Week 6: Alterations of Pulmonary Function Flashcards
***What part of the COVID-19 virus structure causes infection?
Spike Protein (S)
***What makes the (S) Spike Protein so special?
It fuses into our cells, causing MASSIVE replication without recognition from our immune system.
more review What is the patho of COVID-19?
- Hyperinflamm. response causes increased permeability of vascular & epithelial membranes, edema, & tissue necrosis (esp. lung tissue)
- Hypercoagulable state like Disseminated Intravascular Coagulation (DIC)
***What are the non-respiratory symptoms of COVID-19?
- (heart) inflammation/immune changes in myocardium; cardiomyocyte death
- (brain) Neuro. inflammation.; brain damage @ parenchyma & cerebral vasculature
- (kidneys) Acute Kidney Injury (AKI); especially in critically ill patients…
nephrology –> acute tubular necrosis (ATN) –> glomerulosclerosis
What does ARDS stand for?
acute respiratory distress syndrome
What is ARDS? (2)
- acute lung inflammation
- diffuse alveolocapillary injury
…because of direct pulm. injury/severe sys. infection
TRUE or FALSE: ARDS is potentially deadly
TRUE
TRUE or FALSE: Since COVID-19 emerged, there has been a decrease in ARDS cases globally
FALSE
What is seen in ARDS? (2)
- acute onset of BILATERAL INFILTRATES on chest x-ray (ex. pulmonary edema)
- persistent hypoxemia even though O2 is given :(
What does PARDS stand for?
PEDIATRIC acute respiratory distress syndrome
_______ & ________ cause direct lung injury in PARDS (?)
COVID-19 & pneumonia
more review What is the patho of ARDS?
- Inflammatory response
—–infiltration of macrophages…activation of complement/clotting system “cytokine storm”
—— Results in diffuse alveolar & micro. vas. DAMAGE and THROMBOSIS
——- Fluid LEAKS into pulm. interstitium…so V/Q mismatch & hypoxemia
What are the 3 stages of ARDS?
- Exudative (inflammatory)
- Proliferative
- Fibrotic
**In ARDS, during the _________ stage, there is severe _____________.
Fibrotic stage, RIGHT to LEFT shunting
What are the key clinical manifestations of ARDS? (5)
- Dyspnea, hypoxemia
- Initial hyperventilation & resp. Alkalosis
- Metabolic acidosis
What is Glomerulosclerosis?
Glomerulosclerosis is scarring of the filtering part of the kidneys (glomerulus). This causes a loss of protein into the urine. These proteins help fluid stay within the blood vessels. Without them, fluid leaks into the nearby tissue causing swelling.
COVID-19 transmission consists of:
Droplet (ex. cough, sneeze, talking)
Aerosol :0
**symptomatic = MOST infectious
What is COVID-19’s incubation period?
up to 1 week
**What is the key concept in COVID-19 in children?
It’s mild for kids usually, but some may develop serious illness…
- Multisystem inflammatory syndrome in children (MIS-C)*****
What are the clinical manifestations of COVID-19? (6)
- myalgias (muscle ache/pain)
- fever
- cough
- fatigue
- SOB
- loss of smell/taste
In COVID-19, what are the primary causes of mortality? (2)
Respiratory failure & septic shock
Name the 2 monoclonal antibodies drugs
TixageviMAB & CilgaviMAB
Which drug (s) does/do Ontario NOT recommend anymore for preventing COVID?
TixageviMAB & CilgaviMAB
What is the use of TixageviMAB & CilgaviMAB?
- prevent COVID
- pre-exposure to COVID
What is the mechanism of action of TixageviMAB & CilgaviMAB?
- attach to receptor-binding portion of COVID spike protein
—> This combo of drugs BLOCKS virus’ interaction w/ HUMAN ACE 2 receptor req. for viral fusion w/ host cell
What are the side effects of TixageviMAB & CilgaviMAB? (3)
- hypersensitivity
- anaphylaxis
- injection site reaction
Name the 2 antiviral drugs to treat COVID:
Nirmatrelvir & Ritonavir
What is the use of Nirmatrelvir & Ritonavir?
Treats mild/moderate COVID
—> (+) test
—> HIGH RISK of getting severe COVID…(hospital/death)
:) stops virus from multiplying
:) decreases severe outcomes
*****What are the age groups that can take antivirals? (Nirmatrelvir & Ritonavir)?
- 60+
- 18+ immunocompromised
- 18-59 & HIGHER risk of severe COVID (1+ comorbidity; inadequate immunity; unvaxxed/incomplete series…OR had COVID/infection 6+ months ago)
What is DIC stand for?
Disseminated Intravascular Coagulation (DIC)