thera II test I flu

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201549
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thera II test I flu
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2013-02-22 12:21:20
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thera II test flu
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thera II test I flu
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  1. anchors the virus to the cell it is infecting
    hemagglutinin HA
  2. helps digest the body's mucous defenses and aids in later release of replicated viruses
    neuraminidase NA
  3. allo the virus to infect cells
    M2 & M1
  4. 3 characteristics of type A
    • moderate to severe illness
    • all age groups
    • humans and other animals
  5. 4 characteristics of type B
    • changes less rapidly than type A
    • milder epidemics
    • humans only
    • primarily affects children
  6. 2 characteristics of type C
    • rarely reported in humans
    • no epidemic
  7. 3 characteristics of antigenic drift
    • minor change, same subtype
    • caused by point mutations in gene
    • may result in epidemic
  8. 3 characteristics of antigenic shift
    • major change, new subtype
    • caused by exchange of gene segments
    • may result in pandemic
  9. 3 characteristics of epidemic
    • sudden onset of infection
    • large percentage of people
    • disappears in approx 3 months
  10. 3 characteristics of pandemic
    • appear suddenly in an isolated area
    • spread is worldwide and infects millions
    • large number of deaths
  11. 2 imprtant points of the pathogenesis of influenza
    • 1. grows best at 25 C, not great at 37 C, and dies at 40C
    • 2. virus survives 5 minutes on skin
    •    1-2 days on dry non-porous surfaces
    •    incubation period 2 days
  12. communicability of influenza
    • 1. 18-72 hr incubation
    • 2. infectious 1-2 days before onset
    • 3. viral shedding in respiratory secretions 5-10 days after onser
  13. when are throat and naopharyngeal swabs obtained
    within 3 days of onset of illness
  14. what is the most frequent common complicaion of influenza
    pneumonia
  15. how is the influenza vaccine decided
    • 1. 3 strains that are most likely to cause influenza infection the next year are chosen
    • 2. 2 type A and 1 type B are used
  16. advisory committee on immunization practices (ACIP) recommendations for annual influenza vaccination
    every person > 6 months of age unless there is a contraindication
  17. what is the immune response to TIV and LAIV
    • TIV - high serum IgG antibody response
    • LAIV - lower IgG and high IgA mucosal response
  18. safety side effect of TIV
    sore arem
  19. safety side effect of LAIV
    runny nose
  20. who is indactied for TIV
    >6 mo and healthy
  21. who is indicated for LAIV
    5-49 and healthy
  22. which influenza virus vaccine is for immunocompetent or compromised
    TIV
  23. when should pregnant women or postpartum use anti-virals for the flu
    withing 2 weeks after delivery
  24. which influenzas are the neuraminidase inhibitors effective against
    both A & B
  25. 11 CI for LAIV
    • 1. anaphylaxis
    • 2. guillain-barre syndrome
    • 3. history of hypersensitivity
    • 4. < 2yo
    • 5. asthma
    • 6. > 50 years of age
    • 7. chronic pulmonary, cardiovascular, renal, hepatic, neurologic, hematologic, or metaboic disorders
    • 8. immunosuppressed
    • 9. 6mo - 18yo receiving aspirin or other salicylates
    • 10. pregnant women
    • 11. precaution with a moderate or severe illness w/ or w/o fever
  26. 4 common symptoms of a cold
    • 1. stuffy nose
    • 2. sore throat
    • 3. sneezing
    • 4. chest discomfort, hacking cough
  27. 5 symptoms of the flu that aren't seen with a cold
    • 1. fever - usually high 100-102
    • 2. headache
    • 3. general aches, pains - often severe
    • 4. fatigue, weakness - can last 2-3 wks
    • 5. extreme exhaustion - at the beginning
  28. complications of a cold
    • sinus congestion
    • middle ear infection
    • asthma
  29. complications of the flu
    • brochitis
    • pneumonia - can be life threatening
  30. prevention of a cold
    • wash hands often
    • avoid close contact with anyone with a cold
  31. prevention of the flu
    • annual vaccinations
    • antiviral medicines
    • see your doctor
  32. Tx of a cold
    • antihistamines
    • decongestants
    • NSAIDS
  33. Tx of the flu
    • antiviral medicines
    • see your doctor
  34. 8 high risk people to recommend antiviral therapy
    • 1. <2yo
    • 2. >65 yo
    • 3. comorbidities - many
    • 4. women who are pregnant or postpartum
    • 5. <19yo and receiving lng-term ASA therapy
    • 6. american indians/alaska natives
    • 7. morbidly obese - bmi >40
    • 8. resident of nursing home or chronic care facility
  35. which neuramidase inhibitor needs to be adjusted for < 30 ml/min CrCl
    oseltamivir - tamiflu
  36. side effect seen in relenza but not tamiflu and group not recommended for use in
    • cough
    • people with underlying respiratory disease
  37. Tx durations of tamiflu and relenza
    • tamiflu - >2wks
    • relenza - >7wks
  38. prophylaxis Tx for tamiflu and relenza
    • tamiflu - > 1wks
    • relenza - > 5wks
  39. general antiviral Tx recommendationduration
    5 days
  40. general anti-viral prophylaxis recommended duration
    • 7 days
    • for control of outbreaks in ling-term care facilities and hospitals is minimum 2 wks
  41. dosing schedule of neuramidase inhibitors for Tx and prophylaxis
    • Tx - BID
    • prophylaxis - QD

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