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Block 9 Week 4 > Influenza and Viral pneumonia-AuCoin > Flashcards

Influenza and Viral pneumonia-AuCoin Flashcards

1
Q

(blank) is an inflammation of the lungs caused by infection with a virus or bacteria

A

pneumonia

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2
Q

Pneumonia is infection of the pulmonary (blank) the (blank) are primarly affected

A

parenchyma

alveoli

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3
Q

The inflammation of pneumonia is also caused by (Blank) to infection

A

immune response

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4
Q

(blank) is more likley to occur in young children and older adults due to a naive or weakened immune system.

A

Viral pneumonia

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5
Q

What are they typical symptoms of pneumonia?

A

cough, fever, chills, SOB

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6
Q

What are the common causes of viral pneumonia?

A
  • influenza A and B
  • RSV
  • Parainfluenza virus
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7
Q

What does parainfluenza virus cause?

A

croup

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8
Q

What are some Less common causes of viral pneumonia?

A

LESS COMMON:

  • adenovirus
  • rhinovirus
  • metapneumovirus
  • SARS
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9
Q

What are viruses that cause other disease and may cause pneumonia?

A 
Herpes simplex virus
Varicella-zoster virus
Measles
Rubella
Cytomegalovirus
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10
Q

What family does RSV and Human parainfluenza virus belong to?

A

paramyxovirus

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11
Q

What are the barriers for respiratory viruses?

A
  • Epiglottis and cough reflex (prevent intro of particulat matter in the lower airway)
  • Ciliated respiratory epithelium (propels overlying mucous layer upward toward mouth)
  • In alveoli (cell mediated immunity, humoral factors, inflammatory response defenf against lower respiratory tract infections )
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12
Q

What kind of virus is influenza virus? Is it a DNA or RNA virus?
Is it enveloped?

A

orthomyxo
E
(-)RNA

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13
Q

Is influenza common?

How is it transmitted?

A

very common, kills thousands/years: may cause pandemics

respiratory droplets

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14
Q

App. (blank) people die of influenza each year in the US

A

36,000

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15
Q

What types of influenza causes pandemics?
What type of influenza causes outbreaks?
What type of influenza causes milder infections?

A

A
B
C

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16
Q

Influenza A virus has (blank) antigenic types of HA and (blank) types of (NA).

A

16

9

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17
Q

What is the reassortment of segments of the genome RNA?

A

antigenic shift

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18
Q

What are small mutations in the genome RNA caused by RNA polymerase transciption mistakes?

A

Anitgenic drift

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19
Q

Antigenic changes to HA and NA causes (blank and blank)

A

epidemics and pandemics

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20
Q

What test can you do to detect the influenza virus?

A

Hemagluttinin assay

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21
Q

How long is the incubation period of influenza virus?

A

24 to 48 hours

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22
Q

What are the symptoms that develop after the incubation period (24-48 hrs) of orthomyxovirus?

A 
DEVELOP SUDDENLY:
Fever
Myalgia
Headache
Sore throat
Cough
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23
Q

WHo are at high risk of getting influenza virus?

A

elderly and those with cardiac or pulmonary disease

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24
Q

How long does it take for flu symptoms to resolve from influenza virus? What can complicate this course?

A

4 to 7 days

-pneumonia

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25
Q

What does your immunity to influenza virus depend on?

A

secretory IgA targeting HA in the respiratory tract

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26
Q

How do you diagnose inflluenza?

A

clinically, lab tests are available

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27
Q

How do you treat and prevent influenza?

A

Oseltamivir (Tamiflu) and Zanamivir (Relenza)

Vaccination (consists of influenza A and B viruses)

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28
Q

How does oseltamivir and zamivir treat influenza?

A

it is a neuramidase inhibitor which prevents the virus from being released from the infected cell

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29
Q

What is a well-known complication of influenza?

A

Bacterial pneumonia caused by Staph aureus

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30
Q

How come the influenza virus has a short incubation period?

A

because it only goes to the lungs and doesnt go anywhere else

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31
Q

(blank) illnesses are responsible for more than half of all acute illnesses each year in the US

A

respiratory illnessess

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32
Q

Influenza circulates in the US in the (blank) and (blank)

A

Fall

Early spring

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33
Q

How come it is difficult to control influenza infection?

A

mutability and high frequency of genetic reassortment

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34
Q

Influenza (blank) is antigenicaly variable and causes the majority of disease. Less antigenic changes occur with influenza (blank). (Blank) is antigenically stable.

A

A
B
C

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35
Q

Influenza A strains are also known to infect (blank, blank, blank and blank)

A

Aquatic birds
chickens
ducks
pigs

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36
Q

What does the influenza virus bind to on a cell to infect it?

A

sialic acid receptor

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37
Q

How does a virus get out of an endosome?

A

Changes pH to cause the viral envelope to fuse with endosomal membrane and dump its contents into the cell

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38
Q

How can you make a negative sense RNA infect a cell?

A

you need it to bring RNA dependent RNA polymerase with it to make + RNA so that the cell can read it :)

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39
Q

What binds to the sialic acid receptor on respiratory epithelial cells?

A

HA hemagglutinin (HA)

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40
Q

What are the 7 steps of influenza virus replication?

A
  1. Receptor mediated endocytosis
  2. segmented ribonucleoproteins released into the cytoplasm
  3. Genome transported to the nucleus
  4. Repliation and transcription
  5. Viral mRNAs transported to the cytoplasm for translations
  6. Early viral replication proteins transported back to the nucleus
  7. Assembly and budding occurs at PM
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41
Q

What does the virion contain that allows it to replicate?

A

RNA dependent RNA polymerase

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42
Q

What is unusual about influenza being an RNA virus?

A

It has its RNA trnscription and relication in the nucleus

usually RNA viruses dont have both happen here

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43
Q

THe (blank) of the endosome facilitates membrane fusion and release of the viral (blank) in the cytosol

A

low pH

RNPs

44
Q

Shortly post infection there is a (blank) of host cell protein synthesis

A

shut off

45
Q

What is the virus encoded RNA polymerase composed of?
What will this do?
What happens to the (+) sense mRNA?

A

three viral proteins (P proteins) are responsible for transcription

  • polymerase will produce (+) sense mRNA from the (-) sense RNA genome
  • translated into viral proteins and also used as a template to produce viral (-) sense RNA genomes
46
Q

What is used as a template to produce (-) sense RNA?

A

(+) sense mRNA

47
Q

What is a ribonucleoprotein (RNP)?

A

the nucleoprotein (NP) associates with the viral RNA to form a ribonucleoprotein (RNP) structure

48
Q

What are three other encoded proteins bound to the viral nucleoprotein (NP) and what are they responsible for?

A

PA, PB1, PB2

RNA transcription and replication

49
Q

(blank) forms a shell below the viral membrane which is important for particle assembly.

A

Matrix protein M1

50
Q

(blank) surrounds the viral particle derived from the plasma membrane of the host cell.

A

Lipid envelope

51
Q

What 2 glycoproteins are found embedded in the lipid envelope?

A

Hemagglutinin (HA)

neuraminidase (NA)

52
Q

HA and HA are exposed as (blank) on the surface of the virus. Why are these 2 surface glycoproteins important?

A

spikes

they are the antigens that determine antigenic variation of influenza virus

53
Q

T or F

2 distinct influenza viruses may infect a single host cell

A

T

54
Q

Segmented RNA genomes will be shuffled in this cell creating a new infleunza virus. This process is called (blank). What will this do to the surface antigens?

A

reassortment

creates a sudden change in them which explains the challenge of producing only one influenza vaccine

55
Q

What are used to divide influenza viruses into types A, B, and C?

A

antigenic differences b/w internal structure proteins, nucleocapsid (NP) and matrix (M) proteins

56
Q

Antigenic variation among surface glycoproteins, HA and NA are used to (blank) the viruses

A

subtype

57
Q

What is the nomenclature system for influenza virus?

A

type, host origin, geographic origin, strain number, year of isolation, HA and NA subtype

58
Q 
There are (Blank) subtypes of HA (HA1-HA15) and (blank)  subtypes of NA (N1-N9) in many different combinations isolated in birds, animals or humans.
Which types of H and which types of N are found in humans?
A

15
9
H1,2,3,5 and N1 and N2

59
Q

(blank) proteins and (blank) proteins are relatively stable conserved sequences that do not drift as much as glycoproteins.

A

nucleocapsid proteins and matrix proteins

60
Q

What are susceptible cells?

A

Cells that viruses can enter but cannot replicate inside

61
Q

What are permissive cells?

A

cell has everything the virus needs to replicate

62
Q

(blank) on the influenza virus binds to suscpetible cells

A

HA protein

63
Q

(blank) is the MAJOR antigen which neutralizing (protective) antibodies are directed

A

HA

64
Q

(blank) is primarily responsibe for the continual evolution of new strains and subsequent influenza epidemics

A

Variability of HA

65
Q

What does NA do and when does it start doing its job?

A

facilitates the release of virus particles from infected cell surface during the budding process-> functions at the end of the viral replication cycle

66
Q

(blank) have a selective advantage over parental virus (original virus) in the presence of antibody directed against the original strain.

A

Antigenic variants

67
Q

Minor antigenic changes are (blank), major changes in HA and NA are termed (blank)

A

antigenic drift

antigenic shift

68
Q

What is antigenic drift due to?

A

accumulation of point mutations in the gene and sequence changes can alter antigenic sites on the glycoprotein

69
Q

Antigenic shift reflects (blank) changes in the sequence of the viral glycoproteins. What is the mechanism for this?

A

drastic changes

genetic reassortment b/w human and avian influenza viruses

70
Q

How does influenza virus spread?

A

from person to person by airborne droplets or by contact with contaminated surfaces

71
Q

What does the influenza virus do to the respiratory epithelium?
How long is the incubation period?

A

infects them, kills them and spreads to other cells

-1 to 4 days

72
Q

When is interferon detectable in respiratory secretions?

A

about 1 day post infection

73
Q

Antibody and cell mediated immunity for influenza is detectable in (blank) weeks

A

1-2

74
Q

In influenza, cellular destruction is widespread and therefore resistance to (blank) is common.
What ones in particular?

A

secondary bacterial infections

-staph, strep, and H. influenzae

75
Q

How is interferon turned on?

A

double stranded RNA, viral glycoproteins, bacterial LPS

76
Q

What does IFN do?

A

upregulates the amount of MHC that is displayed, signals for macrophages and neutrophils. Stops viral replication and warns neighboring cells that there is a virus around

77
Q

Routine annual influenza vaccination is recommended for all persons aged (blank)

A

greater than 6 months

78
Q

What are the three kinds of flu viruses commonly circulating among people today?

A

Influenza A (H1N1) viruses, Influenza A (H3N2) viruses, and influenza B viruses

79
Q

What rae the vaccine virus strains included in the 2014-2015 trivalent vaccine?

A

an A/California/7/2009 (H1N1)pdm09-like virus
an A/Texas/50/2012 (H3N2)-like virus
a B/Massachusetts/2/2012-like virus.
B virus (B/Brisbane/60/2008-like virus).

80
Q

What is this:
A 70-year-old women with a history of congestive heart failure is seen in January by her primary care physician with an abrupt onset of fever, cough, and myalgia that requires hospitalization. Two days later, she experiences increasing cough and shortness of breath. Chest X-ray reveals lung infiltrates.

A

Orthomyxovirus-Influenza virus

81
Q

(blank) is the most common cause of pneumonia and bronchiolitis in INFANTS

A

RSV

82
Q

Who are susceptible to getting pneumonia with RSV?

A

neonates, premature infants, infants with cardiopulmonary disease

83
Q

How is RSV transmitted?

A

via respiratory droplets

84
Q

What does RSV cause in adults?

In elderly?

A

common cold and bronchitis

pneumonia

85
Q

Infants with RSV have pronounced (blank) and ( blank)

A

cough and expiratory wheezing

86
Q

How do you detect RSV in the respiratory secretions?

A

Rapid antigen test

87
Q

(blank) is recommended for severely ill hospitalized infants.
How does it work?

A

Ribavirin

Stops viral RNA synthesis and viral mRNA capping (guanosine ribonucleic analog)

88
Q

(blank) with a monoclonal antibody directed against the fusion protein of RSV (palivizumab, Synagis) can be used for prophylaxis in premature or immunocompromised infants.

A

Passive immunization

89
Q

What are the surface spikes on RSV?

A

fusion proteins

90
Q

What will the fusion proteins on RSV cause?

A

cells to fuse and form multinucleated giant cells (synctia) (this is why we call it respiratory synctial virus)

91
Q

RSV causes outbreaks every (blank). Where does it occur? Who gets infected with it?

A

winter
worldwide
virtually everyone has been infected by age of 2-3

92
Q

RSV also causes outbreaks of respiratory infections in hospitalized (blank). Outbreaks can be controlled by (blank)

A

infants

hand washing and using gloves

93
Q

When infants and children are exposed to RSV for the first time, 25% to 40% of them have signs or symptoms of (blank or blank)

A

bronchiolitis or pneumonia

94
Q

A 6-week-old infant is brought to the pediatric clinic in respiratory distress. Physical examination is significant for diffuse expiratory wheezing and mild cyanosis. The chest X-ray is suggestive of bilateral pneumonia. The infant is admitted to the intensive care unit. Nasopharyngeal swab and nasopharyngeal washing are sent for culture and direct examination.

A

RSV

95
Q

What does parainfluenza virus cause in children?
What does it cause in adults?
How is it transmitted?

A

croup, laryngitis, bronchiolitis pneumonia in children

  • common cold
  • respiratory droplets
96
Q

What is the main cause of croup in children younger than 5 years old?

A

PIV 1 and 2

97
Q

Croup is characterized by a (blank) and (blank)

A

barking cough and hoarseness

98
Q

Parainfluenza virus also causes a variety of respiratory diseases such as the (blank X 6)

A

common cold, pharyngitis, laryngitis, otitis media, bronchitis, and pneumonia

99
Q

(blank) is seen in lower respiratory infections in children. Most infections are diagnosed (blank)

A

PIV 3

clincally

100
Q

The surface spikes consist of (blank) (blank) and (blank) on parainfluenza virus

A

HA (hemagglutinin), NA (neuraminidase), F (Fusion proteins)

101
Q

What does the fusion protein do on parainfluenza virus?

A

mediates the formation of multinucleated giant cells

102
Q

In parainfluenza virus, the (blank and blank) proteins are on the same spike; the F protein is on a (blank) spike

A

HA and NA

separate

103
Q

Parainfluenza virus causes and upper and lower respiratory tract disease without (blank)

A

viremia

104
Q

Antibody to either the HA or the F protein neutralizes (blank). Is there a vaccine or therapy available?

A

infectivity

no

105
Q

A 2-year-old child is brought to the emergency department by worried parents because of a barking cough and inspiratory stridor that got worse at night. The present illness began 2 days earlier with a fever, sore throat, rhinorrhea, and mild cough. Finding on examination include a temperature of 102oF, tachypnea, wheezing, and respiratory distress.

A

croup

Block 9 Week 4 (9 decks)

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