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Clinical - Winter > 1 - Influenza > Flashcards

1 - Influenza Flashcards

1
Q

What is influenza?

A

Contagious viral respiratory illness

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2
Q

What are the 3 types of the influenza virus?

A

A, B, and C

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3
Q

Which types of influenza can cause disease in humans? Which causes the majority of disease?

A

Types A and B; type A causes about 90% of influenza

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4
Q

What are different subtypes of influenza A based on?

A

Surface hemagglutinin (HA) or neurominidase (NA) glycoproteins

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5
Q

What are the primary subtypes of influenza A affecting humans?

A

H3N2 and H1N1

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6
Q

____ is the most effective way to prevent influenza infection

A

Vaccination

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7
Q

Describe how influenza spreads

A
  • Respiratory droplets caused by coughing and sneezing are transferred to surfaces
  • Uninfected person touches a surface w/ influenza on it and then touches their mouth or nose
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8
Q

How long are people infected w/ influenza contagious?

A

1 day before symptoms develop and 5-10 days after symptoms develop

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9
Q

What is the typical incubation period for influenza?

A

1 to 4 days (average 2 days)

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10
Q

The current vaccine for influenza is ___valent

A

Quadrivalent

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11
Q

What are the early symptoms of influenza?

A
  • Fever (usually very high)
  • Muscle pain
  • Headache
  • Non-productive cough
  • Malaise
  • Sore throat
  • Rhinitis
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12
Q

How long does it take early symptoms of influenza to resolve?

A

Usually about 1 week; cough and malaise may persist for more than 2 weeks

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13
Q

What are some symptoms of influenza that rarely occur from the common cold?

A
  • Fever
  • Headache
  • Aches and pains
  • Weakness
  • Bedridden
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14
Q

What are some symptoms of the common cold that rarely occur from influenza?

A
  • Runny, stuffy nose

- Sneezing

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15
Q

What are some complications of influenza?

A
  • Respiratory failure, especially w/ chronic conditions (ex: asthma)
  • Pneumonia or other secondary bacterial infections
  • Dehydration
  • Worsening of concurrent medical conditions
  • Viral myocarditis (*rare)
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16
Q

What are some complications of the common cold?

A
  • Congestion

- Sinus or ear infection

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17
Q

What is most likely to cause hospitalization when infected w/ influenza?

A

Viral pneumonitis

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18
Q

____ and _____ increase during flu season

A

Acute coronary syndromes and exacerbations of chronic pulmonary conditions

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19
Q

What are the monitoring parameters for px w/ influenza?

A
  • Monitored daily for resolution of sx (fever, myalgia, headache, malaise, non-productive cough, sore throat, rhinitis)
  • Sx should resolve w/in about 1 week
  • If px continues to exhibit sx beyond 10 days or worsening of sx after 7 days, refer b/c may be a secondary bacterial infection
20
Q

What are common causes of secondary bacterial infections associated w/ influenza?

A
  • Staph aureus

- Strep pneumoniae

21
Q

What are some possible samples for influenza testing?

A
  • Nasopharyngeal or throat swab
  • Nasal wash
  • Nasal aspirate
  • Blood for antibodies
22
Q

Viral culture for influenza provides results in ____ days

A

3-10

23
Q

Why should a viral culture be done for influenza?

A
  • Subtypes can be determined

- Surveillance for new strains that may need to be included in next years vaccine

24
Q

Viral cultures detect influenza ____

A

A and B

25
Q

What are rapid influenza diagnostic tests?

A

Immunoassays that can identify the presence of influenza A and B viral nucleoprotein antigens in respiratory specimens

26
Q

What are the advantages of rapid influenza diagnostic tests?

A
  • Quick results w/in 30 mins or less

- Simple to perform

27
Q

What are the disadvantages to rapid influenza diagnostic tests?

A
  • False negative results are common
  • Only some can distinguish between influenza A and B
  • Do not provide info on influenza A subtype
28
Q

What is used to identify the presence of influenza viral RNA in respiratory specimens?

A

Latest reverse transcription-polymerase chain reaction (RT-PCR)

29
Q

What are advantages to RT-PCR for influenza testing?

A
  • Improved sensitivity

- Produces results w/in 20 mins

30
Q

What are disadvantages to RT-PCR for influenza testing?

A

Result is highly dependent on sampling site

31
Q

What is serological testing for influenza?

A
  • Testing serum samples for influenza antibody to diagnose recent infection
  • 1 sample taken w/in first week of illness and 2nd sample taken 2-4 weeks later; if Ab levels are higher in 2nd sample, it is likely the influenza virus was present
32
Q

How is oseltamivir excreted and what does this mean?

A
  • Glomerular filtration and tubular secretion

- Reduce dose in renal impairment

33
Q

_____ can decrease the renal excretion of oseltamivir carboxylate

A

Probenecid

34
Q

What are common side effects of oseltamivir and how can they be lessened?

A
  • GI (nausea, vomiting, diarrhea)

- Ingestion w/ food

35
Q

When must oseltamivir be initiated in order to have decrease illness resolution?

A

W/in 48 hours of illness onset

36
Q

When is antiviral treatment indicated for influenza?

A

Recommended as early as possible for any px w/ confirmed or suspected influenza who:

  • Is hospitalized
  • Has severe, complicated, or progressive illness
  • At higher risk for influenza complications
37
Q

What are some examples of px at higher risk for influenza complications?

A
  • Children under 2
  • Adults 65 y/o and older
  • Immunosuppressed
  • Pregnant or w/in 2 weeks after delivery
  • Morbidly obese
38
Q

What are the 2 neuraminidase inhibitors in Canada?

A
  • Oseltamivir

- Zanamivir

39
Q

Is there an advantage to combination therapy w/ antivirals?

A

No, oseltamivir alone has best efficacy

40
Q

Is there a need for higher doses of oseltamivir in severe influenzal illness?

A

No, showed to eradicate the virus faster, but had no influence on survival

41
Q

Who is recommended for the annual influenza vaccination?

A

All persons aged 6 months and older

42
Q

What is used as a preservative in the influenza vaccination?

A

Thimerosal

43
Q

The influenza vaccination contains ___ virus

A

Inactivated (killed)

44
Q

How long does it take to develop immunity after receiving the quadrivalent flu vaccine?

A

2 weeks

45
Q

What is an adjuvanted vaccine? Is the influenza vaccine adjuvanted?

A
  • Vaccine that includes a substance that boosts an individual’s immune response to the vaccine (ex: squalene oil and/or vitamin E)
  • Influenza vaccine is not
46
Q

Does the administration of a second dose of influenza vaccine in elderly or immunocompromised px have an advantage?

A

No

47
Q

Who should not receive the influenza vaccination?

A
  • People who have had a previous anaphylactic
  • People w/ IgE-mediated hypersensitivity to eggs
  • People currently experiencing high fever
  • People w/ serious acute febrile illness (can get vaccine when sx subsided)

Clinical - Winter (24 decks)

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