sore throat? | Adenovirus |
| Adenovirus a a ______________________________________ virus. | Naked, linear, dsDNA |
| Common viral cause of "pink eye"? | Adenovirus |
| HPV pertains to which viral family? | Papillomavirus |
| What is the structure of Papillomavirus? | Naked, double-stranded circular DNA |
| What conditions/pathologies are associated with Papillomavirus? | 1. HPV - warts 2. CIN 3. Cervical cancer |
| Which papilloma stereotypes are most commonly associated with HPV warts? | 1, 2, 6, 11 |
| Cervical cancer serotypes of Papillomavirus are: | 16 and 18 |
| Naked, double stranded circular DNA describes which DNA viruses? | Papillomavirus and Polyomavirus |
| What are associated medical conditions of Polyomavirus? | 1. JC virus --> Progresive multifocal leukoencephalopathy (PML) in HIV 2. BK virus --> transplant patients, commonly targets the kindney |
| Which organ is most affected/targeted by BK virus? | Kidney |
| JC virus causes what condition in HIV patients? | Progressive multifocal leukoencephalopathy (PML) |
| What is the unique structure of Parvovirus? | Naked, single stranded, and linear DNA virus |
| Which is the smallest DNA virus? | Parvovirus |
| Parvo = | Small |
| What subtype of Parvovirus is very important? | B19 virus |
| What causes B19 Parvovirus infection? | Aplastic crisis in sickle cell disease, "slapped cheek" rash in children |
| What condition(s) are associated with "slapped cheek" rash in children? | Erythema infectiosum or (fifth disease) |
| What is another name for Erythema infectiosum? | Fifth disease |
| How does Parvovirus cause Hydrops fetalis in pregnant women? | It promotes RBC destruction in fetus |
| What is the possible result of parvovirus infection in healthy adult? | Pure RBC aplasia and rheumatoid arthritis- like symptoms |
| Which population, other than children, is in high risk of an B19 virus infection? | Sickle cell disease patients |
| What is the structure description of Herpesviruses? | Envelope, DS, and linear DNA viruses |
| Herpesviruses are DNA or RNA? | DNA |
| What is the clinical significance of Herpes simplex virus-1? | Gingivostomatitis, keratoconjunctivitis, herpes labialis, herpetic whitlow on finger, temporal lobe encephalitis, esophagitis, and erythema multiforme |
| Erythema multiforme is seen with what type of Herpes virus? | HSV 1 |
| What type of encephalitis is often seen with HSV 1 infection? | Temporal lobe encephalitis |
| Which cranial lobe is most commonly affected by HSV 1? | Temporal lobe |
| Herpes labialis, Temporal lobe encephalitis and erythema multiforme are all due to HSV _____ infection. | 1 |
| Which ganglia is most commonly seen with LATENT HSV 1? | Trigeminal ganglia |
| What is the most common cause of Sporadic Encephalitis? | HSV-1 infection |
| What are common symptoms of HSV-1 induced sporadic encephalitis? | Mental status changes, seizures, and/or aphasia |
| What are the two conditions seen with HSV -2 infections? | 1. Herpes genitalis 2. Neonatal herpes |
| Genital ulcers due to __________ are painful. | HSV-2 |
| Route of transmission of HSV-2? | Sexual contact and Perinatal |
| Zoster virus refers to which herpes type? | HHV-3 |
| What is the MC complication of Varicella-Zoster-shingles? | Post-herpetic neuralgia |
| What are common conditions caused by HHV-3 infection? | Varicella-zoster (chickenpox, shingles), encephalitis, and pneumonia |
| What ganglia are associated with latent HHV-3? | Dorsal root and trigeminal ganglia |
| Associated ganglia of HSV-2? | Sacral ganglia |
| Viral meningitis is more common with HSV-1 or HSV-2? | HSV-2 |
| What CN V branch is responsible for Herpes zoster ophthalmicus? | V1 |
| Infection to CNV1 with Varicella-Zoster virus causes? | Herpes zoster ophthalmicus |
| What is the common name of HHV-4? | Epstein-Barr virus |
| "Kissing disease" is due to infection with: | EBV |
| EBV is the same as ______________ . | HHV-4. |
| What is the Monospot test? | Form of the heterophile antibody test. |
| Rapid test for infectious mononucleosis due to Epstein–Barr virus (EBV) | Monospot test |
| A positive Monospot test indicates? | Mononucleosis due to EBV |
| CMV mononucleosis has a _______________ Monospot test. | Negative |
| What are clinical features of EBV mononucleosis? | Fever, hepatosplenomegaly, pharyngitis, and lymphadenopathy |
| Which lymph nodes are most affected by EBV mononucleosis? | Posterior cervical nodes |
| Posterior cervical node enlargement is most likely due to: | Mononucleosis due to EBV infection |
| Malignancies associated with EBV are: | 1. Lymphoma (Burkitt) 2. Nasopharyngeal carcinoma (Asian adults) 3.. Lymphoproliferative disease in transplant patients |
| What cells are most affected by EBV? | B cells through CD21 |
| What receptor is use by EBV in B cells to better infect? | CD21 |
| What is the result of treating EBV mononucleosis with amoxicillin? | Characteristic maculopapular rash |
| Burkitt lymphoma is commonly seen with _______________ infection. | EBV |
| What is the mode of transmission of CMV? | Congenital transfusión, sexual contact, saliva, urine and transplant |
| Which kind of patients are more susceptible for (-) monospot mononucleosis? | Immunocompetent |
| Which population is at risk of severe complications with CMV infection? | ImmunoCOMPROMISED |
| What are some conditions associated with CMV infection in those immunocompromised? | 1. Pneumonia -- transplant patients 2. Esophagitis 3. AIDS ---> Retinitis |
| Which cells keep latent form of CMV? | Mononuclear cells |
| What is the histologic key feaute of CMV infected cells? | "Owl eye" intranuclear inclusions |
| What is the common name for HHV-5? | Cytomegalovirus |
| How is CMV retinitis presented? | Hemorrhage, cotton-wool exudates, and vision loss |
| Cotton-wool exudates is a key finding for: | CMV-retinitis |
| Which two forms of herpesvirus give rise to Roseola? | HHV-6>> HHV-7 |
| How is Roseola clinically described? | Fever first, Rosy (rash later) |
| Another name for Roseola infantum? | Exanthem subitum |
| High fevers for several days that can cause seizures, followed by diffuse macular rash. | Roseola infantum |
| Key fever for Roseola infantum? | High fever for several days |
| Kaposi Sarcoma is due to what infectious agent? | HHV-8 |
| Neoplasm of endothelial cells due to HHV-8 infection in HIV patient. | Kaposi sarcoma |
| What is the description of Kaposi sarcoma? | Dark/violaceous plaques or nodules representing vascular proliferations |
| What organs are most affected by Kaposi sarcoma? | Skin>>>> GI tract and lungs |
| What HSV identification is used for herpes encephalitis? | CSF PCR |
| What virus is identified with the Tzanck test? | Herpes simplex |
| A smear of an opened skin vesicle detect multinucleated giant cells commonly seen in HSV-1, HSV-2, and VZV infection. | Tzanck test |
| What histological finding is seen in HSV-1, HSV-2, and VZV? | Intranuclear eosinophilic Cowdry A inclusions |
| What receptors are used by CMV? | Integrins (heparan sulfate) |
| Heparan sulfate or integrins are used as receptor by __________. | CMV |
| CD 21 are the receptors used by __________. | EBV |
| Which receptors are used by EBV? | CD21 |
| What are the receptors used by HIV? | CD4, CXCR4, and CCR5 |
| What receptors are used by Parvovirus B19? | P antigen on RBCs |
| Where is the P antigen used by Parvovirus B19 located? | On the RBCs |
| Which virus used Nicotinic AChR (receptor) for infection? | Rabies |
| The ICAM-1 serves as receptor for which virus? | Rhinovirus |
| What is the receptor used by Rhinovirus? | ICAM-1 |
| Which are the exceptions to RNA viruses all replicating in the cytoplasm? | Retrovirus and Influenza virus |
| What are the medically relevant conditions associated with Reovirus infection? | 1. Coltivirus - Colorado tick fever 2. Rotavirus - cause of fatal diarrhea in children |
| What virus is responsible for the Colorado tick fever? | Coltivirus |
| The Rotavirus is part o the _______________ viral family. | Reoviridae |
| What is the structure of Reovirus? | Naked, ds-stranded, linear RNA virus |
| What is the capsid shape of reoviruses? | Icosahedral (double) |
| How many segments does Reoviruses usually have? | 10-12 |
| NOn-enveloped, (+) single-stranded, linear RNA viral families? | Picornavirus, Hepevirus, Caliciviruses |
| What mnemonic is used to recall the associated pathologies due to Picornaviruses? | PERCH |
| PERCH stands for: | P- Poliovirus -polio Salk/Sabin vaccines - IPV/OPV E- Echovirus - aseptic meningitis R- Rhinovirus - "common cold" C- Coxsackievirus - aseptic meningitis; herpangina; hand, foot, and mouth disease, myocarditis; pericarditis H- HAV - acute viral hepatitis |
| Which two Picornaviruses are causative of aseptic meningitis? | Echovirus and Coxsackie virus |
| What is herpangina? | Mouth blisters and fever |
| What virus causes Hand, foot, and Mouth disease? | Coxsackievirus |
| The Rhinovirus is the most common cause of the _______________. | Common cold |
| What is the organism that causes the common cold? | Rhinovirus |
| HEV is part of the _____________ viral family. | Hepeviridae |
| What is the most common Calicivirus? | Norovirus |
| What is the result a Norovirus infection? | Viral gastroenteritis |
| Enveloped, SS (+) linear, Icosahedral capsid. Seen with which RNA viruses? | Flaviviruses and Togavirus |
| What is the difference between the structure of Togaviruses and Flaviviruses, to that of Coronavirus? | Coronavirus family have a helical caspied while Togaviruses and Flaviviruses have a Icosahedral capsid symmetry |
| What are the Medical relevant Flaviviruses pathologies? | 1. HCV 2. Yellow fever 3. Dengue 4. St. Louis encephalitis 5. West Nile virus - meningoencephalitis 6. Zika virus |
| HCV is a _______________________. | Flavivirus |
| What is the molecular shape of HCV and Yellow fever? | Enveloped SS(+), linear icosahedral |
| Rubella is caused by _______________ viral family | Togavirus |
| What are the 3 main associated conditions of Togaviruses? | Rubella, Western and Eastern equine encephalitis, and Chikungunya virus |
| Chikungunya virus is part of the _________ viral family. | Togaviridae |
| What is very special about retroviruses? | Have reverse transcriptase |
| What are two common Retroviruses? | HTLV ---> T-cell leukemia HIV ----> AIDS |
| Coronavirus is : | Enveloped, single stranded (+) sense, linear and with a helical capsid |
| What are common Coronavirus conditions? | "Common cold", SARS, MERS, and COVID-19. |
| SARS and MERS are both _______________. | Coronaviruses |
| How many segments are in Orthomyxoviruses? | 8 segments |
| What is the most common Orthomyxovirus? | Influenza virus |
| The influenza virus is an ____________________, that replicates in the ____________. | Orthomyxovirus; nucleus |
| What are the 4 main Paramyxoviruses? | Parainfluenza, RSV, and Measles, Mumps |
| Parainfluenza virus is an ___________________ that causes _________. | Paramyxovirus; Croup |
| MCC of bronchiolitis in babies? | RSV |
| RSV is an _________________. | Paramyxovirus |
| Measles and Mumps, both are _______________. | Paramyxoviruses |
| What the genomic structure of Rhabdoviruses? | Enveloped, SS (-) linear, helical RNA virus |
| What is the condition caused by Rhabdoviruses? | Rabies |
| Common types of Filovirus? | Ebola/Marburg hemorrhagic fever |
| Ebola is a type of __________. | Filovirus |
| How many segments are in Arenavirus? | 2 |
| 2 Conditions due to Adenovirus? | 1. LCMV- Lymphocytic choriomeningitis virus 2. Lassa fever encephalitis |
| What animals spread the Lassa fever encephalitis virus? | Rodents |
| Viral genome of Bunyaviruses is seen in _______ segments | 3 |
| What are 4 conditions/viruses of the Bunyaviridae family? | 1. California encephalitis 2. Sandfly/Rift Valley fevers 3. Crimean-Congo hemorrhagic fever 4. Hantavirus - hemorrhagic fever, pneumonia |
| HDV is a ____ virus | Delta |
| Which is known as a "defective" virus | HDV |
| Negative stranded viruses must ---> | Transcribe (-) strand to (+) |
| What is "brought by negative stranded virions" in order to transcribe into (+ ) strand? | RNA-dependent RNA polymerase |
| Which are the negative stranded viruses? | Arenavirus, Bunyaviruses, Paramyxoviruses, Orthomyxoviruses, Filoviruses, and Rhabdoviruses |
| BOAR stands for: | Bunyavirus, Orthomyxoviruses, Arenaviruses, and Reoviruses |
| Which mnemonic is used to remember the Segmented viruses? | BOAR |
| What are the common symptoms of the Yellow fever virus? | High fever, black vomit, and jaundice |
| What the key histological findings of liver bx in a patient with Yellow fever virus? | Councilman bodes |
| What are the Councilman bodies? | Eosinophilic apoptotic globules |
| What condition is seen with the appearance of Councilman bodies on liver biopsy? | Yellow Fever |
| What are the two most common reservoirs of Yellow fever virus? | Monkeys and humans |
| Flavi = | Yellow, jaundice |
| Yellow fever virus is an ________________________. | Flavivirus |
| What is the most important cause of infantile gastroenteritis? | Rotavirus |
| A rotavirus is recommended for all infants except for those with: | Hx of Intussusception or SCID |
| What virus is the MCC of acute diarrhea in winter in places such as day care centers and kindergartens? | Rotavirus |
| What is the result of the villous destruction with atrophy caused by Rotavirus? | Decreased absorption of Na+ and loss of K+ |
| Rotavirus is a ___________________________________. | Segmented dsRNA virus (a reovirus) |
| Influenza viruses are: | Orthomyxovirus. Enveloped, (-) ssRNA viruses with 8-segment genome. |
| What are two important antigens in the Influenza viruses? | 1. Hemagglutinin 2. Neuraminidase |
| What is the role of Hemagglutinin in the influenza virus? | Binds sialic acid and promotes viral entry |
| What influenza antigen promotes viral entry? | Hemagglutinin |
| What is the function of the Neuraminidase antigen in Influenza viruses? | Promotes progeny virion release |
| Which influenza virus antigen promotes the release of progeny virion? | Neuraminidase |
| A coinfection with some bacteria and the Influenza virus leads to a: | Fatal bacterial superinfection |
| Which are the most common bacteria that produce a fatal bacterial superinfection as they are co-infectious with influenza virus? | S. aureus, S. pneumoniae, and H. influenzae |
| What does the"flu shot" contain? | Viral strains most likely to appear during the flu season, due to virus' rapid genetic change |
| The "flu shot" is a vaccine for what organism? | Influenza virus |
| What route is used for the Live attenuated Influenza vaccine? | Intranasal |
| What is special about the Live attenuated influenza vaccine? | Contains a temperature-sensitive mutant that replicates in the nose bu not in the lung. |
| What type of antigenic change are responsible for PANDEMICS? | Genetic/antigenic shift |
| What is a antigenic shift? | Reassortment of viral genome segments |
| What is an antigenic drift? | Minor changes based on random mutation in hemagglutinin or neuraminidase genes |
| The combination of human flu A virus reassortant with swine flu A virus. | Antigenic shift |
| An antigenic shift or antigenic drift is more severe? | Antigenic shift |
| What was the old name of Rubella? | German (3-day) measles |
| What are the clinical symptoms of Rubella? | Fever, postauricular and other lymphadenopathy, arthralgias, and fine, maculopapular rash that starts on face and spreads centrifugally to involve trunk and extremities |
| How is the rash seen in Rubella spread? | Starts on face; Spreads centrifugally to involve trunk and extremities |
| German (3-day) measles is also known as: | Rubella |
| What are some important features of Congenital Rubella? | "blueberry muffin" appearance due to dermal extramedullary hematopoiesis. |
| What is the expression of dermal extramedullary hematopoiesis in Rubella? | "blueberry muffin" appearance |
| What population is most affected by Paramyxoviruses? | Children |
| What diseases are caused by Paramyxoviruses? | Parainfluenza (croup), mumps, measles, RSV, and human metapneumovirus, which causes bronchiolitis or pneumonia in infantas |
| What is the function of surface F (fusion) protein in Paramyxoviruses? | Respiratory epithelial cells to fuse and form multinucleated cells |
| What is the best treatment for RSV infection in infants? | Palivizumab |
| Palivizumab is n: | Monoclonal antibody against F protein |
| What condition is treated with Palivizumab? | Infant-bronchiolitis caused by RSV |
| What is the typical description of cough seen in Croup? | "seal-like" barking cough and inspiratory stridor |
| What are classign findings on x-ray of Croup? | Narrowing of upper trachea and subepiglottic leads to characteristic steeple sign |
| X-ray finding --> "Steeple sign". Dx? | Croup |
| What is a possible complication of severe croup? | Pulsus paradoxus secondary to upper airway obstruction |
| What are the 3 C's of measles? | Cough Coryza Conjunctivitis |
| What vitamin supplementation has proven to reduce morbidity and mortality of Meals (rubeola)? | Vitamin A |
| What is another name used for Measles? | Rubeola |
| What are the bright red spots with blue-white center on buccal mucosa seen in Measles? | Koplik spots |
| What is happens 1-2 days later appearance of Koplik spots in a Measles patient? | Maculopapular rash that starts at the head/neck and spreads downward |
| How does the measles (rubeola) rash spreads? | Downward |
| What are histological findings in the lymphadenitis caused by Measles? | Warthin-Finkeldey giant cells in background of paracortical hyperplasia. |
| What are three possible sequelae of Measles virus infection? | 1. SSPE (Subacute Sclerosing Panencephalitis) 2. Encephalitis 3. Giant cell pneumonia |
| What viral family causes Mumps? | Paramyxovirus |
| What vaccine is used to prevent mumps? | MMR vaccine |
| What are the most significant signs and symptoms of mumps? | Parotitis, Orchitis, aseptic Meningitis, and Pancreatitis |
| If mumps happen after ____________________-, it is much highly probable to cause infertility. | Puberty |
| What is severe complication of mumps after puberty? | Infertility |
| What is orchitis? | Inflammation of testes |
| Bulle-shaped virus. | Rabies virus |
| Which virus has Negri bodies (cytoplasmic inclusions)? | Rabies virus |
| Where are Negri bodies found in the patient infected with Rabies? | Purkinje cells of cerebellum and in hippocampal neurons |
| What is post exposure prophylaxis to Rabies virus? | Wound cleaning plus immunization with killed vaccine and rabies immunoglobulin. |
| What is the incubation period of Rabies virus? | Weeks to months |
| Rabies virus travels to the CNS in a ______________________ fashion. | Retrograde |
| What receptors do Rabies virus bind to in order to retrogradely travel to the CNS? | ACh receptors |
| What is the progression of Rabies? | Fever, malaise --> agitation, photophobia, hydrophobia, hypersalivation --> paralysis, comma --> death. |
| Patient with too much saliva, bothered by lights and refuse to drink water. Dx? | Rabies |
| What are the most common animal bites that transmit rabies? | Bat, raccon, and skunk |
| Person in a bat cave is possible to contract what via aerosol transmission? | Rabies virus |
| What is the target of the Ebola virus? | Endothelial cells, phagocytes, hepatocytes. |
| What are some severe complications of Ebola virus infection? | DIC, diffuse hemorrhage, shock |
| Ebola's mode of transmission. | Requires direct contact with bodily fluids, fomites, infected bats or primates. |
| What is the incubation period (time) of Ebola? | 21 days |
| What laboratory technique is used to diagnose Ebola? | RT-PCR within 48 hours of symptoms onset |
| What is the mosquito that transmits ZIka virus? | Aedes mosquito bites |
| Common flavivirus | Zika virus |
| What are fetal complications of Zika virus infection? | Congenital microcephaly or miscarriage |
| What areas are most commonly affected by Zika virus? | Tropical and subtropical climates |
| Besides Aedes mosquito bites, how else is Zika virus transmitted? | Sexual and vertical transmission |
| What are common symptoms of Zika virus infection? | Conjunctivitis, low grade pyrexia, and possible itchy rash |
| What are the signs and symptoms of all hepatitis viruses? | 1. Episodes of fever 2. Jaundice 3. Elevated ALT and AST |
| Which two hepatitis viruses are NOT destroyed by the gut? | HAV and HEV |
| Why are HAV and HEV not destroyed by the gut? | They lack envelope |
| What is a unique activity or feature of HBV? | HBV DNA polymerase has DNA- and RNA-dependent activities |
| Why is there variation in antigenic structures of HCV envelope proteins? | HCV lacks 3'-5' exonuclease activity --> no proofreading ability |
| HAV belongs to which viral family? | RNA picornavirus |
| WHat is the viral family of HBV? | DNA hepadnavirus |
| Which is the only DNA hepatitis virus? | HBV |
| Which hepatitis virus is of RNA flavivirus family? | HCV |
| HDV is part of the _______________________ viral family. | RNA deltavirus |
| RNA hepevirus gives rise to which hepatitis virus? | HEV |
| Which two hepatitis viruses have long incubation periods? | HBV and HCV |
| Which hepatitis infection ins seem clinically mostly asymptomatic and acute? | HAV |
| Clinical presentation of HBV infection. | Initially like serum sickness (fever, arthralgias, rash); then may progress to carcinoma |
| HCV is clinically presented with: | Possible progression to cirrhosis or carcinoma |
| Which Hepatitis virus a similar clinical view as HBV? | HDV |
| Fulminant hepatitis in expectant (pregnant) women? | HEV |
| Which hepatitis infection has a high mortality in pregnant women? | HEV |
| What is the most common prognosis of an HAV infection? | Good prognosis |
| Hepatitis infection associated with Superinfection? | HDV infection after HBV |
| Coinfection of HDV and HBV produces a ____________ incubation period. | Long |
| Which hepatitis viruses carry HCC development risk? | HBV, HCV, and HDV |
| HAV and HEV have short incubation periods and both do not ---> | Progress to HCC |
| What are the findings in HAV liver biopsy? | Hepatocyte swelling, monocyte infiltration, and Councilman bodies |
| What histologic finings is characterisctic of HAV infection ? | Councilman boides |
| What is the description to liver biopsy in a HBV (+) patient? | Granular eosinophilic "ground glass" appearance; cytotoxic T cell mediated damage |
| Lymphoid aggregates with focal areas of macrovesicular steatosis | HCV liver biopsy |
| Which hepatitis liver bx finding is described as "ground glass" appearance? | HBV infection |
| Macrovesicular steatosis is found in _______ liver biopsy | HCV |
| Description of HEV liver biopsy. | Patchy necrosis |
| Which two hepatitis have carrier states? | HBV and HCV |
| What is the hematologic extrahepatic manifestation of Hepatitis B infection? | Aplastic anemia |
| What are the most common hematological manifestations of HCV infection? | 1. Essential mixed cryoglobulinemia 2. Increased risk B-cell NHL 3. Autoimmune hemolytic anemia |
| Which are the renal extrahepatic manifestations of HBV and HCV infections? | 1. Membranous GN 2. Membranoproliferative GN |
| HBV infection has more cases of __________________________ as an renal extrahepatic manifestation. | Membranous GN |
| What is the most common vascular extrahepatic manifestation of Hepatitis B infection? | Polyarteritis nodosa |
| Leukocytoclastic vasculitis is often associated with HBC as: | Vascular extrahepatic manifestation |
| Which infection, HBV or HCV, has more extrahepatic manifestations? | HCV |
| How are some forms of cutaneous manifestation of HCV infection? | Sporadic porphyria cutanea tarda, and lichen planus |
| What are endocrine manifestations of HCV infection? | Increased risk of diabetes mellitus and autoimmune hypothyroidism. |
| Serologic marker for acute hepatitis A | Anti-HAV (IgM) |
| IgG antibody indicates prior HAV infection and/or prior vaccination. | Anti-HAV (IgG) |
| Which hepatitis A serologic marker indicates protection against reinfection? | Anti-HAV (IgG) |
| Which HBV antigen indicates Hepatitis B infection? | HBsAg |
| Where is HBsAg found? | On surface of HBV |
| What does Anti-HBs indicate? | Immunity to hepatitis B due to vaccination or recovery from infection |
| Which hepatitis serologic marker is associated with core of HBV? | HBcAg |
| What is Anti-HBc? | Antibody to HBcAg |
| IgM Anti-HBc indicates: | Acute/recent infection |
| IgG Anti-HBc indicates: | Prior exposure or chronic infection |
| What is the sole marker during the window period of HBV infection? | IgM anti-HBc |
| Which Hepatitis B serum marker indicates active viral replication and high transmissibility? | HBeAg |
| Anti-HBe indicates? | Low transmissibility |
| What hepatitis B serum marker is secreted by infected hepatocyte into circulation? | HBeAg |
| Active HBV replication is indicated by which serologic marker? | HBeAg |
| Which serum marker is (+) in an immunized Hepatitis B virus? | Anti-HBs |
| Acute infection with HBV is positive for the following serum markers: | HBsAg + HBeAg + IgM anti-HBc |
| HBsAg + HBeAg + IgG anti-HBc | Chronic HBV (high infectivity) |
| A patient in HBV infection recovery is seen with (+) serum markers: | Anti-HBs + Anti-HBe + IgG anti-HBc |
| What patient HBV infection status has (+) for all antibodies? | Recovery |
| Which serum marker distinguishes a patient with low and high HBV infectivity? | Low infectivity is (+) Anti-HBe, and high is (+) for HBeAg |
| Which are the 2 HIV envelope proteins? | gp41 and gp120 |
| In HIV, which protein is the "Docking glycoprotein"? | gp120 |
| How are gp41 and gp120 (HIV envelope proteins) acquired? | Budding from host cell plasma membrane |
| How is the HIV genome? | Diploid genome (2 molecules of RNA) |
| What doe it mean the HIV has a diploid genome? | 2 molecules of RNA |
| What are the 3 structural genes of HIV? | 1. env (gp120 and gp41) 2. gag (p24 and p17) 3. pol |
| The gag gene in HIV is: | Composed of p24 and p17, which code for capsid and matrix proteins respectively. |
| gag p24 component codes for: | Capsid of HiV |
| What are the components (enzymes) of the HIV structural gene "pol"? | Reverse transcriptase, aspartate protease, and integrase |
| What is the primary receptor for HIV? | CD4 |
| What are co receptors used by the HIV? | 1. CCR5 on macrophages (early infection) 2. CXCR4 on T cells (late infection) |
| The binding of HIV to CCR5 indicates: | 1. Early infection 2 Binding to macrophages |
| HIV binds to CXCR4 on which cells? | T cells |
| HIV binding to CXCR4 on T cells indicaties: | Late infection |
| What does a homozygous CCR5 mutation produce? | Immunity to HIV |
| What mutation is needed to create a slower course for HIV infection? | Heterozygous CCR5 mutation |
| What lab technique is used to diagnose Presumptive HIV? | HIV-1/2 Ag/Ab immunoassays |
| What is detected with HIV-1/2 Ag/Ab immunoassay? | Viral p24 Ag capsid protein and IgG Abs to HIV-1/2 |
| What is the confirmatory test for HIV? | HIV-1/2 Ab-differentiation immunoassays |
| Four stages of untreated HIV infection: | 1. Flu-like (acute) 2. Feeling fine (latent) 3. Falling count 4. Final crisis |
| What happens during latency phase of HIV? | Virus replicates in lymph nodes |
| When does a an AIDS-defining illnesses emerge? | < 200 CD4+ cells/mm3 |
| What is the presentation of candida albicans infection when the CD4+ count is < 500? | Oral thrush; a scrapable white plaque, pseudohyphae on microscopy . |
| Describe Oral hairy leukoplakia | Un-scrapable white plaque on lateral tongue |
| Which oral plaque is unscrapable? | Oral hairy leukoplakia |
| Which opportunistic organisms cause Oral hairy leukoplakia in HIV patients with CD4+ count < 500? | EBV |
| List of organisms that cause opportunistic infections in HIV patients with CD4+ count < 500? | Candida albicans, EBV, HHV-8, and HPV |
| Kaposi sarcoma? | Caused by HHV-8 in AIDS patients with CD4+< 500 |
| What is the presentation of HPV infection when CD4+ count is < 500 cells? | Squamous cell carcinoma, commonly in anus ( men who have sex with men) or cervix (women) |
| HPV affects homosexual men in the ______________. | Anus |
| Which anatomical part is affected in females with HPV infection and CD4+ cell count less than 500? | Cervix |
| What are common organisms that produce disease in HIV patients with a CD4+ count < 200? | Histoplasma capsulatum, HIV, JC virus, and Pneumocystis jirovecii |
| Presentation of Histoplasma capsulatum infection in HIV patient? | Fever, weight loss, fatigue, cough, dyspnea, nausea, vomiting ,and diarrhea |
| AIDS patient with CD4+ of 198, shows clear signs of dementia. MC affecting organism? | HIV |
| What organism (virus) presents with this finding "Non Enhancing areas of demyelination on MRI" | JC virus (reactivation) |
| "Ground-glass" opacities on CXR | Pneumocystis jirovecii |
| What are the findings of Aspergillus fumigatus infection in AIDS patient with CD4 + cell count of < 100? | Cavitation or infiltrates on chest imaging |
| What organism causes Bacillary angiomatosis in AIDS patient? | Bartonella henselae |
| What is the clinical presentation and findings of C. albicans infection in an AIDS patient with CD4+ count <100? | Esophagitis; White plaques on endoscopy; yeast and pseudohyphae on biopsy |
| CMV causes an opportunistic infection with the CD4+ count is less than: | 100 |
| What are the clinical presentation of CMV infection in a patient with AIDS? | Retinints, esophagitis, colitis, pneumonitis, and encephalitis |
| Linear ulcers on endoscopy + cotton-wool spots on fundoscopy? | Retinitis and esophagitis caused by CMV in AIDS patient |
| EBV clinical presentation in patient with CD4+ cell count of 99? | B-cell lymphoma (non-Hodgkin lymphoma, CNS lymphoma) |
| CNS lymphoma caused by EBV is found on MRI as: | Solitaire ring enhancing lesion |
| Multiple ring-enhancing lesions on MRI. | Toxoplasma gondii infection AIDS patient |
| What organism causes the development of brain abscesses in AIDS patient with a CD 4+ < 100? | Toxoplasma gondii |
| What are three common Prion diseases? | 1. Creutzfeldt-Jakob disease 2. Bovine spongiform encephalopathy 3. Kuru |
| Rapidly progressive dementia, typically sporadic, caused by prions. Dx? | Creutzfeldt-Jakob disease |
| What is another name for Bovine spongiform encephalopathy? | Mad Cow disease |
| Which population is commonly seen to develop Kuru? | Human cannibals |
| What condition is an acquired prion disease noted in tribal population practicing human cannibalism? | Kuru |
| What is the main reason for Prion disease development? | Conversion of a normal (predominantly a-helical) protein termed prion protein (PrpP c) to a B-pleated form. |
| What are the shared clinical manifestation of all prion disease? | Spongiform encephalopathy and dementia, ataxia, and death |
| Which form of prion protein is resistant to protease degradation? | B-pleated form (PrP sc) protein |
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rakomi
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