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Year 2 Resp Exam 2 > Viral infections and Tx, The Kinders, CIS > Flashcards

Viral infections and Tx, The Kinders, CIS Flashcards

1
Q

50 y.o 1 day Hx fever, weakness and body aches
normal WBC
preemptive Dx

A

flu

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2
Q

Tx for influenza A and prophylaxis

A

oseltamivir

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3
Q

What are amantidine and rimantidine

A

M2 Ch blockers for Tx influenza A only

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4
Q

how oseltamivir works

A

blocks release of new influenza A and B virions

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5
Q

how does rimantadine and amantadine work

A

prevents penetration of influenza A (not B) virus into the host cell

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6
Q

when do you initiate anti-viral therapy

A

within 48 hrs of Sx

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7
Q

caution should be uses with which antiviral in patients with COPD or asthma

A

zanamivir because bronchospasm

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8
Q

side effect of oseltamivir

A

diarrhea, psychiatric behavior changes

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9
Q

3 mo ED with fever, difficulty feeding and thick nasal discharge
baby stops breathing when feeding
winter season
most likely infection?

A

RSV

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10
Q

Tx RSV

A

supportive care

pharmacotherapy: bronchodilators, hypertonic saline, ribavirin

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11
Q

what is ribavirin MOA

A

nucleoside analog that inhibits replication RNA and DNA viruses
inhibits viral protein synthesis

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12
Q

ribavirin is reserved for what and why

A

life threatening disease because may be toxic

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13
Q

what is palivizumab and use

A

monoclonal Ab for prophylaxis of RSV

inhibits RSV replication

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14
Q 
52 y.o M
DM with recent kidney transplant
on tacrolimus, mycophenolate, prednisome
bactrim, valganciclovir
what is bactrim used prophylactically for?
A

PCP prophylaxis

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15
Q

bactrim prophylaxis regimen after transplant

A

6 mo-1 yr

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16
Q

alternative prophylaxis for PCP if sulfa allergy

A

atovaquone
dapsone
inhaled pentamidine

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17
Q

which CMV prophylactic has greater bioavailability

A

valganciclovir

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18
Q

33 y.o M painful rash on back and chest
pain burning and tingling 2-3 days prior
Dx?

A

varicella zoster

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19
Q

how is varicella zoster spread

A

respiratory droplets

exposure as child

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20
Q

how is varicella zoster prevented in adults

A

varicella zoster vaccine that is given to adults>60

live attenuated

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21
Q

contraindications for varicella zoster vaccine

A

immunocompromised
CD4<200
immunosuppressive therapy
TNF alpha therapy

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22
Q

why is acyclovir virus specific

A

virus specific initial viral step

thymidine kinase

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23
Q

major limitation of acyclovir

A

low bioavailability, up to 5x a day

24
Q 
9 y.o M 
fever cough and dyspnea
rash on face that spreads down
high fever, tachycardia and tachypnea
red spots with blue white centers
A

kopilik spots

rubeola- measles

25
Q

how is measles spread

A

respiratory droplets

26
Q

3 Cs in measles

A

cough, coryza(nose inflammation) and conjunctivitis

27
Q

how long is child with measles infectious

A

8 days

4 days before and 4 days with onset

28
Q

complications of measles

A

diarrhea, otitis media and pneumonia

encephalomyelitis and sclerosing panencephalitis

29
Q

prognosis of subacute sclerosing panencephalitis

A

fatal

30
Q

how is measles prevented

A

mmr

31
Q

signs postinfectious encephalomyelitis

A

2 weeks after rash

onset HA, fever, vomiting, stiff neck

32
Q

16 y.o M with fever HA malaise, facial swelling 3 days
testicular pain
unknown vaccination status

A

mumps

33
Q

clinical manifestations of mumpms

A

parotitis
aseptic meningitis
encephalitis rare and severe
orchitis

34
Q

how is mumps spread

A

respiratory droplets

35
Q

Tx mumps

A

supportive

36
Q

55 y.o M
fever, chills, myalgias HA
no edema, lungs CTA, heart RRR

A

viral or bacterial

37
Q

elevated PT and PTT is characteristic

A

DIC

38
Q 
4 y.o M
severe dyspnea
hypoxic 84% on RA
expiratory wheezing
b/l interstitial infiltrates
Tx with albuterol
but returns with LE paralysis, MRI shows anterior myelitis
A

polio
boltulinum toxin
guillain barre
enterovirus D-68

39
Q

second most common cause of common cold

A

corona virus

40
Q

reservoir for SARS

A

birds and small mammals

41
Q

Dx SARS

A

clinical Hx and travel Hx

far east or Toronto

42
Q

clinical manigestations SARS

A

flu like

fever above 100.4

43
Q

Tx SARS

A

supportive

44
Q

what are shape paramyxoviruses

A

enveloped helical nucleocapsid

negative sense ssRNA

45
Q

shape CMV

A

ds DNA

46
Q

large central basophilic intranuclear inclusion “owl eye” is indicative of what

A

CMV

47
Q

Clinical manifestations of congenital and neonatal CMV

A

microcephaly, intracerebral calcification
HSM and rash
mental retardation and hearing loss

48
Q

how does CMV present in immunocompetent

A

asymptomatic

some have mono-like illness

49
Q

CMV in transplant recipient

A

fever, neutropenia, atypical lymphocytes and HSM
hepatitis
pneumonia
colitis-diarrhea

50
Q

CMV in AIDS patients

A

CD4<50
retinitis
colitis

51
Q

Dx CMV

A

culture, CMV Ag or nucelic acid detection

serology

52
Q

Prevention of CMV

A

reducing exposure to body fluids

53
Q

Tx RSV

A

ribavarin

54
Q

clnical manifestations of RSV

A 
conjunctivat injection, mucous discharge from nose
cough low grade fever
otitis media
lower resp Sx
expiratory wheezing
diffuse interstitial pneumonitis
55
Q

clinical presentation measles

A

incubate 8-12 days

flu like with koplik spots which proceed to maculopapular rash

56
Q

What does parainfluenza cause

A

croup
bronchiolitis or pneumonia
cold

57
Q

What are the paramyxoviruses

A

parainfluenza
measles
mumps
RSV

Year 2 Resp Exam 2 (33 decks)

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