Influenza

Question 1

Influenza is an acute upper respiratory tract infection caused by

Answer 1

Influenza type A and/or B

Question 2

Influenza season is during _____ through _____

Answer 2

October through May

Question 3

Common systemic symptoms of influenza include ________, ________, _______, malaise and chills. Respiratory symptoms include sore throat, nonproductive cough and rhinitis

Answer 3

Fever, Myalgia, Headache

Question 4

The symptoms of influenza typically last about _____ days

Answer 4

4-7 daysR

Question 5

Red Flag symptoms for referral (all age) in influenza:
1.
2.
3.
4.Flu-like symptoms improve but then return with fever/worse cough
6. Fever with a rash
7. seizures

Answer 5

1. Rapid breathing/difficulty breathing
   2.Blush skin colour
   3.Not drinking enough fluids/interacting

Question 6

Generally, PCR/RAT testing for influenza in the community is NOT necessary, true or false?

Answer 6

true

Test patients who require hospitalization for respiratory illness
Consider in select patients in the ER
Long-term care patients should be tested IF there are >2 cases of influenza like within a 72 hour period

Question 7

Non drug measures for influenza
1
2
3

Answer 7

Wash hands frequently
Cough/sneeze in tissue
Stay at home if flu-like symptoms present

Consider masking

Question 8

These over the counter products can be used for fevers headaches and myalgia for influenza:

Answer 8

Analgesics such as Tylenol, ibuprofen, naproxen

Question 9

This age group should Avoid ASA:

This age group should avoid DM:

This age group should avoid decongestants:

Answer 9

<18

<12

<12

Question 10

_____________ is the most effective way to prevent influenza and its complications

Answer 10

Influenza vaccination

Question 11

The live-attenuated influenza vaccine provides improved efficacy compared with inactivated vaccines in children ≤6 years of age but should be avoided in certain populations (those <2 or >59 years of age, _________ women, those with __________________ or severe _________, or children receiving ASA therapy

Answer 11

Pregnant

Immunodeficiencies

Severe Asthma

The inactivated vaccine is safe in all stages of pregnancy and during breastfeeding

Question 12

True or False: Based on clinical evidence, allergy to eggs is no longer considered to be a barrier to vaccination against influenza

Answer 12

True

Question 13

The optimal time for vaccination is mid-_____ to mid-_______

Answer 13

October-November

However, if this time frame is missed, vaccination should be performed at any opportunity that becomes available prior to the end of the flu season, typically the end of April in Canada

Question 14

True or False:
The use of antivirals in treating healthy children and adults can be considered if<48 hours since symptom onset, but IS NOT ROUTINELY RECOMMENDED

Answer 14

True

Question 15

The following patients should generally receive antiviral therapy regardless of time since symptom onset:
1.
2.
3. patients requiring hospitalization
4. serious, complicated or progressive

Answer 15

1. Patients >1 yo with a chronic condition or immunocompromised
2. patients >65 yo in which influenza is strongly suspected

Question 16

Patient presents with mild uncomplicated influenza 48 hours after symptoms onset during influenza season or outbreak:

Children 1-5 yo:

Patient 5-64 years of age AND has no risk factors for severe disease:

Patient 1-64 years of age with risk factors OR is IMMUNOCOMPROMISED OR is adult >65:

Answer 16

Consider treating for children 1-5 based on clinical assessment, healthy children with mild illness do not routinely require treatment with neuraminidase inhibitor

NO routine treatment with neuraminidase inhibitor

Treat with neuraminidase inhibitor for 5 days

Question 17

Neuraminidase inhibitors are not approved by Health Canada for use in children ____

Answer 17

<1 year

Question 18

___________ is not used for treatment or prevention of influenza due to almost complete resistance of circulating viruses

Answer 18

Amantandine

Question 19

Neuraminidase inhibitors prevent symptoms and shorten the duration of illness by about ____ if taken within 48 hours of the onset of symptoms

Answer 19

~ 1 day

Question 20

List the three most common neuraminidase inhibitors
1
2
3

Answer 20

Oseltamivir (PO) - Approved 1 years and older

Zanamivir (Inhaled)

Peramivir (IV)

Question 21

Zanamivir can be used if:
1
2
3
4 Influenza B

Answer 21

1. > 7 years old without lung disease or severe influenza
2. no enteral access
3. failure or progression on oseltamivir or infection while on oseltamviri prophylaxis

Question 22

Peramivir can be used if:
1
2
3

Answer 22

1. > 18 yo
2. unable to take inhaled or oral
3. IV accesss available

Question 23

All antiviral treatment for influenza is for this many days:

Answer 23

5 days

Question 24

All antiviral agents, avoid administration with ______ 2 weeks before or 48 hours after

Answer 24

LAIV

Question 25

Oseltamivir side effects
1.
2.
3.

Answer 25

N/V

neuropsychiatric effects

headache

Question 26

Zanamivir is contraindicated in severe _____ allergy

Answer 26

milk

Question 27

Zanamivir side effects
1.
2.
3.

Answer 27

1. bronchospasm
2. headache/dizzi
3. cough

rare delerium

Question 28

Peramivir side effects:
1.
2.
3.

Answer 28

1. Diarrhea
2. Rash
3. SJS (rare)

Question 29

Prophylaxis for influenza should be offered in these cases:
1. prevention in high-risk individuals during the first ____ weeks following vaccination

2. Prevention for people with severe ________
3. Prevention for people at risk for _______ from influenza who cannot receive influenza vaccine due to contraindication
4. Prevention of influenza among residents of institutions, such as long-term care facilities during influenza outbreaks in the institution

Answer 29

1. two
2. immune defeceinces
3. complications