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RESP II Exam 2 > Virus CIS > Flashcards

Virus CIS Flashcards

1
Q

50yo F one day fever, weakness, aches, hurts all over, T 102, WBC 5,900 1% bands

A

nasal swab influenza A

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2
Q

most appropriate initial therapy for influenza

A

oseltamivir

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3
Q

neurominidase inhibitor

A

oseltamivir

zanamivir

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4
Q

mechanism of oseltamivir

A

neuroanimidase inhibitor

  • influenza A and B
  • blocks release of virions
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5
Q

active against influenza A and B

A

oseltamivir

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6
Q

block release of influenza A only

A

rimantadine and amantadine

prevents penetration of influenza A - block uncoating of virus

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7
Q

benefit of beginning antiviral tx

A

prevent viral shedding

  • within 48 hours
  • decrease duration of symptoms 1 - 2 days
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8
Q

used with contraindication in asthma/COPD patient

A

zanamivir

-bronchospasm, decreased pulmonary function

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9
Q

side effect of oseltamivir

A

diarrhea, nausea, vomiting

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10
Q

3mo infant, fever, difficulty feeding, nasal discharge, stop breathing when feeding, premature birth and congenital heart disease

A

respiratory syncytial virus

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11
Q

RSV

A

age < 12 mo
winter season
lower resp tract

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12
Q

Tx of RSV

A

primarily supportive

and possibly bronchodilators - if wheezing

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13
Q

ribavirin

A

inhalation aerosol

nucleoside analog - inhibit RNA and DNA virus replication, inhibit viral protein synthesis

toxic to healthcare workers

only for life-threatening disease

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14
Q

palivizumab

A

monoclonal Ab

-prophylaxis for RSV given monthly

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15
Q

52yo M kidney transplant follow up, DMII, elevated serum Cr (normal with kidney transplant)

A

trimethoprim/sulfamethoxazole (bactrim) - prophylaxis for PCP

pneumocystic jirovecii

immunocompromised patient

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16
Q

TMP-SMX

A

trimethoprim/sulfamethoxazole - prophylaxis for PCP

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17
Q

alternative for sulfa given bactrim

A

atovaquone
dapsone
inhaled pentamidine

18
Q

valganciclovir

A

prophylaxis for CMV

19
Q

CMV prophylaxis

A

valganciclovir

20
Q

CMV

A

most common following solid organ transplant

1-4 months after transplant

highest risk if donor + for CMV in negative recipient

21
Q

34yo M painful rash on left back and chest, pain, burning, tingling

A

varicella zoster

22
Q

varicella zoster

A

respiratory droplets

human mucosa and nerves

infected when child with chicken pox

remains dormant in CN ganglia - dorsal ganglia

reactivation - herpes zoster

23
Q

Tx of varicella zoster

A

acyclovir

oral - shingles
IV - if immunocompromised

24
Q

varicella zoster vaccine

A

adults > 60yo
live attenuated

not in immunocompromised
-AIDS, HIV, CD4 < 200, anti-tumor necrosis factor

25
Q

virus specific acyclovir

A

requires viral specific thymidine kinase activation step

inhibits DNA synthesis

26
Q

limitation of acyclovir

A

low bioavailability

valacyclovir - higher bioavailability - absorbed better

27
Q

varicella zoster tx

A

onset of rash - within 72 hours

moderate reduction in postherpetic neuralgia

28
Q

9yo M, ER, fever, cough, difficulty breathing, rash started on face and spread downward, T 104, pulse 140, throat small red spots with blue - white centers, blotchy red rash over body, CXR infiltrate

A

koplik spots

measles

29
Q

koplik spots

A

blue white centers small red dots - in throat

seen with measles

30
Q

rubeola virus

A

measle

paramyxovirus

31
Q

spread of rubeola virus

A

resp droplets

32
Q

3 C of rubeola

A

measles

cough, coryza, conjunctivitis

33
Q

how long measles infectious

A

4 days prior to rash until 4 days after onset of rash

34
Q

complications of measles

A

diarrhea, otitis media, pneumonia

postinfection encephalomyelitis

subacute sclerosing panencephalitis (severe) - years after measles - fatal

35
Q

measles prevention

A

MMR vaccine

36
Q

16yo M, fever, HA, malaise, facial swelling 3 days, pain in testicles, swollen/tender

A

mumps

parotitis
aseptic meningitis
orchitis

37
Q

mumps transmission

A

droplet spread - upper resp secretions

38
Q

55yo M nurse, fever, chills, myalgia, HA, T 100, Sx progress weakness, HA, confusion, SOB, N/V/D, rash, petichiae on legs, liver enzymes elevated, prolonged PT and PTT, fibrin degradation products, multiorgan failure, death

A

DIC - long PT, PTT, fibrin degradation products

ebola

39
Q

ebola

A

single-strand RNA virus
-hemorrhagic fever virus

coag defect, cap leak syndrome, shock

begins non-specific flu sx

tx - supportive
-experimental - ZMapp - monoclonal Abs for ebola viral glycoprotein

40
Q

4yo M dyspnea, fever, runny nose, sneezy, cough body aches, severe SOB last couple days, hypoxic, expiratory wheezing, CXR b/l interstitial infiltrates, tx goes home, 2 weeks later flaccid paralysis of lower extremities

A

DDx - polio, guillane barre, botulism

anterior myelitis on MRI - polio

enterovirus D68

41
Q

SARS

A

coronarvirus
-birds, small mammals

fever, flu, dry cough, dyspnea, far east or toronto

mortality 50%

RESP II Exam 2 (23 decks)

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