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Questions and Answers
What is a manifestation of conjunctivitis in a child?
What is a common symptom of infectious mononucleosis caused by EBV?
What are Koplik's spots associated with?
Which cells does EBV primarily infect?
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Where are Koplik's spots typically found in the oral cavity?
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Which of the following is a microscopic feature of Koplik's spots?
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What laboratory finding is typically observed in patients with infectious mononucleosis?
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In which condition does reactivation of EBV primarily lead to B-cell neoplasms?
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What is a characteristic finding in the lungs of a measles patient?
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Which of the following is NOT a common microscopic finding in measles?
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What is a characteristic pathological finding in the lymph nodes during EBV infection?
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What type of inflammation is indicated by neutrophilic exudate?
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What mode of transmission is most commonly associated with EBV?
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What is a feature of the measles rash?
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Which observation indicates an immune response in lymphoid tissue during measles infection?
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What is the most common cause of genital herpes?
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What is the primary presentation of genital herpes lesions?
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What type of inclusion bodies are characteristic of HSV infection?
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What is a possible serious complication of HSV infection in neonates?
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Which of the following symptoms is associated with disseminated HSV infection in neonates?
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Where do Cowdry Type A inclusion bodies typically form in HSV-infected cells?
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What systemic symptoms are seen in a disseminated HSV infection?
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What is a common skin manifestation of HSV infection?
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HSV infection can lead to necrotic lesions in which organs?
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Which of the following is NOT characteristic of genital herpes lesions?
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What is the primary viral agent responsible for mumps infection?
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Which major gland is primarily affected by mumps parotitis?
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What type of cells predominantly infiltrate the edematous interstitium of the parotid gland in mumps pathology?
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What is a potential severe complication related to mumps affecting the testis?
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What is a common clinical symptom of dengue fever?
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Which type of hemorrhagic condition is associated with dengue fever?
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How is dengue fever primarily transmitted?
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What pathological finding is associated with mumps infection in the pancreas?
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What clinical condition is linked with the presence of thrombocytopenia in dengue fever?
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What type of viral disease is associated with perivenous demyelination in the central nervous system?
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What is the dominant mode of transmission for CMV after the age of 15?
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Which of the following is a characteristic finding in CMV-infected cells?
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What type of inclusion bodies are associated with CMV infection?
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Which of the following findings is typical in herpes zoster infection?
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What is a potential mode of neonatal transmission of CMV?
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What occurs alongside herpetic intranuclear inclusions in dorsal root ganglion cells infected by VZV?
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What is the appearance of cells infected by CMV in lung alveoli under microscopic examination?
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Which route is NOT associated with CMV transmission?
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What type of inflammatory cells are predominantly associated with VZV ganglion cell infection?
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In microscopic examination of herpes zoster, what features are observed in epithelial cells?
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Study Notes
Measles
- Koplik's spots are ulcerated mucosal lesions in the oral cavity near the opening of the Stensen's duct
- Koplik's spots are pathognomonic for measles
- Microscopically, Koplik's spots consist of necrosis, neutrophilic exudate and neovascularization
- They are found in the oral cavity, particularly the lateral buccal mucosa and upper lip
- Measles rash and conjunctivitis are common symptoms
- Warthin-Finkeldey giant cells are multinucleated giant cells found in the lung
- Warthin-Finkeldey bodies are found in lymph nodes and the lungs
- Lung biopsy of a patient with measles pneumonia shows obliteration of the normal alveolar architecture
- Other microscopic findings include follicular hyperplasia and large germinal centers
Mumps
- Mumps is a contagious viral infection that causes swelling of the salivary glands, primarily the parotid glands.
- The virus enters the respiratory tract through inhalation of respiratory droplets
- It spreads to draining lymph nodes and replicates in T-lymphocytes
- Mumps can spread hematogenously to various organs
- Mumps parotitis is swelling and pain in the salivary glands
- Mumps encephalitis is characterized by perivenous demyelination and perivascular mononuclear cuffing.
- Mumps pancreatitis features acinar cell injury, release of digestive enzymes resulting in parenchymal necrosis, fat necrosis, and neutrophil-rich inflammation.
- Mumps orchitis presents with edema, mononuclear infiltration, and focal hemorrhages in the testes.
- Mumps orchitis may lead to infarction, necrosis, scarring, atrophy, and sterility.
- Mumps oophoritis is inflammation of the ovaries
- Mumps is characterized by a swollen neck region due to enlarged salivary glands
- Bilateral involvement in 70% of cases.
- The mumps virus infects ductal epithelial cells of the salivary gland
- Microscopic pathology involves edematous interstitium of the parotid gland, diffuse infiltration by lymphocytes, macrophages, and plasma cells, compressing the acini and ducts
- Neutrophils and necrotic debris may fill the lumen of the ducts, leading to focal damage to the lining epithelium
Dengue
- Dengue is a viral hemorrhagic fever caused by Flavivirus
- It is transmitted by mosquito bite (Aedes aegypti)
- Dengue infects mononuclear phagocytes and hepatocytes
- Clinical symptoms include headache, fever, myalgia, joint pain, conjunctival congestion, retro-orbital pain with generalized transient macular rash, and mild to severe hemorrhage
- Dengue hemorrhagic fever is a more severe form of dengue fever
- It is associated with hypoproteinemia, thrombocytopenia, prolonged bleeding time, and elevated prothrombin time
- Dengue Hemorrhagic Fever is a severe, life-threatening, multi-system syndrome involving vascular damage
- Dengue Hemorrhagic Fever causes widespread hemorrhage and shock.
- The diagnosis of dengue fever is based on clinical history, hemoconcentration, leukopenia with lymphocytosis, thrombocytopenia, and serological tests
- Gross pathology findings include conjunctival hemorrhage and pinpoint areas of bleeding
Herpes Simplex Virus (HSV)
- Genital herpes (Herpes Genitalia) is commonly caused by HSV-2
- HSV-2 causes vesicles on the genital mucus membranes and external genitalia, which rapidly convert to ulcerations.
- In neonates infected during passage through the birth canal, HSV can result in fulminating infection
- This is usually caused by HSV-2
- Neonatal HSV infection is characterized by generalized lymphadenopathy, splenomegaly, and necrotic foci throughout lungs, liver, adrenal glands, and CNS
- Cowdry type A inclusions (inclusion bodies) are large, pink to purple intranuclear inclusions in HSV-infected cells consisting of viral replication proteins and virions at various stages of assembly
- The inclusions push chromatin to the edge of the nucleus.
Herpes Zoster (Varicella Zoster Virus - VZV)
- Herpes zoster is a reactivation of varicella-zoster virus (VZV)
- VZV infects the dorsal root ganglion
- VZV infection of ganglion cells leads to ganglion cell necrosis, associated inflammation and herpetic intranuclear inclusions within the neurons and their supporting cells
- Herpes zoster (shingles) includes painful vesicular rashes distributed in a dermatomal pattern.
Cytomegalovirus (CMV)
- CMV infection can be acquired through neonatal transmission, genital route, saliva and respiratory secretions, feco-oral route, and iatrogenic transmission through blood transfusions or organ transplants.
- CMV-infected cells exhibit gigantism, presence of large intranuclear basophilic inclusion bodies surrounded by a clear halo (owl's eye).
Epstein-Barr Virus (EBV)
- EBV is a herpesvirus that causes infectious mononucleosis
- EBV is a factor in the development of several human cancers, including nasopharyngeal carcinoma, Burkitt lymphoma, B cell Non-Hodgkin lymphoma, and Hodgkin lymphoma
- EBV infects B cells and oropharyngeal epithelial cells
- EBV binds to Complement Receptor 2 (CR2), resulting in latent infection
- Transmission is through close human contact, frequently with saliva during kissing.
- In immunocompetent hosts, infection is often asymptomatic or results in infectious mononucleosis
- Infectious mononucleosis is characterized by fever, sore throat, generalized lymphadenopathy, splenomegaly, and the appearance of atypical lymphocytes (mononucleosis cells).
- Symptoms of infectious mononucleosis appear on the initiation of the host’s immune response
- Cellular immunity is mediated by CD8+ cytotoxic T lymphocytes and NK cells.
- In patients with defective cellular immunity, EBV reactivation can lead to uncontrolled proliferation of B cells, resulting in EBV-associated B-cell neoplasms
- EBV causes cervical lymphadenopathy.
- Cervical lymphadenopathy in infectious mononucleosis commonly involves posterior cervical lymph nodes, axillary lymph nodes, and inguinal lymph nodes.
- Microscopic findings: Expansion of paracortical areas due to activation of the T cells.
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Description
This quiz covers critical information about measles and mumps, including symptoms, histopathology, and pathognomonic signs like Koplik's spots and Warthin-Finkeldey giant cells. Test your knowledge on these contagious viral infections and their implications for public health.
