mb exam #4
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mb exam #4
Mycology is the study of..
What are the two classifications of fungi?
Yeasts and Molds
What is the yeast morphology?
unicellular (single, oval or spherical fungal cell)
"bacteria-like" in appearance
How does yeast reproduce?
asexually by budding
What are the 5 steps of budding?
1. Division of nucleus
2. Passage of one nucleus to a bud that "balloons out" from the wall of the mother cell
3. Formation of wall between the bud and mother cell
4.Daughter cell – bud or blastospore
5. Daughter cell initially smaller, increases in size and produces own buds
What is the fungi morphology?
filamentous (multicellular) filamentous or tubular structures.
How does mold reproduce?
What are the 6 steps of mold growth.
1.Germination of condium (reproductive element) – sends out a filament that grows by elongation at its tip
2. Hyphae – elongated filament
3. Mycelium – multiple branches of hyphae
4. Many nuclei within each hyphae
5.Formation of septae – "crosswalls" within hyphae
6.Conidia – terminal end of hyphae – "seeds" for new colonies
multiple branches of hyphae
How many nuclei tend to be in each hypahe?
What is the formation of septae?
"crosswalls" within hyphae
Terminal end of hyphae - "seeds: for new colonies
two reproductive bodies connect and haploid cells fuse to form diploid cells (spores)
the property of having two morphological shapes
Dimorphic fungi at 37 C froms what?
dimorphism fungi at 25C forms what?
mold or mycelial
what are the four major distinguishing morphological characteristics of dimorphic fungi?
size, presence of capsule, cell wall thickness, spores or conidia production
if dimorphic fungi is aerobic, you have
if dimorphic fungi is facultative anaerobes you have.....
what is the pH range for dimorphic fungi growth?
4 -> 6
What are the three selective medias that can be used for dimorphic fungi?
Sabouraud's Dextrose Agar (SDA)
Dermatophyte Test Media (DTM)
Nigerseed (birdseed) agar
What is the minimal media that can be used for dimorphic fungi growth?
corn meal agar (spore formation)
what kind of slide cultures is needed for the dimorphic fungi?
Molds colonial morphology
(dry, cotton-like, masses)
yeasts colonial morphology
(moist, opaque, creamy colonies)
cutaneous mycoses or dermatomycoses
fungal infections of keratinous structures
infections penetrate beneath the skin and involve that subcutaneous connective and bone tissues
systemic or deep mycoses
infections of internal organs
infections in compromised or immunosuppressed
superficial mycoses is minor infections of the _______ or _______
hair or skin
superficial mycoses appearance
lesion appearance - scaly or pigmented area of the skin, or nodules on shaft of hair
superficial mycoses prevention
What is the only contagious fungal diseas in humans?
dermatomycoses (cutaneous mycoses)
fungi that invade keratinized and cutaneous areas of the body (nails, hair and skin)
What are the three major genera of dermatomycoses (cutaneous mycoses)?
Trichophyton– T. rubrum
what are the three modes of infection for dermatomycoses (cutaneous mycoses)?
1. Hyphae of dermatophytes grows into keratinized tissue
2.Growth outward from infection site in concentric circles
3. Enzyme production – keritinase, elastase and collagenase
What are the 6 major infections of dermatomycoses (cutaneous mycoses)?
Tinea Capitis (ringworm of the scalp)
Tinea Barbae (ringworm of the beard)
Tinea Pedis (ringworm of the foot)
Tinea Curis (ringworm of the groin)
Tinea Corpis (Ringworn of the body)
Tinea unuium (ringworm of the nails)
What is the initial symptom of tinea capitis?
inflammation and itching of scalp
tinea capitis mode of infection?
hyphae spread into keratinized areas of scalp and hair follicle
fungal growth weakens hair
breakage at shaft
alopecia (hair loss) which is localized and spotty
(hair loss) which is localized and spotty
what is the infection site of tinea barbae?
what is the superficial infection of tinea barbae?
what is the severe infection of tinea barbae?
developement of deep pustules
what is the result of tinea barbae?
permnanent hair loss
what are the symptoms of tinea pedis?
foot lesions "athletes foot"
tinea barbae mode of infection?
growth between toes of small fluid filled vesicles
development of shallow lesions that itch
pre-disposing conditions for tinea pedis?
public showers, swimming pools, failure to dry between toes.
Symptoms of tinea curis?
lesions in groin or perianal area
Red, scaly, itchy and dry "jock itch"
prediposing factors of tinea curis?
moisture in groin area, wet bathing suits, athletic suporters, tight-fitting slacks, pantyhose and obesity
tinea corpis infection sites?
non-hairy areas of the body
tinea corpis symptoms?
lesions are reddened, scaly with papular eruptions
tinea unguium infection sites?
fingernails and toenails
initial symptoms of tinea unguium?
superficial thie pathced nail bed
later symptoms of tinea unguium?
thickening of nail, accumulation of cheesy debris, cracking and discoloration of nail
How can dermatomycoses be diagnosed?
Microscopic ID : (tissue scrapings) + (10% KOH or 10% NaOH) + heat -> (frees hyphae from keratinous material) + stain (gram stain, wright stain or periodic acid - schiff) -> Presence of septate hyphae
Macroscopic ID: Cultures on (Dermatophyte Test Media (DTM) or Sabouraud's Dextrose Agar) for about 1 to 2 weeks in room temperature -> funal colonies
What is the treatment for Dermatomycoses
(Cutaneous Mycoses) ?
nonprescription – salves/ointments contain tolnaflate; symptomatic relief
oral antibiotic therapy – griseofulvin (accumulates in keratin tissue)
topical antifungal agents – Azoles (ketoconazole, miconazole and itraconazole)
sporotrichosis is another word for....
What is the fungal source of subcutaneous mycoses?
normal inhabitants of soil or organic matter
how is subcutaneous mycoses introduced to the host?
wounds or abrasions of skin
cutaneous sporotrichosis is also called what?
rose gardner's disaease
what is the causative agent for cutanouse sporotrichosis?
what is the cutaneous sporotrichosis mode of infection?
traumatic implantation of fungus into skin
painless papule at inoculation site
enlarge to form an ulcerated lesion
spread of cutaneous infection to regional lymph nodes
Lymphocutaneous sporotrichosis mode of infection?
fungus forms multiple nodules after being spread by draining lymph channels
nodules may ulcerate
untreated lesions last years
what are the occupational risk groups of Lymphocutaneous sporotrichosis
horticulturists, foresters, gardeners, farmers and basket weavers
How is subcutaneous mycoses diagnosed?
A direct culture is taken from lesion exudate
Yeast (37 C) - oval, cigar shaped
Mycelial phase (25 C) - brown/black colonies; conidia - flower-like clusters
What are the treatments for cutaneous sporotrichosis?
potassium iodide orally in juice or milk
potassium iodide – topical application on open lesions
fungus cannot withstand heat – heat packs
what is the treament for lymphocutaneous sporotrichosis?
antibiotic of choice – amphotericin B
systemic mycoses are also called?
what is the mode of infection for systemic mycoses?
inhalation of dried yeast cells
colonize lower respiratory tract
asymptomatic or primary pulmonary infection (PPI) that parallels TB
disseminated to other organs due to compromised defense mechanisms
What is the major infection of systemic mycoses?
what is the causative agent for cryprtococcosis?
what is the resovoir for cryptococcosis?
soil, high association with pigeon droppings
Where does the primary infection of Cryptococcosis take place?
where does the secondary infection of Cryptococcosis take place?
disseminated sites - (brain, meninges, CNS and mucicutaneous systems)
what are the initial symptoms of Cryptococcosis?
fever, cough, nodules of lung
what are the later symptoms of Cryptococcosis?
arise dues to tumor-like masses at secondary sites, headaches, mental changes, coma, parlysis, eye disturbances and seizures.
What are the two risk groups of Cryptococcosis?
Occupational risk - (outbreaks associated with workers demolishing buildings where pigeons have roosted)
AIDS patients - highest case rate U.S - chronic meningitis (most common)
How do you diagnose Systemic Mycoses?
The presence of the capsule
What are the 4 different "presence of capsule" types you can have for systemic mycoses?
India Ink Preparation
Latex Agglutination Test
India Ink Preparation
wide, clear capsular halo
Sarbouraud Agar (SDA)
slimy, mucoid colony
Latex Agglutination Test
presence of crptococcal capsular polysaccharide
What is bird seed agar used for in spcies identification for cryptococcus?
What are the treatments for systemic mycoses (cryptococcosis)?
amphotericin B and fluconazole
What is the endogenous type infection of opportunistic mycoses caused by?
Normal flora for the opportunistic mycoses is found where in the body?
respiratory tract, mouth, intestinal tract and vagina
What is the process of an opportunistic infection?
overgrowth of normal flora
inflammation of epithelial surfaces (most frequently oral cavity and vagina)
infectivity of internal organs
What is the main type of infection that is opportunistic mycoses?
What are the two types of candidiasis infection?
cutaneous infections and disseminated infections
What is the causative agent of the candidiasis infection?
What are the four types of candidiasis cutaneous infections?
Thrush or oral candidiasis
Vaginal candidiasis (VC)
Why do candidiasis cutaneous infections arise?
due to host's conditions.
diabetes, natural immunological deficiencies, or exposure of skin to moist environment
What is the mode of infection for candidiasis cutaneous infections?
adherence of blastoconidia to epithelial surfaces
invasion of epithelial tissue
Which candidiasis is the most common?
Thrush or Oral Candidiasis
what is the symptomatic appearance of thrush or oral candidiasis
white, adherent patches (pseudomembranes) attach to the epithelial membranes of the tongue, gums, cheeks or throat
What is another term for the oral candidiasis pseudomembrane ?
What is the composition of the oral candidiasis pseudomembrane?
yeast, hyphae and epithelial debris
Who has increased susceptibility to oral candidiasis?
how is oral candidiasis transmitted to a newborn or child?
mother -> child
What is the most common form of vaginal infection?
Vaginal candidiasis (VC)
What are the symptoms of vaginal candidiasis?
yellow to white milky discharge, inflammation, painful ulcerations and itching
What is the candidal overgrowth associated with vaginal candidiasis related to?
an increased glucose content of vaginal secretions
who is likely to get vaginal candidiasis?
diabetic women, pregnant women and broad spectrum of antibiotic therapy users
What is Esophageal Candidiasis?
complication of AIDS patients
What are the symptoms of Esophageal Candidiasis ?
painful bleeding, ulcerations, nausea and vomiting
What is general candidiasis infections?
infections of epidermal tissue
What are examples of areas that are succeptible to general candidiasis infections?
folds of skin on obese people (usual sites – upper legs or underarms)
tissue that remains wet (occupation –dishwasher)
skin covered by wet diapers (diaper rash)
What are the two types of disseminated infections?
A disseminated cutaneous infection produces what kind of disease?
a multi-system disease
What is disseminated iatrogenic infections?
(produced by physicians) – usage of catheters or prosthetic devices
How can you diagnose a candidiasis infection?
: gram stain the lesions or exudates. (gram positive = budding yeasts cells)
: cultures on SDA– (white to cream colored colony, pasty with a yeasty odor) // clutures on corn meal agar – (chlamydospore formation)
Germ tube test
: yeast cells + serum + (incubation for 2-4 hours) = germ tube formation
What are the treatments for the candidiasis infections?
cutaneous - imidazoles
disseminated - amphotericin B
Viruses are what in size?
hetergeneous in size
Viruses are obligate _________ parasitess
what do viruses require to replicate ?
Where do viruses replicate?
the cytoplasm or the nucelus of infectedells.
what host cell machinery does the viruses use for their own replication?
protein synthesizing processes
what is the genetic material (genome) of viruses?
either RNA or DNA (NOT BOTH)
How is viral pathogenesis inititated?
have to enter the host and replicate in particular cells or organs.
Viral pathogenisis is the study of?
study of how viruses cause disease in their target hostsusually carried out at the molecular or cellular level.
what must viruses do to produce diesease (the process)
viruses must enter a host, come in contact with susceptible cells, replicate and produce cell injury or cell death.
What are the four routes in which viruses can enter the host.
sexually transmitted route
How through viruses enter the host via the fecal-oral route?
contaminated food or water
How through viruses enter the host via the respiratory route?
through the air
How through viruses enter the host via the arthropod-borne route?
bite of insects or animals
How through viruses enter the host via the sexually transmitted route?
what diseases result from viruses entering via the fecal-oral route?
poliovirus, rotavirus, hepatits A virus
what diseases result from viruses entering via the respiratory route?
influenza viruses, parainfluenza viruses, measles virus, mumps virus, respiratory syncytial virus
what diseases result from viruses entering via the arthropod-borne route?
encephalitis viruses, rabies virus
what diseases result from viruses entering via the sexually transmitted route?
herpes viruses, haptatitis B, C and D viruses, HIV
What are the two different genome a viruses can have?
The protein shell that surrounds the genome
the structure of the genome AND the capsid
true or false, all viruses contain enzymes associated with its genome?
false, only some
enzymes associated with its genome
in some viruses, an ________ encloses the capsid
What is the enevelope made of?
viral glycoproteins and lipid bilayer derived from the membrane of the infected cell
In some viruses, the envelope contains glycoproteins in the form of spikes called _________.
glycoproteins in the form of spikes in the envelope
Viruses containing peplomers, _______________ prior to entry into the cells.
attach to the host cell receptor
The complete, infectious virus particle
structural subunits of the capsid
What is the criteria for virus classification?
the organization of the genome :
RNA or DNA
Single or double strandedness
Manner in which the genome is expressed after uncoating in cyotplasm or infected cell.
Explain how the viral genome displays its expressions.
1. After uncoating in the infected cell
2. Synthesis of virus-specific mRNAs that
or host enzymes
for this process
3. All viruses use host protein synthesizing machinery to make virus-specific protein(s).
How is the genome expressed?
synthesis of virus-specific messenger (m) RNA molecules that are translated into virus-specific protein(s).
What is the strandedness for most RNA?
what is the segmentation of RNA?
1 or more segments
What are the two kinds of polarity of RNA?
+ (mRNA) or - (Anti-mRNA)
What examples of RNA have a positiv3 polarity?
polovivirus and hepatitis A virus
the genome in a positive polarity is...
In positive polarity, the genome can directly act as an...
In positive polarity the genome is translated directly to produce...
Genomic RNA in infection in which polarity?
What is an example of a negative polarity virus?
the rna genome ____ directly translated into protein in negative polarity
the genomic RNA in not infectious in which polarity?
what happens after uncoating in the negative polarity?
virion-associated transcriptase (RNA dependent RNA polymerase)-transcribes the negative-sense (-) RNA genome into m(+)RNA molecules
What is the main difference about the positive polarity genomes between class 1 and class 3?
The genome is class 3 has TWO identical positive (+) strands of RNA.
What is the viral example of the class 3 positive polarity?
The flow of infomation in the class 3 positive polarity is...
genomic RNA to DNA to mRNA
what happens after uncoating in the class 3 positive polarity?
virus contains a virion-associated reverse transcriptase, which transcribes the genome (RNA) into a complementary (c) ds-DNA
What happens with double stranded (ds) DNA in class 3 positive polarity?
it is translocated to the nucleus and integrates with host
What is responsible for the production of mRNA in class 3 positive polarity?
The genome (DNA) is transcribed by....
a host cell DNA-dependent RNA polymerase in the nucleus of the infected cell (few exceptions).
Class 1 of DNA replication involves what kind of viruses?
Viruses with double-stranded (ds)-DNA
What is the flow of information in the Class 1 DNA replication?
ds-DNA to mRNA (regulated) to viral proteins (classical pathway found in eukaryotic cells)
Where does the DNA replication of class 1 positive polarit take place?
What happens in class 1 dna replication After
uncoating and transcription of viral genome to make mRNA’s is REGULATED?
multiple cycles resulting in expression of alpha,beta and gamma genes
what kind of genes are the alpha?
immediate early genes - trancsription regulatory genes
What kind of genes are the beta?
early genes - required for viral DNA syntheis
what kind of genes are the gamma?
the late genes - transcribed after DNA synthesis and produce viral structural proteins
what is an example of a class 1 DNA replication virus?
What kind of viruses are in the class 3 of DNA replications?
viruses with partially ds-DNA
The genome in dsDNA is partially ___________.
A revers transcriptast step is involved in which replication process?
what is the relaxaed circuliar genome repaired and converted into a closed ciruclar form by?
virion-associated DNA polymerase
What is the genome after the RT Step transcribed into?
(i)mRNA that is translated to produce viral proteins and (ii) genomic length RNA that serves as a template for the synthesis of genomic DNA by a virion-encoded .RNA dependent DNA polymerase (RT)
what is an example of a class 3 DNA virus?
hepatitis B virus
what is the flow of information in the class 3 relpicatiom for DNA?
Genomic DNA to RNA to Genomic DNA
What happens after uncoating in the class 3 DNA replication?
virion genome is converted to complete ds-DNA by virion associated DNA polymerase
In class 3, DNA replication, what is da-DNA transcribed by?
HOST RNA polymerase
in class 3, DNA replication, ds-DNA is transcribed by HOST RNA polymerase to make....
(i) mRNA’s and (ii) genomic length (+) RNA
in class 3 in dna replication, The (+) RNA is converted to genomic DNA .....
virion-encoded reverse transcriptase (RT)
In class 3, of DNA replication is there an intergration of viral DNA in host cell DNA?
What is the order of the seven steps of dna/rna replication'?
entry into cell
synthesis of viral proteins
replication of viral genome
virion attach to an appropriate cell via virus-specific receptor
ENTRY INTO CELL:
non-enveloped viruses: receptor-mediatedendocytosis envelopedviruses: fusion of viral envelopewith host cell membrane
removal of capsidproteins in non-enveloped viruses (genome is free in the cytoplasm of cell) or release of nucleocapsid in cytoplasm (enveloped viruses)
SYNTHESIS OF VIRAL PROTEINS:
Expression of virus genome: RNA and DNAviruses have different strategies
REPLICATION OF VIRAL GENOME:
different strategies, depending on the nature of the genome(RNA or DNA).
assembly of progeny virions in thecytoplasm (poliovirus) or in the nucleus of the infected cell (herpes virus) - depends on the virus and cell involved.
progeny virions (newly synthesized) arereleased from infected cells by cell lysis (lytic cycle) or by the process of budding from the host cell membrane (enveloped viruses).
How many people are infected with HIV worldwide?
65 million people
How many people are living with HIV/AIDS?
How many aids-orphans are there?
over 16 million
Estimated, how many people die each die of AIDS?
How many people in the u.s are living with HIV/AIDS?
what percentage of men, and what percentage of women are living with aids in the u.s?
70% - men
30% - women
How many people in NYS are living with HIV/AIDS?
The New York City AIDS case rate is ____ times the national average?
How many people in buffalo are living with HIV/AIDS?
Origin of HIV
theory that simian immunodeficiency virus crossed into humans early 1900s
theory that HIV came to US from _____ in _____.
Haiti in 1969
HIV is an RNA virus with two ______.
identical strands of RNA
HIV integrates into hist genome and replicates in _____
host cell nucleus
Aids patients have ________ antibodies
What are the 4 high risk groups for AIDS?
Homosexual and bisexual men
Intravenous drug users
Children born to mothers who are HIV+
Hemophiliacs (blood product recipients)
What is inside the capsid of HIV?
Genome (two identical strands of RNA)
What are the three virion associated enzymes present in the HIV capsid?
Reverse transcriptase (HIV)
RNA dependent DNA polymerase
intergrates DNA into host chromosome
cleaves certain certain proteins during replication
What are the three main things that the HIV enevelope is made up of?
stalk for GP120
site of attachment to host cell receptors
combination of GP41 and GP120
HIV targets cells of the immune system that have ______.
HIV kill __ Cells and also stops the production of new ones from _____.
from bone marrow and the thymus
What are the five cells that HIV targets?
Dendritic Cells in lymphocytes
Microglial cells in brain
What is the flow of info for HIV replication?
RNA -> DNA -> mRNA
HIV genomic replication occurs when?
within hours of virus entering the system
Why is HIV a very efficient replication?
because it brings it's own enzymes
Once the ______ is present, the HIV virus cannot be removed.
why might there be several strains present in the same individual (HIV)?
HIV undergoes rapid genetic changes
What are the 7 steps of HIV replication?
attachment of GP120 to host cell CD4 receptor
fusion - viral envelope and host cell plasma membrane fuse together and release viral core into cytoplasm
virion -associated reverse transcriptase synthesizes a complementary double stranded DNA
Complemenetary DNA is intergrated into host chromosome (provirus) by integrase
The provirus is transcribed to produce genomic RNA (genome) and mRNA (viral proteins)
Assembly of new viruses occurs in the cytoplasm
Viruses are released by budding - acquires envelope and GP120
Ptahogenesis and disease of HIV is caused by....
the destruction of immune system cells
Death from HIV is usually caused by...
a secondary or opportunistic infection
What are the factors that determine the speed and severity of the disease?
host cell environment
tuberculosis (enhances pathogenesis)
The course of the HIV disease is divided into ___ stages
Stage 1 of HIV?
Acute or primary HIV disease stage
Stage II of HIV?
asymptomatic HIV disease stage
Stage III of HIV?
Chronic symptomatic HIV disease stage
Stage IV of HIV?
Crisis stage of AIDS
Acute retorviral is in what HIV stage?
Stage 1 of HIV develops ________ weeks after exposure
HIV stage I lasts how long?
Stage 1 HIV is characterized like...
What are the symptoms of stage 1 HIV?
fever, sweat, lethargy, headache, diarrhea
In Stage 1, the viruses spread throughout the body with no notable immune response because...
there are high levels of the virus
What is it called when the HIV virus spreads throughout the body but there is no notable immune response?
"window of infectivity before sensitization"
the window of infectivity before sensitization
The body has not had enought ime to produce an immune response by cells are making more viruses
In stage 1 a person is highly infectious but shows HIV ________.
Stage II of HIV is?
Asymptomatic HIV disease stage
How long does stage II of HIV last?
anywhere from months to 11 years
in stage II of HIV, HIV level in blood drop and the bodies make....
antibodies against HIV
In stage 2 of HIV there is a balance between the level of HIV and the level of ________.
what stage is when the proviral DNA is in laten stage - viral genome is intergrated into host genome?
in stage 2 of HIV patient is still infectious but there are lower levels of _____
What is stage 3 of HIV?
chronic symptomatic HIV disease stage
How long can stage 3 of HIV last?
for months or years
in stage 3 of HIV, virus replication destroys....
in stage 3 of HIV, the t4 cell count is ____ or less per microliter of blood
In what stage of HIV does viremia begin?
high levels of virus in blood which can infect more host cells
What are the symptoms of stage 3 of HIV?
fever, weight loss, malaise, fatigue, night sweats, headaches, and swollen lymph glands
In stage 3 of HIV, destruction of T4 cells leads to...
the loss of immune response and the onset of opportunsitic infections and cancer
What is stage 4 of HIV called?
Crisis stage or AIDS
What does the patient aquire in stage 4 of HIV?
opportunistic infections and cancer
in what stage of HIV is there a marked destruction of immune system cells leading to sever immunodeficiency?
What are the common organism involved in opportunsitic infection in AIDS?
cryptosporidium, toxoplasma, pneumocystis, mycobacterium, cytomegalovirus, epstein-Barr virus, herpes simplex virus, kapsi's sarcoma
HIV is not transmitted casually, but AIDS is a _________ disease
HIV can be transmitted during which stages?
all of them
what stages is HIV the greatest risk?
first and third stages
Parenteral transmission (HIV)
Perinatal transmission (HIV)
infected mother to newborn
What % chance is it that HIV is passed from mother to baby?
How is transmisson of HIV reduced between mother and newborn?
Giving an antiviral
If an antiviral is started before birth what is the chance of prenatal HIV transmission lowered to?
If an antiviral is started after 3 days of life, what is the chance of prenatal HIV transmission lowered to?
ART for HIV stands for?
A cure for HIV infections would require ......
cleansing the body of HIV
to cure HIV you would need to remove....
all cells containing the provirus while eliminating any viruses from the body
why is there no vaccine available fror HIV?
the rate of mutation of HIV
What are the 5 main anti-HIV drugs?
Reverse transcriptase inhibiotors
What are two types of reverse transcriptase inhibitors?
What are 3 nucleoside analogs?
AZT, tenofovir, emtricitabine
what are 3 kinds of non-nucleoside compounds?
nevirapine, delavirdine, efavirenz
What are 3 types of protease inhibtors?
saquinavir, ritonair, indinavir
What does a CCR5 antagonist do?
block receptor which inhibits viral attachment
what does integrase inhibitors do?
prevent intergration would give a better chance to eliminate virus (if it is extracellular)
What are the two types of combination therapies for HIV?
Highly active anti-retroviral treatment (HAART)
What is Highly active anti-retroviral treatment (HAART)?
use of triple combination therapy
All anti HIV drugs are highly toxic and very _______.
Currently there is research to kill cells that are (HIV) ....?
"reservoirs or dormant HIV"
What two things rapidly kill HIV infected macrophages?
miltefosine and perifosine
ELISA stands for?
(enzyme-linked immunosorbent assay)
What does ELISA test for?
What are two rapid HIV tests?
Ora Quick rapid HIV-1 antibody test
Uni-gold recombigen HIV
If a person has a positive test for HIV, they are tested .....
a second time six months later then a confirmatory test is performed.
What is the confirmatory test for HIV?
What does a western blot test detect?
Several virus-specific proteins
What is the paramyxoviridae genome?
Non-segmented single stranded RNA
paramyxoviridae paramyxoviridae viral glycoproteins (hemagglutinin and neuramidase) locations
paramyxoviridae viral glycoproteins (hemagglutinin and neuramidase) locations
on the same glycoprotein
paramyxoviridae examples? (4)
parainfluenze, RSV, Measles, Mumps
Segmented single stranded
orthomyxoviridae virion-associated polymerase presence?
orthomyxoviridae viral glycoproteins (hemagglutinin and neuramidase) locations?
on seperate glycoproteins
Both the orthomyxoviridae and paramyxoviridae groups of viruses are responsible for what in childrean and adults?
upper and lower respiratory tract infections
Both the orthomyxoviridae and paramyxoviridae groups of viruses cause what percentage range of adult colds in the U.S?
Human parainfluenze viruses have how many serotypes?
What serotypes of Human parainfluenze viruses cause infections in humans?
1,2 and 3
Human parainfluenze viruses is more common in children up to ________ years old.
Human parainfluenze viruses transmission?
respiratory route (inhalation of droplets)
where does Human parainfluenze viruses replicate?
in the respiratory tract
is there viremia in Human parainfluenze viruses?
Human parainfluenze viruses types 1 and 2 cause what in children 6mo to 3yrs?
what are the clinical symptoms of croup of Human parainfluenze viruses?
characteristic spasmodic cough
what diseases are cause by Human parainfluenze viruses type 3?
bronchiolitis and pneumonia
Human parainfluenze viruses immunity?
transient (short lived); reinfiection possible
Human parainfluenze viruses diagnosis?
detect viral antigens in cells from nasal secretions
Human parainfluenze viruses treatment?
no ant-viral drugs, only symptom management
is there a vaccine for Human parainfluenze viruses?
how many Respiratory syncytial virus (RSV) serotypes are there?
Respiratory syncytial virus (RSV) is prevalent in......
infants and children
Respiratory syncytial virus (RSV) transmission
does Respiratory syncytial virus (RSV) have viremia?
what is the Respiratory syncytial virus (RSV) incubation period?
what are the clinical symptoms of Respiratory syncytial virus (RSV)?
bronchiolitis and pneumonia in infants less than 6mos old
fever and cough
Respiratory syncytial virus (RSV) immunity?
transient; reinfection possible
Respiratory syncytial virus (RSV) diagnosis?
detect viral antigens in cells of nasal secretion
Respiratory syncytial virus (RSV) treatments
Isolation of infected child
antiviral drug, ribavirin, used if severely infected
Respiratory syncytial virus (RSV) passive immunization?
RSV immune globulin (synagis0 - short lived, given monthly
is there a vaccine for Respiratory syncytial virus (RSV)?
how many serotypes does mumps have?
mumps is a _________ disease
mumps has a high rate of _______infections
where does mumps replicate?
respiratory tract and lymph nodes
does viremia occur with mumps?
mumps incubation period?
mumps clinical symptoms?
fever, headache, pain
swelling of (one or both) parotid glands
symptoms have sudden onset
What are the 2 complications that can occur with mumps?
orchitis - swelling of testes (higher chance in adults)
meningitis - CNS involement
IgM antibodies present for a month after infection
IgG antibodies not present during acute infection; present during convalescent stage and for life.
is there a vaccine for mumps?
what are the mumps vaccines?
Live, attenuated (non-virulent) vaccine - MMR (measles, mumps, rebeola)
when are the two doses of vaccines for mumps?
First at 12-15 mos old
Second at 4-6 years or 11-12 yrs old
how many serotypes does measles (rubeola) have?
what does measles (rubeola) cause?
acute febrile (fever)
is measles (rubeola) infectious?
What are the two reasons that measles are able to be eliminated completely?
Humansa are the only natural host
There is no carrier state
measles (rubeola) transmission
measles (rubeola) incubation period?
measles (rubeola) clinical symptoms?
The 3 C's
: cough, coryza (head cold, rinorrhea), conjunctivitis (eye infection)
characteristic of measles; red/yellow spots with white ceter around molars in the mouth
warthin-finkeldey syncytial cells (function)
as virus infects neighboring cells it causes them to fuse together resulting in giant, multinucleated cells, characteristics of measles
reddish rash on the hands and face which can spread to rest of body
measles (rubeola) immunity
permanent immunity, IgG antibodies persist for life
measles (rubeola) diagnosis?
serodiagnosis (test for antibodies)
is there a vaccine for measles (rubeola) ?
yes. MMR vaccine
how many serotypes does influenza have?
What are the three serotypes of influenza?
A,B and C
What influenza serotypes cause infections in humans?
only A and B
what is the influenza resovoir?
Pigs and birds
_____ have a receptor for human, avian and swine influenza viruses
The influenza genome is segmented into how many pieces?
each influenza genome segment has its own....
transcriptase that makes mRNA
the influenza viral envelope has ____ peplomers.
what are the two peplomers that the influenza viral envelope has?
H or HA - hemagglutinatinin for attachment to cell receptor
N or NA - neuraminidase for release from infected cells
the influenza lipid bilayer is derived from the...
host cell membrane
influenza undergoes ______ changes each year
What do we need to do to respond to antigenic changes?
make a new vaccine each year
How can the RNA for peplomers change?
by two mechanisms
minor antigenic shift
point mutation (action)
virion-associated transcriptase changes one or two nucleotides which slightly changes the antigenic properties of the peplomers
influenza incubation period?
influenza clinical symptoms
abrupt onset of fever which lasts 3-4days
myalgia (muscular aches)
common complication - pneumonia
no permananet immunity
What is there no permamnent influenza immunity?
antigenic changes in the virus
anti-influenza drugs :inhibit uncoating
What are the anti-influenza drugs?
The anti-influenza drugs only work for which type of influenza?
today, most if not all strains of influenza are resistant to....
What are the neuraminidase inhibtors?
Relenza (zanamivir) - nasal spray
Tamiflu (oseltamivir) - tablet
What drugs work for type A and B influenza?
How do neuarminidase inhibitors work?
prevent the release of virus from infected cells, decreases the severity and duration of infection.
all influenza vaccines contain what?
two subtypes of influenza A and one subtype of influenza B
Why does influenza vaccine composition change each year?
to respond to antigenic changes of the virus
What are the two FDA approved influenza vaccines?
Inactivated virus vaccine given to high risk groups
live, attenuated intranasal vaccine (LIAV) given to healthy people (2-49yo)
Who are the high risk groups for influenza?
elederly, people with immune, cardiovascular, pulmonary or metabolic disorders, infants, people on aspirin therapy or people with asthma.
in influenza, temperature sensitive mutants can grow in....
influenza mutants only grow in the....
Upper respiratory Tract (URT)
What are two contradictions for LIAV (influenza vaccine)
vaccine is grown in chicken eggs, so shouldnt be given to someone with allergies to eggs
Vaccine should not be given to people who have a fever or those who are not fully healthy.
North america swine influezna virus contains genes from...
H of H1N1
Asian and Europen swine influezna virus contains genes from...
N of H1N1
North American avian virus has what subunit?
transcriptase subunit 1
Human influenza virus has what subunit?
transcriptase subunit 2
Hepatits A virus has what kind of infections?
subclinical or asymptomatic
acute viral hepatitis A infection
Which Hepatits A virus infection has a higher incidence than other Hepatits A virus infections?
which Hepatits A virus infection occurs, but shows no symptoms, having the host not even know it's infected?
subclincial or asymptomatic infection
subclinical or clincal aysmpotomatc has ______% antibodies to the virus.
does acute viral hepatitis A infection have a carrier state?
acute viral hepatitis A infection incubation period
15- 50 days
What is the two symptom phases of acute viral hepatitis A infection?
acute viral hepatitis A infection preicteric phase
virus is replicating in intesitnal cells;
abrupt onset of fever
anorexia (loss of appetite)
acute viral hepatitis A infection preiteric phase time length?
a few weeks to several years
acute viral hepatitis A infection icteric phase
viremia - liver infected
acute viral hepatitis A infection icteric phase time lentgh?
The majority of individuals with acute viral hepatitis A infection __________ recover
acute viral hepatitis A infection trasnmission
fecal-oral route (contaminated food)
acute viral hepatitis A infection immune response
IgM and IgG antibodies are produced
in acute viral hepatitis A infection IgM lasts for....
a few months
in acute viral hepatitis A infection IgG last for
acute viral hepatitis A infection diagnosis
test for presence of IgM and HAV antibodies
acute viral hepatitis A infection treatments
passive and active immunization
acute viral hepatitis A infection passive immunization
human gamma globulins - give person specific antibodies for immediate but short lived protection
acute viral hepatitis A infection active immunization
what are the two vaccines for acute viral hepatitis A infection?
inactivated hepatitis A vaccine
inactivated hepatits A vaccine
used for children between 12 and 23 mos old, two doses spaced six months apart
combined hep A and hep B vaccine - used for persons 18 years and older.
Hepatits B virus is also called
The Dane particle
an estimated _____% in the U.S ifected with Hepatits B virus develop acute hepatits.
10-25% of people who develop acute hepatits from Hepatits B virus will become...
carriers of Hepatits B virus and have a higher risk of chronic liver disease.
Hepatits B virus is the major cause of what 3 diseases?
primary hepatocellular carcinoma (HCC)
can Hepatits B virusbe grown in cell celtue
Hepatits B virus genome
partially double stranded DNA with a virion-assoicated polymerease
Hepatitis B surface antigen
envelope protein that is specific to Hepatits B virus
HBV surface antigen function
differentitate between hap A and hep B
30 - 70% of Hepatits B virus infections are....
HBsAG is present in serum for....
IgG and HBsAg antibodies persist for life giving.....
Acute Hepatits B virus clinical symptoms?
similar to HAV (have iteris and preucteric phases)
acute Hepatits B virus infection incubation period
HBsAg is transiet and is present in serum for....
less than six months
theres a theory that fulminant hepattli is caused by ...
HBV and HDV
what causes severe cirrhosis of the liver and has a high mortality rate?
transmission of subclinical and actue Hepatits B virus
sexual contact or by contaminated food
chronic hbv infection carrier state
chronic carrier state
persistent viral hepatitis
one of the common long term sequela (pathological condition resulting from disease) of acute hep B.
HBsAg is in seruj for life, but a _____ amount of antibodies are produced.
Chronic HBV transmission
from infected mother to infants
theres a 70=90% chance for infection of Chronic HBV if the mother is a....
Chronic HBV immune response
IgG and HBsAg antibodies are produce and give lifelong immunity after infection
Chronic HBV diagnosis (2)
perform a test to detect the presence of HBsAg (only indicates the presence of an infection, not the type)
perform further tests, spaced 6 months apart to determine type
Chronic HBV treatment passive immunization
Hepatitis B immunoglobulin (HBIG) - more selective, higher amount of antibodies for the virus
standard immune serum globulin
human gamma globulin
Chronic HBV activve immunization
Recombinant vaccines used for 0-18 year olds
for infants born to HBsAg postive mothers
Chronic HBV recombinant vaccines?
how are recombinant vaccines made?
isolating the genes for antigen production and putting them into a yeast cell which can make the antigen thich is purified and used as a vaccine
infants born to HBsAg positive mother should recieve 3 or 4 doses of ______ starting at birth.
What causes post-tranfusion hepatitis?
60 - 70% of HCV infections are ....
in most cases an HCV acute infection results in...
the establishment of a persistent infection
What makes it hard to remove the HCV chronic virus?
high rate of chronic/persistent infection leading to hepatocellular carcinoma
in HCV chronic infection _______ occurs serveral weeks after infection and can last for years
HCV infections are slow or fast?
time takes for HCV clinical hepatitis?
time takes for HCV liver cirrhosis?
time takes to develop HCV HCC?
parentally or by sexual contact
use antibody testing to detect the presence of HCV antigens (not type)
treatment of HCV chronic infections?
combined interferon-alpha2b and ribavirin
combined interferon-alpha2b and ribavirin
combination of two has a synergistic effect; used to reduce the level of virus which prevents or slows liver cirrhosis and HCC (cant completely remove virus)
HDV is also called...
HDV has defective...
RNA virus that cannot replicate itself
For HBV carrie that have HDV what is needed for replication?
requires the presence of HBV for replication and trasmission
HDV share similar characteristics with...
plant viruses (viroids)
HDV trasmission is similar to that of...
Coinfection of HBV and HDV may result in...
fulminant hepatits (higher mortality rate)
detection of anti-HDV IgG antibodies
Herpesviruses are anciet and may have infected...
what are the 8 known herpes viruses that infect humans?
Varicella Zoster Virus VZV
Epstein Barr Virus EBV
the herpesvirus lipid membrane is derived from....
the host cell (w/ glycoprotein spikes)
proteins made by the virus that aid in attachment
herpesvirus structure components?
lipid membrane w/ glycoprotein spikes
viral proteins that help start the infectious process in cells
icosahedral shaped structure that contains genetic material
genetic material inside the nucelocapsid; usually double stranded linear DNA .
primary herpesvirus infection is usually
the major feature of herpesvirus pathogensis is...
herpesvirus reactivation (second infection) gives rise to
herpesvirus reactivation is caused by...
certain signals in the host when immune system is weakened
a primary herpesvirus infetion causes ubiquitous.....
Most people are infected with ____ out of the 8 herpesviruses, with the exceptions of what two ?
HSV- 2 and HHV8
HSV 1 caauses
varicella - chicken pox, zoster-shingles
Burkitt's lympohoma, nasaopharyngeal carcinoma, oral hairy leukopaka
mostly mild or asymptomatic infections
HHV 6 causes
neutopic and lymphoproliferative
HSV 1 treatment
fecal - oral route
abortive and nonparalytic polio (minor)
paralytic and bulbar poliomyelist (severe)
trivalent, inactivated vaccine
coxsackie virus family
coxsackie virus genome
small single stranded RNA
coxsackie virus transmission
fecal - oral route
coxsackie virus diseases
herpangina and hand foot, mouth diseases
pleurodyna and heart infections (severe)
coxsackie virus vaccine
single stranded (-) RNA, cells is bullet shape
rabies (highly fatal)
double-caspsid segmented double stranded RNA
fecal - oral route
rotarix and rota Teq
requires intermedate host (pigs) then to humans
single straded (+) RNA
monkeys and humans
West Nile Virus families
West Nile Virus genome
singles stranded (+) RNA
West Nile Virus reservoir
West Nile Virus transmission
West Nile Virus treatment
single stranded segmented RNA
Hentavax (not FDA approved)
herpesvirsues have what replication cycle?
lytic replication cycles
herpesvirus replication steps
virus bind and enters cell
nucleocapsid moves through cytoplasm to host nucleus
nucleocapsid binds to nucleus and injects DNA and tegument
new viruses are assembled in the nucleus
viruses bud off of the nucleus and move into the golgi bodies
viruses exit through cell membrane and evets
Where does HSV replaicate ?
epidermal cells and neurons enervating the skin
when does HSV stop repilcating?
when it reaches the neroun cell body (end) (latent)
certain singals reactivate viruses and cause recurrent infecron, in this case, it travels down to where'?
the same area where primary infection occured
HSV1 and HSV2 are genetically...
the face and skull
waist and hip area
disseminated infection b/c of immature immune system
terminates viral DNA chai growth
has to be activated by viral eznymes to start working
HSV adds a phosphate group to
valine increases the solubility of the drug makinging it....
more avalible to cells
once it enters a cell, valine is replaced by _______.
Adenosine arabinosde (araA) treats
trifluridine and idodeoxyuridine treats what?
what are the 5 types of lymphotropic herpesviruses?
the three HHV types
lymphotropic herpesviruses are viruses that infect...
cells of the immune system (t cells, b cells, monocytes,macrophages and dendritic cells)
EBV blunts the T cell response and infects...
B cells where it becomes latent
EBV is a causative agent of
cytomegalovirus is present in all..
cytomegalovirus is associated with..
monocytes, polymorphonuclear leukocytes and macrophages
cytomegalovirus is the major cause of deafness and hearing loss in...............
embryo, neonates, young children
in cerbral-spinal fluid
HHV6B is associated with (bone transplants)
encephalitis, causative agent of roseas
HHV7 can infect T cells but...
not yet associated with any human disease
HHV8 is associated with
castleman's disease, primary effusion lymphoma, and body cavity lymphoma
poliovirus is an ________ human virus
why is there no vaccine for the rhinovirus
there are more than 100 types
90% of poliovirus infections are , 5% are, 1-2% are and 0.1-2 are..
abortive polio (self limiting)
bulbar poliomyitid has a ____% mortlity rate.
Coxsackie A has self limiting, _____ infections, while coxsackie B has ________ infections
rabies incubation period
weeks or month depending on the bite
three stages of rabies?
prodome stage - virus infects nerves onset (2 - 10 days)
neurolgic stage - hallucination, virus to organs (2 -10 days)
comatose stage and death
immediate washing of wound with soap and water is a treatment for...
rotaviruses are relatively ______ at a range of pH
stable (can pass through stomacha)
rabies vaccine given on what days?
day of exposure, days 3,7,14 and 28
rotavirus incubation period
75% of emerging viruses are...
rotarix is ____ derived monovalent and given at 2mos and 4 mos
rotaTeq is ____ derived pentavalnet and given at 2,4 and 6 mos.
Nipah incubation period
how many strains of dengue virus is there?
when was dengue first observed?
asi, africa and north america in 1780's
first case of west nile virus was when and where?
uganda, africa, 1937
hantaviruses incubation period
what the four corners disease?
hantavirus was first isolated where?
hantaan river in south korea in 1978
what are the 5 emerging viruses of 2010?
rift valley fever - african cattle and sheep
coexistence where neither orgainsm harms the other
coexistence where both organisms benefit
coexistence where one organism has the potential to harm the other
species in which sexual reproduction occurs
species in thich asexual reproduction occurs
unnatural host that parasite is not adapted to survive in
ebola and marbug family
ebola and marbug transmission
respiratory or fecal-oral route, (human to human)
ebola marbug vaccine
ebola marbug treatments
what are the two phylums under unicellular parasites?
2 subphylums of sarcomastigophora
organism in the subphylum sarcodina
organisms in the subphylum mastigophora
giardia lamblia, trypanosma cruzi
classes,suborders of phylum apicomplexa
class sporozoea, suborder eucoccidia
class sporozoea, suborder eucoccidia organisms
toxoplasma gondii, cryptosporidium
suborder haemosporina organism
entamoeba histolytica infectious stage
cysts (can survive high temps and chloride)
entamoeba histolytica excystation
cysts change into tropozoites, occurs in small intestines
entamoeba histolytica reproductive/ pathogenic stage -
small peptides that form pores in cell membranes
entamoeba histolytica encystation
trophozoites change into cysts, occurs during passage through the gut
entamoeba histolytica pathogeneisis, transmission by...
cysts ( 1 cysts realeases 8 trophozites)