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ID > Howrie > Flashcards

Howrie Flashcards

1
Q

annual flu epidemics are due to mutations caused by antigenic _____

A

drift

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2
Q

flu pandemics are due to reassortment of genomes between human and animal viruses caused by antigenic ____

A

shift

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3
Q

what is hemagglutin responsible for

A

attachment and fusion

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4
Q

what is neuraminidase responsible for

A

the release of virus from infected cells

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5
Q

which type of flu test can detect flue A or B

A

RT-PCR

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6
Q

high risk flu groups

A

65+ yo, <2 yo, pregnant or 2 weeks postpartum, chronic pulmonary disease, diabetes, morbidly obese, immunocompromised: HIV/AIDS, cancer

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7
Q

when is the greatest benefit of flu antivirals

A

administered within 24-30 hours of symptom onset

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8
Q

what are the benefits of flu antivirals

A

shorten duration of flu symptoms by 1-3 days, reduce severity and complications, length of hospital stay, mortality

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9
Q

oseltamivir dosing

A

75 mg po bid x 5 d. high dose of 150 bid for severely ill. adjust for renal function

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10
Q

tamiflu side effects

A

HA, n/v, confusion, dizzy

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11
Q

zanamivir dosing

A

2 inhalations (10 mg) BID x 5d

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12
Q

when is zanamivir not recommended

A

asthma or COPD (underlying respiratory disease)

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13
Q

what does baloxavir inhibit

A

cap-dependent endonuclease

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14
Q

big counseling point for baloxavir

A

avoid coadministration with cations, dairy

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15
Q

how is baloxavir dosed

A

weight-based. 40-80 kg gets 40 mg po once. >80 kg gets 80 mg po once

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16
Q

therapy for post-exposure flu prophylaxis

A

oseltamivir 75 mg daily. zanamivir 10 mg inhaled once daily. for SEVEN DAYS

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17
Q

who gets flu post-exposure prophylaxis

A

those at higher risk for complications who aren’t vaccinated or HCW who aren’t vaccinated. not a substitute for vaccine. only use if antivirals can be started within 48 hours of exposure. might still transmit the virus even without clinical illness

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18
Q

who gets pre-exposure chemoprophylaxis

A

nursing home residents when there is an outbreak, regardless of vaccination, for a minimum of 2 weeks. and the unvaccinated staff members who care for them.

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19
Q

what is a key point of flu in the respiratory tract

A

it causes an extensive loss of ciliated epithelium

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20
Q

which flu can infect animals

A

A

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21
Q

what kind of genome does flu virus have

A

RNA

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22
Q

what are flu-like symptoms due to

A

massive cytokine release and interferon effects

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23
Q

how is flu transmitted

A

aerosol droplets in cool, less humid environment (winter, heating)

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24
Q

what kind of virus is HPV

A

dsDNA

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25
Q

what kind of infection is HSV

A

latent

26
Q

most cancers from HPV are due to what strains

A

16 and 18

27
Q

what proteins inactivate p53 and p105 growth suppressor genes

A

E6, E7

28
Q

what proteins enhance cell growth by making cells more sensitive to growth signals

A

E5

29
Q

effects of 9-valent HPV vaccine

A

86% decrease in HPV that cause cancer and genital wards. does not prevent progression of infection to disease, treat disease, or improve clearance of infection

30
Q

dosing schedule for HPV vaccine

A

2 doses for age 9. 3 doses for those who start at age 15 (6 months apart)

31
Q

who should get HPV vaccine

A

everyone through age 26 years if they were not adequately vaccinated

32
Q

HSV genome

A

dsDNA

33
Q

how does HSV release

A

exocytosis, cell lysis, CELL TO CELL BRIDGES

34
Q

what kind of immunity for control does HSV use

A

cell-mediated immunity

35
Q

what infection pattern does HSV have

A

latent

36
Q

what can cause reactivation of HSV

A

ultraviolet B radiation (tanning), fever, emotional or physical stress, immunosuppression (transient, chemo, HIV)

37
Q

which HSV is primary STI

A

HSV2

38
Q

which HSV infections are primary in infancy and childhood, transmitted by contact with infected saliva

A

HSV1

39
Q

which HSV can cause genital lesions

A

HSV1

40
Q

which HSV can cause oral lesions

A

HSV2`

41
Q

recurrent genital HSV is more common with which HSV

A

HSV2

42
Q

acyclovir, valacyclovir, and famciclovir are equally effective but most effective when used within ____

A

first 2 days of symptom onset

43
Q

therapy for first clinical HSV episode

A

acyclovir 400 TID, valacyclovir 1 g BID, famciclovir 250 TID x 7-10d

44
Q

episodic therapy for recurrent HSV infection

A

duration is 3-5d typically

45
Q

when to use antivirals for HSV suppression

A

when 3 episodes in 6 months or 6 episodes in 12 months

46
Q

how is VZV transmitted

A

direct contact or inhalation of aerosols from vesicular fluid of skin lesions or respiratory secretions. contagious 1-2 days before rash and until all chickenpox lesions have crusted

47
Q

VZV treatment

A

topical agents like calamine, domeboro. acetaminophen to control fever. antivirals within 24h of onset: for 5-7 days (acyclovir 800 5x daily, valacyclovir 1 g TID, famciclovir 500 TID)

48
Q

who cannot get VZV vaccine

A

immunocompromised: cancer, pregnancy, immunosuppression

49
Q

dosing schedule for VZV vaccine

A

children who never had chickenpox: 2 doses at 12-15 months, 4-6 years.
ages 13+ who never had chickenpox: 2 doses at least 28 days apart

50
Q

when to give antivirals for VZV prevention

A

individuals at high risk for disease contraction who are ineligible for vaccination or past the 96hr window after direct contact

51
Q

what agent to give for VZV prevention

A

acyclovir 20 mg/kg/dose 4x daily for 7 days. passive immunization varicella immune globulin IM within 10 days of exposure

52
Q

pre-eruptive phase zoster

A

paresthesia, pain, burning, itching, malaise, myalgia, HA, photophobia, fever

53
Q

acute eruptive phase zoster

A

> 1 neighboring dermatomes, vesicles distributed in a stripe or belt-like pattern, heals within 2-4 weeks, post herpetic neuralgia can last for months

54
Q

antivirals for zoster

A

acyclovir, famciclovir, valacyclovir with optimal duration 7 days. fam and val preferred to reduce post herpetic neuralgia

55
Q

other management for zoster

A

burrow’s solution/domeboro, calamine lotion, pain management with topical lidocaine patches, gabapentin, opioids for as few days as possible

56
Q

what kind of vaccine is shingrix

A

recombinant, adjuvanted, non-live

57
Q

who gets shingrix

A

healthy adults age 50 and older: 2 doses separated by 2-6 months

58
Q

what is unusual about flu replication

A

it replicates in nucleus

59
Q

what vaccine can’t you give to immunocompromised

A

varicella- it is a live vaccine- can’t give to pregnant or cancer

60
Q

which virus can you give passive immunization

A

varicella- immune globulin

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