Viral Diseases of the Respiratory tract

Question 1

What is the most common cause of the common cold? Second most common?

Answer 1

Rhinovirus

Coronavirus

Question 2

What is the virus that causes pneumonia and bronchiolitis in young children?

Answer 2

RSV

Question 3

What is the cause of croup?

Answer 3

Parainfluenza virus

Question 4

What does adenovirus cause?

Answer 4

Common cold and pharyngitis in children

Question 5

What does HSV usually cause?

Answer 5

Gingivostomatitis in children; pharyngotonsillitis in adults

Question 6

What does human cytomegalovirus cause usually?

Answer 6

Mono-like disease or pneumonia in transplant pts

Question 7

What does human metapneumovirus usually cause?

Answer 7

LRTI in children

Question 8

What is the enveloped status, and genetic makeup of coronavirus?

Answer 8

Enveloped

+ssRNA

Question 9

What type of virus is SARS and MERS?

Answer 9

Coronavirus

Question 10

What is the animal reservoir for SARS? MERS?

Answer 10

SARS= bats
MERS= camels

Question 11

What are the ssx for SARS and MERS?

Answer 11

Fever
Cough
SOB
ARDS

Question 12

What is the severity of SARS? MERS?

Answer 12

SARS need hospitalization

MERS = asymptomatic to ARDS

Question 13

What is the fatality rate of SARS? MERS?

Answer 13

SARS = 10%
MERS = 36%

Question 14

How long do the ssx of the flu last?

Answer 14

3-5 days peaks

Fatigue and weakness x2-6 weeks

Question 15

What is the incubation period for the flu?

Answer 15

1-4 days

Question 16

What is the contagious period for the flu?

Answer 16

5-7 days post ssx.

Question 17

What are the indications for treatment of the flu with oseltamivir?

Answer 17

within 48 hours of onset

Have risk factors

Question 18

What is the MA of oseltamivir?

Answer 18

Oseltamivir is a neuraminidase inhibitor, serving as a competitive inhibitor of the activity of the viral neuraminidase (NA) enzyme upon sialic acid, found on glycoproteins on the surface of normal host cells. By blocking the activity of the enzyme, oseltamivir prevents new viral particles from being released through the cleaving of terminal sialic acid on glycosylated hemagglutinin and thus fail to facilitate virus release

Question 19

Children under what age are at risk for complications from the flu?

Answer 19

Under 2 yo

Question 20

Adults over what age are at risk for complications from the flu?

Answer 20

65

Question 21

Pregnant women and women how many weeks postpartum are at increased risk for complications from the flu?

Answer 21

2 weeks postpartum

Question 22

What medical conditions (generally) pose an increased risk for the development of complications from the flu?

Answer 22

Lung or heart disease

Kidney or liver disease

Question 23

People younger than what age taking daily ASA are at increased risk for flu complications? What is the primary complication concerned here?

Answer 23

Younger than 19

Reye’s syndrome

Question 24

What is the MOA of zanamivir?

Answer 24

Neuraminidase inhibitor

Question 25

What are the two M2 protein (ion channel) inhibitors for influenza type A?

Answer 25

Amantadine | Rimantadine

Question 26

What is the route of administration for zanamivir? Oseltamivir?

Answer 26

``` Zanamivir = inhalation Oseltamivir = oral ```

Question 27

What is the pattern of pneumonia from influenza as compared to one from a bacterial infection following flu infection?

Answer 27

Bacterial following = biphasic | Primary = progressively worse

Question 28

What is the average onset for pneumonia from influenza as compared to one from a bacterial infection following flu infection?

Answer 28

``` Bacterial = 7 days following initial ssx Flu = 1-4 days ```

Question 29

What are the culture results of pneumonia from influenza as compared to one from a bacterial infection following flu infection?

Answer 29

bacterial - bacteria | viral = PMNs

Question 30

What is the usual CXR pattern of infiltrates with flu pneumonia?

Answer 30

Interstitial pattern

Question 31

What is the fatality rate of pneumonia from the flu virus?

Answer 31

50%

Question 32

What is the gram stain and morphology of H. influenzae?

Answer 32

gram negative rods

Question 33

What group of people is the live attenuated vaccine for the flu appropriate for?

Answer 33

healthy, non-pregnant 2-49 year olds

Question 34

What group of people is the recombinant vaccine for the flu appropriate for?

Answer 34

18-49

Question 35

What group of people is the inactivated, IM vaccine for the flu appropriate for?

Answer 35

anyone older than 6 months

Question 36

What group of people is the inactivated SQ vaccine for the flu appropriate for?

Answer 36

18-64

Question 37

What is the makeup of the trivalent and quadrivalent flu vaccines?

Answer 37

2 A + 1 B or 2 A + 2 B

Question 38

What is the cell culture based vaccine? Who is this indicated for?

Answer 38

Flucelvax | greater than 18 yo

Question 39

What is the high dose flu vaccine? In whom is this indicated?

Answer 39

Fluzone | Greater than 65

Question 40

What is the intradermal vaccine for the flu? Who gets this?

Answer 40

Fluzone ID quadrivalent | 18-64

Question 41

What is the recombinant flu vaccine? Who gets this? How is this administered? How is this made?

Answer 41

Flublok 18 yo or older IM Insect eggs

Question 42

What is the classic histological finding for herpes?

Answer 42

"owl eyes" Giant cells on tzanck smear

Question 43

What is the classic histological finding for papillomavirus?

Answer 43

Clear cells

Question 44

What is the classic histological finding for poxvirus?

Answer 44

Molluscum bodies

Question 45

What is the family and genetic material for cytomegalovirus?

Answer 45

Herpesviridae | dsDNA

Question 46

Where does cytomegalovirus replicate?

Answer 46

Mucosal epithelium

Question 47

Where is cytomegalovirus latent?

Answer 47

Monocytes

Question 48

What is the common risk factor for the development of CMV?

Answer 48

Immunosuppression from transplant

Question 49

What is the usual ssx of CMV in immunocompetent individuals?

Answer 49

Asymptomatic to mono-like

Question 50

What are the usual ssx of CMV in HIV patients?

Answer 50

CMV retinitis | Pneumonitis

Question 51

What are the usual ssx of CMV in neonates?

Answer 51

CMV inclusion disease

Question 52

What are the usual ssx of CMV in transplant recipients?

Answer 52

CMV pneumonitis | Gastritis

Question 53

What percent of mothers with a new CMV infection will transmit the virus to the fetus?

Answer 53

37%

Question 54

What percent of mothers with an old CMV infection will transmit the virus to the fetus?

Answer 54

1%

Question 55

Does breast milk contain CMV in infectious mothers?

Answer 55

yes

Question 56

What are the usual postnatal infectious etiologies of CMV?

Answer 56

Saliva or genital secretions | Toys

Question 57

Is CMV sexually transmittable?

Answer 57

yes

Question 58

What part of RBC transfusions contain CMV? How do you get rid of this issue?

Answer 58

Leukocytes | Leukoreduced RBCs

Question 59

True or false: CMV in bone marrow transplant recipients are usually due to transmission via the graft

Answer 59

false-- usually due to patient's latent infection

Question 60

What are the usual ssx of CMV transmission from transplants?

Answer 60

- Spiking fever 40 to below 3 - Malaise - Pneumonitis - Hepatitis - Thrombocytopenia

Question 61

What are the 2 antivirals that can be used to treat CMV?

Answer 61

ganciclovir | Valganciclovir

Question 62

What is the MOA of ganciclovir and Valganciclovir?

Answer 62

DNA polymerase

Question 63

How do you prevent CMV infection? (3)

Answer 63

- Match donors - Antiviral prophylaxis - Monitor for viremia, then give antivirals

Question 64

What is the MOA of foscarnet? What is this used for?

Answer 64

Inhibition of DNA polymerase | CMV

Question 65

True or false: Disseminated CMV does not show vesicular rashes in infants

Answer 65

True

Question 66

What is the main complication from varicella?

Answer 66

Pneumonitis

Question 67

What does EBV cause?

Answer 67

Mono

Question 68

What is HHV8?

Answer 68

Kaposi's sarcoma