08.20 - Viral Pneumonia (Cross) - Questions Flashcards Preview

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Flashcards in 08.20 - Viral Pneumonia (Cross) - Questions Deck (50):
1

Nearly all viruses that cause pneumonia can cause ___ as well

URTI's

2

Atypical Pneumonia (viruses) is an acute febrile respiratory disease characterized by

(1) Pathcy inflammatory changes; (2) Absence of consolidation; (3) Lack of alveolar exudates

3

Path findings of Atypical Pneumonia

Alveolar walls infiltrated with mononuclear cells (Lymphocytes, Some plasma cells)

4

Persistent cough and severe wheezing in 3 month old boy

RSV

5

Features of RSV-1

Pleomorphic; Enveloped; Negative-sense; Single-stranded; Linear RNA

6

Dx tests of RSV-1

RT-PCR on nasal swab or washings; Rapid antigen test on nasal swab or washings

7

Which common group is not at risk for RSV pneumonia

45-year-old male with 20 pack-year smoking history

8

In healthy adults, RSV presents as

common cold --> One way it may be transferred to infants

9

Usual natural course of RSV in previously healthy infants

Bronchiolitis resolves w/out complications; Mortality rate low (2%)

10

What patients can be severely affected by RSV

Premature; <12 weeks of age; Cardiopulmonary dz; Immunodeficiency

11

Tx and Prevention Options for RSV

Palivizumab; Supportive care w/ hydration, albuterol, oxygen; Ribivirin not recommended

12

Palivizumab

mAb against F protein - prevents binding of virus to host cell

13

mAb against F protein - prevents binding of virus to host cell

Palivizumab

14

Ribivirin in RSV

Routine use in children not recommended

15

Why is RSV one of most likely viral infections to have a picture on step 1

Giant Cell (Syncitia) formation

16

In whom is adenovirus most severe? Most commonly tested?

More severe in infants; Common in military

17

Tx of Adenovirus

None

18

Transmission of Adenovirus

Aerosol, Fecal-Oral, Direct inoculation

19

Most common cause of respiratory tract infections that result in physician visits and hospitalizations in the US

Influenza

20

Most common causes of post-viral secondary bacterial pneumonia

Strep Pneumo, then Staph Aureus

21

2 important surface proteins found on influenza virus

Hemagluttinin; Neuraminidase

22

Hemagluttinin

Attach influenza virus to its cellular target

23

Attach influenza virus to its cellular target

Hemagluttinin

24

Neuraminidase

Facilitates release of newly formed influenza virions

25

Facilitates release of newly formed influenza virions

Neuraminidase

26

Surface F Protein

Causes respiratory epithelial cells to fuse and form multinucleated giant cells (RSV)

27

Causes respiratory epithelial cells to fuse and form multinucleated giant cells (RSV)

Surface F Protein

28

Spike (S) Protein

Mediates fusion between Coronavirus and host cell membrane

29

Mediates fusion between Coronavirus and host cell membrane

Spike (S) Protein

30

How is influenza transmitted and what type of pathology occurs during infection?

Respiratory droplets; Necrosis of superficial layers of respiratory epithelium

31

What results in emergence of new viral strains each year

Antigenic drift

32

Antigenic drift results from

spontaneous mutations in viral genome as it replicates

33

Antigenic shift results from

Reassortment of genome segments (encoding HA and NA genes in flu)

34

Non-segmented negative strand RNA viruses: Shift or Drift

Drift, but not shift, because polymerase makes a lot of mistakes

35

Confirmatory dx of influenza

RT-PCR of Nasopharyngeal Swab

36

Rapid Urine Antigen Test is used in

Legionella, Strep Pneumo

37

3 dx tests of influenza

RT-PCR; Direct fluorescent Ab; Rapid viral antigen test

38

How should patient with influenza be treated

Oseltamavir, Zanamavir, Abx for secondary bacterial pneumonia

39

Influenza important sequelae

Reye's Syndrome

40

Adenovirus important sequelae

Bronchiectasis, Bronchiolitis Obliterans

41

RSV improtant sequelae

Asthma

42

Reye's Syndrome

Encephalopathy and Liver Degeneration; In children following viral infections

43

What virus causes SARS

Coronavirus

44

What virus causes MERS

Coronavirus

45

Hantavirus multiplies in

Pulmonary capillary endothelial cells --> Bilateral pleural effusions w/ interstitial infiltrates of mononuclear cells

46

Transmission of Hantavirus

Aerosol inhalation of rodent excreta (deer mouse)

47

2 important points on HMPV

Respiratory droplets; Winter months

48

Which virus is typically associated with croup and inspiratory stridor?

HPIV-1

49

Typical presentation of Parainfluenza Viruses

Mild URTI, Croup, Bronchiolotitis and Pneumonia

50

Prognosis of Parainfluenza virus

Good, most children recover after a few days. Reinfection common.