Respiratory Viruses

Question 1

Describe bronchiolitis

Answer 1

• Occurs in < 2 years old
• Inflammation and plugging of small bronchioles
• Caused by RSV
• Might need oxygen/NIV
• Rare in first month of life
• Peak age 2-5 months

Question 2

What are clinical presentations of respiratory viruses (depending on virus and host)?

Answer 2

• Bronchiolitis
• Pharyngitis
• Common cold (rhinorrhea)
• Croup
• Pneumonia (primary viral or secondary bacterial)
• Influenza-like illness
• Extra-pulmonary illness (gastroenteritis, encephalitis, myocarditis)
• MERS

Question 3

How are most viruses spread?

Answer 3

Droplet spread (not respiratory route)

Question 4

What is the incubation period of influenza?

Answer 4

1-4 days

Question 5

What is the incubation period of RSV?

Answer 5

2-8 days

Question 6

What is the incubation period of MERS?

Answer 6

< 14 days

Question 7

What are the three upper respiratory tract infection syndromes?

Answer 7

1) Common cold
2) Pharyngitis
3) Laryngitis

Question 8

What are the key features of common cold?

Answer 8

• Nasal obstruction
• Nasal discharge
• Sneezing

Question 9

What are the key features of pharyngitis?

Answer 9

• Sore throat
• Inflammation
• ± exudates

Question 10

What is the key feature of laryngitis?

Answer 10

Hoarseness

Question 11

What are the three syndromes associated with infection of the major airways?

Answer 11

1) Croup (laryngo-tracheo-bronchitis)
2) Tracheobronchitis
3) Bronchiolitis

Question 12

What are the key features of croup?

Answer 12

• Hoarseness
• Barking cough
• Stridor
• Associated with apnoea

Question 13

What are the key features of tracheobronchitis?

Answer 13

• Cough

- Substernal pain

Question 14

What are the key features of bronchiolitis?

Answer 14

• Cough
• Dyspnoea
• Wheezing

Question 15

What is lower respiratory tract infection?

Answer 15

Pneumonia/pneumonitis

Question 16

What are the key features of pneumonia/pneumonitis?

Answer 16

• Cough
• Dyspnoea
• Chest pain
• Rales (crackles)

Question 17

What are the key features of influenza like illness?

Answer 17

• Upper and lower respiratory tract symptoms

- Systemic symptoms - fever, malaise, myalgia, headache, chills

Question 18

What is the common cause of bronchiolitis?

Answer 18

RSV

Question 19

What are the common causes of the common cold?

Answer 19

Rhinoviruses
Coronaviruses
(Parainfluenza viruses)
Enteroviruses

Question 20

What is the common cause of croup?

Answer 20

Parainfluenza viruses

Question 21

What is the common cause of influenza like illness?

Answer 21

Influenza viruses

Question 22

What are the common causes of pneumonia?

Answer 22

Influenza viruses
RSV
Adenoviruses

Question 23

What is R0?

Answer 23

The average number of individuals you will infect if you have that disease

Question 24

How are influenza viruses classified?

Answer 24

H?N?

Question 25

How is influenza transmitted?

Answer 25

• Coughing and sneezing causes aerosolisation
• Large droplets
• Direct contact with secretions

Question 26

What are the causes of influenza deaths?

Answer 26

• Secondary bacterial pneumonia
• Increases risk of MIs and strokes bc immune response leads to hypercoagulability
• Viral pneumonitis

Question 27

How many days before the measles rash can someone be infectious?

Answer 27

4 days

Question 28

When is ECMO used?

Answer 28

When the lungs can’t ventilate

Question 29

When is tamiflu/oseltamivir (antiviral) effective?

Answer 29

As a prophylactic agent

Question 30

Why is oseltamivir not v effective once the patient is symptomatic?

Answer 30

• There are a huge number of respiratory tract cells infected which are going to die so stopping replication might not help very much

Question 31

What can measles cause?

Answer 31

Pneumonitis

Question 32

What happens for a year after you have measles?

Answer 32

You have immunoparesis where your immune system is less effective

Question 33

What can CMV cause?

Answer 33

Multifocal patchy pneumonia