IMMUNE 139 Influenza and Ageing

Question 1

What are the 6 Geriatric Giants?

Answer 1

Confusion, not coping, incontinence, poor mobility, falls and collapse

Question 2

What 5 domains do you need to check in a comprehensive geriatric assessment?

Answer 2

Medical, mental health, functional capacity, social circumstances and environment

Question 3

How can pharmacological absorption change with ageing?

Answer 3

Achlorydia

Decreased hepatic blood flow = decreased first pass metabolism

Question 4

How can pharmacological distribution change with ageing?

Answer 4

Body fat increase = increased distribution of lipophillic drugs
Decreased plasma binding = huge increase in bioavailability

Question 5

How can pharmacological metabolism change with ageing?

Answer 5

Decrease activity of hepatic phase 1 metabolism

Decreased renal function

Question 6

What are the two models of frailty?

Answer 6

Phenotype model and Cumulative deficit model

Question 7

Describe the phenotype model of frailty

Answer 7

5 variables of weight loss, self reported exhaustion, low energy expenditure, slow gait speed and weak grip strength
3+ = frail
1/2 = pre-frail

Question 8

Describe the cumulative deficit model of frailty

Answer 8

92 variable symptoms, signs or lab results giving a cumulative frequency index

Question 9

What does a naked virus contain?

Answer 9

Nuceocapsid only - genome and the capsid

Question 10

Describe receptor-mediated endocytosis

Answer 10

Virus attaches to membrane, membrane invaginates to form coated pit, this pinches off and is acidified to free nucelocapsid

Question 11

How do DNA containing viruses transcribe?

Answer 11

Using hosts DNA dependant RNA polymerase

Question 12

What sense is mRNA?

Answer 12

+ve

Question 13

What type of viruses carry RNA polymerase?

Answer 13

SS -ve RNA and ds +/- RNA

Question 14

Describe an acute infection?

Answer 14

rapid-onset, short lived

Question 15

Describe a persistent infection

Answer 15

Remains in body, with or without symptoms

Question 16

Describe a chronic infection

Answer 16

Persists with symptoms, slow to resolve

Question 17

Describe a latent infection

Answer 17

Persists but can be reactivated

Question 18

Describe a subclinical (carrier) infection

Answer 18

Infected, asymptomatic but is still transmissable

Question 19

Describe an insidious infection

Answer 19

very long incubation before symptomatic

Question 20

Give an example of a virus that disseminates via nerves

Answer 20

Rabies

Question 21

What is the most common route of a disseminated infection

Answer 21

Via bloodstream

Question 22

What areas in the alimentary tract may be sites of antigen uptake and therefore entry of infection

Answer 22

M-cells

Question 23

How can viral infection indirectly cause damage to the host?

Answer 23

From hosts own immune response
Free radical production
Immunosuppression

Question 24

How can viral infection directly cause damage to the host?

Answer 24

blocking protein synthesis, cell entry/exit, cytoskeletal breakdown, cell death

Question 25

When is NO produced?

Answer 25

During acute inflammation

Question 26

How does aciclovir work?

Answer 26

By replacing guanosine on DNA and therefore blocking replication

Question 27

What is aciclovir active against?

Answer 27

HSV and VZV

Question 28

What does aciclovir require to become active and what advantage does this confer?

Answer 28

Requires phosphate addition and needs a viral enzyme for this - targets virally infected cells only

Question 29

Why is ganciclovir less effective that aciclovir?

Answer 29

Acts on all cells as doesn't need viral enzyme for phosphorylation