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Flashcards in HIV Deck (68)
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1

What are the key receptors involved in thee infection of CD4 cells by the HIV virus?

Viral gp120 attaches to CD4 receptor then binds to CCR5 or CXCR4 coreceptors. viral gp41 is exposed and facilitates fusion and viral entry.

2

Mortality in HIV/AIDS is usually secondary to....

opportunistic infections,
wasting,
cancer

3

in a HIV infected pregnant woman, Caesarian delivery is indicated if....

viral load >1000

4

what is the typical course of HIV infection?

1. Primary HIV infection
2. Asymptomatic HIV infection
3. Symptomatic HIV infection
4. Full-blown AIDS

5

The combination of these two tests in confirming a HIV diagnosis yields an overall sensitivity and specificity of >99%....

ELISA and Western Blot

6

Phase I: Primary HIV infection

mononucleosis-like syndrome 2-4 weeks after HIV exposure

Duration is brief: 3days-2 weeks

Nonspecific symptoms
High false negative rate due to pre-seroconversion

7

Phase 2: Asymptomatic HIV infection

Seropositive
No clinical evidence of HIV infection
CD4 counts are normal
Longest Phase: lasts 4-7 years if untreated

8

Phase 3: Symptomatic HIV infection

first evidence of immune system dysfunction
Phase lasts 1-3 years with out treatment

Characterized by generalized lymphadenopathy, fungal infections, oral hairy leukoplakia, seborrheic dermatitis, constitutional symptoms

9

Phase 4: Full-blown AIDS

CD4 count

10

if CD4 count is >500, immune system is...

essentially normal

11

CD4 level between 200-500

Increased risk of HIV related problems:
herpes zoster
TB
lymphoma
bacterial pneumonia
kaposi sarcoma

12

CD4 count

most opportunistic infections occur at this level

13

Target goal for HIV viral load

want undetectable viral load

14

How often should viral load and CD4 count be measured?

At time of diagnosis and every 3-4 months afterward

15

Pro and Con to p24 antigen assay for diagnosing HIV infection

test is less expensive
but it is less sensitive than viral load testing

16

Patients with acute (primary) HIV infection have very high...

levels of viremia

17

what is the leading cause of death in AIDS?

Pneumocystis Pneumonia (PCP)

18

Treatment of PCP

TMP-SMX (trimethoprim/sulfamethoxazole) for three weeks

*If hypoxic or elevated A-a gradient, give steroids

19

What is the recommended prophylaxis treatment for PCP?

oral TMP-SMX 1 dose daily

20

TB, CMV, MAC infections are more likely when....

CD4 count

21

Seroconversion

When patient is positive for HIV antibody
Occurs 3-7 weeks after infection
Confirms HIV diagnosis

22

IF HIV ELISA is positive, what is the next step?

Confirm with Western Blot Test

23

HIV Patient with subtle memory impairment and cognitive deficits, followed by changes to mental status, aphasia, and motor abnormalities should be evaluated for....

AIDS dementia

24

HIV patient with CNS symptoms and head imaging findings of contrast-enhanced mass lesions in basal ganglia and subcortical white matter should be suspected of having...

reactivation of latent toxoplasmosis

25

How is cryptococcal meningitis diagnosed?

CSF cryptococcal antigen
CSF culture
CSF stain with India Ink

26

How should cryptococcal meningitis be treated in HIV patients?

amphotericin B for 10-14 days followed by 8-10 weeks of oral fluconazole

*Lifelong maintenance treatment with fluconazole is indicated

27

Non-infectious CNS diseases in HIV patients:

CNS lymphoma
Cerebrovascular Accidents
Metabolic encephalopathies

28

The most common GI complaint in HIV patients is....

Diarrhea

29

What is the most common cause of dysphagia in HIV patients?

Esophageal Candidiasis

30

Common dermatologic/malignant condition in HIV:

kaposi sarcoma: painless, raised brown-black or purple papules