Crunch Time Infection Flashcards

1
Q

Blood transfusions prior to _____ led to increased risk of HIV transmission

A

1985

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2
Q

Test to screen for HIV

Test to confirm HIV

A

ELISA to screen

Western blot to confirm

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3
Q

A CD4 count of < ____ is AIDS-defining

A

200

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4
Q

If you see an HIV patient with eye symptoms, you should think of ______. What symptoms will they have?

A

CMV retinitis

blurry/worsening vision and eye pain

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5
Q

oral thrush ______(does/doesn’t) scrape off easily

A

DOES!

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6
Q

Treatment for CMV retinitis

A

ganciclovir

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7
Q

Diagnostic test for candidal esophagitis. Treatment?

A

KOH prep

nystatin or clomitrazole

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8
Q

MC cancer in AIDS patients

A

Kaposi’s sarcoma

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9
Q

HIV pt with subcutaneous, reddish-brown or bluish nodule on face or hands/feet. Dx?

A

Kaposi’s sarcoma

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10
Q

2 bugs that you should think of if you see neuro symptoms in an HIV patient

A

cryptococcus neoformans

toxoplasmosis gondii

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11
Q

In toxoplasmosis gondii, the lesions are ______

A

ring-enhancing

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12
Q

treatment for toxoplasmosis gondii

A

pyrimethamine AND sulfadiazine AND folate

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13
Q

classic diagnostic finding in cryptococcus neoformans

A

high opening pressure on LP

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14
Q

Which has more specific neuro deficits? Toxoplasmosis or cryptococcus?

A

Toxoplasmosis (crypto is more cryptogenic, or general; headache, non-specific findings); toxo can have focal neuro deficits, seizures, is more severe

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15
Q

Diagnostic test for Cryptococcus neoformans

A

india ink stain or cryptococcal antigen on CSF

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16
Q

treatment for cryptococcus neoformans

A

amphotericin B +/- flucytazine

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17
Q

Some diagnostic clues for pneumocystis jirovecii

A

groundglass opacities on CXR

high LDH

18
Q

diagnostic test for pneumocystis jirovecii

tx?

A

bronchiolar lavage

bactrim for 21 days, +/- prednisone if v sick

19
Q

2 common bugs that cause diarrhea in HIV pts

A

cryptospiridium

isosporum

20
Q

diagnostic test for cryptosporidium

A

acid-fast stain of stool, serology or ELISA

21
Q

treatment for cryptosporidium in HIV pts

A

parmomycin or azithromycin for 4 weeks

22
Q

treatment for isospora diarrhea in HIV pts

A

bactrim for 21 days

23
Q

most notable AE of didanosine

A

pancreatitis

24
Q

Most notable AE of indinavir

A

kidney stones

25
Q

Most notable AE of ifavirenz

26
Q

most notable AE of pentamide

A

hyper or hypoglycemia

27
Q

common parasitic GI infx in HIV pts

dx?

A

cryptosporidium and isospora

ACID FAST STAIN

28
Q

common fungal diarrheal infx in HIV pts

A

cryptococcus

histoplasma

29
Q

common invasive bacteria that cause diarrhea in HIV pts

A

salmonella, shigella, e coli, campylobacter, C diff (just as with non-HIV patients!)

30
Q

tests to consider in diarrhea in HIV pts

A
stool ova/parasites
stool leukocyts
stool bacterial culture
c diff
acid-fast stain
31
Q

how to treat diarrheal infection in HIV patients

A

supportive care if not super sick
can consider fluoroquinolone if immunocompetent
if think it’s opportunistic infx –> metronidozole +quinolone
sick: fluids, admit

32
Q

treatment for esophagitis

A

likely admission
supportive care
IV antimicrobials (antifungals or antivirals)
THIS IS AN AIDS-DEFINING ILLNESS (from candida, HSV, CMV)

33
Q

work up for suspected neuro infection in HIV pt

A

CT, LP (not if mass effect), empiric coverage

34
Q

empiric coverage for neuro infection in HIV pts

A

covering for common bugs

  • ceftriaxone
  • vanc if hardware/MRSA
  • younger or older: ampicillin
  • if concern for encephalitis (seizures): acyclovir
35
Q

abnormal opening pressure in LP

36
Q

opportunistic infections in HIV pts

A

cryptococcus
toxoplasmosis
syphillis

37
Q

Tests to order on CSF in HIV pts

A
India Ink (for cryptococcus)
cryptococcal antigen 
toxoplasmosis antibodies
RPR
(in addition to standard studies)
38
Q

tx for cryptococcus meningitis

A

amphotericin B

39
Q

CT findings in toxoplasmosis

A

ring-enhancing lesions (focal lesions; focal deficits or seizures are common)

40
Q

tx for syphillis meningitis

A

a LOT of penicillin (just choose the biggest dose that’s given)