DNA VIRUSES AND TRANSMISSIBLE SPONGIFORM ENCEPHALOPATHIES (DR. PELLET)

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davis.tiff
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170405
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DNA VIRUSES AND TRANSMISSIBLE SPONGIFORM ENCEPHALOPATHIES (DR. PELLET)
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2012-09-15 22:18:25
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MICROBIOLOGY INFECTIOUS DISEASES
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MICRO/ID EXAM IV
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  1. The JC virus is what type of virus?
    Polyomavirus
  2. True or false. The movement of viruses is dependent on the microtubules inside of the neurons.
    true
  3. Match the following.

    1. neurotrophic
    2. neuroinvasive
    3. neurovirulent

    A. can cause disease by damaging nervous tissue
    B. can enter CNS after infecting a peripheral site
    C. can infect neurons and/or associated cells (regardless of route of infection or pathogenic consequence)
    • 1. neurotrophic - C. can infect neurons and/or associated cells (regardless of route of infection or pathogenic consequence)
    • 2. neuroinvasive - B. can enter CNS after infecting a peripheral site
    • 3. neurovirulent - A. can cause disease by damaging nervous tissue
  4. True or false. Many common viruses that cause sporadic encephalitis have high neuroinvasiveness but low neurovirulence.
    False, many common viruses that cause sporadic encephalitis have low neuroinvasiveness but high neurovirulence.
  5. Match the following.

    1. Mumps virus
    2. Rabies virus

    A. high neurovirulence
    B. low neurovirulence
    C. high neuroinvasiveness
    D. low neuroinvasiveness
    • 1. Mumps virus - C. high neuroinvasiveness, B. low neurovirulence
    • 2. Rabies - A. high neurovirulence, C. high neuroinvasiveness
  6. What are the 4 herpesvirus infections of the CNS?
    • HSV
    • VZV
    • CMV
    • Herpes B infections
  7. Describe the genome of herpesviruses?
    • enveloped
    • icosahedral
    • linear dsDNA
    • >80 genes
    • lytic and latent phases
  8. _____ infection is most common in HSV-1 and -2 viruses. They populate ganglia with a _____ virus and periodically reactivate to the _____ site. Rarely, do they reactivate and transmit to the ____.
    peripheral; latent; peripheral; CNS
  9. What is the most common sporadic fatal encephalitis in adults?
    HSV-1 encephalitis
  10. What are the symptoms of HSV-1 encephalitis?
    • focal encephalitis
    • fever
    • altered consciousness and behavior
    • disordered thinking
  11. True or false. The parietal lobe of the brain is most often involved in HSV-1 encephalitis.
    False, the temporal lobe of the brain is most often involved in HSV-1 encephalitis.
  12. What are the diagnostic criteria for HSV-1 encephalitis?
    • clinical features are not conclusive
    • MRI (showing temporal lobe edema/hemorrhage)
    • EEG spike and slow wave activity
    • PCR of CSF
  13. What is the treatment for HSV-1 encephalitis?
    acyclovir (valcyclovir)
  14. What are the etiology/pathogenesis factors for the Varicella-Zoster virus?
    • acquired via aerosol or direct contact
    • replication at site of entry
    • secondary infection of lymphoid cells
    • viremic phase
    • vesicular skin rash
    • latency in sensory ganglia
    • reactivation after loss of immune system
  15. What are the 2 most common complications of Varicella virus?
    • encephalitis
    • transient cerebellar ataxia
  16. What are the 2 most common complications of Zoster virus?
    • post-herpetic neuralgia
    • encephalitis
  17. What are the 2 vaccines available for VZV and what are the appropriate age groups for administering them?
    • Varivax (preschoolers)
    • Zostavax (>60 years old)
  18. What are the diagnostic criteria and treatment for VZV?
    • PCR of CSF
    • Famciclovir (valacyclovir)
    • vaccines
  19. What are the clinical signs of CMV at birth?
    • intrauterine growth retardation
    • hepatosplenomegaly
    • microencephaly
    • also may include: mental retardation, seizures, blindness, deafness and death
  20. What are the diagnostic criteria and treatment for congenital CMV?
    • PCR
    • direct fluorescence
    • culture of CSF
    • IVIG (prevention), ganciclovir (treatment)
  21. What are the etiology/pathogenesis factors for Herpes B virus?
    • acquired through animal bite or contact with saliva
    • persons at risk: veterinarians, researchers, etc.
    • close relative of HSV-1 and -2
  22. What are the diagnostic criteria and treatment for Herpes B virus?
    • National B Resource center
    • High dose acyclovir (and/or ganciclovir)
  23. Describe the genome of polyomaviruses?
    • unenveloped
    • circular dsDNA
    • 6 genes
    • nuclear replicating
    • dependent on host cellular enzymes for DNA replication and gene expression
  24. Polyomaviruses cause what types of infections?
    upper respiratory diseases
  25. What disease is JCV most associated with?
    Progressive multifocal leukoencephalopathy (PML) (in immunocompromised)
  26. What are the clincial features/symptoms of PML?
    • personality alterations
    • intellectual deficits
    • loss of motor skills
    • sensory loss
    • rapid progression, death within 2-12 months
  27. What are the etiology/pathogenesis factors involved in PML?
    • common in immunocompromised (AIDS patients)
    • sites of pathology: cerebrum, cerebellum, brain stem
    • loss of myelin - due to viral replication in oligodendrocytes
    • little (or no) inflammation
  28. What are the diagnostic criteria and treatment for PML?
    • MRI or CT (lesions in subcortical and deep white matter)
    • PCR of CSF
    • brain biopsy
    • no specific antiviral therapy for PML
    • HAART can be used
    • very poor prognosis
  29. How is transmissible spongiform encephalopathies (TSE) usually transmitted?
    • ingestion
    • inoculation
  30. What are the clinical features/symptoms of TSE?
    • impaired cognitive function
    • ataxia
    • degeneration of neurological functioning > death
  31. What are the histological features of TSE?
    • spongiform degenration
    • amyloid plagues
    • activated astrocytes/microglial cells
  32. What are the molecular features of TSE?
    accumulation of abnormal, protease-resistant, form of PRNP gene product
  33. What is the abnormal form of the PRNP and its relation to TSE?
    PrPsc (sc = scrapie) or PrPres (res = protease resistant); causative agent for TSE
  34. What is the most common TSE that affects human?
    Creutzfeldt-Jakob Disease (CJD)
  35. What are some of the neuropathologies of CJD?
    • spongiform degeneration
    • astrocytosis
    • cerebral atrophy
    • neuronal vacuolization
    • amyloid plagues
    • no inflammation
  36. Match the following.

    1. sporadic CJD
    2. familial CJD
    3. latrogenic CJD
    4. variant CJD

    A. no identifiable cause
    B. caused by transmission of the Bovine spongiform encephalopathy (BSE) to humans
    C. neurosurgery, transplantation, brain-derived hormones
    D. autosomal dominant muations in PRNP
    • 1. sporadic CJD - A. no identifiable cause
    • 2. familial CJD - D. autosomal dominant muations in PRNP
    • 3. iatrogenic CJD - C. neurosurgery, transplantation, brain-derived hormones
    • 4. variant CJD - B. caused by transmission of the Bovine spongiform encephalopathy (BSE) to humans
  37. Match the following.

    1. PrPc
    2. PrPsc

    A. primarily beta-sheet configuration
    B. membrane-bound glycoprotein with a high alpha-helical content
    • 1. PrPc - B. membrane-bound glycoprotein with a high alpha-helical content
    • 2. PrPsc - A. primarily beta-sheet configuration
  38. True or false. Picornaviruses infect the white matter of the CNS, while JCV (PML) infects the grey matter of the CNS.
    False, Picornaviruses infect the grey matter of the CNS, while JCV (PML) infects the white matter of the CNS.

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