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Microbiology Unit II > 2 Viral And Chlamydial Respiratory Infections > Flashcards

2 Viral And Chlamydial Respiratory Infections Flashcards

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Biology 101 flashcards
1
Q

Infections of the nasal cavity and pharynx are generally referred to as…

A

Upper respiratory tract infections (URI)

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2
Q

Acute respiratory diseases are more severe in…

A

Children

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3
Q

Hallmark signs of a URI

A

Nasal discharge/obstruction

Sneezing, cough, malaise, throat discomfort

2-4 days incubation

Fever, or other indications of a constitutional infection are uncommon in these cases - typically benign, transitory, and self-limited

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4
Q

Most common etiologic cause of acute respiratory diseases?

A

Viral infections

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5
Q

Most common viral causes of URI

A

RHINOVIRUSES - 25-50%

Coronaviruses - 10%

Adenoviruses (and other unknown viruses) - 30-40%

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6
Q

Rhinoviruses are better transmitted by _____ than by ______

A

By touch than by cough

Don’t shake hands!!!

Wash hands, clean toys at daycare

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7
Q

Why did the FDA say not to use Zicam anymore (2009)?

A

Intranasal zinc remedy, can lead to permanent loss of sense of smell

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8
Q

Treatment for URIs

A

Supportive, symptomatic relief only

Abx will not alter course of disease with these agents and it is best to avoid prescribing them in these cases

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9
Q

__________ infections are predictably hyperendemic in winter months

A

Rhinovirus

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10
Q

The greatest incidence of rhinovirus infections is in …

A

Children and young adults

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11
Q

Are colds caused by exposure to cold temps?

A

No, you idiot

Experimental data suggests that simple exposure to cold temps does not DIRECTLY induce disease

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12
Q

How is rhinovirus transmitted?

A

By aerosol and fomites and direct contact

Hands are a major vector

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13
Q

Treatment of Rhinovirus

A

Primarily symptomatic relief

B/c hands are the major vector, hand washing and disinfection of objects are best means of control

Don’t use Zicam. Just don’t. You’ll lose your sense of smell

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14
Q

Possible pharmacological treatment for rhinovirus

A

Picovir (Pleconaril) - inhibits virus infective process by binding in rhinovirus virion canyon

Not yet approved for mass use in US

But many viruses cause colds and are not susceptible to pleconaril, so limited usefulness

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15
Q

Skeletal muscle weakness/paralysis syndrome similar to poliomyelitis, non-polio enters viruses and West Nile virus

A

Acute Flaccid Myelitis (viral etiology suspected, not yet proven)

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16
Q

What are the three types of influenza?

A

A, B, and C, defined by nucleocapsid proteins

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17
Q

Influenza type that is most problematic

A

Type A

Type B also causes epidemics and type C is the least pathogenic

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18
Q

How are different subtypes of influenza categorized/labeled?

A

Based on envelope proteins

H hemagglutinin (viral attachment)

N neuraminidase (viral penetration and release from infected cells)

Nomenclature: Type / Location / Year / Isolation # / Antigenic type
Ex: “A/HongKong/68/H2N1”, “A/Spanish/18/HswN1”

19
Q

Clinical manifestations of influenza

A

Short incubation (1-2 days)

Very abrupt onset of symptoms

Respiratory tract entry

SSx - FEVER, aches, chills, cough, sometimes severe
Persists for about 1 week, with long convalescence (1-2 weeks)

Viral destruction of respiratory tract ciliated epithelium (mucociliary escalators system) sets stage for complication

20
Q

In flu patients, return of fever after it went away usually indicates…

A

Possible secondary pneumonia (most common way it kills)

21
Q

Pulmonary complications of influenza

A

Primary influenza viral PNA

Secondary bacterial PNA
• Strep pneumo
•Staph aureus
• H flu type B (if unvaccinated)

22
Q

Two other categories of non-pulmonary complications of influenza

A

Reye’s syndrome
• Associated with many viral infections
• Acute, sometimes catastrophic systemic disorder —> edematous encephalitis and fatty alteration of liver

Guillain-Barré syndrome
• Demyelination disease, insult unclear
• Associated with 1976 swine flue vaccine

23
Q

Reye’s syndrome is primarily observed in …

A

Children aged 6 months - 15 years with influenza

24
Q

What is important to keep in mind with regards to Guillain-Barre and the flu vaccine?

A

Influenza vaccination may induce GBS but bear in mind the estimated risk is 10x higher after a natural infection with the virus

25
Q

How do you diagnose influenza

A

Clinical findings are diagnostic in epidemic situations but lab confirmation is available via direct viral isolation from throat nasopharyngeal swabs

Rapid antigen detection kits are now available in-office (but lots of false negatives, esp early in course of disease)

26
Q

Treatment for influenza

A

Typically supportive, symptomatic relief

Amantadine/Rimantadine - effective against the type A viruses only by stopping uncoating/penetration but no longer used (resistance)

Osetamivir and Zanamivir - neuraminidase inhibitors, stop viruses from releasing/spreading

NEW in 2018 - Xofluza - inhibits viral cap-dependent endonuclease

27
Q

Why does the CDC issue specific advice on meds each season?

A

Emergence of resistance is a constant concern for all anti-influenza agents and the situation is very fluid

28
Q

Multivalent vaccines are made available each season around October for ….

A

Influenza

Formulation changes each year and you need a new one every flu season

The trivalent vaccines contain the two type A and one type B viruses predicted most likely to be dominant that season (quadrivalent is two As and two Bs and is now more common)

29
Q

The flu shot is a ________ vaccine while FluMist (intranasal) is __________

A 
Shot = inactivated
FluMist = live attenuated
30
Q

How to vaccinate kids against influenza

A

Children under 9 without history of prior influenza infection require two administrations of vaccine to attain max degree of protection

31
Q

Type of influenza vaccine developed to primarily target elderly patients (age 65+)

A

High potency and adjuvanted flu vaccine

32
Q

What is the intruder all flu vaccine

A

Used in patients 18-64, much smaller needle used to inject antigen under skin

33
Q

Most common adverse event with the flu vaccine is …

A

Pain at the site of injection

Almost all vaccines are produced in embryonated chicken eggs so concerns over allergies and meeting demand for vaccine in timely fashion

34
Q

Influenza vaccine target groups

A

Persons ≥65
Residents of nursing homes or other care/housing facilities
Adults and children with chronic pulmonary or CV disorders
Children with asthma
Debilitating chronic disease or immunosuppression
DM
CKD
Hemoglobinemias
Pediatric patients on long term aspiring therapy (Reyes)
Health care workers

35
Q

What allows type A influenza viruses to create novel forms that cause pandemics?

A

Segmented genome

36
Q

The two basic types of influenza virus antigenic variations:

A

Antigenic drift

Antigenic shift

37
Q

Point mutations of the H or N genes in influenza that usually cause comparatively minor genetic variations but are recognized to be of major importance to flu epidemiology

A

Antigenic drift

38
Q

The result of exchange of genomic segments of the influenza virus —> major variations in the virus

A

Antigenic shift

Recombination involving entire genome segments encoding H and/or N

39
Q

Over 80% of last year’s flu deaths were in what group?

A

Patients >65 years of age

40
Q

What is the typical flu season?

A

December - March/April

The 2009 H1N1 was unique - emerged early, before the vaccine was ready

41
Q

Obligate intracellular parasites that are something in between a true bacteria and a virus

A

Chlamydiae

They are biochemically restricted, energy parasites (remove ATP from host since they have no means of synthesizing it themselves)

42
Q

Infant pneumonia with onset ~3 weeks after birth is usually caused by …

A

Chlamydia trachomatis

Rhinitis —> cough

Risk factor = infected mother (child aspirated agent during birth)

43
Q

Chlamydia trachomatis infection is associated with what syndrome?

A

Reiter’s syndrome

44
Q

Microbe associated with atherosclerosis

A

Chlamydophila pneumoniae

Widely distributed species, cause of bronchitis, pneumonia, and sinusitis

Microbiology Unit II (7 decks)

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