Disease Exam : virus quiz Flashcards

Terms Definitions
Methodology: ImmunoassayAdditional Information: This test allows rapid diagnosis of the presence of respiratory syncytial virus. It avoids the necessity of obtaining acute and convalescent specimens over a two-week period. It may be particularly useful in
Qualitative determination is usefulAntibodies to HIV-1 should not be present in uninfected individualsPresence of HIV-1 antibodies (any level), indicates HIV-1 infectionPositive does not confirm active disease ( AIDS) and does not indicate protection
Mycoplasma pneumonia:
atypical pneumonia, adults
Immunohistochemistry is the localization of antigens or proteins in tissue sections by the use of labeled antibodies as specific reagents through antigen-antibody interactions that are visualized by a marker such as fluorescent dye, enzyme, or colloidal g
Poliomyelitis means inflammation of the gray (poliós) spinal cord . Until the 1950s, when anti-polio vaccination became routine, summer outbreaks of polio were common in western countries, often spread via the oral-fecal route while using swimming pools.
Pneumonia review:
Klebsiella pneumoniae, typical pneumonia, nosocomial, alcoholics, less likely neonates (bith-6 months)Pneumocystis jiroveci, atypical pneumonia, immunocompromisedMycoplasma pneumoniae, atypical pneumonia, adultsRespiratory syncytial virus Chlamydia pneumoniae, atypical pneumonia, children 6 weeks-18 yrs, same age group as respiratory syncytial virus; All ages at risk, but most common in school-age children; The mother is diagnosed with or suspected of having a chlamydial infection during pregnancy, eye discharge, eye swelling, or both develop in conjunctivitis.
Viral gastroenteritis, most common cause of diarrhea in infants less than 3 yrs
rotavirus
Enteroviruses are spread by hand-to-mouth contact and to a lesser extent by respiratory and fecal routes. Among viruses, enteroviruses are the most common cause of aseptic meningitis.
HIV spreads hematogenously, while rabies, polio, and herpes virus spread are ___ (spread through neurons).
neurotrophic
Hepatitis __ is self limiting.
A
CMV in Immunosuppressed Individuals: Immunocompromised individuals (e.g., transplant recipients, HIV-infected individuals) are susceptible to severe CMV infection. This can be either primary infection or reactivation of latent CMV. CMV is the most common
Viruses are obligate intracellular parasites meaning that they can only ___ inside a host cell and cannot survive long term outside of a host cell.
replicate
Problem: the attenuated Sabin vaccine has back mutation- result from recombination between wild type virus and the vaccine strain. Polio cases that use the attenuated live virus vaccine (about 8 per year in the US until recently) resulted from mutation of
Chlamydia pneumonia:
atypical pneumonia, children 6 weeks-18 yrs, same age group as respiratory syncytial virus; All ages at risk, but most common in school-age children; The mother is diagnosed with or suspected of having a chlamydial infection during pregnancy, eye discharge, eye swelling, or both develop in conjunctivitis.
To eliminate the risk for Vaccine-Associated Paralytic Poliomyelitis, the ACIP recommended an all-inactivated poliovirus vaccine (IPV, (inactivated: Salk ) schedule for routine childhood polio vaccination in the United States. As of January 1, 2000, all c
viral meningitis incidence increases in __ and __ __.
summerearly fall
With influenza The external antigens (H and N) show more variation and are the subtype and strain-specific antigens. These are used to determine the particular strain of influenza A responsible for an outbreak.
Rubella Serology is usually performed as a routine test in pregnancy, to confirm that the mother has antibodies in her blood to protect against future infection with the rubella virus. These antibodies are acquired by being immunized as part of the routin
A pregnant woman whose immunity (antibodies) to Rubella is unknown or deficient, should usually have Rubella Serology tested if she develops a rash, or has contact with a rash, that looks like German Measles.
Obtain acute and convalescent serum specimens for rubella specific IgG antibody to confirm a rubella diagnosis. This is especially important if the rubella specific IgM antibody titer is drawn at the wrong time or confounded by other infections. Draw bloo
As its name implies, CMV-infected cells exhibit gigantism of both the entire cell and its nucleus. Within the nucleus is a large inclusion surrounded by a clear halo (owl's eye).
HPV: specific morphology: clear halos around nuclei
Reactivation of latent VZV causes shingles (also called herpes zoster)
Viral culture is the “Gold standard,” but… Specimen requirements are stringentCollection techniques and transport are critical Must eliminate contaminating bacteria, fungi, and cellsCell culture lab is needed (not available in many smaller labs)
Hepatitis C vertical transmission:
less than 10%
mono spot test for heterophile antibody is ___.
qualitative
IgG antibodies in both newborn and maternal sera Rising IgG: congenital infection Falling IgG: passively acquired antibody
True influenza is an acute infectious disease caused by a member of the orthomyxovirus family -Influenza virus A, B or, to a much lesser extent, influenza virus C
Rubella IgG with IgM: acute but convalescence
measles is showing the typical red blotchy rash on his buttocks and back during the third day of the rash. Measles is an acute, highly contagious viral disease. Symptoms include fever, conjunctivitis (red eyes), runny nose, cough, and spots on the inside
In addition, the immunity that results from the Sabin vaccine lasts much longer that that by the Salk vaccine, making fewer boosters necessary. Since it elicits mucosal immunity (IgA) in the gut, the Sabin vaccine has the potential to wipe out wild type v
Mumps IgG antibody is used to determine immunity to mumps virus. Special Instructions: Paired sera (acute and convalescent) should be submitted on separate request forms.Reference Interval: • Negative: Borderline: 0.91-1.09 index; Positive: >1.09 indexU
Antigenic drift is due to ___. Antibodies to the HA protein are most important in protection, although those to NA also play a role. Both H and N go through antigenic drift so that immunity is hard to acquire. Antigenic drift leads to sporadic outbreaks a
mutations
Also like HSV, VZV evades immune responses and establishes a latent infection in sensory ganglia
An unknown number of high-risk HPV infections progress to high-grade cervical dysplasia. The progression of untreated lesions to micro-invasive and invasive cancer is associated with the integration of the HPV genome into the host chromosomes
specimen of HSV is best collected within first 3 days of lesion, but no longer than 7 days.
Hepatitis B envelope antigen (-e) high level of viral replication
2 serological measures with HCV:
- anti-HCV- HCV-RNA
Someone is considered a hepatitis B carrier (HBV carrier) if they have circulating ____ 6 months or longer after initial detection, without clinically apparent disease.
HBsAg
PCR:
Rapid method to amplify a specific fragment of DNA Oligonucleotide primers bind to the DNA Amplification is performed by a heat stable DNA polymeraseThe amplified DNA is detected in an appropriate detection system
Presence of anti-HBs is an indicator of clinical recovery and subsequent immunity to hepatitis B virus. This test is useful for evaluation of possible immunity in individuals who are at increased risks for exposure to the hepatitis B (ie, hemodialysis uni
With CMV, the severity of the end-organ disease is related to the degree of ___.
immunosuppression
Latency definition:
the inability to recover infectious particles from cells that harbor the virus.
Lab diagnosis of HIV:
SerologyELISA and Latex agglutination Initial Screening Western blotConfirmation
There are two types of polio vaccine, both of which were developed in the 1950s. The first, developed by Jonas Salk, is a formalin-killed preparation of normal wild type polio virus. This is grown in monkey kidney cells and the vaccine is given by injecti
The presence of ___ is also detectable in acute Hepatitis B infections and reflects viral replication and increased infectivity.
HBeAg
CMV transmission:
- TORCH (in utero)- birth canal- breast milk- saliva- veneral- iatrogenic via organ transplant/blood transfusion
All major transplantations (kidney, liver, heart, lung, bone-marrow) are associated with increased risk for ___ infection. Most common with bone marrow transplants. This increased risk is due to all the immunosuppresive drugs the patient is on to prevent
cytomegalovirus (an opportunistic infection)
___ __ are seen with measles. These are small, white spots on a reddened background that occur on the inside of the cheeks ealry on in measles.
Koplik spots
MOST COMMON CAUSE OF PNEUMONIA IN INFANTS UNDER 6 MONTHS OLD:
Respiratory Syncytial Virus
4 m old, severe respiratory distressCough, rhinitis, wheezing, feverCXR: Lung diffuse interstitial infiltratesBlood and nasopharyngeal secretions submitted Specific treatment initiatedWhat is the most likely diagnosis?
Respiratory Syncytial virus
Influenza virus infects the __ __ of the respiratory tract. The cells die due to the effects of the virus on the cell, the effects of interferon, and actions of cytotoxic T cells. Thus ciliary clearance is reduced leading to impaired function of the mucus
epithelial cells
With Hepatitis A, ___ antibodies to HAV remain for life. To determine if hepatitis is acute, look for ___ antibodies in the serum.
- IgG- IgM
diagnostic for Hep B:
anti-HBcAg aka IgM antibody to core
HPV is one of the most common STI, infecting over half of all sexually active men and women during their lifetime. Varies from 2-7% of sexually active women ages 18-28Currently about 20 million Americans are infected with HPV, and another 5.5 million acqu
In chronic hepatitis B infection, Hepatitis B surface antigen (HBsAg)persists for 6 months, and __ does NOT develop. in chronic infection, IgM anti-HBc disappears and is replaced by IgG anti-HBc. HBeAg is present variably in chronic infection. Presence of
- anti-HBs does NOT develop
Liver cirrhosis either comes from __ or __ _.
- alcohol- hepatitis B
Gamma-group HSV viruses include ___ and _____ (the cause of Kaposi sarcoma) which produce latent infection in __ __.
- EBV- KSHV/HHV-8- lymphoid cells
With acute hep A you will have IgM but not IgG yet. With prior Hep A you will have IgG but no IgM.
Cytopathic effects allow for ___ __ __ via viral cytology.
rapid initial diagnosis
Cell pathological mechanisms as a result of a virus include arrest of ___ ___ synthesis resulting in cell death, ___ attack, ___ production, and envelope damage to other cells.
- macromolecule synthesis- immunologic attack- cytokine production
H1N1 is the __ __. On June 11, 2009, the World Health Organization (WHO) declared that a pandemic of 2009 H1N1 flu was underway.
swine flu
Hepatitis B __ __ indicates recovery or immunity. There are 2 reasons a patient would have this: if they had the virus and it is now cleared, or if they were vacinnated.
- Hepatitis B surface antibody
cytopathic effect of varicella zoster (chicken pox):
- multinucleated syncytial cells with intranuclear inclusions
In a Tzanck preparation of HSV/varicella zoster infection what cytopathic changes would be seen?
- multinucleated giant cells with intranuclear inclusions
List the 3 subgroups of Herpes Virus:
- alpha-group viruses- lymphotrophic beta group viruses- gamma-group viruses
Rubella (and measles) should both be included in the differential diagnosis of patients presenting with an acute generalized rash and fever. Collect specimens for both culture and serology. The only reliable evidence of acute rubella infection is the pre
A positive rubella-specific IgM antibody, A significant rise in IgG antibody from paired acute and convalescent sera,A positive viral culture for rubella, orDetection of the virus (antigen, rather than viral antibodies) by reverse transcription-polymerase chain reaction (RT-PCR).
In a small portion of patients, ___ just indicates prior exposure with clearance of virus rather than active virus. In such cases, ___ and __ levels are usually ___. In unclear cases HCV-RNA is measured b/c it is always positive if virus is present.
- anti-HCV- ALT and AST
HSV PCR is a single test that detects both the presence of __ __ and determines which __ is present in the positive samples. This test is intended as an aid in diagnosis of HSV.
- HSV DNA- type
What kind of viral cytology will be noted in cells infected with Herpes Simplex Virus (HSV)?
Cowdry type A intranuclear inclusions
Use for Epstein-Barr Virus (EBV) Acute Infection Antibodies Profile Test Includes: EBV-EA, IgG; EBV-VCA, IgG; EBV-VCA, IgM; Epstein-Barr nuclear antigen antibodies (EBNA); interpretationSpecimen: Serum
Differentiation of acute from chronic or reactivated infections with Epstein-Barr virus
RSV is diagnosed by __ __ of respiratory secrestions (not common)or by rapid diagnostic tests such as __ ___, __ ___ ___, and __ __ __ __ ___ assays.
- viral culture- enzyme immunoassays- direct immunoflouresence assyasa- reverse transcriptase polymerase chain reaction (RT-PCR)
Viruses consist of a central __ of RNA/DNA and a protein ___ shell- together these form the ___. Many viruses also have an outer ___ made of ___ often with ___ spikes.
- central genome- protein capsid shell- nucleocapsid- envelope- lipoprotein- glycoprotein
You have an immunocompromised patients who is presenting with symptoms similar to TB, though you think it also could be Mycobacterium avium intracellulare. How can you tell the difference based on the culture?
- MAI: plate will be covered with growth- TB: few organisms
__ __ __ is diagnostic for acute Hep. B. HBsAg cannot be used for this b/c it will also be present in chronic hepatitis.
- IgM antibody to core
To measure titer to Hep B, what is measured?
- Hepatitis B surface antibody
HSV-1 and HSV-2 differ ___ but are ___ similar and cause a similar set of primary and recurrent infections. These viruses produce acute and latent infections. Both viruses replicate in the skin and the mucous membranes at the site of entrance of the virus
- differ serologically - genetically similar
different ways to detect CMV:
- IgG (4 fold increase in 4 weeks is indicative)- IgM- Urine cytology- Polymerase Chain Reaction (PCR)- Immunohistochemistry
CMV latently infects ___ and their __ __ ___ and can be reactivated when cellular immunity is ___.
- monocytes and their bone marrow progenitors- depressed
Do NOT allow a viral specimen to dry out, and you cannot gram stain a virus, also do NOT freeze it, instead what should you do?
Place the specimen in a transport medium at a temperature that inhibits cellular degradation and microflora proliferation
/ 80
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