26/27 Viral Respiratory Tract infections Flashcards

1
Q

most URT caused by baceteria or viruses

A

viruses

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2
Q
  • rhinitis (inflammation of nasal mucosa)
  • pharyngitis (sore throat)
  • No high fever, LRT involvement or respiratory distress
A

common cold

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3
Q

what are the complications of the common cold?

A
  • otitis media
  • sinus infections
  • exacerbation of asthma
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4
Q

what is the most common cause of cold? second most?

A
  1. rhinovirus

2. coronavirus

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5
Q

describe rhinoviruses

A
  • picornavirus family
  • non-enveloped
  • +ssRNA genome
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6
Q

how are rhinoviruses spread?

A

respiratory secretions

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7
Q

treating rhinoviruses?

A

conservatively

-no vaccine or prescription

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8
Q

describe coronaviruses

A
  • enveloped

- +ssRNA genome

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9
Q

treating coronaviruses?

A

conservatively

-no vaccine or prescription

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10
Q

describe adenoviruses?

A
  • non-enveloped
  • dsDNA genome
  • icosahedral capsid
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11
Q

only common cold virus with a DNA genome?

A

adenovirus

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12
Q

which adneovirus serotypes cause URT disease/ common cold?

A

1, 2, and 5

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13
Q

no seasonal pattern to this common cold

A

adenovirus - ppl can shed the virus for up to 18 m.

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14
Q

which adenovirus serotypes cause GI disease?

A

40 and 41

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15
Q

what other illnesses are associated with adneoviruses besides common cold?

A
  • conjunctivits
  • pharyngitis
  • fever
  • croup
  • bronchiolitis
  • pneumonia
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16
Q

adenovirus treatment?

A

live oral vaccine to serotypes 4 and 7 only for military recruits

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17
Q

describe coxsackievirus

A
  • enterovirus (subfam of picornavirus)
  • nonenveloped
  • +ssRNA genome
  • able to survive GI tract
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18
Q

transmission of coxsackievirus

A
  • transmitted through the fecal oral route
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19
Q

coxsackievirus treatment

A

no vaccine available

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20
Q

herpangina caused by…

A
  • caused by coxsackievirus
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21
Q

abrupt onset of fever

small vesicles on the soft palate which form small white ulcers

A

herpangina caused by coxsackievirus

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22
Q

hand-foot-mouth disease caused by

A

coxsackievirus

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23
Q
  • fever

- vesicular lesions on the palms of hand and soles of feet and on oral areas

A

hand foot and mouth disease

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24
Q

which influenza viruses are associated with the common cold

A

influenza viruses B and C

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25
common cold viruses (7)
- rhinovirus - coronavirus - adenovirus - coxsackievirus - influenza B and C - RSV - parainfluenza virus
26
what is croup?
laryngotracheobronchitis
27
- brassy "seal's bark" cough - inspiratory stridor - "steeple's sign" narrowing of air shadow in trachea
croup
28
complication of croup
hypoxia
29
treatment of croup with stridor at rest
oxygen epinephrine glucocorticoids
30
treatment of croup without stridor at rest
humidified air | hydration
31
etiology of croup
parainfluenza virus | - most often type 1
32
what other viruses may cause croup besides parainfluenza?
RSV | measles virus
33
describe the parainfluenza virus
- -ssRNA genome - helical nucleocapisd - contains hemagglutinin adn neuraminidase - paramyxovirus family
34
- myalgia - headache - fever - shaking chills - cough peaking 3-5 days - weakness lasting weeks
influenza
35
peaks during the winter months
influenza
36
groups at risk for complications due to influenza
- younger than 2 - over 65 - pregnant and up to 2 wks postpartum - certain medical conditions: asthma, diabetes, etc...
37
define pneumonia
inflammation of lung parenchyma leading to abnornal gas exchange
38
fever, chills, cough, chest pain, increased respiratory rate, wheezes and crackles
pneumonia | shows up as opacity on chest xray
39
primary influenza virus pneumonia etiology
influenza A
40
pneumonia 1-4 days following flu symptoms/ chest radiograph bilateral, midlung, lower lung infiltration
primary influenza virus pneumonia
41
biphasic (flu then return of symptoms later), gram stain may contain bacteria
bacterial influenza-associtated pneumonia
42
etiology of bacterial influenza-associated pneumonia
1. s. pneumoniae 2. s. aureus and h. influenzae others: n. meningitidis, other streptococcus, and gram negative bacillus
43
describe the influenza virus
- orthomyxovirus - segmented, ssRNA virus genome - enveloped with hemagglutinin (H) and neuraminidase (N)
44
hemagglutinin (H)
- used for attachment protein | - agglutinates RBC
45
neuraminidase (N)
- cleaves sialic acid | - virion release and spread
46
small changes in H and N
antigenic drift | - driven by point mutations made by PCR during replication
47
large changes in H and N
antigenic shift | - driven by reassortment of two viruses
48
co-infection of the same cell and risk for pandemics
antigenic shift
49
classic method of production of vaccines..
production in embryonated chicken eggs
50
advantages of novel method of vaccine production
1. rapid scale up of vaccine production | 2. reduced likelihood of egg protein carryover
51
advantages of baculovirus expression vector system production
1. rapid scale up of vaccine production | 2. egg-free system
52
what is chemoprophylaxis?
daily dose of anti-viral for duration of flu season in the community
53
describe the SARS coronavirus
- enveloped - +ssRNA genome - more resistant to environmental conditions than non-SARS coronavirus
54
1. fever, malaise, and myalgia 2. dry cough and shortness of breath 3. severe: adult respiratory distress syndrome and death
SARS coronavirus
55
transmission of SARS coronavirus
fecal-oral, close contact and aerosal routes
56
expiratory wheezing/ nasal flaring/ air trapping/ subcostal retractions/ variable fever
bronchiolitis
57
most common cause of bronchiollitis and pneumonia in children less than 1 year old
RSV
58
describe RSV
- paramyxovirus family - enveloped - -ssRNA genome - highly infectious
59
nearly all children have been infected by age 4
RSV
60
aerosilized ribavirin treatment
for severe LRT RSV infections
61
mechanism of aerosolized ribavirin treatment for bronchiolitis
inhbits nucleotide biosynthesis and mRNA capping and promotes hypermutation of the genome
62
Indications fro passive RSV immunoprophylaxis
- birth less than 32 weeks gestation | - age less than 2 years and therapy for chronic lung disease within 5 months preveding RSV season
63
what are the agents for RSV passive immunoprophylaxis
- palivizumab | - RSIG
64
palivizumab
chimeric humanmouse monoclonal anti-RSV antibody
65
RSIG
pooled human immunogobin enriched for antiRSV antibodies