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51 Cards in this Set

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Stages of pertussis
incubation - 7-10 days
Catarrhal - 7-14 days
Paroxysmal - 2-4 weeks
Convalescent - 3-4 weeks +
Which phase of pertussis includes "whooping"
paroxysmal
Pertussis in Adults Accounts for up to ___% of cough illnesses per year
7
Pertussis complications (pneumonia and/or hosptitalization) occur in which age group?
<6 months
Diagnosis of pertussis?
by culture- best to use nasopharyngeal aspirate
What kind of swab should be used to diagnose pertussis?
use dacron or other non-cotton swab

Cotton swabs contain a fatty acid that is toxic to B. pertussis
transport media for Bordatella pertussis?
Put sample in Regan-Lowe transport media
agar for culture of bordatella pertussis
Lab will culture on Bordet-Gengou agar
DOC for pertussis
Macrolides
Pertussis vaccine is Given along with tetanus and diphtheria vaccines
what are the 2 types?
Whole cell vaccine (TDwP)
Acellular vaccine (TDaP)
What age group is getting pertussis lately?
>25

There has been a general rise in pertussis incidence since 1970s.
Tdap vaccines in adolescents aged 11–18 years in place of ________ toxoids (Td) vaccines.
tetanus and diphtheria
What is acute inflammation of the tracheobronchial tree called?
Acute bronchitis
Bronchitis
Clinical manifestations
Purulent cough plus or minus:
Fever
Malaise
Rhinorrhea or nasal congestion
Sore throat
Wheezing
Dyspnea
Chest pain
Myalgias or arthralgias
Viral causes of acute bronchitis
Influenza, parainfluenza, adenovirus, rhinovirus, and a number of other viruses
Bacterial causes of acute bronchitis
Mycoplasma pneumoniae; Chlamydophila pneumoniae; Streptococcus pneumoniae; Haemophilus influenzae; Bordetella pertussis
____% of acute bronchitis has a non-bacterial cause (ie due to virus or non-infectious)
>90
Clinically, with presentation of symptoms like Acute Bronchitis, first rule out what disease?
pneumonia
Viral causes of bronchiolitis
RSV (******)
PIV
Influenza
Adenovirus
Human Metapneumovirus
Bacterial cause of bronchiolitis
M. pneumoniae can cause in older children and adults
Paramyxoviridae
Most common cause of LRTI in infants and young children (<3)
Respiratory Syncytial Virus
Important antigens of RSV
HN- adsorption
G-also involved in adsorption
F-fusion protein
Disease associations of RSV
Bronchiolitis
Pneumonia
Colds
A Paramyxoviridae that is Clinically and epidemiologically similar to RSV, but Not nearly as common a cause of serious disease as RSV
Human Metapneumovirus


~100% infection rate in childhood
2 strains of RSV that circulate annually
A and B
RSV:
Transmitted by what?
large droplet secretions on hands and fomites
RSV season:
winter-spring
What increases risk of infection with RSV?
Day care
Infants in households with school aged siblings
Exposure to tobacco smoke
Lack of breast feeding
RSV:
100% infection rate by ___ years of age
3
Which group of children is at most risk for RSV mortality?
infants with congenital heart disease


(37% mortality rate in this group)
What component of humoral immunity is most important regarding RSV (but is short lived)
anti-viral IgA
Diagnosis of RSV
Virus isolation
Viral antigen detection (ELISA)
RSV:
high risk infants
Premature infants
Infants with cardiopulmonary disorders
Immune suppressed infants
Immune globulin products available for prevention of HSV
Humanized monoclonal antibody against viral F protein (Palivizumab)
6 viruses causing viral penumonia
RSV
PIV (parainfluenza)
Influenza
Adenovirus
Metapneumoviruses
Hantavirus
Viruses are most common cause of pneumonia in what pts
in young children and are common causes in adults older than 60.
____ is the most common cause of LRTI in children less than 3
RSV
Reservoirs of Hantavirus
deer mouse, white footed mouse, rice rat, cotton rat
In the past 14 years, how many cases of Hantavirus infection have there been?
465
Points about Hantavirus Pulmonary Syndrome
Rapidly progressing adult respiratory distress syndrome following mild flu-like illness
Hypotension
Bilateral pulmonary infiltrates
Hemoconcentration
DIC
ARDS
Diagnosis of Hantavirus
Clinical manifestations
Serology
Virus isolation
Viral antigen detection
PCR
Treatment of Hantavirus Syndrome
1) Supportive
Oxygenation
Vasopressors (Dopamine, dobutamine)
Volume replacement
2) Antiviral
Ribavirin being investigated
People don't get rid of Cytomegalovirus. Where is it?
Latent in white blood cells and possibly other cells (ie, endothelial cells)
Symptomatic primary infection of CMV:
Mononucleosis-like syndrome
Post-transfusion syndrome


(but, Most infections and reactivations are asymptomatic)
Sequellae of CMV in immunocompromised
Pneumonia
Chorioretinitis
GI disease
Encephalitis
Diagnosis of CMV Pneumonia
Virus isolation from lung tissue or bronchial aspirate
CMV antigen detection
Histopathology or cytology


***nuclear inclusion bodies with perinuclear halo
***cytoplasmic inclusions
Antivirals Effective Against CMV
Interfere with viral ___synthesis
DNA
3 Antivirals Effective Against CMV
Ganciclovir
Nucleoside analogue
Cidofovir
Nucleoside analogue
Foscarnet
Pyrophospahte analogue
Reactivation of latent CMV can or cannot be prevented ?
cannot
Use of _____-IG may prevent development of disease in seronegative at-risk patients (ie transplant)
CMV
Prevent primary infection in seronegative immune suppressed by:
Use of seronegative blood for transfusion
Use of organs from seronegative donors