| Positive sense RNA | ||
| Naked | ||
| Polyprotein product | ||
| Cleaved portion of polyprotein | ||
| Hep A | ||
| Hepatosplenomegaly | ||
| Fecal oral transmission | ||
| Enteroviruses | ||
| Polio, Echovirus, Coxsackie | ||
| Aseptic meningitis | ||
| CSF glucose normal | ||
| Elevated protein | ||
| No organisms visible on microscope | ||
| Children most affected by meningitis | ||
| Rhinovirus | ||
| Upper respiratory infection |
| Acid stable (boiling acid pool) | |
| Picornavirus | |
| Positive sense naked RNA | |
| Asymmetrical paralysis | |
| Anterior (motor) horn of spinal cord | |
| Causes aseptic viral meningitis | |
| Salk = killed vaccine | |
| Sabin live vaccine | |
| IgA response to vaccines | |
| Replicates in lymphoid tissue like Peyer's patches |
| Picornavirus | |
| Positive sense naked RNA | |
| Type A | |
| Aseptic viral meningitis | |
| Type B | |
| Devil's grip = Bornholm's dz, pieurodynia | |
| Dilated cardiomyopathy |
| Hepadnaviridae: Hep B Virus (and Deltavir.: HDV) "The Hippy Pad" | |
| In viral hepatitis ALT > AST (ALT beachball is high, AST is low) | |
| ALT rises in acute phase and falls dramatically afterwards (") | |
| Give at-risk infants anti-Hep B IgG antibodies along with killed vaccination (kid has IgG) | |
| Partially double-strand DNA virus | |
| Intranuclear AND Cytoplasmic replication | |
| Coinfection with Hep B and D is better prognosis than superinfection with Hep D. | |
| Hep D requires HbsAg to be infectious | |
| Hep B has Circular genome | |
| Hep D is RNA negative virus | |
| HBV uses reverse transcriptase | |
| Chronic infection leads to cirrhosis | |
| Assoc. with hepatocellular carcinoma | |
| Assoc. with membranoproliferative nephritis | |
| Assoc. with membranous nephritis | |
| Causes arthralgias | |
| After polyarteritis nodosa, kidney disease | |
| Purpuric macules | |
| 90% of neonate infections become chronic | |
| Transmitted during delivery from mixing of maternal and fetal blood | |
| 10% of adult HBV infections become chronic | |
| Transmitted via sex and blood products (sign) | |
| TORCH infection (tiki torches) | |
| Rx: Lamivudine, NRTIs, Interferon Alpha, (Lamb, alpha and omega, NRTI lady) | |
| HbSAg = Hb Surface antigen = envelope, 1st serum marker of infection | |
| HbEAg, sign of increased infectivity | |
| Anti-HbC antibodies, first detectable antibody. Only seen in infection, not vax. | |
| Anti-HbE antibodies, seen later | |
| Anti-HbS, indicate immunity or recovery from infection. Seen in vaxed and recovered |
| Largest Physical Size DNA virus family | |
| Replicates in cytoplasm | |
| Replicates in incusion bodies called Guarnieri bodies in cytoplasm | |
| Dumbbell shaped core | |
| Poxviruses form their own envelopes | |
| Smallpox | |
| Same-age lesions, as opposed to VZV multiple stages at once | |
| Lesions more on trunk, whereas VZV more on extremities | |
| Has DNA-dependent RNA polymerase | |
| Cowpox: contact with infected cow udders, confers smallpox immunity | |
| Molluscum contagiosum | |
| Diffuse infection in adults suggests HIV | |
| Flesh-colored, dome-shaped, umbilicated lesions | |
| Umbilicated lesions on trunk in children |
| Live vaccine for military recruits (camo shirts) |
| Fecal-oral transmission (lion eating near poop) |
| Respiratory droplet transmission (drops from stalactites) |
| Children commonly afffected (kids in camo) |
| Public swimming pool outbreaks (kid swimming) |
| Conjunctivitis, Pink eye (red eyes in the darkness) |
| Adenitis, Tonsilitis, Hemorrhagic cystitis (cave is red like tonsils, statue is peeing red) |
| Parvovirus: B19 = 5th Disease = Slapped cheek dz | ||
| Causes aplastic anemia in sickle cell pts (sickle on a plane over a spider-web bone) | ||
| Lacy rash starts on face and moves downwards | ||
| Joint pain, arthritis (because B19 replicates primarily in bone marrow, guy on his knees) and edema (fat guy) in adults | ||
| Can mimic Rheumatoid arthritis, but no RF, no citrullated proteins, infectious, and self-resolves. | ||
| Smallest DNA virus (blue walls) | ||
| Only single strand DNA virus (single runway) | ||
| Vertical transmission TORCHES infection | ||
| Respiratory droplet transmission | ||
| Can cause hydrops fetalis |
| Guardasil is inactivated subunit vaccine, protects against types 6,11, 16, 18. | |
| HPV 1-4: Common wart, no vaccine (1 and 4 yo with warts) | |
| HPV 6 and 11 | |
| Laryngeal papillomatosis (11 yo eating frogs) | |
| Anogenital warts = condyloma accuminata from sexual transmission (kid putting frogs in pants) | |
| HPV 16, 18, 31, 33 | |
| Anogenital cancers (frog on seat of chair) | |
| Immunocompromised at increased risk and decreased latent period (gal has cane) | |
| E7 gene (straw shaped like a 7) disrupts RB antitumor gene (straw in Root Beer) | |
| Pap smear: if positive, see koilocytes (on table) | |
| E6 gene disrupts P53 suppressor (fork in shrimp next to crab (cancer) cracker) |
| BK virus (Brutus Kills) | |
| hemorrhagic cystitis (blood fountain behind brutus) | |
| BK nephropathy in transplant pts (meat on ice falling behind Brutus) | |
| JC virus (Julius Caesar) | |
| Non-enhancing multifocal brain lesions in white matter (white garland around Caesar's head) | |
| Progressive Multifocal Leukoencephalopathy (PML, statue of Caesar says PML) | |
| Leukoencephalopathy demyelinates nerves (table legs being demyelinated) | |
| Active in HIV pts with CD4 < 200 (200 senators) |
| Kaposi-s Sarcoma |
| Kaposi lesions commonly on the hard palate |
| Causes proliferation of vasculature |
| Vasculature prolif. Looks similar to Bacillary angiomatosis from Bartonella henselae: panther |
| Infection of B-cells can cause Primary Effusion = B-cell Lymphoma |
| Violaceous lesions on nose, extremities and mucous membranes |
| AIDS and immunosuppressed associated |
| Lesions in GI tract |
| Causes dysregulation of VEG-F growth factor |
| Higher incidence in Russian men |
| Roseola |
| Exanthema subitum |
| 4 day fever |
| Develops febrile seizures |
| Infects CD4 T cells |
| After fever, a diffuse lacy body rash occurs that spares the face |
| Affects children 6 months to 2 years and is self-limiting |
| Chicken Pox; Shingles = Herpes zoster |
| HIV pts with CD4 > 200 may be given VZV vaccine |
| Shingles reactivation with stress, aging or immune compromise |
| Postherpetic neuralgia = pain after the rash is gone |
| Live zoster virus vaccine for adults over 60 yo |
| Herpes zoster opthalmicus, CN1 involvement leading to blindness |
| Encephalitis, especially in immunocompromised |
| Vesicular "dew drops on rose-petal" lesions |
| Fever and headache |
| Rx: valcyclovir, famcyclovir for shingles |
| Rx: Acyclovir for children +12, adults, immunocompromised |
| Live attenuated children's chicken pox vaccine |
| Respiratory droplet transmission |
| Tzanck smears: Multinucleated Giant Cells (Same as HSV 1 and 2) |
| Vertical TORCHES transmission |
| Congenital Varicella syndrome: limb hypoplasia, dermatomal scarring, blindness |
| Latent in dorsal root ganglia |
| Enveloped virus |
| Extremely painful rash |
| Shingles has dewdrop on rosepetal appearance, dermatomal distribution |
| In immunocompromised pts, if VZV crosses midline, is said to be disseminated VZV |
| Rx: Gancyclovir | |
| 80-90% infected are asymptomatic | |
| Congenital CMV | |
| Hepatosplenomegaly and Jaundice | |
| Seizures | |
| Hydrops fetalis | |
| Blueberry muffin rash | |
| #1 viral cause of hearing loss and retardation | |
| Periventricular calcifications | |
| Ventriculomegaly | |
| Owl's eye inclusions | |
| Lymphadenopathy similar to Mononucleosis | |
| TORCHES infection | |
| Pharyngitis | |
| Rx: Foscarnet if resistant to Gancyclovir | |
| UL97 Kinase gene mutation leads to Gancyclovir resistance | |
| Can be latent in B and T cells, macrophages or other mononuclear immune cells | |
| Attacks immunosuppressed with CD4 counts < 50. | |
| CMV colitis | |
| Linear ulcerations in CMV esophagitis | |
| CMV retinitis causes pizza pie look under retinoscopy |
| No contact sports (sporty knight) | |
| Enveloped, dsDNA, positive sense virus | |
| HIV pts: oral hairy leukoplakia: does NOT rub off (unlike oral Candidiasis)(HCL Rx: Cladribine)(bearded guy with cane) | |
| Asians: Oropharyngeal carcinoma (asian guy with crab biting nose) | |
| Envelope protein binds CD21 on B cells ("Must B 21 or older") | |
| Rapid Dx: Monospot aka Heterophile Test (Dart Board with darts in one spot) | |
| Assoc. w Hodgkin Lymphoma | |
| CD15+ Reed-Sternberg "owl eye" Cells (Owl in the Reeds) | |
| Local lymph nodal spread | |
| Good prognosis | |
| Primarily transmitted in saliva (kissing girl) | |
| Pharyngitis, tonsillar exudates (drooling boy) | |
| Tender posterior lymphadenopathy (knight is grabbing boy by scruff of neck) | |
| aka mononucleosis (CMV can have similar symptoms) | |
| Fever | |
| Reactive cytotoxic CD8 T cells (Downey Cells) seen on blood smear | |
| Splenomegaly (spleen on cow rump) | |
| Endemic or African Burkitt Lymphoma | |
| Large Jaw lesion and swelling | |
| 8;14 translocation | |
| If mistakenly given Amoxicillin or Ampicillin, maculopapular rash | |
EBV remains latent in B cells Downey Cells ----  Reed-Sternberg "Owl-Eye" Cells of Hodgkin Lymphoma |
| Enveloped, dsDNA, positive sense virus | |
| Dx: Fluoroscein slit lamp exam reveals serpinginous corneal ulcers | |
| Rx: Acyclovir and valacyclovir to prevent breakouts | |
| Dx: Fluoroscein slit lamp exam reveals serpinginous corneal ulcers | |
| Vertical (mother to fetus) transmission | |
| Intranuclear Cowdry inclusion bodies | |
| Erythema mutiforme 1-2 wks after infection | |
| Herpetic whitlow, often in dentists | |
| Keratoconjunctivitis | |
| Tzanck smear: multinucleated giant cells (same as VZV) | |
| Dewdrops on rose petal vesicle on erythematous base appearance | |
| HSV1 | |
| #1 cause of sporadic encephalitis in the USA | |
| latent in trigeminal ganglia | |
| Gingivostomatitis is the first sign | |
| Herpes labialis = "cold sores" | |
| HSV2 | |
| Painful inguinal lymphadenopathy | |
| latent in sacral ganglia | |
| May cause aseptic meningitis in teens and adults |
| Double-stranded, segmented virus | |
| Naked | |
| Infections more common in winter | |
| Colorado tick virus | |
| myalgia | |
| fevers | |
| vomiting | |
| Rotavirus | |
| Watery, secretory diarrhea | |
| NSP4 toxin causes chloride permeability, leads to secretory diarrhea | |
| Tx: rehydration | |
| Live attenuated oral vaccine | |
| 11 RNA segments | |
| #1 cause of severe diarrhea in infants and children, Children at risk |
| Negative RNA helical virus | |
| CCHRS: California Enceph, Crimean Congo, Hantavirus, Ritf Valley/San fly virus | |
| Hantavirus | |
| 3 Segmented virus | |
| Transmitted via rodent urine and feces | |
| Deer mouse is reservoir | |
| Pre-renal azotemia | |
| Enveloped from Golgi body | |
| Hemhorragic fever | |
| Pulmonary capillary leak | |
| Arboviruses: California, Rift Valley fevers | |
| Aedes mosquito | |
| Seizures | |
| Encephalitis |
| Marburg and Ebola |
| Negative RNA helical virus |
| Bats may be reservoir |
| Primates may be carriers |
| Transmitted via bodily fluids |
| fever |
| Petechial rash |
| Hemorrhagic fever |
| End organ failure in days |
