COVID-19 Flashcards

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2
Q

What are the genera within the Coronaviridae family?

A

(a) Alphacoronavirus
(b) Betacoronavirus
(c) Gammacoronavirus
(d) Deltacoronavirus

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3
Q

List three emergent Coronaviruses and their respective genera.

A

πŸ‘‘ MERS-CoV (Middle East Respiratory Syndrome Coronavirus): betacoronavirus
πŸ‘‘ SARS-CoV (Severe Acute Respiratory Syndrome Coronavirus): betacoronavirus
πŸ‘‘ SARS-CoV-2: betacoronavirus

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4
Q

SARS-CoV-2
(a) Order
(b) Family
(c) Genus
(d) Sub-genus

A

(a) Order: Nidovirales
(b) Family: Coronaviridae
(c) Genus: Betacoronavirus
(d) Sub-genus: Sarbecovirus

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5
Q

List four common Coronaviruses and their respective genera.

A

πŸ‘‘ Human coronavirus 229E (alphacoronavirus)
πŸ‘‘ Human coronavirus NL63 (alphacoronavirus)
πŸ‘‘ Betacoronavirus 1 (OC43) (betacoronavirus)
πŸ‘‘ Human coronavirus HKU1 (betacoronavirus)

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6
Q

Briefly discuss the structure of Coronaviruses [including the various protein components].

A

πŸ›Έ enveloped
πŸ›Έ Spike (S) proteins protrude form the viral envelope and are responsible for binding to host cell receptors.
πŸ›Έ Envelope (E) proteins embedded in the envelope are small proteins involved in virus assembly and release.
πŸ›Έ Membrane (M) proteins are the most abundant structural proteins, giving the virus its shape.
πŸ›Έ Nucleocapsid (N) proteins bind to the RNA genome, forming a helical structure.

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7
Q

What type of genome do Coronaviruses have?

A

single strand, positive-sense RNA

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8
Q

What is the primary receptor for SARS-CoV-2?

A

ACE2 (angiotensin-converting enzyme 2) receptor

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9
Q

Briefly discuss SARS-CoV-2 transmission pathogenesis.

A

Transmission:
πŸ‘‘ The virus primarily enters the body through respiratory droplets when an infected person coughs, sneezes, or talks.

Pathogenesis:
πŸ‘‘ The virus begins to replicate in the cells lining the nasopharynx and oropharynx.
πŸ‘‘ This initial replication can cause symptoms like sore throat and nasal congestion.
πŸ‘‘ The virus then spreads down the respiratory tract to the bronchi and eventually to the lungs.
πŸ‘‘ This can lead to more severe respiratory symptoms such as cough and shortness of breath.
πŸ‘‘ In the lungs, the virus specifically targets type 2 pneumocytes, which are cells responsible for producing surfactant to keep the alveoli (air sacs) open. The destruction of these cells impairs gas exchange and leads to respiratory distress.
πŸ‘‘ The immune response to the infection causes inflammation in the lung tissue.
πŸ‘‘ Inflammatory processes increase vascular permeability, leading to fluid leakage into the alveoli.
πŸ‘‘ Chronic inflammation can result in fibrosis (scarring) of lung tissue, further impairing lung function.
πŸ‘‘ The damage to the alveoli and fluid accumulation reduce the lungs’ ability to oxygenate the blood, leading to hypoxia (low blood oxygen levels).
πŸ‘‘ This can cause widespread inflammation, leading to septic shock, characterized by dangerously low blood pressure and organ failure.
πŸ‘‘ This can cause symptoms such as cyanosis (bluish discoloration of the skin), confusion, and fatigue.
πŸ‘‘ The virus and the immune response can damage both the epithelial cells lining the airways and the endothelial cells lining the blood vessels.
πŸ‘‘ This damage can lead to further leakage of fluid and proteins into the lung tissue.
πŸ‘‘ In severe cases, the immune response can become dysregulated, leading to a massive release of cytokines (cytokine storm).
πŸ‘‘ This can cause widespread inflammation, leading to septic shock, characterized by dangerously low blood pressure and organ failure.

[Diagram 1] [Diagram 2]

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10
Q

Briefly outline signs and symptoms of SARS-CoV-2 infection, categorizing them into common, less common and emergency signs.

A

(a) Common signs
fever, cough, fatigue

(b) Less common
chills, sorethroat, headache, muscle aches, diarrhoea, nausea/vomiting, runny nose, loss of smell, loss/change in taste

(c) Emergency signs
difficulty in breathing, persistent chest pain, confusion, cyanosis, loss of consciousness

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11
Q

List risk factors for severe Covid-19.

A

Age > 60, Coronary Artery Disease, Stroke, Diabetes, Hypertension, Cancer, Chronic Lung Disease, Frailty, Pregnancy, Immunosuppression, Chronic Kidney Disease, Obesity

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12
Q

Briefly discuss the stages of Covid-19.

A

(1) Incubation Period
Duration: Typically 2-14 days after exposure, with an average of 5-6 days.

(2) Early Stage (Days 1-7)
Initial symptoms often include fever, dry cough, fatigue, sore throat, and muscle aches. Some people may experience loss of taste or smell, nasal congestion, or gastrointestinal symptoms like diarrhea.

(3) Pulmonary Stage (Days 7-12)
Symptoms can worsen, leading to difficulty breathing (dyspnea), persistent chest pain, and increased cough. Some patients may develop pneumonia.

(4) Hyperinflammatory Stage (Days 10-14)
The immune system’s overreaction can cause a cytokine storm, leading to widespread inflammation and multi-organ damage.
This stage can result in septic shock, organ failure, and increased risk of death.

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13
Q

(a) What is long COVID?
(b) List common symptoms of long COVID.

A

(a) This is a condition where symptoms last for at least three months after the initial COVID-19 infection.

(b) Symptoms:
General: fatigue, fever
Respiratory/Heart: difficulty breathing, shortness of breath, cough, chest pain, heart palpitations
Neurological symptoms: brain fog, headaches, sleep problems, dizziness, changes in smell/taste
Digestive: diarrhea, stomach pain, constipation

[Diagram 1] [Diagram 2] [Diagram 3]

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14
Q

Briefly discuss sample collection and testing methods for diagnosis of COVID-19.

A

Sample collection: a nasopharyngeal or oropharyngeal swab is taken

Testing methods:
(1) PCR
(2) Rapid tests for antigens
(3) Sequencing
(4) Imaging: a chest X-ray may be done to show lung abnormalities such as infiltrates or consolidation.

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15
Q

Briefly discuss supportive treatment measures of COVID-19.

A

πŸ‘‘ Antipyretics/Analgesics: Used to reduce fever and relieve pain.
πŸ‘‘ Oxygen Therapy: Administered to patients with low oxygen levels to maintain adequate oxygenation.
πŸ‘‘ Anticoagulation Therapy: Given to hospitalized patients to prevent blood clots.
πŸ‘‘ Immunomodulation: Includes the use of steroids (e.g., dexamethasone) and anti-IL6 agents (e.g., tocilizumab) to modulate the immune response.
πŸ‘‘ Monoclonal Antibodies: Target the SARS-CoV-2 virus to neutralize it and prevent severe disease progression.
πŸ‘‘ Fluid/Electrolyte Therapy and Renal Care: Ensures proper hydration and kidney function.
πŸ‘‘ Antibiotics: Used when bacterial superinfection is suspected.
πŸ‘‘ Mechanical Ventilation: For patients with severe respiratory failure.
πŸ‘‘ ECMO (Extra-corporeal Membrane Oxygenation): Used in critical cases to provide cardiac and respiratory support.

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16
Q

List three immunomodulants that may be administered to patients suffering from COVID-19.

A

πŸ’Š Dexamethasone
πŸ’Š Anti-IL6 Receptor (Tocilizumab) – for critical cases
πŸ’Š Janus-Kinase Inhibitor (Baricitinib)

17
Q

List two RNA polymerase inhibitors that may be administered to patients suffering from COVID-19.

A

πŸ’Š Remdesivir
πŸ’Š Molnupiravir

18
Q

Name one RNA protease inhibitor that may be administered to patients suffering from COVID-19.

A

Paxlovid (Nirmatrelvir/Ritonavir)

19
Q

List some monoclonal antibodies that may be used for early treatment and pre-exposure prophylaxis of COVID-19.

A

πŸ’‰ Tixagevimab + Cilgavimab
πŸ’‰ Sotrovimab
πŸ’‰ Bamlanivimab + Etesevimab
πŸ’‰ Casirivimab + Imdevimab

20
Q

Outline prevention measures against COVID-19.

A

πŸ’‰ Vaccination
πŸ’‰ Screening at ports of entry
πŸ’‰ Contact tracing
πŸ’‰ Travel restriction
πŸ’‰ Masks
πŸ’‰ Physical distancing
β—Ύ Isolation of sick persons
β—Ύ Quarantine (self, supervised, contacts)
β—Ύ Closure of schools, pubs, restaurants
β—Ύ Working from home

21
Q

Briefly discuss vaccination strategies against COVID-19.

A

(1) mRNA vaccines: These vaccines use messenger RNA to instruct cells to produce a protein that triggers an immune response. Examples include the Pfizer-BioNTech and Moderna vaccines.

(2) Viral-vector Vaccines: These vaccines use a modified virus (not the coronavirus) to deliver genetic material that instructs cells to produce a protein that triggers an immune response. Examples include the AstraZeneca and Johnson & Johnson vaccines.

(3) Inactivated Vaccines: These vaccines use a virus that has been killed or inactivated so it cannot cause disease but still triggers an immune response. Examples include the Sinopharm and Sinovac vaccines.

(4) Subunit Vaccines: These vaccines use pieces of the virus (often proteins) to trigger an immune response without using the whole virus. An example is the Novavax vaccine.

22
Q

List four challenges facing vaccination against COVID-19.

A

πŸ’‰ Supply (Inequality)
πŸ’‰ Distribution
πŸ’‰ Misinformation
πŸ’‰ Vaccine hesitancy

23
Q

One of the following is recommended for treatment of COVID-19?
(a) Acyclovir
(b) Remdesevir
(c) Lamivudine
(d) Ribavirin
(e) Hydroxychloroquine

A

(b) Remdesevir

24
Q

Which one of the following is recommended for treatment of COVID-19?
(a) Favipravir
(b) Nirmatrelvir
(c) Ribavirin
(d) Acyclovir
(e) Azithromycin

A

(b) Nirmatrelvir

25
Q

In which of the following SAR-CoV-2 viral structures are mutations most
frequently detected?
(a) gRNA
(b) S protein
(c) E Protein
(d) M protein
(e) N protein

A

(b) S protein

26
Q

Which one of the following about Covid-19 vaccines is false?
(a) Booster doses are not necessary for viral-vector vaccine types
(b) Thrombosis is a possible side effect
(c) No live-attenuated vaccines have been licensed yet
(d) They reduce the rate of hospitalization
(e) May cause fever

A

(a) Booster doses are not necessary for viral-vector vaccine types

27
Q

Which one of the following statements about control of COVID-19 is not true?
(a) Maintaining social distancing and wearing masks
(b) Use of personal protective equipment when treating affected patients
(c) Frequent hand-washing and sanitising
(d) Improving sanitation and sewage disposal and use of bednets
(e) Limiting public gatherings

A

(d) Improving sanitation and sewage disposal and use of bednets

28
Q

Which one of the following statements about COVID-19 is true?
(a) It has no long-term sequelae
(b) Azithromycin is the drug of choice
(c) It is caused by MERS-CoV-2
(d) It does not cause severe disease in children
(e) lt attaches to angiotensin converting enzyme-2 receptor

A

(e) lt attaches to angiotensin converting enzyme-2 (ACE2) receptor

29
Q

Which of the following is true about SARS-CoV-2?
(a) Genetic homology between SARS-CoV and SARS-CoV-2 is less than 50%
(b) SARS-CoV-2 has higher affinity for ACE-2 receptors as SARS-CoV
(c) Mutations in the RNA polymerase gene aid the virus to escape existing immunity
(d) Current PCR tests only detect about 50% of all positive cases due to mutations in SARS-CoV2
(e) Less than ten variants have been reported globally

A

(b) SARS-CoV-2 has higher affinity for ACE-2 receptors as SARS-CoV

30
Q

Which of the following is true about SARS-CoV-2?
(a) Genetic homology between SARS-CoV and SARS-CoV-2 is less than 50%
(b) Mutations in the RNA polymerase gene aid the virus to escape existing immunity
(c) Current PCR test only detect about 50% of all positive cases due to mutations in SARS-CoV2
(d) Thousands of variants have been reported globally
(e) SARS-CoV-2 has the same affinity for ACE-2 receptors as SARS-CoV

A

(d) Thousands of variants have been reported globally

31
Q

Which one of the following is recommended for treatment of COVID-19?
(a) Lamivudine
(b) Ribavirin
(c) Baricitinib
(d) Hydroxychloroquine
(e) Acyclovir

A

(c) Baricitinib

32
Q

WHO-licensed Covid-19 vaccines include the following types EXCEPT
(a) Killed-whole vaccine
(b) DNA-vector vaccines
(c) Subunit vaccines
(d) MRNA vaccine
(e) Live attenuated vaccine

A

(e) Live attenuated vaccine

33
Q

Which of the following viral structures is the most appropriate target for Covid-19 vaccines?
(a) S protein
(b) E Protein
(c) N protein
(d) gRNA
(e) M protein

A

(a) S protein

34
Q

Which of the following is the most appropriate sample for detection of SARS-CoV-2 IgG antibodies?
(a) Both oropharyngeal and nasopharyngeal swab
(b) Rectal swab
(c) Nasopharyngeal swab
(d) Blood
(e) Oropharyngeal Swab

A

(d) Blood

35
Q

Which one of the following about Covid-19 vaccines is true?
(a) They are suspected to cause infertility
(b) They prevent over 92% of infections in recipients
(c) They prevent over 90% of severe cases in recipients
(d) Thrombosis is a common side effect
(e) They have no side effects

A

(c) They prevent over 90% of severe cases in recipients

36
Q

Which one of the following statements about COVID-19 is false?
(a) lt attaches to angiotensin converting enzyme-2 receptor
(b) It may affect other organs such as the heart and pancreas
(c) Hydroxychloroquine is the drug of choice
(d) It is caused by SARS-CoV-2
(e) It is transmitted through droplets

A

(c) Hydroxychloroquine is the drug of choice