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Respiratory > Viruses in Lung > Flashcards

Viruses in Lung Flashcards

1
Q

Respiratory Viruses:

Start with Respiratory transimission–> replication in upper tract and you can have what three complications?

A

Upper and sometimes lower respiratory infections and diseases

Respiratory disease; serious such as pneumonia

replication leads to viremia in target organs

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2
Q

Influenza virus

_____subtypes of hemagglutinin (HA)

___ subtypes of neuraminidase (NA)

with both animal and human hosts playing key role in epidemiology

A

16

9

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3
Q

Explain difference between antiginetic drift and shift in regards to influenza virus

A

Drift happens with slowly, over years, with small changes to HA or NA while NP stays constant

Shift happens rapidly (one year) with one big shift in NA or HA

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4
Q

Flu Vaccine

  1. Each year make vaccine to ___ strains
  2. Post vaccine, body makes ____
  3. If you are exposed to any of those strains, anitB latch onto virus’s _______ and prevent flu from attaching to healthy cells
A

3 strains (2 for A 1 for B)

body makes antibodies

latch onto virus’s HA antigens

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5
Q

INfluenza virus genes are made of ____ making them more prone to mutations

If HA gene changes, so can the antiG that encodes it causing it to change shape… the antiB we got from flu vaccine no longer work, this is called

A

RNA

antigenic DRIFT

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6
Q

The genetic change that enables flu strain to jump from one animal species to another including human:

A

anitgentic SHIFT

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7
Q

W/out undergoing genetic change, a bird strain of influenza A can jump to another duck or even human, the new strain may further evolve and then can spread person to person… if so a flu _____ can arise

A

Pandemic

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8
Q

How does genetic mixing result in a new strain of influenza

A

A bird can pass influenza A to pig

A person can pass influenza A to same pig

If both viruses infect the same cell and the genes mix–> get new strain

New strain can spread intermediate host to human

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9
Q

The third way a bird host can get influenza to a human is if the influenza bird strain jumps to _____ and then to humans

A

human host

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10
Q

Influenza ____ result from antigenic shift

A

pandemics

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11
Q

H5N1 in 2014 was confirmed avian influenza that 393 people died from… is it easy to trasmit and how does it transmit?

What about H7N9?

A

does not transmit easily, people exposed to infected household poultry or contaminated environment

H7N9: doesn’t transmit easliy, killed 175

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12
Q

Influenza pathogenesis:

what type of disease is it?

How does it infect host?

How is it replicated?

A

Influenza - acute respiratory diseaes

Virus infects ciliated epi cells lining URT, trachea and bronchi

Replicates by destruction of respiratory epithelium

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13
Q

How does influenza cause cell damage?

A

From virus activation of cytotoxic T cells

***viremia doesn’t play major role in pathogenesis

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14
Q

Describe tracheal mucosa:

normally-

3 days post infection

7 days post infection

A

Normally: ciliated

3 days post: all cilia gone (susceptible to 2nd bacterial infection) and decreased clearance of gunk

7 days post: slow regrowth of cilia

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15
Q

Disease mechanism of A and B influenza viruses

  1. Where it established infection
  2. Cause of systemic symptoms and local symptoms
  3. key for immune resolution
A
  1. establishes infection in upper and lower RT
  2. Systemic symptoms from interferon and cytokine response to virus

Local from epithelial cell damage: to ciliated and mucus secreating cells

  1. •Interferon and cell-mediated immune responses (natural killer and T cells)
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16
Q

Antibody for future protection against influenza is specific for ____ and ____

which can undergo major ______ or shift and minor _____ or drift

A

HA hemagglutinin and NA neuramidase

minor (mutution:drift) and major (reassortment: shift)

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17
Q

Influenza B only undergoes what kind of changes?

A

minor antigenic changes

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18
Q

Influenza is normally self limited, for 3-7 days and is more sever in ____ and ____

What is our major cause of death with influenza?

A

young and old

death from secondary bacterial infections: S.penumonaie, S.aureues, H.influenzae

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19
Q

What rare complications can arise from influenza virus?

A

myositis and cardiac involvement
– Guillain-Barre’ syndrome
– encephalitis
– Reye syndrome

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20
Q

What are our three vaccine options for influenza?

A

a. formalin inactivated - mixture of prevalent antigenic types (hemagglutinin and neuramindase)
b. attenuated infectious viruses → intranasal administration
c. quadrivalent vaccine available 2013

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21
Q

Antiviral used to treat influenza that inhibits uncoating by blocking M2 protein

A

Amantadine adn imantadine (not used bc of high degree of antiviral resistance)

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22
Q

Antivirals to tx influenza that are neuraminidase inhibitors (inhibit release of progeny virus):

A

Zanamivir and Oseltamivir (Tamiflu)

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23
Q

Rhinovirus – key points
• Cause____% of common colds
• Antigenic diversity - _____ serotypes identified
RV-A (75 serotypes), RV-B (25 serotypes), RV-C (51 serotypes)
•_____ only natural host

A

50%

150

Humans

24
Q

Rhinovirus infections are _________ and temperature sensitive between ____ and ___ degrees

A

infections are mild and self limiting grow better at 33 degrees then 37

25
Q

How is Rhinovirus transmitted?

How is rhinovirus prevented and controlled?

A

Transmission via respiratory secreations/ individual to individual and FOMITES

PRevention and control: no antivirals no vaccines as of now, just handwashing and disinfectants

(has the canyon floor pore)

26
Q

Resonsible for summer colds and flus: common cold symptoms, like fever, head ache and fatigue

A

Enterovirus

27
Q

Enterovirus has what two syndromes? what vaccine or antivirals are available?

A

Respiratory tract infection and undifferentiated fever

no vaccine or antivirals available

28
Q

EV-D68 is enterovirus 68, seen this year in october… what are the symptoms of this disease?

A

Saw flaccid paralysis, not sure why, spread via respiratory secreations from human to human and inactivated by low pH thus doesn’t replicate in GI tract

29
Q

What type of illness do we see do we see in Enterovirus D68?

A

mild to severe respiratory illness, severe; difficulty breathing and wheezing particullarly bad in asthmatics.

30
Q

Corona viruses causes what?

What symptoms do we see?

Is there a vaccine available?

A

cause common colds (second most prevalent cause representing 10 -15% of total)

  • watery eyes, sneezing, nasal congestion, sore throat, sometimes fever, chills, headache, other aches, cough

• no vaccine available

31
Q

Where in the body does Coronavirus infect?

A

• disease limited to upper respiratory tract, infects epithelial
cells (optimal temperature for viral growth is 33° to 35°)

32
Q

Sudden Acute Respiratory Syndrome- what kind of virus?
• Fatality rate among people with illness - about ____
• Transmission mainly by:

A

Coronavirus

10%

f_ace-to-face_ contact , virus in respiratory secretions and feces, **not highly
contagious **

33
Q

How was SARs controlled?

What was the source?

What tx/vaccines are available?

A

By containment

source = bats

No vaccines or antivirals available

34
Q

MERS is what type of virus?

What besides humans does it infect?

How is it transmitted?

A

Coronavirus

infects bats and camels

Doesn’t pass human to human easily, it’s an RNA virus thus unstable

35
Q

What symptoms/ disease results from MERS?

A

Disease: acute severe pnemonaie and renal failure~ people in serious cases tend to have underlying medical issues*

**nosocimial documented

36
Q

Nosociomial transmission of MERS (not sure how important this is below, just be aware)

A

Patient 1 visited Dubai in April 2013, Patient 2 lives in France and did not
travel abroad. Both patients had underlying immunosuppressive
disorders.
Initial clinical presentation included fever, chills, and myalgia in both
patients and diarrhea in Patient 1. Respiratory symptoms rapidly became
predominant with acute respiratory failure leading to mechanical
ventilation. Both patients developed acute renal failure.
MERS-CoV was detected in the lower respiratory tract specimens with
high viral loads.
The two patients shared the same room and bathroom in the hospital for 3
days. The incubation period was estimated at 9-12 days for the second
case. No secondary transmission was documented in the hospital staff
despite the absence of specific protective measure before the diagnosis of
MERS-CoV was suspected.
Patient 1 died on May 28 due to refractory multiple organ failure.
Patient 2 recovered and was discharged from the hospital.

37
Q

When do we see parainfluenza?

What group is at risk?

Vaccine available?

A

occurs in fall and winter, common nosocimial infection

See complications from parainfluenza in infants and young children (CROUP)

No vaccine

38
Q

This virus cause lower respiratory complications in infants and young children such as Croup = subglotal , fever, hoarse voice, loss of apetite, barking cough adn stridor on inhilation

A

Parainfluenza

39
Q

Type I and 2 parainfluenza are common causes of :

Type 3 is simular to:

Type 4 is:

A

1 and 2 like croup

3 simular to RSV

4 mild

40
Q

Respiratory syncytial virus – key points

Where is the infection located?

What problem can it cause in infants?

When are most people infected with this?

A

Localized infection of respiratory tract, no systemic spread
Blockage of narrow airways of infants
Infects virtually everyone by age 2

41
Q

How does Respiratory Syncytial virus cause blockage of airways in infants?

A

Blockage of narrow airways of infants
◊ Virus-induced CPE includes syncytia (multinucleated cells)
◊ Induction of inflammatory cytokines

42
Q

ONce you are infected with RSV, will you get it again?

A

Natural infections do not prevent re-infection
◊ Infections throughout life, can be severe in the elderly
◊ Presents vaccine challenges

43
Q

Clinical consequences of RSV in

Chilren under one:

Children:

older children/adults:

A

Children under 1: bronchiolitis, penumonia or both w/ fever, cough, dysnpnea and cyanosis

Children: febrile rhinitis and pharnygitis

Older: common cold

44
Q

Tx of RSV in otherwise health infant:

premmaure/immunocompromised infants:

Premature:

A
  • Otherwise healthy infant – treatment is supportive, oxygen, IV fluids, nebulized cold steam
  • Premature or immunocompromised infants - aerosolized ribavirin
  • Premature infants – passive immunization with anti-RSV Ig and humanized monoclonal antibodies
45
Q

Metapneumovirus is simular to what disease and in what pt population?

By what age are children seropositive for Metapneumovirus and how is it identified?

Vaccine?

A

disease similar to RSV but in general milder, with the most severe disease seen in infants, the elderly, and immunocompromised

By 5 most kids have it, identified by RT-PCR

No vaccine available

46
Q

• Two emerging respiratory viruses with high mortality
rates
• Have made the apparent jump from bats to people with
pigs as an intermediate host in Australia and Asia.

A

Hendra and Nipah virus

47
Q 
Causes a wide spectrum of disease:  respiratory infection 
(pharyngitis), conjunctivitis (pink eye), gastrointestinal infections, 
hemorrhagic cystitis (inflammation of the urinary bladder)
A

Adenovirus

48
Q

Adenovirus disease is determined by:

When do we see systemic infection of adenovirus

A

determined by the tissue tropism of the specific group or serotype of the virus (>50 serotypes of adenovirus)

See systemic infection in immunocompromised patients

49
Q

What prevention and control is available for adenovirus?

A

o No adenovirus vaccine available for general public, new live
attenutated vaccine against adenovirus types 4 and 7 was
approved by the FDA in 2011 for military recruits
o Cidofovir has been used to treat s_evere adenovirus_ in
immunocompromised people

50
Q

Pharyngoconjuctival fever (red eyes, sore throat adn fever in young kid)

athlete with flu like symptoms, vomitting, chills and high fever–> progressing to pneumonia

febrile respiratory illness on Naval base

What do all of these have in common?

A

Cuased by adenovirus

51
Q

Measles virus is characterized by what symptoms?

What’s the most common cause of death in young children with measles?

A

cough, conjunctivitis, coryza, with otitis media, croup, pneumonia

Pneumonia

52
Q

Adenovirus is in

  1. Which virus family?
  2. DNA or RNA?
  3. Naked or enveloped?
A

Adenovirdiae

DNA and Naked

53
Q

Rhinovirus and enterovirus are both ______

They are DNA or RNA

Naked or Enveloped

A

Rhino and Entero are both Pircornavirus

They are +RNA and Naked

54
Q

SARs, MERS are both Coronavirus, which is

DNA/RNA

Enveloped/Naked

A

Coronavirus are +RNA and Enveloped

55
Q

What virus family does Influenza belong in?

DNA or RNA

Enveloped or Naked?

A

Inlfuenza is in Orthomyoviridae

-RNA and is Enveloped

56
Q

Parainfluenza, RSV, Metapneumovirus and Measles are all in what virus famaily?

They are DNA or RNA

Naked or Enveloped

A

Parainfluenza/RSV/metapneumovirus/Measles

=Paramyxoviridae famiy

(-)RNA and is Enveloped

Respiratory (15 decks)

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