COVID 19 NEET MDS 2020-21 INICET MDS 2021 QUICK RECAP

having us i'm back here uh with one more content on kovid19 so as per the prediction and the strategy that we have discussed for inicit it's good to see decent number of questions from covid19 and the same thing can happen in the upcoming neet examinations so let's go into the top so covet 19 is a one this is which most of us most of the population okay most of the family members have suffered in the past few days okay so in this process you may learn so many things not academically but to increase your awareness towards covet 19 we have learned so much so i'll just clear cut the things what you and i have learned in the process of general information to a proper literature okay proper literature from academic point of view so covet 19 so the first is is diagnosis right so diagnosis is by a combination of few things that is the clinical features that includes the symptoms and signs the radiographical features and the laboratory futures so all these together combine to give a proper diagnosis means alone radiographic futures or image modalities alone cannot be used either in the diagnosis or either in the screening even your ct cannot be used for diagnosis and screening your chest x-ray cannot be useful for diagnosis and screening they should be combined with the clinical features and they should be combined with the laboratory findings to come out with the proper diagnosis of this covet 19. so they can ask you the first image modality that is used in kobit 19 the first image modality or the first line image modality that is used in the kovid 19 it is not ct it is chest x-ray checks x-ray is the first image modality that is used in the screen make a note your chest x-ray is not useful for diagnosis and it is not useful for screening okay alone cannot be useful for diagnosis and screening even your ct ct is not useful for diagnosis alone not useful for diagnosis not useful for screening okay very clear and make a note if a patient if a patient of a particular symptom signs all these are regularly asked questions right in your case based approach so all these features like clinical features giving and they can if they clearly mention the ct is normal or the chest x-ray is normal may cannot normal chest x-ray does not rule out covet 19 normal ct scan patient may have normal ct scan but he may have see scovite 19 infection patient may have normal chest x-ray okay so normal chest x-ray normal ct scan does not rule out kovid 19. very specific and very important is your rtpc that is reverse transcriptase pcr is the one which helps the things to get settled well now okay so your rt pcr hope most of you have heard this term that is reverse transcriptase pcr is 95 or more percentage sensitive so this is the best way to identify kobit 19 as of now okay this is the best way to identify the kovid 19 as of now so what is the difference what is the advantage of ct now nowadays like everyone are being uh affected or symptomatic and they want to get results okay so your rtpcr will take time okay whereas your ct will be immediate like once the patient is affected take ct scan okay the cd result is out and you will see the investigations on ct so ct the only advantage of course it helps in the diagnosis but alone cannot help in diagnosis but it should be combined with rt pcr but ct is going to give you the results immediately ct scan is going to give results results are immediately so if you want you can make a note about the laboratory findings uh which are seen in this cobit 19 the laboratory findings which are seen in the kovite 19 are there will be decreasing in the lymphocytic count increasing in the c reactive protein okay increasing in the lymphocytic count and increasing in the c react to protein and decreasing in the lymphocytic ground are some of the laboratory findings that you can see so when you go to this chest x-ray so most of us this is a normal chest x-ray you can see this is a normal chest x-ray so when you see you can see the haziness okay so that is the main thing that you can see in your covet 19 the peculiar radiographic features in the covet 19 are hazing as you can see okay you can see this haziness like here it's normal here it is normal you can see this haziness okay uh in this particular tone you can see this haziness in this particular job so there is altered of haziness the areas of haziness which can be seen on the city city as well as city you can see them on the chest x-ray okay so that and if you go in detail into these hazinesses these hazinesses are of two types one is crown class opacities that is called as ggos that is ground glass opacities and the second one is called as consolation okay so ground glass opacities is the first line it comes first and followed by as the time increases with the infection it will be converted into consultation okay and other important features most of these c cities as well as the chest x-rays the peculiar features of this kovit 19 one is bilateral means you you you the affected will be bilateral means both the sides of the both the lungs left as well as right are affected by lateral and it is multifocal means you'll have more number of focus multifocalities it's not a uniform it is multifocal most most of the lobes will get affected it's not single loop you can see here one lobe affected here one lobe tool up here three to four lobes are affected so most of the lobes get affected even phyllops are also affected in few conditions and the other important aspect about this one is most of these are peripheral okay you can see peripheral most of these are peripheral they are outside they are not center they are not center they are outside they are on the periphery so the three important features that you have to make a note about the ct as well as the chest x-ray they are bilateral both the sides multi-focal different lobes are affected in the lobes you can see multifocal similarly like your amyloblastoma which is unilocular and multi-ocular right so unilocular unicystic amyloblastoma multicystic aminological similarly it's not at one point it is at multiple areas and most of these are periphery they stay outside okay they say outside the periphery of the peripheral borders of the lungs and if you take the condition into if you take the situation into consideration they can ask you the most commons ground glass opacities are most common than any other radiographic feature in the ct scan one point second thing multifocal are more common when compared to that of the unifocal that is a other important aspect that you have to make a note when we are talking about the cd scan or chest x-ray so if you go detail into this this is a ct cd okay this is a ct scan so you can clearly see these yellow color uh markings okay these yellow color markings are your these yellow color markings are your ground glass opacities these are low color markings are your ground glass opacities whereas your green color markings okay your green color markings are your space considerations these green color markings are your space considerations right so these are the important things that you have to make a note okay these features are common both for the ct as well as well as for the x-rays and if you if you see this particular thing into consideration okay the main aspects that you have to make a note is one is ground glass opacities so in the case of your ground glass opacities where you can see here the groundless opacities where you can see some networks which are going here and there these networks are nothing but the underlining vessels so in ground grass opacities you can see the underlining vessels whereas these groundless opacities after few days they are going to convert into considerations okay as the infection increases okay so where these vessels are going to disappear the ct futures you do you need to make a what about the ct futures okay we have already discussed one important cd feature is ground glass or basically the second important ct feature is consideration and the other important ct feature that you have to make a note is crazy paving pattern it's something like around the periphery for example if you take this groundless appearance the periphery is something like a radio opaque border right so this radio quick broader is in such a way that it looks like bricks were arranged at the circumference so that is called as crazy paving pattern okay so these are the most important things the most common thing that you find in ct or x-ray just x-ray of cobit 19 patient is ground glass opacities okay so you're clear like okay so what what are the peculiar features coming to the city and uh ct and chest x-rays groundless opacities consolidation and craving crazy paving pattern apart from this very specific features of cb uh your cobit 19 are your multifocal bilateral and periphery even you can see most of these are periphery here okay you can see most of the features are periphery here okay or are periphery or are around the outer side not on the inner side or the central side okay so as the patient is recovering you can you can see the recovery also from the cd okay so for example a mild case or a recovery case only one lobe get affected whatever the cases we have seen as of now the ct and chest x-ray most of the lobes in the chest were in the lungs were affected but when the patient is mild or in the recovering stage only one lobe can get affected okay so that is very very important and please do make a note uh other important features uh about your rats okay so these rats is again the most common aspect for kobe 19 question okay a difficult question can be given for a dental student on this rats okay so the rats helps in level of suspection of seaweed see kovid 19 infection so it starts from rats one to rad six very simple as it moves down the severity of suspection increases rad one is known and your ct findings will be uh yeah there will be normal okay it is a low chances uh the abnormality uh like the the i mean like the findings may be similar to kobit 19 but can be suspected by other like the patient may have tb but you you you when you're cross checking the cds the series looks like obvious 19. so that that is called as law and this next one is indeterminate okay it is unclear okay it is unclear about the coveted 19. next rats 4 is highly the patient is highly suspicious of kobe 19. like if you take the features of radiographic features you can see this ground glass opacities or considerations or you can see all the features multifocal and everything but but but you you're not perfectly sure that it's going to be coveted but there are high chances maybe 90 percent is plus chances of covet 19. and the next one is very high chances means the features are very typical to covet 19 exactly the lobes the multi-focal bilateral the periphery everything mimics the kovid 19 situation so that cases comes under very high high and very high are more risk of i mean like they're like probably they will be covet 19. and the rat six is the one in which you'll have all the features and on the ct scan but the patient is positive to rt pcr so that is the highest okay so hope hope they can ask you like they can give you the case scenario and they can ask you uh they can they can add a ct finding or they can directly give uh the ct scan photograph and they can ask you about this uh rats whether it starts from one two or ends at six okay so that's an important aspect the other important aspect like i just want to give an idea so when the patient is recovering or when the patient is mild recovery or the patient is mild you may have only one lobe get affected regularly it is multifocal multi-laws more than one lobe get affected and other findings in cbct your ct scan okay of of your lungs of your chest which which may give you a conclusion of other things is so no pleural effusion regularly pleural effusions are not seen in the copic 19. so whenever you have a pleural efficient i mean like regularly a ct chest will have pleural effusions when the patient is having a congenital heart disease or a bacterial uh i mean pneumonia bacterial causing pneumonia in such conditions you can see this pleural effusion and similarly you can see lung cavities sometimes you have radio pace it is radio big radio opacities inside the lungs completely here you can see haziness but regularly you can see lung cavities okay lung cavities when you have lung cavities it's not covered 19 lung cavities are most commonly associated with again pneumonias the bacterial pneumonia and the fungal pneumonia pneumonia and the next one is i mean like all these features what we have learned this opaque ground glass radio basis all these features are not only very specific to covet 19 but specific to majority of the viral pneumonia so uh once you diagnose it as a viral pneumonia with all these things what we have learned then you have to confirm it with rtpcr or other laboratory investigations to confirm it to covet 19. okay so these are the things that we have to take into consideration because uh i mean the severe case of covad19 okay the pneumonia is common so you should differentiate whether the pneumonia is basically due to covid19 or the pneumonia is basically due to the secondary infection that is caused by covid19 so you have to differentiate the pneumonia whether it is viral bacterial or fungal so basing upon which the treatment plan should be should be done accordingly okay so i'm done for now uh probably we are planning to come out with few more uh a few more uh stuff related to kobe 19 and latest updates uh which can be predicted as an mcqs uh in your need 2020. okay uh hope hope uh hope everything is clear so please do make a note about the ct scan and the chest x-ray uh how they're different what are the futures are seen and you need to make a note about what is sensitivity specificity related to the diagnosis of covet 19 rt pcr reverse transcriptase pcr is the best one for the diagnosis okay your ct scan or your chest x-ray cannot be alone useful for the diagnosis of covet 19 cannot be useful in the diagnosis cannot be useful in the screening but the main advantage of these is they are immediate they are immediate okay so done for now signing off dr srikad from team mds conquer