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121 Cards in this Set
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how long do viruses take to replicate?
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Viruses:
1-3 wks to replicate |
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what is the most common way to spread viral infection? how to stop it?
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Most common route of viral transmission = contact => washing hands decrease transmission
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Tropism
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=> viruses have receptors for certain cells, enter via endocytosis
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Genetic drift
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spontaneous mutation (Ex: Influenza B)
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Genetic shift
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gene reassortment (Ex: Influenza A, Rotavirus)
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5 steps of Viral Entry Into The Cell:
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1) Invasion
2) Adhesion to their receptors 3) Penetration 4) Uncoat 5) Replication 6) Assembly 7) Lysogeny |
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Adhesion
what happens presentation |
to their receptors (viremic, asymptomatic)
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Invasion:
what happens presentation invasion inhibitor |
virus enters body (viremic, asymptomatic)
Inhibitor: y-Globulins |
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Penetration:
what happens what virus is an exception to this? |
via receptor-mediated endocytosis - except HIV
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Uncoat
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take capsule off to expose RNA or DNA (Eclipse)
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tx Influenza A
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uncoating Inhibitors:
• Amantidine • Rimantidine • Selegeline |
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Amantidine
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Anticholinergic/DA release
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Rimantidine
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quick resistance
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Selegeline
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MAOI
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Replication
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(Eclipse): inserts his DNA/RNA into your genome
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what are the viral replication inhibitors?
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Inhibitors:
Guanine Analog Adenosine Analog •Thymidine Analogs |
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what are the guanine analogs (6)
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Acyclovir
Pencyclovir Demcyclovir Valcyclovir Gancyclovir famcyclovir |
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Acyclovir
MOA given how many times? |
guanine analog
take 3-5 times per day |
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Pencyclovir
MOA how many times a day? |
guanine analog
take 3x/ day |
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Demcyclovir
how many times its given |
take 3x/ day
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Valcyclovir
MOA how many times is it given? |
guanine analog
take 1x/day, better compliance (not a cure) |
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Gancyclovir
MOA tx |
guanine analog
tx CMV retinitis |
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famcyclovir
MOA tx |
guanine analog
tx shingles |
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Adenosine Analog:
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Vidarabine
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Thymidine Analogs
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Idoxuridin, Trifluridine
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Assembly:
describe presentation |
package the virus
(viremic, symptomatic) |
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Lysogeny:
what happens in RNA/DNA viruses? pt. presentation how do we get autoimmune diseases? |
virus explodes out of the cell (viremic, symptomatic)
• RNA ⇨ destroys cell membrane • DNA ⇨ destroys nuclear membrane • Wrap themselves with cell membrane=> autoimmune diseases |
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Viral Associated Cancers: EBV
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Nasopharyngeal CA, Burkitt's lymphoma
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Viral Associated Cancers: HPV 16,18,31,45:
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Cervical CA
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Viral Associated Cancers: Hep B
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Liver CA
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Viral Associated Cancers: HIV
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Kaposi's sarcoma, CNS/testicular lymphoma's
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Viral Associated Cancers: HTLV-1
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T cell leukemia
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Encephalitis: Sx and name 2 bugs
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Headache, ataxia
• Arbovirus • HSV-1 |
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Arbovirus:
vector presentation loves what part of the brain |
equine mosquitos =>headache, ataxia (frontal lobe)
"more e's~> more lethal'' |
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HSV-1
disease it causes presentation EEG what part of the brain affected? |
hemorrhagic encephalitis
seizures EEG slow wave complexes (temporal lobe) |
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Meningitis:
presentation positive for what test? |
headache, photophobia, stiff neck (infection of pia and arachnoid)
positive for these test • Brudzinski's sign • Kernig's sign |
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Brudzinski's sign
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bend neck => knee flexion
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Kernig's sign
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flex knee => pain, resistance
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most common cause of Viral Meningitis: kids and adults, tx
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Kids: Arbovirus
Adults: HSV -2 (Tx: Acyclovir) |
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Bacterial Meningitis Tx:
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Vancomycin + Ceftriaxone
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bacterial meningitis prophylaxis
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Rifampin or Ciprofloxacin
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most common pathogen of bacterial meningitis
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Strep pneumo
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0-2 mo: most common pathogen of bacterial meningitis
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Group B Strep/E. coli/Listeria can cause deafness "Baby BEL"
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10-21 y/o: most common cause of bacterial meninngitis
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N. meningitides
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Meningitis CSF: PMNs
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⇨ bacteria
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Meningitis CSF: T cells/MP
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⇨ non-bacterial
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Meningitis CSF: Normal glucose
Dx and what is the name of the pathogen? |
⇨ viral (usually Enteroviruses)
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Meningitis CSF: Low glucose
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⇨ fungus, TB
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Meningitis CSF: Protein
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⇨ TB
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Meningitis CSF: ( +) Quelling
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Pneumococcus
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Meningitis CSF: Geimsa stain:
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Trypanosomes
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Meningitis CSF: India ink
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cryptococcus
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Meningitis CSF: Gram stain
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Bacteria
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Meningitis CSF: Wet mount
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N. Fowlerii
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Meningitis CSF: PCR
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HSV
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Meningitis CSF: AFB
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TB, Nocardia
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Coxsackie A:
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Hand-Foot-Mouth dz
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Coxsackie B:
diseases it cause |
• Endocarditis
• DM type1 |
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Common Cold Viruses in spring
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Coronavirus
"drink a Corona beer on spring break" |
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summer Common Cold Viruses
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Rhinovirus => runny nose
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Common Cold Viruses in the fall:
pathogen presentation |
Adenovirus => red eyes, necrotizing bronchiolitis,
"swimming pool conjuctivitis" |
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Common Cold Viruses in the winter? what bacteria follows it?
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Influenza virus=> Staph aureus follows it
=> pneumonia (an orthomyxovirus) |
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influenza proteins function
tx |
H protein: penetrate cells
• N protein: explodes out of your cells • Tx: Amantadine, Ramantadine • Tx: Oseltamivir "Tamiflu", Zanamivir'- neuraminidase inhibitors |
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which protein is used as a influenza vaccine
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H protein: vaccine
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Parainfluenza:
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most common cold Virus
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common cold viruses
Herpesvirus: pt presentation what should not be given to the patient? |
painful ulcers of gums, keratitis
cornea will be destroyed by steroid tx! |
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CMV: eye clue, who is at risk, tx
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vision loss w/ "floaters" (neonates, AIDS pts)
Tx: Ganciclovir or Foscarnet |
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Coxsackie B:
• ST Depression=> • ST Elevation=> |
Coxsackie B:
• ST Depression=> myocarditis • ST Elevation=> pericarditis |
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EBV Mononucleosis: presentation
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teenager w/ sore throat, fatigue, splenomegaly
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EBV Mononucleosis: test and Ab
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Monospot test: may be negative for first week
(+) Heterophile Ab. |
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EBV Mononucleosis: presentation and recommendations and Tx
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• Posterior cervical lymphadenopathy
Avoid contact sports (can rupture -spleen) Tx: NSAIDs |
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CI for EBV Mononucleosis:
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No Ampicillin => skin rash if have EBV due to circulating PCN Ab
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HSV-1:
presentation |
• Gingival stomatitis (gum ulcers)
• Herpetic keratitis=> dendritic spine cornea "shattered window'' on fluorescein stain |
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HSV-1:
test and CI |
• + Tzanck prep
• no steroids |
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Rabies: sx
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hydrophobia, laryngospasm
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Rabies tx: Bat exposure
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(aerosolized bat poop)
Tx: Rabies vaccine "toxoid" x 5 doses+ Ig |
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Rabies: Dog/ cat/wild animal bites (raccoon/ skunk/ fox). tx
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Tx:
1) tetanus toxoid x 3 doses (if > 5 yrs) 2) Tetanus Ig (if dirty wound) 3) Amoxicillin/ Clavulanate |
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Rabies from Rodent bites (mice/ rats/squirrels/rabbits) tx
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no rabies
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how does the rabies attack the body
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Virus ⇨ unmyelinated nerves ⇨
CNS (hippocampus) ⇨ peripheral nerves, Negri bodies. |
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Meningitis:
0-2mo: >2mo: 10-21y/o: |
0-2mo: "baby BEL"
• Group B Strep • E: coli • Listeria. >2mo: Strep pneumo 10-21y/o: N. meningitidis |
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Human Herpes Viruses: name all
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1: HSV1
2: HSV2 (genital) 3: Varicella "chickenpox:" 4: Epstein-Barr virus 5: CMV 6: Sixth Disease 7: Pityriasis Rosea 8: Kaposi's Sarcoma |
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HSV 1, type HHV, what diseses can it cause?
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HHV 1: (oral) => fever blisters, corneal blindness, herpetic whitlow (dentist finger pustules)
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HSV II: HHV, what diseses can it cause?
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(genital) = > genital ulcers, neonatal herpes (via birth canal)
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Varicella "chickenpox:"
HHV what diseses can it cause? |
HSV 3
Zoster "shingles"=> encephalitis in AIDS pts |
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Epstein-Barr virus
HHV # diseases (3) |
HSV 4: => mononucleosis, Burkitt's lymphoma, oral hairy leukoplakia (AIDS pt)
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CMV
HHV what diseses can it cause? |
HSV 5: fetal blindness, pneumonia (transplant pts)
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Sixth Disease
HHV presentation |
HSV 6: => roseola in kids (fever ⇨ rash)
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Pityriasis Rosea
HHV presentation |
HSV 7: herald patch ⇨ then follows skin lines "C-mass tree appearance"
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Kaposi's Sarcoma
HHV who is at risk presentation |
HSV 8: (AIDS pts)- purple, pink, brown nodules all over body·
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Herpes Virus Tx: name all (6)
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• Ganciclovir (G)
• Idoxuridine (T) • Vidarabine (A) • foscarnet (phosphonate) • Acyclovir (G) • Valacyclovir |
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Ganciclovir
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(G) analog
tx CMV |
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Acyclovir
MOA SE |
(G) analogue
kills renal tubules |
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Valacyclovir cotraindications
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don't use w / cimetidine ( increase CNS toxicity)
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Core Ag
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gone before pt has symptoms (2 mo)
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Core Ab
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past infection (stays positive for life, "natural-immunity")
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Surface Ag
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current infection (or recent immunization if surface Ag only)
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Surface Ab
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vaccination
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E Ag
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transmissibility/infectivity
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E Ab
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low transmissibility
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Window period
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core Ab only (no Ag) "equivalence zone"
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Hepatitis etilogy
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virus, EtOH, Acetaminophen, Aflatoxin
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hepatitis:
how long does the surface antigen last? how long does the elevated enzymes last? what does it mean when a patient is jaundiced? |
Surface Ag >6 mo
Elevated enzymes >6 mo Icteric jaundice phase of hepatitis => bile plugs in canaliculi |
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Chronic persistent hepatitis
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nothing wrong with liver
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Chronic active hepatitis
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will have fibrosis and can lead to cirrhosis, cancer
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hepatitis tx
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Tx: Interferon or Amantidine/Rimantidine
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Hep A: infection
IgG => IgM => |
Hep A:
IgG => past IgM => current |
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Autoimmune Hepatitis:Type 1:
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anti-SM Ab (young women)
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Autoimmune Hepatitis:Type II:
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anti-LKM Ab (kids)
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HepA/E
Incubation: Transmission: Chronic active: Cancer: Tx: |
HepA/E
incubation period: 2-6 wks Transmission: Fecal-oral "Vowels from the bowels" Chronic active: no Cancer: No Tx: none |
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Hep E and Hep A
who is at risk? most common cause of Hep A? |
• attacks pregnant women/ Asians
• Shellfish = >Hep A |
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HepB
Incubation: Transmission: top 4 Chronic active: Cancer: Tx: |
(DNA virus) rvs transcriptase
Incubation: 2-6 months Transmission: 1. IV 2. Blood 3. Sex 4. Vertical (mom-baby) Chronic active: 10% risk Cancer: highest risk Tx: INF + Lamivudine |
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Hep C
Incubation: Transmission: Chronic active: Cancer: Tx: |
Incubation: 20-30 years
Transmission: 1. Blood, 2. Transfusion 3. IV 4.Sex (not vertical) Chronic active: 70% risk Cancer: Less than B Tx: INF+ Ribavirin |
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Hep D
Incubation: Transmission: Chronic active: Cancer: Tx: |
Hep D "defective"
Incubation: none Transmission: Post-Hep B ⇧AST,ALT Chronic active: none Cancer: none Tx: none |
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hep B
kind of particle and when should the vaccination be recieved? |
• Dane particle= DNA
• Baby must get vaccine and IgG at birth |
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Envelope: RNA/DNA
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DNA virus: Naked (except herpes, pox, hepadenovirus)
RNA virus: Enveloped (except "CPR" calcivirus, reovirus, piconovirus) |
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Strands: RNA/DNA
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RNA virus: single stranded
Except: • Reovirus ( ds) • Rotavirus '(segmented ds) DNA virus: Double stranded Except: • Parvovirus (ss) • Hepadenovirus (segmented) |
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Replication: RNA/DNA virus exceptions
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RNA: Cytoplasm (except retrovirus)
DNA: Nucleus (except poxvirus) |
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Polymerase: RNA/DNA viruses
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RNA viruses (2)
RNA polymerase (RNA dep: retrovirus) DNA polymerase (rvs transcriptase) DNA viruses RNA polymerase (DNA dep: poxvirus) |
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Assembly of : RNA/DNA viruses
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RNA: cell membrane
DNA: nuclear membrane |
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why does it take longer for a ( - ) strand to replicate than ( + ) strand.
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(-)strand ⇨ (+) mRNA before it is Assembled on cell membrane
( +) strand: illness takes < 1 wk (Ebola) (-) strand: illness takes 1-3 wks |
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why do DNA viruses can cause cancer?
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"intranuclear" inclusions
DNA viruses cause cancer b/c they replicate in the nucleus |
