Foundations/Basic
Team 1: Write at least three basic features of Influenza Pneumonia and both virulence factors (Do Not State the MOA of either risk factor).
Team 2: Outline the MOA for the two virulence factors and relate them to the pathogenesis
Features- Single Stranded Linear, Negative Sense RNA virus, replicates in host cell. Member of Orthomyxoviridae. Hemagglutinin (binds to sugar on host cell and lets virus enter) and Neuraminidase (Cleaves Host Glycans allowing the virus to escape)
Inhalation, respiratory replication (nose, throat, bronchial tubes, and lungs). Inflammation as viral replication triggers the immune system. Pneumonia development of pneumonia (alveoli in the lungs become filled with fluid impairing breathing and Oxygen in the bloodstream)
Pathogenesis involves the inflammation and cell damage in the respiratory tract, fluid accumulation, decreased O2 in the blood, reduced lung function, immune system activation, increased mucus production leading to coughing and difficulty breathing.
Team 2: You have a long line of people were all exposed to influenza in the past week. What test do you order and how does it work if not already explained?
Sputum: Specimen Identification
Blood Culture: Specimen Identification (Bacterials)
CBC: Diagnostic for WBC count and other values
RIDT: Detects Viral Antigens
Team 2: RIDT, results in 15-30 minutes, nasal swab, test strip that contains influenza antibodies, colored line appears on strip with positive test
Explain the test that could make you consider the use of Levofloxacin instead of Oseltamivir. Include the MOA for each drug
Team 1: Oseltamivir
Team 2: Levofloxacin
Blood Culture Agar. Can see if bacterial secondary infection has formed.
Oseltamivir is an antiviral medication that works by inhibiting the activity of the virus that causes influenza. It specifically targets the viral enzyme neuraminidase, which is essential for the release of new viral particles from infected cells. By blocking this enzyme, oseltamivir slows the spread of the virus and reduces the severity and duration of symptoms.
Levofloxacin is a type of antibiotic known as a fluoroquinolone. It works by inhibiting the activity of bacterial DNA gyrase and topoisomerase IV, two enzymes that are essential for the replication of bacterial DNA. By blocking these enzymes, levofloxacin prevents the bacteria from reproducing, which ultimately leads to the death of the bacteria. Levofloxacin is commonly used to treat bacterial pneumonia and other types of bacterial infections.
Both: List the main risk factors and why if possible) for viral pneumonia.
Age (young children and older adults are at higher risk)
Weakened immune system (due to underlying conditions, medications, or other factors)
Chronic respiratory diseases (such as asthma, chronic obstructive pulmonary disease (COPD), or bronchiectasis)
Smoking or exposure to secondhand smoke
Heart disease
Diabetes
Pregnancy
Obesity
Malnutrition
Travel to areas with high incidence of pneumonia
Team 2: Respiratory Syncytial Virus
Both: What are the most common etiologies of viral pneumonia?
Influenza Virus (this case)
Respiratory syncytial virus (RSV): common in children, sometimes elderly and immunocompromised
Human Metapneumovirus (HMPV): Relatively new
Adenovirus: Causes a lot of infections especially in children
Parainfluenza
SARS- causes pneumonia and severe acute respiratory syndrome
Discuss the potential benefits and limitations of oseltamivir and its role in preventing superinfection.
Team 1: Benefits
Team 2: Limitations
Efficacy: Oseltamivir has been shown to be effective in reducing the severity and duration of symptoms of influenza, especially when taken within the first 48 hours of symptom onset.
Convenience: Oseltamivir is taken orally, making it a convenient option for treating influenza, especially in patients who are unable to receive injections.
Preventing superinfection: By reducing the severity and duration of symptoms, oseltamivir can help prevent secondary infections, such as bacterial pneumonia, which can occur as a result of a weakened immune system.
Limitations:
Resistance: The widespread use of oseltamivir has led to the emergence of antiviral-resistant strains of influenza, which may limit its effectiveness in the future.
Cost: Oseltamivir can be expensive, which may limit access to the medication for some patients.
Shortage: In times of high demand, such as during a pandemic, oseltamivir may be in short supply, making it difficult for patients to access the medication.
Team 1: Describe the role of the pneumococcal vaccine and the type of vaccine. Why is it given every year?
Team 2: Outline the risk of the pneumococcal vaccine for a healthy individual. What are other mechanisms for stopping stread besides vaccines?
Vaccination is the best prevention for the spread of influenza.
Extremely minimal aside from allergic reactions, avoidance, wash your hands and wear a mask :)
Team 1: Define Antigenic Drift and Shift. How do these apply to the prevention mechanisms for influenza?
Team 2: Differentiate between Influenza A and B
Antigenic drift and shift: Virus A can change via DRIFT meaning it changes the surface proteins via random mutations. Differs from Shift in which the humans (A) and animal (B) viruses exchange material and produce a new hybrid (C) that can infect humans.
Influenza A- wider host range (animals, humans, winter), Influenza B- (humans and seals, spring)
Why is thoracoabdominal diaphragm myofascial release/rib raising useful for influenza pneumonia? Verbalize the procedure
Thoracoabdominal diaphragm myofascial release/rib raising is a manual therapy technique used to improve the mobility and function of the diaphragm, which is the primary muscle responsible for breathing. This technique can be beneficial in cases of influenza pneumonia because it can help improve respiratory function and alleviate respiratory symptoms.
Team 1: Give the Epidemiology of the flu virus. Relate the signs and symptoms with the spread of influenza in the body and the virulence factors.
Team 2: Relate the signs and symptoms with the spread of influenza in the body and the virulence factors.
Epidemiology varies depending on the strand and population. The virus strands are seasonal and increase in frequency during the winter. The young and old are at higher risk for developing viral pneumonia as well as the immunocompromised.
The signs and symptoms of viral pneumonia vary but commonly: Fever, Cough, Shortness of Breath, Chest Pain, Fatigue, Muscle Aches (myalgias), Nausea, Vomiting, or diarrhea.
Both: Explain how RT- PCR is used in influenza.
RT-PCR tracks the spread, characterizes the strains, and supports a diagnosis.
Team 1: Outline the potential effects of untreated pneumonia. (There are 5 main ones)
Team 2: If losing reset all points if anyone on your team can say what SARS stands for.
Respiratory Failure due to fluid accumulation
Secondary Bacterial Infections of Pneumonia (Staph A, Hemophilus I, Strep Pneumonia)
Sepsis- Widespread Inflammation and Vital Organ Damage
Chronic Lung Disease: can lead to COPD/Bronchitis Development
Neurologic Damage: Meningitis or Encephalitis
Severe Acute Respiratory Syndrome.