COVID 19

Question 1

clinical presentation of patients COVID

Answer 1

fever/ headache 
cough 
myalgia 
diarrhoea 
renal failure 
pneumonia 
septic shock
SOB

Question 2

alveolar cells

Answer 2

type 2 cells
promote expansion of the alveoli
produce surfactant

Question 3

CV complications COVID

Answer 3

myocarditis
stress cardiomyopathy 
myocardial ischaemia 
arrhythmia 
heart failure 
mixed shock 

neutrophils recruited to site of infection destroying infection immune response
type 1+2 cells destroyed ALVEOLI collapse - Acute respiratory distress syndrome

cytokine storm - fatigue joint muscle pain diarrhoea

Question 4

COVID CELL

Answer 4

protein rich alveoli infusion triggers macrophage + neutrophil
small clots in heart lung kidneys livers
high levels of blood clotting fibres
aggregation of platelets at site of infection
formation of blood clots
fibring strands laid down - scarring

Question 5

hypoxic vasoconstriction

Answer 5

local control mechanisms to keep vent and perf matched
decreased tissues PO2 around undervent. alveoli constricts their arterioles, diverting blood to better ventilated alveoli.

Question 6

V/Q ratio

Answer 6

Balance between pulmonary ventilation and capillary blood flow.
In healthy lungs, ventilation and perfusion are matched.
In compromised lungs, ventilation and perfusion are not matched.
Shunt and Dead Space are types of mis-match.

Question 7

atelectasis

Answer 7

• post surgery
• not taking deep breaths
• alveoli not getting chance to expand

Question 8

dead space

Answer 8

blood flow reduced or not present
air inhaled not able to take part in gaseous exchange
pulmonary embolus
blood not able to reach the ventilated alveoli

Question 9

critical opening pressure

Answer 9

once alveoli reach a certain point, resistance decreased and much easier to open alveoli
over expansion - risk of barotrauma

Question 10

medications for covid

Answer 10

tocilizumab

reduce length of hospital stay and need for ventilation

Question 11

P/F ratio

Answer 11

Ratio of arterial oxygen concentration to fraction of inspired oxygen
Demonstrates how well the lungs absorb O2 from inspired air.
Measure of the severity of Hypoxemia.
Track trends of respiratory failure.
Measure the effectiveness of different treatment interventions.P = Partial Pressure of O2 in arterial blood in mmHg (PaO2)
F = Fraction of inspired O2 (FiO2)
PaO2 ÷ FiO2 = PFR

Question 12

treatment of covid

Answer 12

oxygen support
high flow nasal oxygen
non-invasive ventilation
ironing

Question 13

stages of treatment

Answer 13

nasal cannula 
non rebreather mask 
continuous positive airway pressure 
invasive mechanical ventilation
extracorporeal membrane oxygenation

Question 14

oxygen on delivery systems

Answer 14

+1L of oxygen = 4% of extra oxygen
increase RR of patient diluting oxygen
3L of oxygen 32%
but if high RR may not be getting that

Question 15

PEEP

Answer 15

PEEP is a mode of therapy used in conjunction with mechanical ventilation. At the end of mechanical or spontaneous exhalation, PEEP maintains the patient’s airway pressure above the atmospheric level by exerting pressure that opposes passive emptying of the lung.