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Clinical part B > Influenza > Flashcards

Influenza Flashcards

1
Q

whcih influenza is responsible for pandemics

A

A

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2
Q

which of the single stranded family of RNA viruses causes influenze

A

orthomyxoviridae

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3
Q

how is influenza spread

A

resp droplets from coughing and sneezing

touching nose and mouth after touching something with influenza virus

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4
Q

when is influenza transmittable

A

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

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5
Q

incubation period for influenza

A

1-4 days

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6
Q

what is the most common subtype of inflenza detected

A

influenza A H3N2

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7
Q

common clinical presentation of influenza

A 
abrupt onset of.....
high fever
muscl epain 
headache
non productive cough 
malaise
sore throat
rhinitis
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8
Q

when do you see resolution of symptoms

A

resolves in 1 week

cough and malaise may persist for more than 2 weeks

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9
Q

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

A

respiratory symptoms or fever during influenza season

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10
Q

fever in influenza or cold?

A

rare in common cold

high in influenza

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11
Q

headache in i or c?

A

headache frequently in influenza and rarely in cold

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12
Q

aches, pains or wekness in i or c?

A

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

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13
Q

bedridden with i or c?

A

influenza can be bedridden for 5-10 days

not bedridden with a cold

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14
Q

runny stuffy nose or sneezing in i or c?

A

much more common in a cold but can happen in influenza

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15
Q

chest discomfort in i or c?

A

usually have chest pain in influenza

sometimes in cold but much more mild

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16
Q

complications that can occur due to influenza

A

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

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17
Q

complications of a common cold

A

congestion

sinus or ear infection

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18
Q

prevention of influenza

A

vaccine
frequent hand washign
cover cough

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19
Q

prevention of the common cold

A

frequent hand washing

cover cough

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20
Q

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

A

staph aureus
strep pneumoniae
h inflenzae
other gram negative bacilli

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21
Q

where do you take samples from to test for influenza

A

nasopharyngeal or throat swab
nasal wash
nasal aspirate
blood for antibodies

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22
Q

how long does it take for viral culture to produce results

A

3-10 days

23
Q

during outbreaks what should you include in the samples and why

A

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

24
Q

what are fapid influenza diagnostic tests

A

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)

25
Q

advantages of rapid influenza tests

A

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

26
Q

disadvantages of rapid influenza tests

A

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

27
Q

what is serological testin

A

testing serum samples for influenza antibody to diagnose recent infection

28
Q

how is serological testing done

A

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

29
Q

what do the results of serological testing tell you

A

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

30
Q

what is the role of serological testing

A

seroprevalence studies

surveillance

31
Q

osteltamivir path thought the body

A

converted to active metabolis by hepatic esterases

cleared by glomerular filtration and tubular secretion by an anionic transporter system

32
Q

why should you reduce the dose of oseltamivir in renal impairment

A

clearance by the kidney

33
Q

side effects of osteltamivir

A

NV
diarrhea
take with food

34
Q

why is zanamivirs use limited

A

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

35
Q

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

A

not metabolized or secreted renally so no dosage adjustment is suggested

36
Q

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

A

2 days

37
Q

who should antiviral treatment be offered to

A

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

38
Q

is there any resistance to oseltamivir or zanamivir

A

no

39
Q

why are adamantanes no longer used

A

resistance to it

40
Q

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

A

decreased efficacy

41
Q

result of the combo product vs just zanamivir

A

increased efficacy

42
Q

is an increased dose of oseltamivir recommended

A

may have faster eradication but does not decrease mortality

increases chance of renal failure, not worth it

43
Q

when is influenza season

A

october to may

44
Q

what age can you start getting the vaccine

A

over 6 months

45
Q

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

A

2 weeks***

46
Q

the current vaccines do not contain an adjuvant what is that

A

substance that boosts an individuals immune response to the vaccine

47
Q

what does the vaccin result in the production of

A

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

48
Q

what does the antibody response after vaccination depend on

A

age
prior and subsequent exposure to antigens
immunodeificiency states

49
Q

what do you have to get the flur shot every year

A

viruses change over time

antigenically drifted strains so have to change the antigenic components of the vaccine each year

50
Q

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

A

no

51
Q

who should not be vaccinated***

A

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

52
Q

adverse reactions to vaccination

A

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

53
Q

drug interaction swith vaccine

A

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

Clinical part B (15 decks)

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