Long-URTi Flashcards
What is the etiology for uRTI?
Involves Cole and Flu viruses
Irises are believed to account for up to _____ of cases of acute respiratory infections
3/4 cases
What are the viruses that causes common cold?
Graph on D15 pre work page 3
What is most frequent cause of colds?
Adenovirus causes rhinorrhea (Runny virus)
Describe the pathogenesis of Rhinovirus.
The virus infiltrates the host cells via endocytosis; infection stimulates the release of cytokines that give rise to the signs/symptoms of rhinovirus-induced colds.
How is Rhinovirus manifested?
Common cold, Sore throat, Cough w/ mucus production.
Describe the pathogenesis of Coronavirus.
Upon inhalation SARS-CoV-2 binds to respiratory cells via viral structural spike (S) protein and ACE2 receptor.
Acute Respiratory Distress (ARD) is associated with reduced ACE2 receptor expression and accumulation of Angiotensin 2 (pro-inflammation)
What are some of the antivirals used for Coronavirus?
Nirmatrelvir/ritonavir (Oral)
Remdesivir (IV)
what is inhibited by Nirmatrelvir?
Protease
Ritonavir is a ______ inhibitor.
CYP3A4
Why is a booster useful for COVID?
Booster blocks liver metabolism of Nirmatrelvir
What prodrug is used for Coronavirus?
Remdesivir (Veklury)
What happens to Remdisivir after prodrug activation?
changes into Remdesivir triphosphate which disrupts viral RNA replication
What are diseases caused by Adenovirus?
Pneumonia, Cytitis
How is Adenovirus spread?
Via Respiratory droplets and fecal matter
What are the diseases caused by Parainfluenza Virus?
Bronchiolitis, Pneumonia and Croup
How can you describe Croup? What is it cause by?
Loud cough that resembles the seal barking (Stridor). It is caused by Parainfluenza
What does Infuenza virus causes? what type of species it effects?
Seasonal flu; a pulmonary disease of warm-blooded birds and mammals
Major causes of the Flu in humans is the influenza A virus
What is Influenza virus comprised of?
Viral Genome
what is the role of Proteins in Influenza virus?
RNA is stabilized by Proteins (Nucleoprotiens)
What one protien and an enzyme embedded on the surface area of Influenza virus?
Hemagglutinin (H), Neuraminidase
What are common strains of Influenza Virus?
A subtypes H1N1 and H3N2
How is influenza virus transmitted?
Aerosolized respiratory secretions
Why do we have to get new vaccines for Influenza every year?
Virus Undergoes Spontaneous mutations (antigenic drift)
H proteins contains 5 epitopes that are sued for recognition during anti-body mediated immune response.
Changes in the amino acids sequence within the epitopes of H due to antigenic drift require a new flu vaccine each year.
Describe the pathogenesis of Influenza virus (Virus binding)
Viruses preferentially bind via hemagglutinin (H) to sialic acid on the surface of human respiratory epithelial cells. Also infects macrophages
In what shape does Influenza virus leaves the infect cell?
Virus leaves the cell via budding
What facilitates the exit of Virus budd?
Neuraminidase (N)
What prevents bacteria from entering into the lungs?
Destruction of mucoepthilial lining prevents the secretion of mucus which is important in preventing bacteria from infiltrating the lungs —-> leads to secondary bacterial pneumonia
How is Influenza virus manifested?
Fever, Dry cough, Deaths are often caused by complications such as pneumonia and secondary bacterial infections.
Secondary bacterial pneumonia how does bacteria get access to lower respiratory tract?
the mucocilliary escalator has been impaired by the virus
What is the oral agent for Influenza A?
Rimantadine
what is the MOA of Rimantadine?
Inhibit the ability of the influenza virus to uncontrollable at during endocytosis of host cells
What is the Adverse reaction of Rimantadine?
CNS toxicity
What is the Aerosolized product that is an anti-influenza agent with activity against both influenzas A and B?
Zanamivir (Relenza)
MOA of Zanamivir?
Inhibitor of neuraminidase enzymes used during viral shedding
What is an Adverse reaction of Zanamivir? does it have good oral absorption?
Bronchospasms; No
How is Zanamivir administered?
Comes in blister pack to use with a disc inhaler device
What is an oral agent used for Influenza A and B?
Oseltamivir
What is the brand name of Oseltamivir?
Tamiflu
What is Oseltamivir approved for by FDA?
Treatment for acute influenza A and B illness who have not been symptomatic for >48hrs;
What’s the MOA of Oseltamivir?
Inhibitor of neuraminidase enzymes used during viral shedding.
How is RSV spread?
Respiratory Secretions
Who is more likely to get RSV?
incidence highest among infants
How is RSV manifested?
bronchiolitis, croup
What’s the Prophylaxis of RSV?
Aerosolized ribavirin delivered by nebulizer;
Palizumab (humanized monoclonal antibody that blocks RSV binding to epithelia cells)
MOA for Ribavirin?
interferes with viral RNA synthesis
Adverse reaction of Ribavirin?
Hemolytic anemia
Whats the difference between Inhalation form vs oral?
Inhalation has longer half life than oral form
What is another name that measels is known as?
Rubeola
What vaccine is used for Measles?
MMR vaccine
How is measles transmitted?
Respiratory secretions
How is Measles manifested?
Maculopapular rash (Koplik’s Spots)
What’s the other name of Rubella?
German measles virus
How is Rubella transmitted?
Respiratory secretions
How is rubella manifested?
Milder then Rubeola (3 days measles), Maculopapular rash
What do Mumps causes?
Causes painful swelling of the salivary glands (parotid)
How is Mumps transmitted?
Respiratory Secretion
What vaccine protects against Mumps?
MMR
What causes Slapped cheeks syndrome?
Parovirus, infects erythrocytes
How is slapped syndrome transmitted?
Respiratory secretions
Manifestation of Slapped cheek syndrome
Facial erythema
What is Otitis Media?
Inflammation of the middle ear mucosa
What causes Acute Otitis Media?
S. pneumoniae, M. catarrhalis, H. Influenzae
Best prevention method for Acute Otitis Media?
Vaccination against S. pneumoniae and H. Influenzae
Viral uRTIs could cause what?
swelling and mucosa blocking the eustachian tube
How are children more prone to uRTIs?
they have shorter and straighter eustachian tubes —> more prone to ear infections
What is Acute Rhinosinusitis?
Sinusitis = inflammation of the nasal sinus mucosa
What is Primary infection of Acute Rhinisinusitis cause by?
Respiratory virus
What is secondary infection of Acute Rhinisinusitis cause by?
bacteria
When is uRTIs considered complicated?
In secondary bacterial sinusitis
Pathophysiology of Acute Rhinosinusitis?
Viral infection of the nasal mucosa spreads to the sinuses.
Mucosal edema leads to sinus blockage. Micro flora proliferates
What is Epiglottitis?
Inflammation of Epiglottis
What causes Epiglottitis cause by?
H. Influenzae (Hib)
What could happen if Epiglotittis swelling gets worse?
Obstruct breathing
How is Epiglotittis manifested?
Blush skin (cyanosis); X-ray shows “thumbs up” sign
What is Acute Pharyngitis?
an acute infection (usually viral)
What is the most common type of Pharyngitis?
Streptococcal Pharyngitis (Strep Throat) more frequent in children
What complications could Phyringitis cause?
Scarlet fever, rheumatic fever
What are some of the etiologies of Pharyngitis?
respiratory viruses cause most cases of acute pharyngitis
What virus causes Pharyngitis?
Rhinovirus
What bacteria causes Pharyngitis?
S. progenies (GAS = strep throat)
How micro-organisms are transmitted?
Airborne respiratory secretions
pathophysiology of Pharyngitis
Breach in pharynx mucosa (by viral infection) allow micro flora S. pyogenes to infiltrate and damage oropharyngeal epithelia
What is Scarlet fever?
Complication of strep throat
What bacteria causes Scarlet fever?
S. Pyogenes (GAS)
How is Scarlet fever manifested?
Pharyngitis Strawberry tongue, Scarlet-colored rash
What causes Diphtheria?
Corynebacterium diphtheriae
Where does Corynebacterium diphtheriae lives?
in mouth
How are Corynebacterium diphtheriae transmitted?
Respiratory secretions
How are Corynebacterium diphtheriae manifested?
Pharyngitis, Bull neck lymphadenopathy
What vaccine is used for Diphtheria?
DTaP vaccine
What is Pertussis?
Whooping cough
What causes pertussis?
Bordetella pertussis
What lead to development of Tdap booster vaccines?
Increase rate of pertussis in adults due to waning immunity
How is Pertussis transmitted?
respiratory secretions
How is Pertussis manifested?
Bronchitis (pertussis), repetitive dry cough with a whoop sound
What vaccine protects against Pertussis?
DTaP vaccine (primary) and Tdap (Pertussis booster)
What is Conjunctivitis?
Inflammation of the conjunctiva
What is most common type of Conjunctivitis?
Viral Conjunctivitis and is highly contagious
Purple t pus conjunctivitis suggests what? Nonpurulent?
Purulent: bacterial
Non purulent: viral or allergic
