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Respi > Respi tract viruses > Flashcards

Respi tract viruses Flashcards

1
Q

Structure of influenza virus

A

Envelope
- lipoprotein
- covered w/ radially-projecting glycoprotein surface projections

Neuraminidase -> cleaves neuraminic acid receptors to allow virus release

Nucleocapsid
- type specific antigenicity -> influenza A,B,C
- RNA

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2
Q

Features of the radially-projecting glycoprotein surface projections

A

Haemagglutinin

Spikes for virus attachment to host cells -> specific for respi tract receptors

Antigenic variation

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3
Q

Clinical features of influenza

A

Incubation period -> 1-4 days

Abrupt onset of fever, myalgia, malaise, headache

Rhinorrhoea, sneezing

Sore throat, dry cough

Viral multiplication in respi epithelium w/ desquamation and ciliary damage

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4
Q

Complications of influenza virus infection

A

Pneumonia
- pri viral -> respi failure
- sec bacterial after damage of bronchial mucosa -> a lot of inflammation and excessive mucus production -> affect gaseous exchange

Myocarditis

Myositis

Reye’s syndrome

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5
Q

Common cause of sec bacterial pneumonia

A

S. pneumoniae

H. influenzae

S. aureus

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6
Q

Features of Reye’s syndrome

A

Usually associated w/ influenza B and aspirin intake in children

Cerebral oedema

Fatty degeneration -> liver

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7
Q

Lab diagnosis for influenza

A

Virus isolation

IF of antigen in respi epithelial cells

RT-PCR

Point-of-care (POC) test

Serology -> not commonly done

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8
Q

What are the various antigen structures of influenza?

A

Souluble/’s’ antigen
- same antigen shared by all influenza A viruses

Haemagglutinin
- varies from 1 strain to another
- main neutralising antigen responsible for host immunity

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9
Q

Why are there epidemics of influenza?

A

Due to antigenic variation

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10
Q

What is antigenic variation?

A

Recombination of RNA segments of 2 antigenic types simultaneously infecting same cell

Major antigenic change of both surface components

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11
Q

What is antigenic drift?

A

Spontaneous mutations leading to minor changes in haemagglutinin

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12
Q

Management of influenza virus infection

A

Differential diagnosis (flu-like illness)

Symptomatic treatment

Recognise and treat complications

Neuraminidase inhibitors -> -mivir

Polymerase inhibitors -> baloxavir

Minimise spread by respi route

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13
Q

Types of vaccination avail for influenza

A

Inactivated vaccine comprising of antigens from circulating A/H1N1, A/H3N2 and B strains
- quadrivalent -> cover B/Victoria and B/Yamagata lineages

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14
Q

Who are at risk of complications for influenza vaccine?

A

Elderly

Indivs w/ chronic cardiorespiratory conditions

Pregnant women

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15
Q

Issues w/ influenza vaccination

A

Timely preparation

Short-lived immunity -> strain of virus might have changed

Incomplete protection

Guillain-Barre syndrome

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16
Q

Features of paramyxovisruses

A

Enveloped helical RNA virus

No genetic recombination

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17
Q

Eg of pathogenic paramyxovisruses

A

Parainfluenza virus

Measles

Mumps

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18
Q

Clinical features of parainfluenza virus

A

Infection acquired by age of 5

4 serotypes

19
Q

Disease associations w/ the various serotypes of parainfluenza virus

A

Type 1 -> croup in infants

Type 2 -> epidemics (winter)

Type 3 -> bronchiolitis and bronchopneumonia in young infants/croup in older infants

Type 4 -> minor respi infection

20
Q

Common symptoms across the 4 serotypes of parainfluenza virus

A

Febrile common cold
- sore throat
- cough
- hoarseness

Croup

Bronchiolitis

Bronchopneumonia

21
Q

Features of croup

A

Acute laryngo-tracheo-bronchitis

Cough, hoarseness

Severe -> dyspnoea, stridor, cyanosis

22
Q

Lab diagnosis of parainfluenza virus infection

A

Tissue culture

Antigenic detection -> IF

RT-PCR

Serology
- early -> S antigen
- late -> V antigen

23
Q

Treatment and control of parainfluenza virus infection

A

Ventilatory support

Antibiotics for sec bacterial infection

Sedation and hydration

24
Q

Is there vaccine for parainfluenza virus?

A

No

25
Q

Features of respiratory syncytial virus (RSV)

A

No haemagglutinin and neuraminidase

Commonest cause of bronchiolitis in young children
- wheezing is vry characteristic

Immune-mediated and/or mechanical obstruction of narrow bronchioles by inflammatory process

URTI in older children and adults due to larger bronchiole

26
Q

Complications of RSV infection

A

Sec bacterial infections

Otitis media

Cardiac failure

Apnoea

27
Q

Lab diagnosis of RSV infection

A

Tissue culture

Viral antigen demonstration -> IF

RT-PCR

Serology
- 1 serotype

28
Q

Characteristic histological feature for RSV infection

A

Refractile syncytium (cells fusing) formation of multinucleated giant cells

29
Q

Treatment and control of RSV infection

A

Ribavirin aerosol therapy

Ventilatory support

Isolation of infected

RSV monoclonal Ab to protect infants at risk of severe RSV disease

30
Q

What are some things metapneumovirus associated w/?

A

Infants and children w/ acute respi disease

Asthma in children -> acute wheezing attacks

31
Q

Symptoms of metapneumovirus infection

A

Similar to RSV infections

32
Q

Features of adenovirus

A

DNA virus

More than 50 serotypes

Infect URT, mucosa and lymphoid tissue

33
Q

Symptoms of adenovirus infection

A

Pharyngoconjunctival fever -> associated w/ swimming pool

URTI w/ fever

Pneumonia

Acute follicular conjunctivitis

Keratoconjunctivitis (shipyard eye)

Haemorrhagic cystitis

Enteritis
- mesenteric adenitis
- intussusception

Chronic infection of tonsils and adenoids

34
Q

Lab diagnosis of adenovirus infection

A

Tissue culture

PCR

Serology -> IF/serotyping

35
Q

Histological features of adenovirus infection

A

Swelling and clustering of infected cells w/ intra-nuclear inclusions -> bunch of grapes

36
Q

Control of adenovirus infection

A

Vaccine (for certain serotypes)

37
Q

Features of rhinovirus

A

More than 100 serotypes

Genetic/antigenic variation

Inhabit URT

Causative agent of common cold

May precipitate asthmatic attacks and aggravate chronic bronchitis

Readily spread by close contact and respi secretions

Neutralising Ab protective against same serotype -> can get common cold many times

38
Q

Symptoms of rhinovirus infection

A

Rhinorrhoea

Sneezing

Sore throat

Cough

Mild fever

Hoarseness

Headache

NOTE: essentially symptoms of common cold

39
Q

Lab diagnosis of rhinovirus infection

A

Tissue culture

Serotyping -> NT

RT-PCR

40
Q

Features of coronavirus

A

Enveloped RNA virus

Crown-like projections on surface

Haemagglutinate RBCs

Multiple antigenic types

Cause common colds

41
Q

Is tissue culture possible for coronaviruses?

A

No

42
Q

Treatment and control of coronavirus

A

No specific treatment

No routine vaccines except for Covid-19

43
Q

Eg of coronaviruses

A

SARS (severe acute respiratory syndrome)

MERS (middle east respiratory syndrome)

Respi (16 decks)

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