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Year 5 path SW COPY > Microbiology 15: Antiviral Therapy > Flashcards

Microbiology 15: Antiviral Therapy Flashcards

1
Q

What disease does EBV cause ?

A

Infective mononucleosis

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2
Q

Where does Varicella Zoster Virus lay dormant in the body?

A

Dorsal root ganglia

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3
Q

What is a complication of Chickenpox in adults?

A

Varicella pneumonitis

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4
Q

What is a complication of shingles in adults ?

A

Post-herpetic neuralgia

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5
Q

Which medication is 1st line for treatment of HSV and VZV ?

A

Aciclovir

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6
Q

What type of anti viral is acyclovir ?

A

Nucleoside analogue

They get incorporated into growing chain of DNA causing it to terminate

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7
Q

Give 2 reasons why aciclovir has reduced toxicity to normal cells compared to cells infected with a virus?

A

Aciclovir requires activation by viral thymidine kinase (found in cells infected by viruses)

Aciclovir has a higher affinity for Herpes virus DNA polymerase compared to human DNA polymerase

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8
Q

Which medical emergency is caused by HSV ?

A

HSV encephalitis

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9
Q

What is the characteristic histological appearance of CMV infection ?

A

Owl’s eye inclusions

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10
Q

Which virus are immunocompromised patients particularly at risk of compared to immunocompetent people ?

A

CMV

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11
Q

In which cells does CMV tend to lie dormant ?

A

Monocytes

Dendritic cells

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12
Q

What anti viral treatments are used to treat CMV infection ?

A

Ganciclovir
Foscarnet
Cidofovir

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13
Q

Which disease can EBV cause in immunocompromised patients ?

A

PTLD - post transplant lymphoproliferative disease

The EBV keeps dividing unless kept in check by the immune system
This causes polyclonal activation of B cells

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14
Q

What does PTLD predispose to ?

A

B cell lymphoma

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15
Q

What is the treatment for PTLD ?

A

Rituximab - monoclonal antibody against CD20 B cell surface marker

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16
Q

What are the 2 main surface proteins on influenza virus ?

A

HA- haemaglutinin

NA- Neuraminidase

17
Q

Which disease is commonly caused by RSV ?

A

Bronchiolitis

18
Q

Who should palivizumab be given to prophylactically ?

A

High risk infants (preterm, heart or lung disease, SCID) in the winter months
Prevents severe disease from RSV

19
Q

Which 2 diseases does BK virus cause in immunocompromised patients?

A

Haemorrhagic cystitis in bone marrow transplant patients

BK nephritis in renal transplant patients

20
Q

Which immunomodulatory therapy is used to treat hepatitis B ?

A

Interferon Alpha

21
Q

Which antiviral drug is used to treat and prevent Influenza In the elderly?

A

Oseltamivir

22
Q

Which antiviral can be used in aerosol form to prevent RSV infection in children with heart and lung disease ?

A

Ribavirin

23
Q

Which ART is given to pregnant women with HIV ?

A

If already on ART don’t change it - most likely Zidovudine

Otherwise:
Nevirapine

24
Q

Which antiviral is the drug of choice for CMV infection ?

A

Ganciclovir

25
Q

What is the prodrug of aciclovir that can be used in VZV infection ?

A

Valaciclovir

26
Q

Which antiviral drug is used to treat severe resistant herpes infection ?

A

Foscarnet

27
Q

Which drug is effective against Influenza A but not Influenza B ?

A

Amantadine

28
Q

Which HIV drug works by inhibiting reverse transcriptase by acting as a guanine analogue?

A

Zidovudine

29
Q

treatment for HSV encephalitis

A

medical emergency

start empirical treatment with IV aciclovir 10 mg/kg tds without awaiting test results

30
Q

treatment for HSV meningitis

A

usually self limiting
IV aciclovir 2-3 days, then switch to oral for 10 days
valaciclovir alternative in immunocompetent to avoid cannulation

31
Q

indications for treatment for VZV

A

chickenpox in adults (risk of pneuonitis)
shingles in adults >50 yrs ( risk of post-herpetic neuralgia)
primary infection/reactivation in an immunocompromised patient
neonatal chickenpox

32
Q

consequences of CMV in immunocompromised patients

A

bone marrow suppression, retinitis, pneumonitis, hepatitis, colitis, encephalitis

33
Q

treatment for CMV infection

A

ganciclovir (IV) - S/E = BM toxicity
valganciclovir (PO)
foscarnet (IV) - nephrotoxicity
cidofovir (IV) - nephrotoxicity

34
Q

describe how viruses gain entry into cells

A

HA mediated virus binding and entry into target cell
NA allows the release of progeny virus particles from the host cell
NA is the target for current anti-influenza drugs

35
Q

treatment for RSV

A

(most common cause of bronchiolitis)
ribavirin - neucleoside analogue
IVIG - in immunocompromised
palivizumab - monoclonal ab against RSV

36
Q

BK virus treatment

A

lifelong carriage in the kidneys and urinary tract
problems in the immunocompromised
BK haemorrhagic cystitis - bladder washouts, cidofovir IV
BK nephropathy - reduce immunosuppression and IVIG

37
Q

adenovirus treatment

A

cidofovir IV
IVIR
brindcidofovir PO

38
Q

immunoglobulin preparations for post-exposure prophylaxis

A

VZIG
hepatitis B ig
human rabies IG

Year 5 path SW COPY (106 decks)

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