RNA Viruses

Question 1

What is the physicians approach to managing a pt with common cold symptoms?

Answer 1

Supportive tx - inhalers
Monitor S&S severity
Watch for rashes that could suggest something more insidious

Question 2

Is there specific tx for human metapneumovirus?

Answer 2

No, just supportive tx

Question 3

Is there a vaccine for human metapneumovirus?

Answer 3

No

Question 4

This resp virus can be serious in infants and older adults due to airway inflammation

Answer 4

RSV

Question 5

Is there a vaccine for RSV?

Answer 5

No
mRNA vaccine currently in development

Question 6

Influenza can cause this syndrome —> aggravated resp failure leading to systemic organ failure

Answer 6

Cytokine storm syndrome

Question 7

Majority of influenza are of this strain

Answer 7

Influenza A — 75-95%

Question 8

What characteristic do orthomyxoviridae have that allows for reassortment of —> different HA/NA combinations

Answer 8

Segmented genomes

Question 9

This antiviral is used to treat influenza A and B. What class is it?

Answer 9

Oseltamivir (Tamiflu)
Neuroaminidase inhibitor
No recommend bc of resistances

Question 10

This virus is responsible for gastro and has a 2-dose vaccine available, but not virus specific tx.

Answer 10

Rotavirus

Question 11

This virus is responsible for gastro and has no specific tx or vaccine available

Answer 11

Norovirus

Question 12

A pt presents to your clinic after travelling to the southern United States to visit family. They returned to the Canada 10 days ago. Over the past 4 days, they have had a non-cyclic fever, conjunctivitis, and cough.
Their vaccination hx is unknown. What is your dx?
What tests are needed to confirm the dx?

Answer 12

Measles
Serology for measles virus ab or RNA from resp samples

Question 13

This is an important complication to consider with measles virus infection

Answer 13

Encephalitis — brain swelling

Question 14

What is the tx for measles?

Answer 14

No specific tx
Symptom mgmt with ibuprofen, airway dilators, and Vit A to ↓ risk of blindness

Question 15

What are some symptoms of chronic HIV/AIDS?

Answer 15

N&V
Persistent diarrhea
Rapid weight loss
Rashes, sores, lesions
Persistent infections
Neurological — memory loss, confusion

Question 16

There are 3 stages to the course of HIV infection. During which stage is subclinical immune dysfunction, peaked anti-HIV ab, and low viral count present?

Answer 16

Stage 2

Question 17

During what stage of HIV infection is there a peak in virus c/mL and high CD4 and T-cell count?

Answer 17

Stage 1

Question 18

During this stage of HIV infection systemic immunodeficiency is present. Viral load begins to increase and anti-HIV ab count falls off

Answer 18

Stage 3

Question 19

What are the classes of antivirals used for the tx of HIV?

Answer 19

Nucleoside analoge reverse transcriptase inhibitors (NRTI)
Nonnucleoside analogue reverse transcriptase inhibitors (NNRTI)
Protease inhibitors (PI)
Binding and fusion inhibitors
Integrase inhibitors
Latency-reversing agents

Question 20

What would constitute a therapeutic response to ART?

Answer 20

↓ viral load
Steady ↑ in CD4
Loss of S&S of HIV+

Question 21

What would constitute a therapeutic failure to ART?

Answer 21

Selection of resistant viruses
↑ viral load
↓ in CD4 and loss of immune function

Question 22

In context of HIV, what is an elite controller?

Answer 22

Someone able to maintain a low viral load for yrs w/o having ART

Question 23

This hepatitis virus is the only one that’s curable.

Answer 23

Hep C

Question 24

What drug combo demonstrates up to a 99% cure rate for Hep C?

Answer 24

Polymerase/NS5A cocktail