Flashcards in Influenza Deck (18):
Influenza A is divided into subtypes based on?
Hemagglutinin antigen (glycoprotein that allows virus to stick to epithelium) and Neuraminidase antigen (promotes viral release from host cell)
Difference between antigentic drift and shift?
Drift is a small mutation that prevents antibodies from binding to antigens. (seen in A and B) A shift is when the virus undergoes a genetic change that allows it to pass from species to species and can eventually cause a pandemic. Only seen in Influenza A
How is influenza normally spread?
Respiratory droplets after coughing or sneezing. Can last on objects for 24-48 hours.
What does the body release in response to the virus?
Tumor necrosis factor, interleukin-6, and interferon alpha
Symptoms of influenza?
Rapid onset. Fever (100-104), shaking chills, myalgias, toxic appearance, headache, mild sore throat, weakness, cough (mostly nonproductive)
Clinical pearls for diagnosis influenza?
After holiday season and fever present, influenza in DD, patient will hurt everywhere, pinpoint exact time of infection, cough not their primary complaint.
Physical exam findings for influenza?
Vital signs, toxic appearence, eyes may be red and watering, nasal discharge present, lymph nodes may be swollen, rhonchi or rales may be present
Complications of influenza. Quick progression of cough, dyspnea, and hypoxemia could mean?
Primary influenza viral pneumonia
Causes of secondary bacterial pneumonia? What is the course for the infection?
Streptococcus pneumonia, S. aureus. Patient will improve after initial influenza prodrome and then become symptomatic again
When should anti viral therapy begin for influenza?
Within 48 hours of symptoms. Can decrease illness by 1/2 to 3 days.
Name high risk patients that should be given anti viral immediately?
>65yo, morbid obesity, chronic medication illnesses, immunosuppressed, nursing home residents, pregnant women, native americans and Alaska natives
This medication works by inhibiting neuraminidase and is effective against influenza A and B. It is inhaled? Dosing?
Zanamivir (Relenza). Treatment 2 oral inhalations BID x 5 days in pts >/= 7. Prophylaxis: 2 oral inhalations QD x 10 days in pts >/= 7
This medication works by inhibiting neuraminidase and is effective on A and B. May be less effective on B? Dosing?
Oseltamivir (Tamiflu): Treatment: 75mg BID x 5 days in pts >/= 13. Prophylaxis: 75mg QD x 10 days in pts >/= 13. Needs adjust for pts
Medication is given IV and inhibits neuraminidase?
Peramavir (Rapivab): 600mg IV as single dose
High dose trivalent or quadravalent should be given to what individuals?
Those over the age of 65 yo. Reduces rates of hospitalizations
Intradermal and Afluria using Pharmajet injector is indicated in what individuals?
18-64 years old
Intranasal live vaccine is indicated in what individuals?
2-49 years old