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Infectious Disease > ID Exam 2 Viral respiratory infections > Flashcards

ID Exam 2 Viral respiratory infections Flashcards

1
Q

Respiratory viruses

Common URTI/LRTI

A

Target and infect epithelial cells
URTI: rhinovirus unique
Either URTI/LRTI: parainfluenza, RSV, flu, adeno

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2
Q 
Common causes of:
Bronchiolitis
Common cold
PNA
Croup
A

Bronchiolitis: RSV
Common cold: rhinovirus, coronavirus
PNA: flu, RSV, adeno
Croup: parainfluenza

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3
Q

Viral infections of respiratory tract: characteristics
Symptoms result of?
Temp preference

A 
Fomites/aersol transmission
Targets epithelial cells
Cytokine release = symptoms
Rhino prefers 33˚ -> URI, compared to warmer lower
Attenuated vaccines also prefer 33˚
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4
Q

Patterns of replication
Infect and exit?
Persistent infection?
Systemic?

A

Just surface epi and exit: para/orthomyxovirus
Persistent epi: EBV, adeno, papillo
Systemic replication: MMR, HHV types

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5
Q

RNA - characteristics

A

Must bring own DNA polymerase
All replicate in cytoplasm (except orthomyxo)
All single stranded (except rio)

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6
Q

Orthomyxovirus: characteristics

Genetics/mutations

A

Enveloped
Replicates in nucleus (NOT cytoplasm)
Segmented genome (8) -> BOAR
Flu A: shift and drift - pandemics (multi-animal)
Flu B: just drift - epi/endemics (only human)
Flu C: only human, not worried about
A/B/C differentiated by nuclear protein and M protein

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7
Q

Antigenic drift vs. shift

A

Drift: point mutation, epidemics (seasonal flu)
Shift: segments are shared (reassortment), pandemics

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8
Q

Orthomyxovirus: pathophys and complications

A

Hemagglutinin (H1, H2, H3) - binds sailic acid
M2 protein - creates pH for replication
Neuraminidase - cleaves sailic acid to release
Complications: bacterial superinfection (PNA) by S. aur, S. pne, H. flu

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9
Q

Orthomyxovirus: treatment and vaccine

A

Tx: -mantadine: target M2 (Flu A only) lots of resistance
Tx: -tamivir: prevent NA cleavage (give early)
Killed vaccine and live attenuated (nasal)

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10
Q

Paramyxovirus:

A 
-RNA, enveloped
MMR vaccine
PaRaMMyxo:
Parainfluenza - croup
RSV - bronchiolitis in babies; Rx - ribavirin
Measles (rubeola)
Mumps
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11
Q

Measles: S/Sx

A

CCCC:
Cough
Coryza (runny nose)
Conjunctivitis
Koplic spots (small, blue/white spots on red, buccal mucosa)
Fever
Maculopapule rash after koplic (face and down), confluence rash - not important for transmission

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12
Q

Measles complications

A

Giant cell PNA

Subacute sclerosing panencephalitis (SSPE)

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13
Q

Measles characteristics

A

HA but no NA
Fusion protein: multinucleated giant cells
Warthin-Finkeldey giant cells (fused lymphocytes)

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14
Q

Measles treatment and vaccines

A 
Vitamin A can help
MMR vaccine (CI in pregnancy and immunosuppressed)
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15
Q

Mumps: characteristics, virulence

A 
Replicates in parotid glands
Humans are only reservoir
Worse infection with older age
Later can present as unilat/bilat orchitis
Meningitis
Virulence: HA and NA, fusion protein
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16
Q

RSV: characteristics, virulence, treatment

A

Attached to G protein to infect epithelium
Most common cause of PNA and bronchiolitis in infants
Virulence: fusion protein
Tx: ribivirin used in adults (not kids or pregnant)
Tx: prevent in high risk (premies) infants w/ palivizumab

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17
Q

Parainfluenza virus: S/Sx, virulence factors, CXR

A

Croup, stridor (laryngotracheobronchitis)
Virulence factors: HA, NA, and fusion protein
CXR: steeple sign
2-6 days incubation
Children aged .5-2
4 types (PIV4=rare, but can cause URI in adults)

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18
Q

Segmented viruses

A

Bunyaviruses
Orthomyxoviruses
Arenaviruses
Reoviruses

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19
Q

Influenza spread and symptomology

A 
Can spread in absence of symptoms
Replicated in ciliated epi of URT
Self-limited, 3-7 days
Bacterial superinfection most common cause of death
(except 1918 pandemic)
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20
Q

Dx of flu

A

RT-PCR

Clinical dx: fever, HA, myalgia, season

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21
Q

Tx of flu

A

NA inhibitors: zanamivir, oseltamivir, peramivir (A and B)
Must give within 48 hours of onset to decrease duration
Maybe prevent bacterial superinfections
M2 inhibitors: amantidine, rimantadine (A)

22
Q

Sub types of parainfluenza

A

PIV-1: outbreaks of croup in Fall
PIV-2: Fall outbreaks leading to bronchitis/PNA
PIV-3: Peak=spring/summer, but can be all year
PIV-4: rare, but can cause URI in adults

23
Q

RSV diagnosis and complications

A

Rapid nasal swab tests

Most common cause of PNA in kids under 2

24
Q

Measles in pregnancy

A

Infection in unvaccinated, pregnant women:
Premature labor
Spontaneous abortion
Low BW infants

25
Q

Mumps: s/sx

A 
glands as big as POM-Pom's
Parotitis
Orchitis
aseptic Meningitis
Pancreatitis
Sterility (post-pubertal)
26
Q

Sensitivity

A

TRUE positive rate

27
Q

Specificity

A

Disease absent patients

TN/(TN+FP)

28
Q

Assays in diagnostic viruology can detect:

A

Virus nucleic acid
Viral antigens
Virus
Virus-specific antibody

29
Q

HIV diagnostic and confirmatory testing (in order)

A
  1. ELISA (HIV-ab)

2. Western blot (HIV-ab)

30
Q

Viral cultures

A 
Abx added
Looks for cellular changes = cytopathic effect (CPE)
CPE = rounding up, fusion, lysis
CPE is evidence of infectious virus
Not all viruses result in CPE
31
Q

Hemadsorption test vs.
Hemadsorption inhibition test vs.
Hemagglutination inhibition test

A

Infected cells result in RBC binding and aggregation
Inhibition test: add antibody specific for virus, block of RBC binding indicates which antibody binded
Agg inhib: Serological test with virus, inhibition of agglutination indicates presence of viral antibody in serum

32
Q

Rapid influenza diagnostics

A

Rapid antigen tests (range of sensitivity)
Direct fluorescent antibody assay (required technical experience)
RT-PCR (technical experience and expensive equipment)
Still need to do culture to determine future vaccine and potential viral resistance

33
Q

Togavirus group

A

Arborvirus (Wester/Eastern/Ven equine encephalitis)
Rubella
Enveloped, +RNA

34
Q

Rubella

A

Postauricular and occipital lymphadenopathy
Fine, confluent rash that starts face and moves down
Long polyprotein cleaved by proteases
MMR vaccine (HIV >200)

35
Q

Rubella s/sx

A

Mild, self limiting febrile rash in infants
BUT infected pregnant mother: TORCHES
Infects within first 3 months -> infects placenta

36
Q

Acute vs convalescense serum

A

Acute: during infection
Convalescent: 4 weeks after recovery
Rise in ab (ex. IgM) from acute to con = was active infection

37
Q

Zika virus s/sx and diagnosis for active/recent infection

A

Eye pain, myalgia, conjunctivitis, fever, rash
Travel to Mexico, Guatamala, Belize
IgM and RT-PCR
NO aminocentesis (s/s not known, progression not known)

38
Q

Zika virus fetal s/sx

A

Neuronal cell death

Decrease in head circumference

39
Q

Flaviviruses

A

+RNA, enveloped
Dengue fever (type II, break bone) -> thrombocytopenia, hemorrhagic, renal failure, sepsis (mosquitos)
Yellow fever: jaundice, bloody both ends, back pain, live attenuated virus
West nile: encephalitis, meingitis, seizure
Hep C

40
Q

Capture ELISA

A

Start with known anti-human antibody instead of known virus antigen
Add virus antigen later

41
Q

DFA testing

A

Base of cells
Add patient serum (and potentially virus)
Virus infects cells, expresses surface proteins
1˚ to bind surface
2˚ to bind ab and have flouro

42
Q

Human Metapneumovirus

A

Causes URI and LRI
Usually mild and self-limited
RT-PCR, grows very slowly in culture
Treatment is supportive

43
Q

Adenovirus

A

dsDNA,
Most are asx, long latent periods
Reactivations are problem in AIDS patients
Can be shed for long periods of time

44
Q

Adenovirus: diseases

A

Conjunctivits
Acute hemorrahgic cystitis
GI
Myocarditis

45
Q

Adenovirus: vaccines and treatment

A

Vaccines: Live vaccine, military recruits only
Treatment: self limiting, supportive care

46
Q

Rhinoviruses

A

A picornavirus, naked +RNA
Yuuuuge amount of serotypes, no vaccine
Replicate best at 33˚ (URI, colder)
C can replicate at 37˚

47
Q

Coronaviruses

A

Enveloped with glycoprotein spikes (crown)
Unstable in environment (vs. rhino)
Respiratory and enteric (neonates) disease
Replication in respiratory epithelium
1/3 cause of common cold
Can be systemic (like mumps)

48
Q

Coronaviruses and more severe illness

A

SARS and MERS

49
Q

Spillover vs. genetic change

A

Reservoir population with high pathogen comes in contact with novel host population
So far, none have included fast human to human transmission

50
Q

Patterns of replication and examples:
Acute
Persistent
Systemic

A

Acute - confined to respiratory epi: paramyxovirus
Persistent - EBV, adeno, papilloma
Systemic - mumps, measles

Infectious Disease (13 decks)

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