Covid & Polio

Question 1

large family of viruses commonly found in humans and other species of animals (bats, camels, cattle, cats, white tailed deer, and hamsters)

Answer 1

coronaviruses

Question 2

what is SARS-CoV-2

Answer 2

COVID-19

Question 3

all coronaviruses likely originated in what animal

Answer 3

bats

Question 4

MC transmission for covid

Answer 4

respiratory droplets

Question 5

covid infection highest in what populations

Answer 5

young and middle aged adults

Question 6

covid-19 mortality rates higher in what age group and why

Answer 6

> 50
lower levels of concomitant antibodies to benign cold-causing coronaviruses

Question 6

predicts risk of critical illness in hospitalized COVID-19 patients.
uses x-ray abnormality, age, hemoptysis, dyspnea, unconsciousness, number of comorbidities, etc

Answer 6

COVID GRAM critical illness risk score

Question 7

predicts the 24 hour risk of critical respiratory disease after hospital admission
uses respiratory rate, pulse ox, and oxygen flow rate

Answer 7

quick covid-19 severity index

Question 8

what do you see on CBC for covid

Answer 8

lymphopenia, leukocytosis, thrombocytopenia

Question 9

what do you see on LFT for covid

Answer 9

elevated AST and ALT

Question 10

acute phase reactants (markers) for covid

Answer 10

CRP and D-Dimer

Question 11

covid markers of increased mortality

Answer 11

increased serum troponin
IL-6
LFTs
serum Cr and CK
ferritin
procalcitonin

Question 12

3 common tests used for diagnostic test of covid

Answer 12

• molecular (PCR)
• rapid antigen detection
• antibody (serologic) (IgG and IgM)

Question 13

imaging for covid

Answer 13

• chest x ray
• chest CT
• Lung ultrasound

Question 14

covid psychiatric complications

Answer 14

• anxiety
• depression
• substance use disorder
• PTSD

Question 14

an individual <21 presents with fever, lab evidence of inflammation, and evidence of clinically severe illness requiring hospitalization, with multi system (>2) organ involvement
AND
no alternative plausible diagnoses
AND
positive for recent SARS-CoV-2 infection or exposure within 4 weeks prior to onset of symptoms

Answer 14

multisystem inflammatory syndrome
MIS-C (children)

Question 15

individuals who have any of the various signs and symptoms of COVID-19 and do not need supplemental oxygen who have an oxygen saturation >94% on room air

Answer 15

mild to moderate illness

Question 16

individuals who have SpO2 <94% on room air or needing supplemental oxygen

Answer 16

severe illness

Question 17

individuals who have respiratory failure subcategorized as:
- needing high-flow oxygen or non-invasive ventilation
- needing mechanical ventilation and extracorporeal membrane oxygenation (ECMO)

Answer 17

critical illness

Question 18

risk factors for severe covid-19 that needs hospitalization

Answer 18

• age >50 years
  -unvaccinated or not up to date on covid vaccine
• specific/multiple medical conditions
• immunocompromised

Question 19

when should covid treatment be started

Answer 19

asap and within 5-7 days of symptom onset

Question 20

covid treatment

Answer 20

Paxlovid (adults and children 12 and older and at least 40kg)
remdesivir (adults and children 28 days and older and at least 3kg)
molnupiravir (adults)

Question 21

nirmatrelvir/ritonavir

Answer 21

paxlovid (viral protease inhibitor)

Question 22

regulations for paxlovid

Answer 22

• mild to moderate covid-19
  -12 or older
  -at least 40 kg
• high risk for progression to severe covid-19

Question 23

approved by the FDA for the treatment of covid patients requiring hospitalization and supplemental oxygen (but not mechanical ventilation)

Answer 23

remdesivir (veklury) RNA polymerase inhibitors

Question 24

treatment of patients with severe disease (those who require supplemental oxygen and those who are mechanically ventilated or need ECMO)

Answer 24

dexamethasone

Question 25

- an enterovirus that is highly contagious through the fecal oral route, especially during the first week of infection - most often in children < 15 (esp infants and young children) - still occurs in Afghanistan, Pakistan, syria, Africa

Answer 25

polio

Question 26

signs and symptoms of polio

Answer 26

at least 95% are asymptomatic if symptomatic: - abortive poliomyelitis - non paralytic poliomyelitis - paralytic poliomyelitis

Question 27

constellation of symptoms that affect polio survivors and is not infectious

Answer 27

post- poliomyelitis syndrome

Question 28

- nonspecific symptoms - fever, headache, vomiting, diarrhea, constipation, and sore throat lasting 2-3

Answer 28

abortive poliomyelitis

Question 29

- fever, headache, vomiting, diarrhea, constipation, and sore throat lasting 2-3 AND - signs of meningeal irritation and muscle spasm occur in the absence of frank paralysis

Answer 29

non paralytic poliomyelitis

Question 30

- flaccid asymmetric paralysis affecting mostly the proximal muscles of the lower extremities - febrile period is present over 2-3 days - sensory loss is very rare - two forms (which may coexist): spinal poliomyelitis and bulbar poliomyelitis

Answer 30

paralytic poliomyelitis

Question 31

- the syndrome presents with signs of chronic and new denervation - most frequent symptoms are progressive muscle limb paresis with muscle atrophy, with fasciculations and fibrillation during rest activity - restless leg syndrome

Answer 31

post poliomyelitis syndrome

Question 32

how to test for polio

Answer 32

- throat washings (early) - stools (early and late - PCR of washings, stool, or CSF and also facilitate diagnosis

Question 33

polio CSF findings

Answer 33

- normal or slightly increased pressure and protein - glucose not decreased - WBC count usually <500/mcL and are principally lymphocytes after the first 24 hours

Question 34

polio treatment

Answer 34

Acute phase: - hospitalize - respiratory weakness or paralysis --> ICU - pocapavir (capsid inhibitor antiviral agent)

Question 35

polio prevention

Answer 35

- part of routine childhood immunization - IPV vaccine

Question 36

what ages should children get the 4 IPV doses

Answer 36

2 months 4 months 6-18 months 4-6 years

Question 37

what to do for someone who has never been vaccinated against polio

Answer 37

3 doses of IPV - first dose any time - second dose 1-2 months later - third dose 6-12 months after second