AIDS Flashcards
what are stages of HIV infection?
- stage 1 = acute HIV infection
- stage 2 = clinical latency (HIV inactivity or dormancy)
- stage 3 = AIDS (aquired immunodeficiency syndrome)
indicator diseases of AIDS
- PJP
- pulmonary TB
- KS
- extra-pulmonary cryptococcosis
- HIV encephalopathy
- NHL
- CMV
- HSV
coccidiodomycosis - toxoplasmosis
- candidiasis
- non-typhoid salmonella bacteremia
definition of AIDS
- CD4+ < 200 cells/mm3
- CD4+ < 14% of all lymphocytes
- 1 or more AIDS defining illness
commonest reason for HIV-infected pts to be admitted to ICU
respiratory failure 2/2 PJP
PJP PNA presentation
- prolonged prodromal illness
- fever
- dry cough
- pleuritic, retrosternal pain
PJP PNA presentation in more advanced cases
- DOE
- lethargy
- weight loss
cxr findings for PJP PNA
either normal or if severe than faint b/l interstitial infiltrates similar to ARDS
definitive dx of PJP PNA
organism identified in one of the following
- induced sputum
- BAL
- transbronchial lung bx
- open lung biopsy
lab value that can be elevated in PJP PNA
LDH
complication of PJP PNA
PTX
mortality of PJP a/w PTX
10%
tx of PJP PNA
iv smx/tmp or pentamidine
main problem w/ PJP tx
high incidience of adverse effects, > 50%
adverse effects from smx/tmp
- nausea/vomiting
- diarrhea
- rashes
- glossitis
- erythema multiforme
- toxic epidermal necrosis
- pancreatitis
- blood dyscrasias
- pseudomembranous colitis
- jaundice
- hepatic necrosis
adverse effects from pentamidine
- hypoglycemia/hyperglycemia
- pancreatitis
- arrhythmias
- AKI
- hypocalcemia
- blood dyscrasias
- rashes
- bronchoconstriction
- orthostatic hypotension
how long does it take for PJP PNA pts to get better once they start tx?
end of first week
do some pts initially get worse when PJP tx is started?
yes (maybe from increased lung capillary permeability and edema)
tx shown to reduce risk of respiratory failure and death in pts w/ AIDS
glucocorticoids
- need to be given w/i 24-72 hours
when are glucocorticoids indicated in PJP PNA?
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