High yield notes on micro midterm spring quarter

HSV-1, HSV-2, VZV (alpha group)

Cowdry Type A inclusions, multinucleated giant cells (like parainfluenza, RSV, giant cell pneumonia in measles too), broad host range, latency in DRG.

CMV (beta group, along with HHV-6 the cause of exanthem subitum)

Infects leukocytes; retinitis, encephalitis in AIDS patients; interstitial pneumonitis in transplant patients; enteritis in both; mononucleosis in transfusion patients; most common cause of congenital abnormalities -- deafness, mental retardation, blueberry muffin baby, seizures, periventricular calcifications; transmitted by any contact with bodily fluids; treat with first line ganciclovir (bone marrow suppression, nephrotoxicity), backup foscarnet (nephrotoxicity).

EBV (gamma group, along with HHV-8 the cause of Kaposi's)

Infects oropharynx epithelial cells and B cells. Transmitted by saliva. Causes infectious mononucleosis. Associated with endemic form of Burkitt's lymphoma in Africa (affects jaw). Associated with 20% of Burkitt's (predominantly abdominal) in this country. In immunocompromised associated with other lymphomas, both Hodgkin's and non-Hodgkin's. Also associated with nasopharyngeal carcinoma (especially in southern China). Can see reactive T lymphocytes (not themselves infected) in peripheral blood smear, called atypical lymphocytes or Downey cells. Associated with positive heterophile antibody test, where nonspecific antibodies agglutinate sheep or horse RBCs. A rise in EBV-specific antibodies is diagnostic. To diagnose mononucleosis: fever, sore throat, cervical lymphadenopathy, enlarged liver and spleen. Like other members of herpesviridae, establish latency -- in B cells. No vaccine or effective treatment. Anti-EBNA antibodies appear late, 3-4 weeks after onset. IgG anti-VCA and IgM anti-VCA are present at clinical presentation; IgM disappear by 4-8 weeks, IgG are lifelong.

Adenovirus

Cause of pharyngitis, pneumonia, colds (5 most common causes of colds are coxsackie, rhinovirus, coronavirus, adenovirus, and influenza C), conjunctivitis, gastroenteritis, cystitis. Doesn't cause meningitis (3 most common causes of aseptic meningitis are coxsackie, echovirus, mumps). Adenovirus prevents transport of MHC Class I to cell surface -- thus protecting itself against one arm of cell-mediated immunity, the CD8 cytotoxic T cell, but exposing itself to another, the natural killer cell. Adenovirus has taken a page from human papilloma virus' playbook: it has proteins E1A, and E1B, that knock out Rb and p53, respectively.

Poxvirus

Need to bring a DNA-dependent RNA polymerase in the virion and encode a DNA-dependent DNA polymerase, because it replicates in the cytoplasm, unlike other DNA viruses.

Latent infections

Herpesviridae and Papilloma/Polyoma family viruses tend to be latent.