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Pulm by Minnie: AH Update > SM 179a - Viral Infections > Flashcards

SM 179a - Viral Infections Flashcards

1
Q

How can adenovirus be prevented?

A

Oral, live, nonattenuated vaccine for types 4, 7, 21

Separate vaccines given separately

Reserved for military recruits (not available to the public)

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2
Q

What kind of nucleic acid does parainfluenza virus (PIV) have?

A

(-)ssRNA

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3
Q

Whart are the roles of hemaglutinin and neuraminidase in influenza pathogenesis?

A

Hemaglutinin and neuraminidase play a major role in inluenza A

  • Hemaglutinin
    • Binds sialic acid
    • Limits species transfer
  • Neuraminidase
    • ​Role in viral release in propagation
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4
Q

What are the signs and symptoms of 2019-nCoV?

A

Fever

Cough

Shortness of breath

Myalgias, confusion, headache, sore thorat, rhinorrhea

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5
Q

What is antigenic drift?

What causes it?

A

A minor change based on mutations in a viral genome

Due to mistakes made by RNA polymerase

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6
Q

Which virus is most likely to cause a “barking cough” in children?

A

PIV 1 and PIV 2

Barking cough = croup, most often occurs in children

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7
Q

Which viruses are most likley to cause pneumonia in adults?

A

When I have pneumonia, I-RAPSS myself in blankets

  • Influenza
  • RSV
  • Adenovirus
  • PIV
  • SARS-CoV
  • Sin nombre
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8
Q

Why do so many viruses affect the human respiratory tract?

A

The respiratory tract is in direct contact with the environment

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9
Q

What animals are associated with MERS-CoV?

A

Camels

Bats

Humans

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10
Q

How is RSV transmitted?

A

Respiratory droplets or fomities

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11
Q

What animal is linked to novel-Coronavirus (2019-nCoV)?

A

Bats

Unclear secondary animal source

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12
Q

What is the most effective prevention for influenza?

What is the efficacy?

A

Flu vaccine

Efficacy = 20-60%

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13
Q

What kind of nuleic acid does rhinovirus have?

A

Non-segmented ssRNA

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14
Q

Influenza C causes disease in __________

A

Influenza C causes disease in children

Adults have protective immunity

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15
Q

What is the “steeple sign?”

Which virus/clinical syndrome is it associated with?

A

The steeple sign is a radiographic finding associated with croup, usually caused by PIV 1 or PIV 2

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16
Q

What animals were associated with SARS-CoV infection?

A

Palm civet

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17
Q

What complication of influenza are people younger than 19 receiving long-term aspirin therapy at risk for?

A

Reye syndrome

Vomiting, confusion, may progress to coma

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18
Q

Which country is the origin of the majority of MERS-CoV cases?

A

Saudi Arabia

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19
Q

Which viruses are most likely to cause pneumonia in children?

A
  • RSV
  • PIV
  • Influenza
  • Rhinovirus*
  • Measles*
  • CMV*

* = Not likely to cause pneumonia in immunocompetent adults

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20
Q

Describe the clinical presentation of RSV

A
  • Children and older or immunocompromised adults
    • Lower respiratory tract
      • Pneumonia or bronchiolitis
  • Everyone else
    • Upper respiratory tract (less severe)

May lead to airway reactivity similar to asthma and decreased lung function

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21
Q

Where does baloxavir act?

A

Site 1

Inhibits mRNA synthesis - prevents viral protein synthesis

Baloxavir is a cap-dependent endonuclease inhibitor

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22
Q

Where in the human body does RSV replicate?

What areas are typically infected?

A

Replicates in the nasopharynx

Infects the bronchial epithelium - Infection is restricted to the lungs

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23
Q

Which influenza medication is a neuraminidase inhibitor?

What does it do?

A

Oseltamivir (Tamiflu)

Prevents the release of new virions from infected cells

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24
Q

Where are outbreaks of adenovirus likely to occur?

A

Close quarters

Dorm rooms, military barracks, etc

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25
Q

How is adenovirus transmitted

A

Aerosol droplets

Direct inoculation

Fecal-oral

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26
Q

What is the treatment for RSV?

A

Supportive

Ribavirin may have some benefit in adults, but do not use in children

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27
Q

Where in the body is rhinovirus likely to cause infection?

Why?

A

Upper respiratory tract (not lower)

Does not replicate well at high temperatures

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28
Q

What is the treatment for adenovirus?

A
  • Supportive: Most cases are self-limiting
  • Antivirals
    • If disease is severe: pneumonia, organ-invasive
      • Cidofovir (very nephrotoxic)
      • Brincidofovir
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29
Q

What kind of nucleic acid doe HCoV have?

A

Nonsegmented ssRNA

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30
Q

How is influenza diagnosed?

A

PCR aka molecular assay (preferred)

Rapid antigen detection (not as good)

Run the test of you suspect flu (fever, sore throat, cough, myalgia)

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31
Q

What are the two major drugs used to treat influenza?

What are their mechanisms of action?

A
  • Oseltamivir (Tamiflu) - This one is better
    • Neuraminidase inhibitor
    • Prevents the release of new virions from infected cells
  • Baloxavir (Xofluza)
    • Cap-dependent endonuclease inhibitor
    • Prevents viral mRNA synthesis
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32
Q

How is influenza transmitted?

A
  • Spread via respiratory droplets and fomites
  • Invades ciliated epithelial cells of the URI
33
Q

Does the flu vaccine help us keep up with antigenic drift or antigenic shift?

A

Antigenic drift

34
Q

How is SARS-CoV spread?

A

Person to person or via droplets

Some people are “super spreaders”

35
Q

What is the function of the SH protein in RSV?

A

Inhibits apoptosis

36
Q

Which patient popoulation should NOT recieve the flu vaccine?

  1. Cancer patients recieving chemotherapy
  2. Persons with AIDS (CD4 count <200)
  3. Recipients of a lung transplant
  4. Persons with egg allergies
  5. None of the above
A

e. None of the above

Everyone should get the flu vaccine!

37
Q

Airway obstruction in croup is greatest during…

A

Inspiration

38
Q

Symptoms of croup arise from….

A

Inflammation and obstruction of the subglottic structures

39
Q

What is the treatment for PIV?

A

Supportive

40
Q

Which influenza medication inhibits mRNA synthesis?

A

Baloxavir (Xofluza)

Cap-dependent endonuclease inhibitor

(But Oseltamivir is usually used instead)

41
Q

Where does oseltamivir act?

A

Site 3

Prevents the release of new virions from infected cells

Oseltamivir is a neuraminidase inhibitor

42
Q

Is there a vaccine for RSV? Why not?

A

No vaccine :(

Reinfection is common and immunity does not persist

43
Q

Bronchiolitis is an infection of the _________________

A

Bronchiolitis is an infection of the

terminal bronchiolar epithelial cells

44
Q

Who should we treat for influenza?

A
  • Peopel with severe symptoms
  • Anyone hospitalized
  • People at high risk for complications
    • Children ≤ 2 years old
    • Adults ≥ 65 years old
    • Pregnant women
    • Obese patients
    • People with chronic medical conditiosn
    • People <19 recieving long-term aspirin therapy
    • People with immunosuppressive conditions
45
Q

Which influenza medication prevents the release of new virions from infected cells?

A

Oseltamivir (Tamiflu)

Neuraminidase inhibitor

46
Q

Influenza B causes severe disease in __________

A

Influenza B causes severe disease in elderly and at risk people

47
Q

What disease is caused by PIV 3?

A

Lower respiratory tract infection in children (pneumonia)

48
Q

Which types of PIV cause croup?

A

PIV 1, PIV2

49
Q

Which respiratory virus might also cause bilateral conjunctivitis?

A

Adenovirus

50
Q

What is hantavirus cardio-pulmonary syndrome?

A

Initial fever followed by the abrupt onset of acute pulmonary edema and shock

51
Q

Which virus does not utilize the respiratory tract for transmission and estabilishment of infection

  1. Measles virus
  2. Varicella-Zoster virus
  3. Ebola virus
  4. Epstein-Barr virus
  5. Sin Nombre Virus
A

c. Ebola virus

Note: All herpes viruses utilize the respiratory tract to establish infection

52
Q

What kind of nucleic acid does adenovirus have?

A

dsDNA

53
Q

List the possible presentations of adenovirus

A
  • Common cold
  • Pharyngitis
  • Pharyngitis + conjunctivits
  • Bronchitis
  • Pneumonia
  • Epidemic keratoconjunctivitis
    • Bilateral conjunctivitis, painful corneal opacities
54
Q

Who is most likely to be infected by PIV?

A
  • Children
    • PIV 1 and PIV 2 -> Croup, otitis media, pharyngitis, cold
  • Adults
    • Common cold
  • Older adults
    • Pneumonia
  • Immunocompromised
    • Severe disease: pneumonia w/ high mortality
55
Q

What feature of its genome allows influenza to undergo antigenic shift?

A

Segmentation of the genome

56
Q

Which clinical syndrome is most closely associated wtih PIV?

A

Croup (laryngotracheobronchitis)

57
Q

What is the treatment for rhinovirus?

A

Supportive

Vitamin C may reduce symptoms

Zinc therapy may reduce symptoms

58
Q

Why does SARS coronavirus prefer the lung?

A

SARS CoV binds the angiotensin-converting enzyme (ACE-2) receptor, which is found in the lung

59
Q

Which influenza medication is a cap-dependent endonulease inhibitor?

What does it do?

A

Baloxavir (Xofluza)

Inhibits viral mRNA synthesis

(But Oseltamivir is usually used instead)

60
Q

What kind of nucleic acid does the influenza virus have?

A

(-)ssRNA

61
Q

Which viruse are most likley to cause croup?

A

PPIMA

  • PIV1
  • PIV2
  • Influenza
  • Measles
  • Adenovirus

PIV = parainflenza virus

62
Q

The influenza virus is shed for ________ days prior to symptoms and up to ________ days after symptom onset

A

The influenza virus is shed for 1-2** days prior to symptoms and up to **5 days after symptom onset

Immunocompromised individuals may shed for months

63
Q

Describe the clinical features of influenza

A

The following symptoms may last 3-5 days

  • Fever
  • Myalgias
  • Sore throat
  • Non-productive cough
  • Pneumonia if v. severe

Only ~50% of patients with the flu have all 4 symptoms

64
Q

What are the 2 important virus particle proteins in RSV?

A
  • SH protein
    • ​Inhibits apoptosis
  • F (fusion) protein
    • ​Mediates the fusion of infected cells together to form syncytia
65
Q

Influenza A causes disease in __________

_________ are the main reservoir

A

Influenza A causes disease in humans, mammals, and birds

Aquatic birds are the main reservoir

66
Q

Which viruses are most likely to cause the common cold?

A

Oh CRRAP I have a cold

  • Coronavirus
  • Rhinovirus
  • RSV
  • Adenovirus
  • PIV
67
Q

What is antigenic shift?

What causes it?

A

A major change in the viral genome due to re-assortment of segments of RNA

This leads to completely new N and H combinations, which can lead to high infectivity or virulence.

68
Q

What is the function of the F protein in RSV?

A

F protein = Fusion protien

Mediates the fusion of infected cells together to form syncytia

69
Q

How is rhinovirus transmitted?

A

Aerosol droplets

Contaminated hands or surfaces

70
Q

Which viruses are most likely to cause pharyngitis?

A

A RICH *ECH* (clears throat)

  • Adenovirus
  • Rhinovirus
  • Influenza
  • CMV
  • HSV
  • EBV
  • CMV
  • HIV
71
Q

What disease is caused by PIV 4?

A

Common cold

Pneumonia in immunocompromised persons

72
Q

Describe the disease outbreaks caused by adenovirus 14

A

Sporadic outbreaks of severe diseases and pneumonia

73
Q

List some of the most serious complications of influenza?

A
  • Secondary bacterial pneumonia
  • Exacerbations of cardiopulmonary conditions
    • Viral myocardidits
    • Viral encephalitis
  • Reye syndrome (in children taking ASAs ex: asprin)
    • Severe vomiting, confusion, may progress to coma
74
Q

What disease does HCoV cause?

A

Common cold

75
Q

Which viruses are most likely to cause tracheobronchitis?

A
  • Influenza
  • Parainfluenza (PIV)
76
Q

Which influenza undergoes both antigenic drift and antigenic shift?

A

Influenza A

77
Q

Which viruses are most likely to cause bronchiolitis?

A
  • RSV
  • hMPV
  • Coronavirus
  • Bocavirus
78
Q

When should you start treatment for a suspected influenza infection?

A

While the results of PCR or rapid antigen testing are pending

(Treat empirically with osiltamivir)

Pulm by Minnie: AH Update (34 decks)

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