AIDS and the GI tract Flashcards
Name 4 conditions that occur in the oral cavity in a patient that also has AIDS.
- Oral candidiasis: Candida a.
- Hairy Leukoplakia: EBV, HPV
- Aphthoous Ulcers: CMV, HSV, HIV
- Kaposi Sarcoma: HHV-8
(aphthous ulcers are canker sores)
3 most common bugs that infect the esophagus in patients with AIDS.
- Candida a.
- CMV
- HSV
Treatment for Candida Esophagitis.
Normally oral thrush appears first, so patients with oral thrush have the esophagus treated concurrently even without endoscopy to confirm if the esophagus is even affected.
Topical agents (minor symptoms): clotrimazole, nystatin
Oral Agents: ketoconazole, fluconazole, Amphotercin B
Characteristic lesions on the esophageal mucosa in HSV esophagitis.
Volcano Ulcers
Treatment for HSV esophagitis.
Acyclovir
For resistant strains: foscarnet, vidarabine
Most common life-threatening infection in AIDS patients.
CMV
Type of ulcer seen in CMV esophagitis.
Large deep ulcers
Treatment for CMV esophagitis.
Ganciclovir
Foscarnet in ganciclovir resistant strains
Adverse effects of ganciclovir and foscarnet.
Ganciclovir: thrombocytopenia, leukopenia (should not be used with AZT)
Foscarnet: renal failure, hypocalcemia
Cause of idiopathic ulcers in AIDS patients and treatements.
Originally unknown (idiopathic) but now HIV is believed to cause the ulcers.
Treat: steroids, thalidomide
Most common AIDS associated pathology of the stomach.
Kaposi Sarcoma (HHV-8)
Most common etiology of AIDS-associated diarrhea.
Infection
Why do AIDS pts. infected with Cryptosporidium present with lactose intolerance?
Parasites cause villous atrophy in small bowel.
Why is fever absent in most AIDS patients with infection?
Immune system is weak.
Treatment for Cryptosporidium infection.
Zidovudine (AZT): to boost immune system.
-nucleoside RT inhibitor
Treatment for Isospera b. infection
TMP-SMX
Complication and treatment of Microsporidia infection.
Has the ability to disseminate thru the body.
Treatment is usually ineffective but albendazole works the best
Most common manifestation of CMV enteric infection.
Huge ulcers in the Right Colon
Common manifestation of Mycobacterium Avium Complex (MAC).
Malabsorption syndrome
Dx and Tx for Idiopathic Diarrhea in AIDS patients.
Dx: rule out all other infection, toxin, or autoimmune causes in AIDS patients
Tx. Somatostain analog (octreotide)
What is responsible for Sqamous Cell Carcinoma in AIDS patients in the anorectal area?
HPV
Most common sites of Kaposi Sarcoma.
Gingiva, hard palate, stomach, intestine
asymptomatic unless obstruction occurs
Most common AIDS-associated liver disorder.
MAC/MAI (mycobacterium avium complex/infection)
Best way to diagnose MAC in the liver.
Biopsy
Liver tests that rise in CMV infection of the liver.
ALP
AST
ALT
Pathogenesis, causative agent, and Tx for Biliary Peliosis Hepatitis.
Path: Infection causes dilation of blood filled sinusoids causing fever, abdominal pain, lytic bone lesions
Bug: Rochalimaea henselae or R. Quintana
Tx. Erythromycin or Tetracyclines
