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Pulmonology > SM 179 Viral Infections > Flashcards

SM 179 Viral Infections Flashcards

1
Q

Where do respiratory viruses have the greatest mortality rates?

A

The developing world

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2
Q

Why do some respiratory viruses show seasonal variation?

A

Favorable environmental conditions and potential human behavior changes, such as indoor crowding

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3
Q

Which respiratory viruses lack seasonality?

A

Coronavirus and Adenovirus, which are active year-round

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4
Q

Which viruses tend to cause the common cold?

A

Rhinovirus and coronavirus

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5
Q

Which viruses cause pharyngitis?

A

Adenovirus, influenza

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6
Q

Which viruses cause croup?

A

Parainfluenza Viruses 1 and 2

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7
Q

Which virus tends to cause bronchiolitis?

A

RSV

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8
Q

Which viruses cause pneumonia in children?

A

RSV, PIV, influenza

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9
Q

Which viruses cause pneumonia in adults?

A

Influenza, adenovirus

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10
Q

Which viruses cause pneumonia in the immunocompromised?

A

CMV, HSV

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11
Q

How long does the common cold last?

A

Typically lasts 10 days, via multiple viral agents

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12
Q

How does respiratory virus induced pharyngitis present?

A

Sore throat and nasal congestion suggest respiratory viral causes of pharyngitis

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13
Q

Which group tends to get Croup?

A

Young children infected with PIV1 and PIV2

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14
Q

How does Croup manifest and why?

A

Presents as a typical cold that worsens to a deep, barking cough due to inflammation and obstruction of the subglottic structures

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15
Q

How does Croup affect respiration?

A

Inflammation and swelling of the subglottic structures may obstruct airflow and lead to cyanosis

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16
Q

What differentiates tracheobronchitis from the common cold, and what causes it?

A

Non productive cough that lasts for more than one week, due to Influenza and PIV

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17
Q

What is bronchiolitis?

A

Viral infection of the terminal bronchiolar epithelial cells that leads to edema and mucus obstructing the small airways

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18
Q

What type of virus is Influenzavirus?

A

Influenza is a negative ssRNA virus

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19
Q

What are the 3 types of Influenzavirus and which one causes pandemics?

A

The 3 types are A, B, and C; only A causes pandemics

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20
Q

What surfaces antigens does Influenza A have?

A

Hemaglutinin and Neuraminidase

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21
Q

How does Influenza A cause pandemics?

A

Influenza A is able to undergo Antigenic Shift, which causes major reassortments of its Hemaglutinin and Neuraminidase, within and between species, leading to pandemics

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22
Q

Why does Influenza B not cause pandemics?

A

Influenza B predominantly experiences Antigenic Drift, which are minor mutations due to errors in RNA Polymerase

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23
Q

What is the difference between Antigenic Drift and Antigenic Shift?

A

Antigenic Drift is due to errors in RNA replication by RNA Poly and leads to minor changes; Antigenic Shift is due to reassortment of genes between viruses and leads to major changes

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24
Q

What caused H1N1?

A

A quadruple reassortment (antigenic shift) between swine (2), avian, and human influenza

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25
Q

Is Influenza seasonal in the US?

A

Yes, during the colder months

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26
Q

How does Influenza spread?

A

Droplets and fomites after invading the epithelial cells of the upper respiratory tract

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27
Q

When can Influenza be spread between people?

A

Virus sheds 2 days prior to symptoms and 5 days after symptoms abate

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28
Q

What are the complications of influenza?

A

Secondary S. aureus pneumonia and exacerbation of cardiopulmonary conditions

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29
Q

Who tends to die of Influenza?

A

The elderly

30
Q

When can a clinical diagnosis of Influenza be made?

A

A clinical diagnosis of sx like fever, sore throat, etc. can only be made during flu season due to low sensitivity = 60%

31
Q

What is the ideal way to diagnose Influenza

A

PCR, due to high sensitivity and specificity

32
Q

When should Influenza be tested for?

A

Only test for Influenza if it impacts patient care or puts the patient in a hospital

33
Q

What should be done while waiting for Influenza test results?

A

Start empiric antivirals of Neuraminidase inhibitors and CAP dependent endonuclease inhibitors

34
Q

What class of Influenza drugs is no longer used?

A

M2 inhibitors like Amantadine, DO NOT USE THEM

35
Q

How do Neuraminidase inhibitors work?

A

Oseltamivir prevents release of viruses from cell and therefore prevent other cells from being infected

36
Q

How do Neuraminidase inhibitors affect the course of the disease?

A

Decrease symptom and shedding duration

37
Q

How do CAP dependent endonuclease inhibitors work?

A

Baloxavir blocks mRNA synthesis and prevent the formation of new virus

38
Q

What is Oseltamivir?

A

An Influenza Neuraminidase inhibitor

39
Q

What is Balozavir?

A

A CAP dependent endonuclease inhibitor

40
Q

Who should be treated for Influenza?

A

Anyone with severe sx/hospitalization, young children, older adults, pregnant women, medically complicated, and immunosuppressed px

41
Q

Who should be vaccinated for Influenza?

A

Everyone

42
Q

Is the Influenza vaccine effective?

A

Up to 50% effective for all strains

43
Q

What are the antigens of RSV?

A

SH and F protein

44
Q

What does RSV’s SH protein do?

A

Inhibits apoptosis of the infected cell

45
Q

What does RSV’s F protein do?

A

Mediates fusion of infected cells together

46
Q

What infection does RSV cause?

A

Pneumonia and bronchiolitis in young children and immunocompromised

47
Q

How does RSV spread?

A

Respiratory droplets and fomites

48
Q

Why is re-infection common in RSV?

A

Immunity to RSV does not persist

49
Q

How is RSV treated?

A

Supportive care (oxygen, bronchodilators, saline), Ribavirin in adults

50
Q

What antigen does PIV have?

A

Fusion protein that mediates formation of

51
Q

How can PIV infectivity be stopped?

A

Antibodies to Fusion protein

52
Q

What radiographic sign is associated with PIV?

A

Steeple Sign on CXR

53
Q

What group is most affected by Adenovirus?

A

People in close quarters like Adenovirus

54
Q

What epidemic can Adenovirus cause?

A

Epidemic keratoconjuctivitis

55
Q

Which form of Adenovirus causes serious outbreaks?

A

Adenovirus 14

56
Q

Who gets treated with Adenovirus and how?

A

Most adenovirus infections are self limiting, so treatment with Cidofovir is reserved for seriously ill px

57
Q

Does Adenovirus have a vaccine?

A

Yes, for Type 4 and 7

58
Q

What type of virus is Rhinovirus?

A

Non-segmented Positive ssRNA

59
Q

What type of virus is Adenovirus?

A

Nonenveloped dsDNA

60
Q

Why is Rhinovirus so hard to vaccinate against?

A

More than 100 serotypes

61
Q

Where does Rhinovirus reproduce and why?

A

Nose and conjunctiva because it replicates poorly at body temperature

62
Q

How does Rhinovirus spread?

A

Aerosol droplets and contaminated surfaces

63
Q

What does Rhinovirus bind?

A

ICAM-1 on respiratory epithelial cells, leading to cell lysis

64
Q

How is Rhinovirus treated?

A

Symptom management only

65
Q

What is Coronavirus?

A

A nonsegmented ssRNA virus

66
Q

What does SARS Coronavirus bind to?

A

ACE-2 Receptor

67
Q

What can Coronavirus cause?

A

SARS, MERS

68
Q

What is Hantavirus?

A

An emerging virus spread by deer excretion

69
Q

What Is HCPS?

A

Initial fever followed by abrupt pulmonary edema and shock

70
Q

Where did SARS Coronavirus come from?

A

Zoonosis via the Palm Civet

71
Q

Where did MERS Coronavirus come from?

A

Zoonosis via Camel contact

Pulmonology (22 decks)

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