Influenza

Question 1

whcih influenza is responsible for pandemics

Answer 1

A

Question 2

which of the single stranded family of RNA viruses causes influenze

Answer 2

orthomyxoviridae

Question 3

how is influenza spread

Answer 3

resp droplets from coughing and sneezing

touching nose and mouth after touching something with influenza virus

Question 4

when is influenza transmittable

Answer 4

1 day before symptoms develop and 5-10 days after becoming sick

Question 5

incubation period for influenza

Answer 5

1-4 days

Question 6

what is the most common subtype of inflenza detected

Answer 6

influenza A H3N2

Question 7

common clinical presentation of influenza

Answer 7

abrupt onset of.....
high fever
muscl epain 
headache
non productive cough 
malaise
sore throat
rhinitis

Question 8

when do you see resolution of symptoms

Answer 8

resolves in 1 week

cough and malaise may persist for more than 2 weeks

Question 9

diagnosis difficult based on symptoms alone what can help confirm that it is influenza

Answer 9

respiratory symptoms or fever during influenza season

Question 10

fever in influenza or cold?

Answer 10

rare in common cold

high in influenza

Question 11

headache in i or c?

Answer 11

headache frequently in influenza and rarely in cold

Question 12

aches, pains or wekness in i or c?

Answer 12

influenza has severe aches and pain and weakness that can last months
cold maybe has some slight aches and pains

Question 13

bedridden with i or c?

Answer 13

influenza can be bedridden for 5-10 days

not bedridden with a cold

Question 14

runny stuffy nose or sneezing in i or c?

Answer 14

much more common in a cold but can happen in influenza

Question 15

chest discomfort in i or c?

Answer 15

usually have chest pain in influenza

sometimes in cold but much more mild

Question 16

complications that can occur due to influenza

Answer 16

respiratory failure, especially if the patient has chronic conditions (exacerbation)
viral pneumonitis
pneumonia - secondayr bacterial infection
dehydration
worsening of concurent medical conditions
viral myocardidis - rare
acute coronary syndrome

Question 17

complications of a common cold

Answer 17

congestion

sinus or ear infection

Question 18

prevention of influenza

Answer 18

vaccine
frequent hand washign
cover cough

Question 19

prevention of the common cold

Answer 19

frequent hand washing

cover cough

Question 20

causes of secondary bacterial pneumonia that can occur in severe influenzal illness

Answer 20

staph aureus
strep pneumoniae
h inflenzae
other gram negative bacilli

Question 21

where do you take samples from to test for influenza

Answer 21

nasopharyngeal or throat swab
nasal wash
nasal aspirate
blood for antibodies

Question 22

how long does it take for viral culture to produce results

Answer 22

3-10 days

Question 23

during outbreaks what should you include in the samples and why

Answer 23

culture so influenza subtypes can be determined and for surveillance for new strains that may need to be included in next years influenza vaccine

Question 24

what are fapid influenza diagnostic tests

Answer 24

immunoassays that can identify the presences of influenza A or B viral nucleoprotein antigens in resp specimines and display the result in a qualitative way (positive or negative)

Question 25

advantages of rapid influenza tests

Answer 25

produce quick result in 15 min or less simple to perform some approved for office/bedside use

Question 26

disadvantages of rapid influenza tests

Answer 26

sensitivity false negatives common esp when influenza acivity is high false positive also occur when activity is low do not provide info on influenza A subtype or specific strain

Question 27

what is serological testin

Answer 27

testing serum samples for influenza antibody to diagnose recent infection

Question 28

how is serological testing done

Answer 28

collect one sample within the first week of illness and the second 2-4 weeks later

Question 29

what do the results of serological testing tell you

Answer 29

if antibody levels are higher in the second sample than in the first, likely that influenza virus was present

Question 30

what is the role of serological testing

Answer 30

seroprevalence studies | surveillance

Question 31

osteltamivir path thought the body

Answer 31

converted to active metabolis by hepatic esterases | cleared by glomerular filtration and tubular secretion by an anionic transporter system

Question 32

why should you reduce the dose of oseltamivir in renal impairment

Answer 32

clearance by the kidney

Question 33

side effects of osteltamivir

Answer 33

NV diarrhea take with food

Question 34

why is zanamivirs use limited

Answer 34

not orally bioavailable administered by inhalation via a dry powder inhaler not much is absorbed systemically so distribution of the drug to extrapulmonary sites is minimal

Question 35

dosage adjustment of zanamivir for people with impaired renal or hepatic function

Answer 35

not metabolized or secreted renally so no dosage adjustment is suggested

Question 36

when must an antiviral e administered to reduce the duration of uncomplicated influenza by one day and reduce the risk of complication in the severly ill

Answer 36

2 days

Question 37

who should antiviral treatment be offered to

Answer 37

ppl at higher risk for complications <2 - >65 chronic pulmonary, cardiovascular, renal, hepatic, hematological, metabolic, neurological disorders immunosuppression, HIV pregnant or 2 weeks post partum under 19 recieveing long term aspirin therapy first nation, inuit, metis morbidly obeses residents of nursing homes and other chronic care facilities

Question 38

is there any resistance to oseltamivir or zanamivir

Answer 38

no

Question 39

why are adamantanes no longer used

Answer 39

resistance to it

Question 40

what happened when the 2 antivirals were combined in comparison to just oseltamivir

Answer 40

decreased efficacy

Question 41

result of the combo product vs just zanamivir

Answer 41

increased efficacy

Question 42

is an increased dose of oseltamivir recommended

Answer 42

may have faster eradication but does not decrease mortality | increases chance of renal failure, not worth it

Question 43

when is influenza season

Answer 43

october to may

Question 44

what age can you start getting the vaccine

Answer 44

over 6 months

Question 45

how long fdoes ti take to develop immunity after recieving the qaudrivalent flu vaccine

Answer 45

2 weeks***

Question 46

the current vaccines do not contain an adjuvant what is that

Answer 46

substance that boosts an individuals immune response to the vaccine

Question 47

what does the vaccin result in the production of

Answer 47

circulating iGg antibodies to the viral hemagglutinin and neuraminidase cytotoxic T lymphocyte response

Question 48

what does the antibody response after vaccination depend on

Answer 48

age prior and subsequent exposure to antigens immunodeificiency states

Question 49

what do you have to get the flur shot every year

Answer 49

viruses change over time | antigenically drifted strains so have to change the antigenic components of the vaccine each year

Question 50

does administering a second dose of influenza vaccin result in an antibody boost

Answer 50

no

Question 51

who should not be vaccinated***

Answer 51

previous anaphylactic shock to any element IgE hypersensitivity to eggs currently experiencing a high fever serious acute febrile illness until symptoms have lessened can give if non serious febrile illness

Question 52

adverse reactions to vaccination

Answer 52

mild symptoms may last 1-2 days soreness, redness, swelling where injection given fever in children

Question 53

drug interaction swith vaccine

Answer 53

can inhibit the clearance of warfarin and theophylline but no adverse effects