197 - Human Immunodeficiency Virus Disease: AIDS and Related Disorders Flashcards by Salman Majid

HIV patients are classified according to their __ levels and their different __.

CD4

symptoms

How well did you know this?

Not at all

Perfectly

There are 5 levels for HIV classifications. 0- negative _ months post exposure, 3- if __ infection. The rest of the levels are determined according to the __ levels.

6
opportunistic
CD4

How well did you know this?

Not at all

Perfectly

Treatment __ determined according to the level of HIV/AIDS.

is not

How well did you know this?

Not at all

Perfectly

The physician should choose HIV treatment according to the ___

presentation

How well did you know this?

Not at all

Perfectly

The chance for HIV transmission during sexual intercourse is __%.

1.4

How well did you know this?

Not at all

Perfectly

Different infections increase the risk to be infected with HIV: 6

T. pallidum
H. ducreyi
HSV
chlamydia
N. gonorrhoeae
trichomonas vaginalis

How well did you know this?

Not at all

Perfectly

The chance for HIV transmission during IVDU is __%.

0.6%

How well did you know this?

Not at all

Perfectly

The chance for HIV vertical transmission during 1st trimester is__%, during the birth ___%, breast feeding.

23-30%
50-65%
12-20%

How well did you know this?

Not at all

Perfectly

Breast feeding if HIV is present is __ in developed countries, in developing countries it is not to case (use __ during)

contraindicated

retro antiviral

How well did you know this?

Not at all

Perfectly

Eclipse phase-__

The virus cannot be found in blood for several days post infection.

How well did you know this?

Not at all

Perfectly

One of the important areas infected by HIV is the __

GALT

How well did you know this?

Not at all

Perfectly

Mucosal infection leads to __ to be the first to get infected.

How well did you know this?

Not at all

Perfectly

Hematologic infection leads to __ to be the first to get infected.

spleen

How well did you know this?

Not at all

Perfectly

Acute HIV syndrome occurs in _% of patients, and is defined by severe __. Clinically it can be __ or __.

50
viremia
asymptomatic
IM like

How well did you know this?

Not at all

Perfectly

Antibodies for HIV are diagnosed by __ test.

ELISA`

How well did you know this?

Not at all

Perfectly

Due to high percentage of FP, if ELISA result was positive- continue to __ test.

western blot

How well did you know this?

Not at all

Perfectly

For western bolt to be positive - _ out of _ antibodies should be positive (__/__/__).

2
3
gag/pol/env

How well did you know this?

Not at all

Perfectly

If western blot is not conclusive- perform __ test.

cross reaction

How well did you know this?

Not at all

Perfectly

In recent exposure if __ is negative, return after __ and __ after.

ELISA
six weeks
3 months

How well did you know this?

Not at all

Perfectly

OraQuick rapid HIV-1 antibody test is a very __ test (99%), but if negative- __.

specific

ELISA

How well did you know this?

Not at all

Perfectly

-% of patients infected with HIV will develop acute retroviral syndrome - weeks post infection.

50-70%

3-6

How well did you know this?

Not at all

Perfectly

The symptoms of HIV acute retroviral syndrome depend on the severity of the __

viremia

How well did you know this?

Not at all

Perfectly

The general symptoms of acute retroviral syndrome are: 7

fever
pharyngitis
lymphadenopathy
headache
lethargy/malaise
anorexia/weight loss
nausea/vomiting/diarrhea

How well did you know this?

Not at all

Perfectly

Neurologic symptoms of acute retroviral syndrome include: 4

meningitis
encephalitis
peripheral neuropathy
myelopathy

How well did you know this?

Not at all

Perfectly

Cutaneous symptoms of acute retroviral syndrome include: 2

maculopapular / erythematous rash | mucocutaneous ulcers

During acute retroviral syndrome __ infections are possible.

opportunistic

_% of HIV patients will develop __ disease after acute retroviral syndrome, the rest will enter the latent phase.

10 | fulminant

The median time period in untreated HIV patients for the appearance of clinical disease is __ years.

During the latent phase, CD4 decrease by __ uL/year

When CD4 drops below __, the deficiency is sufficient for ___ infections and ___.

200 opportunistic malignancies

AIDS related disease make up to __% of mortality, non AIDS malignancies, liver disease, CV disease make up to _-_% each.

50 | 10-15

In order to reduce complications in HIV patients keep __levels low using __, and treat __.

replication cART infections

Acute __ and __ are present in all stages of HIV

bronchitis | sinusitis

Diagnosing sinusitis is done using _/_. Treatment is optional, but will reduce the __ of the disease.

MRI/CT | length

What are the common pathogens causing sinusitis in HIV patients?

H. influenza strep pneumonia mucormycosis (debridement + amphotericin B)

What is the most common complication of HIV?

pneumonia

Untreated HIV patients are X_ more likely to have __ and X_ for __.

6 bacterial pneumonia 100 bacteremia

HIV bacterial pneumonia should be treated with Abx such as-

ceftriaxone (cephalosporine)+ azithromycin (macrolide)

HIV patients are advised to quit __, and receive the following vaccination: 2

smoking conjugated pneumococcal vaccine 23 valent pneumococcal

PCP=__

Pneumocystis pneumonia

PCP cause __% of pneumonia in HIV patients in the US, and is the leading microbe causing it.

25%

When CD4< 200 in HIV patients, give __ treatment for PCP with __.

prophylactic | aerosolized pentamidine

PCP clinical presentation include: 4

fever unproductive cough CXr with bilateral interstitial infiltration CT with ground glass

PCP treatment include __.

resprim (TMP-SMX)

HIV patients are __ times more prone to active __.

100 | TB

Which atypical mycobacteria are more common in HIV patinets?

M. avium | M. intracellular

The most common CV disease in HIV patients is- __

CHD

HIV patients tend to have increased __, and decreased __.

TG | HDL

HIV associated ___ present with edema and dyspnea.

cardiomyopathy

Esophagitis in HIV patients is usually due to 3, and cause retrosternal pain and dysphagia. Diagnosis is made with __.

candida CMV (one big lesion) HSV (multiple small lesions) endoscopy

What are the common pathogens causing intestinal infections in HIV patients? Bacteria- 3 fungal- 3

``` salmonella shigella campylobacter histoplasma coccidiomycosis penicilliosis ```

CMV colitis symptoms include: 3

diarrhea abdominal pain weight loss/anorexia

CMV colitis should be diagnosed with __ (multiple mucosal lesions), __ (intranuclear and cytoplasmic inclusions bodies).

endoscopy | biopsy

Chronic __ syndrome is when no etiology beside HIV was found. may cause weight loss and malabsorption.

diarrheal

_% of mortality of HIV patients is due to hepatobiliary disease. Some due to __, while other due to the __.

15 hepatitis drug treatment

What are the common kidney/urinary HIV related disease? 4

microalbuminuria HIV associated nephropathy UTI vulvovaginal candidiasis

33-75% of HIV patients suffer from __ due to thymidine analogues or protease inhibitors. As a result: 3.

lipodystrophy TG increase total cholesterol increase hyperinsulinemia + hyperglycemia

Many HIV patients will develop ___, usually due to a combination of pulmonary or CNS disease- resulting in __.

SIADH | hyponatremia

Hyperkalemia can be found in HIV patients, due to __ insufficiency, __, or __.

adrenal nephropathy drugs

___ Cushing due to hypothalamic-hypohisaric - adrenal axis inhibition (__)

iatrogenic | steroids

Adrenal disease in HIV patients can be caused by: 5

``` mycobacterial infection CMV cryptococcoses histoplasma iatrogenic ```

IRIS-___

immune reconstitution inflammatory syndrome

IRIS is a paradoxical reaction after starting with __ treatment. It may lead to: 3

cART worsening of opportunistic infection AI disease unmasking unknown problem

IRIS exist in __% of patients, and is more common in patients with CD4 < __ when the treatment was initiated.

30 | 50

IRIS clinical symptoms include: 8 :(

``` local lymphadenitis prolonged fever pulmonary infiltration hepatitis ICP uveitis sarcoidosis graves disease ```

What are the common hematopoietic clinical symptoms related to HIV?

``` persistent generalized lymphadenopathy anemia neutropenia thrombocytopenia DVT/PE ```

Dermatologic problems are present in __% of HIV patients.

90%

HIV patients may experience drug reactions such as __-__ syndrome, and toxic epidermal __.

Steven Johnson | necrolysis

What opportunistic CNS disease are common in HIV patients? 4

toxoplasma Cryptococcus leukoencephalopathy (vanishing white matter) primary lymphoma

HIV encephalopathy/ HIV associated dementia is an HIV __ disease.

characterizing

What is the main cause for meningitis in HIV patients? It occurs when CD4

cryptococcus | 100

What is the treatment for cryptococcus?

AMP-B

When toxoplasmosis is more likely to cause CNS disease in HIV patients?

when CD4 < 200

What are the typical MRI lesions defining toxoplasmosis?

multiple round enhancement in the brain

How should you treat toxoplasmosis?

resprim (TMP-SMX)

50% of HIV advanced patients will present __-__ spots in an ophthalmological examination

cotton wool

What are the common ophthalmological disease in HIV patients? 2

CMV retinitis | HSV/VZV necrotizing retinitis

What are the common neoplastic disease in HIV patients? 4

Kaposi's sarcoma lymphoma (non-Hodgkin's) Multicentric Castleman disease invasive cervical carcinoma

consider expanding on neoplastic disease

What are the 4 categories of HIV treatment?

reverse viral transcriptase inhibitors protease inhibitors integrase inhibitors cell entry prevention

HIV treatment should consists of ___ drugs and last for __.

multiple | life

Which HIV patients should receive medicinal treatment?

all patients

HIV patients diagnosed while suffering opportunistic infection can postpone cART by _-_ weeks, focusing on treating the infection.

2-4

One of the goals of HIV treatment is a X__ decrease in viral load within the first _-_ months, and then further decrease to __ RNA copies within _ months.

10 1-2 50 6

One of the goals of HIV treatment is an increase of __ cells to _-_ in the first month, followed by further increase of _-_ per year until they are normal.

CD4 100-150 50-100

197 - Human Immunodeficiency Virus Disease: AIDS and Related Disorders Flashcards

(85 cards)