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Questions and Answers
Which of the following is an RNA virus that can cause respiratory symptoms?
Which of the following is an RNA virus that can cause respiratory symptoms?
Based on the provided list, which virus is associated with oral herpes?
Based on the provided list, which virus is associated with oral herpes?
Which of these RNA viruses is NOT explicitly listed as a respiratory virus in the provided content?
Which of these RNA viruses is NOT explicitly listed as a respiratory virus in the provided content?
Which of these is classified as an emerging virus, according to the provided content?
Which of these is classified as an emerging virus, according to the provided content?
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Based on the provided content, which of the following is a common symptom associated with most cold-causing viruses, regardless if they are RNA or DNA?
Based on the provided content, which of the following is a common symptom associated with most cold-causing viruses, regardless if they are RNA or DNA?
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Which symptom associated with coronaviruses is typically not reported as frequently as the others?
Which symptom associated with coronaviruses is typically not reported as frequently as the others?
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What is distinctive about the genomes of coronaviruses compared to other RNA viruses?
What is distinctive about the genomes of coronaviruses compared to other RNA viruses?
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What is the term used to describe the characteristic nested subgenomic mRNAs produced during the replication of coronaviruses?
What is the term used to describe the characteristic nested subgenomic mRNAs produced during the replication of coronaviruses?
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Which of the following is NOT a type of infection that coronaviruses are known to cause?
Which of the following is NOT a type of infection that coronaviruses are known to cause?
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In the timeline of human coronavirus outbreaks, which virus had the highest case fatality rate (CFR)?
In the timeline of human coronavirus outbreaks, which virus had the highest case fatality rate (CFR)?
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Which characteristic is unique to rotavirus among the viruses listed?
Which characteristic is unique to rotavirus among the viruses listed?
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A patient presents with a fever for at least 3 days, a cough, head cold, and conjunctivitis. Which diagnostic method would confirm the patient has Measles?
A patient presents with a fever for at least 3 days, a cough, head cold, and conjunctivitis. Which diagnostic method would confirm the patient has Measles?
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Which of the following is NOT a typical complication associated with measles?
Which of the following is NOT a typical complication associated with measles?
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What type of medication is NOT indicated in the treatment of Measles?
What type of medication is NOT indicated in the treatment of Measles?
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What is the significance of reverse transcriptase (RT) inhibitors in the context of HIV?
What is the significance of reverse transcriptase (RT) inhibitors in the context of HIV?
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Which symptom is specific to chronic HIV infection, as opposed to acute HIV?
Which symptom is specific to chronic HIV infection, as opposed to acute HIV?
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Which of the following viruses does NOT have a specific treatment?
Which of the following viruses does NOT have a specific treatment?
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What is the primary reason why there is no vaccine available for HIV?
What is the primary reason why there is no vaccine available for HIV?
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What is a major characteristic of influenza that distinguishes it from Human Metapneumovirus?
What is a major characteristic of influenza that distinguishes it from Human Metapneumovirus?
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Which statement about Respiratory Syncytial Virus (RSV) is accurate regarding its impact on age groups?
Which statement about Respiratory Syncytial Virus (RSV) is accurate regarding its impact on age groups?
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What unique feature of the Orthomyxoviridae family contributes to the prevalence of influenza strains?
What unique feature of the Orthomyxoviridae family contributes to the prevalence of influenza strains?
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Why is there a lack of a specific treatment for both Human Metapneumovirus and RSV?
Why is there a lack of a specific treatment for both Human Metapneumovirus and RSV?
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What symptoms are commonly associated with influenza that are not typically seen in cases of RSV?
What symptoms are commonly associated with influenza that are not typically seen in cases of RSV?
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What is the primary action of Nonnucleoside Analogue Reverse Transcriptase Inhibitors (NNRTI)?
What is the primary action of Nonnucleoside Analogue Reverse Transcriptase Inhibitors (NNRTI)?
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Which of the following is NOT a characteristic of therapeutic failure in HIV treatment?
Which of the following is NOT a characteristic of therapeutic failure in HIV treatment?
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What group of individuals is defined as 'elite controllers' in the context of HIV?
What group of individuals is defined as 'elite controllers' in the context of HIV?
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What is a major complication associated with chronic Hepatitis C Virus (HCV) infection?
What is a major complication associated with chronic Hepatitis C Virus (HCV) infection?
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What is a common symptom of chronic HCV infection?
What is a common symptom of chronic HCV infection?
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Which of the following statements about HCV treatment is true?
Which of the following statements about HCV treatment is true?
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How does Integrase Inhibitors function in HIV therapy?
How does Integrase Inhibitors function in HIV therapy?
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What is a significant barrier to the effectiveness of IFN + Ribavirin treatment for HCV?
What is a significant barrier to the effectiveness of IFN + Ribavirin treatment for HCV?
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What indicates a positive therapeutic response to HIV treatment?
What indicates a positive therapeutic response to HIV treatment?
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Study Notes
RNA Viruses
- RNA viruses are a group of viruses with RNA as their genetic material.
- Common RNA viruses include Coronaviruses (OC43 229E), Enterovirus, HAV, HCV, HEV, HIV, HTLV, Human metapneumovirus, Influenza A, Influenza B, Measles, MERS, Mumps, Norovirus, Parainfluenza, Polio, Rhinoviruses, Rotavirus, RSV, Rubella (German Measles), SARS, SARS-CoV-2.
- Learning objectives include describing symptoms, diagnosis, and treatment of common RNA viruses.
Common Cold Symptoms
- Common cold symptoms typically present similarly, including: sneezing; stuffy nose; runny nose; sore throat; coughing; post-nasal drip; watery eyes; fever (rare); chills (rare).
- Doctors often recommend monitoring symptom severity, using inhalers (more readily prescribed now), and watching for rashes.
- Breathing and temperature checks are key aspects of monitoring.
Coronaviruses Background
- Coronaviruses are a family of enveloped, positive-sense, single-stranded RNA viruses.
- They have the largest genomes of all RNA viruses (~30kb).
- They infect humans, other mammals, some birds, livestock, and pets.
- They account for approximately 10-15% of upper respiratory tract infections.
Nidovirales Coronaviridae
- Nidoviruses are named for the nested subgenomic mRNAs generated during infection.
- Coronaviruses are enveloped viruses (100-150nm).
- Coronaviruses have RNA genomes.
Types of Infections from Coronaviruses
- Coronavirus infections can affect the respiratory system (human OC43, 229E; avian IBV), the brain (neurotropic MHV, demyelinating), the liver (MHV), or the gastrointestinal tract (procine TGEV, avian IBV, MHV).
Human Coronaviruses: Timeline
- Common cold coronaviruses OC43 and 229E have been present since the 1980s.
- SARS-CoV emerged in 2002, causing 812 deaths (10% case fatality rate).
- HKU1, NL63, and Croup affected people in 2004 and 2005.
- MERS-CoV emerged in 2012, causing 866 deaths (34% case fatality rate).
- SARS-CoV-2 (COVID-19) emerged in 2019, leading to over 6.7 million deaths (1% case fatality rate initially, 2-3 % originally-note this is an important distinction).
- Seasonal influenza typically infects between 250,000 and 500,000 people annually.
Human Metapneumovirus
- Human Metapneumovirus (hMPV) can cause upper and lower respiratory disease in individuals of all ages, particularly young children and older adults.
- Symptoms include cough, fever, nasal congestion, bronchitis, or pneumonia.
- There is no specific treatment or vaccine for hMPV.
Respiratory Syncytial Virus (RSV)
- RSV usually causes mild cold-like symptoms.
- Most people recover within 1-2 weeks, but can be serious in infants and older adults.
- Symptoms include runny nose, decreased appetite, coughing, sneezing, fever, and wheezing.
- Almost all children have had RSV by age two.
- There is no specific treatment or vaccine currently available, but an mRNA vaccine for adults is currently being developed.
Influenza
- 75-95% of influenza cases are influenza A, and the remaining 5-25% are influenza B.
- Influenza affects the nose, throat, and lungs, and can cause mild to severe illness.
- Symptoms include fever (not everyone experiences it), cough, sore throat, runny/stuffy nose, muscle aches, headache, fatigue, and sometimes vomiting and diarrhea.
- Flu patients are more susceptible to bacterial infections.
- Cytokine storm syndrome (excessive inflammatory response) can aggravate respiratory failure and lead to systemic organ failure.
- Influenza viruses have segmented genomes, allowing for reassortment, which affects vaccine design and effectiveness yearly.
- Oseltamivir (Tamiflu) is a neuraminidase inhibitor used to treat influenza A and B but is not often recommended due to resistance.
Rotavirus
- Rotavirus is a double-stranded RNA virus of the Reoviridae family.
- Symptoms include watery diarrhea, vomiting, fever, and abdominal pain.
- There is no virus-specific treatment.
- There is a 2-dose vaccine available.
Norovirus
- Norovirus is a single-stranded RNA virus of the Caliciviridae family.
- Symptoms include diarrhea, vomiting, nausea, and stomach pain.
- There is no virus-specific treatment or vaccine available.
Measles Virus
- Measles symptoms begin 10-14 days after exposure, characterized by a four-day fever, cough, coryza (head cold, fever, sneezing), conjunctivitis, and a typical rash.
- Diagnosis involves checking for fever for at least 3 days, and one of the "3C's", and confirming the presence of measles virus antibodies or RNA from respiratory samples.
- Complications include diarrhea, pneumonia, bronchitis, and brain inflammation (rarely subacute sclerosing panencephalitis) and corneal ulceration.
- Treatment involves managing symptoms (e.g., ibuprofen) and providing airway dilators if necessary. Vitamin A may be given to reduce the risk of blindness.
Human Immunodeficiency Virus (HIV)
- HIV is the etiological agent responsible for AIDS.
- HIV was discovered in 1984.
- Approximately 40 million people globally have HIV, with about 50,000 cases in Canada.
- No vaccine is available.
- Approximately 30 drugs are currently in use for HIV treatment. These medications inhibit reverse transcriptase, protease, entry, and integrase.
- Acute HIV infection is rarely diagnosed except in high-risk individuals who are frequently tested. Late diagnosis is common, often due to lack of symptoms, especially in rural areas.
- Chronic HIV infection symptoms include nausea, vomiting, persistent diarrhea, rapid weight loss, rashes, sores/lesions, persistent infections, and neurological complications including memory loss and confusion.
- The course of untreated HIV is characterized by progressive decline in CD4+ T cells and increasing viral load.
Hepatitis C Virus (HCV)
- 70-85% of untreated HCV infections become chronic.
- 15-20% of untreated HCV infections develop into hepatocellular carcinoma.
- Approximately 71 million people worldwide are infected with HCV, and 270,000 Canadians are infected (0.8 % of the Canadian population, or 2-4 people per 100,000 people).
- About 3,200 to 5,000 new HCV cases emerge each year in Canada.
- HCV transmission commonly occurs through injection drug use (60%), but other routes exist (sexual transmission, transfusion, and unknown sources).
- Chronic HCV symptoms can include fatigue, muscle aches, loss of appetite, weakness, weight loss, blood clotting problems, and liver-specific problems like cirrhosis, fibrosis, and hepatocellular carcinoma.
- Interferon (IFN) and ribavirin were once the only treatment, but are less effective due to genotype specificity and poor tolerability.
- Protease inhibitors, polymerase inhibitors, and NS5A inhibitors have become available since 2011, which significantly improved cure rates (now upwards of 99% in clinical trials and 95% in real-world treatment using cocktails).
- Several HCV treatment drugs are available, including Sofosbuvir (NS5B), Velpatasvir (NS5A), Daclatasvir (NS5A), Ombitasvir (NS5A), Paritaprevir (NS3/4A), Ritonavir (CYP3A), Dasabuvir (NS5B non-nuc), Ledipasvir (NS5A), and Sofosbuvir (NS5B).
- HCV was discovered in 1989.
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Description
Test your knowledge on RNA viruses and their characteristics in this informative quiz. It's designed to cover various aspects of respiratory symptoms, emerging viruses, and the unique properties of coronaviruses. See how well you understand the complexities of virology!