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Pulmonology > Viral Pneumonia - Cross > Flashcards

Viral Pneumonia - Cross Flashcards

1
Q

Viruses cause (typical or atypical) pneumonia?

A

Atypical

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2
Q

Viruses causes (lobar or diffuse) findings in lung?

A

Diffuse pictures in lungs, absence of physical findings of consolidation

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3
Q

WBC count in viral pneumonia?

A

Only moderate elevation of WBC

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4
Q

Alveolar walls infiltrated with what type of cells in viral pneumonia?

A

Mononuclear cells, as opposed to polymorphonuclear cells in bacterial pneumonia

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5
Q

Nearly all viruses that cause pneumonia can cause what else?

A

URTIs (upper respiratory tract infections) aka “common colds”

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6
Q

List some risk factors that predispose to extension of infection in viral pneumonia?

A

Extremes of age (very young, very old)

Malnutrition

Alcoholism

Underlying debilitating illnesses (does Marfan’s count?)

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7
Q

List the 3 steps in the general mechanism of disease/ infection seen in viral pneumonia?

A
  • attachment to respiratory epithelium
  • viral replication causes cell death and inflammation
  • resulting damage and impairment of local defenses (mucociliary clearance) can predispose to bacterial superinfections
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8
Q

Which virus is the most common cause of respiratory tract infections that result in physician visits each year?

A

Influenza

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9
Q

Which virus causes the most number of deaths each year?

A

Influenza; 36,000 deaths each year. Mortality highest in elderly and children under 2 years old

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10
Q

Influenza

viron shape?

envelope?

genetic material - single or double strand? sense?

A

helical, enveloped, single stranded, negative sense, linear RNA

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11
Q

RSV

virion shape?

envelope?

type of genetic material - single or double strand? sense?

A

RSV

pleomorphic

enveloped

single stranded, negative sense, linear RNA

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12
Q

Adenovirus

envelope?

type of genetic material? single or double strand?

A

Adenovirus

Nonenveloped

double stranded, linear DNA

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13
Q

Parainfluenza virus

envelope?

type of genetic material? single or double stranded?

A

envelope

single stranded, linear, nonsegmented RNA

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14
Q

Coronavirus - SARS

envelope?

type of genetic material? stranded? sense?

A

coronavirus - SARS

enveloped

single stranded positive sense RNA

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15
Q

3 proteins involved with influenza?

A

hemagglutinin, neuraminidase, M2 ion channel

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16
Q

Hemagglutinin function? How many subtypes?

A
  • binds to cell surface receptor and promotes viral entry.
  • 3 subtypes (H1 - H3)
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17
Q

2 Neuraminidase functions ? How many subtypes?

A
  • cleaves neuraminic acid to release progeny virus from infected cell
  • Also degrades protective layer of mucus in respiratory tract
  • 2 Subtypes (N1, N2)
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18
Q

M2 ion channel purpose?

A

Essential for viral infectivity

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19
Q

Which type of influenza only infects humans? (A or B)

A

Influenza B

Influenza A can infect animals

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20
Q

Which type of influenza is associated with epidemics and pandemics?

A

Influenza A

Influenza B causes sporadic outbreaks

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21
Q

Which type of influenza is classified by subtypes? Importance of these subtypes?

A

Influenza A, Single subtypes predominate throughout the world at any given time.

Influenza B is not classified by any subtypes

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22
Q

Widespread infection in 1 geographic community? Epidemic or pandemic

A

Epidemic.

Pandemic = widespread infection over multiple geographic locations

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23
Q

Which causes pandemics? (drift or shift)

A

Antigenic shift.

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24
Q

Reassortment with ANIMAL virus associated with shift or drift?

A

Reassortment with animals = shift.

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25
Q

Spontaneous mutations associated with shift or drift?

A

Spontaneous mutations = drift

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26
Q

All individuals are susceptible in shift or drift?

A

Shift

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27
Q

Influenza transmission route?

A

airborne respiratory droplets

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28
Q

What causes myalgias seen in influenza virus?

A

Cytokines being released

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29
Q

4 ways to diagnose influenza? Which is most specific (can tell subtypes) ? Which not usually used

A
  • RT-PCR (most specific/sensitive, can tell subtypes)
  • direct fluorescent antibody
  • Rapid viral antigen test
  • Viral culture (not usually used)
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30
Q

Treatment for influenza? Which one causes bronchospasm and is rarely used?

A

Oseltamivir or Zanamivir.

Zanamivir can cause bronchospasms and is rarely used

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31
Q

Major complications of influenza (2)?

A

Secondary or viral pneumonia

Reye’s Syndrome

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32
Q

Reye’s syndrome characterized by?

A

Encephalopathy and liver degeneration

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33
Q

What drug can cause Reye’s Syndrome

34
Q

2 Bacteria that most commonly cause post-viral seconadry pneumonia?

A

S. pneumo & S aureus

35
Q

7 types of patients at risk of influenza complications. List as many

A
  • Young children/elderly
  • Those with CHRONIC DISEASES
  • Immunosuppressed
  • Pregant or up to 2 weeks post partum
  • Morbidly obese
  • Nursing home peeps
  • Native Americans or Alaskan natives
36
Q

Conjunctivitis “pink eye” (did you fart on my pillow) associated with what virus?

A

Adenovirus

37
Q

Who should receive a influenza vaccine?

A

Everyone 6 months of age and older

38
Q

What medication can be given prophylactically for influenza?

A

Oseltamivir

39
Q

Bacterial antibiotics preventing post viral secondary pneumonia

Antibiotic against gram (+) ?

Antibiotics against gram (-) ?

A

Vancomycin for gram (+)

Piperacillin/Tazobactam (Zosyn) for gram (-) = best choice. others available too

40
Q

Most important cause of bronchiolitis and pneumonia in infants?

41
Q

Military associated virus?

A

Adenovirus

42
Q

Fusion proteins associated with what virus? What is their function?

A

RSV

cause respiratory epithelium cells to FUSE forming multinucleated giant cells

43
Q

Gastroenteritis

A

Adenovirus

44
Q

Transmission route of RSV?

A
  • Respiratory droplets
  • Direct contact of contaminated hands with nose or mouth
  • Community outbreaks every winter; hospital outbreaks also occur
45
Q

Clinical manifestations of RSV

A

Persistent cough, wheezing, fever, tachypnea, hypoxemia

46
Q

2 ways to diagnose RSV

A

RT-PCR, Rapid antigen test on nasal swab and washings

47
Q

Only type of DNA virus (for these slides)

A

Adenovirus

48
Q

Only nonsegmented virus

A

Parainfluenza virus

49
Q

Only positive sense virus

A

Coronavirus - SARS

50
Q

Febrile pharyngitis associated with what virus?

A

Adenovirus

51
Q

Healthy adult has URT infection lasting 4-5 days then resolves, associated with what virus?

52
Q

(5) groups at risk for RSV pneumonia

A
  • Immunocompromised (bone marrow transplant)
  • Institutionalized elderly
  • Infants with chronic lung disease
  • Infants born during RSV season who are less than 6 months of age, particularly who attend daycare
  • Infants born before 35 weeks gestation
53
Q

Bronchiectasis or bronchiolitis obliterans can be as a consequence of what virus?

A

Adenovirus

54
Q

Reinfection common in what virus

A

Parainfluenza virus

55
Q

Ribavirin used to treat what virus?

Not recommended for who?

Recommended for what subset of patients

A

RSV

not recommended for children, efficacy unproven

Recommended for stem cell transplant patients

56
Q

Prophylatic treatment for RSV? MOA of drug

A

Palvizumab

Monoclonal antibody against F protein. Prevents pneumonia caused by RSV in premature infants by neutralizing virus infectivity

57
Q

Palvizumab must be given via what route?

A

IM, cant give orally. its a monoclonal antibody

58
Q

Asthma can result from what virus?

59
Q

What subset (4) of patients can be severly affected by RSV?

A
  • Preemies
  • less than 12 weeks of age
  • underlying cardiopulmonary disease
  • immunodeficient patients
60
Q

Which virus can be transmitted via aerosal droplet, fecal-oral route, or direct inoculation?

A

Adenovirus

61
Q

Mortality rate of RSV?

A

2%, most healthy infants survive

62
Q

Palvizumab monoclonal antibody detail (Whitt stressed it)

A

its a chimerized humanized monoclonal antibody.

63
Q

Hemorrhagic cystitis associated with what virus?

A

Adenovirus

64
Q

70% mortality rate occurs in what subset of patients infected with adenovirus?

A

Occurs if immunocomprimsed patient has disseminated infection

65
Q

Military recruits receive a vaccine for what virus? What serotypes of this virus?

A

Adenovirus, serotypes 4 and 7

66
Q

Croup associated with what virus? What specific subtypes?

A

Parainfluenza virus

hPIV 1,2,3

only 2-3% of infection progress to croup

67
Q

Asian associated virus? What year did it occur

A

Coronavirus - SARS, 2002

68
Q

What virus(es) cause leukopenia?

Which causes thrombocytopenia?

What 2 syndromes are this associated with?

A

Coronavirus can cause leukopenia seen in SARS & MERS

SARS also associated with thrombocytopenia

69
Q

Year associated with MERS?

70
Q

Route of transmission of human metapneumovirus?

A

Respiratory droplets

71
Q

What year was human metapneumovirus discovered?

A

2001.

If question stem has a year before 2001, you can rule this virus out

72
Q

Metapneumovirus is clinically indistinguishable from what other viruses?

A

RSV

influenza

human parainfluenza virus - 3

73
Q

CXR shows bilateraly peripheral infiltrates in MIDDLE and LOWER lungs. Which virus?

A

SARS coronavirus

74
Q

Stridor seen in which virus?

A

Parinfluenza virus

75
Q

Besides croup, hPI3 can cause what other infections?

A

Pneumonia and bronchiolitis

76
Q

Common cold caused by what subtype of which virus?

77
Q

Mucous membranes of the throat are infected in early or late stage parinfluenza virus?

What other clinical symptoms are seen and in which stage?

A

Initially, mucous membranes of throat are affected

Extensive infections will involve larynx and upper trachea

78
Q

Helical, enveloped, single-stranded negative sense linear RNA virus

79
Q

Pleomorphic, enveloped, negative-sense single stranded linear RNA virus

80
Q

Non-enveloped, double stranded, linear DNA virus

A

Adenovirus

81
Q

Enveloped, single stranded linear nonsegmented RNA virus

A

Parainfluenza virus

82
Q

enveloped, single stranded positive sense RNA virus

A

Coronovirus family - SARS, MERS

Pulmonology (31 decks)

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