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11 - Herpes
Terms in this set (42)
Lateral sacral veins
Which veins allow for anterior travel of prostate and ovarian cancers?
Sciatic nerve, from the sacral plexus
What is the largest nerve in the body and where does it originate?
Two or more strains of a virus combine to form a new subtype having a mixture of the surface antigens of the two or more original strains (ex. influenza type A - infects humans or animals) - confers a phenotypic change (BIG DEAL)
Define antigenic shift.
Natural mutation over time of known virus may lead to a loss of immunity or vaccine mismatch (occurs in influenza A, B, C) (smaller deal)
Define antigenic drift.
List factors that contribute to viral reactivation.
Inhibiting MHC I presentation to cytotoxic T cells while expressing MHC class I homologues that inhibit NK cells
Produce receptors for Fc domain of Igs and inhibit complement
Degrade MHC II molecules - impairing presentation to T helper cells
List ways HSV evades the immune system.
Anterior thorax, breast tissue (superolateral quadrant and subareolar plexus)
What does the anterior axillary lymph node drain?
Posterior thorax and subscapula
What does the posterior axillary LN drain?
Deep structures of the arm, lymph drainage accompanying the basilic vein and cubital LNs
What does the lateral axillary LN drain?
Anterior, posterior and lateral axillary LNs
What does the central axillary LN drain?
Aspects of the breast, central axillary LN and some direct drainage accompanying the cephalic LNs (thumb)
What does the apical axillary LN drain?
Lymphatics accompanying the greater saphenous vein (medial structures), superficial drainage of inferolateral quadrant of the trunk,
fundus of the uterus
What does the Superficial inguinal LN drain?
Popliteal LNs, lymphatics accompanying the small saphenous vein,
glans clitoris and glans penis
What does the deep inguinal LN drain?
Deep and superficial inguinal nodes,
body of the uterus (female) OR intermediate and spongey urethra (male), superior bladder, pelvic ureter, cervix (anterior) and upper vagina (female) OR pelvic vas deferens and upper seminal vesicle
What does the external iliac LNs drain?
Base of bladder and urethra, inferior ureters, anal canal (above pectinate line),
middle and upper vagina, posterior cervix (female) OR inferior seminal glands, prostate, cavernous bodies
What does the internal iliac LNs drain?
Attachment - receptor recognition and attachment
Penetration - receptor-mediated endocytosis
Uncoating - shedding of capsid
Viral synthesis - early gene expression
Assembly - creating of capsid and virion formation
Release of progeny - budding or lysis
How do viruses invade hosts?
List factors involved in viral reactivation.
1. Virus travels down neuron (anterograde) via kinesin
2. Virus enters lytic stage and sheds viral particles
- shedding occurs 7 days before and after appearance and disappearance of symptoms
List the order of events for reactivation of a viral infection.
1. Primary infection of tissue
2. Virus travels (retrograde) up neuron via dyenin
3. Virus enters lysogenic phase within the nerve ganglion
List the order of events for how a virus becomes latent.
What nuclei are targets for latent viruses?
I - HSV I
II - HSV II, enveloped
III - varicella zoster (trigeminal)
IV - epstein-barr virus - B cells and epithelium
V - cytomegelovirus - monocytes and epithelium
VI - Roseola infantum, infects T cells
VII - infects T cells
VIII - Kaposi's sarcoma-associated herpes, lymphocytes; latent in B cells
List the different types of herpes viruses.
- Down regulates expression of MHC I and II
- Upregulates expression of HLA-G (prevents NK response)
- Secretes IL-10 analogue to decrease cytokine production
How does HSV invade the immune system?
Where does the primary HSV1 infection show?
Ulcers on the throat, complain of painful sore throat
Where does the secondary, reactivation of HSV1 show?
Vermillion border - cold sore
What are the different CNS infections in HSV1 compared to HSV2?
1 = encephalitis (temporal lobes)
2 = meningitis
What virus causes blueberry muffin syndrome (rash) on newborn babies?
Congenital CMV (can also be caused by Rubella)
What diagnostic indicator would indicate CMV?
Owl's Eye Nuclei on Biopsy
What drugs would you prescribe to treat CMV?
What diagnostic indicator would indicate VZV?
Tzanck smear would show multinucleated giant cells under microscope
What diagnostic indicator would indicate EBV?
Monospot test (aggultinated sheep RBCs after introducing a finger stick of patients blood)
Serum antibodies for EBV
Atypical lymphocytes (T cells) show dark nucleus and larger than normal (>10% of WBCs)
What can EBV be mistaken for?
Strep throat - given amoxicillin and develop a rash
Syphillis - gives VDRL false positive
What are the two differences between HSV1 and HSV2?
HSV1 favours oral mucosa, transmitted via saliva, latent in trigeminal ganglion
HSV2 favours sexual tissue, sexually transmitted, latent in lumbosacral ganglion
List 3 rare complications of ZVZ
Ophthalmic zoster (blindness)
If a baby presents with newborn deafness and blueberry muffin syndrome, how can you differentiate between the two causes?
CMV - also present with seizures and hepatosplenomegaly
Rubella - also present with cataracts and congenital heart disorder
What population are at risk for listeria infection?
Those with weak Th1 responses:
- Newborns/elderly (meningitis)
- Pregnant women (granulomatosis infantiseptica)
How are granulomas formed?
Macrophages become giant cells which are stimulated by IFN gamma
What are the two forms of leprosy and why do they form?
Tuberculoid - strong Th1 response
Lepromatous - Th2 response, antibodies cannot reach intracellular bacteria
What is the different between Crohn's disease and Ulcerative Colitis
Crohn's: noncaseating granulomas, Th1 mediated
Ulcerative colitis: abscesses, ulcers with bleeding - no granulomas and Th2 response
List types of DNA viruses
Hepadna virus (HBV)
Herpes virus (HSV1-8)
Adenovirus (febrile, aplastic anemia)
Polyomavirus (JC, BK viruses)
Pox virus (cowpox, small pox, molluscum contagiosum)
Parvovirus (not DS) (-hydrops fetalis in pregnancy, RA-like symptoms, aplastic anemia)
List the DNA virus that is not double stranded
Which RNA virus is double stranded
List the viruses that are naked and indicate if they are DNA or RNA based
(PAPP smears and CPR to naked Hepes)
DNA: parvovirus, adenovirus, polyomavirus, poxvirus
RNA: calciviridae, picornaviridae, reoviridae, hepevirus
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