Immunology Final Lectures 6-10

  1. Initial infection with HCMV (human cytomegalovirus) generally occurs during ____

    35-90% of adults have been previously infected with HCMV
  2. What the four modes of transmission of HCMV between adults
    • Saliva and other bodily fluids
    • Sexual means
    • Organ transplantation
    • Blood transfusions
  3. Where does HCMV establish latency? (3)
    macrophages/monocytes as well as wells of the kidney
  4. ____ represents the most common intrauterine viral infection in the US today
  5. ____ HCMV diseases can cause damage to the liver, spleen, blood forming organs and the nervous system
  6. Why can't you use acyclovir on HCMV?
    HCMV doesn't synthesize thymidine kinase (this is needed to start the processes of stopping chain elongation)
  7. Which two viruses have similarities to HCMV (and are in the same herpes subfamily)
    HHV 6 and HHV 7
  8. HHV 6 and HHV7 are the causative agent in what disease?
    Roseola infantum (rash in infants)
  9. What is the most common clinical syndrome associated with HHV6 infection among aids patients?
    encephalitis (brain inflammation)
  10. what virus plays a role in the accelerating the progression from early HIV to AIDS?
  11. HHV 8 is also known as
    Kaposi sarcome associated herpes virus
  12. What virus is linked to kaposi sarcoma
    HHV8--> it has been found in more than 90% of patients with kaposi sarcoma
  13. what was the most common cancer associated with AIDS but declined after the introduction of HAART
    Kaposi sarcoma
  14. what does HAART stand for?
    Highly active anti-retroviral therapy
  15. How is EBV generally transmitted and what cells does it infect?

  16. What does the EBV use on the B-lymphocyte
    A complement (C3b) receptor (pre-exisiting)
  17. Where does EBV establish latency?
    In the B-lymphocyte
  18. EBV induces cell multiplication and immortilization of the B-lymphocyte it infects and this increases the synthesis of what 3 Ig?
    • IgG
    • IgM
    • IgA
  19. IgM contains ____ ___ which are capable of agglutinating sheep and horse RBCs
    Heterophile antibodies
  20. what are Heterophile antibodies
    antibodies that react with things that are not the designated antigen for them

    saw this with cardiolipin and syphillis (cross-reactivity)
  21. What three disease can EBV cause
    • Infectious mononucleosis (IM)
    • Burkitt lymphoma 
    • EBV associated nasophayngeal carcinoma
  22. EBV can cause what in immunocompromised individuals
    B-cell lymphoma
  23. IM can be identified by detecting heterophillic antibodies using what test?
    Paul-Bunnell test 

    (this is an older version of the mono spot test)
  24. T/F: none of the antiheroes drugs are effective in treating IM due to EBV or preventing development of EBV-related B cell malignancies
  25. What can be used to treat oral hairy leukoplakia (white spots on the tongue), in which the EBV is actively replicating int he epithelial cells of the tongue
  26. malignancy of the JAW  that is found in unusually high frequency among children residing in certain regions of equatorial Africa
    Caused by EBV
    Risk factors: malarial parasites and HIV
    Burkitt Lymphoma
  27. What is one of the most common cancers in the southeast asia and north africa regions  and among the Inuit population but less common else where
    nasopharyngeal carcinoma
  28. A study found that CMV enhanced the immune system in
    By increasing the T cell response
  29. Hep A, C, D and E contain ____ genomes
    Hep B contains a ____ genome
    • RNA
    • DNA
  30. portions of asia are endemic for what?
    Hep B
  31. The complete viral protein of HBV is called the
    Dane particle
  32. the HBV genome is unique because its a circular DNA molecule that is
    partly single stranded and partly double stranded
  33. Why can RT inhibitors be used to treat HBV?
    because it uses RT in transcription (partly RNA in the genome)
  34. HBV uses what two enzymes during replication?
    • RT 
    • RNA polymerase
  35. The majority of acute HBV infections result in what?
  36. What are the 4 (5) proteins encoded by the HBV genome
    • HBcAg (Hep B nucelocapsid core antigen)
    • HBeAg (derivative of C--> not considered a separate protein)
    • HbsAg (hep B surface antigen)
    • multifunctional reverse transcriptase/DNA polymerase
    • X protein (a nonstructural regulatory protein)
  37. Where is hep B found?
    In all boldly fluids of infected individuals
  38. In southeast asia, africa, and the middle east the majority of population gets HBV infection _____ but in the western countries people get HBV from ___ or _____
    at birth or shortly afterwards (pick it up from mother or infected sibling)

    • sexual contact
    • IV drug use
  39. individuals infected with HBV at a very young age have an increased risk of developing
    heptaocellular cancer
  40. What is the primary cell type infected by HBV?
    Fully differentiated hepatocytes
  41. the titer of infectious HBV (and antibodies to HBV) can be as high as _____ viral particles per mL of blood
    100 million
  42. What is used as a marker of disease progression in HBV patients?
    levels antigen and antibodies in the titers
  43. What would rise concurrently with HBcAg (nucelocapsid core antigen)
    Things like liver enzymes and other collateral processes
  44. what three factors can play a role in the development of fulminant (explosive) hepatitis
    • more virulent strain of virus
    • coinfection with other viruses 
    • uncontrolled cytokine activity
  45. _____ HBV greatly increases the risk of developing heptocellular carcinoma
  46. What is used to prepare the vaccine for HBV?
    HbsAg (surface antigen)
  47. A healthcare worker is exposed to HBV through a needle stick accident. What would be the immediate treatment?
    give the person antibodies against HBV (hepatitis B immunoglobulin-->HBiG)
  48. What is found in nature as a co-infection with HBV?
    HDV (hepatitis D)
  49. HDV is found in nature as a co-infection with HBV but what is different about the two?
    HBV is a DNA virus and HDV is a ssRNA virus
  50. What is the difference between positive strand and negative strand RNA?
    • positive means it can be readily translated into protein
    • negative means it needs to be converted to positive before it is made
  51. all enteroviruses can cause ___ including ____
    • CNS disease
    • viral meningitis
  52. _____ meningitis is generally milder than ___ meningitis
    • Viral
    • Bacterial
  53. What enterovirus is associated with type 1 diabetes?
  54. A disease where the gray matter of the brain is inflamed, aka "infantile paralysis"
  55. poliovirus selective destroys what?
    the lower motor neurons of the spinal cord and brain stem, resulting in flaccid paralysis
  56. Polio virus binds to a specific receptor that is a member of the ____ ___ family of proteins
    Immunoglobulin supergene
  57. Polio virus has the following courses:

    • 95%: no illness-->asymptomatic infection 
    • 4%: minor illness--> abortive infection, minor nonspecific symptoms 
    • 1%: major illness
  58. ____ ___ of poliovirus is when the symptoms are indistinguishable from meningitis caused by other viruses
    nonparalytic infection
  59. ____ ___ of poliovirus is characterized by muscle paralysis and sometimes respiratory paralysis
    Paralytic poliomyelitis
  60. what is post-poliomyelitis syndrome (PPS)
    when you have had the disease and you get over it and then get muscle weakness, pain, atrophy, and fatigue later on in life
  61. what are the two different explanations for PPS
    • fatigue of overworked motor units (new motor units form after polio and they aren't as strong as the original ones)
    • possible brain damage from viral infection
  62. what are the two polio vaccines and what is the difference between them?
    • Salk vaccine-- inactivated virus
    • Sabin vaccine-- live, attenuated virus
  63. Why did they switch from the Sabin to the Salk  vaccine?
    Since sabin was live they were worried about reversion to virulence of the virus
  64. Three countries where polio is endemic
    Afghanistan, Pakistan, Nigeria
  65. Rhinovirus differes from enterovirus because...
    enterovirus survives better in acid and rhinovirus survives better in cold environments
  66. How is Hep A transmitted?
    Fecal oral route--> consuming contaminated shellfish that have come in contact with sewage
  67. HAV infection is common in countries with ____ ____
    poor sanitation
  68. T/F: prognosis of hep A is generally favorable as the development of persistent infection and chronic hepatitis is uncommon
  69. immunoglobulins directed against HAV has been used for ___ ____ (passive immunization)
    post-exposure prophylaxis 

    this is passive immunization!
  70. Rubella causes ____ but rubeola causes____

    these are NOT the same thing
    german measles

  71. Why is it important for pregnant women and children should be vaccinated for rubella?
    because it can cross the placenta and spread to the fetus without protective antibodies 

    it is ~teratogenic~
  72. Class triad of rubella symptoms in the affected neonates (think CDCA)
    • Cataracts
    • Deafness
    • Cardiac abnormalities
  73. T/F: rubella can cause a rash
  74. The majority of infections with HCV are _____
  75. ____ used to be a major cause of post transfusion hepatitis before blood was testing for disease
  76. Vaccines available?
    • HAV: yes
    • HBC: yes
    • HCV: no
  77. Modes of transmission
    • HAV:fecal-oral route, contaminated food
    • HBV: in the USA (IV drug use, sexual means), in other parts of the world (mother to fetus)
    • HCV: IV drug users
  78. HCV if linked to what?
    IV drug use
  79. Most chronic hepatitis infections are :

    • Us: hep C > hep B
    • World: hep B> hep C

    A not chronic
  80. Order of most common new hepatitis viruses per year in the US
    B> A> C
  81. How is the mumps spread?
    Respiratory droplets
  82. what does the mumps affect? (2)
    The salivary glands, particularly the parotid

    can also cause orchitis which can lead to sterility
  83. T/F: measles is more virulent than mumps
  84. What is the MMR vaccine?
    A live attenuated vaccine for measles, mumps and rubella
  85. The receptor for measles virus is found on most or all nucleated cells and is function is an inhibitory complement receptor, what is it?
  86. the measles starts with a prodromal fever and the three Cs...what are they
    • Coryza (a nose cold)
    • Cough
    • Conjunctivitis
  87. What is a diagnostic sign associated with measles?
    Koplik spots

    small white spots on red mucous membranes of the mouth and throat
  88. T/F: koplik spots and the skin rash you get from measles are the same thing
  89. Influenza is what type of virus?
    an orthomyxovirus
  90. The flu virus consists of ____ separate and different ____ ____

    RNA molecules
  91. What is neuramindiase involved in?
    Exit from the host cell
  92. What is hemagluttin involved in
    entry into the host cell

    both attachment and fusion functions
  93. The influenza virus attaches to ____ ___ on host respirtory cell glycoproteins or glycolipids to get into the cell and cleaves it to bud out of the cell
    sialic acid (aka neuraminic acid)
  94. replication of the flu virus involves synthesis of ____ positive strand mRNA molecules
  95. When do infections from influenza peak?
    from october to may
  96. What the two processes that cause the antigenic variability of the influenza viruses?
    • Antigenic drift
    • Antigenic shift
  97. caused by random mutations in the viral RNA of the flu virus and does NOT involve change in the viral subtype
    antigenic drift

    example: H1N1 stays H1N1 there is just a small/conservative change that doesn't affect the phenotype
  98. A more dramatic change in the antigenic properties of the H and/or N proteins of the flu virus and occurs every 10-20 years
    antigenic shift

    example: H1N1 to H2N2
  99. antiviral agent used to TREAT influenza A and B
  100. How does tamiflu work?
    it inhibits neuraminidase and therefore blocks exit of the virus from the cell
  101. the flu vaccine consists of
    a formalin-inactivated influenza virus
  102. a live, attenuated influenza virus vaccine which is administered intranasally
  103. What is the different between flumist and tamiflu
    Flumist is a vaccine and tamiflu is a medication
Card Set
Immunology Final Lectures 6-10
Exam 3 Material