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Questions and Answers

What does LRT stand for?

Lower respiratory tract

Which of the following is the most common cause of bronchiolitis in infants?

  • Coronaviruses
  • Para influenza virus
  • Respiratory Syncytial Virus (RSV) (correct)
  • Influenza virus

    • What is the incubation period of bronchiolitis?

  • 10-14 days
  • 7-10 days
  • 4-8 days (correct)
  • 1-3 days

    • What are two common signs of bronchiolitis?

    <p>Crackles and wheezes</p> Signup and view all the answers

    Bronchodilators are often used to treat bronchiolitis.

    <p>True</p> Signup and view all the answers

    Antibiotics are used to prevent secondary bacterial infections in bronchiolitis.

    <p>True</p> Signup and view all the answers

    What condition is recommended to hospitalize children with?

    <p>Underlying heart or lung disease</p> Signup and view all the answers

    What is the abbreviation for Community Acquired Pneumonia?

    <p>CAP</p> Signup and view all the answers

    Viral pneumonia is a serious condition for elderly patients.

    <p>True</p> Signup and view all the answers

    What percentage of CAP in adults and children is caused by viruses?

    <p>35%</p> Signup and view all the answers

    Which of the following is NOT a risk factor for viral pneumonia?

    <p>Obesity</p> Signup and view all the answers

    What type of onset does viral pneumonia tend to have compared to bacterial pneumonia?

    <p>Gradual</p> Signup and view all the answers

    Symptoms of viral pneumonia usually begin several days after upper respiratory symptoms.

    <p>True</p> Signup and view all the answers

    Secondary bacterial respiratory infections are more common in high-risk patients with viral pneumonia.

    <p>True</p> Signup and view all the answers

    Which of the following is NOT a common organism that causes viral pneumonia?

    <p>Rhinovirus</p> Signup and view all the answers

    What is the main route of infection for viral pneumonia?

    <p>Inhalation</p> Signup and view all the answers

    To what family does the influenza virus belong?

    <p>Orthomyxoviridae</p> Signup and view all the answers

    What type of viruses are influenza viruses?

    <p>Spherical or filamentous</p> Signup and view all the answers

    What type of genome do influenza viruses have?

    <p>Single-stranded RNA</p> Signup and view all the answers

    What are the three serotypes of influenza?

    <p>A, B, and C</p> Signup and view all the answers

    What are the two surface glycoproteins found on influenza viruses?

    <p>Hemagglutinin and Neuraminidase</p> Signup and view all the answers

    Antigenic drift is a major antigenic change that can cause pandemics.

    <p>False</p> Signup and view all the answers

    Antigenic shift involves a major antigenic change in hemagglutinin or neuraminidase resulting in pandemics.

    <p>True</p> Signup and view all the answers

    Antigenic drift can occur in influenza A serotypes but not in B serotypes.

    <p>False</p> Signup and view all the answers

    Antigenic drift can cause epidemics.

    <p>True</p> Signup and view all the answers

    What is the usual incubation period for influenza?

    <p>3-4 days</p> Signup and view all the answers

    Which of the following is NOT a complication of influenza?

    <p>Hepatitis</p> Signup and view all the answers

    The Guillain-Barré syndrome is a complication of influenza.

    <p>True</p> Signup and view all the answers

    Which of the following is a common laboratory test used to diagnose influenza?

    <p>RT-PCR</p> Signup and view all the answers

    Which of the following antiviral medications is used to treat influenza?

    <p>Oseltamivir (Tamiflu) and Zanamivir</p> Signup and view all the answers

    There is currently no vaccine available to prevent influenza.

    <p>False</p> Signup and view all the answers

    Live attenuated vaccines are more effective than inactivated vaccines at inducing the formation of circulating antibodies.

    <p>False</p> Signup and view all the answers

    Which of the following is NOT a type of vaccine used for prophylaxis?

    <p>Antibiotic vaccine</p> Signup and view all the answers

    Killed vaccines induce the formation of circulating antibodies and provide local immunity.

    <p>False</p> Signup and view all the answers

    Live attenuated vaccines stimulate the production of local IgA antibodies.

    <p>True</p> Signup and view all the answers

    Which of the following coronaviruses caused the 2003 SARS outbreak?

    <p>SARS-CoV</p> Signup and view all the answers

    What type of virus is the coronavirus?

    <p>Enveloped, positive-sense, single-stranded RNA viruses</p> Signup and view all the answers

    What is the incubation period for coronaviruses?

    <p>2-14 days</p> Signup and view all the answers

    MERS-CoV is a type of Coronavirus.

    <p>True</p> Signup and view all the answers

    The 2019-outbreak coronavirus is from bats.

    <p>True</p> Signup and view all the answers

    The COVID-19 virus, SARS-CoV-2, has a high mortality rate.

    <p>False</p> Signup and view all the answers

    The COVID-19 virus is a more contagious virus than other coronaviruses.

    <p>True</p> Signup and view all the answers

    The COVID-19 virus is primarily spread through respiratory droplets.

    <p>True</p> Signup and view all the answers

    There is no specific antiviral treatment for COVID-19.

    <p>True</p> Signup and view all the answers

    The incubation period for COVID-19 is 2 to 14 days.

    <p>True</p> Signup and view all the answers

    Most people infected by COVID-19 are asymptomatic.

    <p>True</p> Signup and view all the answers

    Diarrhea is a common sign of COVID-19.

    <p>False</p> Signup and view all the answers

    Which of the following is a diagnostic test for COVID-19?

    <p>RT-PCR</p> Signup and view all the answers

    Corticosteroids are effective in treating COVID-19 pneumonia.

    <p>True</p> Signup and view all the answers

    What is the name of the protein that the COVID-19 virus binds to on the surface of human cells?

    <p>ACE-2</p> Signup and view all the answers

    Which of the following is an example of an opportunistic fungal infection?

    <p>Candidiasis</p> Signup and view all the answers

    Fungal infections are frequently seen in intensive care units (ICUs).

    <p>True</p> Signup and view all the answers

    What is the cause of Valley Fever?

    <p>Coccidioides immitis</p> Signup and view all the answers

    Valley Fever is endemic to the southwestern U.S.

    <p>True</p> Signup and view all the answers

    North American Blastomycosis is caused by Blastomyces dermatitidis

    <p>True</p> Signup and view all the answers

    Cryptococcosis is most frequently seen in individuals who are gardening.

    <p>False</p> Signup and view all the answers

    Pneumocystis jirovecii pneumonia is a common opportunistic infection in patients with AIDS.

    <p>True</p> Signup and view all the answers

    There is a readily available culture for Pneumocystis jirovecii pneumonia.

    <p>False</p> Signup and view all the answers

    Which of the following is NOT a typical method used to diagnose a fungal infection?

    <p>Blood counts</p> Signup and view all the answers

    Study Notes

    Viral & Fungal Pneumonia

    • Viral pneumonia and fungal pneumonia are respiratory infections.

    Viral Infection of Lower Respiratory Tract (LRT)

    • Pneumonia: An infection of the lungs.
    • Bronchiolitis: An infection of the small bronchioles in the lungs.

    Bronchiolitis

    • Acute viral infection affecting small bronchioles
    • Primarily in infants and young children (under 2 years old)
    • Only humans can transmit the infection
    • Etiology: Respiratory Syncytial Virus (RSV)
    • Incubation period: 4-8 days
    • Symptoms: cough, wheezing, shortness of breath; difficulty feeding in some children.
    • Signs: crackles or wheezes heard on lung auscultation
    • Chest X-ray shows typical bilateral perihilar fullness of bronchioles
    • Treatment: Bronchodilators, Antibiotics (to prevent secondary bacterial infections), hospitalization may be necessary for children with underlying heart or lung conditions.

    Viral Pneumonia

    • Viruses are a significant cause of community acquired pneumonia (CAP).
    • It is a serious illness, especially in older and immunocompromised individuals.
    • Viruses cause up to 35% of CAP in adults and children.
    • Risk factors: Elderly, chronic chest diseases (e.g., Asthma), immunocompromised patients
    • Symptoms tend to be of gradual onset and are less severe than bacterial pneumonia.
    • Symptoms of viral pneumonia begin a few days after upper respiratory symptoms, such as a sore throat.
    • Secondary bacterial infections are common among high-risk individuals.
    • Common viral causes: Influenza virus, RSV, Coronaviruses, Para-influenza virus, Adenovirus type 7, Epstein-Barr Virus (EBV), Cytomegalovirus (CMV), Herpes simplex virus (HSV), Measles virus

    Influenza Virus

    • Family: Orthomyxoviridae
    • Spherical or filamentous viruses
    • Single-stranded, segmented RNA genome
    • Three serotypes (types A, B, and C) differentiated by internal and matrix proteins
    • Hemagglutinin (HA) and neuraminidase (NA) are surface glycoproteins on the virus envelope.
    • Antigenic drift: minor changes in HA or NA proteins resulting in epidemics.
    • Antigenic shift: major changes in HA or NA proteins resulting in pandemics due to gene reassortment.

    Viral Pneumonia: Clinical features

    • Incubation period: 3-4 days
    • Symptoms: fever, myalgia, sore throat, nonproductive cough, headache
    • Complications: pulmonary (secondary bacterial infection), non-pulmonary (myositis, encephalitis, peripheral nervous system complications like Guillain-Barré syndrome, Reye's syndrome).

    Viral Pneumonia: Lab diagnosis

    • Demonstration of virus antigen (RT-PCR, immunofluorescence).
    • Isolation of the virus (monkey kidney cells).
    • Serology (hemagglutination inhibition, complement fixation test, ELISA).

    Viral Pneumonia: Treatment

    • Antivirals (Amantadine, Rimantidine, Oseltamivir, zanamivir)

    Viral Pneumonia: Prophylaxis

    • Inactivated vaccines, inactivated subunit vaccines, recombinant vaccines, live attenuated vaccines

    Coronaviruses

    • Large family of viruses causing illness in humans and animals.
    • Coronaviruses belong to the family Coronaviridae.
    • Crown-like spikes on the outer surface.
    • Enveloped, positive-sense, single-stranded RNA viruses with a helical nucleocapsid.
    • Common cause of the common cold.
    • Incubation period: 2-14 days
    • Mortality: 11% especially for elderly individuals.
    • SARS-CoV, MERS-CoV, SARS-CoV-2 (COVID-19) are important strains.

    Severe Acute Respiratory Syndrome (SARS)

    • Caused by a coronavirus.
    • First outbreak in southern China in 2002.
    • Pandemic in 2003 affecting 30 countries with over 800 deaths.
    • Flu-like symptoms (fever, chills, dry cough, shortness of breath, muscle aches, diarrhea).
    • Complication: pneumonia, respiratory failure, heart and liver failure.

    SARS Lab diagnosis

    • PCR (sputum, blood, stool), detection of serum antibodies.

    SARS Treatment

    • Respiratory support, ribavirin, interferons, high-dose steroids (controversial) - no vaccine.

    Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

    • First cases in Jordan and Saudi Arabia in 2012
    • People with comorbidities (diabetes, cancer, weakened immune systems, chronic lung, heart, or kidney disease) are more likely to be infected or experience severe disease
    • Primarily transmitted through close contact with ill individuals.
    • Incubation period: 5-6 days, range of 2-14 days.
    • Symptoms: fever, cough, shortness of breath, gastrointestinal symptoms (diarrhea, nausea, vomiting).
    • Complications: pneumonia, kidney failure.

    MERS-CoV Lab diagnosis

    • Respiratory specimens, serum.
    • Serologic testing, antibody detection, real-time RT-PCR testing

    MERS-CoV Treatment

    • No vaccine. No specific antiviral treatment. Supportive management is crucial.

    SARS-CoV-2 (COVID-19)

    • Infectious disease caused by a coronavirus closely related to SARS-CoV.
    • Primarily spread through respiratory droplets from infected individuals.
    • ACE-2 is a functional receptor for SARS-CoV-2 and is highly expressed in pulmonary epithelial cells.
    • Incubation period: 2-14 days.
    • Symptoms: fever, cough, shortness of breath; diarrhea or upper respiratory symptoms are less frequent
    • Potential complications: pneumonia, multi-organ failure.

    COVID-19 Diagnosis

    • Molecular tests (RT-PCR), Serology, Blood tests, Chest X-ray

    COVID-19 Treatment

    • Antiviral drugs (Lopinavir, Ribavirin, interferon beta-1b), corticosteroids (dexamethasone, prednisolone), Immunomodulator (tocilizumab)

    COVID-19 Prevention

    • Wear facemasks
    • Cover coughs/sneezes
    • Frequent handwashing
    • Social distancing
    • Quarantine

    Fungal Pneumonia

    Fungal Pneumonia: Introduction

    • Fungal pneumonia is a lung infection caused by either primary pathogenic or opportunistic fungi.
    • Pathogenic fungi can infect both healthy and immunocompromised individuals.
    • Mortality can be very high (90%) in immunocompromised patients, while normal immune systems often respond well to antiviral therapy.

    Fungal Pneumonia: Transmission

    • Inhalation of fungal spores is the typical method of transmission.
    • Pathogenic examples include: Histoplasma capsulatum (histoplasmosis), Coccidioides immitis (coccidioidomycosis), Blastomyces dermatitidis (blastomycosis), Paracoccidioides brasiliensis (paracoccidioidomycosis) - all thermally dimorphic fungi.
    • Fungal infections are geographically specific (e.g., Histoplasmosis, Coccidioidomycosis).

    Fungal Pneumonia: Histoplasmosis

    • Caused by Histoplasma capsulatum.
    • Often associated with the Ohio river valley.
    • Dimorphic (yeast form and mycelial form depending on temperature).
    • Typically a mild, self-limiting disease, but can be severe in immunocompromised individuals.

    Fungal Pneumonia: Coccidioidomycosis

    • Caused by Coccidioides immitis.
    • Endemic to Southwestern U.S. and northern Mexico.
    • Distinctive morphology (block-like arthrospores, spherules containing endospores in the lungs).
    • Lung infection is common, but dissemination to the central nervous system (meningitis) can occur.

    Fungal Pneumonia: Blastomycosis

    • Caused by Blastomyces dermatitidis.
    • Native to North America.
    • Generally occurs in pulmonary form, but can cause skin or bone infections.
    • Dimorphic characteristic.

    Fungal Pneumonia: Paracoccidioidomycosis

    • Caused by Paracoccidioides brasiliensis.
    • Found in Central and South America.
    • Lung infection followed by lesions and other problems and is typically restricted to the mucosa of the mouth and nose.

    Fungal Pneumonia: Opportunistic Fungi

    • Pneumonia caused by opportunistic fungi is rising due to immunosuppressive drugs after organ transplant, cytotoxic drugs in cancer therapy, and a proliferation of AIDS patients globally.
    • Includes Candida albicans (oral thrush, systemic candidiasis), Aspergillus species (aspergillosis, fungus ball), Cryptococcus neoformans (cryptococcosis), Pneumocystis jiroveci (pneumonia).

    Fungal Pneumonia: Diagnosis and Treatment

    • Diagnosis: microscopic examination of sputum (silver staining), Bronchoalveolar lavage (BAL), cultures (Sabouraud dextrose agar), molecular methods (PCR), serologic testing (ELISA), skin testing
    • Treatment: depends on the causative agent (e.g., antifungals like amphotericin B, fluconazole).

    Prevention of Viral and Fungal Pneumonia

    • Handwashing, covering coughs/sneezes, quarantining
    • Avoid touching eyes, nose, and mouth with unwashed hands.

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