L10 Respiratory Tract Infections: Influenza and Chlamydia

Question 1

Causes of ARD

Answer 1

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

Question 2

Rhinovirus season

Answer 2

endemic and winter

Question 3

Relationship between cold weather and URI

Answer 3

NO direct causation

Question 4

Rhinoviruses transmission

Answer 4

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

carrier state likely

Question 5

rhinovirus immunity

Answer 5

transient, 18 months

Question 6

Acute flaccid myelitis

Answer 6

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

Question 7

Acute flaccid myelitis symptoms

Answer 7

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

Question 8

Species of influenza and what defines them

Answer 8

A B C

Their nucleocapsid proteins

Question 9

Influenza A

Answer 9

the worst influenza

Question 10

Influenza B

Answer 10

also causes epidemics

Question 11

Influenza C

Answer 11

weak strain

Question 12

Antigenic subtypes of influenza are defined by

Answer 12

envelope proteins

large numbers are known

Question 13

Hemagglutinin

Answer 13

H antigen

Viral attachment

Question 14

Neuraminidase

Answer 14

N antigen

Viral penetration and release from infected cells

Question 15

How is an influenza virus named

Answer 15

Type/Location of Discovery/Year/Antigenic type

Ex: A/Spanish/18/HswN1`

Question 16

influenza incubation

Answer 16

SHORT
1-2 days
very abrupt onset of sx

Question 17

influenza symptoms

Answer 17

fever
aches
chills
cough

Question 18

influenza duration

Answer 18

illness for 1 week with long convalescence

Question 19

Complications of Infuenza

Answer 19

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

Question 20

causes of secondary bacterial pneumonia from influenza

Answer 20

Streptococcus pneumoniae
Staphylococcus aureus
Haemophilus influenzae type B (Hib)

Question 21

Reyes syndrome

Answer 21

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

Question 22

Guillain Barre syndrome

Answer 22

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

Question 23

Recent cause of Guillain Barre syndrome

Answer 23

1976 swine flu vaccine

Question 24

influenza rapid antigen tests problems

Answer 24

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

Question 25

when to vaccinate against the flu

Answer 25

october, before the typical flu season begins

Question 26

Flu vaccines are

Answer 26

multivalent

Question 27

2 forms of the flu vaccine

Answer 27

``` Inactivated Live attenuated (flumist) ```

Question 28

elderly patients get a flu shot which is

Answer 28

high potency and adjuvanted form

Question 29

Flu shots are given

Answer 29

intradermal

Question 30

Nomenclature shift in flu shots

Answer 30

TIV to IIV (inactivated influenza vaccine)

Question 31

Quadrivalent influenza vaccine

Answer 31

2 type A viruses and 2 type B viruses

Question 32

flu shots for children under 9 years old

Answer 32

2 administrations given

Question 33

the flu shot has reports of

Answer 33

post-vaccine illness and adverse events

Question 34

how are flu vaccines grown

Answer 34

in embryonated chicken eggs

Question 35

problems with embryonated chicken egg vaccine production

Answer 35

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?

Question 36

influenza vaccine target groups

Answer 36

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)

Question 37

point mutations of H or N antigens | minor variation

Answer 37

Antigenic drift

Question 38

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

Answer 38

Antigenic shift

Question 39

Influenza type A forms

Answer 39

endemic, epidemic, or pandemic | not predictable which it will be

Question 40

influenza in infants

Answer 40

rare in infants <1 year old

Question 41

Pandemics are

Answer 41

unpredictable

Question 42

2009 flu was

Answer 42

Swine flu pandemic emerged out of mexico | H1N1

Question 43

Influenza-disease-promoting situations

Answer 43

human use of animals and animal products

Question 44

The chlamydiae

Answer 44

Chlamydia trachomatic | Chlamydia pneumoniae

Question 45

considered somthing between true bacteria and viruses

Answer 45

The chlamydiae

Question 46

The chlamydiae life cycle

Answer 46

obligate intraacellular parasites that depend on host ATP | 2 forms: EB and RB

Question 47

Elementary body form

Answer 47

infectious, nongrowing form of chlamydia responsible for dispersal

Question 48

Reticular body form

Answer 48

growing/vegetative form of chlamydia

Question 49

C trachomatis

Answer 49

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

Question 50

induction of reiter's syndrome after infection with

Answer 50

C trachomatis

Question 51

infant pneumonia

Answer 51

C trachomatis

Question 52

serovars of C trachomatis are based on

Answer 52

major outer membrane proteins (MOMP)

Question 53

serovars of C trachomatis that cause infant pneumonia

Answer 53

B Ba D E F G H I J K

Question 54

C pneumoniae

Answer 54

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

Question 55

how to detect C pneumoniae

Answer 55

culture PCR Fluorescent antibody

Question 56

C pneumoniae aka

Answer 56

TWAR

Question 57

microbe associated with atherosclerosis

Answer 57

C pneumoniae

Question 58

influenza complications arise due to

Answer 58

viral destruction of mucociliary escalotory system "sets the stage"

Question 59

Rimantadine, Amantadine

Answer 59

Type A only: stops uncoating/penetration | Use stopped due to resistance

Question 60

Oseltamivir, Zanamivir, Peramivir

Answer 60

Neuraminidase inhibitors for type A and B

Question 61

adverse effects of the flu vaccine

Answer 61

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

Question 62

allows type A influenza to cause pandemics by creating novel forms

Answer 62

segmented genome

Question 63

2017-2018 flu

Answer 63

H3N2

Question 64

bird flu

Answer 64

H5N1

Question 65

infant influenza

Answer 65

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