Influenza - 139

Question 1

Name some of the ‘geriatric giants’

Answer 1

Confusion, falls, poor mobility, collapse, incontinence, not coping

Question 2

What is delirium?

Answer 2

Disturbance of consciousness with reduced ability to focus, sustain, or shift attention. Usually acute, not due to pre-existing dementia

Question 3

How would you manage delirium?

Answer 3

Well lit room, same nursing staff if possible, repeated orientation, glasses/hearing aid if worn, identify and treat cause

Question 4

Why is increased drug use in the elderly a problem?

Answer 4

They have altered drug responses

Question 5

How are drug responses altered in the elderly?

Answer 5

• First pass metabolism decreases with age -> some drugs (e.g. B-blockers and Ca channel blockers) undergo extensive first pass metabolism and will not be properly metabolism in the elderly.
• achlorhydria increases with age, which affects drug absorption
• Elderly have an increased proportion of body fat and decreased proportion of muscle mass -> leads to increased distribution of lipophilic drugs and decreased distribution of hydrophilic drugs
• Renal function declines with age

Question 6

What is achlorhydria?

Answer 6

Little or no hydrochloric acid in GI secretions

Question 7

What is the average incubation period for influenza?

Answer 7

2-3 days

Question 8

Fever, chills, headache, aching muscles, weakness and anorexia are symptoms of what?

Answer 8

Influenza

Question 9

How is influenza transmitted?

Answer 9

Airborne and through indirect surface contamination

Question 10

What are neuraminidase and hemagglutinase molecules? What are their specific roles?

Answer 10

Proteins on the surface of viruses. H mediates virion binding to target cells, N is involved in the release of progeny virions from host cells

Question 11

Mistakes made during virus replication resulting in the production of a virus with different antigenic proteins describes what phenomenon?

Answer 11

Antigenic drift

Question 12

What is antigenic drift? Why does it take place?

Answer 12

Mistakes made during virus replication resulting in the production of a virus with different antigenic proteins
RNA viruses do not have proof reading mechanisms

Question 13

What is antigenic shift?

Answer 13

The formation of a new flu virus due to reassortment of genetic material - can be from 2 different flu types, e.g. human and avian

Question 14

Influenza pandemics occurs because of what phenomenon?

Answer 14

Antigenic shift

Question 15

Why are flu pandemics dangerous?

Answer 15

The population has no pre-existing immunity. Human-human transmission is possible

Question 16

In what age group is H1N1 most common?

Answer 16

5-14 years

Question 17

What 2 drugs can be given to treat influenza?

Answer 17

Oseltamivir (tamiflu) - within 48 hours

Zanamivir - within 36 hours

Question 18

When is antiviral treatment indicated?

Answer 18

When flu is circulating, an ‘at risk’ person, if treatment can be started within start time (48 hours latest)

Question 19

In what exception would antivirals be started after 48 hours?

Answer 19

Life-threatening condition

Question 20

Who is the influenza vaccine offered to annually?

Answer 20

• 65 + years
• between 6 months - 64 years in ‘at risk’ group
• all those over 2 years and under 18 years

Question 21

What kind of virus is herpesvirus?

Answer 21

DNA, ds, enveloped

Question 22

What kind of virus is poliovirus?

Answer 22

RNA virus, +ve stranded, icosahedral

Question 23

Name 2 viruses that are from the family Paramyxoviridae

Answer 23

Mumps and measles

Question 24

What kind of viruses are measles and mumps?

Answer 24

RNA, SS

Question 25

What is the most common route of viral penetration?

Answer 25

Receptor-mediated

Question 26

What kind of surfaces can undergo surface fusion as their route of penetration?

Answer 26

Enveloped

Question 27

What infections could aciclovir be used to treat?

Answer 27

HSV and VZV

Question 28

What infections could ganciclovir be used to treat? What are side effects of this?

Answer 28

CMV.

Can cause neutropenia, or anaemia

Question 29

Which route is the most common route of viral infection?

Answer 29

Respiratory route

Question 30

Which cells are thought to be used by many pathogens for entry? Give an example of a virus

Answer 30

M cells of the gut. Reovirus