Long-URTi Flashcards by Syed Ali

What is the etiology for uRTI?

Involves Cole and Flu viruses

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Irises are believed to account for up to _____ of cases of acute respiratory infections

3/4 cases

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What are the viruses that causes common cold?

Graph on D15 pre work page 3

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What is most frequent cause of colds?

Adenovirus causes rhinorrhea (Runny virus)

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Describe the pathogenesis of Rhinovirus.

The virus infiltrates the host cells via endocytosis; infection stimulates the release of cytokines that give rise to the signs/symptoms of rhinovirus-induced colds.

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How is Rhinovirus manifested?

Common cold, Sore throat, Cough w/ mucus production.

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Describe the pathogenesis of Coronavirus.

Upon inhalation SARS-CoV-2 binds to respiratory cells via viral structural spike (S) protein and ACE2 receptor.

Acute Respiratory Distress (ARD) is associated with reduced ACE2 receptor expression and accumulation of Angiotensin 2 (pro-inflammation)

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What are some of the antivirals used for Coronavirus?

Nirmatrelvir/ritonavir (Oral)
Remdesivir (IV)

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what is inhibited by Nirmatrelvir?

Protease

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Ritonavir is a ______ inhibitor.

CYP3A4

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Why is a booster useful for COVID?

Booster blocks liver metabolism of Nirmatrelvir

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What prodrug is used for Coronavirus?

Remdesivir (Veklury)

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What happens to Remdisivir after prodrug activation?

changes into Remdesivir triphosphate which disrupts viral RNA replication

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What are diseases caused by Adenovirus?

Pneumonia, Cytitis

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How is Adenovirus spread?

Via Respiratory droplets and fecal matter

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What are the diseases caused by Parainfluenza Virus?

Bronchiolitis, Pneumonia and Croup

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How can you describe Croup? What is it cause by?

Loud cough that resembles the seal barking (Stridor). It is caused by Parainfluenza

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What does Infuenza virus causes? what type of species it effects?

Seasonal flu; a pulmonary disease of warm-blooded birds and mammals

Major causes of the Flu in humans is the influenza A virus

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What is Influenza virus comprised of?

Viral Genome

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what is the role of Proteins in Influenza virus?

RNA is stabilized by Proteins (Nucleoprotiens)

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What one protien and an enzyme embedded on the surface area of Influenza virus?

Hemagglutinin (H), Neuraminidase

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What are common strains of Influenza Virus?

A subtypes H1N1 and H3N2

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How is influenza virus transmitted?

Aerosolized respiratory secretions

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Why do we have to get new vaccines for Influenza every year?

Virus Undergoes Spontaneous mutations (antigenic drift)

H proteins contains 5 epitopes that are sued for recognition during anti-body mediated immune response.

Changes in the amino acids sequence within the epitopes of H due to antigenic drift require a new flu vaccine each year.

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Describe the pathogenesis of Influenza virus (Virus binding)

Viruses preferentially bind via hemagglutinin (H) to sialic acid on the surface of human respiratory epithelial cells. Also infects macrophages

In what shape does Influenza virus leaves the infect cell?

Virus leaves the cell via budding

What facilitates the exit of Virus budd?

Neuraminidase (N)

What prevents bacteria from entering into the lungs?

Destruction of mucoepthilial lining prevents the secretion of mucus which is important in preventing bacteria from infiltrating the lungs —-> leads to secondary bacterial pneumonia

How is Influenza virus manifested?

Fever, Dry cough, Deaths are often caused by complications such as pneumonia and secondary bacterial infections.

Secondary bacterial pneumonia how does bacteria get access to lower respiratory tract?

the mucocilliary escalator has been impaired by the virus

What is the oral agent for Influenza A?

Rimantadine

what is the MOA of Rimantadine?

Inhibit the ability of the influenza virus to uncontrollable at during endocytosis of host cells

What is the Adverse reaction of Rimantadine?

CNS toxicity

What is the Aerosolized product that is an anti-influenza agent with activity against both influenzas A and B?

Zanamivir (Relenza)

MOA of Zanamivir?

Inhibitor of neuraminidase enzymes used during viral shedding

What is an Adverse reaction of Zanamivir? does it have good oral absorption?

Bronchospasms; No

How is Zanamivir administered?

Comes in blister pack to use with a disc inhaler device

What is an oral agent used for Influenza A and B?

Oseltamivir

What is the brand name of Oseltamivir?

Tamiflu

What is Oseltamivir approved for by FDA?

Treatment for acute influenza A and B illness who have not been symptomatic for >48hrs;

What’s the MOA of Oseltamivir?

Inhibitor of neuraminidase enzymes used during viral shedding.

How is RSV spread?

Respiratory Secretions

Who is more likely to get RSV?

incidence highest among infants

How is RSV manifested?

bronchiolitis, croup

What’s the Prophylaxis of RSV?

Aerosolized ribavirin delivered by nebulizer; Palizumab (humanized monoclonal antibody that blocks RSV binding to epithelia cells)

MOA for Ribavirin?

interferes with viral RNA synthesis

Adverse reaction of Ribavirin?

Hemolytic anemia

Whats the difference between Inhalation form vs oral?

Inhalation has longer half life than oral form

What is another name that measels is known as?

Rubeola

What vaccine is used for Measles?

MMR vaccine

How is measles transmitted?

Respiratory secretions

How is Measles manifested?

Maculopapular rash (Koplik’s Spots)

What’s the other name of Rubella?

German measles virus

How is Rubella transmitted?

Respiratory secretions

How is rubella manifested?

Milder then Rubeola (3 days measles), Maculopapular rash

What do Mumps causes?

Causes painful swelling of the salivary glands (parotid)

How is Mumps transmitted?

Respiratory Secretion

What vaccine protects against Mumps?

MMR

What causes Slapped cheeks syndrome?

Parovirus, infects erythrocytes

How is slapped syndrome transmitted?

Respiratory secretions

Manifestation of Slapped cheek syndrome

Facial erythema

What is Otitis Media?

Inflammation of the middle ear mucosa

What causes Acute Otitis Media?

S. pneumoniae, M. catarrhalis, H. Influenzae

Best prevention method for Acute Otitis Media?

Vaccination against S. pneumoniae and H. Influenzae

Viral uRTIs could cause what?

swelling and mucosa blocking the eustachian tube

How are children more prone to uRTIs?

they have shorter and straighter eustachian tubes —> more prone to ear infections

What is Acute Rhinosinusitis?

Sinusitis = inflammation of the nasal sinus mucosa

What is Primary infection of Acute Rhinisinusitis cause by?

Respiratory virus

What is secondary infection of Acute Rhinisinusitis cause by?

bacteria

When is uRTIs considered complicated?

In secondary bacterial sinusitis

Pathophysiology of Acute Rhinosinusitis?

Viral infection of the nasal mucosa spreads to the sinuses. Mucosal edema leads to sinus blockage. Micro flora proliferates

What is Epiglottitis?

Inflammation of Epiglottis

What causes Epiglottitis cause by?

H. Influenzae (Hib)

What could happen if Epiglotittis swelling gets worse?

Obstruct breathing

How is Epiglotittis manifested?

Blush skin (cyanosis); X-ray shows “thumbs up” sign

What is Acute Pharyngitis?

an acute infection (usually viral)

What is the most common type of Pharyngitis?

Streptococcal Pharyngitis (Strep Throat) more frequent in children

What complications could Phyringitis cause?

Scarlet fever, rheumatic fever

What are some of the etiologies of Pharyngitis?

respiratory viruses cause most cases of acute pharyngitis

What virus causes Pharyngitis?

Rhinovirus

What bacteria causes Pharyngitis?

S. progenies (GAS = strep throat)

How micro-organisms are transmitted?

Airborne respiratory secretions

pathophysiology of Pharyngitis

Breach in pharynx mucosa (by viral infection) allow micro flora S. pyogenes to infiltrate and damage oropharyngeal epithelia

What is Scarlet fever?

Complication of strep throat

What bacteria causes Scarlet fever?

S. Pyogenes (GAS)

How is Scarlet fever manifested?

Pharyngitis *Strawberry tongue*, Scarlet-colored rash

What causes Diphtheria?

Corynebacterium diphtheriae

Where does Corynebacterium diphtheriae lives?

in mouth

How are Corynebacterium diphtheriae transmitted?

Respiratory secretions

How are Corynebacterium diphtheriae manifested?

Pharyngitis, *Bull neck* lymphadenopathy

What vaccine is used for Diphtheria?

DTaP vaccine

What is Pertussis?

Whooping cough

What causes pertussis?

Bordetella pertussis

What lead to development of Tdap booster vaccines?

Increase rate of pertussis in adults due to waning immunity

How is Pertussis transmitted?

respiratory secretions

How is Pertussis manifested?

Bronchitis (pertussis), repetitive dry cough with a whoop sound

What vaccine protects against Pertussis?

DTaP vaccine (primary) and Tdap (Pertussis booster)

What is Conjunctivitis?

Inflammation of the conjunctiva

What is most common type of Conjunctivitis?

Viral Conjunctivitis and is highly contagious

Purple t pus conjunctivitis suggests what? Nonpurulent?

Purulent: bacterial Non purulent: viral or allergic

Long-URTi Flashcards

(100 cards)