L80

Question 1

What viruses cause the common cold?

Answer 1

1. Rhinovirus
2. Corona (MERS)
   Adeno
   Entero
   Parainflu, flu, RSV, metapneumo

Question 2

Rhinovirus:
DNA or RNA?
Be sure to include specifics

Answer 2

Rhinovirus

+ ssRNA

Question 3

What are characteristics that rhinovirus requires for optimal growth?

Answer 3

Cooler temps!

Nose > lungs

Question 4

Rhinovirus attaches to host cells via….

Answer 4

ICAM 1

Question 5

How does rhinovirus cause the symptoms of rhinitis & sore throat?

Answer 5

↑bradykinin –> ↑vasc perm of nasal submucosa

↑local PMNs

Question 6

Does the common cold present with fever?

Answer 6

NO

Question 7

Which disease presents in kids with a “barking cough”? Name the virus most likely to cause it.

Answer 7

Croup = acute laryngo-tracheo-bronchitis

Parainflu

Question 8

What age group do you expect croup in?

Answer 8

0-6 yo

Question 9

Parainflu:
DNA or RNA?
Include specifics

Answer 9

• ss RNA

Question 10

How does influ cause the croup cough? What unique sign are you looking for?

Answer 10

Inflammation –> narrow trachea

Steeple sign on XR

Question 11

Test for parainflu

Answer 11

Nash wash:

• Viral culture
• Immunofluoro
• PCR

Question 12

Treat croup

Answer 12

Supportive

Question 13

What disease presents with infant wheezing –> ↓oxygenation? Viral causes.

Answer 13

Bronchiolitis
1. RSV
2. Metapneumo
Rhino, influ, parainflu, corona

Question 14

RSV
DNA or RNA
Be specific

Answer 14

• ss RNA

Question 15

What outer proteins are unique to RSV? How does RSV change host cell morphology?

Answer 15

F protein = fusion
Syncitia formation = fusion of multiple cells
Leads to inflam + necrosis -> small airway obstruction -> bronchiolitis

Question 16

When does bronchiolitis peak?

Answer 16

WINTER

Question 17

Diagnose bronchiolitis

Answer 17

CXR - steeple sign

Pulse ox - ↓↓

Question 18

Who and what do you use for bronchiolitis prophylaxis?

Answer 18

Premies = ↑risk
Palivizuman = monoclonal Ab

Question 19

Which viral resp infection should you be particularly concerned about in ELDERLY?

Answer 19

Flu!!!
B/c U shaped mortality/morbidity curve
↑ hospitalization and death in the elderly

Question 20

Flu: DNA or RNA - be specific

Types?

Answer 20

• ss RNA
  *segmented genome
  Types A-C
  A & B cause illness and outbreak

Question 21

What are the 2 targets of the flu vaccine?

Answer 21

HA

NA

Question 22

What in unique about flu release in host cells?

Answer 22

ACIDIC

Via M2 creating proton pumps to acidify the endosome

Question 23

Is flu epidemic caused by genetic drift or shift?

Answer 23

DRIFT = random mutations from RNA pol

Why we update the flu vaccine every year

Question 24

Is flu pandemic due to genetic drift or shift?

Answer 24

SHIFT = reassortment that creates brand new virus
The vaccine won’t help you year
Ex: H1N1 - hit young people b/c vaccine didn’t cover + older people probably had some existing immunity from prior year strain

Question 25

What 2 bugs would cause a retro-orbital headache?

Answer 25

Flu

Dengue Fever

Question 26

2 tests for flu - include pros and cons of each

Answer 26

Rapid antigen test
- Pro = fast
- Con = can’t get subtypes
PCR

Question 27

What 3 drugs can you use to block the the spread of flu (aka not the vaccine)?

Answer 27

NA inhibitors: - “mivir”
Oseltamivir
Zanamivir
Peramivir

Question 28

What mutation makes flu resistant to NA inhibitors?

Answer 28

H275Y = mutation in the NA gene