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Block 9 Week 4 > AuCoin: Influenza and viral pneumonia > Flashcards

AuCoin: Influenza and viral pneumonia Flashcards

1
Q

inflammation of the lungs caused by infection with a virus or bacteria

A

pneumonia

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2
Q

Which portion of the pulmonary parenchyma is primarily affected by pneumonia?

A

alveoli

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3
Q

viral pneumonia more likely to occur in these populations due to a naïve or weakened immune system, respectively

A

young children

older adults

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4
Q

Three most common causes of viral pneumonia

A

Influenza A and B
RSV
Human parainfluenza virus

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5
Q

What are some defense mechanisms that we have to protect from pneumonia?

A

epiglottis and cough reflex
ciliated epithelium to propel mucous toward the mouth
cell mediated immunity in the lung

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6
Q

How is the influenza virus transmitted? Which strains of this virus cause outbreaks? What are two methods in which this virus spreads and causes epidemics?

A

respiratory droplets
pandemics caused by influenza A and B
antigenic shift and antigenic drift make it hard to contain/prevent this virus from spreading

**mutability and a high frequency of genetic reassortment make controlling infection challenging

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7
Q

These folks are at high risk for influenza virus infection

A

the elderly and those with cardiac or pulmonary disease

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8
Q

What can complicate influenza?

A

pneumonia caused by Staph aureus

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9
Q

Immunity to influenza depends on (blank) in the respiratory tract

A

secretory IgA targeting HA

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10
Q

How to treat influenza? How to prevent it?

A

Tamiflu or Relenza;

prevent with flu vaccine (which has A and B strains, and is reformulated yearly)

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11
Q

Which strain of influenza causes the most disease?

A

A

**influenza A is antigenically variable, less changes occur with B and C

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12
Q

When does the flu virus circulate?

A

fall and early spring

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13
Q

The flu virus binds to host cells via the (blank) receptor, and is endocytosed. The genome is transported to the (blank) where replication and transcription occur. Then the viral mRNA are transported back to the (blank) for translation. Assembly and budding of the virus occurs at the plasma membrane.

A

sialic acid; nucleus; cytoplasm

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14
Q

Why is influenza unusual among the RNA viruses?!

A

RNA transcription occurs in the nucleus!

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15
Q

In the flu virus, the virus encoded RNA polymerase is composed of three viral proteins (P proteins) are responsible for transcription
the polymerase will produce (blank) mRNA from the (-) sense RNA genome
the (blank) mRNA will be translated into viral proteins and also used as a template to produce viral (-) sense RNA genomes

A

+ sense

+ sense

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16
Q

In the flu virus, the nucleoprotein associated with the viral RNA to form a (blank). Three other encoded proteins (PA, PB1, PB2) are bound to the NP and are responsible for (blank)

A

ribonucleoprotein;

RNA transcription and replication

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17
Q

(blank) forms a shell below the viral membrane important in particle assembly
(blank) surrounds the viral particle derived from the plasma membrane of the host cell

A 
matrix protein (M1);
lipid envelop
18
Q

These two surface glycoproteins are important antigens that determine antigenic variation of influenza viruses

A

hemagglutinin (HA)

neuraminidase (NA)

19
Q

T/F: two distinct influenza viruses cannot infect a single host cell

A

false; they can!

20
Q

When two infleunza RNA genomes are shuffled inside the host cell, re-assortment occurs. Why is this a problem?

A

this shuffling creates a change in the viral surface antigens –> explains the challenge in producing only one influenza vaccine

21
Q

What is used to divide influenza viruses into types A, B and C?

A

antigenic differences between nucleocapsid (NP) and matrix (M) proteins

22
Q

What is used to subtype the virus?

ex: HA1-HA15

A

antigenic variation among surface glycoproteins, HA and NA

ex: 15 subtypes of HA (HA1 – HA15) and nine sutypes of NA (N1-N9) in many different combinations isolated in birds, animals or humans

23
Q

(blank) is the major antigen against with neutralizing (protective) antibodies are directed

A

HA

24
Q

(blank) functions at the end of the viral replication cycle and facilitates release of virus particles from infected cell surface during the budding process

A

NA

25
Q

minor antigenic changes are antigenic (blank), major changes in HA and NA are termed antigenic (blank) (new subtypes)

A

drift; shift

26
Q

due to the accumulation of point mutations in the gene and sequence changes can alter antigenic sites on the glycoproteins

A

antigenic drift

27
Q

reflects drastic changes in the sequence of the viral glycoproteins
genetic reassortment between human and avian influenza viruses

A

antigenic shift

28
Q

influenza virus spreads from person to person by (blank) or by contact with contaminated surfaces
cells of the (blank) are infected, these cells are killed and the virus spreads to many other cells
the incubation period is 1 to 4 days
(blank) is detectable in respiratory secretions ~1 day post infection
(blank) and cell-mediated immunity is detectable in 1-2 weeks
cellular destruction is widespread and therefore resistance to secondary bacterial infections is common (staph, strep, and Haemophilus influenzae)

A

respiratory droplets;
respiratory epithelium;
interferon;
antibody

29
Q

What is the recommendation for the flu vaccine?

A

Routine annual influenza vaccination is recommended for all persons aged 6+ months

30
Q

Three kinds of flu viruses commonly circulate among people today:

A

A H1N1
A H3N2
B

31
Q

most common cause of pneumonia and bronchiolitis in infants
Neonates, premature infants, and infants with cardiopulmonary disease susceptible
Transmitted via respiratory droplets

A

RSV

32
Q

What does RSV cause in adults? In the elderly? In infants?

A

adult: common cold, bronchitis
elderly: pneumonia
infants: cough, wheezing, pneumonia, bronchiolitis

33
Q

How to treat severely ill patients with RSV?

A

Ribavirin
Passive immunity with antibody is an option, too

**control outbreaks via hand washing and glove use

34
Q

What are the surface spikes on RSV?

A

they are fusion proteins, which cause cells to fuse and form multinucleated cells (syncytia) –> gives rise to the name respiratory syncytial virus

**the spikes are not hemagglutinins and neuraminidases like in the flu virus

35
Q

A 6-week-old infant is brought to the pediatric clinic in respiratory distress. Physical examination is significant for diffuse expiratory wheezing and mild cyanosis. The chest X-ray is suggestive of bilateral pneumonia. The infant is admitted to the intensive care unit. Nasopharyngeal swab and nasopharyngeal washing are sent for culture and direct examination.

A

RSV

36
Q

PIVs cause croup, laryngitis, bronchiolitis, and pneumonia in children
Cause a disease resembling the common cold in adults
These viruses are transmitted via respiratory droplets

A

Parainfluenza virus

37
Q

characterized by a barking cough and hoarseness
Also cause a variety of respiratory diseases such as the common cold, pharyngitis, laryngitis, otitis media, bronchitis, and pneumonia

A

croup

38
Q

main cause of croup in children younger than 5 years old

A

parainfluenza virus 1 and 2

39
Q

What are the surface spikes on the parainfluenza virus?

A

hemagglutinin (HA)
neuraminidase (NA)
and fusion proteins

fusion proteins mediate the formation of multinucleated giant cells

40
Q

A 2-year-old child is brought to the emergency department by worried parents because of a barking cough and inspiratory stridor that got worse at night. The present illness began 2 days earlier with a fever, sore throat, rhinorrhea, and mild cough. Finding on examination include a temperature of 102oF, tachypnea, wheezing, and respiratory distress.

A

parainfluenza virus

41
Q

A 70-year-old women with a history of congestive heart failure is seen in January by her primary care physician with an abrupt onset of fever, cough, and myalgia that requires hospitalization. Two days later, she experiences increasing cough and shortness of breath. Chest X-ray reveals lung infiltrates.

A

influenza virus

Block 9 Week 4 (8 decks)

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