Case 1 - Fresher's flu Flashcards
(37 cards)
What is the unique symptom for common cold? (compared to flu)
- Runny nose/sneeze
- Sore throat (common)
What are unique symptoms for flu? (compared to cold)
- Fever
- Headaches
- Feel sick/tired
- Dry cough (common)
What are the common symptoms for cold and flu?
- Cough
- Aches & pain
- Fatigue
What are the common symptoms for coronavirus?
- Fever
- Cough
- Loss of smell/taste
- Shortness of breath
What is essential to evaluate various differential diagnoses?
Patient history
- Why they are here now, and not before
- Open ended qs
- Listen and observe (body language, nonverbal cues)
Why is time such an important element to diagnosis?
- Reason for why patient is here (could have had symptoms since long time ago)
- How have symptoms changed since beginning
- Did symptoms sudden show up
Onset of symptom; cold vs flu
Cold - gradual
Flu - rapid
Meningitis symptoms
- Headache
- High fever
- Rash
Why think about Meningitis, Glandular fever, infectious mononucleosis, Epstein Barr virus etc?
Rare differential diagnosis, must always see if can be excluded
what can a sore throat (+ fever) be a symptom of?
Most often a viral infection, but could also signal diptheria or streptococcal infection (Strep throat - bacterial)
What are the potential post-covid syndromes? (4 groups)
- Aches/pain
- Myalgia (muscle pain)
- Inflammatory response
- Severe lung fibrosis
What are the viruses that cause the common cold?
- Rhinovirus (most common)
- Coronavirus
- Influenza virus (also flu)
- Adenovirus
What glycoprotein does coronavirus attach to?
ACE2
What glycoproteins do Influenza virus attach to?
Protein on virus:
- Haemagglutinin (HA)
- Neuraminidase (NA)
Receptor:
- Sialic acid
What glycoprotein does rhinovirus attach to?
ICAM1
What is the angiotensin system?
Physiological system
What does angiotensin II cause?
Lung injury
Vasoconstriction
etc.
How does coronavirus enter cell?
Uses ACE2 - Angiotensin Converting Enzyme type 2
How does coronavirus control the angiotensin system?
Mitigate the counter protective system
A-(1-7)/(1-9) are anti-inflammatory, A-II is pro-inflammatory
Virus stops ACE2 converting A-II to A-I, therefore exacerbate lung injury
How does influenza virus get into cell?
Viral HA bind to sialic acid residue on lung surface epithelial cell
How does influenza virus get out of cell?
Viral NA cleaves sugar (galactose) that connects sialic acid to cell
How to predict severity of airway damage?
ICAM1 further up (less severe)
Epithelial cells deeper into lung (more severe)
What are the risk factors to increase risk for infectious disease?
Age Co-morbidities Immune/chronic disorders Pregnant Living in long term facilities Obesity ETC.
How do we know who to vaccinate?
Depending on risk factors
