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RESP > 14. Respiratory Viruses > Flashcards

14. Respiratory Viruses Flashcards

1
Q

How are respiratory viruses transmitted?

A

Droplets and fomites

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2
Q

Which bacteria are transmitted via droplet spread?

A

Pertussis
Neisseria meningitidis
Group A strep

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3
Q

Which viruses cause the common cold?

A

Coronavirus
Rhinovirus
Adenovirus

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4
Q

How are influenza viruses classified?

A

Based on their core proteins

A, B and C

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5
Q

What are the reservoirs of influenza viruses A, B and C?

A

A: Birds and mammals

B and C: confined to humans

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6
Q

Which influenza virus is most commonly associated with outbreaks and epidermics?

A

A causes an epidemic seasonally
B causes one every 2-4 years
C is uncommon and associated with a milder disease

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7
Q

What dictates the subtype of an influenza virus?

A

Haemaglutinin and neuraminidase

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8
Q

What is antigenic drift?

A

Minor antigenic change due to errors in viral DNA polymerase

Results in yearly epidemics as population only has limited immunity

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9
Q

What is antigenic shift?

A

Major antigenic change caused by genes being swapped from different strains

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10
Q

What is the function of haemaglutinin?

A

Binds to receptors on host respiratory epithelial cells

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11
Q

What is the function of neuraminidase?

A

Cleaves sialic acid in respiratory epithelium

Allows release of virus from the cell and prevents clumping

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12
Q

How can an influenza infection cause a bacterial superinfection?

A

Inflammation of the trachea and bronchi leads to ulcerative necrotising trachea-bronchitis and loss of cilia

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13
Q

What are the clinical features of influenza?

A

Abrupt onset of a fever, cough and myalgia

Persistent weakness and depression

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14
Q

What time frame is someone infectious with influenza?

A

1-2 days before symptoms to 7 days after

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15
Q

What percentage of people are asymptomatic with influenza?

A

30%

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16
Q

What complications are associated with influenza?

A

Pneumonia
Secondary bacterial superinfection
Myositis/mycarditis
Reye’s syndrome

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17
Q

What pathogens can cause bacterial superinfection after influenza?

A

Strep pneumoniae
H. influenzae
Staph aureus

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18
Q

What is Reye’s syndrome?

A

Encephalopathy and liver failure after giving aspirin to children with a fever

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19
Q

What is the treatment for influenza?

A

Supportive: analgesics, antipyretics
O2 if hospitalised
NA inhibitor antivirals

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20
Q

Who should be vaccinated against influenza?

A

Anyone at high risk
Healthcare workers
All children 2-12

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21
Q

What long term drug puts someone at higher risk for influenza?

A

Aspirin

22
Q

You can be reinfected with RSV. T/F?

A

True

23
Q

What part of the respiratory system does RSV damage?

A

Bronchioles

24
Q

What are the signs of RSV?

A 
Respiratory distress: tachypnoea, nasal flare, wheeze
Apnoea
Irritability
Cyanosis
Prominent intercostal retraction
25
Q

What does intercostal retraction suggest?

A

Lower airway obstruction

26
Q

What is seen on a CXR in an RSV infection?

A

Flattened diaphragm and hyperlucent lower lung (hyperinflation)

27
Q

What immunity is given to those at high risk of RSV?

A

Palivizumab: passive immunity

28
Q

How many parainfluenza serotypes exist?

A

4

29
Q

What is the incubation time of parainfluenza?

A

3-6 days

30
Q

What diseases are caused by parainfluenza?

A

Croup

Bronchiolitis

31
Q

How are parainfluenza, RSV and influenza detected?

A

Multiplex PCR

32
Q

How many serotypes of adenovirus exist?

A

> 50

33
Q

What diseases are caused by adenovirus?

A

Wide range of RTIs
Diarrhoea
Conjunctivitis

34
Q

What samples can be taken if a patient is suspected of having a respiratory virus?

A

Nasopharyngeal aspirates
Throat swabs
BAL
Sputum

35
Q

Name 3 recent epidemics

A

Avian influenza
SARS
MERS-COV

36
Q

What animal served as a mixing vessel in avian influenza?

A

Pigs

37
Q

What animals were the reservoir hosts in MERS-COV?

A

Camels and bats

38
Q

What is the incubation period of COVID-19?

A

1-14 days

Median 5-6

39
Q

What are the common presentation of COVID-19?

A

Fever
Cough
SOB
Lack of smell and taste

40
Q

What are other symptoms of COVID-19?

A 
Myalgia
Headache
Sore throat
Nasal congestion
Vomiting
Diarrhoea
Fatigue
41
Q

Which patient groups are more likely to have less typical symptoms?

A

Elderly

Immunosuppressed

42
Q

What are the complications of COVID-19?

A

ARDS
Thromboembolism
Sepsis

43
Q

What are the risk factors for severe COVID-19?

A

> 60
Underlying diseases
Smoking

44
Q

How is COVID-19 diagnosed?

A

Nasopharyngeal and throat swab

RT-PCR for viral RNA (because SARS-COV-2 is an RNA virus, DNA must first be made to use PCR)

45
Q

What genes does RT-PCR look for in COVID?

A

E gene
N gene
RNA polymerase genes

46
Q

What cardiac sequelae may follow COVID?

A

Arrhythmias
Myocardial injury
Postviral myocarditis

47
Q

What factors might cause cardiac sequelae after COVID?

A 
Virus itself
Hypoxia
ACE2 receptor downregulation
Hypotension
Inflammation
Drug toxicity
48
Q

Who is at risk of acute kidney injury due to COVID?

A 
elderly
male
CV disease
Hypertension
Chronic kidney disease
49
Q

How is ‘long COVID’ defined?

A

Symptoms longer than 3 weeks after first onset of symptoms

50
Q

Define chronic COVID?

A

> 12 weeks after onset of symptoms

51
Q

What symptoms are associated with long/chronic COVID?

A

Ongoing cough, fever, fatigue, SOB

Psychiatric, cognitive and physical impairments

RESP (17 decks)

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