Viral infections of the lower respiratory tract

Question 1

Lower respiratory tract infection (LRTI) is a significant cause of morbidity and mortality in (children or adults?)

Answer 1

Children

Question 2

_________ account for a significant proportion of LRTI especially in children

Answer 2

Viruses

Question 3

Types of lower respiratory tract infection

Mention 3

Answer 3

Pneumonia
Acute Broncholitis
Acute Bronchitis

Question 4

Types of lower respiratory tract infection

Pneumonia

Infection of the ________ .

Symptoms include fever, respiratory distress and _______.

Often not much clinical “_________”.

RSV, Adenovirus, Influenza

Answer 4

lung tissue itself

cyanosis

consolidation

Question 5

Types of lower respiratory tract infection

Acute Broncholitis

___________ and _______ of ____________

Complete plugging of ———— with ___________ leads to _________

fever and coryzal symptoms, respiratory distress and wheezing.

Can be life-threatening in______ and _______

Respiratory Syncitial virus, Parainfluenza viruses

Answer 5

Inflammation and narrowing of terminal bronchioles

bronchioles; air resorption ; patchy collapse

babies and small children.

Question 6

Bronchiole diameter is (smaller or larger?) during inspiration than during expiration and this leads to _____________ (proximal or distal?) to bronchiole.

Answer 6

Larger

hyperinflation of air sacs

Distal

Question 7

Types of lower respiratory tract infection

Acute Bronchitis

Inflammation of _____, accompanied by fever, cough, wheezing and “________ “.

RSV, Para-influenza viruses, Adenovirus

Answer 7

bronchi

noisy chest

Question 8

Epidemiology

_______ account for the largest proportion of childhood pneumonia.

Answer 8

Viruses

Question 9

Epidemiology

______ is the most frequent cause of lower respiratory tract infection in infants and children

Answer 9

RSV

Question 10

Epidemiology

The ______ viruses are the most common viral cause of pneumonia in adults

Answer 10

influenza

Question 11

Epidemiology

___________ is second in importance only to RSV as a cause of lower respiratory tract disease in children and pneumonia and bronchiolitis in infants younger than 6 months

Answer 11

Parainfluenza virus (PIV)

Question 12

Host defence

Mechanical barriers are _____ from the nostrils that filter particles larger than _______, and ______ clearance,

_______ branching of the central airways that helps the ______-micron particles to become impacted in the mucosa.

Humoral immunity is represented by mucosal immunoglobulin _______

Phagocytic cells consist of polymorphonuclear (PMN) cells;

Answer 12

hairs; 10 microns; mucociliary

Sharp-angle; 5- to 10

A (IgA),

Question 13

Host defence

Phagocytic cells consist of polymorphonuclear (PMN) cells;

Alveolar, interstitial, and intravascular _______; and respiratory ________ cells.

_____________ provide the first defense involved in internalizing and degrading the viral pathogens.
They act as _________ and ________ cells.

Answer 13

macrophages; dendritic

Alveolar macrophages

antigen-presenting and opsonin-producing

Question 14

Pathogenesis

Transmission is by _________ nuclei during _____,________

Touching _______ which are contaminated with the virus

Answer 14

droplet; coughing, sneezing

formites

Question 15

Pathogenesis

Viral multiplication in the ________ of the upper airway

Secondarily infect the lung by means of ________ or _______ spread.

Answer 15

epithelium

airway secretions or hematogenous

Question 16

Pathogenesis

Severe pneumonias may result in extensive ________ of the lungs with varying degrees of _________

Some patients developing _________ and diffuse _____________

Answer 16

consolidation; hemorrhage

bloody pleural effusions

alveolar damage

Question 17

Pathogenesis

Respiratory viruses damage the respiratory tract and stimulate the host to release multiple __________ such as:

histamine, leukotriene C4, and virus-specific _____ in RSV infection and bradykinin, interleukin (IL)–1, IL-6, and IL-8 in _________ infections.

Answer 17

humoral factors

IgE

rhinovirus

Question 18

Pathogenesis

RSV infections can also alter __________ _____ease bacterial adherence to respiratory epithelium, reduce ___________, and alter bacterial phagocytosis by host cells

Answer 18

bacterial colonization patterns,

incr

mucociliary clearance

Question 19

Orthomyxovirus

Influenza virus ___,___,__

_______, pleomorphic, 80–120 nm in diameter (______ nucleocapsid, 9 nm)

______ stranded segmented (___)

______ sense RNA, 13.6 kb overall size

Answer 19

A, B, C

Spherical; helical

Single; 8

negative

Question 20

Orthomyxovirus

______ structural proteins, ____ nonstructural

Envelope contains viral _______, and _________ proteins

Answer 20

Nine; one

hemagglutinin and neuraminidase

Question 21

Orthomyxovirus

The 2 glycoproteins are the important antigens that determine _________ of influenza viruses and _______

Answer 21

antigenic variation

host immunity

Question 22

Influenza virus

Influenza A virus consist of _____ and ______ strains

The ______ and ______ proteins, are used to divide influenza viruses into types A, B, and C.

_________ in HA and NA, are used to subtype the viruses.

Answer 22

human and animal

nucleocapsid (NP) and matrix (M)

Antigenic variations

Question 23

Influenza virus

Only type ___ has designated subtypes.

_____ subtypes of HA (_______) and ___ subtypes of NA (_______), in different combinations.

Answer 23

A

15; H1–H15

9; N1–N9

Question 24

Influenza virus

_______ HA ( _________ ) and ___ NA (_______) subtypes have been recovered from humans.

Answer 24

Four

H1–H3, H5

two; N1, N2

Question 25

Influenza virus Influenza A(_____) and A(______) subtypes are currently circulating among humans

Answer 25

H1N1; H3N2

Question 26

Influenza virus Antigenic drift Accumulation of _______ in the gene, resulting in _________ in the protein. Sequence changes can alter __________ on the molecule such that a virion can escape _______ by the host’s immune system

Answer 26

point mutations; amino acid changes antigenic sites ; recognition

Question 27

Influenza virus Antigenic shift _______ changes in the sequence of a viral surface protein, changes That are ______ to ____________ The ________ genomes of influenza viruses reassort readily in ______________ cells.

Answer 27

Drastic; too extreme; be explained by mutation. segmented doubly infected

Question 28

Influenza virus Antigenic shift The mechanism for shift is ________ between ______ and _____ influenza viruses. Can result in a _________

Answer 28

genetic reassortment human and avian pandemic

Question 29

Influenza B and C viruses exhibit antigenic shift T/F

Answer 29

F Influenza B and C viruses do not exhibit antigenic shift

Question 30

Influenza Is a/an (acute or chronic ?) viral infection that spreads easily from person to person. Viruses circulate ______ and can affect ____ age group. Annual epidemics peak during ______ in ________ regions.

Answer 30

Acute ; worldwide; any winter; temperate

Question 31

Influenza Serious public health problem that causes severe illness and death in high risk populations. children younger than age ____ years, adults aged _____ years or older _________ women, certain medical conditions, such as chronic heart, lung, kidney, liver, blood or metabolic diseases (such as diabetes), or ————- immune systems.

Answer 31

2; 65 pregnant weakened

Question 32

Influenza Influenza virus spreads from person to person by ____________ or by _______ with contaminated hands or surfaces

Answer 32

airborne droplets contact

Question 33

Epidemiology of influenza Influenza occurs ______ with an annual attack rate estimated at __%–__% in adults and __%–__% in children.

Answer 33

globally; 5–10; 20-30

Question 34

Epidemiology of influenza Illnesses can result in hospitalization and death mainly among high-risk groups (the very young, elderly or chronically ill). T/F

Answer 34

T

Question 35

Epidemiology of influenza. Worldwide, these annual epidemics are estimated to result in about ___________ cases of severe illness, and about __________ to ________ deaths.

Answer 35

3 to 5 million 250 000 to 500 000

Question 36

Clinical features of Upper respiratory tract infection chills, headache, and dry cough followed closely by high fever, generalized muscular aches, malaise, and anorexia. T/F

Answer 36

T😂

Question 37

Clinical features of Pneumonia May be complicated by secondary bacterial infection Eg ________ and _______

Answer 37

S. aureus, H. influenzae

Question 38

Treatment of influenza May reduce severe complications and deaths. Ideally they need to be administered early (within ______ of onset of symptoms)

Answer 38

48 hours

Question 39

Treatment of influenza Neuraminidase inhibitor oselta_____ and zana_____ , pera_____ and lanina____ Adamantanes aman______ and riman_____

Answer 39

mivir; mivir; mivir; mivir tadine; tadine

Question 40

Prevention and control ___________ viral vaccines

Answer 40

Inactivated

Question 41

Prevention and control Vaccine composition ———- that targets the _________ most representative virus types in circulation _____ subtypes of influenza A viruses and ——- B virus. Hand hygiene

Answer 41

biannually 3 (trivalent) two; one