Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Influenza - FINAL > FINAL - Influenza > Flashcards

FINAL - Influenza Flashcards

1
Q

How does influenza present vs. Cold

A

Cold - headache, runny nose, sneezinng, sore throat, coughing.
Flu - Headache, runny nose, sneezing, sore throat, coughing, fever, chills and sweats, myalgia, weakness and fatigue, potential complications. Tachycardia, red, watery eyes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the incubation period for influenza?

A
  1. 2 days, maybe 1 to 4 days in length
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are complications from Influenza

A
  • Middle ear infections
  • asthma exacerbations
  • pneumonia
  • sinusitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the estimated cases of influenza in Canada?

A
  • 2.7 milllion cases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How many hospitalizations does flu cause

A
  • 12,000
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the high risk influenza related chronic conditions

A
  • COPD
  • ASthma
  • COPD
  • Diabetes
  • Stroke
  • Obesity
  • Heart disease
  • Stroke
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What group of adults go to the hospital a bit more?

A
  • 45-64 years old - they get sicker
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the % of ICU admissions are those 45 to 64 years old?
>65?

A

32% for each group.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What group are at high risk of influenza-related complications hospitalization and death?

A
  • Age 50!
  • This group is also least likely to get vaccinated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the average duration of stay for hospitalization for flu?

A

11 days

There is a 9.3% 30 day mortality following hospitalization.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which patient populations should be targeted the most?

A
  • Chronic illnesses - diabetes, cardiac disorders, cancer, renal disease, rheumatologic disease, neurologic or neurodevelopment, morbid obesity
  • Health care workers
  • pregnant folks
  • Indigenous people
  • Elderly
  • Children
  • care homes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does does influenza affect CV disease?

A
  1. Direct effect - Viral myocardial infection leading myocarditits or myopericarditits
  2. Indirect effect - Systemic inflammation leading to disruption of atherosclerotic plaques - MI, or Cvascular accident
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How much does the risk of AMI increase within 3 days of infection?

A
  • 10 fold
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Overall in high risk patients, what % does influenza vaccines reduce CV events?

A

36%
NNT = 59

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the three most frequent reasons people don’t get vaccinatied?

A
  1. I am healthy, I never get sick, I am not at risk, its not recommended for me, the flu vacine doesn’t work
  2. I didn’t get around to it
  3. No specific reason
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the differences in A vs B interms of:
1. Which causes more pandemics
2. Which causes more cases of serious disease
3. which targets humans, vs animals and humans
4. Which type causes

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which lineage was gone away with the covid pandemic?

A

Yamagata - GONE!
H1N1, H3N2 and victoria is what matters now

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What goes into variation in vaccine effectiveness?

A
  1. Changes to the circulating virus
  2. Genetic diversity of circulating strains (Especially H3N2)
  3. Variation in individuals responsiveness: age, sex, underlying medical conditions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the difference between antigenic shift vs. drift?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How can we improve vaccines against with the rapidly evolving H3N2 strains?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

HOw is influenza vaccine made?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How are recombinant vaccines made?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which type of vaccine typically has more side effects?

A
  • ADjuvanted!! Ie. Shingrix
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the pathway of a vaccine testing?

A
  1. Immunogenicity, safety
  2. Efficacy safety
  3. Health Canada, NACI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What types of trials are typically done for vaccines?

A
  • Non-inferiority trial
26
Q

Is there a best vaccine?

A
  • Yes and no - population vs individual risk, availability and logistics
  • Various vaccines becoming niche - Cell culture, recombinant, high dose.
27
Q

When is the best time to have the vaccine?

A
  • Difficult to predict
  • Should get it before influenza activity occurs
28
Q

What is the vaccine dosing for pediatrics?

A
  • initially 2 doses
  • Ages 6 months to 9 years should receive 2 doses minimum 4 weeks apart
  • single dose thereafter
29
Q

Which type of test is best for Influenza - RADT, Molecular test?

A
  • Molecular tests.
30
Q

When do we test or not test for flu in the institutional setting?

A
31
Q

When should consider testing for flu in the community?

A
32
Q

How do neuraminidase inhibitors work?

A
33
Q

When to Neuraminidase work best?

A

AS soon as possible!!!

34
Q

What is the average reduction in length of disease for neuraminidase inhibitors?

A

REduces duration by 1 to 1.5 days

Earlier initiation of treatment show a greater effects (3-4 day reduction)

35
Q

HOw do endonuclease inhibitors work?

A
36
Q

Is it better to combined Baloxavir marboxil plus NAI?

A

Studies show no earlier improvement!

37
Q

What are considerations to starting antivirals in a certain population

A
  • Severity of illness.. (Finish later)
38
Q

When should therapy be initiated for flu?

A

Initiate as rapidly as possible after onset of illness. Benefits are much greater at <12 hours than at 48 hours.

39
Q

What situations do we initiate therapy after 48 hours?

A

Severity requires hospitalization; Illness is progressive, severe, or complicated; or patient is at high risk for severe disease

Little benefit for NAI to healthy patients with relatively mild, self-limited influenza initiated >48 hours after illness onset

40
Q

Zanamivir may be preferred to oseltamivir in the following situations:​

A

Intolerance to Oseltamivir​

Patients not responding to oseltamivir therapy​

Patients with illness despite oseltamivir prophylaxis ​

When influenza B is confirmed or strongly suspected

Nonresponse to oseltamivir therapy, virus should be tested forresistance

41
Q

Describe when to give antivirals for mild/uncomplicated suspected or confirm influenza for patients with:
1. No risk factors (for severe disease) <48 hours and > 48 hours
2. Risk factors <48 hours and >48 hours

A
42
Q

What is the treatment recommendation for Adults with moderate to severe complicated influenza?

A
43
Q

What are treatment recommendations for kids with mild to mod influenza, or severe, with and without risk factors

A
44
Q

What are treatment recommendations for flu for immunocompromised patients?

A
45
Q

What is the treatment for pregnant women with flu?

A

Oseltamivir in standard doses is recommended for treatment of women with influenza during pregnancy and up to 4 weeks post-partum (Strong Recommendation, Grade C evidence).​

46
Q

What are recommendations for chemotherapy prophylaxis?

A

The selective use of pre-exposure prophylaxis can be considered for the following scenarios during community outbreaks of influenza illness: (Option, Grade D evidence) ​

as a bridge to vaccine-induced immunity during the 14-day period after immunization of high-risk individuals when inactivated vaccine is used​

protection of high-risk persons for whom vaccination is contraindicated or deemed likely to be ineffective​

protection of patients at high risk and their family members and close contacts when circulating strains of influenza virus in the community are not matched with trivalent or quadrivalent seasonal influenza vaccine strains, based on current data from the local or national public health laboratories​

protection of family members or health care workers for whom influenza immunization is contraindicated (does not include individuals with chicken or egg allergy) and who are likely to have ongoing close exposure to unimmunized persons at high risk, including infants and toddlers aged younger than 24 months​

47
Q

When should post exposure prophylaxis be used for influenza exposure?

A

Post-exposure prophylaxis may be considered in family settings for persons who cannot be reliably protected by immunization (eg, aged younger than 6 months, immunocompromised, or vaccine contraindicated)​

(Option, Grade D evidence)​

To control outbreaks in closed facilities, antiviral drug prophylaxis, combined with treatment and inactivated vaccine administration, is indicated​

(Strong Recommendation, Grade C evidence)​

48
Q

When should post exposure prophylaxis NOT be used?

A

for groups of healthy individuals on the basis of possible exposure in the community​

if the close contact did not occur during the infectious period (from 1 day before the onset of symptoms until 24 hours after fever ends) of the person with suspected or confirmed influenza​

if more than 4 days have elapsed since the last infectious contact. ​

(Option, Grade D evidence).​

49
Q

Egg vaccines account for what % of influenza vaccines?

A

82%

50
Q

What is the main benefit of recombinant vaccines for influenza virus?

A
51
Q

Can people with egg allergies take the flu shot?

A

People with egg allergy may receive any flu vaccine (egg-based or non-egg-based) that is otherwise appropriate for their age and health status.

Beginning with the 2023-2024 season, additional safety measures are no longer recommended for flu vaccination of people who are allergic to eggs beyond those recommended for receipt of any vaccine, regardless of the severity of previous reaction to egg. All vaccines should be administered in settings in which personnel and equipment needed for rapid recognition and treatment of allergic reactions are available.

Most flu shots and the nasal spray flu vaccine are manufactured using egg-based technology. Because of this, they contain a small amount of egg proteins, such as ovalbumin. However, studies that have examined the use of both the nasal spray vaccine and flu shots in egg-allergic and non-egg-allergic patients indicate that severe allergic reactions in people with egg allergies are unlikely.

52
Q

Who should not receive the influenza vaccine?

A

People who have had a severe allergic reaction to other components that are in a flu vaccine should not receive vaccines that contain that component. People who have had a severe allergic reaction to a flu vaccine in the past should generally not receive flu vaccine again, but might be able to get certain flu vaccines, depending on which one caused the allergic reaction. It is important to discuss allergies that you have with your health care provider.

53
Q

What is the gold standard test fod influenza?

A

Viral cultures of nasal pharyngeal or throat cultures.

54
Q

What are pros and cons of RAT for influenza?

A

Pros:
- Results in 15 minutes
- Very specific
Cons:
- Lack sensitivity (~60%)
- Need to be a skilled collector
-

55
Q

What are pros and cons of NAAT (Molecular tests) for influenza?

A

Pros:
- Fast (13 minutes)
- Sensitive and specific
- Confidence in results
- Preferred over antigen tests
Cons:
- Lack of availability
- Cost

56
Q

When are molecular tests used?

A

HOSPITALIZED PATIENTS with suspected influenza.
- If influenza is suspected, treatment should NOT be with held while awaiting results.

57
Q

When should early antiviral therapy be started for flu in adults and children?

A
  1. Those with severe progresive disease?
  2. Those who are hospitalized and
  3. Those who are at higher risk of complications including:
    - Asthma or other lung diseases
    - CV disease exclusing isolated HTN
    - Renal disease
    - liver disease
    - Diabetes
    - Anemia
    - Cancer
    - Neurologic disease
    - Children aged younger than 5
    - Those 65 years of age and older
    - Those in nursing homes
    - Pregnancy and up to 4 weeks post partum
    - Obesity (BMI >40)
    - Children on long term ASA therapy
    - indigenous people
58
Q

What is the recommended treatment for ages <1, ages 1-5, and >5 with mild uncomplicated illness and:
1. No risk factors for complications other than age
2. Risk factors for complications other than age
3. Severe progressive or complicated illn

A
59
Q

What is considered the infectious period fo influenza?

A

(from 1 day before the onset of
symptoms until 24 hours after fever ends)

60
Q

When should influenza treatment occur for close contact of a case?

A
61
Q

Describe the course of symptoms for the flu, how many days oseltamivir reduces symptoms by, when symptom resolution should occur, what side effects are common, and if they last the whole treatment course with oseltamivir?

A

Resolution of symptoms
* Normal course of symptoms peak at
day 3 and resolve over days 4-7
* Malaise may continue for ~2 weeks
in some patients
* Oseltamivir reduces symptoms by ~1
day so resolution expected days 2-5
* Therapy initiated at ~12 hours of
symptom onset so reasonable to
expect a better response
* Call day 2 and discuss symptom
severity and resolution

Influenza - FINAL (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions