Question | Answer |
How long does it take for Herpes to be cleared by the immune system? | It is never cleared. Have for live. |
How long does it take for HPV to be cleared by the immune system? | 2 to 12 months |
How does HSV-2 infect and replicate? | infects epithelial cells. Replicates and releases as it lyses the cell. Enters receptors through the peripheral nerve (retrograde travel). Tethers itself to a chromosome so it isn't degraded. |
What color is the nucleus in an infected nerve cell? | euchromatic |
What keeps herpes latent in a cell and not active? | euchromatic nucleus. No division is occuring so the virus does not replicate and stays latent |
What causes the virus to become active? | stress, trauma etc. activates nucleus and becomes heterochrmomatic allowing the virus to replicate. |
How does HSV-2 prevent the cell from undergoing apoptosis? | blocks neuronal apoptosis thru miRNAi/siRNA. The neuron survives infection and reactivation. |
What are the signs of a primary episode of HSV-2? | can be asymptomatic or occur with meningitis. Painful, usually multiple blister-like lesions on vulva, vagina, cervix, rectum, buttocks, penis or scrotum.. Ininguinal lymphadenopathy. |
What happens before an HSV-2 eruption? | prodrome. Itching, burning, tingling |
How long does the primary episode of HSV-2 last? | 12-20 days |
How much of the viral shedding is asymptomatic? | male 17/100 days and female 30/100 days. |
When is there an increased risk with neonatal herpes? | During 3rd trimester if there is a recurrent disease |
What are the 3 clinical patterns of neonatal herpes? | SEM (skin, eyes, mouth), CNS (wencephalitis) and disseminated. |
What happens to survivors of neonatal herpes? | impaired neurological status |
When do you do a c section on a mother with herpes? | only if lesions are present |
What decreased mortality with neonatal herpes? | acyclovir |
When is most neonatal herpes acquired? | in birth canal |
What are some other possible causes of genital ulcerations? | varicella zoster virus (shingles), syphilis, chancroid, candidiasis, scabies, lice, and dermatological conditions (crohn's and Behcet's) |
How did you diagnose HSV-2? | Viral culture (POCkit, Western Blot, Ab-based tests) |
Who most likely spreads herpes? | asymptomatic shedder |
How do you prevent HSV transmission? | Abstinence during symptomatic outbreaks and condoms |
What is responsible for 95% of cervical cancer? | HPV |
What does HPV cause? | benign tumors |
What are the 4 types of HPV that are mucocutaneous? | 6,11,16, 18 |
Which HPV are potentially malignant? | 16,18 |
Why are benign tumors on layrnx still dangerous? | will collapse the layrnx |
Where are receptors in skin for HPV? | basal layer |
Where does HPV replicate? | granular layer |
What causes cervical dysplasia? | Hyperkeratosis and vacuolization in granular layer |
What does the body do to most HPV? | clears it |
What causes the symptoms of herpes infection and why can it be asymptomatic? | interferons. Shedding is asymptomatic if interferons are not activated. |
How was herpes first diagnosed? | Multinucleated giant cells seen with Tzanck smear |
Does HPV cause malignancy by itself? | NO!!!!! It causes benign growth. Co factors are needed for malignancy and takes 9-15 years |
How does a latent infection turn into benign growth? | integration of HPV into the genome |
How does HPV stop cell apoptosis? | blocks p53 |
What does p53 do? | Guardian of the genome. Inhibition of DNA replication and cell division leading to apoptosis |
What does HPV do to cause more proliferation? | E7 gene inhibits Rb gene which normally inhibits S phase of the cell cycle (proliferation) |
What does E6 gene in HPV do? | induces telamerase and allows for integration into the genome |
What is the net effect of HPV on cells? | inhibits apoptosis and allows for more proliferation |
Why does HPV 16,18 associate more when carcinoma than 6,11? | 16, 18 have a greater affinity for E6/E7 proteins for p53/Rb. 6,11 do not degrade p53 or fully destabilize Rb |
What does the E2 gene do in HPV? | controls expression of E6/7 until it is integrated into the genome where it is no longer able to control expression and it runs rampant. |
How do you diagnose HPV? | Colposcopy and pap smear combine with DNA tests kids (hybrid capture) |
What is hybrid capture test? | RNA/DNA hybrid that is sandwiches and shows up with fluorescence. Very sensitive test. |
How effective is treatment for clearance and recurrence of HPV? | neither are 100% effective |