Diseases of the Immune System V

Question 1

p24

Answer 1

capside protein in HIV

-target for antibodies for diagnosis of HIV

Question 2

enzymes of HIV

Answer 2

protease
reverse transcriptase
integrase

Question 3

p17

Answer 3

matrix protein in HIV

Question 4

gp120 and gp41

Answer 4

two viral glycoproteins on viral envelope

Question 5

targets of HIV infection

Answer 5

CD4 T cells and CNS

Question 6

infection of cells by HIV

Answer 6

gp120 - bind CD4

also, gp120 - binds CCR5 and CXCR4

Question 7

R5 strains

Answer 7

M-tropic

Question 8

X4 strains

Answer 8

T-tropics

Question 9

gp120

Answer 9

binds CD4

conformation change to receptors for chemokines

Question 10

gp41

Answer 10

attached to gp120

inserts into membrane with gp120 activation

fuses with membrane

Question 11

viral replication

Answer 11

reverse transcription to synthesis of double strand DNA

Question 12

naive T cells and HIV

Answer 12

have APOBEC3G

introduces mutations into HIV genome
-ineffective to infect naive cells

Question 13

NF-kappa-beta

Answer 13

gene transcribed with T cell activation

this is bound by the HIV genome
-allowing HIV to thrive when T cells and M0s are activated

Question 14

synctia

Answer 14

fusion of T cells forms giant cells

-in T-tropic X4 type of HIV-1

Question 15

cells infected with HIV

Answer 15

CD4 cells

T cells, M0s, dendritic cells

Question 16

reservoirs of HIV

Answer 16

M0s

follicular dendritic cells

Question 17

CNS cells and HIV

Answer 17

macrophages and microglia

almost exclusively M-tropic

Question 18

course of HIV

Answer 18

begins with acute infection - acute retroviral syndrome

middle, chronic phase - asymptomatic

clinical AIDs

Question 19

HIV specific CD8 cells

Answer 19

detected in blood when viral titers fall

-initial containment of HIV infection

Question 20

acute retroviral syndrome

Answer 20

3-6 weeks after infection
-resolves 2-4 weeks

myalgia, sore throat, fever, weight loss (flu-like)

Question 21

viremia

Answer 21

HIV in blood

-in acute retroviral syndrome

Question 22

clinical latency

Answer 22

asymptomatic

• number of CD4 cells declines
• host defense eventually decreases

Question 23

progression to AIDs

Answer 23

long lasting fever
fatigue
weight loss
diarrhea

Question 24

clinical presentation of AIDs

Answer 24

fever
weight loss
diarrhea
lymphadenopathy
neurologic disease
secondary neoplasms

Question 25

candidiasis

Answer 25

most common fungal infection with AIDs oral cavity, vagina, esophagus

Question 26

cytomegalovirus

Answer 26

viral infection with AIDs affects eye and GI tract

Question 27

pneumonia in AIDs

Answer 27

fungus pneumocystis jiroveci

Question 28

atypical mycobacterial

Answer 28

bacterial infection with AIDs

Question 29

kaposi sarcoma

Answer 29

most common neoplasm in patients with AIDs proliferation of spindle shaped cells -markers for endothelial and smooth m cells NOT malignant iniated by KS herpesvirus -cofactor is HIVs

Question 30

lymphomas

Answer 30

systemic, primary CNS and body cavity B-cells

Question 31

HAART

Answer 31

anti-retroviral treatment

Question 32

amyloid

Answer 32

fibrillar proteins that can aggregate - cross-beta-pleated sheet tertiary conformation - can accumulate extracellular - pressure atrophy

Question 33

common forms of amyloid

Answer 33

AL AA A-beta (alzheimers)

Question 34

primary amyloidosis

Answer 34

immunocyte dyscrasias with amyloidosis -AL type amyloid systemic

Question 35

reactive secondary amyloidosis

Answer 35

AA type amyloid associated with chronic inflammation

Question 36

hemodialysis associated amyloidosis

Answer 36

beta-2 microglobulin not filtered | -in joints, synovium, tendon sheaths

Question 37

familial mediterraneal fever

Answer 37

heredofamililal amyloidosis

Question 38

amyloid of aging

Answer 38

80-90yo | transthyretin

Question 39

congo red stain

Answer 39

stains amyloid salmon pink | -with polarized light - see yellow-green birefringence

Question 40

sago spleen

Answer 40

deposits in splenic follicle

Question 41

lardaceous spleen

Answer 41

deposits in red pulp

Question 42

Dx of amyloidosis

Answer 42

Bx and congo red stain

Question 43

prognosis for amyloidosis

Answer 43

poor - if systemic - survival of B-cell - 2 years myeloma associated worse reactive better outlook