MCQs on long COVID - Clinical Corner

Which of the following is the most common symptom reported in patients with Long COVID?
a) Fever
b) Fatigue
c) Hemoptysis
d) Jaundice
A 45-year-old patient presents with persistent dyspnea and chest pain 6 months after recovering from COVID-19. Which of the following is the most likely underlying pathophysiology?
a) Pulmonary fibrosis
b) Myocardial infarction
c) Pulmonary embolism
d) Chronic obstructive pulmonary disease (COPD)
Which cytokine is most commonly associated with the persistent inflammatory state seen in Long COVID?
a) IL-1
b) IL-6
c) TNF-alpha
d) IFN-gamma
What is the estimated prevalence of Long COVID among patients who have recovered from acute COVID-19 infection?
a) 5-10%
b) 20-30%
c) 50-60%
d) 80-90%
Which of the following populations is at the highest risk for developing Long COVID?
a) Young children
b) Pregnant women
c) Older adults with comorbidities
d) Healthy adolescents

A 35-year-old patient reports “brain fog” and difficulty concentrating 3 months after COVID-19 infection. Which of the following is the most likely explanation?
a) Hypothyroidism
b) Post-viral neuroinflammation
c) Vitamin B12 deficiency
d) Migraine disorder
Which of the following is a hallmark feature of post-exertional malaise (PEM) in Long COVID?
a) Improvement of symptoms after physical activity
b) Worsening of symptoms 24-48 hours after minimal exertion
c) Complete resolution of symptoms with rest
d) No correlation with physical activity
A patient with Long COVID reports persistent anosmia. Which of the following is the most likely mechanism?
a) Damage to olfactory receptor neurons
b) Sinusitis
c) Allergic rhinitis
d) Nasal polyps
Which of the following cardiovascular complications is most commonly associated with Long COVID?
a) Myocarditis
b) Aortic dissection
c) Deep vein thrombosis (DVT)
d) Atrial fibrillation
A patient with Long COVID presents with persistent tachycardia and orthostatic intolerance. Which of the following conditions should be considered?
a) Postural orthostatic tachycardia syndrome (POTS)
b) Hypovolemic shock
c) Addison’s disease
d) Hyperthyroidism

Which of the following tests is most useful in evaluating a patient with Long COVID-related dyspnea?
a) Chest X-ray
b) Pulmonary function tests (PFTs)
c) Echocardiogram
d) All of the above
A patient with Long COVID reports persistent fatigue and muscle weakness. Which of the following laboratory tests is most likely to be abnormal?
a) Creatine kinase (CK)
b) Thyroid-stimulating hormone (TSH)
c) C-reactive protein (CRP)
d) Hemoglobin A1c
Which of the following imaging modalities is most appropriate for evaluating suspected myocarditis in a Long COVID patient?
a) CT scan
b) MRI
c) Ultrasound
d) PET scan
A patient with Long COVID presents with cognitive impairment. Which of the following tests is most appropriate for initial evaluation?
a) Mini-Mental State Examination (MMSE)
b) Lumbar puncture
c) EEG
d) Brain biopsy
Which of the following is the most common finding on chest CT in Long COVID patients with persistent respiratory symptoms?
a) Ground-glass opacities
b) Pleural effusion
c) Pneumothorax
d) Normal findings

Which of the following is the first-line treatment for fatigue in Long COVID?
a) Corticosteroids
b) Graded exercise therapy
c) Cognitive behavioral therapy (CBT)
d) Antiviral therapy
A patient with Long COVID presents with persistent depression and anxiety. Which of the following is the most appropriate initial intervention?
a) Selective serotonin reuptake inhibitors (SSRIs)
b) Benzodiazepines
c) Psychotherapy
d) Electroconvulsive therapy (ECT)
Which of the following is the most effective strategy for managing post-exertional malaise (PEM) in Long COVID?
a) High-intensity interval training
b) Pacing and energy conservation
c) Opioid analgesics
d) Bed rest
A patient with Long COVID reports persistent anosmia. Which of the following treatments has shown the most promise in restoring smell?
a) Antibiotics
b) Olfactory training
c) Nasal corticosteroids
d) Antihistamines
Which of the following is the most appropriate management for a Long COVID patient with suspected POTS?
a) Beta-blockers
b) Increased salt and fluid intake
c) Diuretics
d) Calcium channel blockers

Which of the following is the most common long-term complication of Long COVID?
a) Chronic kidney disease
b) Pulmonary fibrosis
c) Diabetes mellitus
d) Stroke
A patient with Long COVID develops new-onset diabetes mellitus. Which of the following is the most likely mechanism?
a) Autoimmune destruction of pancreatic beta cells
b) Insulin resistance due to chronic inflammation
c) Direct viral damage to the pancreas
d) Medication-induced hyperglycemia
Which of the following factors is associated with a worse prognosis in Long COVID?
a) Younger age
b) Female sex
c) Presence of comorbidities
d) Mild initial COVID-19 infection
A patient with Long COVID develops persistent chest pain and elevated cardiac biomarkers. Which of the following is the most likely diagnosis?
a) Myocardial infarction
b) Myocarditis
c) Pericarditis
d) Aortic dissection
Which of the following is the most common psychiatric complication of Long COVID?
a) Schizophrenia
b) Bipolar disorder
c) Major depressive disorder
d) Obsessive-compulsive disorder

Which of the following is a potential therapeutic target for reducing inflammation in Long COVID?
a) IL-6 inhibitors
b) ACE inhibitors
c) Beta-blockers
d) Anticoagulants
Which of the following vaccines has shown the most promise in reducing the risk of Long COVID?
a) mRNA vaccines
b) Viral vector vaccines
c) Inactivated vaccines
d) All vaccines equally
Which of the following is a potential biomarker for Long COVID?
a) D-dimer
b) Troponin
c) CRP
d) All of the above
Which of the following is the most promising emerging therapy for Long COVID-related fatigue?
a) Monoclonal antibodies
b) Antiviral drugs
c) Mitochondrial support supplements
d) None of the above
Which of the following is the most common research finding regarding the immune response in Long COVID?
a) Persistent viral replication
b) Autoantibody production
c) Complete immune suppression
d) Normal immune function

Which of the following is the most common gastrointestinal symptom in Long COVID?
a) Diarrhea
b) Constipation
c) Nausea
d) Abdominal pain
Which of the following is the most common dermatologic manifestation of Long COVID?
a) Urticaria
b) Hair loss
c) Psoriasis
d) Acne
Which of the following is the most common neurologic symptom in Long COVID?
a) Seizures
b) Headache
c) Stroke
d) Peripheral neuropathy
Which of the following is the most common endocrine complication of Long COVID?
a) Hypothyroidism
b) Hyperthyroidism
c) Diabetes mellitus
d) Adrenal insufficiency
Which of the following is the most common hematologic abnormality in Long COVID?
a) Anemia
b) Thrombocytopenia
c) Elevated D-dimer
d) Leukocytosis