Term
| What is the most common intrauterine viral infection? What is the % prevalence of this virus in healthy individuals? |
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Definition
Human Cytomegalovirus (HCMV)
This virus is usually asymptomatic but prevalent in 90% of the population.
In women experiencing their first CMV infection during pregnancy, 30-50% of fetuses will be infected and 10% will be symptomatic.
Women expressing anti-HCMV have a much lower incidence of virus spread and squelae (a pathological condition as a result of disease, injury or trauma). |
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Term
An infant is born and on inspection the baby appears to exhibit microcephaly, retinitis and jaundice. Palpation of the infant's spleen indicates splenomegaly. Blood analysis indicates thrombocytopenia (low thrombocytes in blood). After discharge, the baby exhibits growth retardation.
What are these symptoms consistent with? |
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Definition
| This could be a congenital infection of Human Cytomegalovirus (HCMV). |
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Term
| A histological preparation of a very sick infant shows cells with "owl-eye" inclusion. What might be a possible diagnosis? |
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Definition
| Human cytomegalovirus infection shows typical owl-eye inclusions. |
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Term
A transplant patient was recently discharged, and a week later the patient began to complain of blurred vision. Eye drops were taken to no avail. The patient also developed pneumonia. After a month, the patient became legally blind.
What might have been a cause of the patient's blindness? |
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Definition
| Could have been human cytomegalovirus infection through the transplanted organ, or perhaps a re-activation of the patient's own HCMV virus due to their immunocompromization during surgery/avoiding tissue rejection. |
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Term
| What is the relationship between HCMV and HIV? |
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Definition
| If co-infected, children tend to show a higher incidence of CNS diseases such as impaired brain growth, or progressive motor deficits. The infectious agents may act synergistically. |
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Term
| What are the therapeutic options regarding a human cytomegalovirus infection? |
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Definition
Either administration of valganciclovir (converted to ganciclovir as a liver metabolite), Cidofovir or Foscarnet can selectively inhibit the DNA polymerase of HCMV, but there is no useful vaccine, mostly because so many people already have antibodies to it! (money).
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Term
What is the disease mechanism of Epstein-Barr vius?
What is another name of this infection? |
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Definition
Targers B-Cell receptors (C3b receptor) and induces cell multiplication in 10%-20% of all B cells.
A clinical hallmark is the non-specific creation of tons of IgG, IgA and IgM
Can see abnormal mononuclear cells in a blood smear of an EBV patient.
AKA Infectious mononucleosis caused by exposure to oropharyngeal secretions. |
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Term
| What are 2 Epstein-Barr virus associated malignancies? |
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Definition
Burkitt's lymphoma (BL)
Nasopharyngeal carcinoma (NPC) |
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Term
An HIV patient in your office expresses B-cell lymphoma and has white-gray lesions on his tongue.
What might be a possible cause of this lesion? What is another name for this lesion? |
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Definition
This might be caused by an infection my Epstein-Barr virus (EBV)
This lesion is known as Hairy leukoplakia |
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Term
| How can one treat Epstein-Barr infection? |
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Definition
Acyclovir inhibits replication of the virus. Can treat oral hairy leukoplakia.
No vaccine available. |
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Term
A Child in the ER in an underdeveoped area is seriously ill. He has a high fever, CNS problems and hemorrhagic fever. You learn that the child lives in conditions where rodent excretia and rodents themselves are rampant. Bacterial cultures/blood tests come back negative for any bacteremia or septicemia.
What might ail this child? |
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Definition
| An Arenavirus infection via Rodent reservoirs can cause disseminated disease in humans. |
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Term
A tropical population that is generally under the poverty line has had several cases recently of individuals developing hemorrhagic fever, widespread bleeding from their skin, mucus membranes, visceral organs, and GI tract. Approximately half of all of these individuals succumbed.
What might be the cause? |
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Definition
| Filovirus infection, specifically Marburg and/or Ebola virus infection. |
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Term
| What is one very probable cause of the development of untreatable and rapidly fatal leukemia after a few decades? |
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Definition
| Human T-Cell Lymphotrophic viruses (HTLV), specifically type 1, are indicative of T-cell leukemia. |
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Term
| Regarding HIV and the number of cases, deaths and prevalance; which of these aspects of HIV is on the rise worldwide? |
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Definition
Prevalance (number of persons living with AIDS)
This is most likely due to new treatments like HAART. |
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Term
| What are the 2 interaction sites (binding sites) of HIV? |
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Definition
1. HIV SU protein (gp120) and the CD4 receptor of helper T cells.
2. HIV TM protein (gp41) and chemokine receptor CCR5 of the T cells (normally receives chemotactic cytokines) |
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Term
| What has been the new focus on the treatment of HIV? |
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Definition
CCR5 Entry inhibitors such as Enfuvirtide peptide by Roche, Vicriviroc and Maraviroc (by Schering-Plough).
Also, integrase inhibitors have been a focus of Merck with Raltegravir. |
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Term
Describe the events of an HIV infection during:
Primary Infection stage
Latency stage
AIDS |
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Definition
Primary Infection: CD4 T cells begin to dip from over 1,000 cells/microliter to around 500 cells/microliter as the number of HIV particles rises to almost 900 viruses/microliter of blood. After this spike, CD4 cells begin to rise again to about 700 and virus particles sharply drop to very low levels. Patients present symptoms similarly to infectious mononucleosis.
Latency: CD4 Cells steadily drop slowly as the virus levels in blood stay low. High steadly levels of Anti-HIV antibody can be seen. Chronic, low intensity symptoms such as fevers, night sweats, weight loss, etc. are seen.
AIDS: Antibody levels drop, virus levels rise steadily and T cell levels are basically non-existent as the virus progresses. Hallmark is a drop in CD4 cells to below 200. Germ centers are gone in End stage AIDS. AIDS encephalopathy through macrophage transport to brain.
It is important for infected mothers to avoid breast feeding. |
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Term
| What cell type is responsible for combating an HIV infection? |
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Definition
| CD8 T cells. The evidence for this is that long term non-progressors exhibit high levels of HIV specific CTLs. |
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