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Resp DRX > 02c: Influenza > Flashcards

02c: Influenza Flashcards

1
Q

(X) family of (bac/viruses) cause influenza. Transmission is via:

A

X = orthomyxoviridae
Viruses;

Resp secretions, small particle aerosols

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2
Q

Orthomyxoviridae family of viruses: (env/non-env) with (RNA/DNA). What’s unique about their genetic info?

A

Env;
ssRNA (neg-sense);

Composed of 8 separate segments

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3
Q

Orthomyxoviridae: glycoprotein spikes form part of (X). What are the types of spikes and respective functions?

A

X = envelope;

  1. Hemagglutinin (attachment)
  2. Neuraminidase (release)
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4
Q

Influenza types (A/B/C/D) generally only infect humans.

A

B and C

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5
Q

Influenza A can be further divided into subtypes based on (X). Which of these are most important in humans?

A

HA (hemagglutinin) and NA (neuraminidase) glycoproteins

H1, H2, H3;
N1, N2

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6
Q

Influenza virus: (X) are proteins that determine the Influenza Type (A-D).

A

X = M1 matrix protein and Nucleoprotein

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7
Q

Ab against (X) neutralizes influenza virus infectivity and is major determinant of immunity.

A

X = HA (hemagglutinin)

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8
Q

Ab against (X) limits influenza virus replication (and severity of illness), but doesn’t prevent infection.

A

X = NA (neuraminidase)

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9
Q

T/F: Infection by one subtype of Influenza virus doesn’t provide cross-protection against another.

A

True

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10
Q

Antigenic (shift/drift): small changes that occur frequently within influenza (A/B/C/D). These changes are a result of (X).

A

Drift;
A or B
X = point mutation (accumulation) in RNA segment that codes for HA

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11
Q

Antigenic (shift/drift): appearance of influenza (A/B/C/D) virus with brand new (X).

A

Shift;
A;
X = HA (plus/minus new NA)

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12
Q

Reappearance of influenza A virus after decades of absence is example of antigenic (shift/drift). Is this capable of causing pandemic disease?

A

Shift;

Yes

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13
Q

(Pandemic/Epidemic) outbreak of influenza is confined to one location, generally during (X) season.

A

Epidemic;

X = winter

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14
Q

Characteristic pattern seen in (pandemic/epidemic) influenza A outbreaks: begins abruptly in (adults/children/elderly), peaks over (X) time period and lasts for (Y) time period.

A

Epidemic;
Children (acute febrile rep illness)
X = 2-3 week
Y = 2-3 month

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15
Q

T/F: Increase in abseneeism from work/school is early manifestation (an indication) of epidemic flu outbreak.

A

False - late manifestation

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16
Q

Epidemic outbreaks have attack rates (in general population) of (X)%. And pandemics?

A

X = 10-20

Pandemics: exceed 50%

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17
Q

(Pandemic/Epidemic) outbreak of influenza involves emergence of new virus (to which population has no immunity). Thus, local (X) progress to involve all parts of world simultaneously.

A

Pandemic;

X = epidemics

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18
Q

Average influenza incubation period:

A

2 days (range: 1-4 days)

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19
Q

Influenza virus: spreads to (X) tissue layer and targets/destroys (Y) cells. This results in the characteristic (Z) symptoms.

A 
X = Respiratory tract epithelium
Y = ciliated epithelial
Z = respiratory
20
Q

T/F: Quantity of influenza virus is proportional to the severity of symptoms in patient.

A

True

21
Q

How might influenza virus infection lead to systemic symptoms?

A

Proinflammatory cytokine release in blood

22
Q

T/F: Influenza viral shedding occurs for 2 weeks in adults and children.

A

False - age-dependent (3-5 days in adults)

23
Q

T/F: Immunity to influenza virus is type-specific.

A

False - subtype-specific

24
Q

What’s the most important (early) clinical finding in influenza infection?

A

Fever rises to 101-104oF (38-40oC) within 12 hours

25
Q

Influenza: when (in clinical course) do respiratory symptoms become apparent?

A

Once systemic symptoms diminish (fever lasts about 1-5 days)

26
Q

Which patient populations are more susceptible to frequent and severe flu illness?

A
  1. Elderly (over 60)
  2. Smokers
  3. Pregnant women in trimester 2-3
  4. HIV pts
27
Q

Attack rates and higher max temperatures from flu infection may be seen in which patient population?

A

Kids

28
Q

Increased frequency of GI symptoms (N/V, abd pain) from flu infection may be seen in which patient population?

A

Kids

29
Q

List the respiratory complications that can occur as result of flu infection.

A
  1. Primary flu virus pneumonia
  2. Secondary bac pneumonia
  3. Mixed bac and viral pneumonia
  4. Abnormal tracheobronchiolar clearance, airway hyperactivity/dysfunction
30
Q

List some non-respiratory complications that can occur with influenza virus infection.

A
  1. Myositis and rhabdomyolysis
  2. Myocarditis and pericarditis
  3. Aseptic meningitis and encephalitis
31
Q

Definitive diagnosis of influenza virus infection is by:

A

Isolate from throat/nasal cavity and culture, PCR, or immunofluorescence testing

32
Q

List the viruses that might be on your differential for influenza infection.

A

Parainfluenza, Adenovirus, RSV, and Enterovirus

33
Q

Influenza virus vaccine is (live/dead).

A

Both exist;

live vaccine only for healthy individuals over 2 y.o.

34
Q

Killed influenza virus vaccine: formulation is based on (X) strains.

A

X = prior season’s

35
Q

T/F: Killed virus vaccine, when matched correctly to epidemic strain, has max 50% efficacy.

A

False; 60-90%

36
Q

T/F: All people over 50 should be vaccinated for flu with killed virus vaccine.

A

True

37
Q

T/F: All kids under age 5 should be vaccinated for flu with killed virus vaccine.

A

False - not if under 6 mo old

38
Q

In elderly, flu vaccination is (X)% effective in preventing hospitalization and pneumonia.

A

X = 50-60

39
Q

T/F: Side effects of flu vaccine can include fever, systemic symptoms, and reaction at site.

A

True

40
Q

Killed flu vaccine is contraindicated for which population(s)?

A

Those with anaphylactic hypersensitivity to eggs

41
Q

List the rare complications that can occur following killed flu vaccine injection.

A

Guillain-Barré syndrome

42
Q

List the components that are included in formal nomenclature of influenza virus.

A
  1. Type
  2. Infected animal
  3. Geographic site of isolation
  4. Strain number
  5. Year of isolation
  6. Subtype
43
Q

We need new flu vaccines every year due to antigenic (shift/drift).

A

Drift

44
Q

Worst case scenario of flu pandemic would mimic that of (X) flu in (Y) year.

A 
X = Spanish
Y = 1918

Highly contagious and deadly (killed more americans than all the wars of 20th century!!)

45
Q

Spanish flu mortality rate was (X)%, unlike other flu epidemics that had (Y)% mortality rate.

A 
X = 2.5
Y = under 0.1
46
Q

Antiviral drugs must be taken consistently in (X) patient populations to prevent flu infection.

A

X = immunosuppressed or those allergic to vaccine

Resp DRX (9 decks)

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