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Block 3 Found Sci > 4- Viral Respiratory Infections > Flashcards

4- Viral Respiratory Infections Flashcards

(50 cards)

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1
Q

how damage predisposes pt’s to super infections (baterial)

A

interrupt mucocilliary escalator (can’t expel bacteria or pollutants) + weaken immune system (fighting viruses instead of bacteria)

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2
Q

common cold symptoms

A
  1. rhinitis (inflamm of nasal mucosa)
  2. pharyngitis (sore throat)
  3. NO high fever, lower respir involvement, or respir distress

allergies can mimic symptoms

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3
Q

complications of common cold

A
  1. otitis media
  2. sinus infections
  3. exacerbation of asthma (rhinovirus C)
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4
Q

common cold treatments

A
  1. antihistamines
  2. decongestants
  3. NOT antibiotics
  4. no vaccines bc high variation of viruses

prevention by washing hands and covering coughs

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5
Q

common cold pathology
viruses

A
  1. attach in nasal epi
  2. replication in epi cells
  3. cell damage
  4. host defense activated to clear cell debris
  5. nasal epi regenerate
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6
Q

etiology of colds
viruses causing colds

A
  1. rhinovirus
  2. coronavirus
  3. other known (adenovirus, coxsackie)
  4. unidentified

all transmission thru contact/droplet except coxsackie fecal-oral

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7
Q

rhinoviruses

A

most common cause
-from picorna (small RNA) family non enveloped, +ssRNA
-species A, B,C but tons of diversity

shed in respir secretions so transmit contact or large droplets

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8
Q

coronavirus

A

coronaviridae family enveloped +ssRNA
-spike proteins to attach
-non SARS that causes common cold

aleviate symptoms to treat, no vaccine

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9
Q

non SARS coronavirus mechanisms

A

rep in epi cells of respir tract
-transmit thru large droplets
-usually infants and children

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10
Q

adenoviruses features

A

non enveloped dsDNA adrenovirus family
-fiber proteins protrude from vertices of capsid for attachment and toxic

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11
Q

adenovirus

A

serotypes 1,2,5 cause colds
-prevalent in children under 5
-can enter lymphoid tissue and stay for 18 mo
-no seasonal pattern

transmit via oral, droplet inhalation, conjuctiva

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12
Q

other illnesses of adenovirus

A
  1. pharyngoconjuctival fever
  2. severe respir infection (croup, pneumonia, bronchiolitis)
  3. GI disease (serotypes 40 and 41)
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13
Q

treatment adenovirus

A

-reduce symptoms
-immunity long lived but serotype specific
-military recruits get live oral vaccine for 4 and 7

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14
Q

coxsackieviruses

A

enterovirus family of picornaviruses
-non enveloped + ssRNA
-replicate in cytoplasm

fecal-oral transmission, no vaccine or treatment needed to recover
-lower sanitation places, children in daycare

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15
Q

herpangina

A

from coxsackie
-abrupt onset of fever + small vesicles/blisters on soft palate that can rupture

high in children 1-7

can lead to meningitis or encephalitis

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16
Q

hand-foot and mouth disease

A

fever + vesicular lesions on palms of hand and soles of feet

common in children, goes away on own

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17
Q

influenza viruses

A

B and C can cause cold symptoms instead of flu symptoms

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18
Q

croup symptoms

A

swelling in subglottic region of larynx ‘laryngotracheobronchitis’

nasal discharge + mild cough+ pharyngitis > fever + brassy cough (like seal bark) + inspiratory stridor rattling
-chest x ray shows narrowing of air shadow ‘steeple sign’
-worried about hypoxia

highest in kids under 6

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19
Q

croup treatment

A

alleviate symptoms
-if no stridor at rest then humidify air and hydrate
-if yes stridor at rest then oxygen, epinephrine, glucocorticoids

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20
Q

croup etiology

A
  1. parainfluenza virus
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21
Q

parainfluenza viruses

Study These Flashcards
A

-paramyxovirus family

22
Q

parainfluenza mechanisms

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A

large droplet and direct contact transmission
-infect/repl in ciliated epithelium of respir tract

can be reinfected more mildly, short lived immunity

23
Q

acute bronchitis

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A

cough without pneumonia/alternative medical disorder/history of chronic lung
-from influenza A and B

cough lasting more than 5 days (median 18 days)

antibiotics (limited effective) or bronchodilators (if wheezing)

24
Q

bronchiolitis

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A

expiratory wheezing + nasal flaring + air trapping + subcostal/intercostal retractions + fever

infants prevelent bc airways so small

25
RSV
causes bronchiolitis and pneumonia transmission thu inhale large droplets and direct contact -nearly all children infected by 4, reinfection more mild like colds
26
RSV season
october-may but varies by part of country -since covid shifted more towards august
27
RSV treatment
aerosolized ribavirin -guanosine analgoue so inhibits nucleotide syn consider if severe lower tract RSV in premature infants, chronic lung diease, congenital heart disease, immunocompromised
28
RSV passive immunoprophylaxis
palivizumab (monoclonal anti-RSV antibody) injected monthly for 5 mo during RSV season prophylaxis of infants in first year if premature, chronic lung dz, or heart dz up to 2nd year if immunocompromised
29
influenza symptoms
-myalgia -headache -fever -shaking chills -cough -fatigue, general weakenss inc severity during pandemic outbreaks peak during winter
30
risk complications influenza
kids under 2, adults over 65, preg women or up to 2 weeks post partum certain med conditions (anything that affects respiratory, metabolic disorders)
31
pneumonia
inflamm of lung parenchyma > abnormal gas exchange fever + chills + cough + pleuritic chest pain + inc respir rate + wheezes/crackles
32
primary influenza virus pneumonia
usually influ A -inc cough, tachypnea, dyspnea, acute respir distress -sputum gram stain shows abundant pmn cells, not much bacteria -radiograph shows lung infiltrtion with interstitial pattern of opacities
33
bacterial influenza associated pneumonia
onset a week after influ symptoms begin -biphasic pattern so symps lessen for little while then progress worse (cough, fever, respir distress) gram stain may show bacteria (S. pneumoniae, S. aureus, H influenze)
34
influ virus
segmented -ssRNA orthomyxovirus enveloped agglutinates RBCs (hemagglutinin) + neuraminidase (virion release and spread)
35
antigenic drift | influ
small changes in H and N driven by point muts (from polymerase during rep) epidemiological significant changes every 2-3 years
36
antigenic shift | influ
large changes in H and N driven by reassortment of two viruses co-infection of same cell by diff virus strains, risk for pandemics
37
reassortment barriers
-specialize for the host so human strains spread in humans but not thru animals and v/v -mixing vessel animals that can support infection from diff species (avian and human can infect swine) allow transmission b/t species
38
anti-virals for influenza
1. ion channel blockers-block rep prior to genome release 2. neuraminidase inhibitors- inhib virion release and spread of A and B 3. endonuclease inhibitor- target cap dependent endonuclease to cleave, single oral dose vs A and B
39
types of neuramindase
1. zanamivir- inhalation admin 2. oseltamivir- oral admin 3. peramivir- IV admin
40
ion channel blockers
amantadine or rimantadine, was only effective vs A but now A has resistance,
41
when to use antivirals
-if no risk factors and within 48 hours otherwise limited effectiveness -if yes risk factors then at anytime
42
influenza vaccines
1. inactivated-dead virus via intramuscular injection 2. live attenuated- intranasal inhalation 3. recombinant - hemagglutinin protein instead of virus, intramuscular
43
production methods of vaccine influ
1. classic- chicken eggs 2. novel- mammalian cells (faster than eggs) like MDCK cells recombinant made by purifying baculovirus that infects a fermenter (faster and egg free)
44
vaccine components
2 influ A + 2 influ B strains
45
dosing and timing
offer vaccine by late october -antibody resp within 2 weeks -1 dose per/year except under 9 then 2
46
COVID diagnosis
1. nucleic acid detection/PCR, most sensitive 2. antigen test
47
COVID antivirals
1. **remdesivir**- targets RdRp of CoV, peds and adults can recieve if pos, hospitalized pts 2. ritonavir boosted nirmatrelvir/**paxlovid**- inhibits cyctochrome enzymes, mild to moderate symptoms, oral, not for hospitalized 3. **molnupiravir**- induces hypermutation so interrupt normal fxn, oral deilvery, not for preg or hospitalized
48
COVID vaccines
1. mRNA based, intramuscular, invoke antibodies vs spike protein, Phizer and Moderna 2. rep defective adenovirus vector encodes spike, J and J 3. recombinant spike protein, Novavax, has adjuvant
49
cytomegalovirus
respir illness in immunocomp indivs
50
measles and varicella

Block 3 Found Sci (60 decks)

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