Influenza and Blood Borne Viruses

Question 1

Influenza (the flu) is caused by

Answer 1

several related viruses
influenze A, B, C
Viruses are subtyped based on the hemagluttinin (H) and neuraminidase (N) antigens

Question 2

Influenza - Hemagluttinin is involved in

Answer 2

binding of the influenza virus to cell surface receptors and is invovled in the release of the viral genome into the cytoplasm

Question 3

Influenza - neuraminidase does what

Answer 3

breaks down the mucus coating of the respiratory tract to facilitate infection and is invovled in the relase of the virus from an infected cell

Question 4

Influenza - is what

Answer 4

an acute respiratory disease

pt presents with fever, myalgia, weakness, HA

Question 5

Influenza occurs when

Answer 5

in US almost exclusively over winter months

Question 6

Influenza - transmission primarily through

Answer 6

inhalation of small particle aerosols produced by coughing and sneezing
Hand to hand fomite is known to occur

Question 7

Influenza - incubation period is from

Answer 7

18-72 hours

Question 8

Influenza - most patients recover within

Answer 8

1 week

cough can continue for an additional two weeks

Question 9

Influenza - increase risk of complications in who

Answer 9

elderly
pulmonary or cardiac disease
DM
renal dysfunction
immunosuppressed pt 
women in 2nd or 3rd trimester

Question 10

Which is most important complication of influenza

Answer 10

pneumonia!

Question 11

Influenza - treatment

Answer 11

Several compounds (amantadine, rimantadine) block the penetration and uncoat the virus
resistance to these is emerging though
Can also use neuraminidase inhibitors (tamiflu, relenza)

Question 12

Influenza - the drugs may do what

Answer 12

reduce duration and severity of illness

Question 13

Influenza - prevention

Answer 13

VACCINATE!
injectible vaccine has inactivated influenza viruses
new inhalable (flumist) that has live, attenuated influenza
ALL HEALTHCARE PROVIDERS SHOULD VACCINATE ANNUALLY

Question 14

Viral hepatitis is what

Answer 14

disease that primarily affects the liver

consequences of infection can range from asymptomatic disease to fulminant liver involvement and death

Question 15

Viral hepatitis is caused by what

Answer 15

hep A (HAV)
hep B (HBV)
hep C (HCV)
hep D (HDV)
hep E (HEV)

Question 16

Viral hepatitis - clinical syndrome

Answer 16

initial sx of HA, fatigue, vomiting, nausea, anorexia, arthralgia, myalgia
Pt eventualyl becomes jaundice within 1-2 wks
Right upper quadrant pain or discomfort

Question 17

Viral hepatitis - complete clinical recovery

Answer 17

may take months

Question 18

Viral hepatitis - Hep A enters the body through

Answer 18

GI tract (fecal - oral)
shellfish
CHildren and young adults are most frequently infected

Question 19

Viral hep - hep A - incubation

Answer 19

30 days

Question 20

VIral hep - Hep A - Virus is shed how

Answer 20

in feces

2 weeks before the appearance of sx and by the time jaundice manifests, shedding will terminate

Question 21

Viral hep - Hep A - resolution

Answer 21

most resolve in 2-4 wks
no chronic state
immune system eliminates the virus

Question 22

Viral hep - Hep A - focal points/people of infection

Answer 22

child care centers, promiscuous homosexual men, IV drug abusers

Question 23

Viral hep - Hep A - prevention

Answer 23

Vaccine!

proper hygiene prevents virus spread

Question 24

Viral hep - Hep A - workers should be

Answer 24

restricted from patient contact, contact with the pt environment, and food handling until a min of 7 days after the onset of jaundice

Question 25

Viral hep - Hep B - acquired through

Answer 25

blood transfusion drug abuse (dirty needles) sexual intercourse maternal transmission to newborn during birth Major routes in western europe and US = sex and percuteous exposure

Question 26

Viral hep - Hep B - incubation

Answer 26

30-180 days

Question 27

Viral hep - Hep B - chronicity

Answer 27

5-10% of adults will become chronic carriers most newborns will become chronic carriers Chronic HBV is associated with inc risk of hepatocellular carcinoma

Question 28

Viral hep - Hep B - tratment

Answer 28

vaccine | all healthcare workers should be vaccinated

Question 29

Viral hep - Hep B - work restrictions on HBV infected chronic carriers

Answer 29

should be evaluated based on the nature of the work performed by the employee

Question 30

Viral hep - Hep C - accounts for what percent of chronic liver disease

Answer 30

40% of cases of chronic liver disease | Most common diagnosis requiring liver transplant

Question 31

Viral hep - Hep C - tranmission

Answer 31

transfusion injection sexual intercourse mother to newborn

Question 32

Viral hep - Hep C - efficiency of virus infection following an accidental needlestick in healthcare workers is

Answer 32

3%

Question 33

Viral hep - Hep C - incubation

Answer 33

50 days

Question 34

Viral hep - Hep C - tx

Answer 34

``` interferon protease inhibitors polymerase inhibitors assembly inhibitors NO VACCINE AVAILABLE ```

Question 35

Viral hep - Hep C - prevention

Answer 35

main mode is screening of blood components for the presence of HCV antibodies as an indicator for exposure to virus and bx changes to limit exposure to virus

Question 36

HIV and AIDS - transmission

Answer 36

sexual activity exposure to blood and blood products from mother to fetus Casual contact or bite of insect has NEVER been shown to transmit HIV

Question 37

HIV and AIDS - worldwide, how many are infected

Answer 37

35 million

Question 38

HIV and AIDS - what percent are due to sexual transmision

Answer 38

75%

Question 39

HIV and AIDS - worldwide, the most common mode of transmission is

Answer 39

heterosexual exposure

Question 40

HIV and AIDS - transmission is ___ times more effective in

Answer 40

8 time more effective in male to female compared to female to male transmission

Question 41

HIV and AIDS - what enhances probability of productive infection

Answer 41

sexual practices that cause traumatic tears to the mucosa or the presence of infectious agents that cause genital ulcerations (syphilis, herpes)

Question 42

HIV and AIDS - risk to healthcare workers

Answer 42

700, 000 are stuck with needles or other sharps/ year! HIV infection through intact skin has never been documented

Question 43

HIV and AIDS - % with fetus

Answer 43

25% transplacental 60% birth 15% breast feeding transmission can go down dramatically when mothers are on antiviral therapy

Question 44

HIV and AIDS - pathogenesis

Answer 44

HIV enters the body and is cleared by the spleen and or lymph nodes and then it replicates Virus spreads throughout the body At this time the individual will present with flu like symptoms then infected individuals experience extended period of time sx free Overtime immune system is suppressed and makes pt susceptible to opportunistic infections

Question 45

HIV and AIDS - Opportunistic infections include

Answer 45

``` bacterial pneumonia pneumocystis carinii pneumonia TB oral thrush (candida albicans) CMV retinitis Kaposi's sarcoma Toxoplasmosis (which causes encephalitis) ```

Question 46

HIV and AIDS - treatment

Answer 46

comination therapy - multiple drugs hitting multipl targets

Question 47

HIV and AIDS - revention

Answer 47

education, counseling, bx modification | provide tx for pregnant women