Virus CIS Flashcards Preview

RESP II Exam 2 > Virus CIS > Flashcards

Flashcards in Virus CIS Deck (41):
1

50yo F one day fever, weakness, aches, hurts all over, T 102, WBC 5,900 1% bands

nasal swab influenza A

2

most appropriate initial therapy for influenza

oseltamivir

3

neurominidase inhibitor

oseltamivir
zanamivir

4

mechanism of oseltamivir

neuroanimidase inhibitor
-influenza A and B
-blocks release of virions

5

active against influenza A and B

oseltamivir

6

block release of influenza A only

rimantadine and amantadine

prevents penetration of influenza A - block uncoating of virus

7

benefit of beginning antiviral tx

prevent viral shedding
-within 48 hours
-decrease duration of symptoms 1 - 2 days

8

used with contraindication in asthma/COPD patient

zanamivir
-bronchospasm, decreased pulmonary function

9

side effect of oseltamivir

diarrhea, nausea, vomiting

10

3mo infant, fever, difficulty feeding, nasal discharge, stop breathing when feeding, premature birth and congenital heart disease

respiratory syncytial virus

11

RSV

age < 12 mo
winter season
lower resp tract

12

Tx of RSV

primarily supportive

and possibly bronchodilators - if wheezing

13

ribavirin

inhalation aerosol

nucleoside analog - inhibit RNA and DNA virus replication, inhibit viral protein synthesis

toxic to healthcare workers

only for life-threatening disease

14

palivizumab

monoclonal Ab
-prophylaxis for RSV given monthly

15

52yo M kidney transplant follow up, DMII, elevated serum Cr (normal with kidney transplant)

trimethoprim/sulfamethoxazole (bactrim) - prophylaxis for PCP


pneumocystic jirovecii

immunocompromised patient

16

TMP-SMX

trimethoprim/sulfamethoxazole - prophylaxis for PCP

17

alternative for sulfa given bactrim

atovaquone
dapsone
inhaled pentamidine

18

valganciclovir

prophylaxis for CMV

19

CMV prophylaxis

valganciclovir

20

CMV

most common following solid organ transplant

1-4 months after transplant

highest risk if donor + for CMV in negative recipient

21

34yo M painful rash on left back and chest, pain, burning, tingling

varicella zoster

22

varicella zoster

respiratory droplets

human mucosa and nerves

infected when child with chicken pox

remains dormant in CN ganglia - dorsal ganglia

reactivation - herpes zoster

23

Tx of varicella zoster

acyclovir

oral - shingles
IV - if immunocompromised

24

varicella zoster vaccine

adults > 60yo
live attenuated

not in immunocompromised
-AIDS, HIV, CD4 < 200, anti-tumor necrosis factor

25

virus specific acyclovir

requires viral specific thymidine kinase activation step

inhibits DNA synthesis

26

limitation of acyclovir

low bioavailability

valacyclovir - higher bioavailability - absorbed better

27

varicella zoster tx

onset of rash - within 72 hours

moderate reduction in postherpetic neuralgia

28

9yo M, ER, fever, cough, difficulty breathing, rash started on face and spread downward, T 104, pulse 140, throat small red spots with blue - white centers, blotchy red rash over body, CXR infiltrate

koplik spots

measles

29

koplik spots

blue white centers small red dots - in throat

seen with measles

30

rubeola virus

measle

paramyxovirus

31

spread of rubeola virus

resp droplets

32

3 C of rubeola

measles

cough, coryza, conjunctivitis

33

how long measles infectious

4 days prior to rash until 4 days after onset of rash

34

complications of measles

diarrhea, otitis media, pneumonia

postinfection encephalomyelitis

subacute sclerosing panencephalitis (severe) - years after measles - fatal

35

measles prevention

MMR vaccine

36

16yo M, fever, HA, malaise, facial swelling 3 days, pain in testicles, swollen/tender

mumps

parotitis
aseptic meningitis
orchitis

37

mumps transmission

droplet spread - upper resp secretions

38

55yo M nurse, fever, chills, myalgia, HA, T 100, Sx progress weakness, HA, confusion, SOB, N/V/D, rash, petichiae on legs, liver enzymes elevated, prolonged PT and PTT, fibrin degradation products, multiorgan failure, death

DIC - long PT, PTT, fibrin degradation products

ebola

39

ebola

single-strand RNA virus
-hemorrhagic fever virus

coag defect, cap leak syndrome, shock

begins non-specific flu sx

tx - supportive
-experimental - ZMapp - monoclonal Abs for ebola viral glycoprotein

40

4yo M dyspnea, fever, runny nose, sneezy, cough body aches, severe SOB last couple days, hypoxic, expiratory wheezing, CXR b/l interstitial infiltrates, tx goes home, 2 weeks later flaccid paralysis of lower extremities

DDx - polio, guillane barre, botulism

anterior myelitis on MRI - polio

enterovirus D68

41

SARS

coronarvirus
-birds, small mammals

fever, flu, dry cough, dyspnea, far east or toronto

mortality 50%