PNA

Question 1

what the symptoms of a common cold

Answer 1

HA, clear nasal discharge, dry cough, sore throat

Question 2

what are the viruses that cause the common cold

Answer 2

rhinovirus
adenovirus
coronavirus

Question 3

describe epidemiology of SARS

Answer 3

2013
Bats
F, cough, SOB, PNA, ARDS
10% death - all hospitalized

Question 4

describe epidemiology of MERS

Answer 4

2012-2015
Camels
F, cough, SOB, PNA, ARDS
30% death - asymptomatic --> hospitalized
France-->Africa/US-->Asia

Question 5

identify the typical symptoms associated with influenza

Answer 5

HA, F, cough with sputum, chills, myalgia, fatigue

Question 6

compare and contrast characteristics of the 4 influenza antiviral agents

Answer 6

1. Oseltamavir: Influenza A/B, neuraminidase inhibitor, oral, no resistance
2. Zanamivir: Influenza A/B, NA inhibitor, inhalation, no resistance
3. Amantadine: Influenza A, adamantanes, oral, 99% resistance
4. Rimantadine: Influenza A, adamantanes, oral, 99% resistance

Question 7

what are the differences btwn the 3 types of influenza vaccines

Answer 7

1. live attenuated - intranasal inhalation - only in healthy and nonpregnant persons
2. inactivated - 2 types - a) IM b) ID
   IM - given to those > 6 mo
   ID - given to those 18-64
3. recombinant influenza vaccine - IM, 18-49yrs

Question 8

discuss the incidence and transmission of cytomegalovirus

Answer 8

• Herpesviridae family, ds DNA

- Owls-eye appearance

Question 9

describe the use of ganciclovir

Answer 9

• antiviral treatment for CMV
• this is activated by viral thymidine kinase
• actual drug target is DNA polymerase

Question 10

describe the use of valganciclovir

Answer 10

-antiviral treatment for CMV

Question 11

describe the use of cidofovir

Answer 11

• antiviral treatment for CMV

- for ganciclovir resistance

Question 12

describe the use foscarnet

Answer 12

• antiviral treatment for CMV

- for ganciclovir resistance

Question 13

describe the symptoms and clinical exam results associated with CMV

Answer 13

• owls-eye appearance of cells

- symptoms: fatigue, fever, mild dyspnea w/ exertion

Question 14

what is the respiratory disease associated with HSV

Answer 14

• 1/2: can become disseminated in neonates and immunocompromised causing pneumonitis and lethality
• 8: Kaposi’s sarcoma causing lung lesions and high mortality in the immunocompromised

Question 15

what is the respiratory disease associated with VZV

Answer 15

-can spread to the lungs or cause secondary infection

Question 16

what is the respiratory disease associated with EBV

Answer 16

-infections that cause mono - fatigue, ST, exudative, tonsillitis, swollen lymph nodes.

Question 17

what are the viruses that cause common cold in adults and severe disease in children

Answer 17

RSV

Parainfluenza

Question 18

what are the viruses mentioned that typically cause more severe disease

Answer 18

HSV
CMV
Influenza A/B

Question 19

what are the 4 groups of people who are at highest risk for influenza

Answer 19

1. pregnant or postpartum up to 2 wks
2. 65 yo
3. DZ: asthma, DM, renal, liver, endo, lung, heart, neuro disease

Question 20

what are the differences btwn primary and secondary PNA

Answer 20

1. Primary: viral cause, interstitial disease on xr, sputum has PMN, progressive worsening of symptoms, 50% mortality
2. Secondary: bacterial, xr and mortality depend on agent, sputum has bacterial agent, biphasic symptom presentation

Question 21

please name the 3 types of influenza vaccines

Answer 21

1. live attenuated
2. recombinant protein
3. inactivated

Question 22

what strains does the trivalent vaccine cover

Answer 22

2 A and 1 B

Question 23

what strains does the quadrivalent vaccine cover

Answer 23

2 A and 2 B

Question 24

list the 2 types of trivalent vaccines that were discussed

Answer 24

1. Flucelvax

2. Fluzone

Question 25

describe Flucelvax

Answer 25

Novartis, > 18yrs, IM, inactivated, standard dose, cell culture based line (canine kidney) - good for egg allergies

Question 26

describe fluzone trivalent

Answer 26

Sanofi Pasteur, >65, IM, inactivated - good for elderly

Question 27

list the 2 quadrivalent vaccines covered

Answer 27

1. Fluzone | 2. Flubok

Question 28

describe Fluzone quadrivalent

Answer 28

Sanofi Pasteur, 18-64 hrs, ID, inactivated

Question 29

describe Flubok

Answer 29

Protein Sciences, > 18yrs, IM, recombinant produced in insect cells

Question 30

describe what kind of disease CMV will cause in transplant patients, HIV, neonates, and healthy

Answer 30

- highest risk in transplant recipients (pneumonitis and gastritis) - HIV pts: retinitis and less commonly pneumonitis/gastritis - neonates: cytomegalic inclusion disease - healthy people: mono or asymptomatic infection

Question 31

describe CMV transmission - 5 types

Answer 31

1. intrauterine: 37% mother's primary infection, 1% seropositive mothers 2. perinatal: breast milk contains virus 3. postnatal: asymptomatic, exposure to saliva/genital secretions, daycare transmission, STD 4. blood transfusion: risk reduced significantly with leukocyte reduction 5. organ transplant: solid organ transplant, bone marrow can cause reactivation of a latent infection

Question 32

what are the 4 antiviral treatments forCM

Answer 32

foscarnet ganciclovir ganciclovir valganciclovir