question

1. What family is the measles virus in?

answer

1. Paramyxoviridae (morbillivirus genus)

question

2. Why is Measles considered a “new” virus?

answer

2. No accounts in early Greek, Required population >100,000, Trade route opened avenue for transmission

question

3. What 3 viruses cause multi-system infections and humans are the only known host?

answer

3. Measles, Mumps, Rubella

question

4. How is Measles different from other paramyxoviruses?

answer

4. Lacks neuraminidase activity, has H protein instead of HN; Receptors are CD46 and SLAM; Forms intracellular inclusion bodies

question

5. What is a distinctive feature of cytopathology for Measles?

answer

5. Intracellular inclusion Bodies

question

6. What is the Entry and Replication strategy for Measles?

answer

6. 1. MV binds receptor (CD46, SLAM), 2. Binding activates F protein, causes membrane fusion (entry). 3. Replication and assembly similar to other negative-strand RNA viruses

question

7. Who typically is infected by Measles?

answer

7. Children

question

8. How is Measles spread?

answer

8. Respiratory route

question

9. What is the main cause of mortality from measles?

answer

9. bacterial pneumonia

question

10. How long does the latent period of measles last? Are there symptoms?

answer

10. 10-14 days; No

question

11. What are the symptoms following the latent period of measles?

answer

11. 2-3 day prodrome of high fever (101-105), cough, conjunctivitis (Photophobia), rhinorrhea

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12. What kind of rash develops after the initial symptoms?

answer

12. maculopapular rash

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13. What does the maculopapular rash of measles coincide with?

answer

13. a strong cell-mediated immune respone and virus clearance

question

14. What viruses do not use sialic acid and don’t have neuraminidase?

answer

14. Measles, RSV, Rhino (class clicker question)

question

15. What is the Clinical Case Definition of Measles?

answer

15. 1. Rash >3 days, 2. Temperature >38.3C(101F), 3. Cough, rhinorrhea, and/or conjunctivitis.

question

16. When do cases of measles need to be reported?

answer

16. If symptoms are epidemiologically linked to another confirmed case of measles.

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17. Where is the initial site of measles infection?

answer

17. Tracheal and bronchial epithelia

question

18. After 2-4 days how does measles spread to the lymph nodes?

answer

18. carried by pulmonary macrophages

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19. What are Warthin-Finkeldey cells?

answer

19. Reticuloendothelial giant cells that are created by measles virus replicating in the lymphoid tissue

question

20. What does amplification of measles in the lymph nodes result in?

answer

20. Viremia and infection of other tissues and organs

question

21. What are the primary cells infected by measles in the blood?

answer

21. Monocytes (other major cell types – epithelial, endothelial, macrophages)

question

22. When is the patient with measles infectious?

answer

22. 1-2 days before symptoms of viremia occur (Rash and Koplik spots)

question

23. How long after exposure to measles is a person infectious?

answer

23. 10-20 days

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24. Where can measles be cultured?

answer

24. mucous membranes of nasopharynx, conjunctivia, mouth, and blood

question

25. What are small red spots with blue-white center found in upper lip and cheek called?

answer

25. Koplik spots

question

26. How does the Maculopapular Measles rash spread?

answer

26. Starts on the back of the neck or forehead and spreads to extremities

question

27. What does the Measles rash result from?

answer

27. infection of the dermal endothelial cells followed by spread to the overlying epidermis

question

28. When are Koplik’s spots usually seen?

answer

28. Before the rash

question

29. What is a complication of the measles virus?

answer

29. Immune suppression – Delayed-type hypersensitivity responses are suppressed, impaired production of antibody and cellular immune responses

question

30. What is the primary cause of measles virus-induced immune suppression?

answer

30. infection of monocytes and other immune effector cells

question

31. What 3 things can be neurological MV complications post infection?

answer

31. 1. Postinfectious encephalomyelitis (PIE), 2. Measles Inclusion Body Encephalitis (MIBE), 3. Subacute Sclerosing Panencephalitis (SSPE)

question

32. What is an autoimmune demyelinating disease caused by MV complications?

answer

32. PIE (postinfectious encephalomyelitis)

question

33. What diseases result from the establishment of persistent infections in the brain after MV?

answer

33. MIBE and SSPE

question

34. What is the vaccine for measles?

answer

34. Live-attenuated measles virus vaccine provides “life-long” immunity

question

35. When do Children receive the measles vaccine?

answer

35. at 12-15 months, 2nd dose at 4-6 years, subcutaneously

question

36. Why is the MMR vaccine so effective?

answer

36. MMR are antigenically stable monotypic viruses

question

37. Are there different strains of MV?

answer

37. Yes, but neutralizing antibody to one strain protects an individual against all circulating strains

question

38. How are the different strains of MV defined?

answer

38. by amino acid differences in the H or HN proteins

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39. Why is measles an ideal candidate for eradication?

answer

39. 1. only one serotype, 2. clinically identifiable, 3. no animal reservoir, 4. eradication requires “herd immunity”

question

40. What is the most common cause of MV resurgence?

answer

40. Parents choosing not to vaccinate

question

41. What are the contraindications for measles vaccination?

answer

41. Allergic reaction to gelatin or neomycin. Moderately or severely ill at the time of vaccination. Pregnant Women. Anyone on immunosuppressive drugs.

question

42. How long should women wait to get pregnant after receiving the Measles vaccine?

answer

42. 4 weeks

question

43. What family is the Mumps virus a member of?

answer

43. Paramyxoviridae family (rubulavirus genus)

question

44. Where does Mumps initially infect?

answer

44. Nasal mucosa and upper respiratory tract epithelium

question

45. Which is more infectious, Measles or Mumps?

answer

45. Measles

question

46. How long is the incubation period for Mumps?

answer

46. ~18days

question

47. What causes the “chipmunk” look of a mumps infection?

answer

47. Spread to the draining lymph nodes, Infection of the Parotid Gland

question

48. What is the first clinical sign of a mumps infection?

answer

48. Infection of the parotid gland causes “chipmunk” look

question

49. When is virus shed?

answer

49. begins ~6 days before onset of clinical disease

question

50. What does half of mumps infection result in?

answer

50. Virus replication in the CNS

question

51. What can virus replication in the CNS lead to?

answer

51. Aseptic meningitis, Deafness

question

52. If you see a truck with some disturbing appendages hanging off the back, what complication did they probably have with the mumps virus?

answer

52. symptomatic gonadal involvement

question

53. What is a major complication of Mumps in post-pubertal men?

answer

53. symptomatic gonadal involvement – testes swell, can cause sterility

question

54. What infection has a correlation with the development of type I Diabetes?

answer

54. Mumps

question

55. What type of vaccine is there for mumps?

answer

55. Live-attenuated vaccine

question

56. Which 2 RNA viruses that cause multi-system infections are (-) stranded?

answer

56. Measles and Mumps

question

57. Which RNA virus that causes multisystem infections is (+) stranded?

answer

57. Rubella

question

58. What is the family of Rubella?

answer

58. Togaviridae family

question

59. What are the 2 genera of Togaviridae?

answer

59. Alphaviruses and Rubiviruses

question

60. How are Rubiviruses distinguished from Alphaviruses?

answer

60. Rubiviruses have limited host range - Humans

question

61. How does Rubella virus replicate?

answer

61. 1. Enters cell by receptor mediated endocytosis, 2. Genome serves as mRNA 3. Polymerase made first 4. (-) strand antigenome is used as template for both progeny genomes and subgenomic mRNA, which encodes the viral capsid and envelope proteins.

question

62. What are the clinical manifestations of the Rubella virus?

answer

62. Mild disease, Low-grade fever, conjunctivitis and sore throat, lymphadenopathy, Morbilliform Rash

question

63. How is does Rubella transmit and replicate?

answer

63. aerosols, replicates initially in the mucosa of upper respiratory tract and nasopharyngeal lymph nodes

question

64. How long is the incubation period of rubella?

answer

64. ~7-9 days

question

65. How long after initial exposure does the morbilliform (maculopapular) rash begin?

answer

65. 16-21 days

question

66. How long can the rubella virus be shed?

answer

66. Shedding begins after incubation period and continues after rash disappears, can be shed for up to a month after initial exposure.

question

67. What is the most devastating effects of Rubella infection?

answer

67. in fetuses – causes congenital birth defects

question

68. When is the highest risk of rubella infections for the fetus?

answer

68. 1st and 2nd trimester

question

69. Infection by Rubella in the first month of pregnancy usually results in what?

answer

69. spontaneous abortion

question

70. What clinical manifestations can be found if a fetus is carried to term by a mother infected by Rubella in the first or second trimester?

answer

70. Mental retardation, motor disabilities, hearing loss, congenital heart disease, cataracts

question

71. What is the primary reason for Rubella vaccination?

answer

71. directed at protecting the fetus from infection

question

72. Why do measles and rubella cause rashes, while Flu, RSV, and hMPV don’t?

answer

72. Flu, RSV, and hMPV don’t spread beyond Respiratory tract. (class clicker question)

question

73. What is most significant about Measles?

answer

73. it’s Highly Contagious

question

74. What was the leading cause of aseptic meningitis prior to development of vaccine?

answer

74. Mumps

question

75. Why is the MMR vaccine so successful?

answer

75. All three viruses are monotypic, Humans are the only known reservoir

question

76. What kind of replication does Parvovirus Have?

answer

76. Autonomous replication

question

77. What is the structure of parvovirus?

answer

77. Linear, single-stranded DNA, Icosahedra capsid, no envelope

question

78. Where does parvovirus replicate?

answer

78. nucleus

question

79. Why does parvovirus need to replicate in rapidly dividing cells?

answer

79. needs active DNAase

question

80. What is “fifth disease”?

answer

80. Parvo B19

question

81. What are the symptoms of Parvo B19?

answer

81. erythema infectiosum – a mild common childhood rash

question

82. How does Parvo B19 spread?

answer

82. direct contact with respiratory secretions, prior to rash

question

83. What is the Biphasic pathogenesis of parvo B19?

answer

83. Initial viremia – flu like symptoms; Second Phase – Rash driven by antigenic response

question

84. What are the characteristic symptoms of fifth disease?

answer

84. “Slapped Cheek” rash, Lacy red rash on trunk and limbs

question

85. What symptoms can adults have from fifth disease?

answer

85. Joint pain or swelling, flu like symptoms, Less rash

question

86. Who is at risk for transient aplastic crisis caused by Parvo B19?

answer

86. sickle cell anemia patients

question

87. What is the risk for pregnant women who contract parvo B19?

answer

87. transplacentally transmitted, can result in fetal anemia, hydrops fetalis, miscarriage

question

88. What is Parvo B19 sometimes confused with?

answer

88. Rubella

question

89. When are patients most infectious?

answer

89. prior to rash, difficult to prevent because diagnosis by appearance of rash

question

90. What’s the best way to prevent spread of Parvo B19?

answer

90. Good Hygiene practices

question

91. What are the 2 genus of the Poxviridae Family?

answer

91. Variola virus and Vaccinia virus

question

92. What is unique about the Poxviridae structure?

answer

92. Large non-icosahedral complex structure, Intracellular virus, core and lateral bodies surrounded by envelope; Large double strand linear DNA with proteins

question

93. What is unique about Pox replication?

answer

93. Cytoplasmic Replication, has everything it needs to replicate on it’s own.

question

94. In Pox replication, what happens in the uncoating I step?

answer

94. Virus enters cell, loses outter membrane, releasing core particle into the cytoplasm

question

95. What happens in the uncoating II step of Pox replication?

answer

95. After Early transcription and mRNA translation, Early proteins complete uncoating of DNA and release into cytoplasm, DNA replication begins in cyto

question

96. Where are the virus factories for Pox replication?

answer

96. Cytoplasm

question

97. Where does the virus get it’s envelope?

answer

97. Derived de novo, crescents with no detectable contacts with exiting membranes begin to envelope core structures

question

98. What are the pertinent infectious agents in the real world?

answer

98. Extracellular enveloped virus (EEVs)

question

99. What 2 pox viruses specifically cause human disease?

answer

99. Variola and Molluscum

question

100. What does variola cause?

answer

100. smallpox

question

101. What are the 2 basic forms of small pox?

answer

101. variola major and variola minor

question

102. How is Smallpox spread?

answer

102. inhalation of virus released from ruptured mouth lesions.

question

103. Where is the generalized rash of smallpox mostly found?

answer

103. Head and Limbs

question

104. How is Smallpox distinguished from chickenpox?

answer

104. Small pox – febrile prodrome, firm well defined lesions (like BBs) develop pit (umbilicated), all lesions will be at the same stage.

question

105. When is smallpox most contagious?

answer

105. small red spots in mouth and tongue rupture

question

106. How long are patients contagious?

answer

106. until last scab falls off

question

107. What are the 2 forms of Molluscum contagiousum?

answer

107. Childhood and young adulthood forms

question

108. What are the characteristics of Childhood form of molluscum?

answer

108. –Lesions on face, trunk, and limbs; -spread by direct contact from skin; -mostly tropical

question

109. What are the characteristics of the Young adulthood form of molluscum?

answer

109. Lower abdomen lesions, sexually transmitted

question

110. What is vaccinia?

answer

110. modern day prototype of small pox, lab strain, used for small pox vaccines

question

111. What 4 key features are necessary for eradication?

answer

111. 1. Humans only reservoir, 2. No healthy carriers, 3. No subclinical infections, 4. Effective vaccine afailable

question

112. Who should not receive the smallpox vaccine?

answer

112. Pregnant or breast-feeding women; immunocompromised; People with eczema, atopic dermatitis, or severe acne; non-emergency situations under 18yo, heart disease patients

question

113. How can adverse reactions to the smallpox vaccine be treated?

answer

113. VIG- vaccinia immune globulin

question

114. What are some non-life threatening complications of the smallpox vaccine?

answer

114. generalized vaccinia, inadvertent inoculation, erythema multiforme

question

115. What are some Life-threatening complications of the smallpox vaccine?

answer

115. progressive vaccinia, postvaccinial encephalitis, eczema vaccinatum, myopericarditis or MI

question

116. What can a defect in immune globulin cause in a patient receiving the smallpox vaccine?

answer

116. progressive vaccinia

question

117. What family is the Polyoma virus in?

answer

117. Papovaviridae

question

118. What is the structure of Polyoma virus?

answer

118. circular double-strand DNA genome packaged around histones, non-enveloped icosahedral capsid

question

119. How does replication of polyoma occur in permissive cells?

answer

119. replication and assembly of progeny occurs in nucleus, released by cell lysis

question

120. How does replication of polyoma occur in non-permissive cells?

answer

120. infection leads to transformation of cells, integrates into host chromosome

question

121. What can transformation of non-permissive cells lead to?

answer

121. tumor formation

question

122. What are the T antigens responsible for?

answer

122. Transformation; Small T and large T – immortalize cells, small T and middle T – transform cells

question

123. What are the 2 known human polyoma viruses?

answer

123. BK and JC

question

124. Are the human polyoma viruses oncogenic?

answer

124. No

question

125. Where does polyoma initially replicate?

answer

125. Respiratory of GI tract

question

126. What happens after initial infection?

answer

126. Viremia, passage to kidney, lung, or brain, persistently infect kidney

question

127. Who is Polyoma a problem for?

answer

127. Immunodeficient; transplant patients, AIDS

question

128. Where can BK be isolated from?

answer

128. urine of AIDS patients

question

129. What is the etiologic agent of progressive multifocal leukoencephalopathy?

answer

129. JC

question

130. What is PML?

answer

130. demyelinating disease of CNS, Reactive JC virus infects and lyses oligodendrocytes, Culture not practical, No virus specific treatment

question

131. What is the structure of the Herpesvirus?

answer

131. iscosahedral capsid surrounded by lipid envelope with virus-encoded glycoproteins

question

132. Where is Herpesvirus replicated?

answer

132. Replicated and assembled in the nucleus

question

133. What Herpesviruses are neurotropic?

answer

133. HSV-1, HSV-2, VZV

question

134. What herpesviruses are lymphotropic?

answer

134. CMV, HHV-6, HHV-7, EBV, HHV-8

question

135. What does the primary infection of VZV cause?

answer

135. chickenpox

question

136. What are the symptoms of chickenpox?

answer

136. fever, itchy rash for 1 week, Late winter/early spring,

question

137. What does a reactivated infection of VZV cause?

answer

137. shingles

question

138. Where does the rash occur in shingles?

answer

138. along the thoracic dermatome

question

139. Who is most at risk for CMV?

answer

139. Transplant Patients!

question

140. Where is CMV found in the body?

answer

140. anything wet – saliva, urine, breast milk, semen, cervical secretions, blood

question

141. What cells does CMV infect?

answer

141. B-cells, causes large, puffed up lymphocyts

question

142. What is a diagnostic feature of CMV?

answer

142. Large Lymphocytes

question

143. What does CMV infection in Neonates cause?

answer

143. deafness and mental retardation

question

144. What is the treatment for CMV?

answer

144. Ganciclovir

question

145. What does EBV cause in adolescence?

answer

145. Infectious mononucleosis

question

146. What can EBV cause in AIDS patients?

answer

146. hairy leukoplakia

question

147. What is Burkitt’s lymphoma?

answer

147. Neoplasm of B-cels that affects bones of the jaw, caused by EBV

question

148. What 3 factors is Burkitt’s lymphoma associated with?

answer

148. Early EBV infection, Activation of c-myc, Malaria

question

149. What kind of carcinoma is associated with EBV and a high salt diet?

answer

149. Nasopharyngeal carcinoma

question

150. What types of Herpesvirus cause Roseola?

answer

150. HHV-6 and HHV-7

question

151. What is the principal symptom of Roseola?

answer

151. High fever

question

152. What herpesvirus is associated with Kaposi’s sarcoma?

answer

152. HHV-8

question

153. What Herpesviruses are Ubiquitous in all US populations?

answer

153. VZV EBV HHV-6 HHV-7

question

154. What Herpesviruses are typically acquired in early childhood in the US?

answer

154. VZV, HHV-6, HHV-7

question

155. What Herpesviruses are sexually transmitted?

answer

155. HSV-1, HSV-2, CMV, HHV-8

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