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Year 4 Block 3-Acute medicine > 401. HIV > Flashcards

401. HIV Flashcards

1
Q

What are the best ways to prevent the spread of HIV?

A

Condoms

Post exposure prophylaxis (take within 24 hours)

Pre exposure prophylaxis- not yet nhs funded

Vertical transmission- HIV positive women commenced on antiretroviral medication by week 24

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2
Q

What are the symtpoms of seroconversion?

A

Flu like symptoms

Erythematous/maculopapular rash

Persisting lymphadenopathy for 3 months

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3
Q

What is the best way to manage a needlestick injury?

A

Encourage bleeding of the wound

Wash with soap and running water. do not scrub

Seek advice from occupational health

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4
Q

Discuss some of the opportunistic infections that can occur in HIV?

A

PJP

Candidiasis

Cryptococcus neoformans

Toxoplasmosis

Cytomegalovirus

Cryptosporidium

Kapsoi’s sarcoma

Lymphoma

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5
Q

Discuss PJP?

A

Progressive SOB, malaise, dry cough

Heamptysis and pleuritic pain rare

CXR perihilar infiltrates

Treated with co-trimaxozole.Steroids in moderate/severe disease

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6
Q

What are the presenting features of candididaisis

Ho wis it treated?

A

Pain in tongue, dysphagia, odynophagia

treated with fluconazole

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7
Q

What is cryptococcus neoformans

How is it treated?

A

Commonest systemic fungla infection iN HIV

Meningits, fever, headache

LP and CSF stain

Liposomal amphoterecin B is first line. Maintenence Fluconazole. Normalise ICP with shunt

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8
Q

What is toxoplasma gondii

How does it present

What is treatment?

A

Coomonest cause of intracranial mass lesions

Focal neurological signs nad seizures common

Ring enhancing lesions seen on MRI

Pyrimethamine, sulfadiazine, folinic acid

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9
Q

What is cytomegalovirus

How is it treated?

A

can presenet across multiple systems: retinitis, enephalitis, Gi disease, hepatitis, bone marrow suppresion, pneumonia

Ganciclovir

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10
Q

What is cryptosporidium?

How is it treated?

A

Common cause of diorrheoa, Can also cause cholangitis and pancreatitis. Investigate with stool microscopy

Suppotrive treatment and atiretroviral therapy

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11
Q

What is kaposis sarcoma

How is it treated

A

Most common tumour in HIV and AIDS

Cause by Herpes virus 8

Cutanoues or mucosal lesions

ART, retinoids, vinblastine

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12
Q

WHat cancers are common in HIV (minus kaposai)

How are they treated?

A

Increased risk of non hodkins lymphoma- diffuse b cell, burkitts and primary CNS lymphoma

ART and chemo
Rituximab

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13
Q

What cardiovascular disease do those with HIV exhibit?

A

Dydlipadeamia

Increased pro-atherosclerotic Inflmaatory processes

Increased caridovascular events

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14
Q

Why do patients with HIV see more bone fractures?

A

Side effects of HRT

Increased risk factors e.g. smoking, alcohol, low vit D, poor nutrition

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15
Q

How is TB treated in those with HIV?

A

All those with Tb ned ART

Consider Truvada and efavirenz

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16
Q

How is Hep B treated in HIV?

A

Need combinaition antivirals with anti-hepatits B actions

17
Q

What can be said about Hep C treatment in HIV?

A

Efficacy of pegylated interferon is reduced with lower CD4 count

18
Q

What should be done before commencing ART for HIV?

A

Counselling- in depth information abou ttreatment

Screen for infections and malignancy- Co trimox if CD4<200

Baseline FBC, CD4, LFT, U&E, Pregnancy test

Review meds for any drug interactions

19
Q

What are the HIV drugs used in antiretroviral therapy?

A

CCR5 antagonsists- Inhibits entry of virus cells

Nuceloside and non- nucleoside transcriptase inhibitors- Inhibits convertion of RNA into DNA

Integrase strand transfer inhibitors- Prevent HIV DNA entering nucleus

Protease inhibitors- Inhibit virus particles maturing

Pharmacokinetic enhancers/boosters- increase effectiveness of ART

20
Q

What is the strating combination drugs?

A

two nucleoside reverse trnsciptase inhibitorrs plus one of:

Pharmokinetic boosted Protease inhibitor

non nucleoside reverse transcriptase inhibitor

Intergrase inhibitor

21
Q

What are the side effects of the nucleoside reverse transcriptase inhibitors?

A

Anorexia, pancreatitis

Lactic acidosis with hepatomegaly

Use with care in CVD and CKD

22
Q

What are some of the potential negative effects of protease inhibitorsa

A

Hyperglycaemia

dylipoadaemia

jaundice, hepatitis

23
Q

Non nuceloside reverse transcriptase inhibtors have some side effects. What are they?

A

Give with food

CNS toxicity, promote suicide

Adverse lipid profile

24
Q

What are Intergrase inhibitors side effects?

A

Rash, Gi distrubance, Insomnia

Year 4 Block 3-Acute medicine (85 decks)

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