Epilepsy,seizure ,status Epilepticus And Covid-19 Flashcards
What are seizures and epilepsy
Seizures are sudden abnormal electric discharges from the brain that result in changes in the sensation,behavior ,movement ,perception or consciousness
Epilepsy is derived from the Greek word epilepsia meaning seizure.
It is the chronic disorder of recurrent seizures
What is Coronavirus(what family does it belong,what characteristic do the members show),coronavirus disease 2019,where does the virus infect?
Coronavirus is an enveloped, positive single-strand RNA virus. It belongs to the Orthocorovirinae subfamily, as the name suggests, whose members show characteristic ‘crown-like’ spikes on their surfaces.
•Coronavirus disease 2019 (COVID-19) is a contagious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). This kind of virus infects the nose, sinuses or upper throat. The first known case was identified in Wuhan, China, in December 2019. It was initially reported to the WHO on December 31st, 2019 and that was how WHO derived the acronym COVID-19 meaning Coronavirus disease 2019.
On January 30, 2020, the WHO declared Covid-19 outbreak a global health emergency and on March 11, 2020, the WHO declared Covid-19 a global pandemic.
•Global cases of COVID-19 continue to rise, causing havoc to several economies. As of January 22nd, 2022, confirmed COVID-19 infections numbered over 359 million individuals worldwide and have resulted in over 5.62 million deaths. In Ghana COVID-19 infections numbered over 156,392 and have resulted in 1,384 deaths. All 16 administrative regions had recorded cases of COVID-19 by June 30, 2020 due to internal migration between the hotspots and other regions.
•From observation of patients presenting to health centres around the world suggests that, over 80% of symptomatic individuals with COVID-19 develop mild or uncomplicated illness, and approximately 14% develop severe disease requiring hospitalization and oxygen support, while 5% may have very severe illness requiring admissdion to an Intensive Care Unit (ICU) with ventilators for care
True or false
True
What is the Cause of CoVid disease,the virus was first isolated from three people with what ?
What is the mode of transmission
Although the virus is widely believed to have originated from animals, there is insufficient scientific evidence to identify the specific animal reservoir or the original mode of transmission of the disease to humans.
•However, SARS CoV-2 was first isolated from three people with pneumonia connected to the cluster of acute respiratory illness cases in Wuhan.
The spread of the disease in humans, however, is currently known to be from person to person, mainly through droplets arising from people sneezing, coughing, speaking or exhaling, which deposit on surfaces.
•The virus may be transferred from contaminated surfaces to mucosal surfaces (eyes, nose, mouth), via the hands.
•Aerosol transmission is also possible when people have prolonged exposure to high concentrations of droplets in relatively closed spaces.
Which four people are at risk of COVID -19
Individuals who have had close contact with a person with known or suspected COVID-19 ( at least, last 14 days)
•International travelers (high at risk countries of infection)
•Aged people
•People with chronic underlying medical conditions such as cardiovascular disease,diabetes, chronic respiratory disease, hypertension and immunosuppression.
What is the pathophysiology of CoVId-19
Inflammation of the lungs will cause what ?
SARS-CoV-2 virus can infect a wide range of cells and systems of the body. COVID‑19 is most known for affecting the upper respiratory tract (sinuses, nose, and throat) and the lower respiratory tract (windpipe and lungs).
•The lungs are the organs most affected by COVID‑19 because the virus accesses host cells via the receptor for the enzyme Angiotensin-Converting Enzyme-2 (ACE-2), which is most abundant on the surface of type II alveolar cells of the lungs. The virus uses a special surface glycoprotein called a “spike” to connect to the ACE-2 receptor and enter the host cell.
- ACE-2 receptors are also expressed in myocardial cells, renal epithelial cells, enterocytes, and endothelial cells in multiple organs, which may explain the extrapulmonary manifestations associated with the disease.
- Inflammation of the lungs will cause fever, shortness of breath and cough
What are the most common symptoms ,less common symptoms,serious symptoms of this Covid-19 disease
State four of each
Most common symptoms:
●Fever
●Cough
●Tiredness
●Loss of taste or smell
Less common symptoms:
●Sore throat ●Headache ●Diarrhea ●Rashes on skin, or discoloration of fingers or toes ●Red or irritated eyes
Serious symptoms:
●Difficulty breathing
●Loss of speech or mobility, or confusion
●Chest pain
●Loss of appetite,
When the Coronavirus disease affects the lungs ,the heart,the brain,spleen,pancreas,liver,kidney,GIT system state theee symptoms of each that show
Lungs:dyspnea
Chest pain
Cough
Pancreas:pancreatitis
Pancreatic injury
Heart: Chest pain Myocardial inflammation Palpitations T serum troponin
Brain: Brain fog Delirium Fatigue Sleep disturbances Depression/anxiety/PTSD/OCS
Spleen:
Decreased T and B lymphocytes
Atrophy of lymphocyte follicles
Liver:
Liver injury
Increased Aspartate aminotransferase
Increased Alanine aminotransferase
Renal:
Renal impairment
Acute kidney injury
GIT:
Diarrhea
Nausea
Sore throat
Blood vessels: Inflammation Vessel damage Coagulopathy Microangiopathy
State six signs of coronavirus disease
Fever (body temperature ≥ 37.5oC) •Tachypnea •Tachycardia •Cyanosis •Flaring of nostrils •Signs of consolidation on chest examination
- Use of accessory muscles of respiration (plus intercostal in-drawing etc.)
- Restricted chest wall movement (unilateral or bilateral)
- Drowsiness
- Restlessness or confusion
- Low blood oxygen saturation by pulse oximeter (SPO2 < 93%)
What are the four main investigations for COVID and four supportive ones
DIAGNOSTIC
•Polymerase chain reaction assay for SARS-COV-2 by nasal swabs
•Chest X-Ray (Patchy consolidation)
•Chest Computed Tomography: Ground glass changes
•Antibody testing
SUPPORTIVE •Full Blood Count (FBC): Raised leukocytes but lymphocytopenia •Liver Function Test •Electrocardiogram (ECG/EKG) •Blood Film for Malaria Parasites •Renal Function Test
State five ddx of coronavirus disease
What is the coMplication of this disease
Pneumonia •Tuberculosis •Asthma •Pleural effusion •Chronic Obstructive Pulmonary Disease •Congestive Cardiac Failure •Lung collapse
Complication
Acute Respiratory Distress Syndrome (ARDS)
How is coronavirus disease prevented
State the vaccines available
Wear a mask in public, especially when physical distancing is not possible
•Cover your nose and mouth with your bent elbow or a tissue when you cough or sneeze.
•Maintain a safe distance from others (at least 1 metre), even if they do not appear to be sick
•Clean your hands often. Use soap and water, or an alcohol-based hand rub
Stay home if you feel unwell. •Monitor your health daily •Get vaccinated; Vaccines available include; oPfizer vaccine oJohnson and Johnson oModerna vaccine oAstraZeneca vaccine oSputnik V vaccine
How is coronavirus disease treated
(Treatment objectives,non pharmacological treatment for kids,for all age groups) state five of the treatments for each
Treatment objectives;
•To prevent person to person transmission
• To alleviate symptoms of the disease
•To prevent and/or manage complications of the disease
• To treat secondary bacterial or other infections
• To eradicate the COVID-19 infection
Non Pharmacological;
●For children
•Tepid sponging to control fever i.e. children < 5 years
•Adequate fluids e.g. breast milk, porridge, coconut water
•Feed as can be tolerated during the episode. Give an extra meal per day for two weeks after recovery
Non Pharmacological
●For all age groups
•Early quarantine of suspected cases and self-quarantine of all contacts of confirmed cases with follow up
•Mechanical ventilation for respiratory distressed patients
•Cessation of smoking
• Physical exercise and Rest
•Lukewarm salt solution gargle 3 to 4 times daily
•Psycho-social support by counselling patients and contacts
What is the pharmacological management of coronavirus disease
State the drugs and how they work
●Pharmacological
•Anti-Viral Drugs
•. Remdesivir was the first drug approved by the FDA. The broad-spectrum antiviral is a nucleotide analog prodrug
Use of Corticisteroids as Supportive Care
•Use of corticosteroids improve survival in hospitalized patients with severe COVID-19 disease requiring supplemental oxygen.
•In other words, patient who requires mechanical ventilation needs it for bronchodilation and anti-inflammatory
ANTITHROMBOTICS
•A review of COVID-19 hypercoagulopathy describes both microangiopathy and local thrombus formation.
• Systemic coagulation defect leading to large vessel thrombosis and major thromboembolic complications, including pulmonary embolism, in critically ill patients.
•While sepsis is recognized to activate the coagulation system, the precise mechanism by which COVID-19 inflammation affects coagulopathy is not fully understood.
What is the pharmacological treatment of confirmed asymptomatic cases
State the first line and second line treatment
1st line treatment
Hydroxychloroquine, Oral
2nd line treatment
Chloroquine, Oral
What is the TREATMENT(Confirmed cases with Mild/Moderate symptoms) for COVID disease
First line and second line
TREATMENT(Confirmed cases with Mild/Moderate symptoms)
•1st Line Treatment
•Hydroxychloroquine, Oral
And
•Azithromycin or Doxycycline
•2nd Line Treatment
•Chloroquine, Oral
And
•Azithromycin or Doxycycline
What are the four drugs used to treat confirmed cases of COVID disease with severe disease
TREATMENT(Confirmed cases with severe diseases) •Hydroxychloroquine, Oral •Azithromycin or Doxycycline •Convalescent plasma •Methylprednisolone, IV
