G7 Flashcards
(180 cards)
1
Q
What is the likely diagnosis for a patient with persistent non-productive cough fatigue chills low-grade fever progressing to high-grade fever and respiratory symptoms after travel to East Asia?
A
COVID-19
2
Q
What virus causes COVID-19?
A
severe acute respiratory syndrome coronavirus 2
3
Q
To which family does SARS-CoV-2 belong?
A
Coronaviridae
4
Q
What genus is SARS-CoV-2 classified under?
A
Betacoronavirus
5
Q
What type of genome does SARS-CoV-2 have?
A
single-stranded positive-sense RNA
6
Q
What viral protein facilitates SARS-CoV-2 entry into host cells?
A
spike protein
7
Q
Which receptor does SARS-CoV-2 spike protein bind to on human cells?
A
angiotensin-converting enzyme 2 receptor
8
Q
What host proteases facilitate SARS-CoV-2 entry?
A
TMPRSS2 and furin
9
Q
How does SARS-CoV-2 enter host cells?
A
endocytosis or direct membrane fusion
10
Q
What cells are predominantly infected by SARS-CoV-2 in the lungs?
A
alveolar epithelial type II cells
11
Q
What immune response can cause severe inflammation in COVID-19?
A
cytokine storm
12
Q
What lab finding correlates with COVID-19 severity?
A
lymphopenia
13
Q
What organs can be affected by SARS-CoV-2 due to ACE2 expression?
A
lungs heart kidneys liver
14
Q
What are common modes of SARS-CoV-2 transmission?
A
respiratory droplets direct contact aerosols
15
Q
What are hallmark symptoms of COVID-19?
A
fever dry cough shortness of breath fatigue myalgia chills sore throat neurological symptoms
16
Q
What neurological symptoms can occur in COVID-19?
A
headache confusion anosmia dysgeusia
17
Q
What imaging findings are typical in COVID-19 pneumonia?
A
bilateral patchy infiltrates ground-glass opacities
18
Q
What is the gold standard diagnostic test for COVID-19?
A
real-time reverse transcriptase polymerase chain reaction
19
Q
What specimens are used for SARS-CoV-2 RT-PCR testing?
A
nasopharyngeal swabs oropharyngeal swabs saliva
20
Q
What does RT-PCR detect in COVID-19 diagnosis?
A
viral RNA
21
Q
How long does RT-PCR testing usually take?
A
a few hours to two days
22
Q
What do antigen tests detect for COVID-19?
A
viral proteins
23
Q
What is a limitation of antigen tests for COVID-19?
A
lower sensitivity false negatives possible
24
Q
What laboratory abnormalities are common in COVID-19 patients?
A
leukopenia lymphopenia elevated liver enzymes elevated lactate dehydrogenase
25
What arterial blood gas abnormalities are seen in COVID-19?
hypoxemia respiratory alkalosis
26
What physical exam findings are common in COVID-19 pneumonia?
tachypnea decreased breath sounds bilateral inspiratory crackles
27
What is the origin reservoir of SARS-CoV-2?
bats
28
What is a possible intermediate host for SARS-CoV-2?
pangolins
29
What oxygen therapy is recommended for COVID-19 patients with SpO2 below 90 percent?
nasal cannula or non-rebreather mask
30
What oxygen flow rates are used with nasal cannula in COVID-19?
2 to 6 liters per minute
31
What respiratory support may be needed in COVID-19 patients with acute respiratory distress syndrome?
mechanical ventilation or high-flow nasal cannula therapy
32
What is the dosing regimen for remdesivir in hospitalized COVID-19 patients?
200 milligrams intravenous day one then 100 milligrams daily for 5 to 10 days
33
What corticosteroid is used in COVID-19 patients requiring oxygen or ventilation?
dexamethasone
34
What is the dexamethasone dose for COVID-19 treatment?
6 milligrams orally or intravenously once daily for up to 10 days
35
What antipyretic is commonly used to manage fever in COVID-19?
acetaminophen
36
What is the maximum daily dose of acetaminophen in COVID-19 patients?
4 grams
37
What laboratory parameters should be monitored during COVID-19 treatment?
liver function tests lactate dehydrogenase arterial blood gases inflammatory markers
38
What infection control precautions are recommended for COVID-19?
airborne and contact precautions with N95 masks gowns gloves hand hygiene
39
What personal preventive measure removes or kills virus on hands?
hand hygiene with soap and water or sanitizer
40
What respiratory etiquette reduces spread of respiratory droplets?
covering coughs and sneezes
41
What personal protective equipment blocks virus-laden droplets in crowded spaces?
face masks
42
What physical distancing is recommended to reduce COVID-19 transmission?
at least 1 meter or 3 feet
43
Why should touching the face be avoided in COVID-19 prevention?
prevents self-inoculation from contaminated hands
44
What environmental measure kills virus on frequently touched surfaces?
regular disinfection
45
How does improved ventilation reduce COVID-19 risk?
disperses airborne virus particles indoors
46
What physical barriers help block droplet spread?
plastic shields
47
What workplace adjustments reduce risk of COVID-19 outbreaks?
remote work staggered shifts
48
Why is regular testing of symptomatic individuals important?
early identification to prevent spread
49
What is the purpose of isolation of confirmed COVID-19 cases?
breaks transmission chain
50
What is the purpose of quarantine of exposed individuals?
prevents asymptomatic spread
51
How does COVID-19 vaccination contribute to prevention?
builds immunity reduces severity and transmission
52
What increases vaccination coverage and community protection?
promoting vaccine awareness
53
What is the role of contact tracing in COVID-19 control?
locates and notifies exposed individuals
54
What does disease surveillance enable in COVID-19 response?
early detection and timely control
55
Why is traveler screening important?
identifies infected individuals before spread
56
How do travel advisories reduce COVID-19 transmission?
limit movement from high-risk areas
57
What combats misinformation about COVID-19?
public health education campaigns
58
What global initiative ensures equitable COVID-19 vaccine access?
COVAX Facility
59
Who organizes the COVAX Facility?
World Health Organization Gavi Coalition for Epidemic Preparedness Innovations
60
What is the purpose of the WHO Strategic Preparedness and Response Plan?
guide countries in pandemic preparation and response
61
What does the ACT-Accelerator aim to do?
speed development production equitable access to COVID-19 diagnostics treatments vaccines
62
What is the goal of the WHO COVID-19 Solidarity Trial?
identify effective COVID-19 treatments
63
What is the National Vaccination Program in the Philippines also known as?
ResBakuna Campaign
64
Who are priority groups in the Philippine National Vaccination Program?
healthcare workers elderly high-risk groups
65
What is the purpose of the Philippine COVID-19 Surveillance and Quick Action Unit?
monitor and respond to outbreaks
66
What legal acts support the Philippine COVID-19 response?
Bayanihan to Heal As One Act Bayanihan to Recover As One Act
67
What is the function of the One Hospital Command Center?
coordinate patient referrals optimize healthcare resources
68
What does the Testing Tracing and Treatment Program do?
expand testing capacity coordinate contact tracing patient isolation
69
What is the diagnosis for fluctuating muscle weakness with ptosis diplopia and proximal limb weakness?
myasthenia gravis
70
What type of disorder is myasthenia gravis?
autoimmune neuromuscular junction disorder
71
Which receptor is targeted by autoantibodies in myasthenia gravis?
acetylcholine receptor
72
What antibody is positive in approximately 85 percent of myasthenia gravis cases?
anti-acetylcholine receptor antibody
73
What antibody may be positive in seronegative myasthenia gravis patients?
muscle-specific kinase antibody
74
What clinical test temporarily improves ptosis in myasthenia gravis?
ice pack test
75
What is the characteristic muscle weakness pattern in myasthenia gravis?
fluctuating fatigable weakness worsening with activity improving with rest
76
Which muscles are commonly affected in myasthenia gravis?
ocular bulbar proximal limb respiratory muscles
77
What is preserved in myasthenia gravis despite weakness?
reflexes sensation cognitive and autonomic function
78
What thymic abnormality is often associated with myasthenia gravis?
thymoma or thymic hyperplasia
79
What does repetitive nerve stimulation electromyography show in myasthenia gravis?
decremental response in compound muscle action potential amplitude
80
What does single-fiber electromyography show in myasthenia gravis?
increased jitter and blocking
81
What is the autoimmune mechanism in myasthenia gravis?
antibodies block internalize and destroy acetylcholine receptors impairing neuromuscular transmission
82
What role does the thymus play in myasthenia gravis?
promotes autoreactive T cells stimulating antibody production thymectomy improves symptoms
83
What symptoms worsen myasthenia gravis?
physical activity heat infections surgery stress certain medications hormonal changes
84
Which medications can worsen myasthenia gravis?
aminoglycosides fluoroquinolones beta-blockers
85
What imaging detects thymoma in myasthenia gravis?
chest computed tomography scan
86
What are common ocular symptoms of myasthenia gravis?
ptosis diplopia
87
What bulbar symptoms occur in myasthenia gravis?
dysarthria dysphagia risk of choking aspiration
88
What bedside test uses cold to improve ptosis in myasthenia gravis?
ice pack test
89
What is the primary diagnostic blood test for myasthenia gravis?
anti-acetylcholine receptor antibody test
90
What is the secondary antibody test for myasthenia gravis?
anti-muscle-specific kinase antibody test
91
What is the functional diagnostic test for neuromuscular transmission defect in myasthenia gravis?
electromyography with repetitive nerve stimulation
92
What physical exam finding shows fatigability in myasthenia gravis?
worsening ptosis with sustained upward gaze
93
Is myasthenia gravis contagious?
no autoimmune disorder
94
What is the initial oral dose range of pyridostigmine bromide for myasthenia gravis?
30 to 60 milligrams every 4 to 6 hours
95
What is the maintenance dose range of pyridostigmine bromide?
180 to 540 milligrams per day in divided doses
96
What is the mechanism of action of pyridostigmine bromide?
acetylcholinesterase inhibition enhancing neuromuscular transmission
97
What is the starting oral dose range of prednisone for myasthenia gravis?
20 to 60 milligrams per day
98
What is the purpose of prednisone in myasthenia gravis treatment?
immunosuppression reducing antibody production
99
What is the starting oral dose range of azathioprine?
1 to 2 milligrams per kilogram per day
100
What is the maximum dose of azathioprine?
3 milligrams per kilogram per day
101
What is azathioprine used for in myasthenia gravis?
reduce long-term corticosteroid use
102
What is the total dose and duration of intravenous immunoglobulin in myasthenic crisis?
2 grams per kilogram over 2 to 5 days
103
What is the purpose of intravenous immunoglobulin in myasthenia gravis?
rapid reduction of circulating antibodies
104
How many plasmapheresis sessions are typically given in severe myasthenia gravis?
3 to 5 sessions over 1 to 2 weeks
105
What is the goal of plasmapheresis in myasthenia gravis?
reduce circulating anti-acetylcholine receptor antibodies
106
When is thymectomy indicated in myasthenia gravis?
thymoma or generalized myasthenia gravis
107
What effect does thymectomy have in myasthenia gravis?
reduces symptoms even without thymoma
108
What respiratory functions should be regularly monitored in myasthenia gravis?
respiratory capacity forced vital capacity bulbar symptoms
109
Why is medication adherence important in myasthenia gravis?
improves nerve-muscle communication reduces immune attacks on acetylcholine receptors
110
Which medications should be avoided in myasthenia gravis?
certain antibiotics beta-blockers
111
What are key lifestyle modifications for myasthenia gravis?
adequate rest avoid stress energy conservation
112
What vaccinations are important for myasthenia gravis patients?
influenza pneumonia vaccines
113
What hygiene practices help prevent infections in myasthenia gravis?
handwashing avoiding sick contacts
114
What environmental factors should be avoided to prevent symptom worsening?
extreme temperatures strenuous physical activity
115
What emergency preparedness is recommended for myasthenia gravis patients?
recognize myasthenic crisis signs have emergency contacts medical alert information
116
What patient support is recommended in myasthenia gravis?
support groups counseling patient and family education
117
What organization manages the Global Myasthenia Gravis Patient Registry?
Myasthenia Gravis Foundation of America
118
What is the purpose of the Myasthenia Gravis Foundation of America?
support patients advance research promote diagnosis and treatment guidelines
119
What European organization advocates for rare diseases including myasthenia gravis?
EURORDIS
120
What is the role of the World Health Organization in myasthenia gravis?
integrate rare diseases into global health policy promote access to care essential medicines
121
What does Global Genes do for myasthenia gravis?
empower patient advocacy support research awareness promote global collaboration
122
What is the Philippine Neurological Association's role in myasthenia gravis?
education awareness specialized clinics referral pathways
123
What law in the Philippines supports rare disease patients including myasthenia gravis?
Rare Disease Act Republic Act No. 10747
124
What does the Rare Disease Act provide for myasthenia gravis patients?
state support access to diagnostics medication treatment patient registration
125
What is PhilHealth's role in myasthenia gravis care?
financial support for chronic neurologic care hospitalization immunoglobulins
126
What does the Philippine Society of Orphan Disorders do for myasthenia gravis?
patient referral medicine access rare disease registries policy advocacy
127
What is T-cell-mediated rejection in kidney transplantation?
immune response by recipient T cells against donor alloantigens
128
What cells infiltrate the kidney in T-cell-mediated rejection?
T lymphocytes and macrophages
129
What histological features characterize T-cell-mediated rejection?
tubulitis interstitial inflammation intimal arteritis
130
What classification system grades the severity of T-cell-mediated rejection?
Banff classification
131
What clinical presentations are associated with T-cell-mediated rejection?
rising serum creatinine oliguria acute renal failure graft tenderness asymptomatic lab abnormalities
132
What immune molecules activate T cells in T-cell-mediated rejection?
donor major histocompatibility complex antigens presented by antigen-presenting cells
133
Which T cell subsets are activated in T-cell-mediated rejection?
CD4+ helper T cells CD8+ cytotoxic T cells
134
How do CD8+ T cells cause graft damage?
kill tubular epithelial cells via perforin/granzyme and Fas-FasL pathways
135
What cytokines do CD4+ T helper cells secrete in rejection?
interferon gamma tumor necrosis factor alpha
136
What role do macrophages play in T-cell-mediated rejection?
release reactive oxygen species and proteases causing tissue injury
137
What tissue damage results from T-cell-mediated rejection?
tubulitis endothelial injury interstitial edema fibrosis
138
What regulatory cells attempt to suppress rejection immune response?
regulatory T cells
139
What is the typical timing for acute T-cell-mediated rejection?
first weeks to months post-transplant or later with reduced immunosuppression
140
What is the mode of transmission for T-cell-mediated rejection?
none immune-mediated process after transplantation
141
What are the Banff grades for T-cell-mediated rejection?
Grade IA IB IIA IIB III
142
What does Grade IIA or IIB (TCMR2) indicate?
vascular involvement intimal arteritis more aggressive rejection
143
How is T-cell-mediated rejection diagnosed?
kidney allograft biopsy histopathology Banff classification
144
What lab tests monitor graft function in rejection?
serum creatinine renal function tests complete blood count
145
What is the significance of donor-specific antibody testing in TCMR?
usually negative helps differentiate from antibody-mediated rejection
146
What immunohistochemistry marker is negative in TCMR?
C4d staining
147
What imaging modality assesses graft size and perfusion?
ultrasound
148
What symptoms indicate graft dysfunction in TCMR?
increased serum creatinine decreased urine output graft tenderness oliguria
149
What immune response leads to tubular epithelial cell injury in TCMR?
activated T cells cytokine release inflammation
150
What can persistent T-cell-mediated injury cause?
fibrosis chronic graft dysfunction graft failure
151
What is the typical oral dose range of tacrolimus in kidney transplant patients?
0.1 to 0.2 milligrams per kilogram per day in two divided doses
152
What is the target trough level for tacrolimus?
5 to 15 nanograms per milliliter
153
What is the oral dose range of mycophenolate mofetil for transplant patients?
1 to 1.5 grams twice daily
154
What enzyme does mycophenolate mofetil inhibit?
inosine monophosphate dehydrogenase
155
What is the intravenous methylprednisolone dose for acute rejection?
500 to 1000 milligrams daily for 3 days
156
What is the oral prednisone taper dose after acute rejection treatment?
20 milligrams per day
157
What is the oral dose range of sirolimus?
2 to 5 milligrams once daily
158
What pathway does sirolimus inhibit?
mechanistic target of rapamycin pathway
159
What is the role of tacrolimus in transplant management?
suppresses T-cell activation
160
What is the role of mycophenolate mofetil in transplant management?
reduces lymphocyte proliferation
161
What is the role of corticosteroids in transplant management?
broad immunosuppressive and anti-inflammatory effects
162
What is the role of sirolimus in transplant management?
immunosuppressive and antitumor activity
163
What is the purpose of therapeutic drug monitoring in transplant patients?
ensure optimal drug levels prevent rejection and toxicity
164
What are key parameters monitored post-transplant?
serum creatinine glomerular filtration rate kidney biopsy
165
What is the role of human leukocyte antigen matching?
reduces recipient T-cell recognition of graft
166
What is the purpose of pre-transplant crossmatching?
ensures donor-recipient compatibility avoids preformed T-cell responses
167
Why is infection prevention important post-transplant?
infections trigger immune activation increase rejection risk
168
What prophylactic treatment minimizes immune stimulation from infections?
cytomegalovirus prophylaxis
169
Why is patient education important in transplant care?
promotes medication adherence early recognition of rejection signs
170
What are signs of rejection patients should recognize?
decreased urine output swelling fatigue
171
What is the first-line treatment upon detection of T-cell-mediated rejection?
high-dose corticosteroids
172
What is the purpose of thymectomy in transplant patients?
improve symptoms reduce rejection risk
173
What risk factors increase immune activation leading to rejection?
medication non-compliance infections under-immunosuppression
174
What comorbidities should be managed to improve transplant outcomes?
hypertension diabetes
175
What global program supports transplant programs in low-resource countries?
ISN-TTS Sister Transplant Centers Program
176
What does the Banff Classification provide?
standardized diagnostic criteria for transplant rejection
177
What organization promotes kidney health and transplant care globally?
World Health Organization
178
What is the role of the Philippine Network for Organ Sharing?
equitable organ allocation distribution
179
What is the purpose of the Human Organ Preservation Effort?
organ preservation and retrieval
180
What does the Philippine Organ Donation and Transplantation Program do?
regulates organ donation transplantation monitors post-transplant care
