Sandbox:BSoni

Case courtesy of Assoc Prof Craig Hacking, Radiopaedia.org, rID: 56030

Are face-masks effective against COVID-19?

• The use of face-masks has been demonstrated to slow the spread of COVID-19.
• Studies conducted in community and healthcare settings observed that the use of face-masks was helpful in reducing the spread of the virus.

Can you have COVID-19 without a fever?

• Yes, one can be diagnosed with COVID-19 without having a fever. Although a majority of patients diagnosed with COVID-19 have fever as a symptom, there are patients who develop other symptoms like shortness of breath, cough and fatigue without developing a fever.

Can COVID-19 be spread through feces?

• There is a lot of research being done regarding this, and there is no conclusive evidence that COVID-19 can be transmitted through feces.

Is there a vaccine for COVID-19?

• No, currently there is no vaccine that can prevent COVID-19. Researchers from all over the world are working on developing a vaccine for this virus, and are hopeful that a viable vaccine will be developed in the coming months.

Does drinking alcohol inactivate the coronavirus?

• Drinking alcohol does not inactivate the coronavirus and does not prevent one from catching the virus. Additionally, excessive use of alcohol can lead to a weakened immune system, leading to a greater risk of becoming sick.

I got my tonsils removed 3 months back, am I more vulnerable than the general population?

• Currently, there is no research linking the removal of tonsils and the vulnerability of getting sick with COVID-19. There have been several studies that have been performed to check the relationship between getting a tonsillectomy and its effect on the immune system. These have found that in a majority of cases, there is no negative effect of removing tonsils on the body's immune system.

I have been on HCQ for many years for an autoimmune condition, does that make me immune to COVID-19?

• Studies have shown that the use of hydroxychloroquine for prevention does not decrease the incidence of COVID-19; and does not make one immune to COVID-19.

Can COVID-19 be transmitted through food?

• There is no current evidence that the COVID-19 virus can be transmitted through food.
• It is highly encouraged to frequently wash hands with soap for at least 20 seconds before eating or handling food.
• Additionally, all food packaging and frequently used surfaces should be cleaned and disinfected thoroughly.

What are the symptoms of COVID-19?

• There are several different symptoms of COVID-19. Below are the majority of them:
  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea
• This is not a comprehensive list and it will be updated as more research is conducted.
• Please see your doctor if you feel sick or if you have come in contact with anyone who has been diagnosed with COVID-19.

Can COVID-19 be transmitted through water?

• There is no evidence that COVID-19 can be transmitted through water.
• Disinfection and chemical treatment of water by water treatment plants has demonstrated the removal of the virus.

I am a consented organ donor, if I die from COVID-19 can my organs still be used for transplantation?

• Unfortunately, if someone passes away due to COVID-19, their organs are unable to be used for transplantation.
• Although the risk of transmission of the virus through transplantation is low, the American Society of Transplantation current guidance is not to use a COVID-19 positive patients's organs for transplantation.
• This guidance may change in the future as more research is conducted and more information is known about the COVID-19 virus.

Where do I go to get tested for COVID-19?

• With the availability of viral tests becoming more common, there are several locations to get tested for COVID-19.
• The best way to find a testing location is to visit your state's health department website, which will have a detailed guide on available testing locations.
• Here is the list of all United States state and territorial public health department websites provided by the Center for Disease Control and Prevention (CDC): State and Territorial Health Department Websites
• Several of these testing locations do not charge for getting tested for COVID-19.

Should an immunosuppressed patient take any drugs to prevent contracting the virus during their hospital visits?

• Currently, there are no drugs that can be taken to prevent from contracting COVID-19.
• Immunosuppressed patients have weakened immune systems, and have a higher risk of getting sick from COVID-19. These patients should continue their regular treatment plan and continue taking their regular medications.

Are there any trials to study the long term effects in immunity, relapses, the effectiveness of drugs in patients?

• Yes, there are more than 450 different trials in the United States that are studying different aspects of COVID-19; and researching immune responses and effectiveness of drugs. For a full list of current clinical trials that are being conducted, please visit: COVID-19 Clinical Trials
• Trials being performed to research the immunity response to COVID-19 are primarily being carried out by the National Institute of Allergy and Infectious Diseases (NIAID); amongst others around the world. Example Trial 1 Example Trial 2

39) Can we consume raw fruits and vegetables?

• Yes, raw fruits and vegetables can be consumed after washing them thoroughly under running water.
• Firmer vegetables like potatoes and carrots should be scrubbed with a brush before consumption.
• Disinfectants, chemicals or soap should NOT be used to clean raw fruits and vegetables, as well as the food packaging containing these foods.

40) What’s a good respiratory hygiene?

• Good respiratory hygiene includes doing the following things to protect yourself and others from spreading the virus:
  • Wear a mask or face covering when outside in a public setting.
  • Cover your nose, mouth and face while coughing and sneezing.
  • Use a hand sanitizer with at least 60% alcohol or wash your hands with soap for at least 20 seconds after touching your mouth or nose.
  • Use tissues and throw them away responsibly after every use.

44) Is air conditioning really bad and does it worsen the spread?

• Like a lot of other things associated with COVID-19, there is not enough research on the correlation between air-conditioning and the spread of the virus.
• One study conducted in Guangzhou, China showed evidence that supported the use of air conditioners increased the spread of the virus BECAUSE of the direction of the air flow.
• It is to be noted that the direction of air flow and the ventilation in a room is more significant than the actual use of air conditioners. A well ventilated room with good air flow is less likely to spread the virus than a closed room with bad ventilation.

Small bowel obstruction vs Ileus
	SBO	Ileus
Etiology	Prior surgery	Recent surgery
Abdominal exam	Distension Increased bowel sounds	Possible distension Reduced/absent bowel sounds
Small bowel dilation	Present	Present
Large bowel dilation	Absent	Present

USING ALGORITHM

Box 1 in Row 1

Box 2 in Row 2

Box 3 in Row 3

Box 4 in Row 4

Another flowchart

Chest Pain

Stable angina

Unstable angina

MI

NSTEMI

STEMI

Heart bundle branch blocks are RBBB and LBBB

Case courtesy of OpenStax College, Radiopaedia.org, rID: 26403

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Historical Perspective

• Disease Name and discovery
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Classification

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• variations of disease