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Year 1 Medicine > Week 139 - Influenza > Flashcards

Week 139 - Influenza Flashcards

1
Q

What happens to arteries and vein as you age?

A

Stiffen

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2
Q

What genetic material are Icosahedral viruses likely to have?

A

DNA & RNA

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3
Q

What genetic material are Helical viruses likely to have?

A

RNA only (e.g. rabies, measles)

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4
Q

What genetic material are “Complex” viruses likely to have?

A

RNA mostly (e.g. smallpox, influenza)

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5
Q

Given an example of an Orthomyxoviridae virus

A

Influenza

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6
Q

Given an example of a Paramyxoviridae virus

A

RSV, Parainfluenza, Measles, Mumps

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7
Q

Given an example of a Picornaviridae virus

A

Polio, Rhinovirus

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8
Q

What viruses can infect by surface fusion?

A

Enveloped only (ph dependent process)

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9
Q

What can aciclovir be used to treat?

A

Similar to Guanosine

HSV and VZV only (due to viral thymine kinase)

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10
Q

What can ganciclovir be used for?

A

CMV (retinitis, pneumonia)

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11
Q

What are the side effects of ganciclovir?

A

Neutropenia, anaemia, thrombocytopenia

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12
Q

What agents can be used for treatment of influenza?

A

Oseltamivir (Tamiflu) - within 48hrs
Zanamivir (Relenza) - within 36hrs
Neuraminidase inhibitors

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13
Q

What is a capsid?

A

Protein coat covering the nucleoprotein core or nucleic acid

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14
Q

What is a capsomere?

A

Protein clusters making up discrete subunits of a viral protein shell

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15
Q

What are the common causes of delirium?

A

UTI
Drugs
General anasthetics

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16
Q

What factors change with age that affect absorption of drugs?

A

↑Achlorhydria (ketoconazole, tetracyclins)

↓First Pass metabolism (β-blockers, Ca channel blockers)

17
Q

What factors change with age that affect distribution of drugs?

A

↑Body Fat (↑distribution of lipophilic drugs, ↓hydrophilic drugs)

18
Q

What is volume of distribution and what do the values mean?

A

↑Volume of distribution = drugs stays in blood

↓Volume of distribution = drugs goes to tissues

19
Q

What happens to renal drug metabolism with increasing age?

A

↓Renal function

Elderly may have “normal” creatinine with poor renal function (due to ↓muscle)

20
Q

What is Digoxin toxicity characterised by?

A 
Dysrhythmias
Nausea and Vomiting
Xanthopsia (things look yellow)
Exacerbated by hypokalaemia
T wave inversion
21
Q

What is an enterovirus?

A

A genus of Picornaviridae that preferentially replicate in the mammalian intestinal tract

22
Q

What is a Herpetic whitlow?

A

A herpes viral infection that results in a painful blistery eruption on one of the digits

23
Q

What is antigenic drift?

A

RNA-dependent RNA polymerase - “no proof reading”
Causing “mistakes”
Immunity to previous influenza provides SOME protection

24
Q

What is antigenic shift?

A

Infection of same cell by two different Flu types, often from different species
Reassortment

25
Q

When is Oseltamivir & Zanamivir recommended?

A

1) Virus is circulating
2) Person is in “at-risk” group
3) Presentation with illness within 48hrs

26
Q

How does NICE define a person “at-risk” of Influenza Infection?

A 
Chronic Respiratory Disease
Chronic Heart Disease
Chronic Renal Disease
Chronic Liver Disease
Chronic Neurological Conditions
Diabetes Mellitus
Immunosuppressed
>65yrs
27
Q

Who is Influenza vaccine offered to?

A

All those >65yrs
All those 6months-64yrs in “clinical risk group”
All those 2-18yrs

28
Q

What is Type I or α error?

A

False Positive Result

29
Q

What is Type II or β error?

A

False Negative Result

30
Q

What are the types of RANDOM ERRORS?

A

Type I and Type II

31
Q

What are the sources of error in clinical trials?

A

Bias
Random Error
Confounding

32
Q

What is Bias and Confounding controlled by in a clinical trial?

A

Randomisation (for both)

And blinding for Bias

33
Q

How is Random Error controlled in a clinical trial?

A

Sample size and Significance level

34
Q

How can confounding be dealt with?

A

1) In the design of the study (matching, restriction)

2) In the analysis (stratified analysis)

35
Q

What is Residual Confounding?

A

Occurs when all known confounders have been accounted for, but there are other unknown confounders

36
Q

What is the difference between cumulative incidence and incidence density?

A

Both incidences
But Cum. Inc. deals with the “number” of people
Whereas Incidence Density accounts for the number of “person-years”

37
Q

How is an Odd’s ratio calculated?

A

Odds of getting something in a population
odds diseased/odds healthy = Odds ratio
or ad/bc= odds ratio

38
Q

How is a Relative Risk calculated?

A

RR= p.exposed/p.unexposed

39
Q

Why is Direct Standardisation method better than SMR?

A

SMR - quick, but does not account for stratification of data

D.S. - BUT need more accurate data

Year 1 Medicine (12 decks)

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