Viral Diseases of the Respiratory tract Flashcards
What is the most common cause of the common cold? Second most common?
Rhinovirus
Coronavirus
What is the virus that causes pneumonia and bronchiolitis in young children?
RSV
What is the cause of croup?
Parainfluenza virus
What does adenovirus cause?
Common cold and pharyngitis in children
What does HSV usually cause?
Gingivostomatitis in children; pharyngotonsillitis in adults
What does human cytomegalovirus cause usually?
Mono-like disease or pneumonia in transplant pts
What does human metapneumovirus usually cause?
LRTI in children
What is the enveloped status, and genetic makeup of coronavirus?
Enveloped
+ssRNA
What type of virus is SARS and MERS?
Coronavirus
What is the animal reservoir for SARS? MERS?
SARS= bats MERS= camels
What are the ssx for SARS and MERS?
Fever
Cough
SOB
ARDS
What is the severity of SARS? MERS?
SARS need hospitalization
MERS = asymptomatic to ARDS
What is the fatality rate of SARS? MERS?
SARS = 10% MERS = 36%
How long do the ssx of the flu last?
3-5 days peaks
Fatigue and weakness x2-6 weeks
What is the incubation period for the flu?
1-4 days
What is the contagious period for the flu?
5-7 days post ssx.
What are the indications for treatment of the flu with oseltamivir?
within 48 hours of onset
Have risk factors
What is the MA of oseltamivir?
Oseltamivir is a neuraminidase inhibitor, serving as a competitive inhibitor of the activity of the viral neuraminidase (NA) enzyme upon sialic acid, found on glycoproteins on the surface of normal host cells. By blocking the activity of the enzyme, oseltamivir prevents new viral particles from being released through the cleaving of terminal sialic acid on glycosylated hemagglutinin and thus fail to facilitate virus release
Children under what age are at risk for complications from the flu?
Under 2 yo
Adults over what age are at risk for complications from the flu?
65
Pregnant women and women how many weeks postpartum are at increased risk for complications from the flu?
2 weeks postpartum
What medical conditions (generally) pose an increased risk for the development of complications from the flu?
Lung or heart disease
Kidney or liver disease
People younger than what age taking daily ASA are at increased risk for flu complications? What is the primary complication concerned here?
Younger than 19
Reye’s syndrome
What is the MOA of zanamivir?
Neuraminidase inhibitor
What are the two M2 protein (ion channel) inhibitors for influenza type A?
Amantadine
Rimantadine
What is the route of administration for zanamivir? Oseltamivir?
Zanamivir = inhalation Oseltamivir = oral
What is the pattern of pneumonia from influenza as compared to one from a bacterial infection following flu infection?
Bacterial following = biphasic
Primary = progressively worse
What is the average onset for pneumonia from influenza as compared to one from a bacterial infection following flu infection?
Bacterial = 7 days following initial ssx Flu = 1-4 days
What are the culture results of pneumonia from influenza as compared to one from a bacterial infection following flu infection?
bacterial - bacteria
viral = PMNs
What is the usual CXR pattern of infiltrates with flu pneumonia?
Interstitial pattern
What is the fatality rate of pneumonia from the flu virus?
50%
What is the gram stain and morphology of H. influenzae?
gram negative rods
What group of people is the live attenuated vaccine for the flu appropriate for?
healthy, non-pregnant 2-49 year olds
What group of people is the recombinant vaccine for the flu appropriate for?
18-49
What group of people is the inactivated, IM vaccine for the flu appropriate for?
anyone older than 6 months
What group of people is the inactivated SQ vaccine for the flu appropriate for?
18-64
What is the makeup of the trivalent and quadrivalent flu vaccines?
2 A + 1 B
or
2 A + 2 B
What is the cell culture based vaccine? Who is this indicated for?
Flucelvax
greater than 18 yo
What is the high dose flu vaccine? In whom is this indicated?
Fluzone
Greater than 65
What is the intradermal vaccine for the flu? Who gets this?
Fluzone ID quadrivalent
18-64
What is the recombinant flu vaccine? Who gets this? How is this administered? How is this made?
Flublok
18 yo or older
IM
Insect eggs
What is the classic histological finding for herpes?
“owl eyes” Giant cells on tzanck smear
What is the classic histological finding for papillomavirus?
Clear cells
What is the classic histological finding for poxvirus?
Molluscum bodies
What is the family and genetic material for cytomegalovirus?
Herpesviridae
dsDNA
Where does cytomegalovirus replicate?
Mucosal epithelium
Where is cytomegalovirus latent?
Monocytes
What is the common risk factor for the development of CMV?
Immunosuppression from transplant
What is the usual ssx of CMV in immunocompetent individuals?
Asymptomatic to mono-like
What are the usual ssx of CMV in HIV patients?
CMV retinitis
Pneumonitis
What are the usual ssx of CMV in neonates?
CMV inclusion disease
What are the usual ssx of CMV in transplant recipients?
CMV pneumonitis
Gastritis
What percent of mothers with a new CMV infection will transmit the virus to the fetus?
37%
What percent of mothers with an old CMV infection will transmit the virus to the fetus?
1%
Does breast milk contain CMV in infectious mothers?
yes
What are the usual postnatal infectious etiologies of CMV?
Saliva or genital secretions
Toys
Is CMV sexually transmittable?
yes
What part of RBC transfusions contain CMV? How do you get rid of this issue?
Leukocytes
Leukoreduced RBCs
True or false: CMV in bone marrow transplant recipients are usually due to transmission via the graft
false– usually due to patient’s latent infection
What are the usual ssx of CMV transmission from transplants?
- Spiking fever 40 to below 3
- Malaise
- Pneumonitis
- Hepatitis
- Thrombocytopenia
What are the 2 antivirals that can be used to treat CMV?
ganciclovir
Valganciclovir
What is the MOA of ganciclovir and Valganciclovir?
DNA polymerase
How do you prevent CMV infection? (3)
- Match donors
- Antiviral prophylaxis
- Monitor for viremia, then give antivirals
What is the MOA of foscarnet? What is this used for?
Inhibition of DNA polymerase
CMV
True or false: Disseminated CMV does not show vesicular rashes in infants
True
What is the main complication from varicella?
Pneumonitis
What does EBV cause?
Mono
What is HHV8?
Kaposi’s sarcoma