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Year 2 > Clinical Features of HIV > Flashcards

Clinical Features of HIV Flashcards

1
Q

What are the two markers used to monitor HIV infection

A
  1. CD4 count

2. HIV viral load

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2
Q

What is the following:

Normal throat
Mouth Ulcers
Mild Lymphadenopathy 
Diffuse Rash
Fever
Headache
A

Acute HIV syndrome

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3
Q

What is distinguishable about the rash in HIV

A

The rash is symmetrical that involves the whole body

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4
Q

What can the rash seen in acute HIV be mistaken for

A

Secondary Syphilis

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5
Q

What is Maculopapular symptom

A

Raised red lumps

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6
Q

When does Acute HIV syndrome occur

A

2-4 weeks after infection

HIV replicates rapidly causing CD4 count to rapidly increase and then rapidly drops during this time

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7
Q

What can Acute HIV syndrome be mistaken for

A

Glandular fever

Flu

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8
Q

What is the significance of the degree of severity of symptoms in Acute HIV syndrome

A

Progression is more rapid when severity is greater

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9
Q

Why can some patients present with aseptic meningitis

A

Direct effect of HIV on CNS

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10
Q

Recap: Symptoms of Acute HIV Syndrome

A
  1. Fever
  2. Sore throat
  3. Myalgia
  4. Rash
  5. Headache
  6. Weight loss
  7. Lymphadenopathy
  8. Vomiting
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11
Q

What do you ask following a patient with fever, rash and non-specific symptoms

A
  1. Ask about sexual history

2. Think of HIV conversion

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12
Q

What is clinical latency

A
  1. HIV viral load rapidly decreases due to activation of CD4
  2. During clinical latency the CD4 population slowly declines causing a very slow increase in HIV viral load (become rapid after clinical latency period)
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13
Q

What are the symptoms during clinical latency

A
  1. NONE

2. May see enlarged lymph nodes

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14
Q

What is Lymphadenopathy

A

Persistant generalised lymph node enlargement (2 areas of the body for atlas 3 months)

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15
Q

How long can clinical latency last for

A

8 years

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16
Q

How do we distinguish shingles from HIV

A

Shingles tends to appear in elderly NOT the young!

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17
Q

What is shingles

A

Reactivation of chickenpox

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18
Q

Shingles vs HIV

A

HIV affects many dermatological areas

Shingles effects one

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19
Q

Later on in clinical latency once CD4 levels are extremely low, what indications are there for HIV

A
  1. Minor infections become very common (thrush) or difficult to treat
  2. . Thrush may appear in the mouth without another explanation
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20
Q

Difference between Oral hairy leukoplakia vs thrush

A

Thrush can be scraped off but oral can’t

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21
Q

What is Oral hair leukoplakia caused by

A

Glandular fever (EBV virus)

If you can scrape it, could be recurrent thrush associated with HIV

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22
Q

What is Kerion

A

A scalp condition caused by ringworm (can become common in HIV)

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23
Q

When do we diagnose AIDS

A

CD4 < 200 or AIDS defining illness symptoms present (PCP)

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24
Q

If a patient presents with Thinness, oral thrush and SpO2 has dropped to 79% on walking, what do they have

A

Pneumocystis Pneumonia (associated with HIV patients)

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25
Q

Difference between PCP and common pneumonia

A

Common pneumonia only effects one area of the lung whilst PCP affects every alveoli

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26
Q

What is the PCP caused by

A

Fungal

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27
Q

Signs of PCP

A
  1. Fever
  2. Dry cough
  3. Drop in SpO2
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28
Q

How dow e diagnose PCP

A
  1. Chest x-ray
  2. Arterial blood gas to assess for hypoxia
  3. Induced septum for PCR
29
Q

What is Induced Septum

A

Squirt saline into the lung and extracted to acquire sputum

30
Q

What is PCP commonly treated with

A

Antibiotic: Cotrimoxazole with Prednisolone is hypoxic

31
Q

What drug is prednisolone

A

Steroid

32
Q

Three issues with late diagnoses

A
  1. Increased transmission
  2. Increased morbidity
  3. Increased mortality
33
Q

How is HIV TB caused

A

Acid fast bacilli

34
Q

Symptoms of HIV TB

A

Night sweats
Weight Loss
Productive Cough

35
Q

When does HIV TB cause issues

A

At any CD4 count - this is AIDS defining

36
Q

What requirements do all patients with TB have

A

To do a HIV test

37
Q

How do we test for acid fast bacilli at a microscopic level

A

Diehl-Neilson staining

38
Q

How does HIV effect the CNS (AIDS defining symptoms involving mass lesions)

A
  1. Mass lesions leads to primary CNS lymphoma
  2. Single mass with surrounding oedema - lymphocytic CSF
  3. Toxoplasmosis (lesions on MRI)
39
Q

If a patient has HIV and a headache, what do we do

A

Undergo a lumbar puncture (low threshold = HIV)

40
Q

How does HIV effect the risk of cancer

A

Any cancer associated with a virus can increase in risk

41
Q

What virus is caused by EBV

A

Lymphomas in HIV (common)

42
Q

What virus is caused by Human papillomavirus

A

Cervical, anal and penile carcinoma (HIV)

43
Q

What virus is caused in individuals with HIV by hepatitis BC

A

Hepatocellular carcinoma

44
Q

What cancer is most commonly seen in HV

A

Kaposi’s sarcoma

45
Q

What is Kapok’s sarcoma caused by

A

Human Herpesvirus 8

46
Q

Symptoms of Karposi’s sarcoma

A

Single to multiple lesions on skin

47
Q

How is Kapok’s sarcoma treated

A

with HAART and chemotherapy

48
Q

Is Kaposi’s sarcoma genetic

A

No

49
Q

How can HIV be managed

A

HAART (highly active anti-retroviral therapy)

3 ART drugs

50
Q

What are the three ART drugs used in HAART

A

NRTI
NRTI
One other

51
Q

What does HAART do

A

Surpasses viruses to undetectable levels (CD4 count high)

52
Q

Pharmacology of ART

A

ART stops active CD4 cells with HIv making anymore viruses causing load to drop by 90% in first few days

53
Q

How long does it take for an individual with a viral count of 100,00 to fall to undetectable levels

A

three months

54
Q

How common is mutation in HIV

A

1 in every 2 produced

55
Q

How do we inhibit HIv from binding to CD4 receptor

A
  1. ENF and MRC Fusion inhibitors
56
Q

What is the most common drug used to treat against HIV

A

Reverse Transcriptase Inhibitors (NRTIs)

57
Q

What are the two subcategories of NRTIs

A

Pyrimidine and Purine analogues

58
Q

What is an NRTI

A

Nucleotide reverse transcriptase inhibitors: Placing a dummy nucleotide in the genome so no more can be active

59
Q

What is an NNRTI

A

Occupy the active site of reverse transcriptase and stop it from working

60
Q

What are integrate inhibitors

A

They stop Viral DNA from integrating to genome

61
Q

What are protease inhibitors

A

Prevents budding and releasing of HIV

62
Q

What is the problem of protease inhibitors

A

Can effect host proteases too

63
Q

How do HIV develop drug resistance

A

Non-adherence - Missing one or two doses

Drug-drug interactions

64
Q

What happens if I give lansoprazole to a patient on rilpvirine

A

Decreases rilpvirine conc. due to increased gastric acid pH levels

65
Q

What is lansoprazole used for

A

proton pump inhibitor

66
Q

Should we co-administer Nevirpine and Itraconazole

A

No

67
Q

Should we co-administer Darunavir/Ritonavir and Clindamycin

A

No

68
Q

Should we co-administer Abacavir and Amoxicillin

A

Yes

Year 2 (155 decks)

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