Mucinous & serous tumors of the ovary

🐾🐾Several vertically transmitted infections are included in the (TORCH) complex, which stands for:

T – Toxoplasmosis / Toxoplasma gondii.
O – Other infections (see below)
R – Rubella
C – Cytomegalovirus
H – Herpes simplex virus-2 or neonatal herpes simplex

"Other infections" include:

Parvovirus B19
Coxsackievirus
Chickenpox (caused by varicella zoster virus)
Chlamydia
HIV

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Owl's eye appearance of inclusion bodies, which is highly specific for cytomegalovirus infection

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🌸 One of the herpsviridae characters is Latency ;

🌸Virus latency is the ability of a pathogenic virus to lie dormant within a cell.

Until There is an endogenous Reactavation like Stress , ..etc
... it Shows secondary infection

Where it remains Dormant ?!

✨ HSV-1 :- Trigminal Ganglia ( OroFacial)
✨ HSV - 2 :- Sacral Ganglia ( Urogenital)
✨VSV :- Dorsal roat Ganglia
✨ EBV :- B- cells ( 3Bs)
✨ CMV :- Leukocytes and kidney ( organ Transplant )
✨ HHV-6 / HHV-7 :- T Lymphocytes
✨ HHV -8 :- Endothelial cells ( Kaposi's Sarcoma )

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⭐️ DNA viruses Characters:-

( ALL , Except )

1- All DNA viuses are( Double stranded) DNA except : ❗️Parvovirus B19 ; (single stranded )

2- All DNA viruses are (linear )except ❗️Papovavirus ;( Circular)

3- All DNA viuses are ( Ichosahedral ) except ❗️ Poxviruses ; ( Complex: Brick shaped)

4- All DNA viruses or All Viruses is small and seem by( Electron microscope) except ❗️ Poxviruses is large ,seen by ( light Microscope)

5- All DNA viruses replicate innside the nucleus and therefore, Have ( intranuclear ) Inclusion Bodies Except; ❗️Poxviruses ; replicate in the cytoplasm because it has its own Transcriptase [ DNA dependent RNA polymerase] and therefore has ( Intracytoplasmic ) Inclusion Bodies.

6- All DNA viruses are (Enveloped) except ❗️ Adenoviruses , Papovaviruses , Parvovirus b19 are ( Naked)..

7- HSV-2 is transmitted vertically during labour through the Birth canal not transplacentally .. can by Avoided by Cesarean ..

🛑Note:- Poxviruses have 3 Exceptions

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💊 Summary of DNA viruses Treatment:-

🌺 Herpsviridae:-

1- HSV-1 :- Acyclovir, avoid Steroids

2- HSV-2 :- Acyclovir , if Pregnant ( cesarean section)

2- VZV :-
a) Acyclovir or Valacyclovir or New version ( Fscavir ) .. Foscarnet ( doesn't require Kinase) .
b) calamine lotion
c) Antihistamine
d) Antibiotics for secondary infection
e) Avoid [ Aspirin ] , Cut nails

3) EBV : ❗️ No treatment

4) CMV :- Ganciclovir

🌺 Poxviruses: eridicated : No treatment

🌺 Adenoviruses: No treatment

🌺 Papovavirus:-
1- For skin Warts ( Verruca Vuligaris ) :- liquid Nitrogen
2- Electrocautery
3- Podophyllin , Trichloroacetic Acid ,Bichloroacetic Acid

🌺 Parvovirus B19:- transfusion of packd red Blood cells

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🌼Diseases caused by DNA viruses :-

🌼 Herpsviridae:-

1- HSV-1 :- ( OroFacial)
💥 1- Herps Labialis
💥 2- Keratoconjunctivitis >> dendritic ulcer >> Bindness
💥 3- Gingivostomatitis
💥4- Herpetic Whitlow on Finger
💥 5- complication : Ecephalitis , Aseptic meningitis

2- HSV-2 :- ( Urogenital)
💥1- Genital Herps
💥2- Neonatal herps through Birth canal
💥3- Cervical cancer


3- VZV:-
💥1- Primary infection:- Vericella ( Chickenpox) generalized rash

💥2- Reactivated infection: Zoster or Shingles ( A belt roses from hell )

4- EBV
💥1- most cases Subclinical
💥2- infectioue Mononucleosis ( Glandular fever ) making B- cell immortal producing Hetrophill antibodies , lymphosytosis with Atypical lymphocytes
💥 Infectious mononucleosis:- may cause Hepatitis ( Viral Hepatitis)
💥 3- Oral hairy Leukoplakia in AIDS patients
💥4- Burkitt's Lymphoma in Negroes
💥5- Nasopharyngeal carcinoma

5- CMV :-
💥1- in normal host :-
a) Asymptomatic, latent
b) Infectious mononucleosis like syndrome including Hepatitis
c) Restenosis of Coronary angioplasty

💥2- In immunecompramised
a ) Retinitis ( Blindness)
b) Pnemonia

💥3- Congenital infection :-
<24 w Abortion
> 24 w Stll birth
* Cytomegalic Inclusion Disese :-
a) Blindness
b) Diffness
c) Mental retardation
d) Hepato- spleenomegaly


6- HHV- 6 :-
💥 Roseola Infantum ( Subitem) >> Sixth disease of Exanthematic Diseses
[ Rose Rash ]

7- HHV-7 :-
💥Roseola Infantum like

8- HHV-8 :-
💥 Kaposi's Sarcoma in patients with AIDS .. ( Endothelial cell tumor )
Multiple vascular nodules

🌼 Poxviruses:-

☄1- Orthopoxvirus :- eridicated
💥a) Smallpox ( variola ) virus
💥b ) cowpox
💥c) vaccine virus

☄ molluscum contagiosm :-
Human soft Warts ( Benign skin nodules) >> Umblicated Papules

🌼 Adenoviruses:-
more than 50 antigenic type
Effects epithelial cells :-

☄1- upper respiratory tract + Eye :-

💥 a) Febrile respiratory disease (4,7,14,21) :
Rhinitis , pharyngitis, bronciolitis , croup [ larynx , trachea ,Bronchi) >military recruits

💥b) pharyngeo- conjunctival fever (3,7) > Swimming pool

💥 Keratoconjunctivitis ( second +HSV-1)

☄ GIT :-
💥Gastroenteritis ( 40,41 )
Diarrhea, vomiting, fever >> infantile Gastroenteritis > Intussusception

☄ UT :- ( 11,21)
💥 Heamorrhagic Cystitis
Dysuria , Frequency, Heamaturia

☄immunecompramised:-
💥Fetal Pnemonia, Gastroenteritis

🌼 Papovavirus:-

☄pa :- Papilloma >> rapid growth of cells ( Warts )

💥1) Skin warts .. ( Verruca Vuligaris)
1,2,3,4,10
💥 2) Genital warts ... ( Condyloma accuminta )
6,11,18,33
💥3 ) Cervical carcinoma ( 16,18) 6,11

☄ po : polyoma
💥1) JC : John Cunningham
Heamorrhagic Cystitis, Nephropathy

💥2) Bk : Brennan Korhn
Progressive multifocal Luekoencephalopathy

🌼 Parvovirus B19 :-
1- slapped Cheek appearance ..fifth Exanthematic Diseses
2- Arthritis
Due to deposition of Immune complexes
3- Transient Aplastic crisis in patients with severe Anemia ( ex :sickle cell anemia)
4- Hydrops fetalis

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🛑 Note :

❗️DNA viruses may be Oncogenic

🛑Cervical cancer may be due to :-
1- HSV-2
2- HPV ( 16,18,6,11 )

🛑 Keratoconjunctivitis:-
By :-
1- HSV-1
2- Adenoviruses

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📛 Exanthematic Diseses: 6

( MS.VRPR)

1- M : measles by Rubeloa virus
2-S : scarlet fever by erythrogenic toxins of Streptococcus pyogens
3-V: Vericella by VSV
4- R: rubella
5- P: Parvovirus b19 , slapped Cheek appearance ( fifth disease)
6-R: Roseola Infantum ( Sixth disease) by HHV-6/7

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💉 Summary of DNA viruses prevention :-

🌺 Herpsviridae:-

1- HSV-1 :-
a) Avoid contact with herpetic lesions
b) Avoid kissing
c) hand washes
d) personal purposes

2- HSV-2 :-
a) Avoid Adultery
b) Cesarean section for new born

2- VZV :- ( Active / Passive immunization)
🍃a) Active:-
❗️For Vericella: 1995 children
Varivax >> Live attenuated >> 2Doses

❗️ For Zoster : old age
a) Zostavax (2006 ) >> live attenuated >> single ... over 60y
b) Shingrix ( 2017 ) >> recombinant

🍃 Passive:-
( VZIG )
Immunoglobulin for Immunocompromized , mother before delivery , neonatel


3) EBV :
a) Avoid kissing
b) vaccine under trail

4) CMV :-
a) blood transfusion free of CMV
b) Donor and recipient of organ Transplant free of CMV
c) vaccine under trial
2018 positive phase1

🌺 Poxviruses : no vaccine

🌺 Adenoviruses:
a) Avoid overcrowded
b) hand washing
C) chorination of Swimming pool
d) vaccne type 3,4&7 which was ceased ( Stopped ) 1999

🌺 Papovavirus:-
1- human Papilloma virus prevention:
a) Quadrivalent (6,11,16,18 ) for female ( 0 , 2 & 6 months )
b) Bivalent ( Cervarix) for Type 16,18 ( Recombinant)

🌺 Parvovirus B19:-
a) Screening of Blood transfusion for patients with chronic anemia , AIDS , anemic pregnant women
b) Vaccine ( 0 ,1 &6 ) recombinant

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🛑 Note for the DNA viruses we have vaccines for 4 Viruses only :-

1- VZV
2- Adenoviruses ( Stopped )
3- human Papilloma virus
4- Parvovirus


And for EBV ,CMV :- Vaccines under trail

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🙂🙂🙂
For
HSV-1
HSV-2
VZV
Direct virus demonstration:
By scrapping the ulcer of from Vesicular fluids
Under light microscope:-
Tzanck smear
Shows ( Multinucleated Gaint cells )
Stained by Geimsa stain

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Most commonly:

Laboratory diagnosis methods used :-

1) PCR
2) Viral atigens by DIF

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🤕 common skin rashes :-

1- macule : small ,flat
2- papule : small ,raised ( solid)
Maculopapule Both^
3- vesicle : small , elevated ( with clear fluid)
4- pastule : vesicle filled with pus
5- Nodule: large , raised, Solid


🤕 Differences between Droplets / Airborne :-

Droplets : Large >5 microns
Surface contamination
Removed by hand wash

Airborne:- smaller ( Droplet nuclei )
<5 microns
Still in the air ( more dangerous)

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🤔For EBV :

Anti - VCA IgM / IgG :- Anti viral capsid

IgM :- Acute infection then disappears
IgG ; may be Occurs in Acute infection, remains in convalescent


anti-EBNA IgG ( EB nuclear antigen)
Only occur in convalescent and indicates previous infection

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🛑 Lymphocytosis is suspected lymphoma utill proven otherwise ..

🛑 Lymphocytosis with Atypical T lymphocytes ..." feel safe "
It is infectioue Mononucleosis

🛑 to Differentiate between infectioue Mononucleosis, and Infectious mononucleosis like syndrome

Infectious mononucleosis, With heterophills Antibodys in EBV

Infectious mononucleosis like, without Hetrophills antibodies in CMV

Both shows symptoms of:
Sore throat, fever , fatigue, lymphadenopathy , enlarged spleen , Hepatitis

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🍃Why small pox is eridicated:-

1- it has only one stable stereotype.
2- The man is the only host
3- no reservoir host
4- no carrier
5- was the first to be controlled by vaccine
6- produce long lasting memory

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🤔🤔 Small pox and Chickenpox:

Both are transmitted by droplets and contact ..

Small pox
❗️Caused by small pox viruse
❗️Rash :- centrifugal
❗️Starts : macule , papule , vesicle , pustules, ends forming crust
❗️Scar formation ..
And Fetal


Chicken pox :
❕ caused by VZV
❕ rash : Centripetal
❕ polymorphic ( all in same time )
Characterized by Umblicated lesion
❕ healed without scar
Not fetal

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🤔 Molliscum contagiosm and Human Papilloma warts

Molliscum contagiosm:-
❗️ Caused by MCV , Poxviruse
❗️ one genotype
❗️ Umblicated cheesy Papules
❗️ soft
❗️ called Human soft warts

Human Papilloma wart : -
❗️ Caused by HPV , Papovaviruses
❗️>100 serotypes
❗️ cauliflower shaped ( Verruca Vuligaris)
❗️ rough
❗️called warts ( Verruca)

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🛑HPV cannot be caltivated in vitro

🛑 virus that transmitted through birth canal :- HSV- 2

🛑 Human Papilloma virus:
Causes cervical carcinoma with genotype 16 ,18 ?
Because the virus produce oncoproteins integrated on DNA
E6 binds to P53
E7 Binds to Rb
Inactivation of This Tumor suppressor genes , Increase mitosis, tumor

🛑 there is some strains of small pox with America and Russia, they may use them in the Bio terrorism.

🛑 Oncolytic viral therapy is a new strategy by which ... There are Viral strains that kill the malignant cells , And stimulate the Immune system ?
How ?
When this virus infect the Tumor , it replicates itself untill the cell burst , ( Lysis of Tumor ) then the product of Bursting tumor cell initiate the immune response !

🛑 Hydrops fetalis may be
Because , infant infected by Parvovirus B19 , Or due to RH incompatibility

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هنا مكتوبات مثل الملزمة..

بس الدكتور عكس بينهم

Jc : Progressive multifocal Luekoencephalopathy

Bk: Heamorrhagic Cystitis, Nephropathy

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