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Pulmonary Week 2 > Viral Pneumonia > Flashcards

Viral Pneumonia Flashcards

1
Q

How is atypical viral pneumonia characterized?

A

-patchy inflammatory changes in the lungs, largely confined to the alveolar septa and interstitium and mononuclear cell infiltrates in alveolar walls

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2
Q

Is consolidation a common finding of viral pneumonia?

A

No

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3
Q

Are white cell counts elevated in viral pneumonia

A

Moderately

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4
Q

Nearly all viruses that cause pneumonia can also cause ____

A

URTIs

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5
Q

What is the most common cause of RT infection that results in physician visits and hospitalizations in the U.S.?

A

Influenza

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6
Q

Describe Influenza

A

Helical, enveloped single stranded negative sense linear RNA virus

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7
Q

What are the major virulence determinants of Influenza?

A
  • Hemagglutinin (promotes viral entry)
  • Neuraminidase
  • M2 ion channel
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8
Q

What does Neuraminidase do?

A

cleaves neuraminic acid to release progeny virus from the infected cell and degrades the protective layer of mucus in the RT (2 types - N1, N2)

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9
Q

Which type of Influenza is responsible for pandemics and epidemics?

A

A

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10
Q

What causes Influenza epidemics?

A

-Antigenic drift

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11
Q

What is antigenic drift?

A

spontaneous mutations in the viral genome as it replicates results in new viral strains

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12
Q

What causes Influenza pandemics?

A

antigenic shift

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13
Q

What is antigenic shift?

A

Occurs when both HA and NA genes are replaces through reassortment with animal influenza viruses

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14
Q

How is Influenza transmitted?

A

airway respiratory droplets

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15
Q

How is Influenza treated?

A

Pseltamivir or Zanamivir

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16
Q

What are the complications of Influenza?

A
  • Secondary viral or bacterial pneumonia

- Reye’s syndrome

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17
Q

What patient populations are at risk for secondary viral or bacterial pneumonia?

A
  • young/elderly
  • chronic disease patients
  • immunosuppressed
  • pregnant
  • obese
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18
Q

What nationality is at risk for secondary viral or bacterial pneumonia?

A

Native Americans or Alaskans

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19
Q

What is Reye’s syndrome characterized by?

A

encephalopathy and liver degeneration (aspirin is a cause)

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20
Q

Vaccine for Influenza

A
  • Trivalent or quadrivalent
  • everyone 6 months or older
  • protection lasts 6 months
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21
Q

Prophylaxis for Influenza

A

Oseltamivir

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22
Q

Respiratory syncytial virus (RSV) belongs to what family?

A

Paramyxovirus

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23
Q

Describe RSV

A

pleomorphic, enveloped, negative-sense single stranded, linear RNA

24
Q

RSV is the most important cause of bronchiolitis and pneumonia in what patients?

A

infants

25
Q

How is RSV transmitted?

A
  • Respiratory droplets
  • Direct contact of contaminated hands with nose or mouth
  • Community outbreaks every winter
26
Q

Infection of RSV in infants typically involves what part of the RT?

A

lower

27
Q

How does RSV present?

A
  • persistent cough
  • wheezing
  • FEVER
  • tachypnea
  • hypoxemia
28
Q

Describe infection of RSV in adults

A

typical URT (lasts 4-5 days and self-limiting)

29
Q

How is RSV diagnosed?

A
  • Rt-PCR on nasal swab

- Rapid antigen test on nasal swab or washings

30
Q

How is RSV treated?

A
  • supportive care (hydration, albuterol, and O2)

- Inhaled Ribavirin (not for children)

31
Q

Prophylaxis of RSV in premature infants?

A

Palvizumab (monoclonal Ab against F protein)

32
Q

Complications of RSV?

A
  • apnea and respiratory failure in preemies, less than 12 weeks of age, CV disease)
  • development of asthma
33
Q

Describe adenovirus

A

non-enveloped, double stranded, linear DNA virus

34
Q

How is adenovirus transmitted?

A

aerosol droplets, fecal-oral, or direct inoculation

35
Q

What are some diseases that adenovirus can cause?

A
  • pneumonia
  • URTI
  • febrile pharyngitis
  • conjunctivitis (pink eye)
  • hemorrhagic cystitits
  • gastroenteritis in -2 yoa
36
Q

How is adenovirus infection treated?

A

supportive (self-limited)

37
Q

What is the vaccine for adenovirus?

A

-live PO enteric-coated vaccines against serotypes 4 and 7 for military recruits

38
Q

Sequelae of adenovirus?

A

bronchiectasis or bronchiolitis obliterans

39
Q

Describe parainfluenza virus structure

A

enveloped single stranded linear non-segmented RNA virus of the paramyoxiviridae family

40
Q

Virulency determinants of parainfluenza virus

A
  • F (fusion) protein

- HN (hemagglutinin/neuraminidase)

41
Q

How is parainfluenza virus transmitted?

A

respiratory droplets

42
Q

There are four kinda of PIV. Which types can cause croup?

A

only 1,2, and 3 (but only 2-3% progress to croup)

43
Q

hPIV3 can cause what diseases?

A

pneumonia and bronciolitis

44
Q

hPIV4 can cause what disease?

A

mild respiratory illness (common cold)

45
Q

Croup (aka laryngotracheaobronchitis) is characterized by what?

A

-seal-like, barking cough caused by inflammation around the larynx, trachea, and bronchi

  • fever, sore throat
  • stridor
  • rhinorrhea
46
Q

What is stridor?

A

harsh vibrating noise when breathing caused by obstructions/inflammation of the larynx

47
Q

T or F. Re-infection of PIV is common

A

T.

48
Q

What is a ‘steeple sign’?

A

inflection of the trachea in stridor caused by inflammation

49
Q

Human metapneumovirus is indistinguishable from what?

A

RSV

50
Q

Describe SARS

A

coronavirus family-enveloped single stranded positive sense RNA virus

common in Asia

51
Q

What are the possible reservoirs of SARS?

A

masked palm civet

horseshoe bat

52
Q

How does SARS present

A
  • fever/chills
  • rigors
  • headache
  • dyspnea and hypoxemia
  • nonproductive cough
53
Q

CBC findings of SARS?

A

leukopenia and thrombocytopenia

54
Q

CXR of SARS

A

bilateral peripheral infiltrates common usually in middle or lower lung zones

55
Q

How is MERS transmitted?

A

human to human

56
Q

Clinical presentation of MERS

A
  • severe illness with pNA and ARDS, some with AKI
  • hemoptysis
  • abdominal pain
  • sore throat, fever, chills, SOB

Pulmonary Week 2 (25 decks)

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