A & P III Exams Flashcards
Diagnosing Carcinoid Tumors
Elevated urinary 5-HIAA
How does H. Pylori cause its damage to the gastric mucosa? (short answer)
Has high Urease activity and converts urea to NH3 which damages the gastric mucosa
Liver oxygen % for Artery and Vein
50:50
What viral hepatitis has the highest pregnancy mortality?
HEV
Zollinger-Ellison syndrome (gastrinoma) is an excessive production of
Gastrin
How do you know if someone has vaccination/immunity to HBV?
Antibody HBsAb
What is the MOA of droperidol?
dopamine blocker
What is the MOA of Zofran?
Serotonin/5-HT3 blocker
What is the MOA of omeprazole?
PPI/H+/K+ ATPase blocker; blocks secretion of H+
Ascites is caused by increased:
portal vein pressure (“portal hypertension”
Defective uptake of bilirubin causes hyperbilirubiemia: What is the name of the syndrome?
Gilbert Syndrome
What Lab is the best indicator for biliary obstruction?
Alkaline Phosphatase
What is the incubation period of Hep A?
3 weeks
What is the normal blood flow of the portal vein?
1300ml/min Total = ~1800ml/min
What is the normal blood flow of the hepatic artery?
500ml/min Total = 1800ml/min
Chief cells produce =
pepsinogen
Physiologic Jaundice is the presence of increased levels of
unconjugated bilirubin
What has an increased risk of colon cancer? UC, Crohn’s, Both, or None
UC
Colorectal fissure and abscess is associated with? UC, Crohn’s, Both, or None
Crohn’s Disease
Hemolysis =
Prehepatic / Unconjugated (free) Bilirubin
Most common cause of hepatitis in USA?
Alcoholic
Patient presenting with L Iliac pain, 3 days of S&S, 100F fever; WWBC ~14,000. Diagnosis?
Acute diverticulitis
A patient with a recent gastrectomy is expected to have pernicious anemia due to what?
Defective Vit B12 absorption
Vit B12 absorption is dependent on:
intrinsic Factor
A pt with a recent splenectomy will need vaccination for:
Pneumococci
The treatment /management of GERD should include all except:
Aspirin
Pseudomembranous Colitis diagnosis is based on
C.dff Toxin in stool
Tylenol overdose; what do you give?
N-Acetylcysteine
Treatment for Pseudomembranous Colitis
Oral Vancomycin and/or Metronidazole
Function of Kupffer cells:
fight off infection; Tissue Macrophage. “blood cleaners” they kill 99% bacteria from the gut slide 50 of GIT2
Transmitted by fecal -oral route (choose two):
HAV HEV “vowels to the bowels”
Syndrome that results from viral infection and aspirin administration:
Reye’s syndrome
A pt with chronic alcoholism doesn’t remember……… 2 days after his surgery. What is the treatment?
Benzodiazepines
What is the MOA of lactulose in the tx of hepatic encephalopathy (Short answer)
lactulose (lactic acid) converts NH3 to NH4 that is poorly absorbed and thus excreted ( Base + Acid = Ionized form)
What requires bile salt emulsification for digestion?
Fat Soluble Vitamins: DEAK (K was option?)
Causes contraction of the gallbladder and relaxation of the sphincter of oddi:
CCK
In severe liver disease, what product is the most difficult to metabolize?
Lipids
enzyme responsible for stimulating pancreatic HCO3 secretion?
Secretin
CCK release is regulated by
increased fatty acid, amino acids “CC’s Pizza” increased with lots of fatty cheese intake”
Achalasia results in
increase LES Pressure -Loss of Myenteric plexus - controls motility; no movement of food
Parietal Cells secrete these products:
HCL Intrinsic Factor
Associated with the terminal ileum UC or Crohn or Both or None
Crohns
What would be a cause for increased Alkaline Phosphatase?
Stones (obstructive)
Insert PIC of Accreta/increta/percreta
Placenta Accreta: A Question from above picture: Label _______ Placenta Increta = upper right Above picture: Label Placenta Percreta = bottom right
What is the 24hr fluid replacement for a 70kg pt with 50% burn
calculation : 3ml/kg/% in 24hrs = 10,500ml
Abnormal implantation on the lower uterine segment
Placenta previa
A pt that had a placental abruption would more than likely thought to be ________ during pregnancy
smoking 2 ppd
Associated with a high risk of DIC:
Abruptio Placenta
Reason to avoid giving atropine with ritodrine
pulmonary edema
Which of the following would not be a fetal complication with gestational diabetes
Hyperglycemia
Associated with an empty ovum and a chromosomal pattern of 46,XX
Complete molar pregnancy
D&C reveals cluster of grape like tissue, snow storm on the u/s and no fetus present
Hydatidiform mole
<20weeks. No POC expelled. Intact membrane; OS closed, bleeding, viable fetus.
Threatened abortion
Postpartum pt that experiences SOB and chest pain with a decreased ETCO2 would more than likely be experiencing
Venous Air Embolism
Definition of HELLP syndrome (Short Answer)
Hemolysis, Elevated Liver Enzymes, Low Platelet Count
Associated with convulsions
Eclamsia
What medication do you give to prevent convulsions
Mag Sulfate
Drug Treatment for magnesium toxicity
calcium gluconate
Picture of female child with what disorder associated with pregnancy?
Fetal alcohol syndrome
What anesthetic medication would you avoid in PIH?
Ketamine
Picture of a baby with phecomelia “seal arms”. The mother likely took what medication?
Thalidomide
What would you use to prevent DVT in maternal surgery?
pneumatic compression stockings
Most serious risk factor associated with surgery during pregnancy
uterine asphyxia
Pathogenesis of fetal acidosis and local anesthetics (discussion)
Infant pH lower than mothers (more acidotic), nonionized form of LA enters fetus and becomes trapped (fetal ion trapping)
A picture of a patient with foot drop. What nerve would more than likely be damaged.
Common peroneal nerve
Picture of a sunburn with blisters
2nd degree burn
Treatment for CO poisoning
100% FiO2
Why is succinylcholine avoided with burn patients? (Short answer)
Due to hyperkalemia associated with tissue destruction with burns. Succinylcholine causes transient rise in potassium levels.
Picture of a 22 yr old chemistry student with a HCL burn. What would be the first line treatment.
Chemical burn with HCL. Initial treatment for chemical burns is PROFUSE IRRIGATION
Which of the following would NOT be included in the treatment of placenta previa
Vaginal exam
Which of the following does not occur in an expectant mother near the time of labor?
Decreased gastric emptying time
Woman in upper 30s experiencing swelling, increased liver enzymes, RUQ pain, visual disturbance, etc.
Preeclampsia
A patient experiencing N/V, vaginal bleeding and an U/S with no fetal parts
Ectopic pregnancy
Question about adnexal mass noted on the right. Location of ectopic pregnancy - Where is the most common site of an ectopic pregnancy?
Fallopian tube
MCC of polyhydraminos
Esophageal Atresia
Burn associated with no pain
3rd degree burn
INSERT IMAGE of Contraction 3 questions on fetal heart rhythms associated with contractions
VEAL CHOP
18 year old male was involved in an automobile accident that resulted in a cervical injury at C5. His S/S include paresthesias, motor weakness, tender abdomen, with an equivocal abdominal tap for blood and a fracture of the femur. He is being evaluated for splenic injury. He is being treated with 40% 02 by mask and skeletal traction. ABG’s are pH 7.4, PCO2 42, PO2 96. Over the next two hours, his weakness becomes more profound and he becomes agitated and repeat ABG’s results are: pH 7.32, PC02 50, PO2 79. At this time, the appropriate management is to:
intubate and ventilate
S&S of DVT:
−Leg pain, tenderness, warmth, redness, swelling −Homan’s sign: dorsiflexion of foot à tender calf muscle
Cause of fever in first 48hrs post op:
atelectasis
Prevention of atelectasis:
early mobilization, breathing exercises, incentive spirometrt
Why are myobacterium tuberculosis/ caseating (cheesy) granulomas found in the apex of the lung?
they’re obligate aerobes. Apex has high PO2 d/t high V/Q ratio
Picture of tuberculin skin reaction - positive test shows:
all of the above (recent immunization, previous tb test, past exposure)
Most specific and sensitive test for pulmonary embolism:
CTA
Tx for pneumothorax
Chest tube; needle decompression
Insert image of pulmonary vol loops
9.) Which image identifies EXTRATHORACIC obstruction? 10.) Which image identifies INTRATHORACIC obstruction? 11.) Which image identifies Airway Obstruction?
Insert image of MOA for terbutaline and NO
12.) On image - Name (SA) Terbutaline 13.) On image - Name (SA) Nitric Oxide
Insert image of resp vol loops (three on one graph)
On image below, Identify COPD
Treatment of COPD:
- Abx - h.influ & S. pneumo 2. Bronchodilators 3. Smoking cessation 4. Supplemental O2 (PO2 < 55) 5. Steroids (increase effectiveness with PFT)
Treatment of COPD:
- Abx - h.influ & S. pneumo 2. Bronchodilators 3. Smoking cessation 4. Supplemental O2 (PO2 < 55) 5. Steroids (increase effectiveness with PFT)
A mast cell stabilizer; not used for acute attacks
Cromolyn
Anti-Leukotrienes - MOA and name
Zyflo/Zileuton; block conversion of A.A.
Treatment of Asthma:
“7-A therapy” 1. anti-inflammatorys 2. antileukotrines 3. anti-IgE therapy 4. Anticholinergics 5. Aminophylline 6. Agonists - Beta 2 7. Antagonist (of leukotrienes)
example of an anticholinergic used to tx asthma
ipratropium
Example of PD3-I
aminophylline
Insert CV loops
A is normal, what is B, Mitral Stenosis What is C Aortic stenosis What is D Mitral regurg What is E Aortic regurg
Insert pic IHSS valley
identify
Insert pic of Aortic Regurg
identify
normal size of aortic valve
2.5-3.5 cm2
normal size of mitral valve
4-6cm2
Hypertrophic CM
Autosomal Dominant
Dilated CM
Alcohol
Not a risk of CAD
High HDL
Silent Ischemia
DM
Eccentric CM is caused by:
Aortic regurgitation Mitral regurgitation
3 Clinical Symptoms of poor prognosis for aortic stenosis:
SAD -Syncope -Angina -DOE
Insert CV loop (red line)
Identify S2: Point D ID S1: Point B Identify LVEDV: Point B
Left Coronary artery perfused during
diastole
HCM: what medications you would avoid EXCEPT: Vasodilator (NTG) Diuretic (lasix) Dig Dopamine Phenylephrine
Phenylephrine
Aortic Stenosis Management
Slow (low heart rate) Full (maintain or á preload) Tight (maintain or á afterload) To maintain coronary perfusion pressure Regular (maintain sinus rhythm) Not too strong (maintain contractility)
20 year Asian women Olympic
Takyasu
what EKG correlates to pleuritic chest pain & pericardial rub in BOTH systole and diastole
diffuse ST elevation
what EKG correlates to pleuritic chest pain & pericardial rub in BOTH systole and diastole
diffuse ST elevation
MI: 1st 6 hours - Gold Standard dx
EKG
4 hour to 7-10days post MI measurement?
Troponin
1st 24hrs post MI; lab?
CKMB
Patient with CP radiating to back; “knife between shoulder” may indicate
Dissecting aortic aneurysm
Hypertrophic CM treatment goals
Increase Preload Increase Afterload
Pulmonary HTN = mean pressure above
25 mmHg
What increases Coronary artery perfusion
Adenosine (Not aortic stenosis, ventricular systole, or tachycardia)
Treatment for Dressler’s Syndrome (short answer)
NSAIDS Ketorolac Codeine Steroids
Dressler’s Syndrome MOA
immunologic
Treatment for MI (short answer)
BOOMAR EKG (1st 6h) Cardiac Enzyme Angioplasty Catheterization LAD = OR
Cause is secondary to coronary artery vasospasm
Prinzmetal’s angina
A patient with jaw pain, tenderness of temporal region and a unilateral headache. What would be likely diagnosos:
Temporal Arteritis
Briefly describe the prevention of deep vein thrombosis (short answer)
Leg elevation Compression stocking Early ambulation Pneumatic compression boot Heparin or LMWH
Description of a pt w/temporal Arteritis. What would be the first step in management of the disease?
Steroids
Equalization of the pressures in the L and R atrium and L and R ventricle at 20mmHg
Cardiac Tamponade
Calculate EF from ESV 70 and EDV 120 =
41%
Causes of Concentric Hypertrophy (Choose 3)?
Hypertension Aortic Stenosis Coarctation of Aorta
Description of Mitral Valve prolapse: young woman, mid-diastolic click. Which of the following would be indicate d in her treatment.
Beta blockers for palpitations
HIV destroys what cells?
CD4 (T helper cells)
Largest antibody, first to appear, and does not cross the BBB is?
igM
What is the difference in anaphylactic and anaphylactoid reactions? Discussion
Anaphylaxis - Antigen induced release of vasoactive mediators from mast cells. IgE formation and binding occurs. Anaphylactoid - mast cell release withOUT igE. Both can be deadly; Type I reactions
Function of the CD4 T-helper cell: discussion
Part of cellular immune response. Originate in bone marrow and mature in the Thymus. Activate macrophages and help B-cells.
Define opsonization (discussion)
A B-cell function of marking/coating bacteria to make phagocytosis by macrophages occur more easily
Patient gets stung by wasps multiple times; has laryngospasm, vascular collapse, etc. what is likely going on ?
Systemic Anaphylaxis
B-Cell deficiency; x-linked Disorder.
Bruton’s Agammaglobuinemia “B cell = Bruton’s”
A patient with Thymic Aplasia (DiGeorge’s Syndrome) is likely to have a deficiency of?
T-cells T-cell deficiency. Thymus and parathyroid fail to develop. Present with Tetany d/t hypocalcemia. T-cell = Thymic Aplasia’
Immune disorder of phagocytic deficiency due to the lack of NADPH oxidase.
Chronic Granulomatous Disease
TB skin test is an example of what hypersensitivity reaction?
Type 4 *TB skin test, transplant rejection, contact dermatitis, Type 1 DM, MS, GB
Poststreptococcal glomerulonephritis is an example of what hypersensitivity?
Type 3 *Poststreptococcal glomerulonephritis, serum sickness, SLE, RA
Mismatched blood transfusion is an example of what hypersensitivity?
Type 2 *Mismatch Blood tx; autoimmune hemolytic anemia, RH disease, Goodpasture’s disease, ITP, Rheumatic fever, Graves, MG
Which one is life threatening: anaphylactic or anaphylactoid?
both
the MOA of motelukast? (discussion)
Competitive antagonist of leukotriene at cystenyl-leukotriene 1 receptor → prevents bronchospasm, vasoconstriction, and eosinophil recruitment
What makes up the membrane attack complex (MAC)?
C5-C9
Contains granules with heparin, histamine and bradykinin
Basophils
these differentiate into Macrophages:
monocytes
Cromolyn sodium prevents _____ degranulation given for exercise induced asthma
Mast cell
Vaccinations required prior to splenectomy (choose all that apply):
Salmonella S. Pneumonia H. Influenza
Which of the following is incorrect regarding passive immunity….
long lasting immunity
COVD 19 Vaccine is what kind of immunty
Active immunity (and acquired/adaptive)
B lymphocytes differentiate into
Plasma cells
A patient with an autoimmune disease producing antibodies to their own RBCs has a deficiency of what:
T-suppressor cells
React with T-helper CD4 lymphocytes in cell mediated immunity
MHC II think 18 and 24 - MHC I/CD8; MHC II/CD4
Infected cells present viral antigen to cytotoxic cells (CD8) cell mediated immunity
MHC I think 18 and 24 - MHC I/CD8; MHC II/CD4
Insert Antibody response Graph
Identify which line is IgG and which is IgM IgG = bright Red and ALWAYS highest line/curve “G = Greatest” IgM = dark red line; first response so peaks before IgG
these cells are affected in multiple myeloma
Plasma cells
Antibody class that crosses the placenta and provides immunity to the infant
IgG IgG crosses the placenta during Gestation
Antibody class found in saliva, breast milk, mucous
IgA
Antibody class that mediates Type I hypersensitivity reactions
IgE “Evil antibody; immEdiate hypersensitivity”
Main determinant of organ rejection
MHC II (CD4)
These cells act as antigen presenting cells
Macrophages antigens are present to CD4
S/S of anaphylactic Reaction Discussion
Asthma, itching, wheal/flare, hypotension and circulatory collapse Pruritus, urticaria, angioedema, SOB, Respiratory Distress, hypotension, shock, arrhythmias, abdominal pain, severe NVD, feeling of impending doom
A patient experiencing rhinitis (Type 1) is likely experiencing a reaction mediated by what antibody (class)
Type 1 = IgE
A patient with a prior infection with chicken pox has long lasting immunity. This is an example of
Active immunity
Picture of a patient with pinworms. What lab value would you expect to be elevated?
Eosinophils
Anaphylactoid vs. Anaphylactic reactions: Which requires IgE mediation?
Anaphylactic
A patient stung by a bee has symptoms of anaphylactic reaction. What is responsible for this?
Mast Cells
First line of defense for natural immunity
skin and mucous membranes
Antibody mediated humoral immunity consists of _____ lymphocytes and cell mediated immunity consists of _____ lymphocytes.
Humoral = B lymphocytes Cell mediated = T lymphocytes Antibody Mediated immunity = B lymphocytes “AMB” cell Mediated immunity = T lymphocytes “ cMIT (or see MIT - like the school)
Oxygenated blood from placenta enters through:
umbilical vein
deoxygenated blood returns to placenta via:
umbilical arteries
Connects the pulmonary trunk directly to aorta in fetal ciruclation
Ductus arteriosus
INSERT PICTURE OF UMBILICAL CORD
Picture of Umbilical cord: Label X Umbilical Vein Picture of Umbilical cord: Label Y Umbilical Arteries
Responsible for blood flow between L and R atriums in fetal ciruclation
Foramen Ovale
Ductus arteriosus closes within ___ after birth
2-3 weeks
Medication used to close a PDA
Indomethacin
What is Eisenmenger’s Syndrome? (discussion)
uncorrected VSD, ASD, or PDA leads to progressive pulmonary hypertension. As pulmonary resistance increases, the shunt reverses from Left to Right to Right to Left, which causes late cyanosis (clubbing and polycythemia)
The most common congenital heart defect
VSD
Picture of a “kink” between proximal and distal aorta: “3 sign”
Coarctation of the Aorta
A patient has different pulses femoral vs radial; likely diagnosis?
Coarctation of the Aorta
Characterized by a continuous murmur
PDA
4 Characteristics of TOF (choose 4)
- Pulmonary Stenosis 2. VSD 3. Overriding Aorta 4. RVH
Which of the following would decrease a R-L shunt
Phenylephrine
All of the following would increase a R to L shunt, EXCEPT:
Increased SVR
Why would you give PGE1 Infusion to a patient with symptomatic TOF? (Discussion)
to keep the shunts open; mixing of the blood is necessary for survival
A patient with bowel sounds in the chest - diagnosis?
Diaphragmatic hernia
Insert picture of TE Fistulas
Choose the most common type: III B
Associated with polyhydraminos
Tracheoesophageal fistula
Associated with oligohydraminos
Renal Agenesis
A patient with a palpable olive shaped mass most likely has
Pyloric stenosis
INSERT PIC OF BARIUM/ PYLORIC STENOSIS Image of string sign on barium study. Diagnostic for:
pyloric stenosis
A patient comes in with a sore throat, drooling, tachypnea, and cyanosis. indicative of?
epiglottisis
Barking cough and Temp of 100F indicative of
Laryngotracheal Bronchitis (RSV was on exam)
This disease is caused by parainfluenza Virus
Croup
Caused by haemophilus influenza B
Epiglottitis
Caused by herniation of abdominal contents into umbilical cord at the base of umbilicus:
Omphalocele
Extrusion of abdominal contents through abdominal folds and does not have a sac
Gastroschisis
Picture of Prune belly syndrome. Describe anesthetic implications
congenital deficiency of abd muscles w/thin weak abd wall. - RF aspiration; can’t cough - Treat as full stomach - Awake intubation - No muscle relaxant - bad kidneys
Discuss Meckel’s Diverticulum
Remnant of the omphalomesenteric duct that can contain ectopic gastric or pancreatic mucosa Rule of 2’s: - Males twice as often as in females - before 2 yrs of age (symptoms) - 2 cm long - 2 feet proximal to ileocecal valve - 2 types of ectopic tissue - 2% of population PE with rectal bleeding; abd pain; umbilical cellulitis. TX by surgical resection
Description of a pt with obstructive sx and bloody stool with a palpable sausage shaped mass. What is diagnosis?
Intussusception
Description of a pt with progression of respiratory disease with a lung transplant at 20 yrs old. Associated cause/disease?
Cystic Fibrosis
Discuss why a pregnant woman should not change a litter box:
Cat feces are associated as a source of Toxoplasmosis. CMV/Toxoplasmosis infection is one of the TORCH Risk Factors for Cerebral Palsy.
Motor disability caused from damage to the cerebral cortex
Spastic CP
Cerebral palsy caused from damage to the basal ganglia
Dyskinetic CP
CP caused from damage to the cerebellum
Ataxic
Picture of a pediatric patient with protrusion of spinal cord - likely?
myelomeningocele
insert image of Intussusception This is?
Intussusception
NG tube coiled in the esophagus is usually due to ?
Tracheoesophageal Fistula
Cystic fibrosis is a result from a defect in ______ channels that is caused by a mutation.
Chloride
Bypasses the liver in fetal circulation:
Ductus Venosus
Causes closure of ductus arteriosus after birth:
The Increased O2 from Respiration and the drop in prostaglandin d/t placental separation closes the DA Indomethacin helps to close PDA. PGE1 keep the PDA open.
how do you diagnosis Cystic Fibrosis?
Sweat Chloride Test
All of the following are true regarding VSD (choose four):
It is NOT a Right to Left shunt -L to R shunt - VSD>ASD>PDA -MC Congenital Cardiac anomaly
MC Congenital Heart defect:
VSD
describe the pathogenesis of HIV
T-helper cells coordinates the immune response from T&B lymphocytes, monocytes and macrophages. therefore impaired immunity of both cell-mediated and humoral immunity occur.
S/S of tetanus?
trismus (lock jaw), jaw spasms, fixed smile, opisthotonus/arching of back, spasms of diaphragm and rib cage that eventually leads to death.
what is tetanospasmin?
2nd most powerful toxin ; blocks inhibitor NT glycine release from spinal cord. leads to continuous uncontrolled muscle contraction
Describe this skin lesions of the HIV patient?
Kaposi’s Sarcoma
Picture of butterfly rash on the face. What disease does this pt have?
SLE - lupus
Describe how strep infection can cause glomerulonephritis?
post streptococcal infection antibody cross reaction that causes kidney damage
Different types of stones
- Calcium oxalalate; MC; Radiopaque 2. calcium phosphate; primary hyperparathyroidism 3. “staghorn stone” triple phosphate; often associated w/UTI 4. Uric Acid; radiolucent
Describe difference b/w RA and OA
RA - Chronic systemic inflammatory arthritis. MC in females 20-40 yrs of age. HLA-DR4 tissue type. + Rheumatoid factor and ESR OA - normal “wear and tear” arthritis of movable joints. degenerative joint disease. Pain worsens with activity and improves with rest.
Common cause of blindness in HIV patient
CMV retinitis
Most common cause of death in HIV patients?
PCP - Pneumocystis carinii pneumonia is the leading cause of death
Describe mycoplasma pneumonia S/S?
atypical pneumoniae; often called “walking pneumonia”. Mild symptoms like sore throat, NP Cough, and H/A. XRay usually w/diffuse infiltrates and “look worse than the patient”
Risk Factors for SSI?
- Chronic illness 2. extremes of age 3. immunocompromised 4. DM 5. Foreign Objects/bodies 6. Biofilm formation on prosthetics 7. Dirty wounds with dead tissue 8. Virulent factors like capsule and enzymes produced by bugs
RF for HIV infection? (modes of transmission)
Body fluids (semen, blood, breast milk) Homosexual and bisexual men IV drug abuse Recipients of blood products prior to 1985 Transmission through the placenta
Name some common infections that can occur in HIV patients
Bacterial - TB Viral - Herpes simplex, zoster, CMV Fungal - thrush, PCP, histoplasmosis Protozan -toxoplasmosis
The treatment for gout:
Probenecid (uricosuric agent) Steroids Avoid thiazide/loop diuretics as can lead to hyperuricemia Allopurinol (avoid in acute attack)
How is pseudomembranous colitis diagnosed?
Toxins A&B in stool
How to treat pseudomembranous colitis?
oral vancomycin or metronidazole
What cells does HIV attack?
CD4 helper cells
Why is PCN not effective against mycoplasma pneumonia?
b/c it has no cell wall
Treatment for PCP ?
Pentimidine or Trimethprim-sulfamethoxazole
Stages of HIV infection
Stage I: flu like (acute) Stage II: Feeling fine (latent) Stage III: Falling Count and s/s worsen –> Final Crisis
