Viral infections of the respiratory tract Flashcards Preview

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Flashcards in Viral infections of the respiratory tract Deck (28)
1

describe the symptoms typically associated with the common cold and how they differ from lower respiratory tract infections

headache, nasal discharge, sore throat, nonproductive cough

2

which viruses typically cause the common cold?

rhinovirus (most common)
coronavirus

3

which viruses cause more serious respiratory tract infections?

human respiratory syncytial virus
parainfluenza virus

4

what is the epidemiology of SARS (stats, animal reservoir, severity, fatality rate)?

stats - 8000 cases Feb-June 2003
likely animal reservoir - bats
severity - most require hospitalization
fatality rate - 10%

5

what is the symptomology of SARS?

fever
cough
SOB
pneumonia
ARDS

6

what is the epidemiology of MERS (stats, animal reservoir, severity, fatality rate)?

stats - 1618 cases Sept 2012-Nov 2015
likely animal reservoir - camels
severity - asymptomatic to ARDS
fatality rate - 36%

7

what is the symptomology of MERS?

fever
cough
SOB
pneumonia
ARDS

8

what are the typical symptoms associated with influenza?

fever
myalgia
headache
shaking chills
cough 3-5 days

9

what are the 4 main patient groups associated with increased risk for influenza complications

1. children younger than 2
2. adults 65 and older
3. pregnant women and women 2 wk postpartum
4. persons with medical conditions

10

how are the 4 influenza antiviral agents similar?

oseltamivir and amantadine / rimantadine are both oral

11

how are the 4 influenza antiviral agents different?

zanamivir and oseltamivir: both neuraminidase inhibitors, for influenza A and B

amantidine and rimantidine: adamantanes, for influenza A (M2 protein)

zanamivir: only inhalation medication

12

what are the differences between bacterial pneumonia following influenza and primary influenza pneumonia (etiology, symptoms, average onset, sputum gram stain, chest radiograph, prognosis)?

bacterial pneumonia following influenza:
etiology - bacterial respiratory pathogens
symptoms - biphasic pattern
average onset - 7 days post symptoms
sputum gram stain - S. pneumo, S. aureus, H. influenza
chest radiograph - depends on etiologic agent
prognosis - depends on etiologic agent

primary influenza pneumonia
etiology - influenza virus (A)
symptoms - progressive worsening
average onset - 1-4 days post symptoms
sputum gram stain - abundant PMN w/o bacteria
chest radiograph - usually interstitial
prognosis - 50% mortality

13

what are the characteristics of the three categories of influenza vaccines (agent, administration, eligible patients)?

inactivated influenza vaccines (IIV):
formalin inactivated
IM / ID
over 6 mo (IM); 18-64 yo (ID)

live attenuated influenza vaccine (LAIV):
attenuated
intranasal
healthy non-pregnant 2-49 yo

recombinant influenza vaccine (RIV):
hemagluttinin protein
IM
18-49 years

14

what are the symptoms associated with CMV pneumonitis?

spiking fever
malaise, lethargy, myalgia, arthralgia
pneumonitis
leukopenia
hepatitis
thrombocytopenia
GI symptoms
correlated with graft vs host disease

15

what are the different presentations for CMV infection?

immunocompetent - asymptomatic or mono-like illness

immunocompromised - CMV pneumonitis / gastritis (transplant), CMV retinitis (HIV)

neonates - cytomegalic inclusion disease

16

what are the routes of transmission of cytomegalovirus?

intrauterine - 1%
perinatal
postnatal
blood transfusion (1-5%)
organ transplant ( 60-80% positive to negative)

17

which antivirals are used to treat CMV?

ganciclovir
valganciclovir
cidofovir
foscarnet (for resistance)

18

what is the respiratory disease associated with HSV?

pneumonitis

19

what is the respiratory disease associated with VZV?

chicken pox can spread to the lungs
secondary bacterial infections

20

what is the respiratory disease associated with EBV?

infectious mononucleosis

21

what is the contagious period of influenza patients?

1 day prior to symptoms to 5-7 days post

22

what kind of vaccine is flucelvax? what is the dose?

cell culture based vaccine; produced in the madin darby canine kidney (MDCK) cell line

standard dose

23

what kind of vaccine is fluzone? what is the purpose? what is the dose?

inactivated, available for adults over 65 to increase efficacy of immune response

high dose

24

what kind of vaccine is flublok? what is significant about it?

recombinant HA produced in insect cells

egg free

25

which flu vaccine is egg free? what is the route and approved age?

flublok

IM, 18 yo and older

26

what is the target of ganciclovir?

DNA polymerase

(it is acted upon by thymidine kinase for activation)

27

what makes up the 2015-2016 trivalent vaccine? quadrivalent?

trivalent - 2 As, 1 B

quadrivalent - 2 As, 2 Bs

28

what are the clinical exam results for CMV pneumonitis?

interstitial infiltrates
hypoxia