Respiratory syncytial virus

Question 1

What’s RSV family?

Answer 1

Pneumoviridae

Question 2

T/F. RSV is a naked virus.

Answer 2

False, its enveloped

Question 3

What type of nucleic acid does RSV has?

Answer 3

Single-stranded, negative-sense RNA

Question 4

How does RSV initially appear under electron microscopy?

Answer 4

Tubular structure

Question 5

What is the mature form of RSV under electron microscopy?

Answer 5

Spherical structure

Question 6

What feature is present on the viral envelope of RSV?

Answer 6

Transmembrane glycoprotein spikes

Question 7

Which proteins make up the RSV nucleocapsid complex?

Answer 7

• Nucleoprotein (N)
• Phosphoprotein (P)
• Polymerase (L)
• Transcription processivity factor (M2-1)

Question 8

This protein accumulates on the inner envelope and is crucial for viral morphogenesis.

Answer 8

Matrix protein (M)

Question 9

Mention the 3 surface glycoproteins present in RSV.

Answer 9

• Fusion protein (F)
• Attachment protein (G)
• Viroporin protein (SH)

Question 10

What is the function of the RSV nonstructural proteins NS1 and NS2?

Answer 10

They inhibit type I and type III interferon activity

Question 11

What proteins does the M2 gene encode, and what are their functions?

Answer 11

• M2-1: transcription processivity factor
• M2-2: Transcriptional regulatory protein

Question 12

What is the primary attachment protein of RSV?

Answer 12

G protein

Question 13

Which receptor does the RSV G protein bind to and in which cells?

Answer 13

CXCR3; respiratory epithelial and immune cells

Question 14

Which RSV protein facilitates viral attachment by binding to nucleolin (the most important receptor)?

Answer 14

F protein

Question 15

What is the role of the F protein in cell-to-cell contact?

Answer 15

It induces fusion forming syncytia

Question 16

What structural changes does the F protein undergo?

Answer 16

Prefusion to postfusion form

Question 17

This protein is critical for viral assembly and budding.

Answer 17

M protein

Question 18

T/F. RSV causes a significant disease burden annually, unlike many other respiratory viruses.

Answer 18

True

Question 19

When does RSV peak in drier climates?

Answer 19

During cooler months

Question 20

Which age group is most affected by severe lower respiratory tract illness due to RSV?

Answer 20

Previously healthy infants within their first year of life

Question 21

Which illnesses are commonly associated with primary RSV infection in infants?

Answer 21

Bronchiolitis and pneumonia

Question 22

What are the main ways RSV is transmitted?

Answer 22

• Direct contact
• Contaminated objects

Question 23

T/F. Small-particle aerosols are more likely to transmit RSV.

Answer 23

False, they are less likely

Question 24

Which cells are primarily affected by RSV in the respiratory epithelium?

Answer 24

Ciliated columnar cells

Question 25

Besides ciliated columnar cells, which other cells can RSV infect?

Answer 25

Type I and II pneumocytes

Question 26

What type of imune infiltration is seen in RSV primary infection?

Answer 26

Lymphocytic peribronchial infiltration with CD69+ monocytes and edema

Question 27

What happens to the bronchiolar epithelium in RSV infection?

Answer 27

Proliferation and necrosis of the bronchial epithelium

Question 28

What causes airway obstruction in RSV?

Answer 28

Sloughed epithelium and increased mucus secretion

Question 29

Why are infants at increased risk of atelectasis in RSV?

Answer 29

They have underdeveloped collateral channels

Question 30

Which two conditions often occur together in RSV-infected infants?

Answer 30

Bronchiolitis and pneumonia

Question 31

What are the key pathological features of RSV pneumonia?

Answer 31

Interstitial infiltration of mononuclear cells, edema, and necrosis

Question 32

What are giant multinucleated syncytial cells, and why do they form in RSV?

Answer 32

Fused cells caused by RSV-induced cell fusion

Question 33

How common is severe RSV disease after the first infection in healthy children?

Answer 33

Uncommon

Question 34

Which part of the respiratory tract is primarily affected in RSV primary infections?

Answer 34

Lower respiratory tract

Question 35

What is the most common clinical manifestation of RSV in young children?

Answer 35

Bronchiolitis, followed by peumonia and tracheobronchitis

Question 36

What are the common symptoms of RSV when infection is confined to the upper respiratory tract?

Answer 36

Fever and otitis media

Question 37

What are the most common symptoms among preschool-aged children with RSV seeking outpatient care?

Answer 37

* Wheezing * Labored breathing

Question 38

T/F. Hoarseness and laryngitis are common in RSV.

Answer 38

False

Question 39

How does RSV typically begin?

Answer 39

As an URI with nasal congestion and cough

Question 40

What are the signs of RSV progression to lower respiratory tract disease?

Answer 40

* More prominent and productive cough * Increased respiratory raye, dyspnea, and intercostal retractions * Bronchiolitis * Crackles and wheesinf on auscultation * Swings in oxygen saturation

Question 41

Which lobes commonly show subsegmental opacities in RSV?

Answer 41

Right upper and middle lobes

Question 42

What is a common complication of RSV infection in young children?

Answer 42

Acute otitis media

Question 43

Which age group is more commonly affected by RSV-associated acute otitis media?

Answer 43

Children older than 1 year

Question 44

What are the most common bacterial pathogens associated with RSV otitis media?

Answer 44

* Streptococcus pneumoniae * Haemophilus influenzae * Moraxella catarrhalis

Question 45

Which populations are at higher risk of RSV infections among older children?

Answer 45

* Families with young children * Schools * Child care facilities

Question 46

What type of illness do most recurrent RSV infections cause in older children?

Answer 46

Upper respiratory tract illnesses

Question 47

What are typical symptoms of RSV infection in adults?

Answer 47

Upper respiratory symptoms followed by lower respiratory symptoms

Question 48

Which symptom is more common with RSV than with other respiratory viruses?

Answer 48

Wheezing

Question 49

Which adult populations are at the highest risk for severe RSV disease?

Answer 49

* Elderly * Those with cardiopulmonary disease * Immunocompromised patients

Question 50

What symptoms were more common in RSV than influenza among healthy adults?

Answer 50

Earache, sinus pain, persistentmcough, and wheezing

Question 51

Which groups of chidren are most likely to require hospitalization due to RSV?

Answer 51

* Premature infants * Children with underlying conditions

Question 52

Which demographic and environmental factors increase the risk of severe RSV infection?

Answer 52

* Male sex * Crowded living conditions * Lower socioeconomic status * Tobacco smoke exposure * Lack of breastfeeding

Question 53

What is one of the most significant acute complications of RSV in young infants?

Answer 53

Apnea

Question 54

What is the most frequently identified bacterial infection in RSV-hospitalized infants?

Answer 54

Urinary tract infections

Question 55

What is one of the most common long-term complications of RSV bronchiolitis in infancy?

Answer 55

Wheezing

Question 56

How does RSV infection affect the immune response?

Answer 56

It triggers a response similar to allergic sensitization

Question 57

Gold standard to diagnose RSV.

Answer 57

RT-PCR

Question 58

Most children and adults with RSV require supportive care, including:

Answer 58

* Comfort measures * Fever control * Adequate fluid intake

Question 59

This is the only approved specific treatment for RSV lower respiratory tract disease in hospitalized infants.

Answer 59

Ribavarin