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Sexual health > Complications of HIV > Flashcards

Complications of HIV Flashcards

1
Q

What complications are likely to develop with a CD4+ count of 200-500?

A
  • Oral thrush
  • Shingles
  • Hairy leukoplakia
  • Kaposi sarcoma
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2
Q

What complications are likely to develop with a CD4+ count of 100-200?

A
  • Cryptosporidiosis
  • Cerebral toxoplasmosis
  • Progressive multifocal leukoencephalopathy
  • Pneumocystis jirovecii pneumonia
  • HIV dementia
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3
Q

What complications are likely to develop with a CD4+ count of 50-100?

A
  • Aspergillosis
  • Oesophageal candidiasis
  • Cryptococcal meningitis
  • Primary CNS lymphoma
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4
Q

What complications are likely to develop with a CD4+ count of <50?

A
  • CMV retinitis

- Mycobacterium avium-intracellulare infection

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5
Q

What should be prescribed to all HIV +ve patients with a CD4+ count <200 cells?

A

Co-trimoxazole (trimethoprim + sulfamethoxazole)

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6
Q

What are the clinical features of toxoplasmosis infection?

A
  • Constitutional symptoms
  • Headache
  • Confusion
  • Drowsiness
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7
Q

How does toxoplasmosis appear on CT?

A

Usually single or multiple ring-enhancing lesions

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8
Q

What is the management of toxoplasmosis infection?

A

Sulfadiazine and pyrimethamine

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9
Q

What virus is associated with CNS lymphoma?

A

EBV

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10
Q

How does CNS lymphoma appear on CT?

A

Single or multiple homogenous enhancing lesions

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11
Q

What is the management of CNS lymphoma?

A
  • Steroids
  • Chemotherapy (methotrexate)
  • Whole brain irradiation
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12
Q

What is the appearance of tuberculosis on CT head?

A

Single enhancing lesion

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13
Q

What are the clinical features of cryptococcal infection of the CNS?

A
  • Headache
  • Fever
  • Malaise
  • N+V
  • Seizures
  • Focal neurological deficits
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14
Q

What LP findings are common in cryptococcal infection of the CNS?

A
  • High opening pressure

- +ve India ink test

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15
Q

How does cryptococcal infection appear on CT head?

A
  • Meningeal enhancement

- Cerebral oedema

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16
Q

What causes progressive multifocal leukoencephalopathy?

A

Widespread demyelination due to infection of oligodendrocytes by a JC virus (a polyoma DNA virus)

17
Q

What are the clinical features of progressive multifocal leukoencephalopathy?

A
  • Subacute onset
  • Behavioural changes
  • Speech, motor, and visual impairments
18
Q

What imaging modality is preferred for progressive multifocal leukoencephalopathy?

A

MRI

19
Q

How does progressive multifocal leukoencephalopathy appear on CT head?

A
  • Single or multiple non-enhancing lesions

- No mass effect

20
Q

What is the most common cause of diarrhoea in HIV +ve individuals?

A

Cryptosporidium (+ other protozoa)

21
Q

Apart from cryptosporidium, what other pathogens commonly cause diarrhoea in HIV +ve individuals?

A
  • CMV
  • Mycobacterium avium intracellulare
  • Giardia
22
Q

What are the clinical features of mycobacterium avium intracellulare?

A
  • Fever
  • Sweats
  • Abdominal pain
  • Diarrhoea
  • Potentially hepatomegaly
23
Q

What is the management of mycobacterium avium intracellulare?

A
  • Rifabutin
  • Ethambutol
  • Clarithromycin
24
Q

What are the clinical features of oesophageal candidiasis?

A

Dysphagia and odynophagia

25
Q

What is the 1st line management of oesophageal candidiasis

A

Fluconazole and itraconazole

26
Q

What virus causes Kaposi’s sarcoma?

A

HHV-8

27
Q

What is the appearance of Kaposi’s sarcoma?

A
  • Purple papules or plaques on the skin or mucosa

- Lesions may ulcerate

28
Q

What is the management of Kaposi’s sarcoma?

A

Radiotherapy and resection

29
Q

Which opportunistic infection in AIDS in most common?

A

Pneumocystis jirovecii

30
Q

What are the main clinical features of pneumocystis jirovecii?

A
  • Dyspnoea
  • Dry cough
  • Fever
  • Few chest signs
31
Q

What are the potential extrapulmonary features of pneumocystis jirovecii?

A
  • Hepatosplenomegaly
  • Lymphadenopathy
  • Choroid lesions
32
Q

What investigations should be done for pneumocystis jirovecii?

A
  • CXR: may show bilateral interstitial pulmonary infiltrates and lobar consolidation; may appear normal
  • Exercise-induced desaturation
  • Bronchoalveolar lavage often needed to demonstrate pneumocystis jirovecii (silver stain shows characteristic cysts)
33
Q

What is the management of pneumocystis jirovecii?

A
  • Mild/moderate: Co-trimoxazole

- Severe: IV pentamidine + steroids if hypoxic

Sexual health (5 decks)

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