Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

xCase 17 SBA > Clinical Aspects of HIV > Flashcards

Clinical Aspects of HIV Flashcards

1
Q

Describe HIV transmission?

A

Blood- IVDU, transfussion, needlesick injury

sexual transmission

mother to babay- birth, breast feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the HIv transmisison ratios of common methods of transmission?

A

needlestick injiury- 1:300

Mucuous membrane 1:1111

Vaginal receptive 1:500

vaginal insertive 1:1111- 1:3333

less risk to men who are cirumcside- lack langerhans cells in forekin which bind HIV

Anal recptive trnamsision higher than insertive

avergaes depemnd on the virla load of person

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what factors increase the risk of HIV transmission in pregnnacy to baby?

A

high virla load

advanced immunodeficincy

IVDU

malnutrtion

complicated labour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how does HIV transmision occur in pregnancy

A

third trimester

during birth process

breat feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what factor has the largets impact on HIV transmission

A

HIv viral load, if undetectable no risk

if viral laod >200 copies/ml high risk

if less than 100 strugeel to pass on

increase risk with concomitnatn STI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Decribe HIv primary infection

A
  • Drop in CD4 cells
  • HIV viral laod si very high after infection 2-10 weeks falls after this rapidly
  • acute HIV syndrom- non specific flu like symptoms, fever, swollen glands, sore throat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

describe the clinical latency phase of HIV

A

takes around qo years between primary ifnection and AIDs defining illness

very few symptoms

graudl fall in Cd4 cells over the years- slow increase in HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what happens after Clinical latency phase of HIV

A

constituional symptoms

oppoutbisitc disase and

death

fall in Cd4 and large increase in HIV viral load

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is HIV seroconversion?

A
  • HIv estblaish itself in the body- immune ssytem recognises- Antibodies
  • 2-6 weeks after ecpsoure
  • asymptomatic 20%
  • symptomatci 80% of the time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the symptoms of HIV seroconversion

A

Symptomatric 80%

  • rash (maculopapular)
  • lymphadenopathy
  • fever
  • sore throat
  • headache
  • diarrhoeas

important to diagnose to prevent trnamsisison and prevnt AIDs

Rare neurlogical- Encephalitis, mononueritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what 2 factros do we measure to determine the progression of HIV

A
  • Viral load and CD4 counts
  • 40% of patients have high Viral load and high CD4 >200 at diagnosis
  • if you have high viral laof above >55x103 even with good CD4 counts chance of developoing AIDs defining illness woithin 3years is higher

Mainly cviral load which determines the probabilioty of AIds rather than CD4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what % of people are living with HIV and are undiagnosed

A

15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is Clinical stage 1 HIV infection

A
  • asymptomatic
  • generalised lymphadenopathy
  • performance scale 1- asymptomatic normal activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is clinical stage 2 HIv infection

A
  • weight loss <10% of body weight
  • minor mucocutaneosu manifestations
    • seborrheic dermatitis, fungal nail infection, reucrrent oral ulcerations
  • herpes zoster within last 5 years (shinles)
    • especially multidermatome
  • recurrent URTI (bacterial sinusitis)
  • and or performance casle 2- symptomatic normal acitivty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe CLinical stage III infection

A
  • weight loss >10%
  • unexplained chronic diarrhoeas >1 month
  • unecplained prolonged fever (intermittiend or constant), 1 month
  • Oral candidiasi
  • oral hair leuoplakia
  • Pulmonary tuberculossi
  • severe bacterial infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is Oesophageal candidiaise

A

AIDs deifning event

oral candidiasis would also be much mroe severe in clcinial stage III (AIDS),

17
Q

what is this?

A

1/3 of patients who present with it AIDs defining illness- oral hairy leucoplakia (EBV) trigger

cannot be scraped away - unlike candida

disappears when immune system improivng on treatment

18
Q

what is CLinal stage IV HIV infection?

A

AIDs

combination of immune system degradation and CD4 count below 200

Defined by AIDs event- infectio

19
Q

what are some AIDs defining illness

A

HIv wasting syndrome (20% of body weight in 6 months)

pneumocystic carinii pneumonia (xray)

kaposis sarcoma

candidiais of oesophagus, trachea, bronchi

oral hairy leucoplakia

cryptospridiosis with diarrhoa >1 month

20
Q

when would be begin to see aids defining illness with regards to CD4 count

A

400 CD4/ul- kapsoi sarcoma

3000- hairy leukoplakia, tuberculosis

200- PCP pneumocycsitis penuomia, fever freuqnrt fungal ifnection, crytococcis, toxoplasmsosi

100- CMv lymphoma

21
Q

what drives tumours in HIV

A

mostly viral driven

  • kapsosi sarcoma - Human herpes virus 8
  • lymphomas- epstein barr virus
  • cervical carcinoma- HPV
  • anal caricnoma - HPV

overall increase to risk of many other cancers.

22
Q

describe kaposis sarcoma.

A
  • induced by human herpes virus 8
  • in usa and northenr europe 95% in gay men
  • rates of hiv similiar to Ks reflect seroprevalence in population
  • apearance
    • vascular tumours, reddish purple riased- check for organ infvovlemt (lung liuver)
    • diffiuclt to treat
  • can disseminated in the skin
23
Q

what is this? and how might we treat

A

lymphoma in the liver

chemotherpay alsonide anti-retrovirals

24
Q

descrie Penumocystic Carini penumon ia (and PJP)

A

occurs when CD4<200

the most common AIDs defining illness

caused by fungus

  • subacute clinical presnetation- dry cough, night sweats, and increasing SOB- over 4-8 weeks
  • Desaturation on exercise specific
    • rapid drop off on oxygen saturations of exercise
    • chest signs may bne minimal/ xray normal
25
Q

describe the treatment and prevention of PCP

A
  • Treatment
    • first line- cotrimoxazole 120mg/kg in 3 divided doses
  • Prvention
    • cotrimoxazole 960mg three times a week
      • primary prophylaics when CD4<250
      • secondary prophalysi after PCP
26
Q

what is the rationale behind mass HIV testing

A

large number of undiagnosed

patient being diagnosed late in disease process

late diagnosis increasing cost and motaltiy

reduced onward trnamsisison

triple ARV very efective

27
Q

what is tuberuclosis associated with in developing word, how does it present

A

HIV- up to 65%

fevr, swetsm weight loss, repsiratory symptoms, lcoalsied symtposm on roganaffected

28
Q

describe CMV disease in hiv infections

A

occurs in advanced immunodeficiency- CD4 less than 50

viraemai precits osnet of lincial disease

eye most commonest site of localsied CMv disease- rpaid onset of visual loss

haemhorage in the arteries in eye and around optic disc- can lead to blindness

29
Q

Describe CNS disease in AIDs

A

opportunistic infections- cyrptooccus, CMV, AMC, PML, toxoplasmsosi

primary cerebral lymhpoma

HIV dementia complex

30
Q

what is this?

A

toxoplamsis ring enchancing lesions in absla ganlia- AIDS

xCase 17 SBA (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions