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Respiratory 2 > Virus & Anti-Virals > Flashcards

Virus & Anti-Virals Flashcards

1
Q

When R naught (epidemic reproductive rate) ____ 1, epidemic is sustained

A

>

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2
Q

Most acute respiratory diseases are caused by…

A

viruses

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3
Q

small, +SS RNA, non-enveloped virus that causes common cold; hard to develop a vaccine due to >100 serotypes; can exacerbate chronic lung diseases

A

Rhinovirus

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4
Q

Pleiomorphic, -ssRNA, enveloped, highly contagious virus that can cause ARI with prodromal stage preceding rash; a good vaccine is available

A

Measles

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5
Q

What virus causes Koplik’s spots (mouth spots) before rash appears on the body?

A

Measles

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6
Q

Rare but what fatal degenerative disease of CNS (deterioration and seizures) can occur 7-10 years after measles infection?

A

SSPE

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7
Q

What viruses are on Exam 2? (5)

A 
Rhinovirus
Measles
RSV
Influenza
Corona/SARS
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8
Q

3 high-yield respiratory viruses

A

RSV (humans only)
Influenza (A-zoonotic; B-humans)
corona/SARS (zoonotic)

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9
Q

-ss RNA, non-segmented, enveloped virus that is seasonal and causes lower airway disease (bronchiolitis) mostly in infants and elders; limited anti-virals and no vaccine

A

RSV

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10
Q

RSV has a single serotype with _____ antigentic groups

A

two (A & B)

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11
Q

Malaria kills the most children under 1 year old globally, and #2 goes to…

A

RSV

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12
Q

What percent of infants experience RSV by 3 years of age?

A

100%

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13
Q

What can possibly lower rates of RSV infection and disease?

A

Breast feeding and maternal antibody

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14
Q

lower tract diseases caused by RSV is usually ______ which is occlusion of small airways due to mucus and inflammatory materials

A

Bronchiolitis

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15
Q

Treatment for RSV

A

Supportive care; non-specific anti-viral; passive anti-RSV antibody

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16
Q

What are virulence factors of RSV?

A

Attachment & Entry: binds to host TLR4 receptor

  • Glycoprotein G (Groups A & B based on different glycoprotein G)
  • Fusion protein F
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17
Q

Viral pathogenesis that results in multiple cell fusion of infected and uninfected cells

A

Syncytium

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18
Q

Since RSV has -ssRNA, what does it must carry with it to replicate in the host?

A

RNA-dependent RNA polymerase (-ssRNA to +ssRNA)

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19
Q

RNA virus with RdRp activity; types based on NP and M sequences

A

Influenza A/B

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20
Q

Influenza virus infection often coincides with bacterial superinfection: which bacteria are most common

A

Staph. aureus

Strep pneumo

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21
Q

T/F: Complications of influenza virus infection include both pulmonary and non-pulmonary

A

True

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22
Q

What influenza type affects both humans & animals (zoonotic), affect all age groups, and cause more severe illness?

A

Type A (from birds/swine to humans)

  • zoonotic increases pandemic potential
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23
Q

What influenza type affects only humans, affect children, and cause milder illness?

A

Type B

24
Q

Influenza nomenclature are based on

A

Virus Subtype: (H#N#)

  • Hemagglutinin (HA)
  • Neuraminidase (NA)
25
Q

What are the functions of virus surface structures found on Influenza viruses?

A
  • HA: glycoprotein on virus that binds to the host cell’s sialic acid receptor
  • NA: cleaves the sialic acid receptor, freeing the virus from the host cell
  • M2 ion channel: maintains p H across viral envelop during cell entry
26
Q

What virus surface structures are on Influenza Type A?

A

HA, NA, M2 ion channel

27
Q

What virus surface structures are on Influenza Type B?

A

HA, NA

28
Q

involves the accumulation of a series of minor genetic mutations, resulting in amino acid substitutions; prevents binding of antibodies induced by previous flu infection/vaccination

A

Antigenic drift

29
Q

involves reassortment (“mixing”) of viral genes in Influenza Type A viruses, resulting in new H/N combinations; responsible for pandemics

A

Antigenic shift

30
Q

Antigenic shift can occur between different types of influenza (A, B and C) (True or False)

A

False: Type A only can experience antigenic shift

31
Q

Influenza vaccines induce antibodies to

A

HA and NA

32
Q

What is the virus responsible for COVID-19?

A

SARS-CoV-2 (from bat to civet to humans)

33
Q

What is the structure of coronavirus?

A

+ssRNA, enveloped, non-segmented virus

  • RNA is packaged in a coiled structure made of N (nucleocapsid) proteins
34
Q

What is the receptor for SARS-COoV-2 for entry into host cells?

A

ACE2

  • protruding viral spike of coronavirus binds ACE2 receptor
35
Q

ACE2 receptors are expressed by what cells?

A

epithelial cells in ORAL, LUNG, intestines, kidney, blood vessels

  • why coronavirus cause upper respiratory and lung-related symptoms
36
Q

Patients with HTN and diabetes are at risk for severe clinical presentations of COVID-19 because

A

they often take ACE inhibitors, resulting in increased expression of ACE2 receptors

37
Q

Drugs of choice to treat CMV by blocking viral DNA synthesis

A

Ciclovirs

  • Ganciclovir
  • Valganciclovir
38
Q

MoA of Ganciclovir

A

Ganciclovir is a purine analog that mimics guanosine during viral DNA replication. It gets triphosphate added by viral and host cellular kinases.

Two Effects:
1) Ganciclovir-triphosphate competes with GTP for binding to polymerase

2) incorporates into DNA causing chain termination

39
Q

MoR against Ganciclovir

A

mutations in CMV kinase or CMV DNA polymerase

40
Q

Toxicities of Ganciclovir

A
  1. Myelosuppression
    - thrombocytopenia
    - neutropenia
  2. Category C Pregnancy risk (both Gan & Val)
41
Q

Why is Valganciclovir more effective than Ganciclovir?

A

Valganciclovir is the pro-drug version of ganciclovir, so metabolism activates it (as opposed to ganciclovir who gets inactivated)

42
Q

Drugs of choice to treat Influenza by inhibiting M2 ion channels

A

Mantadines

  • Amantadine
  • Rimantadine
43
Q

MoA of M2 inhibitors

A

Mantadines inhibit viral uncoating by blocking M2 proton pump which acidifies viral envelop to facilitate viral uncoating.

44
Q

Drugs of choice to treat Influenza by inhibiting neuraminidase (NA)

A

Mivirs

  • Oseltamivir
  • Zanamivir
45
Q

MoA of neuraminidase inhibitors

A

Mivirs inhibit viral release by blocking neuraminidase that cleaves sialic acid-hemagglutinin complex.

46
Q

Which influenza medication is best to start within 1 day of symptoms, or else it becomes drastically less effective?

A

Oseltamivir

47
Q

Why might neuraminidase inhibitors be preferred over M2 inhibitors when treating Influenza?

A

M2 blockers are exhibiting resistance

48
Q

toxicity for Zanamivir

A

Since it’s inhaled: Bronchospasm (avoid in asthma or COPD patients)

49
Q

What pregnancy risk category are NA inhibitors belong to?

A

C

50
Q

Drug of choice to treat RSV by inhibiting viral RNA polymerase

A

Ribavirin

51
Q

MoA of Ribavirin

A

Ribavirin is a purine analog that blocks RSV RNA synthesis. 3 Effects:

  1. Inhibits GTP synthesis acting as an analog
  2. Gets incorporated into RNA producing a defective RNA
  3. Inhibits RNA replication by stopping RNA polymerase
52
Q

Potential drug interactions and toxicities for Ribavirin

A
  1. Hemolytic anemia
    - cause oxidative damage
  2. Nephrotoxicity
    - cleared in kidneys; avoid in patients with kidney problems
  3. Category X
    - cause DNA damage
    - long half-life to be cleared
  4. Blocks activation of HIV drugs
53
Q

Drug of choice to treat coronavirus by inhibiting viral RNA polymerase

A

Remdesivir

54
Q

Remdesivir was originally developed to treat

A

ebola

55
Q

MoA of Remdesivir

A

Remdesivir is an adenosine analog that terminates viral RNA polymerization

56
Q

Toxicities of Remdesivir

A
  1. Hepatotoxicity

2. Avoid in patients with renal issues

Respiratory 2 (6 decks)

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