Randoms Flashcards
50 y/o - complains of chills all over - has a temp and low WBC. Nasal swab positive to influenza A virus. What is treatment? What is recommended for prophylaxis?
Oseltamivir
tx has been shown to decrease the duration of sx by 1-2 days - if given within first 48 hours
Acyclovir
Herpes S Virus
Ganciclovir/Valganciclovir treats what?
CMV
MOA of oseltamivir?
blocks release of new influenza A and B viruses
Neuraminidase catalyzes hydrolysis of sialic acid residues from newly formed virions and host cell receptors, allowing virions to be released from the infected cell.
MOA: neuraminidase inhibitor active against influenza A and B. Neuraminidase inhibitor blocks the release of new influenza A and B virions.
MOA of rimantadine and amantadine?
prevent the penetration of influenza A (not B) virus into the host cell
most common SE of oseltamivir?
diarrhea - GI sx
also see neuropsychiatric changes
3 mos old infant, fever, difficulty feeding, thick nasal discharge, baby appears to stop breathing when feeding, baby was premature with CHD. Ddx?
thinking RSV - suspect in patients <12 mos of age (winter season)
Can ddx viruses through PCR technique
tx: supportive care - can use albuterol or epi if the patient is wheezing.
only use ribavarin in life threatening situations
52 y/o male who just had a kidney transplant, ESRD secondary to DMII. Why is this pt. receiving trimethoprim/sulfamethoxazole? What is NOT an alternative drug of choice for patient with sulfa allergy?
Bactrim is used for the tx of PCP - used for PCP prophylaxis for those that are immunocompromised - this pt. is being given immunosuppresants
PCP is a fungus that causes pulmonary disease in immunocompromised hosts - PCP was 75% of lung transplant recipients before use of Bactriim
What is not an alternative PCP prophylaxis in pts with sulfa allergies? Itracanazole
alternatives: atovaquone, dapsone, inhaled pentamidine
why use valganciclovir?
to prevent CMV
acyclovir?
antiviral for HSV and VZV
valacyclovir?
antiviral for HSV and VZV
33 y/o male, presents to office with complaint of painful rash on left back and chest. Has pain/burning/tingling - what is etiology of pts rash and sx? preventable through? what would you prescribe?
Varicella Zoster virus - VZV
- spread through respiratory droplets: most likely infected as a child with chx pox
- prevented through vaccine of adults through VZV - recommended for adults over age of 60
- CI’s of vaccine: patients that are IC, neoplasma, AIDS/HIV
tx: acyclovir - has low bioavailability and thus needs to be dosed often
9 y/o male, presents to ER with fever, cough, difficulty breathing - rash on face to body - throat shows small red spots with blue/red centers. Ddx?
Measels virus = rubeola
- small red spots with blue centers = “Koplik Spots”
- spread through respiratory droplets
3 C’s: cough, coryza, conjunctivitis
- 4 days before onset of rash, to 4 days after rash appears is how long child will be infectious for
complications: pneumonia, post infectious encephalomyelitis, diarrhea, subacute sclerosing panencephalitis
disease prevented through MMR - live attenuated vaccine
16 y/o male with fever, h/a, malaise, facial swelling for three days. pain in testicles. - see facial swelling and testicular swelling? ddx?
ddx is Mumps - see parotitis and orchitis
transmission through respiratory droplets
prevention through MMR vaccine
54 y/o nurse with abrupt onset of fever, chills, myalgias, h/a’s, elevated temp - sx progress to SOB, nausea, c/p, decreased urination - see maculopapular rash and conjunctival hemorrhage - low platelets, elevated AST/ALT, PT and PTT are prolonged, Fibrin are elevated
ddx: patient has DIC - see elevated PTT, fibrin degradation products —- Ebola
Viral ssRNA virus - “hemorrhagic fever”: primates infected with ebola were sent to Germany and the researchers were infected
see coagulation defects, capillary leak syndrome, shock
transmission: ingestion, inhalation, breaks in skin (urine, saliva, tears, blood) - droplet inoculation of virus into mouth or eyes
onset of sx occurs 8-12 days and sx range from 2-21 days with nonspecific flue like illness
