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Finals > Covid 19 > Flashcards

Covid 19 Flashcards

1
Q

when do symptoms appear after infection with COVID-19 cap

A

afetr 6 days

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2
Q

early symptoms of disease cap

A

cough
malaise
anosmia
headache
myalgia

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3
Q

level of severity

absence of signs of severe or critical disease

A

non severe

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4
Q

level of severity

sp02 less than 90% on air
resp rate above 30
raised resp rate in children
signs of severe resp distress

A

severe

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5
Q

level of severity

requires life sustaining treatment
acute respiratory distress syndrome
sepsis
septic shock

A

critical

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6
Q

symptoms of severe covid pneumonia

A

severe breathlessness
rr over 30
saturation below 90

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7
Q

x rays can show basal atelectasis, what does this mean

A

collapsed lungs

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8
Q

what might you see in a ct in severe covid

A

ground glass infiltrates

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9
Q

what biomarkers would be raised

A

crp
fibrinogen
d dimers
ldh
ferritin

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10
Q

true or false, covid is not prothrombotic and does not increase clot risk

A

false

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11
Q

what causes cytokine storm

A

body inflammatory response

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12
Q

asiatics have greater expression of x which is associated with poorer outcomes

A

tyk2

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13
Q

asiatics have lower x which is associated with poorer outcomes

A

IFNAR2

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14
Q

elevated x is associated with increased mortality and thrombosis

A

d dimer

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15
Q

what does inf reduce

A

inflammation

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16
Q

what prevents the use of inf

A

cost

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17
Q

how can proning help patients with covid

A

less shunting in lungs
alveoli expand

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18
Q

name a mab that clocks viral entry into health cells and clears infected cells from sars cov 2

A

sotrovimab

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19
Q

sotrovimab is reserved for use in which px

A

high risk

20
Q

vit d deficiency means more likely for hypocalcaemia, what benefit can it have for covid

A

correct low calcium at worst and help immune system at best

21
Q

steroids may benefit patients, what 2 ppis may be given alongside for gastro protection to stop gi bleeds

A

lansoprazole or omeprazole

22
Q

oxygen can be given at 4-6ml/min in order to gets sats of

A

92-96%

23
Q

continuous positive airway pressure - cpap machines help control pressure and amount of o2 given to aid breathing, why do staff require high levels of ppe with suitable masks

A

aerosols putting healthcare workers at risk

24
Q

imv requires pt to be sedated and a breathing tube is put into where

A

windpipe
(intubation)

25
Q

why do some patients on ventilation benefit from proning

A

opens up more of lung and allows for better gas exchange between air and bloodstream

26
Q

ecmo allows lungs to be rested and acts as artifical lung giving them a better chance to heal, what is a setback

A

small number of specialist centres in the uk

27
Q

different ways to deliver oxygen in order of escalation

A

nasal cannula
non rebreather mask
cpap
imv
ecmo

28
Q

haematological increases in lab results

A

d dimer
fibrinogen
crp
ldh
ferritin

29
Q

haematological DEcreases in lab results

A

lymphocytes
(hypo)calcaemia

30
Q

name some groups of high risk px

A

organ transplant
chemo/ antibody tx for cancer and immunotherapy
intense radiotherapy
leukemia, lymphoma, myeloma
severe lung condition
dialysis
immunosuppressed/ high steroid dose

31
Q

what percentage of anti retrovirals does a patient have to take to treat hiv effectively

A

90%

32
Q

what dose of enoxaprin is needed for pe

A

1.5mg/kg od or 1mg/kg bd

33
Q

what does apixaban inhibit to work

A

factor xa

34
Q

why is apixaban a better choice than enoxaparin on discharge

A

equally effective
better compliance
less painful
no routine monitoring

35
Q

how would you manage a patient as on 80% o2 cpap and poor sats below 90%

A

increase to 100% o2 cpap and dexamethasone iv 6mg od and stat dose of toclizumab 800mg iv od

36
Q

if a patient had high lactate what changes would you make to their metformin therapy and why

A

stop because it causes lactic acidosis (rare)

37
Q

why would bendrofluazide not be appropriate for a bp of 180/110

A

not strong enough as patient at risk of heart attack or stroke

38
Q

what drug and dose if px has bp 180/110 and hr 110 bpm

A

amlodipine 5mg ng as can not crush MR nifedipine

39
Q

what drug would you use to stop breast milk to reduce engorgement and risk of mastitis

A

cabergoline 1mg stat

40
Q

name a reversal agent for paralysis

A

neostigmine

41
Q

suitable drug to paralyse patients quickly at 50mg stat dose then 0.6mg/kg/hr and still metabolises in low kidney or liver function

A

atracurium

42
Q

vit d levels below x is deficient

A

25

43
Q

alfacalcidol is only used in x patient

A

renal failure

44
Q

how does baricitinib work in covid 19

A

modulates janus kinase enzyme to reduce cytokine storm

45
Q

other therapeutics for COVID-19

A

remdesivir, tocilizumab, baracitinib

46
Q

how long does it take the pfizer vaccine to be effective

A

21 days

47
Q

first line NRV novel antiviral for high risk px

A

paxlovid
molnupiravir - outpx

Finals (30 decks)

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