L10 Respiratory Tract Infections: Influenza and Chlamydia Flashcards

1
Q

Causes of ARD

A

Rhinoviruses (25%)
Coranoviruses (10%)
Adenoviruses + unknown viruses (30-40%)

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2
Q

Rhinovirus season

A

endemic and winter

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3
Q

Relationship between cold weather and URI

A

NO direct causation

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4
Q

Rhinoviruses transmission

A

Aerosol
person-to-person by HANDS
Fomites: stable, persist in environment

carrier state likely

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5
Q

rhinovirus immunity

A

transient, 18 months

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6
Q

Acute flaccid myelitis

A

weakness/paralysis similar to poliovirus
cases started in 2014, mostly children
viral etiology suspected

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7
Q

Acute flaccid myelitis symptoms

A
difficulty moving eyes
drooping eyelids
facial droop/weakness
difficultly swallowing
slurred speech
sudden arm/leg weakness
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8
Q

Species of influenza and what defines them

A

A B C

Their nucleocapsid proteins

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9
Q

Influenza A

A

the worst influenza

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10
Q

Influenza B

A

also causes epidemics

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11
Q

Influenza C

A

weak strain

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12
Q

Antigenic subtypes of influenza are defined by

A

envelope proteins

large numbers are known

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13
Q

Hemagglutinin

A

H antigen

Viral attachment

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14
Q

Neuraminidase

A

N antigen

Viral penetration and release from infected cells

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15
Q

How is an influenza virus named

A

Type/Location of Discovery/Year/Antigenic type

Ex: A/Spanish/18/HswN1`

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16
Q

influenza incubation

A

SHORT
1-2 days
very abrupt onset of sx

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17
Q

influenza symptoms

A

fever
aches
chills
cough

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18
Q

influenza duration

A

illness for 1 week with long convalescence

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19
Q

Complications of Infuenza

A

Pneumonias (primary, or secondary bacterial)
Reyes syndrome
Guillain barre syndrome

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20
Q

causes of secondary bacterial pneumonia from influenza

A

Streptococcus pneumoniae
Staphylococcus aureus
Haemophilus influenzae type B (Hib)

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21
Q

Reyes syndrome

A

associated with many viral infections
influenza A/B or chickenpox in peds patients on long term ASA therapy
edematous encephalitis + fatty alteration of liver

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22
Q

Guillain Barre syndrome

A

demyelination that sometimes (40%) results from a viral infection, otherwise cause unknown

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23
Q

Recent cause of Guillain Barre syndrome

A

1976 swine flu vaccine

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24
Q

influenza rapid antigen tests problems

A

false negatives early in the course of the disease due to low antigen levels

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25
Q

when to vaccinate against the flu

A

october, before the typical flu season begins

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26
Q

Flu vaccines are

A

multivalent

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27
Q

2 forms of the flu vaccine

A
Inactivated
Live attenuated (flumist)
28
Q

elderly patients get a flu shot which is

A

high potency and adjuvanted form

29
Q

Flu shots are given

A

intradermal

30
Q

Nomenclature shift in flu shots

A

TIV to IIV (inactivated influenza vaccine)

31
Q

Quadrivalent influenza vaccine

A

2 type A viruses and 2 type B viruses

32
Q

flu shots for children under 9 years old

A

2 administrations given

33
Q

the flu shot has reports of

A

post-vaccine illness and adverse events

34
Q

how are flu vaccines grown

A

in embryonated chicken eggs

35
Q

problems with embryonated chicken egg vaccine production

A
  1. allergies to eggs
  2. production problems
  3. viruses adapt to eggs and no longer match circulating forms
  4. what if all chickens die of bird flu?
36
Q

influenza vaccine target groups

A
  1. > 65 years old
  2. nursing homes
  3. chronic pulmonary or cardiovascular system disorders
  4. asthma
  5. chronic diseases/immunosuppression: DM, renal, hemoglobinemias
  6. Peds patients on long term ASA therapy (risk for Reye’s syndrome)
37
Q

point mutations of H or N antigens

minor variation

A

Antigenic drift

38
Q

recombination involving entire genome segments encoding H or N gene within virion
implies that mixed infections occur

A

Antigenic shift

39
Q

Influenza type A forms

A

endemic, epidemic, or pandemic

not predictable which it will be

40
Q

influenza in infants

A

rare in infants <1 year old

41
Q

Pandemics are

A

unpredictable

42
Q

2009 flu was

A

Swine flu pandemic emerged out of mexico

H1N1

43
Q

Influenza-disease-promoting situations

A

human use of animals and animal products

44
Q

The chlamydiae

A

Chlamydia trachomatic

Chlamydia pneumoniae

45
Q

considered somthing between true bacteria and viruses

A

The chlamydiae

46
Q

The chlamydiae life cycle

A

obligate intraacellular parasites that depend on host ATP

2 forms: EB and RB

47
Q

Elementary body form

A

infectious, nongrowing form of chlamydia responsible for dispersal

48
Q

Reticular body form

A

growing/vegetative form of chlamydia

49
Q

C trachomatis

A

perinatal respiratory infections: infant pneumonia 3 weeks after birth, rhinitis followed by cough, transmitted by mother

50
Q

induction of reiter’s syndrome after infection with

A

C trachomatis

51
Q

infant pneumonia

A

C trachomatis

52
Q

serovars of C trachomatis are based on

A

major outer membrane proteins (MOMP)

53
Q

serovars of C trachomatis that cause infant pneumonia

A

B Ba D E F G H I J K

54
Q

C pneumoniae

A

recognized as a unique species
single serovar
bronchitits, pneumonia, sinusitis

55
Q

how to detect C pneumoniae

A

culture
PCR
Fluorescent antibody

56
Q

C pneumoniae aka

A

TWAR

57
Q

microbe associated with atherosclerosis

A

C pneumoniae

58
Q

influenza complications arise due to

A

viral destruction of mucociliary escalotory system “sets the stage”

59
Q

Rimantadine, Amantadine

A

Type A only: stops uncoating/penetration

Use stopped due to resistance

60
Q

Oseltamivir, Zanamivir, Peramivir

A

Neuraminidase inhibitors for type A and B

61
Q

adverse effects of the flu vaccine

A

pain at site of injection, “flu-like syndrome”

62
Q

allows type A influenza to cause pandemics by creating novel forms

A

segmented genome

63
Q

2017-2018 flu

A

H3N2

64
Q

bird flu

A

H5N1

65
Q

infant influenza

A

very rare in <1 year of age, but disproportionately severe