Mehlman Influenza, COVID, vaccine table pulmo 11-04 (1)

Question 1

Influenza. CP 3 main?

Answer 1

Causes respiratory distress, fever, and myalgias (muscle pain)

Question 2

Influenza. What HY CP?

Answer 2

For USMLE purposes, the myalgias are exceedingly HY as a vignette finding that usually suggests the flu over other diagnoses.

Question 3

Influenza. virus has what structure?

Answer 3

Has 8 segments, two of which are hemagglutinin and neuraminidase.

Question 4

Influenza. what does hemagglutinin?

Answer 4

Hemagglutinin mediates viral attachment to the cell by enabling its binding at sialic acid receptors

Question 5

Influenza.
If a question asks about the molecule most flu vaccines are targeted against, the answer is ?

Answer 5

hemagglutinin

Question 6

Influenza. Neuraminidase function?

Answer 6

Neuraminidase allows for newly synthesized viral particles to leave the host cell. This enzyme cleaves sialic acid residues, which normally bind the new viral particles within the cell. Once these residues are cleaved, the viral
particles can leave the cell.

Question 7

Influenza. Drugs such as oseltamivir and zanamivir mechnism?

Answer 7

sialic acid analogues that function as neuraminidase competitive inhibitors.

In other words, they
prevent the virus from leaving the cell. If the USMLE asks which drug prevents viral spread within a community, or they tell you a drug is given and now host
cells are “packed with virions” (because they can’t leave the cell), the answer is one of the -mivirs.

Question 8

Influenza. what is antigenic drift?

Answer 8

Antigenic drift is point mutations in hemagglutinin and/or neuraminidase, where the virus has changed slightly. It leads to seasonal epidemics.

Question 9

Influenza. what is antigenic shift?

Answer 9

Antigenic shift is due to two influenza viruses entering a cell, one of human origin, the other of animal origin (such as bird or swine), where they engage in reassortment of viral segments, leading to a completely novel influenza virus. It leads to generational pandemics

Question 10

Influenza. Patient gets a bacterial lobar pneumonia following recent convalescence
from influenza infection, mos?

Answer 10

S. aureus yra HY.

neduos s. aureus ir s. pneumo kartu tarp pasirinkimo variantu.

Question 11

Influenza.
They’ll say something about how a guy recently recovered from a viral illness in which he had high fever and myalgias, and now he has a pneumonia caused by a gram-positive coccus in clusters –>
answer = S. aureus.

In contrast, S. pneumo is gram-positive diplococci.

Answer 11

.

Question 12

Influenza.
IM killed vaccine. When?

Answer 12

Start age 6 months, then give yearly in the fall or winter throughout life; safe to give during pregnancy.

Question 13

Influenza.
IM killed vaccine.
Pregnancy?

Answer 13

safe to give during pregnancy.

Question 14

Influenza.
Intranasal live attenuated vaccine. age. in what population?

Answer 14

ages 2-45; immunocompetent, nonpregnant persons only

Question 15

Influenza.
Intranasal live attenuated vaccine. pregnancy?

Answer 15

nonpregnant persons only

Question 16

COVID.

Has characteristic spike proteins that create a crown-like appearance on electron microscopy.

The spike proteins bind to ACE2 receptor, allowing for viral fusion with host respiratory epithelium.

Answer 16

.

Question 17

COVID. CP?

Answer 17

Presentation can range from mild respiratory symptoms similar to the
common cold (rhinovirus) all the way to severe respiratory disease with multiorgan failure.

Question 18

COVID.

Many different vaccine types exist - i.e., mRNA (Moderna; delivers mRNA coding for the spike protein),

viral vector (AstraZeneca; delivers mRNA in a harmless viral capsid),

and killed (Sinovac; delivers inactivated, killed virus)

Answer 18

.

Question 19

COVID. vaccines adverse?

Answer 19

Both live viral infection as well as vaccination are known to cause rare
adverse effects, such as Bell’s palsy and myocarditis, although these effects are not unique to coronavirus and can rarely happen with many viral infections and vaccines.

Question 20

COVID. vaccine for kids?

Answer 20

Vaccination schedule for children now recommends IM vaccine starting at 6 months; 2-3-doses.

Question 21

Vaccine table.
S. pneumo.
PCV15, age? 4

Answer 21

at 2, 4, 6 months, then again 12-15 months

Question 22

Vaccine table.
at 2, 4, 6 months, then again 12-15 months.
what vaccine?

Answer 22

S. pneumo.
PCV15

Question 23

Vaccine table.
Age >=65.
What s. pneumo vaccine if once?

Answer 23

PCV20 once

Question 24

Vaccine table.
Age >=65.
What s. pneumo vaccine if two?

Answer 24

PCV15 then PPSV23 a year later.

Question 25

Vaccine table.
For asplenia/surgical splenectomy, sickle cell, cochlear implant, CSF leak, chronic renal failure/nephrotic syndrome, HIV, and immunosuppressed
patients:
Vaccination?

Answer 25

extra dose of PCV15, followed by PPSV23 8+ weeks later.

Question 26

Vaccine table.
Influenza.
IM killed vaccine age? pregnancy?

Answer 26

IM killed vaccine: start age 6 months, then give yearly through life; safe
to give during pregnancy.

Question 27

Vaccine table.
Influenza.
Intranasal live-attenuated. age, pregnancy?

Answer 27

ages 2-45; immunocompetent, non-pregnant persons.

Question 28

Vaccine table.
Influenza.
coronavirus. age, doses?

Answer 28

IM vaccine starting at 6 months; 2-3-doses.