This document discusses parvovirus B19, which is a single-stranded DNA virus that causes fifth disease or slapped cheek appearance. It has the smallest viral genome and can cause aplastic crisis in children with chronic hemolytic anemia or arthralgia and arthritis in adults. Transplacental transmission occurs in 30% of cases and can result in nonimmune fetal hydrops.

2.  MOST COMMON POX VIRUS AFFECTING HUMANS
 CANNOT BE GROWN IN EGGS TISSUE CULTURE OR HUMANS
 MCV 1 TO 4
 MCV1  MOST PREVALENT
 MCV2  IN ADULTS ONLY (SEXUALLY TRANSMITTED)

3.  PINK OR PEARLY WHITE NODULE WITH CENTRAL UMBILICATION
 NO ASSOCIATED INFLAMMATION

5.  ENVELOPED dsDNA
 LATENT INFECTIONS
 COWDRY TYPE A INCLUSION
 CAUSE LATENT INFECTIONS

6. α
•HSV 1
•HSV 2
•HSV 3
β
•HSV4
•HSV 8
γ
•HSV 5
•HSV6
•HSV 7

8.  DOUBLE STRANDED ENVELOPED DNA
 HSV1 PRODUCES LESION ABOVE WAIST
 HSV2 LESION BELOW WAIST
 BOTH HSV1 & HSV2 CAN CAUSE GENITAL & ORAL FACIAL INFECTION
 BUT REACTIVATION @ ORAL FACIAL SITE IS DUE TO HSV1 & @ GENITAL SITE WITH
HSV2
 HSV1 ACQUIRE IN EARLY LIFE
 HSV2 IS ACQUIRED AFTER PUBERTY

10.  IP 6-8 DAYS
 PRIMARY HSV INFECTION IS MORE SEVERE & ASSOCIATED WITH
SYSTEMIC SYMPTOMS & COMPLICATIONS THAN REACTIVATION FROM
LATENT INFECTION

11.  HSV1  MOST COMMON CAUS EA/C SPORADIC VIRAL ENCEPHALITIS
 HSV2  CAUSATION CERVICAL CANCER

12. • ORAL FACIAL
• GINGIVOSTOMATITIS &
PHARYNGITIS ARE
MOST COMMON
MANIFESTATION
• HERPES LABIALIS IS
MOST COMMON
MANIFESTATION OF
REACTIVATION
• GENITAL
• MOSTLY HSV2
• MC SITE
• PENIS IN MALES
• CERVIX & URETHRA IN
FEMALE
• PAINFUL & B/L
• TENDER INGUINAL
LYMPHADENOPATHY
• HERPETIC
WHITLOW
• OCCURS IN
DOCTORS
• INFECTION OF
FINGER

13.  HERPETIC GLADIOTORUM
 IN HEAD
 IN WRESTLERS

14.  MC CAUSE OF BLINDENSS IN USA
 FOLLICULAR CONJUNCTIVITIS
 KERATITIS
 DENDRITIC ULCER

15.  IN NEWBORN BORN TO MOTHERS WITH VAGINAL HSV2 INFECTION
 MOST OF THE CASES BY HSV2
 VISCERAL & CNS INFECTION
 SKIN LESIONS ARE THE MOST COMMONLY RECOGNIZED FEATURES

16.  TZANCK SMEAR
 MULTINUCLEATED GIANT CELL
 GEIMSA STAIN
 COWDRY TYPE A INTRANUCLEAR INCLUSION
 HSV PCR  MOST SENSITIVE
 ISOLATION OF VIRUS ON HUMAN FIBROBLAST  MOST SPECIFIC
 RX
 ACYCLOVIR

17.  HERPES VIRUS 4
 IMN /KISSING DISEASE
 MC IN EARLY CHILDHOOD WITH A SECOND PEAK DURING LATE
ADOLESENCE
 TRANSMITTED BY SALIVA /ORAL SECRETIONS OF INFECTED PERSON

19.  MEMORY B CELLS ARE THE RESERVOIR OF EBV
 Although B lymphocytes are infected by the virus, the characteristic atypical cells
are activated suppresser T cells explaining the paracortical location (normally a T
cell zone) in the lymph node atypical lymphocytes
 Lymphocytosis with more than 20 % atypical lymphocytosis

20.  MC SYMPTOM SORETHROAT
 MC SIGN  LYMPHADENOPATHY INFECTIOUS MONONUCLEOSIS
 MC COMPLICATION  MENINGITIS / ENCEPHALITIS

21.  BURKITTS LYMPHOMA
 HODGKINS DS (MIXED XELLULARITY)
 NASOPHARYNGEAL CARCINOMA
 ORAL HAIRY LEUKOPLAKIA IN AIDS PATIENT
 X LINKED LYMPHOPROLIFERATIVE SYNDROME (duncans syndrome)

22.  Heterophile ab test
 Paul bunnel test
 EBV specific Ab test
 Anti viral capsid ag
 Anti EBV nuclear Ag
 Anti early Ag

24.  Salivary gland virus
 Largest virus among herpes virus
 Characterised by enlargement of infected cells (cytomegalic cells) & intranuclear
inclusion
 Owls eye inclusion bodies

25. Eccentrically
placed &
surrounded by
halo

26.  Once infected individual carries CMV for life
 Mc organism causing IU infection
 Mc organism complicating organ transplantation

28.  Most common cause of congenital infection
 It causes
 Triad
 Petechiae
 Hepatosplenomegaly
 Jaundice
 It can also cause intracerebral calcification IUGR choreoretinitis
thrombocytopenia /inguinal hernia
 Diagnosis
 Virus isolation from urine saliva
 PCR of viral genome

29.  Maximum risk of infection after kidney transplant after 1-4 months after
transplantation
 Mc presentation is fever leukopenia HSM
 Mc presentation after BM transplantation is interstitial pneumonia

30.  Diagnosis
 Virus isolation from urine saliva
 PCR of viral genome

31.  Rx
 Ganciclovir
 Valganciclovir
 CMV retinitis

33. Space vehicle appearance
USED AS VECTOR FOR GENE THERAPY

34.  NON ENVELOPED
 DOUBLE STRANDED DNA

36.  ADENOVIRUS CAUSES INFECTIONS OF THE RESPIRATORY TRACT &
LESS OFTEN OF THE INTESTINE
 MOST COMMON MANIFESTATION IN CHILDREN  A/C URTI & RHINITIS
 MOST COMMON MANIFESTATION IN ADULTS IS ARDS

37.  NONENVELOPED DNA VIRUS
 PAPILLOMA VIRUS
 POLYOMA VIRUS
 JC VIRUS  PML IN HIV PATIENTS

39.  HUMAN PAPILLOMA VIRUS CAUSES WARTS

40. TYPE OF WART SITE OF INVOLVEMENT HPV TYPES
VERRUCA VULGARIS MOST COMMON TYPE OF
WART
HANDS & FINGERS
2 (MOST COMMON CAUSE
)
4
27
VERRUCA PLANTARIS
• MOSAIC WART 
SUPERFICIAL
PALMOPLANTAR WART
• DEEP PALMOPLANTAR
WART  MYRMECIA
WART
• PALM
• SOLE
• 2 (MOST COMMON)
• 1(MOST COMMON)
CONDYLOMA
ACCUMINATA
(ANOGENITAL WART)
GENITAL PERINEUM • MOST COMMON 6,11
• OTHER  16 18 31 33 45
LARYNGEAL
PAPILLOMATOSIS
LARYNX RESPIRATORY
TRACT
6,11

41.  IMMORTALISATION
(ETERNITY)OR MALIGNANT
TRANSFORAMTION OF
KERATINOCYTES BY
INTERFERING WITH p53 &
Rb GENE

42.  Ca cervix
 – Low risk – type 6,11 - CIN
 – High risk – type 16,18,31,33 ,45 – Ca Cx
 – Risk factor – early sex, multiple sex, multiparous, OCP

45.  TO DECREASE CERVICAL CANCER
INCIDENCE
 QUADRIVALENT  6,11,16,18
 BIVALENT  CONTAINING HPV 16
18
 VACCINE EFFICACY EXCEEDS 90 %
 AGE OF VACCINATION  9-26 YRS
 3 SEPARATE DOSES (0,2 & 6
MONTHS)

46.  HHV 6B 
 EXANTHEM SUBITUM / 6TH DISEASE
 FOCAL ENCEPHALITIS

48.  Brick shaped
 Produces elementary bodies  paschen bodies

49.  Only disease eradicated globally
 Last case occurred in Somalia in 1977
 WHO declared it on 8 may 1980
 April 1977 india was declared small pox free
 No known animal reservoir
 No long term carrier
 Life long immunity after recovery from disease
 Highly effective vaccine
 Easy detection of cases

51. • SMALL POX
• Centrifugal
• Affects palms & soles
• Axilla is spared
• CHICKEN POX
• Centripetal
• Sparing of palms & soles
• Axilla is affected

52. Chicken pox
 Superficial & unilocular
 Symmetrical mostly on flexor surface
 Pleomorphic
 Dew drop on rose petal appearance
 Centripetal
 Evolution of rash is rapid
small pox
 Deep & multiseated
 Affect extensor surfaces
 Monomorphic
 Umbilicated appearance
 Centrifugal
 Evolution is slow

56.  Varicella zoster (herpes zoster type III)
 IP 10 – 21 days
 Spreads from Respiratory via air droplets or rarely from conjunctiva
 IP of chicken pox is 2 days prior to 5 days after onset of rash
 SAR of 90 %

58.  Tzanck smear  multinucleated giant cells
 Cowdry type A  intranuclear inclusion
 FAMA flurescent Ab to membrane Ag  most sensitive
 ELISA
 PCR for detection of VZV DNA

59. Chicken pox in
immunocompetent
•Symptomatic
•No antiviral
Chicken pox of
<24 hour
•Acyclovir
Herpes zoster
•Valacyclovir
•Famciclovir
Post herpetic
neuralgia
•Analgesics
•Gabapentin
•Lidocaine patch
•amitryptilline

60.  Secondary bacterial infection
 MC
 Staphylococci
 Streptococci
 Varicella pneumonia
 CNS  ataxia encephalitis meningitis
 Others myocarditis arthritis hepatitis
 Herpes zoster in 10 – 30 % patients d/t reactivation in immunosuppression

61.  Crosses palcenta
 More serious if transmitted in first
trimester  fetal varicella syndrome
(cicatrising skin lesions)
 Limb hypoplasia
 Choreoretinitis
 Microcephaly

62.  VZIG
 Given with in 72 hours of exposure
 Premature infants
 Newborn
 If mother develops CP 5 days before delivery – 48 hrs after delivery
 Immunosuppression
 Pregnancy
 Varicella vaccine
 Live vaccine (OKA STRAIN)
 In children after 1 dose  95 % seroconversion
 Above 12 years
 Single dose seroconversion  78 %
 2 doses @ 4 weeks part  99 %
 Use with caution in immunocompromised
 Used only when CD4 count > 15 %
VZIG & vaccine cannot be given
together as VZIG binds to vaccine

64.  ONLY DNA VIRUS HAVING SINGLE STRANDED DNA
 SMALLEST VIRUS
 DIFFICULT TO CULTURE  VIRUS ISOLATION IS NOT USED TO DETECT
INFECTION
 HAS SMALLEST GENOME
 SLAPPED CHEEK APPEARANCE
 APLASTIC CRISIS IN CHILDREN WITH C/C HEMOLYTIC ANEMIA
 ARTHRALGIA & ARTHRITIS IN ADULTS
 TRANSPLACENTAL TRANSMISSION IS 30 % OR HIGHER
 NONIMMUNE FETAL HYDROPS