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UR viral Flashcards

1
Q

What is the temperature that upper respiratory viruses replicated?

A

33-35 C

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2
Q

What is the most common viral infection of the upper respiratory tract?

A

Rhinovirus

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3
Q

What are the symptoms of the common cold? What are not?

A

Rhinitis
Pharyngitis

No high fever, respiratory tract involvement

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4
Q

What is the incidence of colds?

A

2-3/year for adults, 6-8/yr for child

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5
Q

What are the three major complications associated with the common cold?

A

OM
Sinus infection
Asthma exacerbation

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6
Q

What should always be included in the dx for chronic upper respiratory tract infections?

A

Allergies

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7
Q

What are the four most common causes of the common cold in order?

A
  1. Rhinovirus (most)
  2. Coronavirus
  3. Other known
  4. Unidentified
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8
Q

Rhinoviruses are members of what family? What type of genome? What are the three viral species? Are they enveloped?

A

Picronavirus
+ssRNA
A, B, C
No envelope

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9
Q

How are rhinoviruses spread?

A

Respiratory secretions

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10
Q

How much virus is needed for inoculation?

A

Very small amount

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11
Q

What is the incubation period for rhinoviruses?

A

1-3 days

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12
Q

True or false: rhinoviruses do not exacerbate asthma or COPD?

A

False

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13
Q

What is the MOA of rhinovirus?

A
  1. attach to cilia
  2. disrupt epithelial cell layer
  3. fluid outpouring from the LP
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14
Q

What are the treatments for rhinovirus? When are abx indicated?

A

Symptom management

Abx only if there is an associated bacterial infx

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15
Q

Why is it hard to get immunity to rhinoviruses?

A

Over 100 serotypes

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16
Q

Is there any vaccine for rhinoviruses? If so, which serotypes?

A

No–too many serotypes

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17
Q

What is the genomic make up of corona viruses? Enveloped? Where do they replicate?

A

+ ssRNA
Enveloped.
Replicate in the epithelial cells of the upper respiratory tract

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18
Q

What is the optimal temp for Non-SARS coronaviruses? SARS one? What is the significance of this?

A

33-35 C for non

37 for SARS

This explains the differing symptoms

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19
Q

Transmission of the coronavirus through what?

A

Large droplets

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20
Q

What is the incubation period of coronavirus?

A

3 days

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21
Q

What is the treatment for infx with coronavirus? Is there a vaccine? If so, which serotypes?

A

symptomatic

No vaccine

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22
Q

What is the only common cold virus that has a DNA genome? Is it enveloped?

A

Adenovirus (dsDNA)

Non-enveloped

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23
Q

What is the surrounding halo around adenoviruses?

A

Toxins

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24
Q

What are the most common adenoviruses that cause respiratory disease?

A

1, 2, and 5

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25
Q

Individuals can shed adenoviruses for how long?

A

18 months

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26
Q

Where can adenoviruses survive where other viruses cannot? What is the significance of this?

A

Lymphoid tissue–allows a longer period to shed

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27
Q

Which of the upper respiratory tract viruses have no seasonal pattern of disease?

A

Adenovirus

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28
Q

What is the cause of pharyngealconjunctival fever?

A

Adenovirus

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29
Q

Serotypes 40 and 41 or adenovirus cause what diseases?

A

GI diseases

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30
Q

Are there vaccines to adenovirus? If so, for which serotypes?

A

yes, one for serotypes 4 and 7

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31
Q

What is the viral cause of croup, bronchiolitis, and penumonia?

A

Paravirus

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32
Q

Rhinoviruses infect which cells?

A

The ciliated mucosal epithelial cells.

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33
Q

Early in an infection with rhinovirus, nasal secretions are primarily due to what? Later?

A

Initially increased vascular permeability

Later d/t increase in lactoferrin, lysozyme, and IgA

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34
Q

The damage caused by viral infections and predispose patients to bacterial infections how? (2)

A

Interruption of mucociliary escalator

Weakened immune system

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35
Q

Why is it possible to get reinfected with a coronavirus?

A

We develop poor immunity to the virus

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36
Q

What is the treatment for infection with adenoviruses?

A

Symptomatic

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37
Q

Do you developed good immunity to adenoviruses?

A

Yes, but there are so many serotypes

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38
Q

What is the family of coxsackieviruses? Are they enveloped? What is their genetic material?

A

Subfamily of picornaviruses

Non-enveloped

+ssRNA

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39
Q

Where can coxsackie viruses survive, where other viruses cannot?

A

GI tract (can survive low pH)

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40
Q

What is the mode of transmission for coxsackie viruses?

A

Fecal-oral route

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41
Q

Are there vaccines available for the coxsackie virus? If so, which serotypes?

A

None

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42
Q

What is the prognosis for infection with coxsackie viruses?

A

Full recovery in a few weeks

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43
Q

What is the viruses that causes herpangina?

A

Coxsackie virus

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44
Q

What are the symptoms of herpangina? (2)

A

Abrupt fever

Small vesicles on soft palate.

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45
Q

What are the possible complications associated with herpangina?

A

Meningitis or encephalitis

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46
Q

What is the virus that causes hand-foot-and mouth disease? Symptoms? (2)

A

Coxsackie

Fever
Vesicular lesions on the soles of the hands, feet, and in oral areas.

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47
Q

What are all the viruses that cause the common cold? (6)

A
  1. Rhinovirus
  2. Non-SARS corona
  3. Adenovirus
  4. Coxsackie
  5. Parainflu (B &C)
  6. Respiratory syncytial virus
  7. Flu
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48
Q

What is the only common cold virus that is not caused by droplets?

A

Coxsackie

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49
Q

What is the only dsDNA virus that causes the common cold?

A

Adenovirus

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50
Q

What are the symptoms of croup? (3)

A

Fever, seal’s bark, inspiratory stridor

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51
Q

What is the prodrome for croup?

A

Rhinorrhea, mild cough, pharyngitis

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52
Q

What are the complications for croup?

A

Hypoxia

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53
Q

Why is croup more worrisome in children?

A

Smaller airway

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54
Q

What are the two things that should be in your differential when seeing croup?

A
  1. Obstruction

2. Bacterial epiglottitis

55
Q

What is the treatment for uncomplicated croup?

A

Humidified air

56
Q

What is the treatment for complicated croup?

A

Oxygen
Epi
Glucocorticoids

57
Q

What is the test for differentiating between complicated and uncomplicated cases of croup?

A

Stridor at rest

58
Q

What is the most common virus that causes croup?

A

parainfluenza (serotype 1)

59
Q

The parainfluenza virus is from what family? Enveloped? Genome type?

A

From paramyxovirus fam

Helical nucleocapsid + envelop

-ssRNA

60
Q

How is parainfluenza virus transmitted?

A

Droplets

61
Q

What is the incubation period for parainfluenza virus?

A

2-10 days

62
Q

In which cells does the parainfluenza virus replicate?

A

ciliated epithelium

63
Q

How long does immunity against parainfluenza virus last?

A

Short lived

64
Q

What are the major symptoms of the flu that are different from the common cold?

A
  1. Myalgias
  2. Shaking chills
  3. HA
  4. cough
65
Q

What is the incubation period for the flu?

A

2 days

66
Q

What is the biggest complication associated with the flu?

A

Pneumonia

67
Q

Primary influenza virus pneumonia is caused by which flu strain?

A

A

68
Q

What will you see in a patient’s sputum gram stain if they have viral pneumonia?

A

High PMNs, but no significant number of bacteria

69
Q

What is the fatality rate of viral pneumonia?

A

50%

70
Q

When in a flu infection do symptoms of pneumonia develop?

A

1-4 days following symptoms

71
Q

What will a CXR reveal about viral pneumonia?

A

Diffuse interstitial infiltration

72
Q

When do bacterial influenza associated pneumonias develop?

A

1 week after onset of symptoms

73
Q

What are the causative agents of bacterial pneumonia? (3)

A
  1. Strep penumonia
  2. Staph aureus
  3. H. influenzae
74
Q

Why are individuals who recently have been sick with a virus more likely to develop pneumonia?

A

Damage to the mucociliary escalator or respiratory epithelium

Compromised immune function

75
Q

The flu is a member of what family of viruses? Is it enveloped? What is the genetic make up?

A

Orthomyxovirus family
Enveloped
Segmented -ssRNA

76
Q

What are the proteins that the flu virus expresses? What does each do?

A

Hemagglutinin (attachment protein)

Neuraminidase (Cleaves sialc acid to aid in release)

77
Q

What is antigenic drift? How does this apply to the flu? How does it happen?

A

Small changes in H and N proteins brought about by point mutations made by polymerase

78
Q

What is antigenic shift? How does this apply to the flue? How does it happen?

A

Large changes in H and N proteins, driven by reassortment of two viruses (segment reassortment)

79
Q

What is the cause of having to change the flu vaccine every year (antigenic shift or drift)?

A

Antigenic drift

80
Q

How does segment reassortment occur?

A

Segments of two different viruses that have infected the same cell rearrange as new virions are formed

81
Q

How many segments does the flu virus have?

A

7 - 8

82
Q

How are the different hemagglutinin and neuraminidase protein variants distinguished from one another?

A

Different number (e.g. H3N2)

83
Q

The flu virus is a - ssRNA virus. What does it need in it in order to carry out replication?

A

An RNA dependent RNA pol. (RdRp)

84
Q

Where does flu virus reassortment occur?

A

In pigs (they’re called “mixing vessels”)

85
Q

Which part of the flu virus are the dominant targets for antibodies?

A

Hemagglutinin and Neuraminidase

86
Q

In viral naming (e.g. A/Texas/1/77/(H3N2), what does each component stand for?

A 
A = serotype
Texas = location
1 = isolate
77= year
H3N2 = protein subtypes
87
Q

What is the host range for influenza type A?

A

Humans, pigs, birds, other animals

88
Q

What is the host range for influenza type B?

A

Just humans

89
Q

What is the host range for Influenza type C?

A

Humans and pigs

90
Q

What is the severity level for influenza type A, B, and C respectively?

A 
A = severe
B = sometimes severe
C = mild
91
Q

Which influenza type has the ability to cause pandemics? Epidemics?

A 
Pandemics = A
Epidemics = A and B
92
Q

What is the only influenza strain that can undergo genetic shift?

A

A

93
Q

For mild or uncomplicated cases of the flu, what is the determining factor on whether to treat with antivirals or not?

A

Based on risk factors for the patient

94
Q

For a patient with no risk factors, when should you administer antivirals for the flu?

A

within 48 hours of onset

95
Q

For a patient with risk factors, when should you administer antivirals for the flu?

A

Always

96
Q

What are the ion channel blocking medications used for the flu? (2)

A

Amantadine

Rimatadine

97
Q

What is the MOA of ion channel blockers?

A

block the viral M2 ion channel that is required for virus release

98
Q

How long does the seasonal flu last?

A

about 1 week

99
Q

When are the ion channel blocking antivirals used for the flu?

A

For type A, but not anymore d/t resistance

100
Q

What are the three neuraminidase inhibitors?

A

Zanamivir
Oseltamivir
Peramivir

101
Q

What is the MOA of neuraminidase inhibitors?

A

Neuraminidase
inhibitors block the neuraminidase enzyme of influenza A and B viruses, thereby reducing the
ability of the virus to spread from cell-to-cell
and to move through the mucus in respiratory
secretions.

102
Q

What is the route of administration of zanamivir?

A

oral inhalation

103
Q

What is the route of administration of oseltamivir?

A

Oral

104
Q

What is the route of administration of peramivir?

A

IV

105
Q

Neuraminidase inhibitors are effective against which flu strains?

A

A and B

106
Q

What are the three varieties of flu vaccine?

A

Inactivated (IM)
Live attenuated
Recombinant flu

107
Q

How are inactivated flu virus vaccines prepared? How are these administered?

A

“Killed” via formeldehyde

IM or ID

108
Q

What is the age group that should get IM inactivated influenza vaccine?

A

Greater than 6 mo, including those with chronic medical disease

109
Q

What is the age group that should get ID inactivated influenza vaccine?

A

18-64

110
Q

What is the age group that should get live attenuated influenza vaccine?

A

healthy, non-pregnant 2-49 yo

111
Q

What is the age group that should get IM recombinant influenza vaccine?

A

18-49

112
Q

What is the route of administration for the live, attenuate virus flu vaccine?

A

Intranasal

113
Q

What is the agent in the recombinant flu vaccine?

A

Hemagglutinin protein

114
Q

What is the advantage of producing a vaccine from mammalian cells (MDMK)?

A
  1. Rapid scale up

2. Reduced likelihood of egg issues

115
Q

What are the advantages of live attenuated vaccine?

A

IgG production, cell mediated immunity

116
Q

How is the recombinant influenza vaccine made? Is this egg free?

A

a baculovirus is
reengineered to produce appropriate influenza
hemagglutinin (HA) proteins within cultured
insect cells.

This is egg free

117
Q

Antiviral chemoprophylaxis is

indicated for whom?

A

high risk populations

118
Q

What are the strains that are in the trivalent vaccines? quadravalent?

A

2 As and a B = trivalent

2 As and 2 Bs = quadraavalent

119
Q

The SARS virus is from which family?

A

The coronavirus

120
Q

What type of genetic material is in the SARS coronavirus? Is it enveloped?

A

+ssRNA

Enveloped

121
Q

How is the SARS virus transmitted?

A

Fecal oral route

122
Q

What is the incubation period for the SARS virus?

A

2-10 days

123
Q

What are the symptoms of bronchiolitis? (3)

A
  1. Expiratory wheezing
  2. Nasal flaring/Subcostal retractions
  3. Variable fever
124
Q

What is the more common cause of bronchiolitis and pneumonia in children <1 yo?

A

Respiratory syncytial virus (RSV)

125
Q

RSV is from what virus family? Is it enveloped? What is the genetic material?

A

Paramyxovirus fam
Enveloped
-ssRNA

126
Q

How is RSV spread? Incubation period? Duration?

A

Droplets
4-5 days incubation
2 weeks duration

127
Q

What is the antiviral that can be used for RSV? What is the MOA?

A

Ribavirin

Guanosine analogue that promotes mutation of the viral genes

128
Q

The F protein of RSV can lead to the

activation of what immune system protein?

A

TLR4

129
Q

What are the two prophylactic treatments for RSV?

A

Palivizumab

RSIG = (IVIG)

130
Q

What is the MOA of palivizumab? (what is it)

A

Monoclonal antibody to RSB

131
Q

When is prophylaxis for RSV indicated?

A

Premature births

<2 yo with chronic lung disease

132
Q

What is the route used for Ribavirin?

A

Aerosol

133
Q

Once symptoms of RSV have begun, are RSIG or palivizumab effective in treatment?

A

No

Microbio (50 decks)

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