Respiratory Viral infections Dr. Roane Flashcards

(41 cards)

1
Q

What typically causes the common cold and bronchiolitis?

A

-rhinovirus typically causes the common
cold

-respiratory syncytial virus (RSV) causes bronchiolitis

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2
Q

Characteristics of the common cold

A

-acute, usually afebrile (no fever), self-limited

-upper respiratory symptoms: rhinorrhea, cough, and sore throat

-Treatment is supportive

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3
Q

Viruses causing the common cold

A

50% of all common cold cases are caused by the >100 serotypes of rhinoviruses

-Coronaviruses
-Influenza
-parainfluenza viruses
-enteroviruses
-adenoviruses
-respiratory syncytial viruses (RSV)
-metapneumovirus

-> may manifest as the common cold

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4
Q

Bronchiolitis

A

-acute viral infection of the lower respiratory tract (bronchioles - smallest branch)
-affecting infants <24 months
-respiratory distress (fluid leak into the lungs), wheezing, and/or crackles
-tolerated well, but can be dangerous

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5
Q

What causes Bronchiolitis?

A

-respiratory syncytial virus (RSV), can be identified with a rapid assay (diagnosis is often suspected during an outbreak)

-treated supportive with oxygen and hydration

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6
Q

What causes Croup?

A

-caused by parainfluenza virus type 1 infection

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7
Q

Characteristics of Croup

A

-acute inflammation of the upper and lower respiratory tracts

-Brassy, barking cough and inspiratory stridor (noisy breathing)

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8
Q

Treatment of Croup

A

antipyretics (reverse fever mediated increased body temperature)
-hydration
-nebulized racemic epinephrine
-corticosteroids

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9
Q

How is Pneumonia diagnosed?

A

X-ray
Clinical findings (patient presentation)

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10
Q

What are the factors determining the type of Pneumonia?

A

-bacterial, mycobacterial, viral, fungal, or parasitic

-where acquired? community (CAP), hospital (HAP), ventilation (VAP)

-is the patient immunocompromised?

-differ in Causes, symptoms, treatment, preventive measures, and prognosis

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11
Q

What is the leading infectious cause of death?

A

-Pneumonia with Influenza
-9th leading cause of death
-leading in infectious cause of death
-most fatal hospital-acquired infection

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12
Q

What is the most common pathogen that causes Pneumonia?

A

Streptococcus pneumoniae

(pathogens of every sort, from viruses to parasites, can cause pneumonia)

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13
Q

Community-acquired pathogens (CAP)

A

-Bacterial: Streptococcus pneumoniae, Haemophilus influenza, Moraxella catarrhalis

-atypical bacteria: (ie, Chlamydia pneumoniae, Mycoplasma pneumoniae, Legionella species)

-viruses: Coronavirus, RSV, Influenza, Adenovirus, metapneumovirus, parainfluenza

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14
Q

What are the most common hospital-acquired pathogens?

A

-gram-negative bacilli and Staphylococcus aureus

-considered hospital-acquired when developed at least 48 hours after hospital admission

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15
Q

What are the most common ventilator-acquired pathogens?

A

-gram-negative bacilli and Staphylococcus aureus
-MRSA, MSSA, Pseudomonas

-considered VAP after being intubated for more than 48 hours

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16
Q

What are the different types (species) of Influenza?

A

-Influenza A-D
-Influenza A is the common flu

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17
Q

How are the subtypes of Influenza A identified?

A

-Hemaglutinin (Hx) and Neuraminidase (Nx) on the surface of the virus

18
Q

What is the Antigenic Shift seen in Influenza A?

A

-2 strains (f.e. pig and bird) of influenza A can mix their genome to create a new virus with different surface proteins
-> the new virus can now infect different species

19
Q

How is Influenza categorized based on Pathogenicity?

A

Highly Pathogenicity
Low Pathogenicity

20
Q

Zoonotic Influenza

A

Influenza viruses are transmitted from animals to humans

21
Q

What is the Influenza strain with the highest Pathogenicity so far?

A

Highly Pathogenic Avian Influenza - HPAI
-H5N1 from China 1996 -> Bird flu 2004

22
Q

Which strain is responsible for the Spanish flu?

A

-H1N1 (swine)
(Hong-Kong flu -> H3N2)

23
Q

How does Transmission of Zoonotic Influenza occur?

A

Direct contact with animals (slaughterhouse, raising)

24
Q

What are the symptoms of Zoonotic Influenza?

A

-Fever, headache, chills, dry cough
-fatigue, muscle or joint pain, chills, runny nose

25
MOA of Amantadine and Rimantadine
-Blocking the M2 protein, a proton pore protein (viroporin) -Viroporin is needed to release the viral proteins and genome from the virion
26
MOA of Oseltamivir (Tamiflu) oral, Zanamivir (Relenza) inhaled and Peramivir (Rapivab) I.V.?
-Neuraminidase inhibitor -neuraminidase is required for the newly formed Virus to be released from the host cell -> detachment from sialic acid on the host cell -the virus is stuck and gets degraded
27
MOA of Baloxavir
-The virus doesn't have a starting sequence for its translation -it uses an endonuclease to cut one from the host mRNA -> cap-snatching -Baloxavir blocks the Endonuclease
28
MOA of Nirmatrelvir
-the mRNA of the virus is translated in one big protein -the big protein needs to be cleaved into small pieces -> replication/transcription complex -cleavage of the big protein is conducted by the viral protease -Nirmaltrevir blocks the viral protease!
29
Which drug is used to treat SARS-Cov-19?
Paxlovid -Ritonavir and Nirmaltrevir -Ritonavir acts as a booster by deactivating CYP3A4 -Ritonavir is not active against SARS-COVID-2
30
MOA of Remdesavir
-IV administered nucleotide analog (prodrug) of adenosine triphosphate -incorporated into the growing RNA chain by the viral RNA-dependent RNA polymerase -chain termination
31
MOA of Molnupiravir
-Orally administered nucleotide analog (prodrug) of cytosine triphosphate -incorporated by the RNA polymerase of SARS-COV-2 -genome error -> the cytosine analog is read as cytosine or uridine -> mutations
32
Study results of Molnupiravir
-did not lower hospitalization or death -But patients recover faster
33
Respiratory Syncytial Virus (RSV)
-Ubiquitous -> Most children have had it by age 4 -severity is reduced due to previous exposure and antibodies -No drug treatment -Ribavirin has been used, but ribavirin is dangerous in healthcare providers
34
Why is Ribavirin dangerous for health care providers?
-Known teratogen -Has caused testicular abnormalities -Has 2 black boxes: hemolytic anemia, birth defects
35
Adenovirus
-can be asymptomatic or -mild infections of respiratory infections, keratoconjunctivitis, gastroenteritis, cystitis, and primary pneumonia
36
Symptoms of Adenovirus
-mostly in children -fever and upper respiratory symptoms: pharyngitis, otitis media, cough, and exudative tonsillitis with cervical adenopathy -rare in infants: severe bronchiolitis and pneumonia
37
Treatment of Adenovirus
Ribavirin and Cidofovir
38
MOA of Cidofovir and treatment
-used to treat Cytomegalovirus -MOA: gets incorporated as cidofovir diphosphate into the growing chain -> viral DNA synthesis reduction
39
Which drugs work by inhibiting Neuramidase?
-Oseltamivir (Tamiflu) oral, -Zanamivir (Relenza) inhaled and -Peramivir (Rapivab) I.V.
40
Which drugs treat SARS-Cov-2?
-Paxlovid (Ritonavir and Nirmatrelvir) -Remdesavir (adenosine analog) IV -Molnupiravir (cytosine analog) oral
41
Which drugs work by incorporating nucleotide analogs?
-Remdesavir (adenosine analog) -Molnupiravir (cytosine analog) -Cidofovir (acyclic, incorporated as cidofovir diphosphate)