Respiratory Infections 1 Flashcards

1
Q

strict pathogens

A
  • Exogenous transmission cause primary infections
  • Overcome local host defense
  • Adheres to healthy mucosa
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2
Q

Opportunistic pathogens

A
  • Endogenous transmission cause secondary infection
  • Needs alteration of host defenses
  • Binds to damaged epithelium, foreign bodies
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3
Q

Increased risk for severity of primary infections

A
  • Pre-existing lung conditions or intubation
    • Smoking
    • Immunocompromised
    • Age extremities
    • Environmental risks
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4
Q

Innate host response to primary infections

A
  • Interferon alpha and beta: control viral infection initially by inhibiting translation
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5
Q

Nonspecific Febrile Disease

A
  • Generalized flu like symptoms (malaise, fever, aches, anorexia) are a result of type I interferons and T cell proliferation
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6
Q

Adaptive Host Response to viral infection

A
  • CD8 Cytotoxic Lymphocytes which detect viral peptides through MHC Class I are able to kill virus-infected cells by release of granzymes and perforins with assistance from CD4+ T Helper cells
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7
Q

Baltimore classification recap

A
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8
Q

Common cold is mostly caused by which viruses

A
  • Adenovirus: naked, dsDNA; common throughout; stays on surface 2hrs-7days
  • Coronavirus: enveloped, ss+ RNA; common in winter; stays on surface for 3 hrs
  • Rhinovirus: naked, ss + RNA; common in summer; stays on surface 7days-3months
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9
Q

Rhinovirus: Biology

A
  • Family: Picornaviridae
  • Small, non-enveloped, ss(+)RNA, icosahedral viruses • Over 100 antigenically distinct serotypes
  • Labile at acidic pH

4 Viral Capsid Protein: VP1, VP2, VP3, VP4

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10
Q

How is rhinovirus transmitted

A

Transmission is via aerosol, direct contact and indirect contact
• Sneezing/Coughing
• Nose-to-hand, hand-to-hand
• Fomites

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11
Q

Rhinovirus Pathogenesis

A
  • VAP (VP7 capsid) binds to host receptor ICAM-1 on respiratory epithelium
  • Viral replication triggers Interferons, histamine and bradykinin. Replication is preferential to nose at ~33C
  • host immune response: Infection is transient, self- resolving
    • Interferon-α
    • Natural Killer cells
    • Cytotoxic Lymphocytes
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12
Q

Clinical presentation of Rhinitis/Rhino-pharyngitis aka “Common Cold”

A
  • Watery eyes
  • Nasal congestion
  • Runny nose
  • Sneezing
  • Scratchy/sore throat
  • Dry Cough
  • Fever (low to none)
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13
Q

Coronavirus: Biology

A
  • Family - Coronaviridae
  • Single molecule of linear, ss(+)RNA
  • Largest positive strand RNA viruses
  • Latin word ‘corona’ means ‘crown’ or ‘halo‘
  • Enveloped, Helical nucleocapsid
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14
Q

Human coronaviruses are of the genera

A

Alpha coronavirus

Beta coronavirus

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15
Q

2nd most common cause of common cold

A

Common corona

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16
Q

Adenovirus: Biology

A

• Family: Adenoviridae
• Linear, ds DNA
• Non-enveloped, icosahedral
• Medium-sized (90-100 nm)
• Naked capsid has fiber with penton base (Viral Attachment Protein)
• 100+ serotypes known; at least 55+ types infect humans
Immunity is transient!

17
Q

Prevention of adenovirus

A
  • Live oral vaccine against Type 4 & 7 for military

* Vector for gene therapy and COVID-19 vaccines (Johnson & Johnson, AztraZeneca-Oxford)

18
Q

What diseases does adenovirus cause

A
  • pharyngo -conjunctival fever
  • mild URTI- 3rd most common
  • interstitial pneumonia/ARDS
19
Q

Adenovirus: Pathogenesis

A

Fiber protein attaches to CAR (Coxsackie-Adenovirus Receptor)
• Exhibits hemagglutination activity (ability to clump RBCs in vitro)

Internalization of virus is by receptor mediated endocytosis
• Penton base has cytolytic toxic activity
• Inhibition of cellular mRNA synthesis
• Cell rounding, enlargement, intra-nuclear inclusions

20
Q

Clinical Presentation: Pharyngo-conjunctivitis “Pink Eye”

A
  • Low-grade fever
  • Swollen cervical lymph nodes
  • Sore throat
  • Itchy red eyes, often with clear discharge
21
Q

Prognosis for viral URTI

A

No Vaccines for Rhino and Common Coronavirus

▪ Usually mild and self-limiting illness
▪ Complete recovery is usually within 7 days for adolescents & adults; within 10-14 days for children
▪ Severe Complications not common (<10% Secondary Bacterial); very rarely causes fatal disease

22
Q

Prevention of URTI

A

▪ Live vaccine for Adeno (military)
▪ Hand-washing, hand sanitizer
▪ Emphasize other environmental measures to control infections:
▪ Avoiding finger-to-eye, finger-to-nose contact
▪ Coughing and sneezing into the crook of the elbow
▪ Mask wearing
▪ Social Distancing