Influenza & RSV Flashcards
Define influenza
- highly contagious airborne disease
- acute febrile illness
Describe influenza viruses
- encapsulated, single-stranded RNA
- family Orthomyxoviridae
What are the most significant immunologic surface proteins of influenza?
- hemagglutinin (H)
- neuraminidase (N)
What is the function of the influenza surface proteins?
- determine virulence
What is the MOA of hemagglutinin?
- binds to respiratory cells allowing cellular infection
What is the MOA of neuraminidase?
- cleaves the bond that holds newly replicated virions in the cell surface, permitting the spread of infection
What allows for antigenic drift?
- poor error checking of viral RNA polymerase
Define antigenic drift
- inaccurate viral RNA polymerase produces point mutations in error-prone gene regions
Define antigenic shift
- genes resorted between 2 strains
What is the presentation of influenza
- very abrupt
- fever/chills
- sore throat
- H/A
- ptosis
- myalgias
- URI type
What are complications of influenza?
- PNA/2ndary bacterial PNA
- myositis
- myocarditis
- pericarditis
What is the workup for influenza?
- viral culture
- rapid diagnostic test
- PCR
- serologic testing
What is the tx for influenza?
- antiviral drugs
- isolation
- vaccines
Define bronchiolitis
- lower airway (bronchioles) viral infection
What is the etiology of bronchiolitis?
- MC: RSV
What is the incubation period for bronchiolitis?
- 1-2d
- not uncommon s/p well child visit
What are the S&S of bronchiolitis?
- fever
- rhinorrhea
- cough
- white frothy d/c
What is seen on PE of bronchiolitis?
- wheezing
- tachypnea
What diagnostics can be ordered for bronchiolitis?
- CXR (variable) will demonstrated hyperinflation
T/F: Bronchiolitis is highly communicable.
- True ==> hand hygiene!
What is the tx for bronchiolitits?
- observation
- supplemental O2
- parenteral fluids
- ? bronchodilators/steroids
How is bronchiolitis prevented?
- hand hygine
What is the leading cause of lower respiratory tract infections in infants and young children?
- RSV (respiratory syncytial virus)
What are the S&S of RSV?
- low grade fever
- cough
- tachypnea
- cyanosis
- retractions
- wheezing
- apneic episodes
- not eating or sleeping
- profuse white, watery d/c
What is a staccato cough associated with?
- Chlamydia trichoma
What diagnostic tests can be done for RSV?
- CBC
- pulse ox
- culture/ antigen testing/PCR
What is the tx of RSV?
- supportive care
- steroids
- bronchodilators
- alpha agonists
- racemic Epi
- ribavirin
- palivizumab
Treating young children with pertussis with _____ has a risk of _______ _______.
- macrolides
- hypertrophic pyloric stenosis
Cough w/o fever for couple weeks, now vomiting after early morning cough. Diagnose & tx me!
- pertussis
- macrolides
14 y/o w/ disruptive, frequent daytime barking nonproductive cough, no fever cough is not heard at night. PE?
- probably nothing
- quiet expiratory phase
Toddler awoke barking, struggling to catch her breath, mild fever, stridor & cough resolved on the drive to ER. CXR shows steeple sign. What am I and what is the tx?
- croup
- cool moist air, dexamethasone when very bad
How do you treat Mycoplasma pneumonia?
- macrolides
