antiviral treatment

Question 1

what is treatment for VZV

Answer 1

acyclovir
or valacyclovir
PO/IV

Question 2

how do you treat HSV encephalitis

Answer 2

medical emergency

IV acyclovir 10mg/kg TDS without waiting for test results

Question 3

when do you treat VZV

Answer 3

chickenpox in adults

shingles in adults >50 (post-herpetic neuralgia)

Question 4

what is the presentation of CMV on blood smear

Answer 4

owl’s eye inclusions

Question 5

how do you treat CMV

Answer 5

galancyclovir IV

valgancyclovir

Question 6

how do you treat EBV in post transplant lymphoprolifetative disease

Answer 6

reduce immunosuppression

RITUXIMAB (anti CD20)

Question 7

what does EBV cause in immunocompromised

Answer 7

lymphoprolifetative disease

Question 8

what does RSV cause

Answer 8

bronchiolitis

Question 9

how can you treat RSV

Answer 9

rivavarin

IVIG

Question 10

what do you use for RSV prophylaxis

Answer 10

Pavilizumab

Question 11

explain the process of BK virus infectionq

Answer 11

childhood infection causes minimal symptoms
lifelong carriage in kidneys and urinary tract

if immunocompro

Question 12

what can BK cause in BM transplant patient s

Answer 12

haermorrhagic cystitis

Question 13

what can BK cause in renal transplant patients

Answer 13

BK nephritis

Question 14

what is tx for BK haemorrhagic cystitis

Answer 14

bladder washout
reduce immunosuppression
cidofovir IV

Question 15

what is tx for BK nephropaty

Answer 15

IVIG

reduce immunosuppression

Question 16

what are the risks in CMV transmission depending on the type of transplant?

Answer 16

If solid organ transplant: risk if +ve donor, -ve recepient

if SC transplant: risk if -ve donor, +ve recepient

Question 17

what does EBV cause in HIV patients

Answer 17

hairy leukoplakia

lymphoma

Question 18

what are the three types of flu that affect humans each year

Answer 18

Influenza A H1: peaks beginning on Jan
Influenza A H1N1: peaks end of december
Influenza B: peaks March

Question 19

what is the natural reservoir for influenza A

Answer 19

ducks

Question 20

Why was bird flu (H1N1) transmission between humans improbable

Answer 20

because virus does not replicate well at cold temperatures of upper airways

Question 21

What is the influenza vaccine made up of

Answer 21

TRIVALENT: purified fractions of HA and NA of INACTIVATED virus

Question 22

Whaat is the function of HA and NA

Answer 22

Haemagglutinin: HI
- allows entry of virus via binding to saialic acid receptors

Neuraminidase: NA
- cleaves host salicilic acid > exit cell

Question 23

What is an antigenic drift

Answer 23

Mutations occurring in HA/NA to give new strains of the virus

These mutations are basic, gradual > only beneficial ones are selected

Question 24

WHat is antigenic shift

Answer 24

Complete change of HA/NA
Occurs when two different viruses attack the same host cell

So when they repackage into new virus the 8 genome segments are randomly selected and will be a mixture of the two
> FAST and DRASTIC mutation

Question 25

What kind of virus can antigenic shift occur in

Answer 25

INFLUENZA ONLY

Becuase it has 8 RNA segments as genome

Question 26

What are 2 classes of antivirals that can be given for influenza

Answer 26

• Amantadine

- Neuraminidase inhibitors (tamiflu/relenza)

Question 27

How and on what does amantamine work

Answer 27

Amantamine - only for influenza A

Targets M2 ion channel

Question 28

What are examples of neuraminidase inhibitors

Answer 28

Oseltamivir (tamiflu)

Zanamivir (relenza)

Question 29

WHen must neuraminidase inhibitors be given

Answer 29

Effective only if given <48 hours after infection